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Mentioned In 231 Articles
...pending holding up better than typical seasonality. MKM Partners believes Ciena has the best performing 100G+ Metro/Any-Haul product at Verizon, and this is starting to positively move the needle in new city market share...Read Full Article
MobiDent Raises Pre Series A Funding from New York Based DanGold Investment Corp...bad within the next three months" added Vivek. In India the state of the dental industry is appalling. In the Metro towns, the ratio of a dentist to population is 1:20,000 and in rural areas it is 1: 3,00,000. Every year...Read Full ArticleMentions: Metro Vivek Madappa
eGrocery Portal ZopNow Targets $100M GMV in 2017...end consumer but along the way forged long term partnerships with players like Aditya Birla Group, HyperCity, Metro, StarBazaar among others. Growth strategy for ZopNow ZopNow is also offering eGrocery as a Service (SaaS...Read Full ArticleMentions: Metro Birla Mukesh Singh
Cashless Initiative at 10 Metro Stations Put on Hold; Arvind Kejriwal Requests Enquiry into the Tie-Up with Paytm!...ransactions and a cashless economy. DMRC had earlier tied-up with Paytm to go completely cashless at these 10 metro stations. The stations which were supposed to go cashless are Rohini East and Rohini West on the Red Lin...Read Full ArticleMentions: Metro Arvind Kejriwal Mayur Vihar
Indian mobile wallet market expected to reach Rs 30,000 crore by 2022...shopping, hotel/travel/movie ticket reservations, online food order, payment of insurance premium, recharging Metro rail card and others. ALSO READ: United payments system to make mobile wallets redundant: Report While m...Read Full ArticleMentions: Reserve Bank of India Metro Cagr
M-wallet market expected to reach Rs 30,000 crore by 2022: Study...shopping, hotel/travel/movie ticket reservations, online food order, payment of insurance premium, recharging Metro rail card and others. While mobile wallet service contributed to 21 percent share in mobile payment volu...Read Full ArticleMentions: Reserve Bank of India Metro Cagr
BHIVE Workspace Launches New, Centrally Located Co-Working Space at Residency Road, Bengaluru...le reserved parking and is easily accessible from all parts of Bangalore. It is a short walking distance from Metro and easily accessible from popular hotels like Marriott, Shangrila, Oberoi, Taj, Windsor Manor etc. Its ...Read Full ArticleMentions: Metro Marriott Residency Road
Ola Launches Offline Booking; Now, Users Can Book a Cab Without Internet!...ailable across all cab categories including Micro, Mini, Prime and Lux. This feature is currently launched in Metro areas only, and will be opened to other cities in a phased manner. If a user is attempting to book a cab...Read Full Article
Common Mobility Card is Here! You Can Now Use Delhi Metro Cards on DTC Buses to Buy Tickets...mendous and DTC has only realized now how well this can be integrated into our transport system. Buses, cabs, Metro and shuttle services can all be integrated with this one card to make travelling convenient. Not restric...Read Full ArticleMentions: Digital India Metro Delhi Metro
NGT Orders Ban on 10+ years Old Diesel Cars in Delhi; 2.82 lakh Cars May be Affected...e Government also needs to buckle up and provide a good public transportation system in Delhi, apart from the Metro, to accommodate these policies....Read Full ArticleMentions: Metro Delhi Traffic Police Transport department
Public transport info app Ridlr raises $6M in series B funding...ities, growing user base, as well as hiring across key roles. The app provides real time bus, metro and rapid metro schedules for a given city. It also helps users locate the nearest bus stop or metro station and allow t...Read Full ArticleMentions: Matrix Partners Metro Qualcomm Ventures
Xamarin_digital_technical Architect_blr - Mindtree - Bangalore, Karnataka...over-HTTP APIs ?? Experience with Windows 8 location APIs. ?? Familiarity with Windows 8 Metro, WinRT and the Metro Application Model ?? Experience with source control in git and github ?? Proficient in RIA & Web 2.0 rel...Read Full ArticleMentions: Oracle Metro Enterprise Architect
Xamarin_digital_technical Lead_blr - Mindtree - Bangalore, Karnataka...st JSON-over-HTTP APIsExperience with Windows 8 location APIs.Familiarity with Windows 8 Metro, WinRT and the Metro Application ModelExperience with source control in git and githubProficient in RIA & Web 2.0 related tec...Read Full ArticleMentions: Oracle Metro Enterprise Architect
Paytm Has Just Disrupted Indian eCommerce With Their Free WiFi Internet Access...nute WiFi would be offered at Metro Stations to start with, and this is already launched at Noida's Sector 18 metro, which is considered one of the busiest metro stations due to proximity to various shopping malls and ma...Read Full ArticleMentions: Metro Google Vijay Shekhar Sharma
Now Refill Your Delhi Metro Card With Paytm Wallet!...mediate solution to bring respite to Delhi Metro users. Paytm also hopes to encourage people to use the Delhi Metro more as compared to private and commercial vehicles. Now that there is an option of refilling your Delhi...Read Full ArticleMentions: Digital India Metro Delhi Metro
Markets:Bollywood, Gaming, Maps/Local, Mobile, Outsourcing, Social Networking, Telecom, Travel, Video
Financing:Acquisition, Funding
Other:Jobs, Reports
About Metro
A rapid transit, underground, subway, elevated or metro(politan) system is a railway — usually in an urban area—with a high capacity and frequency of service and grade separation from other traffic. In most of the world, these systems are known as a "Metro." In London, the system is called the "Underground," in Buenos Aires "Subte", (a short colloquial word for subterráneo, Spanish for underground) and in most of North America and in Glasgow, Scotland, "subway." The oldest rapid transit system in the world is the London Underground, which opened in 1863. The Underground is also the most extensive rapid transit system in the world.
The two primary ways that subway tunnels are constructed are by cut and cover and tunnel boring.
One hundred sixty-two cities have rapid transit systems, totaling more than 8,000 km (4,900 miles) of track and 7,000 stations. Twenty-five cities have new systems under construction."
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Quotes about Metro
In rural areas, people are buying jewellery as a means of investment and also for marriage purposes. However, in the metro cities, people are holding back their money waiting for the prices to go down.In Rural areas, semi-urbans race ahead in buying jewelery
Metro 3G is the aboriginal buzz in the Metro alternation that offers 3G connectivity and admission to SNS and IM features. This beautiful buzz as well array on annual of its added multimedia features.Ranjit Yadav in Metro 3G Mobile Phone From Samsung
The new entity would have a robust infrastructure of 10 offices in major metro cities across India, a distribution network that includes over 2,500 stores and over 22,000 vendors, thus allowing us to penetrate not just the top 12 cities, but the top 400 cities in India in a very meaningful manner.In ACK Media acquires India Book House


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Welcome to STORYBROOKE MAINE! We are a OUAT site with a MATURE rating. We are set in A LIQUID TIMELINE RUNNING FROM SEASON1 TO SEASON6 and have a low word count. Please register your character with proper capitalisation like this: Sally Sparrow. No OOC accounts are used on this site. Click the arrow in the top left corner to toggle the CBOX. Thank you for visiting us!
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Submission + - Is Vodafone's new broadband service a man-in-the-middle attack? (vodafone.co.uk)
Vodafone broadband also seems to be falling foul noscript's Application Boundary Enforcer designed to prevent DNS rebinding attacks, requiring system ABE rules to be disabled to access https addresses.
So far vodafone have responded by suggesting a security exception is created for each occurrence, and another reply from vodafone respond "I've double checked this with our Broadband team and this is how our routers are set up, we're unable to change any settings at our end."
Though we should not attribute to malice that which is adequately explained by stupidity, is this unwittingly compromising the security of vodafone broadband users?


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With Instructables you can share what you make with the world, and tap into an ever-growing community of creative experts.
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Backpacker's Pantry #10 Can Beef Stroganoff
Backpacker's Pantry
Typically ships the same business day when ordered before 4pm CST.
#10 Can of Beef Stroganoff. Beef and wild forest mushrooms in a sour cream sauce over noodles. The Can includes 16 servings and has a 25-year shelf life. Just Add Boiling Water to Prepare.
- Once the can is open, contents should be consumed within seven days.
- In between consumption, reclose the can with the plastic lid provided. Store at room temperature (70F) or below.
- The lower the temperature of storage, the longer the shelf life will be.
- Temperatures of freezing or lower ( 32F) should be avoided as it may affect the integrity of the can. Cans should be stored OFF the floor in a dry, well ventilated area.
- Rehydration time doubles every 5,000 feet of elevation gain. Our directions are set for 5,000 feet.
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22 Feb 2016
New national research has found commuters can save around £1,000 per year by catching the bus instead of travelling to work by car - despite falling fuel prices at the pumps.
Bus travel costs are around 55% cheaper than the same commute by car, saving passengers an average of more than £90 a month, according to the study.
The savings - even with fuel prices being at their lowest levels for six years - would be enough to cover the entire annual energy costs for a medium-sized house*.
Research by Stagecoach, Britain's biggest bus and coach operator, covered around 35 key commuter routes in England, Scotland and Wales. It compared the weekly price of hopping on the bus with the cost of fuel and car parking for the same journeys.
The study found:
Robert Montgomery, Managing Director of Stagecoach UK Bus, said: "Fuel prices are at their lowest level for six years, but it is still miles cheaper to commute to work by bus for many people up and down the country.
"The average savings would pay a big chunk of people's annual energy bills and for some it would fund the cost of a family holiday for a week in the sun in Florida.
"It's also easier than ever before to catch the bus, with smart ticketing, bus tracking available via your smartphone and free wi-fi on many of our new buses."
Stagecoach works with other major public transport groups in the UK, as well as campaign group Greener Journeys and local authorities to attract more people out of their cars and on to public transport to reduce pollution and congestion in the UK's towns and cities.
The company is currently offering Dayrider** tickets – which provide unlimited travel within a specific local area – for just £2 to passengers aged under 19 in a special promotion. Stagecoach is also the only bus operator to offer a nationwide discount for jobseekers, giving those with a JobCentre Plus travel card a 50% discount on their bus travel to help them find employment.
Stagecoach has invested more than £630million over the past eight years in brand new buses and coaches for local communities.
For further information, please contact: Stagecoach Group communications at email@example.com or tel 01738 442111.


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Fire station burglars caught on tape
The search is on for several suspects who broke into the Butte County Volunteer Fire Station #25 near Butte College.
Investigators released surveillance images showing the suspects who broke into the station Monday.
The suspects got away with a gas-powered generator, flat screen TV and two chainsaws.
Anyone with information about the suspects should contact CAL FIRE Battalion Chief Shannon Garrett at (530) 538-7888.
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Published byJosiah Pillen Modified over 2 years ago
UBI – Unsorted Block Images Artem Bityutskiy
Introduction A new technology for flash devices Designed by IBM Publicly accessible Git tree GPL license www.linux-mtd.infradead.orgMore information at www.linux-mtd.infradead.org
Plan 1.Linux MTD overview 2.UBI overview
Linux MTD overview
MTD overview MTD stands for Memory Technology Devices MTD is a Linux subsystem ( drivers/mtd/ ) MTD provides uniform access to various flash devices MTD provides a generic API for that MTD provides an MTD device abstraction NANDNORDataFlashAG-ANDOneNANDECCd NOR MTD device, MTD API JFFS2character device (/dev/mtd0)
MTD device consists of eraseblocks Eraseblock size varies, typically 32-128 Kilobytes Eraseblocks may be written to MTD device … Eraseblock, 128K MTD device write, but not re-written re-write X Whole eraseblock has to be erased first write Then it is possible to write there
MDT device vs Block device Block device Consists of sectors Sectors are small (512, 1024 bytes) readwrite2 operations: read and write Bad sectors are hidden by hardware Sectors do not get worn out MTD device Consists of eraseblocks Eraseblocks are larger (32-128 Kilobytes) readwriteerase3 operations: read, write and erase Bad eraseblocks are not hidden Eraseblocks get worn-out after 10 4 -10 5 erasures. MTD device is more difficult to handle
MTD partitions Flash chip may be split on several MTD partitions MTD partition is a set of consecutive eraseblocks MTD partitions is a physical flash area … Partition 1 (e.g., initfs) Partition 2 (e.g., rootfs) … so on
Bad blocks Drawbacks of MTD partitions MTD partitions are static – now way to change them on-flight Do not provide wear-leveling for the whole chip … Partition 1Partition 2 JFFS2
UBI overview
UBI layer … Physical flash MTD layer UBI layer Flash File System (e.g., UBIFS)
Create UBI volume C - size 20 logical eraseblocks Re-size volume B to 10 logical eraseblocks Create UBI volume A – size 10 logical eraseblocksCreate UBI volume B - size 15 logical eraseblocks Delete UBI volume ARe-size volume C to 40 logical eraseblock Logical Volumes MTD device (physical flash) Volume A UBI provides logical volumes instead of MTD partitions UBI volumes are in a way similar to LVM volumes UBI volumes may be dynamically created, deleted and re-sized Volume BVolume CVolume BVolume C … and so on
Wear-leveling wholeUBI does wear-leveling across whole MTD device! Wear-leveling is done by UBI, not by the UBI user! Boot volumeRootFS volume DataStorage volume MTD device (physical flash) JFFS2
UBI volume vs. MTD partition MTD partition PEBConsists of physical eraseblocks (PEB) Does not implement wear-leveling Admits of bad PEBs UBI volume LEBConsists of logical eraseblocks (LEB) Implements wear-leveling Devoid of bad LEBs Advantages of UBI Allows dynamic volume creation, deletion and re-sizing more flexibility Eliminates the wear problem simpler software Eliminates bad eraseblocks problem simpler software
Static read-only data PEB 0PEB 6 PEB 7 How it works LEBs are mapped to PEBs PEB 1PEB 2PEB 3PEB 4PEB 5PEB 8PEB 9PEB 10 MTD device LEB 0LEB 1LEB 2LEB 3LEB 4LEB 0LEB 1LEB 2 Volume AVolume B UBI layer erase read Return 0xFFs write read Low erase counterHigh erase counter Move data Re-map LEB Any LEB may be mapped to any PEB
Bad eraseblocks handling UBI volumes are devoid of bad eraseblocks UBI does proper error recovery transparently Bad physical eraseblock Empty physical Eraseblock Partially filled physical eraseblock Write more data Write error! The eraseblocks become bad! No panic! Recover the data to a good PEB Write newcoming data to this PEB Re-map the LEB to this PEB Mark this PEB s bad The data have been successfully written! An UBI volume
UBI interfaces UBI character devices: deletere-sizeget device description 1./dev/ubi0, /dev/ubi1, … – UBI devices: volume create, delete, re-size, and get device description operations readwriteupdateget volume description 2./dev/ubi0_0, /dev/ubi0_1, … - UBI volumes: read, write, update, and get volume description operations UBI sysfs interface: /sys/class/ubi UBI in-kernel interface: include/linux/mtd/ubi.h
Volume update operation Useful for software updates corruptedVolume is in corrupted state if update is interrupted Corrupted volumes are not usable and must be updated
Static and dynamic UBI volumes Dynamic volumes are read-write Static volumes are read-only Static volumes are protected by CRC-32 checksum
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Category:User de-ch
From Wikimedia Commons, the free media repository
These users speak Swiss High German.
This category lists users according to their ability in the Swiss High German language.
Category:User de-ch-N: Native Swiss High German speakers
Category:User de-ch-4: Users with level of Swiss High German comparable to native speakers
Category:User de-ch-3: Users with advanced and fluent level of Swiss High German
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Comedy, Religion & SpiritualityFollow
Religion, politics and all things ethnic with John Safran and Father Bob Maguire. It's the thinking person's podcast.
December 6th, 2015
Episode 91 of 92 episodes
Helen Pankhurst, Great-granddaughter of Women's Rights activist Emmeline, Rochelle Siemienowicz, who was brought up a Seventh Day Adventist and a classic chat with 'Weird Al' Yankovic all the way back from 2006.
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Longbows and ArcheryBy: Brian Williams (author)Paperback
2 - 4 weeks availability
DescriptionA powerful and iconic weapon, the longbow dominated Medieval warfare in England. From the Hundred Years War to Hastings, Robin Hood and Agincourt, the longbow was also used to a devastating effect in naval battles. Kings of England encouraged the use of the longbow by sponsoring tournaments with prizes for successful archers. All other sports were banned on a Sunday except for archery. At any particular time, England would have a large pool of experienced archers ready to be called up for war. Each English shire had to provide the king with a certain number of trained archers per year - and this was enforced by law. But where did the longbow originate and why did it come to dominate archery in this way? The Pitkin Guide to Longbows and Archery explores these questions and looks at the ordinary men who used bows and arrows as soldiers and in their day-to-day lives.
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About AuthorBrian Williams is the author of "The Black Death," "Invaders," and "Medieval England."
Product Details
- publication date: 07/04/2014
- Format: Paperback
- Number Of Pages: 28
- weight: 91
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- Saver Delivery: Yes
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From Open Forum – Guy Kawasaki 's presentation from CES 2011 shows how the power of enchantment enables you to maneuver through difficult decisions, break entrenched habits, defy the wisdom of crowds, and get colleagues to work for long-term, mutually beneficial goals. Topics include how to achieve likability and trustworthiness, how to overcome resistance, how to enchant people who work for you, and how to enchant your boss.
Get the presentation slides here.
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Ramon Ray, Editor & Technology Evangelist, Smallbiztechnology.com . Editor and Founder, Smart Hustle Magazine Full bio at http://www.ramonray.com . Check him out on Google Plus, Twitter or Facebook
Latest posts by Ramon Ray (see all)
- 4 Tips for Staying Safe on a Public Computer - January 20, 2017
- 5 Tips To Choosing Your Marketing Automation Provider - December 16, 2016
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Find a copy in the library
Finding libraries that hold this item...
|Additional Physical Format:
|Online version:
Bush, George W. (George Walker), 1946-
Decision points.
New York : Crown Publishers, ©2010
|Named Person:
|George W Bush; George W Bush; George W Bush; George W Bush; George W Bush; George W Bush; George W Bush
|Material Type:
|Document Type:
|All Authors / Contributors:
George W Bush
|9780307590619 0307590615 9780307885227 0307885224
|OCLC Number:
|Includes index.
LC has no. 2584, signed by author.
|xii, 497 pages, [32] pages of plates : illustrations (chiefly color) ; 25 cm
|Introduction --
Quitting --
Running --
Personnel --
Stem cells --
Day of fire --
War footing --
Afghanistan --
Iraq --
Leading --
Katrina --
Lazarus effect --
Surge --
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Financial crisis --
|George W. Bush.
WorldCat User Reviews (2)
A Very Humanistic Book
Reading this book will allow the reader to acquire a better understanding of George Bush, the president, the human being, the conservative.
Whether you agree with him or not on his decisions, this book tells us the process followed to reach those decisions.
In the end we should agree...
Read more...
- Was this review helpful to you?
a readable book
I read this book because I wanted to know how Bush would defend himself and his administration. My answer about half way through and having skimmed the rest is: "Not well at all."(www.pickcheaps.com)
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Related Subjects:(11)
- Bush, George W. -- (George Walker), -- 1946-
- Bush, George W. -- 1946-
- Bush, George W.
- United States -- Politics and government -- 2001-2009.
- Politics.
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- Politics and government
- Politik.
- Presidents -- United States -- Biography.
- United States -- Politics and government.
- Presidenter -- Förenta staterna -- 2001-2008 -- biografi.
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Navy Takes
U.S. Navy Highlights Environmental Efforts
Personnel from U.S. Fleet Forces (USFF) command highlighted the Navy's environmental efforts during Earth Day 2013 events held in the Hampton Roads, Va. area April 20-21. Earth Day is observed April 22 each year, and the Navy's theme for 2013 was "Global Reach - Local Action." Navy leaders encouraged commands across the Navy to participate in local events and to spread the word on the Navy's many environmental success stories. USFF acted by sending a team of civilians and Navy Reservists to three local community events held in honor of Earth Day. The team helped convey the Navy's commitment to protecting the environment by participating in Earth Day programs at the Virginia Zoo in Norfolk, the Virginia Living Museum in Newport News, and Mount Trashmore Park in Virginia Beach. The USFF team set up a booth at each location and delivered presentations on the various environmental programs the Navy has in place to conserve the environment. Visitors were given the opportunity to look into a set of binoculars and wear the communication headsets similar to those used by lookouts or marine mammal observers aboard Navy ships to search for marine mammals. USFF team members also displayed a guidebook used to identify marine mammals and sea turtles, and provided members of the public examples of the "whale wheels" used by Navy lookouts to identify whales.
U.S. Navy Takes Delivery of ASDS
The U.S. Special Operations Command's (USSOCOM) Advanced SEAL Delivery System (ASDS), developed by Northrop Grumman Corporation, has been turned over to the U.S. Navy. In ceremonies held today in Annapolis, Md., Capt. Joe Fallone, program manager (PMS395), Deep Submergence Systems Program and the ASDS program manager for Naval Sea Systems Command (NAVSEA), signed the DD250, the official document that delivers the ASDS into the hands of the Navy.
This Day in Naval History – March 25
1813 - USS Essex takes Neryeda, first capture by U.S. Navy in Pacific 1898 - Assist. SECNAV Theodore Roosevelt proposes Navy investigate military application of Samuel Langley's flying machine, beginning naval aviation (Source: Navy News Service)
This Day in U.S. Naval History - March 25
1813 - USS Essex takes Neryeda, first capture by U.S. Navy in Pacific 1898 - Assist. SECNAV Theodore Roosevelt proposes Navy investigate military application of Samuel Langley's flying machine, beginning naval aviation Source: Navy News Service
Hijacked Tankship Freed in Nigerian Waters After Gunfight
Pirates took control of the St. Kitts and Nevis-flagged MT Notre on August 15, but an emergency signal was sent to the navy and several gunships were deployed to recover the vessel, Nigeria Navy Flag Officer Rear Admiral Sidi-Ali Hassan informed Reuters. Navy gunships caught up with the vessel and forced it into Nigerian waters but while negotiating the ship's release, the pirates tried to escape on a speed boat. The navy boats pursued but were fired upon by the hijackers
Kalaat Beni-Abbes Delivered at Muggiano Shipyard
The delivery ceremony of new amphibious vessel for the Algerian Navy was held today at the Muggiano shipyard (in La Spezia). The "Kalaat Beni-Abbes" (from the name of a place in the north of the country, which in Arabic means fort of the sons of Abbes), a vessel commissioned in 2011 by the Ministry of Defence of the People's Democratic Republic of Algeria from Orizzonte Sistemi Navali, a company controlled by Fincantieri in which Selex ES also holds an interest
Singapore Takes Part in SEACAT Naval Exercise
The Singapore-leg of the annual Southeast Asia Cooperation Against Terrorism (SEACAT) exercise started here on Monday with the participation of the navies from the countries such as Singapore, the United States, Brunei, Indonesia, Malaysia, the Philippines and Thailand. According to a statement by the Ministry of Defense, the annual SEACAT exercise is taking place from Aug.14 to 22, and the Singapore leg will last two days from Aug. 20 to 21.
This Day in Naval History – Feb. 4
1779 - John Paul Jones takes command of Bonhomme Richard 1959 - Keel laying of USS Enterprise, first nuclear powered aircraft carrier, Newport News, VA (Source: Navy News Service)
This Day in Naval History - September 17
1861 - Union landing party from USS Massachusetts takes possession of Ship Island south of New Orleans, LA. This was the headquarters for ADM David Farragut's Gulf Coast Blockading Squadron. 1944 - Navy Task Force lands Army troops on Angaur, Palau Islands supported by Navy carrier aircraft and shore bombardment (Source: Navy News Service)
Keeping the Navy Ethical: SECNAV's Message to Commanders
Secretary of the Navy Ray Mabus has conducted a video teleconference with U.S. Navy Fleet and Component Commanders to discuss Navy's efforts to address husbanding contracting issues and contracting reforms, and the recent investigation into Glenn Defense Marina Asia. Mabus emphasized that improving acquisition and service contract processes, and uncovering fraud when it takes place requires their personal, direct, and involved leadership.
China Confirms Carrier Conducted South China Sea Drills
China's sole aircraft carrier conducted drills in the South China Sea, the navy said, days after neighbouring Taiwan said the carrier and accompanying ships had passed 90 nautical miles south of the island amid renewed tension between the two sides.
Russia Plans Maritime Drills with Philippines
Russia sent its anti-submarine destroyer and a replenishment oiler to the Philippines in a bid to hold maritime exercises with the latter, according to various media reports. The two ships — Admiral Tributs, an anti-submarine vessel
Chinese Nuclear Sub Spotted at Pakistani Port
A Chinese nuclear-powered submarine was reportedly docked at a port in Pakistan, raising concerns across the border in India that it could have been monitoring the movement of its warships more closely than ever, reported NDTV.
US Navy Fires Warning Shots at Iranian Vessels
A U.S. Navy destroyer fired three warning shots at four Iranian fast-attack vessels near the Strait of Hormuz after they closed in at high speed and disregarded repeated requests to slow down, U.S. officials said on Monday. The incident
China Seizes US Underwater Drone in South China Sea
A Chinese warship has seized an underwater drone deployed by a U.S. oceanographic vessel in the South China Sea, triggering a formal diplomatic protest and a demand for its return, U.S. officials told Reuters on Friday. The drone was taken on Dec
China to Return Seized US Underwater Drone
China's Defense Ministry said on Saturday it plans to return an underwater U.S. drone seized this week by a Chinese naval vessel in the South China Sea, but complained the United States was "hyping up" the incident. The drone was taken on Thursday
GE Blog: Navigating through the Rough Seas
No two days in the navy are the same. Whether teams are facing a humanitarian mission, complex manoeuvres or a training exercise, navy recruits must be prepared for all eventualities, pushing their bodies and minds to the limits of their abilities. The same is true of navy fleets
US Naval Secretary Calls for 355-ship Fleet
In announcing the results of the 2016 Force Structure Assessment (FSA), U.S. Secretary of the Navy Ray Mabus recommended a 355-ship fleet, including 12 carriers, 104 large surface combatants, 52 small surface combatants, 38 amphibious ships and 66 submarines.
Tech Upgrade for German Minehunting Vessels
ATLAS ELEKTRONIK said it has received an order from the Federal Office of Bundeswehr Equipment, Information Technology and In-Service Support (BAAINBw) for the modernization of three minehunting vessels of the Frankenthal class (Type 332) in service with the German Navy.
Fourth Submarine in UK's Astute Class Named
The fourth submarine in the Astute class was officially named Audacious during a December 16 ceremony at builder BAE Systems' Submarines site in Barrow-in-Furness, Cumbria. Guests watched as Lady Jones, Audacious' sponsor and wife of Admiral Sir Phillip Jones
Two Medevaced from Tanker off Sabine, Texas
Coast Guard crews medevaced two men after they were struck by a pressurized object and suffered injuries aboard a tank ship about 20 miles off the Texas Point Wildlife Refuge Wednesday afternoon. The crew of the tanker United Ambassador contacted Coast Guard Marine Safety Unit Port Arthur
Austal delivers Gabrielle Giffords (LCS 10)
Austal delivered the fifth Independence-variant littoral combat ship (LCS), the future USS Gabrielle Giffords (LCS 10), to the U.S. Navy on December 23, exactly six months from the date LCS 8 was handed over, at an official document signing ceremony held aboard the ship.
Russian Navy to Get Two Subs
In recent years, Russia has been putting many efforts in building a modern-day nuclear submarine fleet. The Russian Navy expects to receive the Project 955A nuclear submarine Prince Vladimir and the Project 885M Yasen-M nuclear-powered underwater cruiser Kazan in 2017
Navy Accepts Delivery of USS Gabrielle Giffords
The Navy accepted delivery of the future USS Gabrielle Giffords (LCS 10) during a ceremony, Dec. 23. Gabrielle Giffords is the ninth littoral combat ship (LCS) to be delivered to the Navy and the fifth of the Independence variant to join the fleet
USS Rafael Peralta Completes Acceptance Trials
The future USS Rafael Peralta (DDG 115) successfully completed acceptance trials Dec. 16 after spending two days underway off the coast of Maine. The U.S. Navy's Board of Inspection and Survey (INSURV) reviewed the ship and its crew during a series of demonstrations while underway


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Janod Large Magnetibook - Mosaic Flowers
Guide price: £20
Last updated on 30th Nov 2013
Tags: ifblankjanod early learning centrebooks
Janod Large Magnetibook - Mosaic Flowers
Sturdy cardboard book themed case with magnetic pieces to create flower designs. This quaint sturdy cardboard book opens to reveal 113 magnets for the child to use to create flowers. 5 cards give different suggested designs for the child to try and emulate, or they can of course just use the power of their imagination. All of this is stored in this little book box which means that it is a great toy for when you are travelling and out and about.Includes Magnetibook, 113 magnets and 5 cards.
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Herstory Day
Herstory Day is an intergenerational celebration of women's history in New York City honoring their contributions, creativity, and resilience. Join us for interactive quilting, book-making, snacks, and performances.
Registration suggested, though not required.
Family programs are free with Museum admission and for members, geared to families with children ages 6-12 years old, and include a snack. Programs are designed for adults and children to complete the activities together.


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This 16th-century palazzo was one of the first examples of "Roman style" architecture which was brought to Florence by Baccio d'Agnolo. While the prevalent Florentine style of the time involved façades with rustication and plasterwork, between 1520 and 1523 Baccio d'Agnolo brought in an architectonic style using triangular tympana and columns typical of Roman classicism. This was not warmly received in Florence and in response to this the architect put an inscription in Latin on the façade. His family motto, used by the poet d'Annunzio, can instead be found above the entrance to via Porta Rossa: "per non dormire" (lest we sleep). The pictoral contrasts required by the stone facade have been revealed by recent restoration.
Underneath the Loggia del Porcellino, the marble wheel can be found which commemorates the place where the carroccio was left, an emblem of the Florentine Republic. In medieval times it was used as a pillory for those who dared to dupe the merchants of the city. The Loggia was the work of Giovan Battista del Tasso who built it in the middle of the 16th century as a market place for the sale of fabrics and objects of different kinds. Today the Loggia also houses a market, mainly for tourists. Leather bags, silk scarves, straw hats and other art and craft objects can be found there. The Porcellino is the boar which is part of the fountain on one side of the market. This bronze sculpture was made by Pietro Tacca at the beginning of the 17th Century after a marble original of the Hellenistic period (on show at the Uffizi).
Torre dei Gianfigliazzi is a tower located in the city of Florence which dates back to the Middle Ages. The tower, which was, at the time, used as a residence, now functions as a hotel. The first medieval structure was demolished in 1260 and then reconstructed. The tower is a tall brick building without many embellishments. The tower was again thoroughly renovated during the 18th Century when some structural changes were made such as the addition of new windows.
In its time this palace was the largest private residence in the city of Florence - only the Palazzo Vecchio offered it any competition. In 1289 construction was commenced on the impressive building for the Spini family, prominent bankers and merchants. The fresco by Domenico Ghirlandaio in the Sassetti Chapel in the nearby Santa Trinità Church portrays the original prospect of the palace.
This building, an example of 15th-century civil architecture, is in the heart of Renaissance Florence, near the cathedral of Santa Maria del Fiore and opposite the San Gaetano baroque church, which dates from the year 1000AD. Built for Giovanni Boni, it was constructed by Giuliano da Maiano who included a wide, internal courtyard, reflecting the geometric canons and harmonious equilibrium of the architecture of the time. The building is now private property, having passed out of the hands of the Antinori family in 1506. Their name, thankfully, has been preserved.
Palazzo di Parte Guelfa is located in Florence, Italy. It is a historic building of the middle ages. It was built in the 14th Century and adorns Renaissance style of architecture. Two additions were made to the original building that was built in the proximity to the church. It is now used for various cultural exhibitions and conventions and meetings.
Palazzo dell'Arte dei Beccai is located in Florence, Italy. It was built in the 14th Century and was restored in the early 1970's. Inspired by the 14th-century architecture, the appearance of the facade remains unhampered after undergoing major modification. The building is home to the Accademia Fiorentina delle Arti del Disegno since 1974.
The family was already very powerful when it obtained the palace from the Medicis, but it achieved real fame when the head of the family, Lorenzo Corsini, was elected Pope Clemens XII in 1730. Famous guests such as Michelangelo and Brabante slept here. The frescoes in the bed chamber of Queen Christina of Sweden can still be seen. Moreover a number of the art works now on display in the Galleria Nazionale d'Arte Antica on the second floor originally belonged to the Corsini family.


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We're all behind you
If we work together, the possibilities for positive change are infinite. And all over the state, organizations are working hard to offer resources that help Coloradans get healthy and stay safe. We're proud to partner with several of them, including:
Health Links
Create your own worksite wellness program with Health Links Colorado, an organization that offers support and training for small businesses interested in creating or improving their own worksite wellness programs instead of using ours. Health Links also helps Colorado businesses reach wellness and safety benchmarks and earn a Healthy Business Certification.
Colorado QuitLine
Everyone knows smoking isn't good for them, but did you know it can also slow healing and recovery if you're injured? In some cases, it can cause such a serious risk for people who need surgery that doctors recommend patients quit smoking before they have it.
Colorado Quitline offers telephone-based services tailored to each individual tobacco user's needs. The program consists of a bilingual QuitLine Call Center, coaching sessions and nicotine replacement therapy. With Colorado QuitLine, policyholders' employees have access to free support and resources — including nicotine replacement therapy — to quit using tobacco.
Just call (800) 784-8669 or go online to www.coquitline.org and let them know that Pinnacol Assurance is your workers' compensation provider.
Carson J. Spencer Foundation partnership
Another way we're proud to support policyholders is through our partnership with the Carson J. Spencer Foundation. The foundation is the nation's leader in suicide prevention in the workplace, and known for using innovative methods to address root causes of suicide. They offer specialized programs for industries with higher suicide rates, allowing us to provide safety and wellness resources to our policyholders in those industries. The foundation also assists those coping with the pain and grief resulting from the death by suicide among their family, friends, or co-workers. For more information on this partnership, please contact Christopher Battelli at (303) 219-5042 or at email@example.com.


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Crest Cadillac Collision Center
ReScore Reviews™ (1)
93% Would Recommend
Latest Review 10 months ago
Review for Crest Cadillac Collision Center
James S. on 12/11/2012
Spoke with Alice. She said she has not had time to check the quality yet. There was a problem with something being loose under the front end. Anything that's wrong they will make right. They did pretty well. She was not kept informed because they didn't call her. She said the estimate lined up just fine with the insurance. She is not satisfied with their communication because she doesn't know what repairs they did.
Category: Collision
Service Date: 12/07/2012
Review Created: 12/11/2012
This review was collected via phone interview by Customer Research Inc.


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The Pros and Cons and Hair Removal Creams
There are many hair removal options available and one of those is using hair removal creams. With many different creams on the market, it takes time to choose between them. Before you do that though, you need to make sure that the creams are worth your money. This form of hair removal offers many advantages, especially compared to other forms of hair removal, but there are disadvantages to consider. This helps you choose something that suits your needs; just because your friend is using a hair removal cream doesn't mean that it will suit your hair thickness or skin sensitivity.
Hair Removal Creams Are Safe to Use
When compared to permanent hair removal methods, like laser hair removal, the creams are safe to use. Very few people suffer from side effects – although they can happen! The creams do use chemicals and can cause allergic reactions. Always check the labels to make sure there are no ingredients that you are allergic to.
There is the benefit of the creams can be used on all areas of the body. This includes for males who are looking for creams for their face; but you will need to find creams that are specifically formulated for that area to avoid reactions. The creams have been tested for specific areas to make sure there are no adverse reactions with the chemicals and ingredients.
Hair Removal Options from Amazon
More Comfort With Creams
Waxing and epilating are painful for many people. Shaving pulls the hair out opposite to the direction it grows and there is a bigger chance of developing ingrown hairs. Ingrown hairs are painful and it can lead to itching or sore areas afterwards. There is also the problem of shaving rashes or the skin becoming irritated after epilating or waxing.
There is much more comfort when using hair removal creams. They are quick and easy to use and don't pull the hair. They are completely pain free and perfect for different parts of the body, including the chest, legs and even the bikini line.
Not a Permanent Method of Hair Removal
For those looking for a more permanent option of hair removal, the creams are not that. Permanent hair removal, such as laser options, is more expensive and has a higher risk involved. This is a popular option for many because the cost is less than the average cost over a lifetime of removing hair.
The creams are also not as great as other forms of removing hair. While epilating isn't permanent, it does last much longer due to the way that it pulls the hair from under layers of the skin. Hair removal creams are similar to shaving, by removing the hair from the top layer of skin. However, the hair won't grow at odd angles or under layers, which may be worth the extra work.
When looking into hair removal options, it is important to consider the pros and cons of each. Hair removal creams are affordable and not painful but they are not as good as other methods. Those with sensitive skin may find that shaving or epilating is a better option but check all the ingredients to find something suitable for you.
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Would you like blonde hair? You need to find a blonde hair color that will suit you. This article covers all the things you need to think about to find the perfect shade for your needs.
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The price includes: condo expenses, heating, water and refuse tax.
Electricity, gas, Internet.
This offer is for a bed in a single room.
The apartment has 5 rooms with 5 beds.
TodayFor the selected date, in this apartment, there are:
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Single room
0 square metres
sq m apartment: 180
Number of rooms: 5
Number of bathrooms: 2
Heating: Centralizzato
Number of occupants: 5
Floor: 1°
Energy efficiency class: E
Energy performance index Kw/sq m: 136.47
Washing machine
Bicycle parking


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Functional magnetic resonance imaging and repetitive transcranial magnetic stimulation (rTMS) were used to explore the pathophysiology of auditory/verbal hallucinations (AVHs). Sixteen patients with schizophrenia-spectrum disorder were studied with continuous or near continuous AVHs. For patients with intermittent hallucinations (N = 8), blood oxygenation level–dependent (BOLD) activation maps comparing hallucination and nonhallucination periods were generated. For patients with continuous hallucinations (N = 8) correlations between BOLD signal time course in Wernicke's area, and other regions were used to map functional coupling to the former. These maps were used to identify 3–6 cortical sites per patient that were probed with 1-Hz rTMS and sham stimulation. Delivering rTMS to left temporoparietal sites in Wernicke's area and the adjacent supramarginal gyrus was accompanied by a greater rate of AVH improvement compared with sham stimulation and rTMS delivered to anterior temporal sites. For intermittent hallucinators, lower levels of hallucination-related activation in Broca's area strongly predicted greater rate of response to left temporoparietal rTMS. For continuous hallucinators, reduced coupling between Wernicke's and a right homologue of Broca's area strongly predicted greater left temporoparietal rTMS rate of response. These findings suggest that dominant hemisphere temporoparietal areas are involved in expressing AVHs, with higher levels of coactivation and/or coupling involving inferior frontal regions reinforcing underlying pathophysiology.
Auditory/verbal hallucinations (AVHs) of spoken speech occur in 60–80% of persons with schizophrenia (Sartorius et al. 1974; Andreasen and Flaum 1991). These hallucinations often produce high levels of distress, behavioral dyscontrol, and functional disability that are refractory to antipsychotic drugs. The pathophysiological basis of this syndrome remains uncertain, but if better understood, may lead to more effective treatments.
Neuroimaging studies have associated occurrences of AVHs with activation in diverse brain regions involved in speech generation, speech perception, and verbal memory (Suzuki et al. 1993; Woodruff et al. 1994; Silbersweig et al. 1995; Dierks et al. 1999; Lennox et al. 1999, 2000; Shergill et al. 2000; Copolov et al. 2003; Shergill et al. 2004; van de Van et al. 2005). Many of these studies have found prominent activation during AVHs in the right as well as left hemisphere (Woodruff et al. 1994; Lennox et al. 1999; Shergill et al. 2000) with considerable regional variation from one subject to the next (Lennox et al. 2000; Copolov et al. 2003). These findings have been difficult to interpret due to small sample sizes and uncertainty whether detected activation reflects brain processes directly involved in generating AVHs versus "downstream" consequences of these events such as secondary shifts in attention (van de Van et al. 2005), registration of hallucinations in verbal memory, or activation propagated to nonessential regions.
Our understanding of brain mechanisms producing AVHs may be advanced by research methods that can directly alter function of neurocircuitry components implicated in the genesis of these symptoms. One such tool is repetitive transcranial magnetic stimulation (rTMS), which delivers very brief, 1.5–2 Tesla magnetic pulses that pass relatively undistorted to small regions of the superficial cerebral cortex. Repetitive TMS delivered at a frequency of 1 Hz for 15–20 min duration can produce sustained reductions in excitability or reactivity of the cortical region directly stimulated (Chen et al. 1997; Boroojerdi et al. 2000), possibly via a mechanism analogous to long-term depression elicited by direct electrical stimulation of gray matter at the same frequency (for review see Hoffman and Cavus 2002). An early 15O positron emission tomography study found activation in temporoparietal regions associated with AVHs (Silbersweig et al. 1995). This finding prompted our group to undertake 2 clinical trials involving hallucinating patients using 1-Hz rTMS directed to the TP3 scalp site specified by 10/20 International Electroencephalography (EEG) system (Hoffman et al. 2000, 2003, 2005). The TP3 site overlies the junction of Brodmann area (BA) 39 and 40 in the inferior parietal lobule (Herwig et al. 2003), which neighbors temporoparietal areas highlighted in the study of Silbersweig et al. (1995). Our trials plus 2 others (Chibbaro et al. 2005; Poulet et al. 2005) demonstrated statistically greater symptomatic improvement in AVHs following rTMS delivered to the TP3 site compared with sham stimulation. However, later neuroimaging reports have not detected activation specifically at the BA 39/40 junction (corresponding to the TP3 site) during AVHs (see, for instance, Shergill et al. 2000; Copolov et al. 2003), and negative or equivocal results have been reported for 3 other rTMS trials of patients with AVHs targeting the TP3 site (McIntosh et al. 2004; Fitzgerald et al. 2005; Lee et al. 2005).
Schönfeldt-Lecuona et al. (2004) tested the hypothesis that AVHs are instances of inner speech mislabeled as having a nonself origin as proposed by others (Frith and Done 1989; McGuire et al. 1993; McGuire, Silbersweig, Murray et al. 1996; McGuire, Silbersweig, Wright et al. 1996). Probing Broca's area and primary auditory cortex at sites selected in light of an inner speech task eliciting functional magnetic resonance imaging (fMRI) activation in these regions did not yield consistent improvements in AVHs relative to sham stimulation.
In order to further clarify pathophysiological processes, the study described below used 1-Hz rTMS to probe multiple cortical sites in patients with AVHs determined using 2 alternative fMRI methods. For patients with intermittent AVHs with intervening silent periods, maps of blood oxygenation level–dependent (BOLD) activation comparing hallucination events signaled during scanning and nonhallucination periods were used for positioning the rTMS coil. For patients experiencing AVHs continuously, activation maps corresponding to hallucination events were not possible because there were no nonhallucination periods for comparison. For these patients, the stimulation coil was positioned based on maps of BOLD signal correlations used to detect functional coupling to Wernicke's region. The rationale for the latter approach was based on: 1) speech percept-like qualities of AVHs (Junginger and Frame 1985; Nayani and David 1996), suggesting direct involvement of Wernicke's region, 2) studies demonstrating that functional coupling between brain areas reflecting known network neuroanatomy can be detected as BOLD signal correlations (Biswal et al. 1995; Lowe et al. 1998; Hampson et al. 2002), and 3) preliminary findings suggesting that BOLD signal correlations linking Wernicke's area and Broca's area in patients with AVHs were abnormally elevated when compared with normal subjects (Hampson M, Hoffman R, unpublished data). Our study objectives were to identify those cortical regions where rTMS produced significant improvements in AVHs and then assess the statistical relationship between clinical response in these regions and fMRI findings.
Sixteen right-handed patients meeting Diagnostic and Statistical Manual – Version IV criteria for either schizophrenia or schizoaffective disorder based on the Structured Clinical Interview for Axis I disorders – Patient Edition Version 2.0 (First et al. 1995), and reporting continuous or near continuous AVHs were studied using the protocols described below. Eight patients experienced frequent, intermittent AVHs and 8 patients experienced continuous AVHs. Patients in the former group reported hallucination events on average at least once every 2 min with intervening nonhallucination (silent) periods. Patients in the latter group described continuous hallucinated speech during wakefulness with no intervening silent periods. Continuous hallucinators were studied to expand our sample size. Many of these patients had been referred to our research program due to nearly total resistance to pharmacological treatment. We had found in addition that continuous hallucinators did not respond to rTMS administered to the parietal TP3 EEG site in our previous trial (Hoffman et al. 2005). Positive results using fMRI-guided rTMS in this patient group would therefore suggest a methodological advance. Another potential advantage of studying continuous hallucinators is that the steady-state nature of their hallucinations in theory should be optimal for delineating functional coupling to Wernicke's area via BOLD signal correlations, which was our method for positioning rTMS when BOLD signal activation maps of hallucination events could not be generated. The Table summarizes demographic and clinical characteristics of these 2 patient groups. Our study included 5 patients who had enrolled in a previous rTMS trial where stimulation was positioned at the TP3 site (Hoffman et al. 2000, 2005). Patients remained on their psychotropic medication at unchanged dosages for at least 4 weeks prior to initiation of the trial and for the duration of the trial itself.
Scanning Protocols
For the first 7 patients (4 intermittent and 3 continuous hallucinators), magnetic resonance imaging employed a GE 1.5T Signa LX scanner. T1-weighted images of 14 contiguous 6-mm thick slices were acquired parallel to a line joining the anterior and posterior commissures (the AC–PC line). During these functional runs, intermittent hallucinators were asked to depress and then release a button that digitally marked the onset–offset of each hallucination event during image acquisition. For patients with continuous hallucinations, no behavioral task was assigned. Image acquisition runs lasted for 4 min, 6 s (164 gradient recalled, single-shot echo planar images for each slice; time repitition [TR] = 1500 ms, time echo [TE] = 60 ms, flip angle = 60°, 64 by 64 acquisition matrix, 3.125 × 3.125 × 6 mm resolution). The first 4 images of each slice in each run were discarded in order to allow magnetization to reach a steady state. Subjects completed 5–7 runs. In addition, functional data were collected that examined activation elicited when listening to external speech. These data were used to delineate a functionally defined Wernicke's region in order to generate maps of BOLD signal correlations calculated relative to this region. For this purpose, identical image acquisition parameters were utilized except that 2 runs of 226 images were collected while subjects listened to recorded clips from a narrated story played at 45-s intervals over headphones with intervening 45-s silent periods.
For the last 9 patients, magnetic resonance imaging employed a Siemens 3T Trio scanner. Twenty-two 4-mm T1-weighted images were acquired parallel to the AC–PC line, with 0.8-mm skip between images, and functional imaging data was collected in the same slice locations. Functional runs were collected as described above, but imaging parameters were adjusted for the increased field strength (TR = 1500 ms, TE = 30 ms, flip angle = 80°, 64 × 64 acquisition matrix, 3.125 × 3.125 × 4.8 mm).
Image Analyses
All data were motion corrected using the Statistical Parametric Mapping algorithm. A spatial Gaussian filter was applied to the data with a width of 2 pixels at its half maximum and pixels with a median value over the time course that fell below 5% of the maximum time-course median pixel value were set to zero.
Intermittent hallucinators: mapping regional activation associated with hallucination periods
A hemodynamic lag of 3.5 s was assumed when classifying images in the hallucination versus nonhallucination condition. A statistical parametric map of t-scores was created by comparing signal intensity during hallucinations with signal intensity at rest for each brain pixel. Results from the different runs were averaged to produce a t-map for each subject.
Continuous hallucinators: mapping correlated activity relative to Wernicke's region
A functionally delineated Wernicke's region was ascertained by comparing activation while listening to external speech versus activation during intervening nonspeech periods. Neurally modulated hemodynamics in each listening or silent period were not assumed to be present until the third image collected during that period. A t-test was performed comparing each pixel's signal level during speech presentation blocks with that during resting blocks. Results from runs with external speech were averaged to produce a t-map for each subject. The Wernicke's reference region for correlation analyses was defined for each individual as the 30 most active pixels in the left posterior superior temporal gyrus (STG) corresponding to posterior BA 22. Correlation maps relative to the functionally defined Wernicke's reference region were then generated for scan data collected during the functional runs acquired in the absence of external speech (Hampson et al. 2002). Data from each of those runs were first low-pass filtered with a cutoff frequency of 0.2 Hz. The partial correlation between the time course of each pixel in question and that of the Wernicke's reference region within each of the runs was then calculated after removing the effects of the average time course of the slice in which the pixel was located. The correlations were averaged across runs and transformed to a Gaussian distribution via Fisher's transformation. By fitting the distribution with a Gaussian curve (to full width at half maximum) and adjusting for mean and standard deviation, data were then transformed to a standard normal distribution (Lowe et al. 1998). This yielded a map representing the strength of correlations to Wernicke's area in terms of standardized z values.
Region of Interest Analyses
Regions of interest (ROIs) selected for analyses of fMRI data were those implicated in language processing defined in terms of Talairach coordinates (Talairach and Tournoux 1988). There were 6 such regions: Broca's area (BA 44/45), left primary auditory cortex (BA 41), left temporoparietal cortex (Wernicke's area defined as left BA 22 posterior to y = −30 plus the left supramarginal region, BA 40), and the homologous right-sided region.
For intermittent hallucinators, percent signal change for hallucination periods relative to rest periods was averaged across all pixels in a given ROI to estimate activation in that ROI. For continuous hallucinators, z-maps of BOLD signal correlations relative to the functionally defined Wernicke's region were transformed into Talairach space and then averaged across all pixels in the ROI to yield a quantitative estimate of correlation to Wernicke's area for that subject in that ROI.
TMS Protocols
For the first 5 subjects in the study, the 3 most prominent cortical sites based on fMRI maps (either activation maps of hallucination events or Wernicke's-referenced correlation maps) were selected as rTMS targets. Scalp locations overlying these cortical sites were then identified using a BrainLAB VectorVision frameless stereotactic system (BrainLAB AG, Munich, Germany). Each site plus a sham condition—where the stimulation coil was angled 45° off the scalp while positioned in a temporoparietal site—received 16 min of 1-Hz stimulation once per day for 3 successive days in a crossover design where order of sites was randomized. Except for weekends, different sites were probed sequentially on a once daily basis. Repetitive TMS was administered using a MAGSTIM SUPER system (MAGSTIM Ltd., Whitland, Wales) and a figure-8 coil. Stimulation was administered at 90% motor threshold defined as the minimum stimulation strength applied to primary motor cortex required to elicit visualized motor movements of fingers or thumb in 4/8 tries. Coil position was stabilized using a mechanical arm. Assessments of hallucination severity were conducted after each 3-day block of stimulations and reflected the 24-h period after the last stimulation administered for that block. Study participants, all clinical raters, and all personnel responsible for the clinical care of the patient remained masked to stimulation condition during this 12-day period. Patients received 3 more sessions of active rTMS to the site producing greatest clinical benefit following unmasking.
fMRI data for these first 5 subjects identified more than 3 cortical targets for rTMS per subject with minimal rTMS response observed in 2/5 patients. In order to increase the likelihood of locating regions that yielded rTMS response, the protocol was subsequently revised for the remaining patients so that up to 6 active sites (plus a sham stimulation site in a temporoparietal location) could be targeted. In order to accommodate a larger number of sites while limiting the total number of active stimulation sessions per subject to 24 for practical and safety reasons, continuation of stimulation at a given site was dependent on observed clinical response assessed after every second 16-min rTMS session. If active (or sham) rTMS to that site led to a reduction in hallucination severity ≥ 10% over that 2-day period, then 2 more daily sessions of active (or sham) rTMS were given to that site. If ≥ 10% reduction was not obtained, rTMS was shifted to the next site per a predetermined randomized order. After 2 more days of stimulation, hallucination severity was again assessed and this same decision process applied. This process was repeated until a total of 24 sessions of active rTMS were administered or all targeted sites were studied with active rTMS, whichever came first. Study participants, all clinical raters, and all personnel responsible for the clinical care of the patient remained masked to stimulation condition throughout this protocol.
Assessing Hallucination Severity
Many factors contribute to hallucination severity (e.g., loudness, frequency, and verbal content), and these factors appear to vary in significance from patient to patient. The primary outcome measure consequently was an individualized Hallucination Change Scale (HCS) anchored to each patient's own descriptions of hallucinatory experience (Hoffman et al. 2003, 2005). Each patient generated a baseline narrative description of AVHs for the 24-h time period just prior to initiation of the trial, which was assigned a score of 10. The HCS was scored on subsequent days by requesting the patient to generate a new narrative description of AVHs for the 24-h period subsequent to the last stimulation session. Follow-up severity scores could exceed baseline, with a maximum score of 20 corresponding to AVHs twice as severe as baseline and a score of zero corresponding to no AVHs during the 24-h assessment window. Acceptable levels of interrater and test–retest reliability have been demonstrated for this scale (Hoffman et al. 2003, 2005).
A neuropsychological test battery was administered prior to and after the trial for each subject. Results of these assessments will be reported separately. The sequence of study procedures are summarized in Figure 1.
Statistical Analyses
Change in hallucination severity for rTMS to a given site was quantified as percent change in HCS per stimulation day corrected for baseline HCS at initiation of stimulation for that site, defined as (HCSF − HCSB) × 100/(HCSB × d), where HCSB = baseline HCS for the site in question, HCSF = final HCS for the site in question, and d = number of days of stimulation to that site. A recent clinical trial demonstrated a curvilinear response of HCS to rTMS as the number of stimulation sessions increased (Hoffman et al. 2005). These data suggested that as hallucination severity decreased during the course of the trial, subsequent HCS response rate decreased. Correction for site-specific baseline HCS was therefore incorporated into this outcome measure to avoid underestimating clinical effects of rTMS at sites probed later in the trial when partial improvements had already emerged. Because our outcome measure corrected for partial improvement at initiation of rTMS to a given site as well as the number of stimulation sessions delivered to the site, rate of AVH response to rTMS delivered across sites and subjects could be compared statistically.
Data limited to findings collected only during double-masked conditions are reported here. Data were grouped within broader functionally related regions in order to achieve sample sizes sufficient to compare response rates statistically. Along these lines, outcomes for rTMS delivered to right and left inferior frontal regions incorporating Broca's region (BA 44 and 45) were pooled given that there were no trends suggesting lateralizing effects. For the same reason, results of stimulation delivered to primary auditory cortex (BA 41/42) and auditory association cortex (STG anterior to y = −30), collectively referred to as the anterior superior temporal region, were grouped together. Response data for the left temporoparietal cortex consisting of Wernicke's area and the adjacent left supramarginal cortex (BA 40) were pooled given studies showing that these regions are functionally related and that both regions selectively activate in response to speech inputs (Kertesz et al. 1993; Benson et al. 2001; Matsumoto et al. 2004). Response data for rTMS delivered to the right-sided region homologous to Wernicke's region and the right supramarginal cortex were grouped as the right temporoparietal region.
Response data for the left temporoparietal region departed significantly from normality and were analyzed nonparametrically. Effect size was estimated following partial renormalization via a square root transformation (X′ = SGN(X) × SQRT (ABS(X))) as follows:
All statistical tests were 2-tailed using a P value of 0.05 as the cutoff for significance.
Figure 2 illustrates fMRI activation maps of hallucination events and sites targeted for rTMS for 2 patients with intermittent hallucinations. Figure 3 illustrates fMRI maps of correlations referenced to Wernicke's area and corresponding rTMS sites for 2 continuous hallucinators.
Figures 4 and 5 illustrate changes in hallucination scores for cortical sites probed with active rTMS for subjects with intermittent hallucinations and continuous hallucinations, respectively. Quantitative comparisons of clinical outcomes for rTMS delivered to ROIs are summarized in Figure 6A. Only rTMS directed to the left temporoparietal region produced a greater rate of clinical improvement relative to sham stimulation (Wilcoxon signed ranks test, z = 2.60, P = 0.009, estimated effect size = 1.01). Greater rate of improvement was also observed for rTMS delivered to this region compared with rTMS delivered to anterior temporal regions (Wilcoxon signed ranks test, z = 2.20, P = 0.028, estimated effect size = 1.27).
It is possible that rTMS response for sites probed late in the sequence for a given subject expressed carryover effects arising from stimulating prior sites. If left temporoparietal sites clustered late in the order of sites, this may have contributed to improved response rates in this region. This possibility was assessed by comparing rate of response relative to site order probed with rTMS (Fig. 6B). For the 10 patients probed in at least 4 sites, the fourth site probed was associated with greater improvement than the first site (Wilcoxon signed rank test, z = 2.02, P = 0.043). The number of subjects receiving rTMS directed to left temporoparietal sites at different steps in the sequence was as follows: first in sequence (5), second in sequence (3), third in sequence (4), and fourth in sequence (3). These data indicate that sequential order of left temporoparietal rTMS did not appear to contribute to elevated response rate observed for this region.
ROI data for fMRI maps were assessed as possible predictors of rate of improvement while receiving left temporoparietal rTMS. For intermittent hallucinators alone (N = 6), negative correlations with rate of improvement for rTMS delivered to this region were significant for hallucination-related activation in Broca's region (Spearman rank rho = −0.93, P = 0.008, Fig. 7) and the right-sided homologous region (Spearman rank rho = −.87, P = 0.024) but not for activation in the left temporoparietal region itself (Spearman rank rho = −0.70, P = 0.12). The correlation with Broca's hallucination-related activation remained significant after Bonferroni correction (activation variables utilized in this analysis corresponded to left and right Broca's, anterior temporal, and temporoparietal ROIs yielding a total of 6 variables) with adjusted P value = 0.008 × 6 = 0.048. Confounding effects of 2 factors that may have influenced detected level of activation as well as rTMS response were considered. Number of scanning runs, which could influence robustness of activation maps, may have been influenced by symptom severity (patients with greater symptoms may tolerate extended scanning with more difficulty), which, in turn, could have altered rTMS response. Similarly, frequency of hallucination events during scanning is an index of hallucination severity that could have influenced robustness of activation maps as well as rTMS response. Correlations with rate of improvement for left temporoparietal rTMS for these 2 variables did not, however, approach statistical significance (for number of scan runs per subject, Spearman rank rho = −0.26, P = 0.62; for frequency of AVHs during scanning, Spearman rank rho = .32, P = 0.54).
Correlations between temporoparietal rTMS response and functional coupling in ROIs linked to Wernicke's area were assessed for continuous hallucinators (N = 6). A robust negative correlation was detected between level of Wernicke's coupling to right Broca's area and left temporoparietal rTMS response (Spearman rank rho = −1.0, P = 0.001, Fig. 7) but not for coupling to left Broca's area (Spearman rank rho = −0.60, P = 0.20). Insofar as all continuously hallucinating patients completed an identical number of scan runs (=6), this variable was not a confound influencing these correlational findings. Hallucination frequency in these cases was also identical, that is, continuous.
Patients tolerated active rTMS without significant difficulties. Two patients experienced significant pain during rTMS when stimulating over Broca's region that required reductions of stimulation strength to 70% motor threshold.
Statistically greater rates of improvements in AVHs were observed when rTMS was directed to left temporoparietal sites compared with anterior temporal sites and sham stimulation. Findings did not appear to be accounted for by order of region of stimulation. These data, considered together, implicate left temporoparietal regions in the genesis or expression of AVHs.
The study of patients with AVHs by Schönfeldt-Lecuona et al. (2004) probed an STG site with 1-Hz rTMS corresponding to left primary auditory cortex (BA 41/BA 42) and found improvements at this site compared with control stimulation only at a trend level. Superior temporal sites anterior to Wernicke's area overall demonstrated no consistent evidence of improvement following rTMS in our study. However, improvement following rTMS delivered to right and left primary auditory cortex was detected in 3/5 patients; in contrast, while more anterior sites in STG elicited no change or worsening AVHs. The significance of these findings, because of the small number of subjects, remains uncertain.
We did not find that AVHs were consistently improved by rTMS to Broca's area, a finding also reported by Schönfeldt-Lecuona et al. (2004). These negative findings appear to challenge the mislabeled inner speech hypothesis for AVHs (Frith and Done 1989; McGuire et al. 1993, McGuire, Silbersweig, Murray et al. 1996; McGuire, Silbersweig, Wright et al. 1996; Shergill et al. 2001, 2003) insofar as inner speech produces Broca's activation ordinarily (McGuire, Silbersweig, Murray et al. 1996; Shergill et al. 2001). Of note, however, is that targeting Broca's region with rTMS required stimulation over the anterior aspect of the temporalis muscle, which is thicker than over temporoparietal areas. Two of our patients could not tolerate full stimulation strength during Broca's TMS, and greater muscle mass over this area will displace the stimulation coil from the skull surface (see Fig. 2B). Reductions in Broca's gray matter and the underlying insula in this patient group have been reported (Shapleske et al. 2002; Yamasue et al. 2004) that would further increase distance from coil to cortical surface. Insofar, as effective field strength drops off exponentially as distance from the stimulation coil increases, these factors are likely to curtail rTMS effects.
In spite of the absence of detected efficacy to rTMS-delivered Broca's and right homologous regions for our patients overall, correlations between fMRI data and left temporoparietal rTMS response in our study (Fig. 7) suggest involvement of these inferior frontal regions in AVH pathophysiology. Broca's and left temporoparietal regions (i.e., Wernicke's and supramarginal cortex) are reciprocally connected (Matsumoto et al. 2004) and synchronously coactivate when subjects produce and listen to speech ordinarily (Fried et al. 1981; Mesulam 1990; Friederici 2002). That higher levels of hallucination-specific Broca's activation levels predicted nonresponse to temporoparietal rTMS in our study suggests that functional relationships between Broca's and temporoparietal regions associated with ordinary language processing also reinforce pathophysiology of AVHs. The right-sided region homologous to Broca's area appears to play an important though less well-understood role in language processing (Gaillard et al. 2000; Moro et al. 2001). Higher levels of functional coupling linking this region to Wernicke's cortex appeared to reinforce pathophysiology in the continuous hallucinator group as evidenced by robust correlations with resistance to left temporoparietal rTMS. A less parsimonious hypothesis accounting for the capacity of inferior frontal fMRI data (incorporating Broca's and the right homologous area) to predict subsequent temporoparietal rTMS response cannot be ruled out, however. Another region, perhaps subcortically located, could activate left and/or right Broca's area as well as temporoparietal regions and itself induce rTMS resistance—thereby, producing our correlative findings. Of interest is that level of activation within the left temporoparietal region itself was not as robust a predictor of clinical response. These data suggest that rTMS to this region was able to override partially higher activation levels when accessed directly. The robust negative correlations between temporoparietal rTMS response and hallucination-related activation/coupling involving inferior frontal regions were not accounted for by signal acquisition variables that could have influenced robustness of fMRI maps as well as rTMS response in parallel.
Limitations of our methodology should be considered in interpreting findings:
Five patients were reenrolled from previous rTMS studies administered to the TP3 site positioned based on scalp landmarks due to availability of fMRI maps. Three of these patients previously had a significant response to rTMS, whereas 2 patients had no response, which is roughly comparable to the 52% rate of response in our recently completed trial (Hoffman et al. 2005). Four of these patients received rTMS at left temporoparietal sites during the course of this study, which averaged 2.2 cm distant from the parietal TP3 site used in our previous rTMS studies of AVHs. The focality of the magnetic field produced by the figure-8 coil employed (defined as the distance from the coil center producing a 50% drop-off in magnetic field strength) is likely to have radius of ∼0.75 cm when administered at 90% motor threshold (Thielscher and Kammer 2004). Thus, temporoparietal rTMS sites used in this study had little to no overlap with the more posterior, inferior parietal TP3 site used in previous studies for these four reenrolled patients. The inclusion of patients from earlier protocols was prompted by availability of fMRI maps for these patients and the fact that this study focused on spatial specificity and fMRI predictors of rTMS response rather than assessment of overall efficacy.
Two different fMRI maps were employed that produced different positioning information. Activation maps of hallucination events were used because they can be directly linked conceptually to known effects of 1-Hz rTMS, which are thought to be inhibitory in nature. Given that fMRI activation maps require very high hallucination frequencies (at least one event every other minute) with intervening "silent" periods, this method can be applied to less than 5% of hallucinators, which limited recruitment and prompted us to reenroll patients from earlier protocols for whom these maps had been successfully generated previously. Consequently, we sought to develop a second, correlation-based method for mapping involved neurocircuitry.
For mapping purposes, patient selection was biased toward those with especially severe AVHs. For intermittent hallucinators, average hallucination frequency, as noted above, was required to be very high. We have found that continuous hallucinators had historically demonstrated minimal responses to pharmacological treatment as well as to rTMS delivered to a standard TP3 location (Hoffman et al. 2000, 2005). Overall, our hope was that studying hallucinating patients with especially severe syndromes would shed light on more standard populations. However, it remains possible that patients with less severe hallucination syndromes suffer from somewhat different pathophysiology.
Two different scanners were used in the study. However, there is no suggestion that we obtained improved clinical results due to the higher resolution of the 3T scanner used later in the study.
Total "dose" of rTMS to "best" sites was relatively modest, averaging 3.7 sessions for Wernicke's region and 4.8 sessions for the left supramarginal cortex. It remains possible that protocols designed so that more stimulation is given to these sites might be able to generate symptoms reductions even in the face of pronounced inferior frontal coactivation/coupling.
Carryover effects arising from the crossover nature of this study cannot be ruled out, which would add noise to region-specific rTMS response data.
The strength of magnetic fields generated by TMS coils drops off exponentially relative to distance from the coil surface with effective physiological penetrance extending only 1–2 cm (Cohen et al. 1990; Thielscher and Kammer 2004). Consequently, rTMS can only access cortex adjacent to the skull surface. Our fMRI data appear to demonstrate significant involvement in medially displaced brain areas (see, for instance, sites in BA 21 and 22 in Fig. 2A and sites in BA 45 and 22 in Fig. 3A). There is some evidence that 1-Hz rTMS can produce indirect effects that are transmitted transsynaptically (Wassermann et al. 1998; Rossi et al. 2000). However, propagated effects are likely to be more limited than direct effects. This limitation may impose a ceiling on overall clinical response to rTMS.
Our method for assessing cortical coupling in the continuous hallucinator group relies on the assumption that Wernicke's area is involved in the genesis of AVHs. We had no independent way to verify this assumption in individual cases. It therefore remains possible that our positioning method missed identifying promising cortical sites if Wernicke's involvement was indeed minimal in some continuous hallucinators.
We assumed a relatively brief hemodynamic delay of 3.5 s when mapping activity associated with hallucinations. By comparison, a recent study by Shergill et al. (2004), mapping time course of AVHs assumed a hemodynamic delay between 4–8 s. Our intent was to focus on activation occurring early in and just prior to onset of hallucination events. Along these lines, 2 reports have shown detectable activation that appears prior to hallucination onset that may be of special mechanistic significance (Lennox et al. 1999, Shergill et al. 2004). However, the assumption of a 3.5-s hemodynamic delay may have reduced our statistical power to detect activation emerging later in hallucination events.
In summary, by demonstrating topographic specificity in rTMS response left temporoparietal sites, this study provides evidence that Wernicke's area and/or the adjacent supramarginal cortex play a direct role in generating or expressing AVHs in dextral patients. Correlations between fMRI data and rTMS response data also implicate involvement of Broca's area and its right homologous area in pathophysiology even though rTMS did not produce consistent improvements when directed to these sites. Whether brain mechanisms responsible for generating AVHs reflect a distributed property across a network incorporating these brain regions or a focal disturbance (cf. David 1994) that secondarily propagates across this network—analogous perhaps to some forms of epilepsy (see, for instance, Badier and Chauvel 1995)—remains an important unanswered question.
|Intermittent hallucinators (N = 8)
|Continuous hallucinators (N = 8)
|33.7 ± 13.7
|35.9 ± 6.5
|Gender (F/M)
|Education level (grades)a
|14.4 ± 1.8
|14.1 ± 1.7
|Schizophrenia, paranoid (5); schizoaffective disorder, depressed type (3)
|Schizophrenia, paranoid type (3); schizoaffective disorder, bipolar type (2); schizophrenia, depressed type (1); schizophrenia, undifferentiated type (2)
|Number of psychiatric hospitalizationsa
|5.3 ± 5.5
|5.1 ± 3.9
|Age of first onset of AVHs
|24 ± 5.8
|20.9 ± 4.8
|Months since last remission of auditory hallucinationsab
|118 ± 122
|180 ± 95
|Medication resistance of AVHsc
|7 (88)
|7 (88)
|Intermittent hallucinators (N = 8)
|Continuous hallucinators (N = 8)
|33.7 ± 13.7
|35.9 ± 6.5
|Gender (F/M)
|Education level (grades)a
|14.4 ± 1.8
|14.1 ± 1.7
|Schizophrenia, paranoid (5); schizoaffective disorder, depressed type (3)
|Schizophrenia, paranoid type (3); schizoaffective disorder, bipolar type (2); schizophrenia, depressed type (1); schizophrenia, undifferentiated type (2)
|Number of psychiatric hospitalizationsa
|5.3 ± 5.5
|5.1 ± 3.9
|Age of first onset of AVHs
|24 ± 5.8
|20.9 ± 4.8
|Months since last remission of auditory hallucinationsab
|118 ± 122
|180 ± 95
|Medication resistance of AVHsc
|7 (88)
|7 (88)
Data reported as mean ± standard deviation.
Remission defined as AVHs absent for at least 4 weeks.
Medication resistance defined as daily AVHs occurring in the face of at least 2 adequate trials of antipsychotic medications including at least one atypical antipsychotic medication. An adequate medication trial was defined as a minimum of at least 6 weeks at a dose of 1000 chorpromazine equivalents for standard neuroleptics (Davis 1976) and published recommendations of therapeutic dosing for atypical neuroleptics (minimum dose of risperidone 6 mg/day, olanzapine 15 mg/day, quetiapine 500 mg/day, clozapine 400 mg/day). Data in parentheses correspond to percent of sample.
This study was supported by a Dana Foundation grant (R.E.H.), a National Alliance for Research on Schizophrenia and Depression Independent Investigator Award, Peterson 50th Anniversary Research Partner (R.E.H.), National Institute of Mental Health grants R21MH63326 (R.E.H.), R01MH067073 (R.E.H.), KO2 AA 00261-01 (J.K.), the Department of Veterans Affairs Schizophrenia Biological Research Center (J.K.), National Institutes of Health/National Center for Research Resources/General Clinical Research Center Program grant RR00125, and the Department of Mental Health and Addiction Services of the State of Connecticut through its support of the Abraham Ribicoff Research Center at the Connecticut Mental Health Center. We also extend our thanks to the patients who participated in this study. Conflict of Interest: None declared.


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