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Endovascular grafts have been widely used for the treatment of aneurysms since the early 1990s. They are preferred especially for use in patients in whom conventional surgical methods carry high risks of death and morbidity. Increasing operator experience and technical refinements in endovascular grafting have enabled these procedures to be performed even in critical segments of the aorta, such as the thoracic and arch levels. In this report, we present the case of a patient who was treated successfully with an endovascular graft for a mycotic saccular aneurysm located just below the left subclavian artery.
Endovascular grafts have been used for the treatment of aneurysms since the early 1990s.1 They are especially preferred for those patients in whom conventional surgical methods carry a high risk of morbidity or death, although some operators use endovascular grafting because of the ease of the procedure. Nowadays, increasing experience with graft placement and refinements in graft technology have led to the performance of endovascular procedures for aneurysms of critical segments of the aorta—at, for example, the thoracic and arch levels. In this report, we present the case of a patient who was treated with an endovascular graft for a saccular aortic aneurysm that was just below the left subclavian artery (SCA), an aneurysm that we considered mycotic.
In March 2005, a 38-year-old man was referred to our institution with a diagnosis of saccular aneurysm at the distal aortic arch. He had been treated and followed up at our hematology clinic for acute lymphoblastic leukemia (ALL), which had been diagnosed in February 2005. At the end of his 1st dose of chemotherapy—when he had been discharged before his consolidation chemotherapy—the patient was readmitted with a productive cough, chills, and fever. Chest radiography revealed pneumonia, and antibiotic therapy with penicillin–β-lactamase complex was started immediately. After 1 week, the patient developed acute hoarseness. Chest radiography showed an unusual opacity on the left upper margin of the sternum (Fig. 1). Laryngeal examination revealed vocal cord palsy. Spiral computed tomography (CT) showed a 3.8-cm-diameter saccular aneurysm (with 1.8-cm neck) at the distal aortic arch, 1 cm beyond the left SCA (Fig. 2). As an incidental finding, both carotid arteries were seen to arise from the brachiocephalic trunk (Fig. 2B).
The patient had a history of ankylosing spondylitis, chronic hepatitis B infection, and (in the past) cocaine addiction. He had been a soldier but had retired after a gunshot injury to his left arm; there had been no other trauma or surgical intervention.
The aneurysm was thought to be mycotic, even though blood cultures for infective microorganisms were all negative, because a CT scan performed 2 months earlier in order to evaluate the lungs and abdomen had showed no evidence of vascular disease. After risk–benefit evaluation and the informed-consent procedure, we considered endoluminal stenting as an alternative to open surgery. Because the saccular aneurysm was in the vicinity of the left SCA, we decided to occlude the aneurysm's neck completely by extending the stent above the left SCA. Transcranial and cervical Doppler ultrasonographic studies demonstrated patency of the right SCA, both vertebral arteries, and the circle of Willis, which did not necessitate performing an extra-anatomic bypass to the left SCA before the endovascular intervention.
The patient was placed under spinal epidural and local anesthesia, the right femoral artery was surgically accessed, and a longitudinal arteriotomy was performed. From the femoral artery, a Superstiff 0.035-inch guidewire (Back-up Meier, Schneider Co.; Blach, Switzerland) was positioned at the aortic arch. A 5F sheath was inserted percutaneously through the right brachial artery, through which a 5F pigtail catheter was directed for angiographic monitoring of the stent position. After administrating 5,000 units of heparin, we inserted the 24F delivery system (Talent Thoracic Stent Graft, Coil Track TDS, Medtronic AVE; Santa Clara, Calif) through a longitudinal incision in the right common femoral artery and positioned it, with fluoroscopic guidance, approximately at the aortic arch (Fig. 3A). The stent was then expanded, excluding both the saccular aneurysm and the orifice of the left SCA; however, uncovered parts of the stent unfortunately protruded into the brachiocephalic artery (Fig. 3B). The femoral artery was reconstructed with a patch. The patient was put on oral antibiotic therapy for the presumed mycotic aneurysm and on antiaggregant therapy for both the femoral artery patch and for the protrusion of the uncovered part of the stent into the brachiocephalic artery. Postoperatively, the patient developed no notable signs or symptoms of left-upper-extremity ischemia, but his hoarseness was only slightly diminished. Ten days after the treatment, a CT scan showed a type II endoleak (White classification) into the aneurysm. Graft positioning was correct, but there was a minimal leak, with thrombus formation chiefly inside the aneurysmal sac (Fig. 4). We decided to monitor the patient carefully and to perform coil embolization in the event that the aneurysm increased in size. Accordingly, we released him to the hematology clinic for ALL consolidation therapy. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) performed at the hematology clinic 2 months after the procedure revealed successful exclusion of the aneurysm with no residual endoleakage and with complete thrombus formation inside the aneurysmal sac; in addition, the size of the aneurysm had decreased to 3 cm in diameter (Fig. 5). The patient has been well for more than 7 postoperative months, under the joint care of our hematology and cardiovascular surgery departments.
Endovascular repair of aortic aneurysms was first applied to the abdominal aorta in 1991.1 Since then, increased experience and technological advances have extended the application of endovascular stent-grafts to the thoracic aorta and even to the arch. Stent-grafts are now commonly used for aneurysms and dissections involving the descending aorta, with very good outcomes.2 They are also considered to be a good alternative to open surgical repair because they yield equal mid-term life expectancy, with less perioperative morbidity and lower hospital costs.3,4
The main obstacles to endoluminal treatment at the proximal levels of the aorta are the origins of the arch vessels, especially the brachiocephalic trunk and left common carotid artery. After stenting5 or bypass6of these arteries, endovascular treatment becomes a safe procedure for the treatment of aneurysms at this location. Nowadays, branched and fenestrated endovascular grafts have been produced and marketed, and experiments and trials are evolving rapidly to test the effectiveness of these new products.7–9 On the other hand, the most commonly found and studied endovascular grafts are still the endoluminal tube stent-grafts. When stent-grafts were first applied to the aortic arch, it was thought that revascularization of the left SCA was mandatory after its orifice had been excluded. However, experience has shown that SCA revascularization may not be necessary, provided that appropriate collateral flow to the vessel can be documented. Regardless of the adequacy of collateral blood flow, the main indications for prophylactic left SCA revascularization include the likelihood of vertebral territory stroke after SCA exclusion, the presence of coronary artery bypass grafting with use of the left internal thoracic artery, the presence of an arteria lusoria, and the patient's need for arteriovenous hemodialysis access in the left arm or for precision in the performance of left-handed maneuvers.
In patients under consideration for thoracoabdominal stent-grafting, SCA revascularization may thereby avoid jeopardizing spinal cord blood flow and prevent paraplegia.10 However, SCA revascularization itself carries significant risks of morbidity and death.
If collateral flow is sufficient, the orifice of the left SCA can safely be covered with a graft in order to decrease the morbidity of bypass to the arch vessels and to prevent endoleakage.10 In our patient, transcranial and cervical Doppler ultrasonographic studies documented sufficient collateral blood flow. In addition, both carotid arteries arose from the brachiocephalic trunk, which gave us an even clearer margin of safety for the placement of a stent-graft over the orifice of the left SCA. Even with that clear zone, there was minor type II endoleakage into the aneurysmal sac. In our follow-up on the patient, we found that the aneurysm had thrombosed completely and that no major vascular insufficiency had developed in his left arm.
Mycotic aneurysms, compared with other aneurysms, have a higher risk of rupture before treatment or after unsuccessful treatment. Therefore, major leakage, which can increase aneurysmal diameter, must be managed immediately by such methods as balloon angioplasty or coil embolization. In our patient, the aneurysm decreased in size and substantially thrombosed during the early postoperative period. Both factors were promising for complete thrombosis and occlusion of the aneurysm. Therefore, we decided to monitor our patient periodically with MRA or CT angiography and to consider coil embolization during follow-up, if we observed an increment in the diameter of the aneurysm or blood filling the sac. As it happened, postoperative follow-up MRA showed complete occlusion of the saccular aneurysm in the 2nd month.
Although mycotic aneurysm is a misnomer, these lesions are caused by infective microorganisms, fungal or not.11 They account for fewer than 1% of all aneurysms.12 The most commonly encountered bacterial agents that lead to aneurysm formation are Salmonella, Staphylococcus, and Mycobacterium species.1,12,13 Human immunodeficiency virus is another infective agent that can cause multiple aneurysms at different regions of the aorta.14 The symptoms and blood chemistry values are usually nonspecific.12 Definitive diagnosis is made on the basis of blood or direct tissue cultures from the aneurysm, but both can be negative.13
The conventional treatment of mycotic aneurysms is open aneurysmectomy, together with the débridement of peripheral tissues. Distal revascularization can be achieved either with an in situ prosthesis, which will be at risk from adjacent infection, or with extra-anatomic bypass procedures, which do not have very promising long-term patency rates. In the literature, the mortality rate associated with surgical treatment is reported to reach 36%.12 Mycotic aneurysms still account for high mortality and morbidity rates, notwithstanding improved diagnostic techniques, antibiotics, and surgical interventions.
Our patient had recently been diagnosed with ALL and, after his 1st dose of chemotherapy, pneumonia. He suddenly developed Ortner's syndrome,1 which was found to be due to the saccular aneurysm's compressing the left recurrent laryngeal nerve. Aneurysm formation is a well-known phenomenon in patients with connective tissue disorders15 or a history of drug abuse.16 Even though our patient had ankylosing spondylitis and a history of cocaine addiction, his CT scans only 2 months earlier had been negative for aneurysms, and this led us to consider a mycotic aneurysm even in the presence of negative blood cultures. Those negative results were probably due to the antibiotic therapy that he had been given for pneumonia.
The high mortality and morbidity rates associated with conventional open surgical treatment of mycotic aneurysms direct surgeons to alternative options. Although placement of an artificial material in an infected area is controversial, the low mortality and morbidity rates associated with endovascular grafting have made such grafting an attractive option, even for critical segments of the aorta. Many authors maintain that endovascular stenting is feasible when antibiotic suppression has attained negative blood cultures before the intervention. Moreover, after long-term antibiotic therapy, the results of endovascular grafting have been impressive.1,11–13
To conclude, we believe—in light of our own experience and after reviewing the literature—that endoluminal treatment for mycotic and other aneurysms located in critical segments of the aorta is an attractive alternative to open surgery, especially for high-risk patients. This is a very rare case, in which a mycotic saccular aneurysm of the aortic arch was treated successfully with an endovascular graft. We believe that further information is needed in the form of studies with more patients and with long-term follow-up results.
Address for reprints: Murat Ugurlucan, MD, Bozkurt Caddesi, No:110-112, Benli Apt., Daire: 6, 80250 Kurtulus - Istanbul, Turkey E-mail: moc.oohay@naculrugutarum
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Top Ten Worst Things About Foodfight! (2012 Film)VideoGamefan5
The Top Ten
1 Horrible animation
It is so ugly it's so unwatchable
2 Stupid characters
Their gross and unfunny twerky lame stinky retarded and dumb - VideoGamefan5
3 Stupid innuendos
So gross and stupid they just unfunny and lame - VideoGamefan5
4 Awful script
It sucks so much I hate this movie its just awful - VideoGamefan5
5 The characters look like plastic
Ugh its just gross and stupid I hate this movie so muh it sucks and is unfunny - VideoGamefan5
6 The characters are unfunny
The characters are horrible and stupid - VideoGamefan5
7 It's a huge mess
Huh that's why they call it foodfight! What a fitting title - VideoGamefan5
8 Unfinished And Terrible Animation
9 Terrible Character Dialogues
10 The story is terrible
The story is horrible it sucks its all over the place - VideoGamefan5
The Contenders
11 The Characters Are Stereotyped
12 Use Of It's Nightmare And Ugliness Characters
13 Inappropriate Jokes
14 It's nasty
Ugh its unwatchable I mean it sucks so much I hate this - VideoGamefan5
15 The Characters Are Racist
16 The Use Of Sexuality
17 The Songs
18 Crappy puns
Ugh the puns are just awful they suck so much its horrible - VideoGamefan5
19 Extreme Product Placement
20 It looks scary
BAdd New Item
Recommended Lists
Related ListsTop Ten Things That Would Make Frozen a Better Film Best Things About the Film How to Train Your Dragon Top 10 Things You Would Say to a Celebrity, Musician, Actor, Sportsman, TV Personality, Game Developer, Writer, or Film Director Strangest Things that Ripley's Bought at Auctions in 2012 Music Artists You'd Like to Perform at the 2012 London Olympics Opening Ceremonies
List StatsUpdated 26 Feb 2017
24 listings
244 days old
244 days old
Top Remixes
1. Horrible animation
2. Stupid characters
3. Stupid innuendos
2. Stupid characters
3. Stupid innuendos
1. Unfinished And Terrible Animation
2. Terrible Character Dialogues
3. The Characters Are Stereotyped
2. Terrible Character Dialogues
3. The Characters Are Stereotyped
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subset: commoncrawl


text:
Neat. But Thimg emerged out of a box and wasn't a free roaming being
Doktor A, a sculptor and painter, produced this steampunked version of Thing from the Addams Family for an Addams-themed exhibition at the Wootini Gallery in Carrboro, NC.
Doktor A, a sculptor and painter, produced this steampunked version of Thing from the Addams Family for an Addams-themed exhibition at the Wootini Gallery in Carrboro, NC.
Install the Emotional Labor extension and it will automatically add social niceties to your outbound mail — phrases like "Hey, Lovely! I've been thinking of you." (via 4 Short Links)
The introduction of "shitgibbon" into America's political discourse is a teachable moment for English classes studying the evolution of language.
You may know Charlie Brooker only through his amazing Black Mirror programs, but savvy Brookerfen are avid viewers of his Screenwipe/Newswipe shows — acerbic, potty-mouthed media criticism shows that feature talents of Barry Shitpeas and Philomena Cunk, a thick-skulled, oblivious, amazing deadpan comedic persona of Diane Morgan.
Python is immensely popular in the data science world for the same reason it is in most other areas of computing—it has highly readable syntax and is suitable for anything from short scripts to massive web services. One of its most exciting, newest applications, however, is in machine learning. You can dive into this booming […]
Learning new skills is a great way to improve your resume and stand out from other candidates. Especially in a workforce in which many job-seekers have a wide variety of qualifications. With lifetime access to Virtual Training Company, you won't have to choose a specific focus. You can pick up new expertise whenever you deem it […]
Instead of throwing out all the empties after your next party, why not transform them into some new DIY glassware? Cut back on waste and add some home ambiance with the Kinkajou Bottle Cutter and Candle Making Kit.The Kinkajou is designed as a clamp-on scoring blade to make precise cuts. Just slide a bottle in, tighten […]
Neat. But Thimg emerged out of a box and wasn't a free roaming being
In the TV show. In the movies, (thanks to the magic of CG), he was a free-roaming hand.
You could say that the computer gave Thing a hand. :D
This is why I can't quit you, Steampunk.
Just when I'm ready to write you off, someone comes out with a thing of such forethought, such beauty, a thing entirely devoid of obvious parts from the Home Depot plumbing department, and I fall in love all over again!
Okay, that's overstating it a mite, but this is pretty dang sweet.
Banana. I see no banana.
Don't believe the hype. Steampunk is the white man (and woman) colonialist fantasy non par.
Does it work?
Otherwise – fail.
It looks like an art piece to me. There doesn't seem to be tendons on the palm side so the hand should only be able to open.
I still approve.
can has please ?? eye could make akin with rc aircraft style servos hidden , please ?? ( yah right !! as if !! my most recent wood carving led to a chisel puncture , a hospital trip , and a web search for kevlar gloves !!) Can use for inspiration for daz studio renders maybe ?? ( fair use , eh ?? inspiration , not outright copy , quite , eh ?? ) thank you to the artist , the gallery , cory , and boing boing itself again !!
more steampunk awesomness.
I think I'll start making complex electronics out of cookie dough. It will be less pointless than steampunk because at least the comedic junk I produce will be edible
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RuthiesRooms Studio Apartments, Chania,Crete.
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A company spun out from the UK's University of Manchester has become the first in the world to produce and ship multi-gram quantities of quantum dots – and has launched a unique 'Free Evaluation Samples' program throughout the EU and UK.
Using a patented process, Nanoco Ltd is not only able to ship its standard 'NanoDots' in production-level quantities to meet growing market demand, but can easily configure NanoDots to meet custom performance specifications – previously a long process of trial and error.
Up to this point quantum dots - essential building blocks of multiple nanotechnological applications, from electronics to life science - have been produced in small batches of fractions of a gram in various labs around the world from a method that's both cumbersome and hazardous.
Torsten Schanze | alfa
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In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send "repair-proteins"...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
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Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
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text: Item is not available Find Another One Others Looked At... H&K G3 clone - custom PTR-91 by Investme... SELLER: trinslide 0 $1,400.00 HK 91 with extras SELLER: FandWGuns 1 $3,500.00 Hk 91 .308 Package Deal, Beautiful!! SELLER: Ladies and Gentlemans Firearms LLC 0 $4,000.00 Federal arms FA91 308 SELLER: Togie2016 1 $400.00 VECTOR ARMS V91 RIFLE IN .308 HK H&K G3 ... SELLER: Red Circle Tactical 1 $1,399.99 Vector Arms V53NS HK Style Rifle In 5.56... SELLER: Red Circle Tactical 1 $1,549.99 Guns Rifles Heckler Koch Rifles Tactical Century C HK Clone | 329 | 9 | Lc | 203.1348ms Century C93 (HK93 Clone) For Sale from Troy T | Positive feedback: 100% View | Verified Seller | 18 Completed Sales View Sellers Items This item is no longer available. /UserImages/23289/941668238 5213156.jpg Description Shipping and Payment More Info New C93 made with HK parts. Comes with 2 mags and Bayonet. Buyer pays shipping to FFL Trades Accepted: No Condition: New In Box Caliber: .223 Remington (5.56 NATO) Location: WV Share Item Item #: 941668238 This item is no longer available. Price: Shipping: $40.00 (or Arrange local transfer) Accepted Payment Methods: Returns: No Returns Troy T Seller Since: Aug. 2004 Seller Level: Verified This seller is NOT an FFL City: Fairmont State: WV Your Recently Viewed Items


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Lee Valley Riding Centre is British Horse Society approved and offers horse riding lessons for beginners through to more experienced riders as well as superb equestrian facilities, including 5* livery services and top class tuition in London.
Whether you're a complete beginner, returning to the sport after a break or looking for advanced tuition in competition disciplines, Lee Valley Riding Centre has something for you. As well as group and private lessons the programme of activities includes birthday parties, pony days and evening courses.
Facilities include an indoor arena and two floodlit outdoor arenas, show jumping and cross country courses, café and spectators area, and for horse owners there is a 5* livery service and stables.
Buy a horse lover the perfect present with a Lee Valley Riding Centre gift voucher.
Livery stables just 20 minutes from the centre of London with 5* stabling, care and facilities
Add accommodation, places to go or events in the Lee Valley to an itinerary.
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Program Goal:
To encourage local and international businesses operating in Azerbaijan to reach beyond one-time charity donations and consider strategic philanthropic investments in their communities.
Traditional "local philanthropy" programs in Azerbaijan have been geared more towards ensuring NGO sustainability rather than corporate-community connections, which has reduced the willingness of many companies to become involved in such activities. EPF has decided to structure its program within its private enterprise portfolio and cultivate an open environment for businesses to comfortably meet and discuss their common concerns. At the end of 2007, the Eurasia Partnership Foundation (EPF) in Azerbaijan launched a new vision for social investment through its Corporate Social Investment (CSI) program, which leverages the capabilities, expertise, partnerships and financial resources of businesses with development initiatives that sharpen their own competitive advantages.
EPF's CSI Program focuses on three major areas:
Impact in 2008
As a result of the CSI Program, 2008 saw increased interest in strategic corporate philanthropy among local businesses. Over 40 local companies were introduced to the concept of corporate social investment and about 20 have been engaged in Azeri CSI network of companies, regularly participating in the program's activities. A series of study tours to business companies were attended by representatives of 30 businesses and non-profit organizations; they shared CSI practical tools and techniques. Throughout the year receptions and workshops with prominent western CSR experts were conducted for middle-level business managers and leaders of nonprofit organizations on the CSR concept and its importance in the contemporary business world as well as on the design and implementation of strategic social investment programs.
As part of the Consulting and Capacity development component of the program, EPF provided consulting services for a large well-known insurance company and helped to design a plan for developing the company's CSI portfolio in 2009. As the result of EPF's program, a major mobile operator has decided to create a new position of CSR manager, while two major companies have expressed their commitment to open CSR manager positions and fill them in 2009.
EPF developed and, since February 2008 has been distributing a CSI e-bulletin highlighting recent news on corporate philanthropy from national and multinational companies, program highlights and other CSI activities. There are more than 400 recipients.
EPF's CSI program is a good example of collaboration among businesses, NGOs, and governmental bodies in Azerbaijan, where EPF is partnering with other organizations involved in promoting a more effective business environment. Partners include National Confederation of Entrepreneurs (ASK), Azerbaijan Turkey Business Association, American Chamber of Commerce (AMCHAM) and AZPROMO/UNDP Global Compact project. In November 2008, in cooperation with the American Chamber of Commerce, EPF organized a luncheon in recognition of the visit of Ms. Henrietta H. Fore, the Administrator and Director of U.S. Foreign Assistance at USAID, emphasizing the its successful partnership with USAID in the field of public-private partnership.
EPF's CSI program will work on increasing the number of partner organizations and businesses in 2009 and expand the current partnerships.
Eurasia Partnership Foundation is a member of the Corporate Social Responsibility (CSI) Global Partner Network
01 February 2017
13 January 2017


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Relevant offers
Cabinet Minister Kate Wilkinson refused to waive a $550 fee to allow the crew of an Indonesian fishing crew, who say they were abused and intimidated, to appeal their deportation.
Labour MP Darien Fenton wrote to Wilkinson asking for the reprieve and for the Labour Department to continue to fund their accommodation while they were in New Zealand.
Both Labour and the Green Party believed the 32 seafarers should stay to give evidence to a ministerial inquiry into foreign fishing crews operating in New Zealand waters.
The men say they suffered beatings, overwork, sexual harassment and inadequate pay, clothing and food on the Oyang 75.
Fenton said the crew still had not been paid and could be owed more than $26,000. She said police should also investigate allegations of human trafficking.
''Some of them do want to go home, but leave some behind to deal with their wage issues. We need to stand up for these guys.''
In a letter of reply last week, Wilkinson - who is labour minister and associate immigration minister - said the crew's accommodation was paid between July 14 and August 2 while they gave statements to relevant agencies.
She was not prepared to waive the fee and did ''not consider it appropriate'' to continue to pay for their accommodation.
A spokesman for Wilkinson said the men had received a letter from the Immigration Service warning that deportation ''will become an issue'' for them from Saturday.
But they would not be removed on Saturday.
The men had already given evidence to a separate inquiry into the Oyang 75 and are not required to present to the ministerial investigation, the spokesman said.
The information they provided will be passed to the inquiry into foreign charter fishing boats which was announced last month.
Green MP Keith Locke called for the deportation process to be halted. Forcing them to go home would be ''unjust.''
''New Zealand has a responsibility to make sure the Oyang 75 crew get the payments they are legally entitled to. The crew are also prime witnesses for the Minister's inquiry. We need their detailed evidence if the Minister's report is to be a thorough one.''
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text:
Their result for The what sex position are you Test ...
You scored 41% kinky and 44% passionate!
Their Analysis (Vertical line = Average)
They scored 41% on kinky, higher than 74% of your peers.
They scored 44% on passionate, higher than 36% of your peers.
All possible test results
Awww, when is the wedding date? You are Missionary. This is the original and most romantic position because you can gaze into your lover's eyes. You are passionate and prefer making love rather tha... Read more
Doggie Style
You dirty dog. You like sex and you like it kinky. You are the famous Doggie style which means that you are what every freak likes. When it comes to eye gazing you want no part of that. While your... Read more
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Explore these ideas and much more!
Can someone be so kind as share Ann T's recipe with me for Salisbury steak. I have it in my computer but my computer is being repaired. I am having a dinner on Sunday and would love to fix it....thank you in advance. Jackie
I'm going to get to this creamy frosting recipe, but first I'm going to reminisce a little. Mama Minnie was my great-grandmother on my mom's side of the family. She lived on a large farm, on the Albemarle Sound, in North Carolina. She became a self-sufficient widow, having lost her husband when my grandpa was... Continue Reading →
Prime Rib | 16 Christmas Dinner Ideas Guaranteed To Make Your Night Memorable by Homemade Recipes at http://homemaderecipes.com/cooking-102/seasonalholiday-recipes/16-christmas-dinner-recipes/


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Yesterday I got my wisdom teeth out…on August 2, 2011 at 9:17 am
Among other complaints I have, the two major ones I have right now are my inability to swallow and my severely lacking capacity for remaining vertical. In other words, I can't eat/drink very much and I can't stand for more than about five minutes without getting faint and nauseated. I iced my face all yesterday, but I'm still pretty puffy-looking. The cat has been keeping me company and also drinking from my water glasses (because he's a turd).
So there might not be a comic today, which sucks and I'm sorry.
Also, I didn't even get to see the teeth they removed! I was pissed about that even when I was barely coherent from the general anesthesia. 🙁


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Friend's Email:
Subject: I have found a DVD that I think you would enjoy
|Country Girl
Actor: Various
Director: Various
NR 2013 1hr 44min
An Alcoholic Actor Uses His Wife As A Comeback Crutch. Bestactress Oscar For Kelly.
Larger Image
|Actor: Various
Director: Various
Studio: Paramount Catalog
Format: DVD - Full Screen
DVD Release Date: 05/21/2013
Release Year: 2013
Run Time: 1hr 44min
Screens: Full Screen
Number of Discs: 1
SwapaDVD Credits: 1
Total Copies: 0
Members Wishing: 0
MPAA Rating: NR (Not Rated)
Languages: English
See Also:
|High Society
Director: Charles Walters
UR 2008 1hr 51min
|To Catch a Thief
Special Collector's Edition
Director: Alfred Hitchcock
UR 2007 1hr 46min
|Dial M for Murder
Directors: Alfred Hitchcock, Laurent Bouzereau
PG 2004 1hr 45min
|Born Yesterday
Director: George Cukor
UR 2000 1hr 43min
|The Swan
Director: Charles Vidor
NR 2011 1hr 48min
|Shrek the Third
Widescreen Edition
PG 2007 1hr 33min
|Shrek 2
Widescreen Edition
Director: Andrew Adamson
PG 2004 1hr 33min
|Mr Destiny
Director: James Orr
PG-13 2002 1hr 50min
Widescreen Edition
Director: Joss Whedon
PG-13 2005 1hr 59min
|Jurassic Park III
Widescreen Collector's Edition
PG-13 2010 1hr 32min
|Kung Fu Panda
Widescreen Edition
Directors: John Stevenson, Mark Osborne
PG 2008 1hr 32min
|Herbie Rides Again
Director: Robert Stevenson
G 2004 1hr 28min
Widescreen Edition
Directors: Cory Edwards, Todd Edwards, Tony Leech
PG 2006 1hr 20min
|The Spy Who Loved Me
Special Edition
Director: Lewis Gilbert
PG 2002 2hr 5min
|Stand By Me
Special Edition
R 2000 1hr 28min


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June 2, 2015 9:18 pm
Download audio
Federal chief technology officer Aneesh Chopra recently detailed for the first time his major priorities.
Among them are demonstrating how agencies will apply innovation to affect their mission in a matter of weeks.
Tomorrow at 10:30 a.m. on Ask the CIO, our own Jason Miller talks Aneesh Chopra, the federal chief technology officer, about how he wants to make agencies think more creatively to solve problems.
Hiring freeze result of Trump team's review of federal agencies
Hiring freeze result of Trump team's review of federal agencies
Photos of the amazing, moving, important and amusing things happening in the federal community.
A daily update of important moments in the history of the U.S. government.


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Asked by Pamela Russo, 07716 • Tue Jun 2, 2009
My husband and I finally received an email from the bank's loss mitigator yesterday telling us congratulations, our offer is approved on a short sale. The property condition, however, has declined since we put our offer in - some shingles are missing, and the sellers removed the stove, washer, dryer, and refrigerator. Because of this, we feel it is in our best interest to do a streamline k loan, but the bank wants us to close this month! We want to get as much done as possible prior to receipt of the paperwork from the bank, but how far can the loan truly go in the process without it?
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GISCafe Voice
Susan Smith
Susan Smith has worked as an editor and writer in the technology industry for over 16 years. As an editor she has been responsible for the launch of a number of technology trade publications, both in print and online. Currently, Susan is the Editor of GISCafe and AECCafe, as well as those sites' … More »
United Nations-backed meeting on GIS technologies held in Seoul, Korea this week
October 25th, 2011 by Susan Smith
A five-day series of United Nations-backed meeting is being held from October 23-28 in Seoul, Korea for the purpose of improving the management of geospatial information technologies and using them to tackle global socio-economic challenges. Representatives from 90 countries and delegates from dozens of international organizations and civil society numbering approximately 350 are expected to attend.
The use of geospatial information goes beyond national borders, according to the UN Programme on Global Geospatial Information Management (GGIM). The proliferation of natural disasters has heightened the need for urgent response and quick, accurate and specific geospatial solutions.
Participants will strive to bring countries together to "share their experiences in how to organize their geospatial information infrastructure plan policy priorities and handle privately-sourced information and that produced by national authorities."
UN-backed meeting considers better use of geospatial technology, UN News Centre
Related posts:
Google Maps turn-by-turn directions coming soon for Android 2.0 phones
Rim Fire near Yosemite shown in three different views by Esri Story Map
GIS companies embrace integration with Building Information Modeling workflows and field layout
Tags: Geospatial technologies, GGIM, GIS, Global Geospatial Information Management, Korea, Seoul, United Nations


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AAA Rating is a rating system for lodgings and restaurants in North America by American Automobile Association.
This rating was reported by the venue and has not been verified by Cvent.
Recently opened in October 2013, the Homewood Suites Nashville Vanderbilt is an all-suite, extended stay hotel located in the heart of Music City and just minutes from Downtown Nashville! We are nestled in Midtown between Downtown Nashville, Music Row, and the West End area. The Homewood Suites Nas...
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What do we want to achieve?
We want to invest in projects that provide quality volunteering opportunities and offer individuals engaging, rewarding and enjoyable experiences
Of course what this looks like will vary from person to person, so we're looking for projects that will provide people with opportunities which consider their individual needs and ensure they have the right support to get the most from the experience.
We also want projects to demonstrate a positive impact on the wider community. That might mean anything from cleaner parks and river banks, to improved community relations or reduced stigma around ex-offenders.
To be eligible for the funds, your project will need to demonstrate that it can have a double benefit, for individuals and for the wider community. Specifically, it should contribute to improving:
- Mental wellbeing and/or individual development
- Social and community development.
For more on what these definitions mean, see the government's Sporting Future document and our own Towards an Active Nation strategy.
Pathways and progression
Meaningful volunteering and social action takes time – and the benefits to individuals and communities are unlikely to be achieved through one-off opportunities.
We're keen to invest in projects which have clear plans to set people on a volunteering journey, with opportunities to grow and progress. This might mean, for instance, working towards a qualification or certificate, a new volunteering role with more responsibility, or gaining enough experience to transition into employment.
However, we know it's important to be flexible – we don't want you to put off potential new volunteers by requiring too much commitment too soon. Your focus could simply be on getting first-time volunteers to come back again – and again.
You will need to demonstrate that you have considered what progress looks like, and why it is appropriate for your audience.
Learn what works
To unleash the full potential of volunteering in sport and physical activity, we want to learn more about how to engage people from different backgrounds – and how to keep them involved to achieve real, long-term results. We want to learn what approaches work and why and we are prepared to try out new ideas, even if they turn out to be less successful.
There's any number of potential learning opportunities. Maybe you're planning an unusual partnership, or want to test ways of using new technology to get young people engaged in social action. Perhaps your organisation has never had any connection with sport or physical activity before, but has something different to offer. Whatever your ideas, we're keen to find out what we can discover together.
Replicate and scale
Learning what works also means finding projects that have the potential to be replicated or delivered on a larger scale. That could mean exploring how a tried and tested approach can be adapted for different audiences or introduced to a new community. Or it could be testing whether a successful model used in a different sector, like performing arts or conservation, could be replicated in an active setting.
We're looking to strike a balance between investing in existing, proven ways of delivery and finding new and innovative ideas. Our aim is to find solutions capable of delivering game-changing results. While sport and physical activity should be involved, it doesn't have to be the sole focus. Simply put, we're looking for brilliant ideas.


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Join us as we explore San Diego's beauty on our bike, kayak, and snorkel tours. Discover the spectacular Seven Caves by kayak, ride bikes along the historical San Diego coastline, or begin your once-in-a-lifetime snorkel adventure in the La Jolla Underwater Park. Let our experienced tour guides take you on your next adventure.
(858) 459 - 1114 or email email@example.com and we'd be happy to assist with your tour reservations. Looking to learn more about La Jolla Kayak and the surrounding area before coming down for your tour? Check out our Travel Guide.


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—The broadcast time of a graph G, denoted b(G), is the minimum time necessary to complete the broadcasting in G, i.e. from one of vertices send a message to all other vertices. The Knödel graph W∆,n is a regular graph of even order and degree ∆ where 2 ≤ ∆ ≤ log 2 n. The broadcast time of the Knödel graph is known only for W ∆,2 ∆ and for W ∆−1,2 ∆−1. In… (More)
The equivalence of processes is an important constituent of process optimization. The article considers the functional equivalence problem for processes in object-oriented environments for the case when the turn of executing operations for different objects is not essential. It is shown that this problem can be reduced to the equivalence problem of regular… (More)
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The coco artwork in 2016 has three different visual motives, all very close connected with the city Cottbus:
1. With the Cottbus lake pyramid Prince Pückler designed one of this country most unusual burial grounds, where he was buried himself in 1871.
2. Prince Pückler created "Schloss Branitz" and the beautiful park around in Cottbus as his outstanding late work, after being a famous writer, visionary, landscape designer, and world traveler in the 19th century.
3. The red crayfish is since 1307 til today a central crest motif of the city Cottbus.
4. The Spremberger Turm …


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However, men with a family history of prostate cancer have often been feared to have a more aggressive form of the disease not otherwise represented by these three factors and therefore are sometimes urged to undergo more aggressive treatment.
Now, Mark Buyyounouski, M.D., M.S., a radiation oncologist at Fox Chase, reports that men with a family history of prostate cancer should expect equally good outcomes following radiotherapy for prostate cancer as patients without a family history. Buyyounouski will be introducing the new data at the 53rd annual meeting of the American Society of Radiation Oncology on Wednesday, October 5th.
PSA, GS, and DRE are well established risk factors for prostate cancer that are used everyday to help make decisions about what treatment option may be best for a patient with the disease. These factors appear in both the American Joint Cancer Commission (AJCC) and National Comprehensive Cancer Network (NCCN) model to stratify risk of recurrence and guide treatment. Yet, in some instances, physicians use a family history of prostate cancer to evaluate the degree of risk associated with the cancer and recommend more aggressive treatment.
In the study, Buyyounouski and his team of collaborators examined 1,711 men who received three-dimensional conformal (3DCRT) or intensity modulated radiotherapy (IMRT) between 1989 and 2007 at Fox Chase Cancer Center in Philadelphia. A positive family history was defined as any prostate cancer in one or more first-degree relatives. Twenty-eight percent of the patients had a positive family history for prostate cancer. The median follow-up from completion of treatment was 71 months.
"What we learned was that whether the men had a history of prostate cancer or not, all had equivalent PSA controls, freedom from metastasis, recurrence-free survival, and overall survival," says Buyyounouski. "Patients should feel comfortable knowing that when they receive radiotherapy having a history of prostate cancer in the family doesn't compromise the results. This is important because patients, especially those with a family history, might assume that radiotherapy might not work as well and opt for surgery when it may not be necessary."
Interestingly, Buyyounouski and his colleagues also learned that men with a family history of prostate cancer were more likely to be younger, have a lower PSA, and non-palpable disease.
"This study shows that patients with a family history are being screened and diagnosed with prostate cancer earlier. Careful screening may have contributed to the good results we observed."
Study co-authors include Hilary Bagshaw, Karen Ruth, Eric M. Horwitz, and David Chen from.
Fox Chase Cancer Center is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation's first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center's nursing program has received the Magnet status for excellence three consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. For more information, visit Fox Chase's Web site at www.foxchase.org or call 1-888-FOX CHASE or (1-888-369-2427).
Diana Quattrone | EurekAlert!
Further information:
Further reports about: > Nobel Prize > PSA > family history > prostate cancer > risk factor
Organ-on-a-chip mimics heart's biomechanical properties
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In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
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The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
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Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
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text:
|By Jason Westra
Article Rating:
|December 1, 2000 12:00 AM EST
Several patterns exist for generating primary keys for your EJB application. This month I'll provide a pattern for generating PKs that's scalable, generic, and portable.
My format for defining the pattern will follow the catalogued layout presented in the Gang of Four book, Design Patterns: Elements of Reusable Object-Oriented Software.
UniqueID Generator
Generate unique IDs for persistent objects in an EJB application
Also Known As:
PID (Persistent ID) Factory
GUID (Globally UniqueID) Manager
Enterprise JavaBeans is a server-side component model that targets the specific business domain of online transaction processing (OLTP) applications. OLTP applications generally have the need to store information persistently. The data records or objects for each transaction require unique identifiers to allow them to be stored and retrieved accurately. Thus there's a need to generate unique identifiers for the data involved in an EJB transaction processing system.
For the purposes of this pattern, I'm assuming a relational database is used as the data store rather than an object database, which would provide its own ID generator. A relational database table typically has a primary key column that's indexed to prevent duplicate IDs, which would lead to data integrity problems. Thus each row stored in the table is uniquely identifiable. For instance, in EJB the return value from the call to myHome.findByPrimaryKey is a single entity bean, not multiple entities!
There are numerous ways to generate unique IDs in a Java application. Let's review some approaches before discussing the UniqueID generator pattern presented in this article.
An easy way to generate unique IDs is to utilize the System.currentTimeMillis() method to get the current time in milliseconds and use it as your ID. Although it's an easy way to start creating applications, this approach has implications across high-volume applications. A high-volume OLTP application may perform several calls to System.currentTimeMillis() at the same time, resulting in the generation of duplicate IDs. Thus the generator must perform some sort of synchronization on ID requests. Typically, this is done with a wrapper object that uses the synchronized modifier to queue threads accessing it.
Next, you ask, "What about synchronization across multiple JVMs?" Certainly a clustered-server, multi-JVM architecture will be the norm for an enterprise application, but a clustered application poses two problems for this approach toward generating unique IDs:
- The system time on each machine may be different. Thus, in a multi-JVM architecture, calls to System.currentTimeMillis() can lead to duplicate values.
- The Java synchronize operator doesn't work across multiple JVMs, so even if the system times were equal, simultaneous calls to different machines could still result in duplicate IDs.
EntityBean Key Generator
This approach uses an entity bean to select the next value from a relational database table, which holds the latest value for unique ID generation. An entity bean can encapsulate the SQL, which it executes in a generic fashion by loading in a bean environment property containing a SQL string for each type of database. For instance, in Oracle the dual table should automatically return a sequence value. The SQL statement might look something like this:
"select mysequence.nextval from dual"
Oracle sequences are a proprietary feature and increment the value automatically for the caller by a specified increment count. Other databases that don't have this feature must increment a next ID field and select it in one call. Stored procedures are a common cure for the need to execute multiple database operations within a single request. To get the same ID generation capabilities from Microsoft SQL Server, a stored procedure could be called that both returns a value and increments it for the next caller. Since the stored procedure performs its work inside a transaction in one database request, it eliminates a "window" of opportunity when simultaneous calls for another ID get the same row and attempt to update the value.
Thus our entity bean key generator executes SQL, which it retrieved generically from its bean environment property and executed on the database. However, there are some drawbacks to this approach:
- Each call to get another ID is a remote method invocation, which can create unwanted chatter depending on where the entity bean is deployed in your system.
- Some might argue that entity beans are for business entities rather than utilitarian functionality like generating IDs for business entities.
- Few application servers provide synchronized caching across a cluster. Thus the ability to cache a set of IDs, improving ID generation by preventing database operations, is negated when the application is clustered.
A more scalable approach to ID generation that provides both local caching and guaranteed unique IDs is a singleton object that hands out IDs from its local cache (see Figure 1). Each time the cache of the singleton object is depleted, it gets a set of IDs representing the next available IDs for the application. The singleton fetches IDs from a stateless session bean that accesses the database in a portable manner, allowing it to interact with any database.
Use UniqueID Generator:
- To return a unique identifier for object and/or database row identity
- To cache sets of IDs across multiple JVMs for scalable ID generation
- To abstract database implementations from the core ID generation classes
- Singleton: Acts as the wrapper of the UniqueIDEJB and caches sets of unique IDs to prevent chatty remote invocations and database operations
- UniqueIDEJB: Component made
up of UniqueID (remote interface) and UniqueIDHome (home interface); performs generic SQL to fetch a set of IDs from the database and return them to the singleton client
- Singleton: Calls UniqueIDEJB component to fetch a set of IDs; set is cached locally and a new set is fetched when the maximum is surpassed
The UniqueID generator has several key benefits and some limitations:
- Limited remote method invocations and database operations: The UniqueID generator's singleton object caches a set of IDs that are depleted before another request is made to the UniqueIDEJB. This limits the number of remote method invocations on the EJB and the number of hits the database must handle to generate new IDs.
- Guaranteed UniqueIDs: The UniqueID generator pattern guarantees unique identifiers for your objects/data across an n-tiered solution. If a set of IDs is requested from multiple JVMs at the same time, the transaction isolation of the UniqueIDEJB and/or database layer will automatically queue multiple requests to ensure that only one singleton's request for an ID set is processed at a time.
- Portable across EJB servers: The pattern represents a component that's portable across EJB servers. It's a session bean, and session beans have been mandatory in the specification since its inception, whereas any EJB server still not up to the 1.1 version of the specification wouldn't be able to utilize an entity bean-based pattern.
- Portable across database servers: The implementation of the pattern really determines its portability, but the pattern itself allows for database-specific SQL to be loaded generically from the EJB's environment so that no code changes are required to deploy it against disparate databases.
- Singleton knows nothing about the "incrementBy" value: The singleton object knows nothing about how many IDs are returned in a set. This is controlled at the UniqueIDEJB level by an environment property. To change the incrementBy value, simply redeploy the EJB with a hot-deploy mechanism to avoid downtime and the increment will be changed to the new value without repercussions on the rest of the application.
- ID gaps: Gaps in IDs will occur with this solution. For example, if a set of 50 IDs is retrieved and the server crashes midway, 25 IDs would be lost. My recommendation is to increment only by one until ready for production, then set the UniqueIDEJB's incrementBy environment property to be sufficient for your application's load. This prevents wasting IDs in development and test.
- Support for other data types: The structure section's class diagram shows a long data type used for IDs, yet this could be any data type your application requires. However, the UniqueID generator pattern would have to be extended to account for different ID data types in a single application. For instance, if your application mixed doubles, strings, longs, and ints as keys, the singleton would have to be extended.
Consider the following issues when implementing a generic, portable UniqueID generator pattern:
- Determining incrementBy for your application: The amount of IDs contained in each ID set (and subsequently cached in the JVM) should be determined based on the number of users attempting "insert" transactions per JVM. Thus, if your incrementBy is 50 on a single J2EE server, set it to approximately 25 if you cluster two servers. Also, set incrementBy to a low number, even 1, for development and testing. As with any tunable parameter, metrics gathered from stress testing your application should ultimately drive your settings.
- Ensure portability across EJB servers: When communicating from the UniqueIDEJB to the database, don't use proprietary logic to obtain a connection from a connection pool. Use data sources looked up through JNDI instead.
- Ensuring portability across databases: There are a few ways to ensure that your code to fetch a set of IDs is portable. One way is to store the SQL that will be executed in the EJB's environment. The SQL is set in the deployment descriptor, which allows it to be modified during deployment rather than having to modify the codebase. Another option is to use data access objects (DAOs) to contain the database-specific SQL code. Last, your UniqueIDEJB component couldn't take advantage of database-specific sequence generators. Your component's implementation should create the table at runtime if it doesn't exist already. This approach isn't recommended, but it's an alternative nonetheless.
- Generating different IDs for different tables (classes): To generate a different ID for different tables, each class in the pattern would have to change its interface to take a "sequence" parameter, which indicates which class you want to get the next ID for and is forwarded throughout the pattern to the JDBC call against the database.
- Generating IDs shouldn't rely on a business transaction outcome: The UniqueIDEJB should create its own new transaction when getting an ID set. Incrementing the database to the "next ID value" shouldn't rely on whether or not the business transaction currently executing in your application succeeds or fails.
- Business transactions rely on generated ID success: An error fetching an ID set from the UniqueIDEJB will cause a business transaction to fail. Don't mix different approaches to generating unique IDs when one fails. For instance, let's say your application uses the System.currentTimeMillis() approach to key generation if the first approach, calling UniqueIDEJB, fails. This provides an extra layer of fault tolerance to your application, but you could encounter duplicate IDs! If your database counter is near the number generated by the System.currentTimeMillis(), you'll have problems.
Sample Code
The code in Listing 1 shows how to implement the singleton to cache the ID set, fetch a new set, and handle failures when calling the UniqueIDEJB.
This month I provided an EJB pattern to a common problem in the OLTP world, generating unique IDs. While there are variations of the pattern, the UniqueID generator overcomes many scalability and flexibility issues where other patterns fall short, such as local ID caching, limiting remote method invocations, and portability. I hope this pattern is helpful for your EJB engagement. For other EJB patterns see www.theServerSide.com. And let me know if you're interested in JDJ featuring more patterns in the future.
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