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Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
Synonyms: amyotrophic lateral sclerosis (ALS), Lou Gehrig's disease (USA form - named for a famous baseball player who succumbed to the disease), Charcot's disease, Charcot's syndrome, Charcot's sclerosis
Motor neurone disease (MND) is a rare but devastating illness which leads to progressive paralysis and eventual death. Although rare, many patients are both aware and fearful of it.[1] It is therefore important in primary care to understand the presentation and to be able confidently to reassure worried patients who are unlikely to have a diagnosis of MND. A review of life-prolonging interventions, symptom-control and disease mechanisms is appropriate for non-specialists and outlined in this article.
Most cases of MND are due to ALS. However, other forms occasionally occur. These include:
- Progressive bulbar palsy - about 2 in 10 people with MND have this type. The muscles first affected are those used for talking, chewing and swallowing. See separate article Bulbar and Pseudobulbar Palsy for more details.
- Progressive muscular atrophy - this is an uncommon form of MND. The small muscles of the hands and feet are usually first affected, but muscle spasticity is absent.
- Primary lateral sclerosis - this is another rare type of MND. It mainly causes weakness in the leg muscles. Some patients with this type may also develop clumsiness in the hands or develop speech problems.
This is a degenerative condition that affects motor neurons, namely the anterior horn cells of the spinal cord and the motor cranial nuclei. It causes lower motor neurone (LMN) and upper motor neurone (UMN) dysfunction, leading to a mixed UMN/LMN picture of muscular paralysis, usually with LMN signs predominating. The cause of the disease is unknown, although 5% of those affected have a familial form of the disease due to a mutation in the superoxide dismutase-1 gene.[2, 3]
Current aetiological hypotheses focus on an abnormality of mitochondrial function causing oxidative stress in motor neurons. There may be several causes for such oxidative damage to motor neurons and the disease may just represent an end-stage phenotypic expression of these abnormalities.[4]
- MND is relatively uncommon with an annual incidence of about 2 cases per 100,000 population. Prevalence is about 5-7 per 100,000.[1] General practitioners can expect to see one or two cases in their career.[1]
- It can occur at any age but is more common in people aged over 50. The male to female ratio is 2:1.[3]
- About 5-10% of cases are inherited.[5]
- The mean age of onset is 43-52 years in familial and 58-63 years in sporadic cases of ALS.[6]
- Male sex, increasing age and hereditary disposition are the main risk factors.[6]
MND is mostly a sporadic disease of middle and elderly life presenting in the sixth and seventh decades. However, it can present in younger patients, usually with familial MND.
- The classic form of the disease is also called amyotrophic lateral sclerosis (ALS). It tends to be focal in onset, with a particular group of muscles affected first. This presents In three recognised patterns:
- Limb onset - by far the most common.
- Bulbar onset - 20% of cases.
- Respiratory onset - the least common.
- Presents with symptoms and signs of degeneration of the upper and lower motor neurons, leading to progressive weakness of the bulbar, limb, thoracic and abdominal muscles.
- Other brain functions, including oculomotor and sphincter function, are relatively spared, but may be involved in some patients.
- Cognitive dysfunction may occur and 5-15% of patients develop dementia, usually of frontotemporal type.
- The rarer variants of the disease can present in two ways:
- With pure UMN features (primary lateral sclerosis).
- With pure LMN features (progressive muscular atrophy).
Patients or their families often notice problems occurring in one or more of the patterns below:
- Limb weakness - usually affects the upper limbs:
- Causes patients to drop objects or have difficulty manipulating objects with one hand (turning keys, writing and opening bottles).
- Wrist drop, stiffness, weakness or cramping of the hands may also occur.
- Patients may also notice a change in the appearance of their hands (due to wasting of the intrinsic muscles).
- Fasciculations of the muscles of the limbs may be noticed prior to weakness developing.
- Foot drop (early).
- Gait disorder.
- A sensation of heaviness of one or both legs.
- A tendency to trip.
- Difficulty in rising from low chairs and climbing stairs.
- Excessive fatigue when walking.
- Bulbar onset:
- The first sign is usually slurring of the speech (impaired tongue movement).
- Wasting and fasciculation of the tongue.
- Dysphagia (usually a late feature with significant speech difficulties).
- Accompanying emotional lability (inappropriate laughing or crying) - as with pseudobulbar palsies.
- Other symptoms are difficulty eating, drooling, dysarthria, dysphonia, choking events with meals, nasal regurgitation of fluids or pulmonary aspiration.
- Respiratory onset can present with:
- Dyspnoea and orthopnoea.
- Clinical features resulting from hypoventilation overnight (for example, waking, unrefreshing sleep, hypersomnolence and early morning headaches).[1]
- Rarer features:
- Pain or sensory disturbance is not unknown but is not a common feature of the disease; it is usually the absence of pain or sensory disturbance that helps to distinguish MND from radiculopathies (nerve root pathology) that can cause a similar presentation in peripheral limbs.
- Symptoms due to impaired respiratory muscle function usually occur late in the disease but can occasionally be a presenting feature, causing 'air hunger'. Acute respiratory failure has been reported.[7]
- Some patients with pseudobulbar palsy may have 'emotional incontinence', an over-reaction to sad or funny events that they are aware of as being abnormal.
- Cognitive impairment is not a normal feature but can affect some patients with bulbar palsy.
- LMD dysfunction in the limbs manifests as weakness, atrophy, fasciculations and hyporeflexia. The thighs are often a site of marked fasciculation. Fasciculation can be difficult to distinguish from arterial pulsation, so consider if there is an underlying arterial course before defining twitching movements as fasciculation.
- UMN dysfunction manifests as weakness predominating in the arm extensors and leg flexors with evidence of hypertonia, hyper-reflexia and upgoing plantar responses; the bulbar muscles may also show spasticity with an exaggerated jaw jerk.
- Ocular, sensory or autonomic dysregulation signs are usually late features of the disease.
- Asymmetrical distal weakness frequently occurs.
- Brisk reflexes will occur in a wasted limb.
- There is an absence of major sensory symptoms and pain.
- There is a relentless progression of symptoms and signs.
Diagnostic criteria
This is of course a diagnosis which needs a great deal of careful consideration given the poor prognosis. Nevertheless, it is equally important to ensure that the diagnosis is not unduly delayed. One study found that the average time from suspected diagnosis to confirmation was one year. The authors called for greater educational input in primary and secondary care and a fast-track referral service.[8]
Diagnosis should be made after consideration of the clinical signs and symptoms together with investigations to exclude other causes. Important diagnoses which may cause confusion are listed in the box under 'Differential diagnosis', below.
Because of the very variable clinical presentation, the diagnostic criteria below have been devised, taking into account investigations to confirm the diagnosis and refute other possible causes (revised El Escorial Criteria):
- Presence of:
- Evidence of LMN degeneration by clinical, electrophysiological or neuropathological examination.
- Evidence of UMN degeneration by clinical examination.
- Progressive spread of symptoms or signs within a region or to other regions, as determined by history or examination.
- Together with the absence of:
- Electrophysiological and pathological evidence of other disease processes that might explain the signs of LMN and/or UMN degeneration.
- Neuroimaging evidence of other disease processes that might explain the observed clinical and electrophysiological signs.
The World Federation of Neurology (WFN) has proposed further revision in the light of advances in neurophysiological techniques which can accurately detect degenerative neurological changes. They recommend upgrading the neurophysiological findings and making them as significant as the clinical findings in the diagnosis of ALS.
Differential diagnosis
The differential diagnosis is vast, dependent on the mode of presentation, clinical findings and comorbidities. Diagnoses of particular importance have been singled out in the box below with features which distinguish them from MND.
- Benign cramp fasciculation syndrome:
- Fasciculation or cramps usually affecting large muscles (for example, calves).
- The fasciculation is more common after exercise or with lack of sleep.
- There is no wasting or weakness on examination.
- There is no progression over time.
- Cervical radiculomyelopathy (multilevel degenerative disease of the cervical spine):
- This can present with a mixture of LMN wasting and weakness and UMN brisk reflexes and spasticity signs.
- There is pain (localised to the neck or radicular) and sensory disturbance.
- There are no bulbar symptoms and signs.
- The absence of UMN signs above the LMN signs increases the possibility of this diagnosis.
- MRI scan of the cervical spine can confirm the diagnosis.
- Dual pathologies:
- A cervical myelopathy and a co-existent peripheral neuropathy can present as a mixed upper-lower motor neurone picture.
- Sensory signs and symptoms and absence of bulbar symptoms help to diagnose this.
- Neurophysiological assessment and imaging will confirm the diagnosis.
- Multifocal motor neuropathy with conduction block:
- Often presents in young or middle-aged men as unilateral distal upper limb weakness with little evidence of wasting initially.
- This is an important rare diagnosis to consider in differential diagnosis of MND.
- In the correct clinical context, it can be diagnosed or excluded only by careful neurophysiological evaluation looking for conduction block.
- It is treatable and has a markedly different prognosis than that for MND.
- Inclusion body myositis:
- An inflammatory myopathy which presents with distal weakness without sensory symptoms.
- Clinically long finger flexors are affected preferentially (unusual in MND).
- Electromyography (EMG) and occasionally muscle biopsy are needed to confirm the diagnosis.
- Inclusion body myositis has a more benign prognosis than MND.
The list below shows further conditions that may have similar clinical features:
- Diabetic amyotrophy.
- Guillain-Barré syndrome.
- Post-polio syndrome.
- Myasthenia gravis or Lambert-Eaton myasthenic syndrome.
- Peripheral nerve lesions, particularly due to diabetic neuropathy.
- Thyrotoxicosis with associated myopathy.
- Spinal cord tumours.
- Cerebrovascular disease and stroke.
- Polymyositis or dermatomyositis.
- Glioma of brainstem.
- HIV-associated neuropathy/myopathy/radiculopathy (as one of the complications of HIV).
- Lepto-meningeal disease - eg, due to carcinomatosis or vascular collagen disease.
- Lyme disease.
- Spinal muscular atrophy (Kennedy's syndrome).
- Hereditary polyneuropathies - eg, Charcot-Marie-Tooth syndrome.
- Focal muscular atrophies (monomelic amyotrophy).
- Post-radiation myeloplexopathy.
- Viral plexopathies.
- Tay-Sachs disease (adult form).
There are no specific investigations that will confirm a diagnosis of MND. A range of investigations is carried out to confirm consistent features and exclude other possible pathologies, usually under the direction of a neurologist. It may take several months to decide that the clinical presentation, progression and investigation findings are consistent with the diagnosis. This cautious approach is understandable, given the prognosis of the illness and the devastation that being given the diagnosis may cause to a person's life. The investigations below may be conducted during the course of making the diagnosis:
- Electrophysiological studies such as EMG and nerve-conduction studies (NCS) will show a characteristic pattern but require careful interpretation, along with a consideration of the clinical features. In MND, EMG shows fibrillation and fasciculations. The motor units are polyphasic and have high amplitude and long duration. NCS should show normal motor and sensory conduction in MND. More sophisticated techniques have prompted recommendations (Awaji-shima consensus recommendations for the application of electrophysiological tests, as applied to the revised El Escorial Criteria) that the electrophysiological findings should be given equal weight to the clinical findings in the diagnosis of the condition.[10]
- CT and/or MRI scanning of the brain and spinal cord are useful in excluding other pathologies with similar presentations. Neuro-imaging is not yet considered to be sufficiently sensitive to assess responses to treatment but the European Federation of Neurological Societies recommends that it should be incorporated into the evaluation of research trials.[11]
- Blood tests to exclude other conditions, such as vitamin B12 and folate levels, HIV serology, Lyme disease serology, creatine kinase assay, serum protein electrophoresis, anti-GM1 antibodies (multifocal motor neuropathy with conduction block), urinary hexosaminidase-A assay (Tay-Sachs) and a host of other more specialised tests for rare conditions.
- Muscle biopsy may be considered to exclude or to diagnose myopathic conditions.
Giving the diagnosis
Part of the management of MND is giving the diagnosis and explaining the condition in an appropriately sensitive and informative way. The following points have been made:[1]
- This is a difficult task and time; experience and expertise are needed.
- Follow the well-established good practice principles of breaking bad news.
- Impart information honestly but without destroying hope.
- Maintain a positive emphasis on what can be done to help.
Although specialists lead the diagnostic and monitoring process, GPs have a large part to play in the day-to-day management of the symptoms arising from the condition and the side-effects of medication.[13]
MND is an incurable condition that usually, although not always, leads to death within a few years, with a period of distressing disability preceding it. Thus, the mainstay of management is in supporting the patient, their family and carers through this process and in delivering palliative care at the appropriate juncture. The following measures are helpful in prolonging the survival of those with MND and in helping them to maintain a sense of health, well-being and control over their lives:
- A multidisciplinary approach involving GPs, primary care nurses, occupational therapists, physiotherapists, speech therapists, dieticians, respite care providers, home care workers, hospital physicians and neurologists, along with many others, is likely to best serve the patient, and effective communication between all the interested parties is essential.
- GPs are particularly well placed in ensuring that patients and their carers know where to get information about any social or financial support that may be required.[14]
- Regular physical, occupational and speech therapy to maintain strength and utility of the affected motor functions and allow use of aids designed to overcome specific disability problems.
- Dietetic support to allow adequate hydration and nutrition whilst the patient is able to feed independently, or with the aid of carers.
- Insertion of a gastrostomy tube should be considered when the patient is no longer able to feed by mouth. Current practice is to offer the option of enteral feeding to patients, either through percutaneous endoscopic gastrostomy (PEG), percutaneous radiological insertion of gastrostomy, or nasogastric tube (with 10% weight lost or a body mass index below 18.5).[1]
- Communication can be greatly enhanced by the use of picture-boards or more advanced IT-based solutions tailored to the individual patient's needs and disabilities.
- When respiratory function is impaired, physiotherapy helps to clear pulmonary secretions and maintain respiratory health.
- Positive pressure ventilation may be used in patients who are no longer able to maintain adequate ventilation. This has been shown to improve quality of life and survival greatly.[1] The machines are small and portable and various face masks are available . Patients quickly get used to wearing the masks overnight. In later stages some patients may use non-invasive ventilation (NIV) during the day, using a small nasal mask.
The greatest advance in treating MND has been the discovery of the beneficial effects of NIV, in which the patient uses a mask ventilator system (usually bilateral positive airway pressure) overnight during sleep.[1]National Institute for Health and Care Excellence (NICE) guidelines recommend:[15]
- Discussion about NIV at the time of diagnosis and at appropriate opportunities thereafter.
- The patient should be assessed for the symptoms and signs of respiratory impairment at three-monthly intervals.
- Patients who meet the NICE criteria for treatment of their respiratory impairment should be offered NIV. However, if the patient suffers from severe bulbar impairment or severe cognitive problems related to their respiratory impairment, NIV should only be offered if the patient has sleep-related symptoms or hypoventilation.
- If commenced, acclimatisation should occur during the day.
- Regular treatment should be given at night, before and during sleep.
- Hours of use should be built up as necessary.
- In patients with cognitive impairment, issues of capacity and consent may need to be considered.
Drug treatments
- Riluzole (a neuroprotective glutamate-release inhibitor) is the only drug of proven disease-modifying efficacy.[16]
- Its effects are modest, probably only prolonging lifespan by between two and four months.
- It may have a more significant effect on prolonging tracheostomy-free survival.[17]
- It appears to be well tolerated and of greater benefit the earlier it is started in the course of the disease.[18]
- It has been shown to act by blocking muscle acetylcholine receptors.[19]
- It was hoped that antioxidants might prove beneficial. However, a recent Cochrane review concluded that the use of antioxidants was not supported by currently available clinical trial data.[20]
- Other medications may be used to treat symptoms of the disease; for example:
- Drooling may be reduced by the use of anticholinergics such as hyoscine.[21]
- Muscle cramps and spasticity can be treated with agents such as diazepam, baclofen, tizanidine, phenytoin and quinine.
- Respiratory distress and the sensation of choking may respond to opioid medications but this must be balanced against their tendency to cause respiratory suppression; they are very useful to treat this symptom in the palliative phase.
- Depression associated with MND may respond to the use of antidepressant medications.
- Pain often goes under-recognised and undertreated. It is thought to be due to spasticity but other mechanisms may be operant. The antispasmodic agents listed above are usually helpful but non-steroidal anti-inflammatory drugs and opioids, such as oral morphine, subcutaneous diamorphine and fentanyl patches, are also utilised, particularly in the palliative phase.[22]
End of life care
Inevitably, the disease will progress and both patients and carers may wish to discuss the terminal phase of the illness. Careful discussion about this at a pace determined by the patient, family and carers helps to shape what form care will take. Issues which frequently come up include:
- Hospice care - this may be useful in the later stages of the disease for respite.
- Advance directives - information on these can be given and this can help implementation of patients' wishes.
- Management of symptoms - for example:
- Respiratory distress - this can be treated with opiates.
- Choking - lorazepam sublingually can quickly relieve choking episodes.
- Dyspnoea - if severe and prolonged, is an indication for subcutaneous morphine.
- Respiratory failure and death.
- Pneumonia due to infection or aspiration.
- Urinary tract infections.
- Constipation.
- Spasticity and cramping of muscles.
- Depression
- Loss of speech as a means of communication.
- Immobility and attendant disability.
- Complications of immobility such as skin infections/bedsores and ulcers.
- Cognitive deterioration is rare but is seen occasionally.
- MND is usually a rapidly progressive and fatal disease but the rate of progression is variable.[23]
- Median survival is two to four years.[24]
- End of life care with all that this implies needs a co-ordinated sensitive approach. More than 90% of patients die in their sleep, as a result of increasing hypercapnia (respiratory failure with or without pneumonia) and choking to death is not seen in clinical practice.[1]
- There appears to be a small subgroup of patients (5-10%) surviving for a decade or more.[6]
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BLOOMINGBURG — Firefighters are at the scene of a reported structure fire at 40 Ivy Lane that has gone to second alarm.
Several nearby fire departments have either been called to the scene or to cover Bloomingburg's fire house.
The fire is in a private home; Ivy Lane is off of Winterton Road, a little south of the village center.
UPDATE: As of 11:52 a.m., the main body of the fire has been knocked down.
Fire reported in Bloomingburg
Mar 18, 2013 at 11:40 AM
Mar 18, 2013 at 11:59 AM

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A classic jumper with that cozy feel we all know and love, 'V'Silicon' is a winner. Ribbed and rounded neck, cuffs and hem keep the warmth in. Cut with extra long arms. Large and bold lettering features across the chest and shoulders. Crafted with a stretchy fabric mix.
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Soaring crude prices have boosted French oil firm Total's third-quarter profits despite a weak dollar.
France's largest company by market value said today that its net profit was 3.3 billion euro (£2.9 billion) in the third quarter, up 17% from the same period last year.
Unrest in Libya, which produces the high-quality crude favoured by European refineries, has sent Brent crude prices up sharply this year.
The company noted that, compared to the third quarter in 2010, Brent prices were nearly 50% higher.
The company said its closely watched adjusted income was $4 billion (£3.5 billion), up 24%.
- More about:
- Arab Countries
- Energy
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- Libya
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This page requires a MaxPreps membership account. Don't stress... It's free and easy to setup.
The Hillsboro Spartans football team lost Friday's neutral playoff game against Jesuit by a score of 28-19.
Game Details: Hare Field
This game is a part of the "2010 Oregon High School Football Playoff Bracket - 6A" tournament.
The crowd at Friday's non-league contest between the Jesuit Crusaders (Portland, OR) and the visiting Hillsboro Spartans (Hillsboro, OR), observed Jesuit's football squad edge Hillsboro by a count of 28-25.
The Crusaders now own a 11-1 record. They play next when they travel to Tualatin for a non-league contest on Friday, December 3. Jesuit will encounter a Timberwolves squad coming off a 24-14 non-league win over South Salem (Salem, OR). The Timberwolves record now stands at 12-0.
Coming up next, the Spartans encounter the West Salem Titans (Salem, OR) in a non-league contest, on Saturday, December 4. Hillsboro will attempt to upgrade on its 8-4 season record.


text: "We wish to thank Cohen & Steers for their dedicated service to Large Cap Value Fund shareholders," said Harbor Funds Chairman David G. Van Hooser. Howard Gleicher, CFA, Chief Executive Officer and Chief Investment Officer of Aristotle, will be the portfolio manager for the Harbor Large Cap Value Fund. Mr. Gleicher has 27 years of investment experience and has led the investment effort of Aristotle since 2010. Prior to founding Aristotle, Mr. Gleicher was co-founder, Chief Executive Officer and Chief Investment Officer at Metropolitan West Capital Management, LLC from 1997 to 2010. Aristotle is an investment adviser specializing in large cap value stocks. The firm is headquartered in Los Angeles and manages approximately $1.9 billion in assets. Harbor Large Cap Value Fund has an investment goal of long-term total return by investing in equity securities, principally common and preferred stocks, of companies with market capitalizations that fall within the range of the Russell 1000® Value Index. The Fund had net assets of approximately $300 million as of April 30, 2012. Aristotle uses a fundamental, bottom-up, research-driven approach to identify companies for investment. Aristotle focuses on companies that it believes have higher quality businesses and that are undervalued by the market relative to what Aristotle believes to be their fair value. Aristotle also looks for one or more catalysts that may help the company realize that fair value. Under normal market conditions, Aristotle expects to invest in approximately 35 to 45 companies. Stocks fluctuate in price and the value of an investment in the Harbor Large Cap Value Fund may go down. Over time, a value-oriented investing style may go in and out of favor, which may cause the Fund to sometimes underperform equity funds that use different investing styles. The Harbor Funds lineup of actively managed, no-load mutual funds had combined net assets of $66 billion as of April 30, 2012. Each Harbor fund is managed by an institutional investment firm selected by Harbor Capital Advisors, Inc. based on the firm's experience in a specific asset class.


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Most readers of the Perimeter STAR Team blog probably know where I stand on mobile security issues. I believe that mobile malware, other than on the Android platform, is a tempest in a teapot stirred up by anti-virus vendors scaring up new markets. I believe that modern mobile operating systems are, as a species, much more secure than their PC counterparts due to platform features such as sandboxing, trusted boot and code signing. I believe that vendor-managed App Stores, as constraining as they are in many ways to developer freedom, offer the prospect of significantly increasing customer security.
And most significantly, I believe that data privacy is the third rail of mobile. Exhibit #2,080 was furnished today by Path, a social networking service that connects friends and family. Path offers both web-based and native clients, and is the arguably the fastest-growing social network out there, mushrooming to 2 million users in just over a year of operation.
Read my full thoughts on this topic here: http://blog.perimeterusa.com/2302/
I'd love to know what you think!
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Finnex 4 Gallon Review by David Lass
Thank you to Aquarium Fish Magazine and David Lass for the wonderful write up:
http://i39.tinypic.com/15dxxk0.jpg |
Where does one purchase this tank these days? I can't seem to find it anywhere and it's highly recommended.
Hey there. I apologize but its been hard to keep them in stock lately. Next shipment of aquariums is scheduled a few months from now.
Have the Finnex 4 gallon tanks been discontinued?
Any updates Lowe? |
I'm sorry for the delays but there are current issues with out tank shipments at the moment.
Any update on these tanks being available again?
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When the running gods giveth, the running gods taketh away
As I'm coming up on my 5th year seriously running, I've learned quite a few things. Some from fancy RRCA certified coaching books and others from pounding the pavement. Things like: People riding bikes will rarely waive at you, I scare the crap out of dog walkers when it is 5:00am and I'm huffing and puffing like the Victoria's Secret fashion show is on, and if there is even a VERY small chance that I have to "go" pre-run - I wait it out. One of the things that is only recently becoming clear is that very often, good runs and bad runs come in pairs.
This was never more apparent during this weekend's run and today's run. (Both with my new Garmin 910! I believe the 'kids' say "Squeeeee". Or wait is it "squeeege"? Probably squeege.) On Sunday, the Garmin had a bit of an issue with instant pace so I ran the run a bit fast. 18 miles in 2h 14min (7:26 pace) fast. It was completely effortless. One of those days that you grabbed the unicorn horn and rode him all the way home. However, this morning I realized I wrote a check that my
But, on Sunday I knew that when I saw the 10th or 12th 7:20 mile click by on my watch, I was in for a hurt on Monday. Live and learn.
In fact, while the yin and yang of my two training runs above is pretty expected, I've actually found that it is also the case for my marathons. Regardless if I am cranking away for a PR or just easy running a race, it seems that good and bad races come in pairs. Surprisingly, it isn't always the first one. Check the trend below. Up/down/up/down. Good/bad/good/bad.
Does anyone else suffer from a kick-ass good run hangover the next day? Push just a bit too hard and feel crappy on the next one?
Bonus! Mystery surprise on my foot
Since I know people love these...... while I was running this morning, I felt a bit of a pinch and poke** on my foot. I knew the feeling - something was digging into the side of my toe. Turns out, it was my other toenail!
**That's what she said


text:
Comprehensive databases for nanomaterials, events, products,
companies, research labs, degree programs and publications
Your program will include three semesters at CVTC, where you'll have a rare opportunity to work with state-of-the-art equipment in specially designed facilities, such as the atomic force and scanning electron microscopes and Class 100 cleanroom. Your fourth semester will be a capstone experience at CVTC and another area institution. You'll also complete an internship to gain workplace experience.
Address: | 620 W Clairemont Ave |
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text:
Technologies that can help make accurate, objective and automated decisions to aid the pathologist are sorely needed in clinical practice to improve accuracy and contain costs. The major goal of this project is to provide a practical imaging instrument for clinical and research use that can be operated by any trained person in pathology laboratories. The approach is based, first, on developing novel instrumentation and analytical methods for robust discrete frequency infrared (DF-IR) spectroscopic imaging. The instrument presents a departure from the current state of the art. Second, the approach is made practical by enabling the incorporation of uncooled detectors via advanced control algorithms. Last, the developed instrument is tested in a clinical setting and results that will lead to clinical trials will be obtained. If the project is successful, it has the potential to transform decision-making for patients and alter the standard practice of histologic assessment in research. We specifically target two areas: the rapid detection of important biopsy slides in prostate cancer (those that are diagnostically valid and contain cancer) and rapid detection of cancer in breast tissues. Both are accomplished without any dyes, stains or human supervision.
The first goal of this project is to provide a new chemical imaging instrument for clinical and research use that can be operated by any trained person in pathology laboratories. The project has the potential to transform diagnosis and therapy decisions for patients by enabling early decisions and accurate diagnoses without dyes, stains or human input. Proposing to develop the processes for breast and prostate cancer, the technology could impact over 2 million people screened positive for cancer every year. If successful, establishment of the instrumentation and analytical methods here would alter the standard practice in histologic assessment of future research in cancer.
Mayerich, David; van Dijk, Thomas; Walsh, Michael J et al. (2014) On the importance of image formation optics in the design of infrared spectroscopic imaging systems. Analyst 139:4031-6 |
Baker, Matthew J; Trevisan, Júlio; Bassan, Paul et al. (2014) Using Fourier transform IR spectroscopy to analyze biological materials. Nat Protoc 9:1771-91 |
Holton, Sarah E; Bergamaschi, Anna; Katzenellenbogen, Benita S et al. (2014) Integration of molecular profiling and chemical imaging to elucidate fibroblast-microenvironment impact on cancer cell phenotype and endocrine resistance in breast cancer. PLoS One 9:e96878 |
van Dijk, Thomas; Mayerich, David; Bhargava, Rohit et al. (2013) Rapid spectral-domain localization. Opt Express 21:12822-30 |
Reddy, Rohith K; Walsh, Michael J; Schulmerich, Matthew V et al. (2013) High-definition infrared spectroscopic imaging. Appl Spectrosc 67:93-105 |
Kodali, Anil K; Schulmerich, Matthew; Ip, Jason et al. (2010) Narrowband midinfrared reflectance filters using guided mode resonance. Anal Chem 82:5697-706 |


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Can any of you link a site that sells AK ammo in bulk at good prices? Someone responded in another thread I started a while back that I shouldn't pay more than $200 for a case of 1000 rounds shipped. I can't find a deal like that anywhere though!
the-armory.com. I got a 1260 round case of 7.62 delivered for $240 about 3 months ago. prices have gone up some since then. Ordered it on sunday and it was on the front porch tuesday afternoon.
"Where can I find good deals on AK ammo?" You'll need a time machine. Go back to '94, '95, '96. I used to think that $79.00 per thousand was expensive.
Cope's has Uly for $110/500 rds. plus $8 flat rate shipping. Comes out to be about $228/1k shipped. Not too bad, not for right now anyway.
I remember over the last few weeks seeing cases for $209 + shipping, I think that's the best you are going to do.
In the chart in the post above me there's two Yugo M67 ammos listed; "Yugo M 67 Surplus" and "Yugo M67". Is there a difference, or is it all surplus (and corrosive)? I've been told that I should get some of this ammo, but I'm not sure why it was recommended. Can someone tell me a little bit about it?
It's the same and all the Yugo M67 is "surplus". It's compiled from different sources, so the descriptions aren't 100% consistent. Yes, M67 is corrosive, but still very good ammo. The only bad thing about it is that it's corrosive. Personally, I'd just spend the 1 cent/round more and get the Brown Bear. I shoot corrosive 5.45x39 and 7.62x54R, but that's because the non-corrosive options are much more expensive. 7.62x39--they're pretty neck and neck.
When you say the M67 is good ammo, what do you factor into your decision? How is it when compared to the Brown Bear?
I've personally never shot any, but heard a lot about it on various forums. It's consistent, accurate, and deadly (nasty wound channel). Again, I'm not an ammo expert, I'd think if you were shooting paper and not people/animals, the difference is negligible. Also, if your range tests with a magnet, the Yugo ammo would pass the test.
It wasn't that long ago. Back in the '04-'05 time frame I bought 6,000 rounds of Wolf from SG for $66/1,000 delivered. Still have the unopened cases in my gun room. I wish I had bought a trailer truck load. It's worth more than any other "investment" I have ever made. When I bought my first AK back in the early 90's I bought 1440 round cases of Chinese for $99 per case.
I ordered 1000 rounds of Brown Bear yesterday for $205 before shipping... it was 30 bucks to ship it though, holy crap! The total was $236 or something. That's way too much money...


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CLAM CHOWDER (New England Style)
There are hundreds of recipes for New England Clam Chowder. I was born and raised in Philadelphia, where there are wonderful New England style restaurants....
potato, yellow onions, +bacon, +bay leaves, +celery, +parsley, +black pepper, +thyme, +garlic, +heavy cream, +salt, +green onion, +butter
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Brian's New England Clam Chowder
This is an mix of several other recipes that I took and made my own. I now live in Idaho so I have to use canned clams.Requested often by my finicky teenage...
potato, yellow onions, +bacon, +bay leaves, +butter, +clams, +celery, +chicken broth, +tomato, +clam juice, +corn, +garlic, +heavy cream, +thyme
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Linda's New England Clam Chowder
This is delicious on a cold winter or fall day! If thickened, this is great in a bread bowl. I love mine with oyster crackers on top, and a BIG dill or...
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New England Clam Chowder Recipe
The subtle flavor of a real clam chowder cannot be surpassed by any other clam soup. Fresh clams are used in this recipe but canned one can be substitued....
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Easy New England Clam Chowder
I got this recipe from the bottle of clam juice. My family loves it.
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Simply New England Clam Chowder Recipe
I tried many clam chowder recipes I've found, then created this one myself after all the others failed. My daughter and I love it. Prep:5m
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Easy New England Clam Chowder
This recipe was passed down to me from a family friend. My husband doesn't normally like New England Clam Chowder - this is the only version he will eat.
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New England Clam Chowder Recipe
The infamous, homemade New England Clam Chowder. So hearty and filling it can be a meal in itself. Prep:20m
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Since launching this project eight months ago, we've received 100 donations from our online community that has allowed us to conserve 926 acres of Eastern Arc rainforest (funds raised total nearly $7,500). Thank you!!!
We are excited to let you know that Wednesday, March 16th is Bonus Day at GlobalGiving! All online donations will be matched at 30%, which means a gift of $20 will become $26, allowing ARC to conserve an additional 3 acres of rainforest for one year. Will you make a gift to help us reach our project goal of $10,000? We are almost there (thanks to supporters like you) and so excited to reach it. We have several new community-driven projects in the works and look forward to sharing them with you here on GlobalGiving.
We are currently working with our field partner - The Tanzania Forest Conservation Group - to upgrade the metrics we use for monitoring and evaluation of our conservation and community development programs, as well as bring you first-hand success stories and photos from the field (not always the easiest task when many of the places we work do not have electricity, let alone the Internet!). We see and hear about the impact of our work all the time, but understand that Tanzania is faraway for most of you and it is hard to fully understand how your dollars translate into real conservation. With a little creativity and careful thought we will be changing this. Stay tuned!
In February, ARC celebrated its 20th anniversary with the annual Artists for Africa benefit. If you weren't able to join us, you can read more about it here. If you live in the NYC area, please be on the lookout for upcoming spring and summer events that will highlight the work of the African Rainforest Conservancy. We are so excited to celebrate this special 20th anniversary year with you!
Project Reports on GlobalGiving are posted directly to globalgiving.org by Project Leaders as they are completed, generally every 3-4 months. To protect the integrity of these documents, GlobalGiving does not alter them; therefore you may find some language or formatting issues.
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text: (2) Born Garnett, Kan., Aug. 23, 1869. Educated at Knox College, Ill. He studied law in his father's office and was admitted to the bar in 1891. Married Helen M. Jenkins, of Chicago, in 1898. Mr. Masters wrote several volumes of verse and several poetic dramas, which are now out of print, before he found himself in the "Spoon River Anthology", published first in `Reedy's Mirror' and in book form in 1915. This volume, written in free verse and containing about two hundred brief sketches, or posthumous confessions, shows Mr. Masters to be a psychologist of the keenest penetration, a satirist and humorist, laying bare unsparingly the springs of human weakness, but seeing with an equal insight humanity's finer side. "Spoon River Anthology", which had perhaps a wider recognition than that of any volume of verse of the period, was followed by "Songs and Satires", 1916; "The Great Valley", 1916; "Toward the Gulf", 1917; and "Starved Rock", 1920. |


text:
(5 quotes found)
"We were underrated the whole year, and we totally proved everyone wrong. Everyone played their hardest, and we all came together as a team. We couldn't have done it without every single one of us. All 11 of us, and all the coaches, too."
Danae Danen
"It is a great feeling to know that we are going to state again."
"I'm feeling great. It's a fun experience."
"It's not just the five players on the court, it's all 11 players."
"Their defense was just as good as ours. We both played physical. It was a very physical game and our guards really stepped it up."


text:
LISTEN4EVER NOT 4EVER: The four ISPs who'd refused to buckle to the RIAA's demands that they block their customers access to the controv China-based Listen4ever.com site aren't to be dragged to court after all, since the music-download site has disappeared. The main point of this, of course, is that the test case to see if ISPs can be forced to police client's use of the web that would have happened is delayed for another time. We can breathe a little easier for a while longer.
Suits you, sir [San Jose Mercury-News] - first, apparently, with the news...
Thursday, August 22, 2002
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text:
Curried Leek Soup
"New England is known for its hearty soups. I like to experiment with recipes (luckily I have a wife who lets me mess up her kitchen). I came up with this...
curry powder, +butter, +carrot, +celery, +chicken bouillon granule, +garlic, +leek, +black pepper, +water
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Curried Cabbage Soup
I created this soup for a very dear vegetarian friend (although it can be easily made non-vegetarian if you prefer), and it quickly became one of his most...
curry powder, +brown sugar, +butter, +cabbage, +sugar, +lemon, +onions, +raisins, +rice, +salt, +tomato sauce, +vegetable oil, +breakfast sausage, +water
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Brussel Sprouts Soup Recipe
This dish will be a family favorite! Add some fruit for dessert and you have a healthy meal! Prep:15m
curry powder, +potato, +heavy cream, +chicken broth, +egg yolks, +brussels sprout, +butter, +salt, +black pepper
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Cream of Spiced Butternut Pumpkin Soup
This soup is simply beautiful. I have prepared this soup many times and is always a hit!. Some people dont eat pumpkin for some reason, well if you try...
curry powder, +bay leaf, +butter, +chicken broth, +cream, +garlic, +milk, +nutmeg, +onions, +pumpkin puree, +sugar
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Easy Shortcut Avocado Soup
From the Junior League cookbook, RSVP from Portland, ME. This was submitted by Susan Haynes. It uses canned vichyssoise as a base and you just 3 other...
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text:
The best TV dogs: Our favorites
They don't always get top billing, but it's the four-legged stars who often steal the show.
(Credit: CBS / Ron P. Jaffe)Not since Eddie on "Frasier" has a dog stolen as many scenes as Jim, a Brussels griffon, does on CBS' "Mike & Molly."
(Credit: NBC)Played by Moose the Jack Russell terrier, super-smart Eddie was a great foil to the uptight title character, played by Kelsey Grammer, on the long-running NBC sitcom "Frasier."
(Credit: Disney Channel / Tony Rivetti)As voiced by actor-comedian Stephen Full, Stan, the star of "Dog with a Blog," is hilariously deadpan and, often, quite wise as he guides those humans who can hear him talk (the kids) in the sitcom that debuted in 2012.
(Credit: CMT)Sheriff Roscoe P. Coltrane was rarely without trusty companion Flash the basset hound on CBS' "The Dukes of Hazzard."
(Credit: Handout)Lassie the majestic, and so very helpful, collie has popped up in a variety of media, including books and film, but it was the popular dramatic TV show on CBS, from 1954 to the early 1970s, that made the pooch a household name.
(Credit: Big Feats Entertainment)Wishbone, PBS' literature-loving Jack Russell terrier, imagined himself as a number of characters from famous stories. He embodied Ichabod Crane for "Halloween Hound: The Legend of the Creepy Collars," based on Washington Irving's "The Legend of Sleepy Hollow."
(Credit: NBC / Michael Tighe)NBC's 1900s sitcom, "Mad About You," centered around upwardly mobile New York-based couple Paul (Paul Reiser, center) and Jamie (Helen Hunt, second from left) and their lovable collie mix Murray (Maui).
Related Media
Which dog breed are you? The 13 most influential pop culture animals of 2014 Presidential petsComments
Newsday.com now uses Facebook for our comment boards. Please read our guidelines and connect your Facebook account to comment.


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Hotel Candlewood Suites
- Terms and facilities
- Location
- Opinions
Show on the map
With a stay at Candlewood Suites Minneapolis-Richfield in Richfield (Bloomington - Mall of America), you'll be close to Best Buy Corporate Headquarters and Mall of America. This hotel is within close proximity of Water Park of America and Nickelodeon Universe. Take advantage of recreation opportunities such as a 24-hour fitness center, or other amenities including complimentary wireless Internet access and barbecue grills. Featured amenities include a 24-hour business center, a computer station, and dry cleaning/laundry services. Free self parking is available onsite. Make yourself at home in one of the 134 air-conditioned rooms featuring kitchens with full-sized refrigerators/freezers and stovetops. Wired and wireless Internet access is complimentary, while 37-inch flat-screen televisions with satellite programming provide entertainment. Conveniences include desks and complimentary newspapers, as well as phones with free local calls.
Services and terms: Hotel Candlewood Suites
Accommodation facilities
- Business Centre
- Laundry
- People with reduced mobility access
- Non-smoker Rooms
- Parking
- Shops
Standard Room Services
- Coffee & Tea Making Facilities
- Satellite TV
- Hairdryer
Leisure facilities
- Disco
- Tennis
Location: Hotel Candlewood Suites
The preferred airport for Candlewood Suites Minneapolis-Richfield is Minneapolis, MN (MSP-Minneapolis - St. Paul Intl.) - 6.1 km / 3.8 mi. Distances are calculated in a straight line from the property's location to the point of interest or airport and may not reflect actual travel distance. Distances are displayed to the nearest 0.1 mile and kilometre.
Reviews: Hotel Candlewood Suites
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Permanant Article writer Need- Both writing and re-writing
This project was successfully completed by Saif75 for $30 USD in 6 days.
Get free quotes for a project like thisProject Budget
$30 - $250 USDCompleted In
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5Project Description
I need good article writer for my projects. Articles are categorized as below:
> Article re-writing - [url removed, login to view]$/article (500 words)
>Article write for given keywords (SEO Articles) - 1$(500 words)
Don not bid if you are not agree with the above budget. Also please quote for 100 normal articles.
For re-writing works I will provide the content.
For normal writing works you need to find out the content relevant to keywords and make article.
No spun articles allowed, get the idea of the content and re-write them. Should be 100% copy escape pass. need good grammar.
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text:
The leading cause of adult disability in the US, stroke has an annual incidence of 780,000 with over 5.8 million stroke survivors. Most stroke survivors have some degree of spontaneous recovery, typically occurring in the first weeks to months after stroke;however this recovery is highly variable and in many cases incomplete. Much of our understanding of recovery mechanisms has focused on local cellular and molecular mechanisms involved in brain remodeling. More recent work has examined recovery after stroke at the network level- examining distributed patterns of synchronized neural activity throughout the brain during rest-and has revealed that global patterns of functional network connectivity are altered after focal stroke. Moreover, shortly after ischemic stroke, disrupted interhemispheric homotopic functional connectivity (fc), in particular, predicted poor performance. In a rat focal ischemia model, homotopic fc was found to recover in parallel with behavioral improvement. There is substantial indirect evidence that homotopic interhemispheric fc may be important to recovery, and has given rise to the concept of "interhemispheric competition". This hypothesis holds that an equilibrium between excitation and inhibition across hemispheres may be important for normal unilateral function (e.g. unilateral hand movement). If this interhemispheric balance is disrupted (for example by stroke), local ipsilesional inhibitory influences may exacerbate deficits, worsening functional impairment. This concept has served well to explain the potential efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) to restore interhemispheric balance and improve sensorimotor function. However, there are conflicting reports in humans and animal models regarding the impact of contralateral homotopic influence on functional recovery. In this grant, we will test the hypothesis that interhemispheric connectivity directly influences brain plasticity and behavioral recovery after focal ischemia. To visualize fc, we will take advantage of a novel imaging modality, fcOIS (functional connectivity optical intrinsic signal imaging) developed by Dr. Culver (Co-PI), which for the first time permits fc imaging in mice. We will manipulate interhemispheric connectivity using optogenetic excitation/inhibition and the I/LnJ strain of acallosal mice, to examine their effects on cortical plasticity (brain remapping) and behavioral recovery, in the following aims: 1. To determine the relationship between fc, cortical remapping, and behavioral recovery following focal ischemia in mice. 2. To determine the influence of transcallosal interhemispheric connectivity on cortical remapping and behavioral recovery following focal ischemia. 3. To determine the effect of homotopic nodal excitation/inhibition on somatosensory cortical remapping following focal ischemia. 4. To determine if chronic physiological stimulation/deprivation using vibrissal manipulation alters cortical remapping and interhemispheric fc.
The leading cause of adult disability in the US, stroke has an annual incidence of 780,000 with over 5.8 million stroke survivors. Most stroke survivors have some degree of spontaneous recovery, typically occurring in the first weeks to months after stroke;however this recovery is highly variable and in many cases incomplete. Understanding how brain networks can influence recovery may be important for the development of therapies that enhance brain plasticity. This R01 grant proposes to study the role of functional connectivity within these brain networks in brain plasticity and recovery after ischemic stroke.
Bauer, Adam Q; Kraft, Andrew W; Wright, Patrick W et al. (2014) Optical imaging of disrupted functional connectivity following ischemic stroke in mice. Neuroimage 99:388-401 |


text:
This Spring: New LP, EP, Single, and Retrospective
Genres: Punk / Rock / Alternative
Location: Milwaukee, WI
Stats: 2 fans / 122 plays / 0 plays today
Members: Josh-vocals, guitar Kyle - Bass, Vocals
UPCOMING SHOWS: 2011 shows to come this spring... Billy Dreamer now on Twitter! twitter.com/billydreamer
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view all 7 albums
view all 2 fans
view all 70 friends


text:
I was surprised to see an e-mail from Reed Hastings ("Co-Founder and CEO of Netflix") in one of my inboxes today. For a split-second I thought that Mr. Hastings was about to apologize for calling DVDs-by-mail "Old Fogey discs." But no. His e-mail announces that Netflix's DVDs-by-mail service is now known as Qwikster. And he isn't apologizing for that either.
I suspect that our household will eventually shift to streaming. But we like making lists of films to watch, and we like getting DVDs. (As Elaine points out, they add interest to the mail.) And not everything at Netflix is available on-demand. For now, we are sticking with Qwikster. [Insert grimace here.]
Monday, September 19, 2011
comments: 1
- Elaine said...
I got that e-mail, too! Backing and filling; too little, too late; and excuses, excuses--all came to mind. I felt like Netflix had just gotten greedy and switched to streaming only for now. Most of the time I am using this only while trudging along on the treadmill, so...
I just hate being manipulated and fleeced! - September 20, 2011 3:17 AM


text:
pillow tongue
what a pillock
5:50pm Christmas Eve
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I think this program is really good he cooks food that all of us do and hes like the boy next door. Thank god he does not do that ponsey rubbish.
1:42pm Thu 17 Dec
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Who shot this
It got terible production, looks like jamie got his family too shoot it aswell, he keeping the 30k per episode to him self. wow
8:13pm Tue 15 Dec
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I am so looking forward to tonight's show. I love you Jamie!!!
5:11pm Tue 15 Dec
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Oh Dear
For how much longer do we have to put up with this cook, and now hes got his whole family in on the act.
Gordon Brown
12:21pm Tue 15 Dec
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text: Originally Posted by kumquat Eduard Manet, 1882 Diptyque-Jardin Clos Backwards in time, I dream of spring again. Cool breaths of watermelon tease lilacs out to play. The wind moves gently as the robins feed on juicy bugs. There is little time before the snow, yet the glorious sweetness lingers. Notes: hyacinth, white lilac, watermelon, musk, cedar, moss


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An elderly Swiss couple looking for kicks have been arrested for stealing from church collection boxes and taking off with hundreds of Swiss francs.
The couple, aged 70 and 73, admitted to stealing money from local churches in the Swiss canton of Lucerne, prosecutors said in a statement. Local media reported the husband kept watch outside while his wife emptied the boxes.
The pair began their crime spree last November seeking "the pleasure of the forbidden" and a desire for "adrenaline", according to authorities. They had no previous criminal convictions and no financial problems.
Switzerland was ranked the world's third happiest country in the United Nation's 2013 World Happiness Report.
The investigation continues.
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text:
I'm entranced by Ani DiFranco, the independent-minded "righteous babe" with her quirky guitar style and vocals that swerve from sultry to surly to sulking instantly.
Her latest album, "educated guess," is a departure from recent efforts. DiFranco stripped away the layers of musicians and production that marked her last album, "Evolve," along with much of the jazz influence. gone are the saxophones, clarinets and miscellaneous instruments that seemed to overpower "Evolve."
She recorded "educated guess" alone with an analog reel-to-reel – backing vocals, bass guitar, everything.
It's a stark contrast, which explains part of the reasoning behind the title, and the title song:
so school is in session
get your chin off your desk
now pick up your pencil
and turn over your test
use your education
and take an educated guess
about me
Trying to figure out difranco's musical genius based on any period in her decade-long career is just such an "educated guess."
But there is no guessing about the two pillars of DiFranco's genius. Both are on display on "Educated Guess."
Ani's guitar work is as sharp as ever. In fact, the bare, acoustic focus of this album serves as a reminder from whence the legend of this Buffalo native folky arose.
But it is always the lyrics that mark a DiFranco album. There's a mixture of politics, personal matters, and poetry in a DiFranco effort that makes a wordsmith tingle with excitement. "Educated Guess" is no different.
Get this gem from the title track:
i've got a slot at eye level like
a speakeasy door
and i know you know the passwordcuz i've seen you here before
and i've got something sweet for you
and i don't care if it is more than you deserve
i've got a lot of love and a lot of nerve
so watch me while i take this curve
Interestingly, on the album, it sounds a lot like she says "I've got a slot at *heart* level like a speakeasy door." Which makes a lot more sense, and might be a small glimpse into the heart of the rewriting process that goes on in crafting a near-perfect bit of poetic verse.
or this, from "Origami:"
i know men are delicate
origami creatures
who need women to unfold them
hold them when they cry
but i am tired of being your savior
and i am tired of telling you why
There's also some spoken-word poetry for those who aren't down with the free-stylin' folkiness: "Platform," "The True Story of What Was," and "Grand Canyon."
Despite the craft involved in sculpting this album, I miss the full-band effect, and I hope DiFranco will take these songs on the road with some more instruments, perhaps for a third live album to complement "Living in Clip" and "So Much Shouting, So Much Laughter."
Because the album seems to build to a crescendo, and on "Company," "Raincheck" and "Bubble," I found myself adding a drum line in my mind, something that Andy Stochansky might beat out behind DiFranco's lyrics and guitar.
(all lyrics available here)
As a side note, I'd comment on the first review of this album: Mark really liked the artwork for this album. I have to admit that I was not similary impressed. It was good. Don't get me wrong. But it's something you should be used to from DiFranco (witness the booklet that came with "Living in Clip," or the "Revelling/Reckoning")
However, Mark is spot-on noting the exceptional nature of DiFranco's music. But she's been singing about love and loss for a long time.
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Extra Income For All
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text:
Recipe: Spicy Emma's Shortbread Cookies
- 4 oz. softened, unsalted butter (1 stick)
- 1/2 cup sugar
- 1 x egg yolk
- 1 Tbsp. cream or milk
- 1/2 tsp. Organic Pure Orange Extract
- 1/2 tsp. pure vanilla extract
- 1 Tbsp. Barrier Reef Caribbean Style Seasoning
- 1 Tbsp. Coconut Milk Powder
- 1 1/2 cups all-purpose flour
- 1/2 tsp. baking powder
- 1/2 tsp. salt
- 6 oz. bittersweet chocolate chips
Preheat oven to 350 degrees. In a standing mixer, cream together butter and sugar. Add egg yolk, cream, orange extract, vanilla extract, Barrier Reef and coconut milk powder. Stir to thoroughly combine, scraping bowl if necessary. Sift flour, baking powder and salt together. Add to butter mixture, and stir until thoroughly combined. Dough will be loose. Stir in chocolate chips. Roll into 1-inch balls and press down on center slightly. Place on ungreased baking sheet and bake for 8 to 10 min., or until slightly browned. Let cool on baking sheet for 10 min. to let shortbread harden.


text:
Application planner: quick tips for graduate job-hunters
Quick tips to help you prepare for graduate applications, interviews and assessments. Use them as a handy check list to make sure you're on the right track to get a graduate job.
Step 1: Preparation: make yourself the ideal applicant
- Start with yourself Write down your skills and characteristics so that you know what you have to offer. Make a list of your achievements and pull together all your best work experience examples.
- Make time for employer research Break down employer research into manageable activities: draw up a list of the employers you want to investigate, compare them on basic categories (size, culture, location, salary, training, etc). Shortlist the employers that meet your criteria and research them in greater depth. You can do this on targetjobs with our employer hubs: reports and research on graduate employers.
- Use a range of sources for your research Use the employer profiles and immediate graduate job vacancies here on targetjobs.co.uk to get started. Visit each employer's website to find out specifics about the company. Pick up free copies of TARGETjobs publications from your university's careers service. While you're there, look at the information the careers service holds on employers. To improve your general knowledge of a business sector, follow stories about the companies you're targeting in the national press – look at the Financial Times and business sections of The Times or the Guardian.
- Know what employers want Always check minimum degree requirements and what degree disciplines are required before you start applying. Find out what general competences (eg communication and teamworking) and what specific skills (eg office IT skills) are wanted.
- Check the application process Confirm whether you need to apply online or send a CV and covering letter. And don't forget to find out the application deadline.
Step 2: Graduate applications: the essentials
- Give yourself plenty of time to write applications Good applications take time and concentration. Never leave them until the last minute. Find a place where you won't be distracted when you are working on them.
- Tailor your application to each employer Match your skills and competences to each job and organisation you apply to. Recycle CVs and application responses at your own peril – you might leave in a reference to another employer.
- Prepare longer responses in a separate document This will make it much easier to structure responses and to spell check what you write.
- Use a range of examples to highlight your abilities Choose good examples from your list of work experience and extra-curricular activities to showcase your skills and abilities.
- Check applications carefully before you send them Poor spelling and grammar will immediately jeopardise your chances of success. Never let silly errors slip through. Ask a trusted friend to read through your application before you send it off.
Step 3: Graduate interviews and assessment centres: top tips and advice
- Check the interview or assessment centre process Read any information sent to you by an employer well in advance of the day. This will give you time to make contact and clarify any queries, as well as prepare for interviews and assessment activities.
- Reread your application and the job description Try to anticipate questions you may be asked and prepare a range of fresh examples you can use to demonstrate your skills. Make sure you've thought about your responses to some of the standard job interview questions that may come up.
- Prepare your own questions to ask Write a list of questions you want to ask interviewers and employer representatives about the job vacancy and working life. In the heat of an interview it's easy to forget what you want to ask, so type up your questions and take them with you.
- Participate fully in all assessment activities You can only be assessed if you are taking part and contributing to all the activities. Get stuck in and have a go.
- Be enthusiastic Be ready to tell interviewers why you want to work for their organisation and what you'll bring to the job. Smile, be positive and be yourself at all times.


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Is it worthwhile (in terms of general performance) to split a large table (2M rows) into smaller tables (couple of tables or maybe dozens)? Concrete similar example: Manage the accounts of a bank and all it's branches. In this case, the accounts are frequently updated and new ones created (200K updates and 60K inserts per month). Is it worthwhile to split the accounts by year (2000, 2001, 2003) or by branch? Or is it best to recreate the table periodically? (What are the options to improve extent fragmentation?) Recreating the indexes is regularly done but the system's performance doesn't improve much. Archiving old accounts is difficult as the "accounts" are never "really" closed. Sorry for the poor english and the long and vague text. Thanks in advance, André Cardoso
I'm finding some answers in the FAQ. Sorry for troubling the forum before looking in the FAQ. Thanks, André Cardoso
2 million tables isn't really a lot, and the performance should be ok on a decent server. The issue is probably that the indexes are not appropriate for the queries that are run against this table. It is difficult to give proper advice on the indexes without the table structure and the actual queries run against this database, but if you have a clustered index on account number it would probably be best to changed that to a non-clustered index, and create a clustered index on branch and maybe one or two other columns. Having a clustered index on a unique column is usually not a good idea, there are better things you can do with a clustered index.
2 million tables isn't really a lot, and the performance should be ok on a decent server. The issue is probably that the indexes are not appropriate for the queries that are run against this table. It is difficult to give proper advice on the indexes without the table structure and the actual queries run against this database, but if you have a clustered index on account number it would probably be best to changed that to a non-clustered index, and create a clustered index on branch and maybe one or two other columns. Having a clustered index on a unique column is usually not a good idea, there are better things you can do with a clustered index.
I'll try the advice of changing the clustered index to the branch and account number. The biggest problem is with the account "movements" (? debits/credits) (~20M). Thanks, André Cardoso
If your application can cope up by differentiating the data (movement) then you can go ahead. But you should consider Jacco's reference for indexes. FOr slow running queries use PROFILER to find out which will generate the trace and submit the same to Index Tuning Wizard which will give better recommendations on the indexes. Also on the Hardware part run PERFMON and capture set of counters from Hardware and SQL Server. Refer to the homepage of this site about PERFMON & PROFILER information. HTH _________ Satya SKJ
Jacco: > Having a clustered index on a unique column is usually not a good idea Not sure I agree with this. Can you share your reasoning plz ? Thanks
Andre, I agree with the previous posts in the forum that 2M rows is not too much for a database application. But there can be two exception to this - The table size may be very large which reduces the no. of rows that can fit on a single page hence incersing the IO. The same is applicable for Clustered and Non-Clustered indexes on the same. The second reson may be since u haven't defined the kind of peformance required form the database so it may be difficul to understand the same. I m saying this because performance is not abstract term. It varies from user to user. Anyway.... I am writing my viws on distributing the data across multiple tables. Generally the bank account numbers are unique across the banking software for different clients. Also the account numbers are generated based on branch. i.e. All the account no.'s for a branch start from the same prefix numbers. If this is the case then I would recommend splitting the tables into branchwise tables with check on account no. and creating a partiotioned view on the tables so that the performance of search queries will increase. Hoewver even if the account no.s are not unique, dividing the data on the basis of branch with ckeck on btanch name and again having a partitioned view seems to be feasible. In this case, the branch name has to be included in the search conditons which is not generally possible. I mean a customer might not be aware as to which branch he is having account with. Chappy, the idea is that having a non-clustered index on the unique column will give a great read performance so if there is another column suitable for clustered index, non clustered index can be created on the unique column. Also having a clustered index on primary ever increaing column like account number will make the last page of the table a hot spot as every user will try to insert data at the last page whrn a new account is created. HTH. Gaurav
I cant say ive ever really encountered a serious hotspot problem, and I tend to use a lot of clustered indices on incrementing fields (maybe my servers dont go under a heavy enough load on those operations). My impression was that the situation had been improved in sql 2000 (tho I cant see what they could do to improve it, based on the theory of why it happens). Also its worth noting that if you do choose to have the clustered index as something else, and its more than one column, this will increase the disk space required for non clustered indices, degrading read performance. Youd need to think carefully to make sure you are not merely relocating the cost.
Chappy, As I said I don't advocate using clustered indexes on unique columns because usually you can use the clustered index for better purposes. In the example we are talking about here most accounts will probably be accessed on a one-by-one basis, in which case a non-clustered index will serve the purpose. If on the same table you want to run queries to create reports summarized by branch or date, the performance of these queries will be greatly improved by having a clustered index on the right column. Clustered indexes will improve the performance of statements that use groups of rows, like GROUP BY, WHERE...BETWEEN...AND, and WHERE with low cardinality. If you are only trying to retreive one row, which usually done via the Primary Key or another unique column, the difference between using a clustered index and a non-clustered index is not very big. I don't intend to say that you should never use a clustered index on a unique column, just that you should look if there is not a better use for it, and there often is.
Clustered indexes also affect performance when it comes to inserts which I believe is a factor that is quite often overlooked. I recently ran a comparison test for inserts of "clustered index on bigint identity" versus "clustered index on bigint non-identity". The results showed at least a 50% improvement on performance using the identity version.
I totally agree with that. If you have a table that has mostly single row inserts/updates/selects having the clustered index on a unique column is a good idea. If you have to perform operations on groups however it is better to use the clustered index on a combination of the columns that are include in the GROUP BY or WHERE clauses. The inserts/updates/selects will take about twice as long because both the non-clustered index and the clustered index have to be searched, the group operations will work much faster though, because the clustered index only has to be searched once, independent of the number of rows involved.


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Ladies' Life
Ladies' Life Tuesday September 13 6:30pm Come be refreshed with the Word (Susan Gudgell) a Meal (Linda Fay Tullis & Marsha Rosson and Fellowship (You and Me)
Fruit of the Spirit – Peace
Sunday message is Fruit of the Spirit At 10:30 am
CCC ANNOUNCEMNTS Thursday March 10, 2016
Sunday's message will be "The Names of God". How many can you find in the Word???
Mark your calendars: SUNRISE SERVICES * Easter March 27* Preiss Heights Park Map to Sunrise Services
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We will be having a guest speaker this Sunday from the Gideons Ministry. We look forward to hearing of their work in New Braunfels and around the World as well as inspiration from God's Word.
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Our Youth are working to fund their summer trip to the Christ in Youth conference. This Sunday they will have a POTATO BAR set up following Worship. Stay and enjoy your lunch and the fellowship! Donations welcome!
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1998 GMC K3500 Review
American power and performance team up.
Reviewed by Automotive on
The 1998 GMC K3500 is the largest and most powerful of the K-line. It's equipped with a four-wheel drive and can easily be transformed into a family vehicle with the simple addition of a rear side-panel door. It's a viable choice for those who need a heavy-duty hauler that can also be a family vehicle when needed. Of course, it is important for buyers to remember that they are choosing a heavy-hauler truck. This means that regardless of how comfortable the interior may feel, it will not resemble a car. Although drivers will be pleased with what the truck can accomplish, they may be disappointed if they're hoping for a smooth trip each and every time.
The Range
Engines: 4.3-liter V-6, 5.0-liter V-8, 5.7-liter V-8, 7.4-liter V-8
Transmissions: five-speed manual, four-speed automatic
Models: GMC K3500 SL, GMC K3500 SLE, GMC K3500 SLT
What's New
The 1998 GMC K3500 offers diesel engines that are updated and are more powerful. Heating ducts are added into the rear for the extended cab and crew cab, while more options were added including standard PassLock theft-deterrent system and second generation airbags. Furthermore, additional colors have been added to the ordinary line-up.
The 1998 GMC K3500 truck looks exactly like what it is: a large and powerful truck able to accomplish any task drivers give it to do. It appears sturdy, strong, and rugged. That does not mean that the truck is not attractive as it is quite appealing from the outside. It just lacks the flash that comes with a lot of modern trucks released from competitors. The rear side-access panel ensures easy access to the back bench seat, or the ability to easily store more items. Hauling capacity is high with this powerful truck, and fuel economy is not as bad as expected from such a powerful machine.
The 1998 GMC K3500 will feel much more like a car than it looks from the outside. There are plenty of features and options in the cabin that help passengers feel like they are riding in a car. Instruments are easy to read, use, and access. Storage space is ample, and the front seats are comfortable and relaxing. The rear seat leaves a lot to be desired for the average passenger, though. It is functional, but it does not offer comfort. In fact, it is best if the rear seat is only used for short drives or for those that do not mind a rougher ride. There is even the potential for leather upholstery inside the cab.
Performance & Handling
Although the 1998 GMC K3500 does not offer the same maneuverability as a car especially with its size, it handles on the road fairly well. Optional passenger car tires add to the abilities of the truck. Overall, the ride is not the smoothest that one could find, but it is not the roughest either especially for a large truck. If the car tires are equipped, it will add to the silence.
The 1998 GMC K3500 truck leads the pack with the engine power to handle any task and haul the large loads. The bed allows for ample movement of virtually any object, and the four-wheel drive prevents terrain from being too tough to handle.
The 1998 GMC K3500 comes with second-generation airbags and standard anti-lock brakes.
EPA Fuel Economy
You'll Like
- Comfortable cabin
- Fairly smooth ride
- Powerful engines
- Four-wheel drive
- Heavy-duty towing capacity
You Won't Like
- Mediocre handling
- Truck-like feel
Sum Up
American power and performance team up.
If You Like This Vehicle
- Ford F-Series
- Dodge Ram
- Chevy Silverado


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My goodness, I didn't realise it had been over a month since I'd posted anything! I have not been making much of late, unlike our college ducks, who have been hard at work making new ducks; I leave you with this video by way of apology for my protracted absence.
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If you haven't noticed, I like fancy restaurants. However, when Terry and I travel, we tend to do smaller, less-fancy places because I think you get a flavor of wherever you're at a bit better than at fancier digs. We want to eat with the people. Or something.
I knew that Thomas Keller's restaurants would be on vacation most of the time we were in New York (and that I should have thought about Per Se reservations weeks before I actually did), but I made him promise that we would get to Columbus Circle so I could get some macarons at Bouchon Bakery. I had heard that they were the best macarons in the States, so I had to have some. Then, Kari told me they had the best chocolate chip cookies in the world. I am not one to ignore such tidbits of information, so one slightly overcast day, we headed over there.
There are two sections to the bakery, which is housed in the Time Warner building in Columbus Circle. First, the bakery, which is a simple stand where you can pick up a cookie or a sandwich, and then a full-service cafe. We went through the line at the bakery, hardly able to make up our minds as to what we wanted. I ended up with exactly what I had planned on getting: a macaron and a chocolate chip cookie.
The macaron I chose was fruits of the forest, which were two purplish almond-and-egg-white cookies sandwiching some berry preserves. Crisp and delicious, but a whole lot bigger than the ones I've had in the past. I prefer the small ones, but these were pretty tasty.
The chocolate chip cookie was good, but not the best I've ever had. I think that, perhaps, these would be awesome straight out of the oven. Still, it was a darn good cookie.
We went outside to prance around in Central Park and it started raining. Sheets. So we decided to wait out the rain by having a meal in Bouchon Bakery. After all, I'd only had a macaron (we saved the cookie for later).
The service was excellent; our waiter was knowledgeable but laid back and ignored my picture-taking. Terry (who had munched on some leftovers for breakfast before I was even up) wasn't hungry, but he saw my eyes light up when the waiter mentioned melon soup, so he ordered it. What a trouper. It was fantastic: that amazing sensation of fresh melon, with some tarragon and creme fraiche– outstanding. I savored every bite he shared with me.
It was accompanied by some outstanding French bread and butter.
I ordered a very traditional sandwich– jamon et fromage. Ham, Gruyere, and a bit of mustard pressed together. They were a total trip back to paris– cheesy, melty– if I hadn't been in the middle of a mall (yes, Bouchon Bakery sits inside what is essentially a mall) I'd have thought I was in Paris. It was accompanied by a small salad and a few cornichons.
If you're in the area and want a taste of Thomas Keller but can't get into Per Se, try Bouchon Bakery. And don't skip the macarons for anything!
One of the toughest meals I ever had was Bouchon Bakery when I had used up my allotted calories for the day. They do a nice, plain salad…*sob*
Also in the Time Warner building is Landmarc – pretty good spot for meeting people, not extraordinary but pretty good. Usually quiet at breakfast, too, so good for getting down to business.
My wife was there last month, she got me some of those macaroons but she ate them on her way home.
I still love her though.
Sounds delish – we will have to try it next time we visit the friends & relations.
Must say, though, when we hunger for sweets in NYC (for over twenty years running) our perennial fave has always been Veniero Pasticceria.
Wandering in on a summer evening to enjoy baba rum and an iced capp … oooohhh, memories!
Thanks for the tip. We've just recently discovered you (smile) and look forward to reading more of your adventures!
Jackie– Oh, that sounds horrible. The plain salad WAS nice, but I'd die if I couldn't have a bit of bread or some soup.
Donut Guy– It must be very hard for you, to have been that close to a macaron…
Mr. Majestic– The next time we go (Terry's been going for 25 years or so, used to live there sort of; I've gone three years in a row now) we will try Veniero. I'm a sucker for baked goods. Total sucker! You need to try Angelina's Bakery in Findlay Market if you make it down here– pretty good baba au rhum.
[…] I cannot get burnt out on? Bouchon. I've eaten there three times in Vegas, and once in New York. Two of the three times in Vegas were brunch, one was […]


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Dakota (Dillian's Eric)
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