text:
|Home | About | Journals | Submit | Contact Us | Français
We used diffusion tensor imaging (DTI) to study 2 patients with traumatic brain injury. The first patient recovered reliable expressive language after 19 years in a minimally conscious state (MCS); the second had remained in MCS for 6 years. Comparison of white matter integrity in the patients and 20 normal subjects using histograms of apparent diffusion constants and diffusion anisotropy identified widespread altered diffusivity and decreased anisotropy in the damaged white matter. These findings remained unchanged over an 18-month interval between 2 studies in the first patient. In addition, in this patient, we identified large, bilateral regions of posterior white matter with significantly increased anisotropy that reduced over 18 months. In contrast, notable increases in anisotropy within the midline cerebellar white matter in the second study correlated with marked clinical improvements in motor functions. This finding was further correlated with an increase in resting metabolism measured by PET in this subregion. Aberrant white matter structures were evident in the second patient's DTI images but were not clinically correlated. We propose that axonal regrowth may underlie these findings and provide a biological mechanism for late recovery. Our results are discussed in the context of recent experimental studies that support this inference.
The minimally conscious state (MCS) (1) denotes a specific level of functional recovery of severely brain-injured patients who demonstrate unequivocal, but intermittent, behavioral evidence of awareness of self or their environment. This condition potentially produces a unique burden of isolation, motivating efforts to better understand brain function in MCS patients in the hope of promoting further recovery (2). Here we report magnetic resonance diffusion tensor imaging (DTI) findings from 2 patients following severe traumatic brain injuries. Our index patient recovered reliable communication after remaining in MCS for 19 years whereas the second patient remained in MCS at the time of study 6 years after injury.
DTI (refs. 3, 4 and references therein) is a novel imaging modality capable of characterizing specific white matter pathologies such as atrophy and diffuse axonal injury. The preferential diffusion direction of water in myelinated white matter locally coincides with the direction of white matter fiber bundles in the brain, and the diffusion constant and anisotropy depend on microscopic tissue properties such as density, diameter, and geometry of myelinated fibers. These properties allow DTI to characterize white matter damage and possible neuronal reorganization in the setting of brain injuries. In this study, DTI was used to evaluate white matter integrity across the cerebrum in both patients and in the first patient to characterize changes in intracortical and cerebellar white matter connectivity patterns across 2 studies 18 months apart. We compare our DTI findings in the first patient with fluorine-18 fluorodeoxyglucose–PET (FDG-PET) measurements of the local metabolic rate of brain tissue. The results of these complementary modalities converge, providing evidence of reorganization of the patient's white matter, possibly facilitating functional recovery.
The patient is a 39-year-old male who at age 19 suffered a severe closed head injury in a motor-vehicle accident. Remarkably, this patient spontaneously emerged from MCS 19 years following the initial injury and recovered spoken language. He initially remained in a coma for 1 to 2 weeks followed by further recovery to a vegetative state and subsequently a level of function consistent with MCS within several months of injury. Although gradual improvements in responsiveness were noted over an ensuing 19-year period, the patient was unable to communicate using gesture or verbal output. Limited head nodding and grunting were only inconsistently present. Eight months prior to our first evaluation, he spoke his first word after his brain injury, "mom," which was followed by a recovery over a period of several days of increasingly fluent, but dysarthric, speech and reliable communication.
At the time of the first DTI evaluation, motor examination revealed bilateral upper extremity contractures with active movement noted on the left side only. There was increased extensor tone bilaterally in the lower extremities accompanied by intermittent clonus, bilateral triple flexion responses, and extensor plantar reflexes. Oculomotor examination showed near-continuous random eye movement (with full range of movement). Saccades and pursuits were intact. Motor speech was fluent but severely dysarthric due in part to dystonic tongue movements. Language output was characterized by a pronounced logorrheic tendency. He was oriented to person but did not know his age, selecting "less than 20 years old" when provided with a 2-alternative, forced-choice response format. He misidentified his location and denied that he had been transported to his current location by air 48 hours earlier. He indicated that he did not know the current year and selected "1984" (the year he was injured) from a list of 4 alternatives. There were no discernible paraphasic or dysnomic errors in conversation and no evidence of alexia on single-word reading tasks. Confrontation naming was accurate across 10 consecutive trials involving high-frequency items. Phonemic (8 items in 60 seconds) and semantic fluency (7 items in 60 seconds) were severely impaired due to rapid loss of set, perseverative errors, and behavioral disinhibition (e.g., he began making animal noises while generating names of animals).
Eighteen months later, at the time of the second DTI scan, several areas of neurological improvement were identified. Reassessment of motor functions demonstrated some functional recovery of the left upper extremity (i.e., he was able to point but could not perform self-care tasks such as using a spoon). He remained unable to use the right upper extremity. Most notably, both lower extremities, which were paretic on initial evaluation, showed improvements in strength to at least 4+/5 on volitional movement. He was able to extend both lower extremities when flexed at the knee. These movements were poorly controlled and tended to occur in a ballistic fashion. He also demonstrated a new ability to assume a bridging position in which both legs pushed down to elevate the lower back. Cognitively, there was an overall increase in baseline arousal accompanied by generalized improvement in attentional focus and response persistence. He was able to count from 1 to 25 without interruption and completed a 90-second auditory vigilance, detecting 19 of 30 targets with 1 false-positive error. Speech intelligibility improved, and there was a noticeable decrease in the severity of the logorrhea. He remained oriented to person only and again refused to accept that he had traveled by plane from his home 24 hours earlier. Conversational speech remained free of paraphasic and dysnomic errors, there were no errors on confrontation naming (20/20), and single-word reading was accurate. Verbal fluency was essentially unchanged (trial 1: 8 items in 60 seconds; trial 2: 4 items). He continued to deny awareness of any physical or cognitive problems, typically providing rational but inaccurate explanations for the problems he encountered when symptoms were elicited on examination.
The patient is a 24-year-old male who sustained severe traumatic brain injury in a motor-vehicle accident 6 years prior to examination with DTI. He remained in a vegetative state, as judged by repeated examinations for over a year following the injury. Approximately 17 months into the course of the patient's illness, standardized testing identified reliable vertical visual pursuit, clear evidence of object manipulation with the left upper extremity (grasp and release), and occasional episodes of command following using eye gaze. These changes signaled transition from the vegetative state to the MCS. He continues to be quadriparetic with inconsistent evidence of purposeful movement of the left upper extremity only. There have been no observable clinical changes over the last 4 years.
The anatomical MRI images of both patients show widespread cerebral atrophy (Figure (Figure1,1, A and D). Notably, the lateral ventricles were increased in size, and the corpus callosum and the periventricular white matter were diminished. Color anisotropy maps demonstrate the predominant white matter fiber direction, with different colors indicating different directions (Figure (Figure1,1, B, C, and G–I). The intensity of the color is proportional to the diffusion anisotropy. Anisotropy, measured by the fractional anisotropy (FA) index, was large for the hindered diffusion of water, as it is in the presence of myelinated axons, and smaller for more isotropic regions in the brain, such as normal gray matter or cerebrospinal fluid (CSF). The color FA maps of the patients demonstrate a marked reduction of volume and diffusion anisotropy of the medial corpus callosum and other parts of the brain compared with normal control subjects (Figure (Figure1E). 1E).
To compare both patients' regional white matter integrity with normal control subjects, we performed a quantitative analysis of the DTI data. Histograms of the average diffusion constant (Figure (Figure2,2, A and E) and FA (Figure (Figure2,2, B and F) correlate with global injury to the brain white matter in both patients, showing a marked shift toward lower average diffusion values in white matter (5) and an increased CSF compartment. Overall, diffusion was increased, as expected, whereas anisotropy was decreased. In the aggregate, these findings are consistent with the patients' having both suffered severe diffuse axonal injury (Grade 3 DAI).
A detailed quantitative analysis of the corpus callosum in patient 1 indicated anisotropy loss across substructures: whereas the FA values for the genu of the corpus callosum were within the normal range (first scan, FA = 0.70 ± 0.14; second scan, FA = 0.68 ± 0.13; control, FA = 0.69–0.85), the splenium of the corpus callosum showed significantly lower FA values compared with normal control subjects (first scan, FA = 0.61 ± 0.20; second scan, FA = 0.58 ± 0.11; control, FA > 0.69). Neither measurement showed a significant difference between the first and second scan. The medial portions of callosum showed marked reduction in anisotropy (first FA = 0.38; second FA = 0.28; see Figure Figure2I).2I). This portion of the callosum is very thin, and the measurements were influenced by neighboring tissue with smaller FA (partial volume effect). As an additional and reliable measure for the reproducibility of these values between the 2 scan times of patient 1, we chose the CSF as a large compartment in the brain that could be measured without substantial partial volume effects. For CSF, FA values were normal and equal between the first and second scan (first scan, FA = 0.17 ± 0.07; second scan, FA = 0.18 ± 0.04; control range, FA = 0.15–0.28). The constancy of CSF values supports the quantitative reproducibility of the 2 scans of patient 1. Furthermore, Figure Figure2,2, C, D, G, and H, shows a comparison of diffusion and FA histograms, respectively, for patient 1 and a normal control subject scanned twice in a period of 17 months. Whereas small fluctuations in the voxel counts were unavoidable, for example due to differing partial volume effects between scans, the difference in histograms is marginal compared with the difference between the patient and the control subject's histograms as shown in Figure Figure2,2, A, B, E, and F.
Contrary to the general findings of decreased anisotropy across brain structures in the first scan of patient 1, there were well-confined regions of pronounced right-left anisotropy in the medial parietal, occipital (MPO) areas of the brain, bilateral to the interhemispheric fissure (visible as the red occipital areas in Figure Figure1,1, B and C, and through the sequence of parasagittal images in Figure Figure1G).1G). These fibers were contiguous with the splenium of the corpus callosum (Figure (Figure1F).1F). Based on these qualitative observations, we sought a quantitative comparison of this region in the patient and the normal subjects. As a proxy for the strength of occipital right-left connections, we used 2 measures: the FA and the fiber right-left directionality index, c, defined as the right-left component of the principal diffusion direction. Whereas FA was assumed to reflect myelinated fiber density, diameters, and microscopic structures such as crossing and branching fibers, we used the right-left directionality index c to measure the degree of right-left directionality of fibers, independent of fiber density and diameters.
In the first scan of patient 1, the MPO areas were significantly larger than in normal controls as is evident from a comparison of FA values (P = 0.05) and c (P = 0.05) with normal controls (Figure (Figure2J).2J). In the second scan, 18 months later, the FA values reduced and were no longer separated from the control group. However, in the second scan, another striking region of right-left anisotropy had become evident in the inferior part of the cerebellar vermis (Figure (Figure1H).1H). The increase of FA in the vermis between the 2 scans is statistically highly significant (P < 0.0001; see Figure Figure2K). 2K).
The marked increase in anisotropy of the cerebellar vermis had a direct clinical correlate in the patient's regaining of limited use of the lower extremities over the 18-month interval between evaluations and improved motor function of the left upper extremity. In addition, although less easily graded on a clinical exam, the patient's dysarthric speech pattern notably improved over the same time interval and likely reflected changes in cerebellar function as well.
FDG-PET images of resting metabolism in an awake, eyes-open state provided converging evidence for relatively increased functionality in the MPO area of the brain of patient 1 (Figure (Figure3).3). Compared with all other brain areas, the MPO regions exhibited the highest resting FDG uptake, both at the time of the first PET scan and in a repeat study 18 months later (not shown). Calculation of standard uptake values based on body weight at the first scan showed that the MPO regions maintained slightly above-normal resting values compared with an approximately 25–30% reduction from normal values seen across all other brain structures, with the exception of the cerebellar hemispheres, which showed approximately 50% reductions from normal values, consistent with the patient's quadriparesis. Comparison of the second and first FDG-PET scans revealed an approximately 20% increase in standard uptake values across brain structures without marked qualitative differences. The midline cerebellum standard uptake values, however, increased 50% in the second PET scan. This independent measurement suggests that the observed DTI changes are related to activity-dependent changes in this part of the structure.
The second patient studied exhibited several unusual features in FA color maps that are suggestive of changes in white matter connectivity. In Figure Figure1I,1I, axial slices of the second patient's brain are displayed. The less damaged right hemisphere (compare with Figure Figure1D)1D) in this patient contained several novel-appearing structures, namely thick anterior-posterior connections (green) and strong right-left connections (red) throughout the right frontoparietal cortex that were continuous with the anterior corpus callosum. This asymmetric feature appeared to also receive connections from the thick anterior-posterior fiber tracks. However, as previous studies are not available, we cannot rule out the possibility that these connectivity patterns may have existed prior to injury.
The large changes in anisotropy in patient 1's brain, which otherwise has overwhelming damage consistent with diffuse axonal injury, raise questions about their origin. In the first DTI study of the patient's brain, the bilateral MPO regions had higher-than-normal anisotropy (FA) and directionality (c). Their reduction in anisotropy 18 months later suggests that the directionality may have been a transitional stage of an ongoing process. The stability of other strongly directional features of the DTI images and the newly appearing increases in the midline cerebellar anisotropy further support this view.
How can these findings be explained? It is known that a cortical injury creates a particularly favorable environment for sprouting to occur in the intact remaining cortex (6, 7). Dancause et al. (8) recently provided anatomical and neurophysiological evidence of extensive axonal regrowth in adult squirrel monkeys, arising months after injury. In their studies, M1 axons in the ventral premotor cortex sought new targets in surviving, intact tissue, with a focused fiber direction orientation. This widespread corticocortical sprouting extended to intact cortical areas distant from the injury, which underwent major neuroanatomical reorganization. During the process of axonal growth, it was further observed that the orientation of the new fibers in the injured animals was significantly more focused than the relatively diffuse orientation of fibers in normal control cases. The axonal regrowth was correlated with functional motor recovery. A recent human DTI study, also using FA for quantification, showed a complementary finding that white matter plasticity can be observed in adult humans as a result of intensive piano practicing, with most pronounced changes observed in association (corticocortical) fiber connectivity (9). We conjecture that the initially observed increments of FA and c may reflect such a distant reorganization since the posterior cortical areas were among the least affected by the patient's brain injury. The normalization of FA and c 18 months later could be a result of ongoing sprouting of axons towards other targets. Decreasing FA values have been observed during the development of preterm human cerebral cortex (10) and can likely be explained by innervation by corticocortical axons and synaptogenesis, among other processes (11). Similar to the posterior cortical areas, the increasingly strong anisotropy in the cerebellar vermis may reflect an additional location of remodeling; it is notable that in the first scan the directionality index c was already large for this region compared with the control group.
There is other evidence for large-scale cortical rewiring in adult monkeys after amputations of digits or limbs, or retinal lesions, which could only be explained by axonal growth (ref. 12 and references therein). Some studies have suggested that axonal regrowth beyond 10 mm may also be possible and is likely activity dependent (13). To date, such axonal remodeling has only been observed in response to injuries that persisted months to years. Interestingly, late remyelination specifically within the posterior occipital cortices as suggested here in our patient has been observed in studies of normal, aging nonhuman primates (14). Collectively, in the context of current literature, these findings suggest that regrowth and rerouting of the white matter tracts may account for the measured changes in brain structure.
This interpretation is further supported by the observation of strongly preserved metabolic activity in the MPO regions compared across other cerebral structures. In other studies, we have compared metabolic rates of severely brain-injured patients to normal values using the same PET scanning technologies and correlated the findings with other imaging modalities (15, 16). A general conclusion of these studies is that regional preservation of the FDG-PET signal correlates with both preserved clinical identifiable functionality and electrophysiological activity. Thus, we interpret the findings of a relatively increased metabolism in the same regions where anisotropy is increased as converging evidence for late reorganization of white matter connections in this patient's MPO regions of the brain.
Even if the initially increased and subsequently decreased anisotropy in the MPO regions does reflect ongoing axonal regrowth, the exact relationship to the patient's clinical course is unknown. Since earlier studies are not available, we cannot rule out that the novel MPO feature may have existed prior to injury. The observation of a similar pattern of interval increase in anisotropy in the midline cerebellum, however, strongly supports the possibility of a slow recovery of intraregional connectivity through axonal remodeling, as this finding has a direct clinical correlate. Taken together, both observations in patient 1 suggest that axonal regrowth may play some role in very late recoveries of function in patients with severe brain injuries (17). The interval changes observed in the longitudinal study of patient 1 also provide insight into the possible connection of recovery of speech despite the lack of findings in language-related areas. If axonal reorganization is an ongoing process, these regions may have at one time experienced similar changes in connectivity not resolvable by DTI at this time but nonetheless consistent with the current observations. The suggestive findings of novel pathway development in the second patient cannot be further interpreted at this time.
Collectively, the findings support further efforts to prospectively and longitudinally characterize neuroplasticity in both brain structure and function following severe injuries (16). Studies of ongoing recovery utilizing DTI and PET beginning shortly after brain injury will also likely shed further light on debates surrounding the question of long-distance cortical rewiring (18) in humans and its potential importance in rehabilitation (19).
Our studies were approved by the Institutional Review Board (IRB) of Weill Medical College of Cornell University. IRB-approved consent declarations were obtained from all control subjects and the 2 patients' legally authorized surrogates.
Twenty normal control subjects (9 males, 11 females, age 19–54 years; median age, 25) and the 2 patients were scanned on the same GE Healthcare 3T MRI Signa EXCITE scanner with 50 millitesla/m gradients, using a birdcage head coil in quadrature mode. The 20 control subjects were scanned within 9 weeks before and 5 weeks after the first scan of patient 1. Patient 1 was again examined 18 months after the first scan. Patient 2 was scanned once only. An in-house 2D single-shot spin-echo echo planar imaging (EPI) sequence with repetition time/echo time (TR/TE) = 10000/100 ms was used for DTI. From 58 to 60 consecutive slices of 2.5-mm thickness and axial matrix size of 128 × 128 were acquired in 1 number of acquisitions (NEX), with a field of view of 22 cm. Additionally, T1-weighted anatomical images were acquired from all subjects. To test for reproducibility of the FA and diffusion constant histograms, another normal control subject was scanned twice within an interval of 17 months and 3 times within a week, showing good reproducibility (Figure (Figure2,2, G and H).
For quantification of right-left connectivity, we used FA and the right-left fiber directionality, c, which we defined as the absolute value of the x component of the normalized principal eigenvector of the diffusion tensor. Both FA and c range from 0 to 1. These measures reflect the degree of anisotropy and the directionality of diffusion, respectively (20). FA and c for the MPO region were computed as follows: the sagittal slice with the strongest intensity region of right-left fibers (appearing as red in FA color maps) in the MPO region was selected and a region of interest (ROI) of at least 75 voxels was drawn that encompassed the strongest FA values in that region. ROI-based quantification of anisotropy and diffusion always has some variability and may be biased depending on the subject performing the measurement. To reduce subjective bias, the reported FA and c values for the MPO region of the first scan of patient 1 and the normal control subjects indicated in Figure Figure2J2J were averaged over 3 independent analyses by 3 of the authors. Furthermore, the anisotropy values for the vermis and MPO region of the second scan coincided with values obtained from a high-angular resolution diffusion imaging (HARDI) scan obtained the same day. For testing of significant differences between patient and control values, we used a 1-tailed Wilcoxon rank sum test for both quantities. All other significances in differences in the mean of both quantities were evaluated by 2-tailed Student's t tests. For the second scan of patient 1 and for patient 2, prior to computing quantitative values, the coordinate system of the head was aligned with the magnet coordinate system to adjust for necessary variations of head positioning for each patient. The diffusion gradient directions were rotated accordingly to ensure that in color anisotropy maps (21), the colors would correspond to the head coordinate system and the right-left directionality index to the true right-left direction in the head as well. To test for eddy current–induced distortions in the patients' images that may affect FA (22, 23), images of the quality of fit of the measured signal to the diffusion-attenuated signal, depending on the fitted diffusion tensor components, were used to assess the variability of the diffusion constant; these error plots showed no correlation with the MPO region or the vermis, and generally, the error in cortical areas was significant only for 1 to 2 voxels deep into the cortex. White matter fiber tracking was performed as described previously (24, 25, 26).
Patient 1 was scanned twice, 1 day after the MRI scans in each case. FDG-PET was performed on a GE Healthcare combined PET-CT LS Discovery unit; 11.2 mCi and 10.3 mCi of FDG (at the first and second scan, respectively) were administered about 50 minutes before emission-mode PET scanning. A total of 35 transaxial slices of 4.25-mm thickness with a matrix size of 128 × 128 and a field of view of 25 cm were acquired. The signal was acquired in dynamic high-sensitivity mode, yielding 210 images altogether, which were later averaged slicewise over time. For display (Figure (Figure3),3), the resulting volumes were reinterpolated to sagittal slices of 4.88-mm thickness, and the FDG uptake was color coded and overlaid to CT images prescribed collinear to the PET images. The unitless FDG standard uptake values, defined as regional activity per gram divided by injected dose per patient mass in grams, were measured in ROIs obtained from axial slices of the averaged images.
We thank the Charles A. Dana Foundation (N.D. Schiff) and the Weill Medical College General Clinical Research Center (M01 RR00047) for financial support of these studies. MRI scanning of control subjects was funded by the James S. McDonnell Foundation through a collaborative grant to the Brain Trauma Foundation. H.U. Voss acknowledges financial support from the Cervical Spine Research Society. Finally, we would like to thank the families of the 2 patients for their confidence in and support of this research.
Nonstandard abbreviations used: CSF, cerebrospinal fluid; DTI, diffusion tensor imaging; FA, fractional anisotropy; FDG, fluorine-18 fluorodeoxyglucose; MCS, minimally conscious state; MPO, medial parietal, occipital; ROI, region of interest.
Conflict of interest: The authors have declared that no conflict of interest exists.
Citation for this article: J. Clin. Invest. 116:2005–2011 (2006). doi:10.1172/JCI27021.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


text:
Freeman ponders comeback for relays
Page Tools
Cathy Freeman has ruled out running the individual 400.
Photo: Simon Alekna
Golden girl Cathy Freeman has said it would take "overwhelming support" for her to consider a return to the track at the Commonwealth Games in Melbourne next year.
The Olympic 400 metres champion at Sydney in 2000 flagged a possible comeback in the relay, but ruled out a return to the individual event that was her crowning glory in 2000.
"If there was overwhelming support for me to come back, even for the relay, I would think about it, but not if it was just for myself," Freeman said. "It would be a lot of fun. It would be enough motivation for me to get out there and try again."
Athletics Australia high performance manager Max Binnington was enthusiastic about the suggestion.
"I would be delighted if a fit Cathy Freeman was available to run in the team, (but) she would know full well that even achieving that level is going to be bloody hard work for her," he said.
"She is someone who's particularly important to our sport, whether on the track or off it."
Freeman, 400 metres gold medallist at the Sydney Olympics, will be 33 when the Commonwealth Games are held in Melbourne in March next year.
Track legend Raelene Boyle said she believed the public would get behind Freeman, but questioned whether a comeback was the right move for her.
"For the Commonwealth Games community and the Australians who are going to be there, it would be fantastic to see Cath run, but I'm of the belief that once you retire, you retire," Boyle said.
Boyle said 400 metres hurdles champion Jana Pittman and 800 metres specialist Tamsyn Lewis would be the main contenders for the relay, team but after that it was wide open.
"There's not a huge talent base in the event but you've got to get out and do it," she said.
Boyle speculated that recent turbulence in Freeman's life, including the split with her boyfriend, actor Joel Edgerton, could be a driving force behind the possible change of heart.
Page Tools
Our Advertisers
Giant global seat sale now on. Visit Qantas.com for details
Single again? Your next date is online now!

subset: commoncrawl


text:
Best practices to address real world challenges
Much has been written about the importance of being informed:
"Knowledge is power."—Francis Bacon "An investment in knowledge pays the best interest."—Benjamin Franklin "Knowing is half the battle."—G.I. Joe
Whether you're an English philosopher/scientist, a U.S. founding father, or an animated American hero, the message is simple: information = good; ignorance = bad. When it comes to the global marketplace, however, it's clear that most manufacturers are not as well informed as they should be. Even if you're not internationally active, it's still important to be internationally aware. Here are some items to consider as year-end approaches and you think about your business strategy for 2013 and beyond.
If you're not an internationally active company, why is international awareness so important? Because your supply chain may be internationally active. It's critical that organizations understand their supply chains at least two levels down, if not three. This is significant not only to ensure quality standards but also to gauge any potential global business disruptions. Tragedies like the tsunamis in Japan or the current economic issues in Europe can cause significant issues or catch businesses off guard. There are supply concerns as well; for example, if any part of your supply chain relies on rare earth metals, then you know that they exist largely in China. If China decides to decrease its exports, then demand, and subsequently costs, will increase. That's why it's critical to stay abreast of what's happening in other countries, politically and economically; if you're informed, you can put a plan in place more quickly to address these kinds of issues.
Currency is another concern. Clients who buy and sell in dollars often feel insulated from currency changes; however, if you look down the supply chain, if there's exposure to other currencies, it will affect your dollar pricing. Understand where you have exposure to cross-border transactions within the supply chain, and monitor on your dashboard currency, economic, and political issues that underlie the country with whom you indirectly do business.
Another reason to be internationally aware is technology. It's easy to assume that the United States and Europe continue to have the most advanced technologies. Because of the growth occurring in markets like Russia, China, and Brazil, however, that's no longer necessarily true. These countries have made significant advancements in technology. If you're not attending industry shows or reading trade magazines that cover or are published in these growth markets, you could be caught flat-footed by advancing technologies that seem to appear overnight but, in actuality, have been looming for some time.
For example, let's say you're focusing on battery technology and wind energy. It's important to know that China has made very significant investments at the government and university levels in supplementing research and development of those technologies. Failing to understand and monitor these developments could mean big problems down the road.
So where do you go to inform yourself on these issues? Community banks publish a lot of good information, particularly on currency and cross-border trade issues. Law firms, trade advisory companies, and the U.S. Department of Commerce are also good sources. And, as always, we at Plante Moran Global Services are here to help. If you have any questions, please feel free to let us know.
For Internationally Active Companies: a Year-End Checklist
If you are an internationally active organization, now is the perfect time to look outside and plan for next year.
877-622-2257, x57234


text:
With the recent burst of celebrity endorsements and film franchises in tech products, pop culture-powered headphones have become an industry of their own. The success of Dr. Dre's 'Beats' headphones have influenced many other artists to release their own lines of listening gear and have people going Gaga for crystallized earbuds. Recognized for their powerful quality and show-stopping sleek style, these celeb-inspired designs have quickly caught on as fashionable streetwear.
If you're looking to make a different kind of statement, the influx of Star Wars-inspired headphones makes it easy to stay true to "the force" while listening to music on-the-go. These pop culture-powered headphones are the perfect way to represent your favourite sports team, show, movie or artist, adding a splash of your personal taste to a common tech accessory.
24 Pop Culture-Powered Headphones
More Stats +/-
Jewel Earbuds
Blinged-Out Headphones
Rapper-Approved Earbuds
Stormtrooper MP3 Earbuds
Crystallized Audio Accessories
From Lady Gaga's Studded Earbuds to Sci-Fi Listening Gear
Jul 27, 2011By: Marie C. Hudson -


text:
To purchase ATV programs, call (800) 554-4226
Audio Cassette: $14.95
Featuring: Dr. Maya Angelou, Dr. Johnnetta B. Cole, Dr. Walter E. Massey
Description: A retrospective of significant moments from Dr. King's life will form the foundation for our featured guests to explore the concept of character and values. This live two-hour broadcast will originate from the campus of Morehouse College in Atlanta, Georgia. Questions discussed with students nationwide will include: Can values be taught? Whose values and how can they be taught?
PROGRAM FOCUS:American History, Language Arts, Visual Arts, Communication Arts
Category: Public Service
For Teachers
For Students
Downloads (PDF)
Student Activities
Reference Material
Evaluation Form
Student Reference Material
Student Handout
Teacher's Guide
Teacher's Reference Material
Teacher's Student Activities
Teachers, we've also developed materials for you to integrate portions of Achievement.org into your curriculum through our Achieve*NET Curriculum series.
You might also like these Achieve*Net curriculum:
Advocacy and CitizenshipCharacterJustice and the CitizenToleranceWhat is a leaderFreedom and JusticeThe Democratic ProcessGlobal ConflictsMartin Luther King DayBlack History MonthEarth DayMeet a Nobel Laureate
View more in our section for teachers.


text:
Megelli 250 RV is the name motorcycle product from Minerva brand, from the image below you can see really clear how this motorcycle look like. For me this motorcycle product have really good design, what about you, do you have same think with me? Buy this Minerva motorcycle sport only with price Rp.34.900.000. Another product from Minerva with similar design with 250 RV is Megelli 250 RE.
Harga Baru: Rp.34.900.000
Air Conditioner –
Power Windows –
Power Door Locks –
Power Steering –
Anti-Braking System –
Traction Control –
Air-Bags Driver –
Air-Bags Passenger –
Immobilizer –
Cup Holders –
Folding Rear-Seat –
Rear Wash Wiper –
Alloy Wheels –
Tubeless Tyres –
Central Locking –
Remote Fuel-Lid –
Steering Adjustment –
Tachometer Available
Child Safety Locks –
Front Fog Lights –
Defogger (Rear) –
Leather Seats –
Power Seats –
Radio Available
LCD Screen –
CD Player –
Sun-Roof –
Moon-Roof –
Note : price for Megelli 250 RV in this site maybe different with the actual price, use price in this site just to compare.
Incoming search terms:
- 2012 megelli 250r review
- megelli 250r 2012 review
- megelli 250r review
- megelli 250r review 2012
- megelli 2012 review


text:
The New Zealand dollar fell almost half a US cent after the Reserve Bank left the official cash rate unchanged at 3 per cent and said further rate hikes would be more moderate than previously flagged as Canterbury's earthquake undermines economic growth and fans inflation.
The Reserve Bank said the natural disaster left New Zealand "worse off" as inflationary pressures in construction and private rents in the Canterbury region increased, as well as causing
$4 billion worth of damage to residential, commercial, and government property.
"This takes the gloss off the New Zealand dollar for anyone looking for yield," said BNZ economist Doug Steel. "Now that the market's found out kiwi interest rates aren't going to go as high as they expected, the yield advantage is lessened."
The kiwi fell to 72.61 US cents immediately after Reserve Bank Governor Alan Bollard's announcement, having traded at 73.11 U.S beforehand. The New Zealand dollar also fell to 67.36 on the trade weighted index of major trading partners' currencies from 67.58 at 8pm last night.
It gained to 85.75 yen from 85.44 yen, and fell to 77.52 Australian cents from 77.94 cents. It fell to 55.89 euro cents from 56.39 cents, and down to 46.51 pence from 47.21 pence.
The yield on the benchmark 10-year government bond fell 8 basis points to 5.37 per cent.
"The earthquake that struck Canterbury on 4 September has significantly disrupted economic activity and is likely to do so for some time yet," Bollard said in a statement in Wellington today.
"The pace and extent of further OCR increases is likely to be more moderate than was projected in the June statement."
Since the June MPS, Canterbury has been hit not only by the quake but also the failure of Timaru-based South Canterbury Finance, which made a $1.6 billion call on the retail guarantee.
"There was no chance of a rate hike by Dr. Bollard with the South Canterbury Finance issue hanging over the economy and the earthquake as well," said Tim Kelleher, vice president of institutional banking and markets at Commonwealth Bank of Australia.
The kiwi also came under pressure overnight from offshore markets, as the US dollar staged its biggest daily gain against the yen in nearly two years, after the Bank of Japan spent as much as US$20 billion to weaken the yen and to ward off the threat of slowing the country's exports.
Finance Minister Yoshihiko Noda said Japan intervened in the currency market because of the impact of the yen's gains on the economy.
He said Japan would continue to take action, and had acted without foreign assistance.
The move comes a day after Japanese Prime Minister Naoto Kan won re-election as the head of the ruling party, beating a candidate who had promised action to weaken the yen.
"The kiwi was weaker overnight because of dollar strength, obviously caused by Bank of Japan selling yen and buying dollars,"
Kelleher said.
The Dollar Index, which measures the greenback against a basket of six major currencies, fell 0.3 per cent to 81.45 overnight.


text:
The following commentary does not necessarily reflect the views of AgWeb or Farm Journal Media. The opinions expressed below are the author's own.
Visit www.standardgrain.com for more information!
Visit our website for our Sunday Pre-Open Update!
Call or email anytime with questions! firstname.lastname@example.com / (312) 462-4438
No comments have been posted to this Blog Post


text:
About Pearl Paradise.com Inc.
A Decade of Growth
Founded in 1996 and brought online in 2000, Pearl Paradise has grown into the world's largest online pearl company, with 2006 sales topping $20 million. With a custom-built, 1,400-cubic-foot vault filled with pearls, we offer a selection of pearls unlike any other pearl seller, online or off. Our commitment to offering prices 80 percent below retail has accelerated our growth.
With more than 100,000 satisfied customers to date, we have benefited greatly by word-of-mouth advertising. Our commitment to quality, customer service, and unbeatable pricing and selection has helped us become the Internet's premier source of pearl jewelry.
A Trusted Name
The reputation we have built based on the quality of our merchandise has attracted the attention of journalists around the world. We have been blessed with glowing articles in The Wall Street Journal, Entrepreneur Magazine, Investor's Business Daily, and Inc. Magazine, to name just a few.
The pearl and jewelry industry has followed our growth and featured us in respected industry publications like Modern Jeweler, Jewellery News Asia, and JCK.
Shop Online or Offline
While more than 99 percent of our business is conducted online, we offer appointments for our local clientele in our luxurious Los Angeles showroom. We offer only one appointment per day, and these are often booked weeks in advance. However, no appointments are available mid-November through early January. With thousands of pearl strands for clients to see, we insist on giving our undivided attention. This unique experience has created a following of celebrities and pearl connoisseurs who are regulars in our showroom.
Team of Experts
At Pearl Paradise, every associate is a world-class pearl expert. Every team member is required to complete the Gemological Institute of America's pearl diploma program. Then we train our team in pearl grading, selection, matching, and drilling.


text:
Stephen Harper Birthday: Celebrating Prime Minister's 54th Birthday With 54 Photos
Stephen Harper's 54 years have resulted in just as many memorable photos, so as the prime minister celebrates his birthday on April 30, we're taking a look back at some of our favourites.
He's had some big wins on camera, cuddling with kittens and crashing a wedding to name a few, and man can he rock a cowboy hat. But he's had his fair share of awkward (and entertaining) moments, too.
So, whether you love him or hate him, here's wishing Harper a very happy birthday, and here's hoping for many more fun photos to come.
Stephen Harper and wife Laureen in 2011. Source: Flickr
Part of a painting of Prime Minister Stephen Harper fully nude, by Kingston artist Maggie Sutherland, is shown at the Central Kingston public library in Kingston, Ont. on May 18, 2012.
Prime Minister Stephen Harper gets behind the bar at the Victoria pub in Montreal Friday, March 16, 2012 where he stopped in to meet some supporters and have a drink for St. Patricks Day.
Conservative leader Stephen Harper and Laureen Harper stand next to a tray of hot cross buns at a bakery in Mississauga, on April 23, 2011.
Stephen Harper with wife Laureen and their chinchilla Charlie. Source: Flickr
Prime Minister Stephen Harper waves after going for an ATV ride as he visits a farm for a campaign event in Wainfleet Ont., on Monday, April 4, 2011.
Prime Minister Stephen Harper eats maple taffy as he visits a sugar shack in Norbertville, Quebec on Tuesday, April 5, 2011.
Prime Minister Stephen Harper gives his wife Laureen a kiss following a day of G-20 meetings in Toronto. June 27, 2010. Source: Pm.gc.ca
Prime Minister Stephen Harper plays with foster kittens at 24 Sussex. May 1, 2010. Source: Pm.gc.ca
Conservative Leader Stephen Harper throws a small snowball at photographers after talking with reporters at a campaign stop in Guelph, Ontario Saturday, Jan. 21, 2006.
Prime Minister Stephen Harper gives Taylor Swift the book "Maple Leaf Forever" before her concert at Scotiabank Place in Ottawa. May 20, 2010. Source: Pm.gc.ca
Stephen Harper surprises an Ottawa couple on their wedding day in 2012.
Laureen Harper laughs as she holds a husky dog with Canadian Prime Minister Stephen Harper as they tour Caribou Crossing, Yukon, south of Whitehorse Monday August 20, 2012.
Stephen Harper, his children Ben and Rachel, and wife Laureen cross Abbey Road in 2009. Source: Facebook
Prime Minister Stephen Harper hams it up with Bonhomme Carnaval in the Prime Minister's Centre Block Office. November 25, 2010. Source: Pm.gc.ca
Canadian Prime Minister Stephen Harper, far left, watches a third round match between Agnieszka Radwanska, of Poland, and Serbia's Jelena Jankovic with his children Rachel, center, and Benjamin, right, at the 2012 US Open tennis tournament, Saturday, Sept. 1, 2012, in New York.
Catherine, Duchess of Cambridge, speaks with Canadian Prime Minister Stephen Harper during Canada Day celebrations on Parliament Hill in Ottawa on July 1, 2011.
Prime Minister Stephen Harper and his son Ben watch a bloopers show while attending the Calgary Flames NHL hockey game against the Edmonton Oilers in Calgary, Saturday, April 11, 2009.
Prime Minister Stephen Harper practices a few chords after arriving at home from work. February 19, 2011. Source: Pm.gc.ca
Conservative leader Stephen Harper gets a hug from his mother Margaret during a visit to his campaign office in Calgary, Saturday May 29, 2004.
Prime Minister Stephen Harper holds up a moustache scarf to kick off the start of 'Movember', November 1, 2012 Source: Flickr
Senior Legislative Assistant, Katherine Locke, left, and Government House Leader Special Assistant, Zoe Lawson, show off their House of Commons gingerbread house to Prime Minister Stephen Harper in his office on Dec. 16, 2010. The gingerbread house was filled with rows of gummi bears as members of Parliament. Source: Pm.gc.ca
Prime Minister Stephen Harper waves to tourists as he walks on the beach after the closing of the VI Summit of the Americas on April 15, 2012 in Cartagena de Indias, Colombia.
Prime Minister Stephen Harper plays a game of table tennis with Team Canada's Mo Zhang at Canada House in London on Tuesday, June 5, 2012.
Prime Minister Stephen Harper tries on an old hockey helmet at he tours the Yukon's Hockey History exhibit at the McBride Museum in Whitehorse, Yukon on Thursday, August 25, 2011.
Stephen Harper, his son Ben, and Wayne Gretzky watch the men's ice hockey team's gold medal game at the 2010 Winter Olympics in Vancouver. Source: Flickr
Stephen Harper and his son Ben hit balloons into the crowd after his speech at the party's three-day policy convention in Montreal on Friday March 18, 2005.
Prime Minister Stephen Harper and Jamie Robinson (guitar) play along with Blue Rodeo's front man Jim Cuddy, and recording artist Jimmy Rankin as they belt out a tune during a Juno Awards reception at 24, Sussex March 31, 2012. Source: Pm.gc.ca
Prime Minister Stephen Harper, looks up from dishing out pancakes at Stampede breakfast in Calgary, Alta., Sunday, July 10, 2011.
Stephen Harper welcomes two Chinese pandas at Toronto's Pearson Airport on March 25, 2013. Source: Flickr
A young Stephen Harper.
Clowns ham it up with Prime Minister Stephen Harper at the IAAF World Junior Championships in Moncton, New Brunswick. July 19, 2010. Source: Pm.gc.ca
Prime Minister Stephen Harper, left, throws Senator Gerry St. Germain's cowboy hat into the crowd after presenting him with a new one as his wife Margaret St. Germain, right, laughs during a barbecue at St. Germain's ranch in Surrey, B.C., on Monday August 6, 2012.
Prime Minister Stephen Harper gives the thumbs up from the cockpit of his campaign plane as he arrives in Ottawa,Tuesday May 3, 2011.
Stephen Harper presents Justin Bieber with a Diamond Jubilee Medal on Nov. 23, 2012. Source: Flickr
Stephen Harper and Wayne Gretzky, joined by students on an outdoor ice rink in Saskatoon on Feb. 5, 2010. Source: Facebook
Stephen Harper, wife Laureen and Suraksha, Grade 10, visit an IMAX theatre in Bangalore, India on Nov. 8, 2012.
Prime Minister Stephen Harper poses for a photograph with Halloween trick-or-treaters at his official residence in Ottawa, Wednesday, October 31, 2012.
Prime Minister Stephen Harper bundles up in a parka as he tours Frobisher Bay in Iqaluit, Nunavut on Thursday, February 23, 2012.
Canada's Prime Minister Stephen Harper adjusts his hat prior to the arrival of Britain's Prince William and his wife Catherine, Duchess of Cambridge, for the official start of the Calgary Stampede parade in Calgary, Alberta, July 8, 2011.
Prime Minister Stephen Harper and his wife Laureen play with some furry friends at the official opening of the new Ottawa Humane Society facility on July 6, 2011. Source: Pm.gc.ca
Met Batisse X, official mascot of the Royal 22nd Regiment, prior to welcoming French PM Jean-Marc Ayrault to Ottawa. Source: Flickr
Prime Minister Stephen Harper receives a cricket lesson from Ankur Biswas, cricket team captain, at the Bishop Cotton Boys School. Source: Facebook
Prime Minister Stephen Harper drives a dog sled after meeting mushing teams at the Arctic Winter Games in Yellowknife, N.W.T., Monday, March 10, 2008.
Stephen Harper meets Canada's women's hockey team, gold medal winners at the 2010 Winter Olympics in Vancouver. Source: Facebook
Prime Minister Stephen Harper and his wife Laureen, left, make cookies with 10-year-old brain cancer survivor Baxton Wacholtz, right, and his mom Michelle, of Telkwa, B.C., during a photo opportunity at Ronald McDonald House in Vancouver, B.C., on Tuesday August 7, 2012.
Canadian musician Jens Lindemann visits Stephen Harper before a concert. "His blue trumpet reminded me of Sgt. Pepper," according to Harper. Source: Flickr
Met with Constable Dan Allen of the Child at Risk Response Team (and Cagney the dog) while in Calgary. Source: Flickr
Prime Minister Stephen Harper points out the camera to baby Grayson, dressed up as a giraffe, during his first time trick-or-treating at 24 Sussex. Source: Facebook
Stephen Harper hugs his daughter Rachel Hugging Rachel as results come in after the 2011 election. Source: Facebook
Stephen Harper holds up the Allen Cup, the Canada's senior men hockey championship trophy, after it was handed to him at a campaign event in Brantford Ont., Friday Oct 10, 2008.
Stephen Harper and legendary hockey coach Scotty Bowman shows off his Stanley Cup rings in 2012. Source: Flickr
Stephen Harper plays hockey in a parking lot in 2011 during a campaign stop. Source: Flickr


text:
Our Photography Courses Blog
Photography Course at the National Media Museum in Bradford
We were blessed by incredibly nice weather in Bradford, so many of our pictures were taken outside at Bradford's (some might say extravagant) £24,000,000 water feature in the sunshine. We had a small group with a variety of ages and cameras, but we managed to get some interesting pictures, while avoiding taking pictures of strangers that while legal, get you into trouble!
The museum at Bradford is a fantastic resource and a lovely place to each and have lunch. It also give us the chance to practice museum photography, which is something that many people want to improve (and we can also try out at the British Museum, which we visit from another of our venues, the Camera Cafe).
Bradford has some striking buildings and interesting sights – well worth a visit, you may be surprised to hear!


text:
Get a 5% special discount if you book directly on our website
The offer includes:
• 5% of discount
• Continental Breakfast• Free internet wifi connection
City tax is not included in the price
Book in Advance and get the 12% off!
Offer includes:
• 12% of discount booking at least 3 days in advance• A rich buffet breakfast and a bottle of Italian Prosecco in the room• Wi-fi connection inside and outside the Villa
City tax is not included in the price.
Prepaid, not refundable rate.
Auditorium - Parco della Musica
Christmas at the Auditorium is suitable for an audience of all the ages. Doors open to the Parco della Musica attractions of all kind: music, theater, circus, ice skating, games, exhibitions, market. For more than a month the auditorium is transformed into an "urban village" sparkling decorations and illuminations, complete with Christmas market, playground, skating rink.
The Roma Gospel Festival, Christmas in the Auditorium, has become the largest festival of gospel music in Europe in which they are housed some of the best groups of spirituals and gospels from the United States. In this edition of the festival, we will hear some confirmation and absolute novelties including Dr. Bobby Jones the best known singer and television presenter, Grammy Award winner, and the chorus of New York, the world-famous Harlem Gospel Choir and two choirs youth and adolescents, Chicago Gospel Choir Songs of Solomon and finally the soloists Craig Adams, Monica Lisa Stevenson, groups Spirit of New Orleans, Light of love and Gospel Victory in Chicago.
Lessons of Rock returns this year with twelve events entirely dedicated to the music of the Beatles. Fifty years after the publication of "Love me do", the first disc of the Liverpool band, the Fab Four are celebrated by the pair Gino Castaldo and Ernesto Assante which continues to tell in words, pictures and sounds the characters that have made history.


text:
62% of U.S. Buyers: Social Media Doesn't Work
Social media marketing doesn't influence consumers to buy in IRL. Influence results from "in-real-life" experiences, with consumers liking brands on social media as a result, finds Gallup in research announced on June 23.
Social media has "no influence at all" on their purchasing decisions, 62 percent of respondents to the "2014 State of the American Consumer" tell Gallup. At the same time, many of those consumers say they seek advice from friends and family before making a purchase and 94 percent of respondents say they use social media to connect with friends and family.
So there is hope. Gallup recommends marketers:
- Connect With Consumers Offline. "Social media entail just a fragment of a consumer's experience with a company. Customers are much more likely to be active listeners and participants in a brand's social media community when they have already made an emotional connection with that brand through other experiences. While responsiveness and service are incredibly important in social media departments, this type of initiative does not necessarily lend itself to the more personal, one-on-one connections that typically engage consumers. Those largely happen offline."
- When Marketing on Social Media, Be Authentic. Marketers are in their customers' personal space. In that personal space, no one wants to hear sales pitches. "They want to interact with a human, not a brand. Companies should back away from the hard-sell and focus on creating more of an open dialogue with consumers," according to the report.
- Be Responsive on Social Media. Answer questions and reply to complaints and criticisms, even on nights and weekends. The same consumers who say social media won't influence their purchasing decisions expect a response.
- Be Compelling on Social Media. Buy the product? Yeah, they've already heard that. It's boring, and they're busy. "Content should be original to the company and not related to sales or marketing."
So what came first? Oreo love or the brand's tweets and posts during the Super Bowl power problem?
Robert Bly
What is IRL? Journalistic standards require an acronym to be spelled out in the first usage.


text:
Re: 1977
May the force be with you!
Rejected because: Our lawyers recommended no 'Star Wars' references. Lucas is a tough cookie.
Re: 1977
May the force be with you!
rabbitjr wrote:May the force be with you!
WHat you may want to do is change the saber so it doesn't look exactly like one from Star Wars. Duplicating a movie saber is a great way to earn the wrath of Lucasfilm Stormlawyers.
However, prop saber makers (like Parks Sabers http://www.parksabers.com/ ) make props that are recognizably light sabers without touching on Lucas copyrights.
Best of luck with the redesign!
By date:
By rank:


text:
Northern Territory MP John Elferink has offered his resignation as NT Attorney-General after failing to get the numbers to challenge Terry Mills to become chief minister.
Responding to reports that Mr Elferink was on Monday counting the numbers and had planned a meeting with colleagues, Mr Mills confirmed Mr Elferink had offered his resignation early Tuesday but it was not accepted.
"He has indicated to me that because of the subject of these rumours that he would be prepared to do what he thinks I would require of him," Mr Mills told reporters.
"What I require of John is to focus on the business of the Northern Territory and to offer unqualified support, which he has offered and provided and I have accepted," the Chief Minister said.
The leadership speculation in the Country Liberal Party (CLP) comes just days after a byelection that saw a big swing towards the Labor Party.
Since taking office in August last year in a landslide the CLP has cut costs and raised electricity prices by 30 per cent.
Mr Mills says his government won't be distracted by the leadership issue.
"We have had an election result that has caused some concern to some members of our party," Mr Mills said.
"I am not going to spend my energy on the things that are in the shadows and ... the subject of rumours and speculation.
"This is time for courage under fire," Mr Mills said.
The Australian Financial Review


text:
|← Previous - TP
|TPS report
|track - Next →
Definition of TPS report
TPS report
- a fictional business report made popular by the film "Office Space" and used in the TV show "Lost." Used to represent useless work required by management.
Citation from "Walkabout", Lost (TV), Season 1 Episode 4 blacked out to resolve Google's penalty against this site.
- See more words with the same meaning: business (related to).
Last edited on Nov 05 2011. Submitted by Walter Rader (Editor) from Sacramento, CA, USA on Aug 03 2009.
|Add a definition for this slang term
More info:
Interactive stats:
Related words
Slang terms with the same meaning
Other terms relating to 'business (related to)':
|Definitions include: pejorative term for a person involved in marketing.
|Definitions include: support.
|Definitions include: of an entire task, the easy portions.
|Definitions include: a person's primary skill.
|Definitions include: busy.
|Definitions include: press conference.
|Definitions include: the "Target" retailer.
|Definitions include: a break in the workday when employees gather to ingest drugs.
|Definitions include: acronym for "small office / home office".
|Definitions include: to hit.
|Definitions include: a person hired for their expertise.
|Definitions include: acronym for "End of Day."
|Definitions include: "specification".
|Definitions include: an all-night period of awakedness to finish a task.
|Definitions include: The Salvation Army.
Slang terms with the same root words
Other terms relating to 'report':
|Definitions include: someone who reports to a manager.
|Definitions include: in an organization chart, a solid line is used to indicate the relationship between a manager and their reports.
How common is this slang?
|I use it
|No longer use it
|Heard it but never used it
|Have never heard it
How vulgar is this slang?
Average of 3 votes: 1% (See the most vulgar words.)
|Least vulgar
|Most vulgar
Your vote: None (To vote, click the pepper. Vote how vulgar the word is – not how mean it is.)
|Least vulgar
|Most vulgar
Where is this slang used?
Logged-in users can add themselves to the map. Login, Register, Login instantly with Facebook.
Link to this slang definition
To link to this term in a web page or blog, insert the following.
TPS report
To link to this term in a wiki such as Wikipedia, insert the following.
[http://onlineslangdictionary.com/meaning-definition-of/tps-report TPS report]
Some wikis use a different format for links, so be sure to check the documentation.
|← Previous - TP
|TPS report
|track - Next →


text:
This issue has variants.
Details in this index are currently based on information provided in Grimm Fairy Tales Sinbad Crossover (Zenescope Entertainment, 2012 series) #[nn].
This issue is the conclusion to a three part story. The first two parts were published in Grimm Fairy Tales 2011 Annual (Zenescope Entertainment, 2011 series) #[nn] and Grimm Fairy Tales Giant-Size 2011 (Zenescope Entertainment, 2011 series) #[nn].


text:
Ann Vernon has chronic intractable pain and had been charged with cannabis cultivation after police found cannabis at her house.
Last Friday she was discharged without conviction when she reappeared in Waihi District Court.
The charge of cultivation was not proven, so the charge was amended to permitting premises to be used for cultivation, and when the judge heard mitigating medical evidence (as she has support from her doctor) so she was discharged without conviction.
Ann has been suffering chronic pain for many years after being trampled by horses when she was quite young.
"I received back injuries.
"Then later on I had an unrelated surgery [private] and severe emotional trauma which caused post traumatic stress disorder.
"I have pain pretty much throughout my whole body. Back, joints and shooting pains down my legs.
"Panadol doesn't even touch the edges."
Over the years, Ann has used and been prescribed many different pain killers. She has been in pain for 12 years and is often bedridden.
Two and a half years ago, a medical specialist (gynaecological) and an osteopath suggested she try cannabis to help relieve her painful symptoms.
"Initially I thought it was a crock," said Ann.
But she tried cannabis and it made sleeping easier.
"It didn't cut the pain out completely but I was able to get up and get moving. It took my focus off the pain.
And her nausea disappeared when she was using cannabis.
Since using cannabis Ann has stopped using most of her conventional medication. She still takes some opiates but has reduced her use by two thirds.
Ann uses a herbal vapouriser to release the active cannabis ingredients but with no smoke. It is a handheld device which allows her to inhale the cannabis vapour directly.


text:
Mirroring Hope Dinner: Meet Rabbi Rosen and Help Save Palestinian Villages!
Rebuilding Alliance
Tuesday, April 23, 2013 from 6:30 PM to 9:00 PM (PDT)
San Mateo, CA
Contact the Host
When & Where
Unitarian Universalists of San Mateo
300 East Santa Inez Avenue
San Mateo,
Tuesday, April 23, 2013 from 6:30 PM to 9:00 PM (PDT)
Add to my calendar
Rebuilding Alliance
Rebuilding Alliance is a San Mateo non-profit that partners with Palestinian and Israeli NGO's to help rebuild at-risk Palestinian communities – then works with constitutents and Congress to intervene to keep them standing. Succeeding in the village of Al Aqaba, we ask your help to extend to 12 more.
In Area C of the West Bank, 149 Palestinian communities are facing demolition orders. Americans of all faiths are already deeply engaged in on-the-ground projects which bring Palestinians, Israelis and internationals together to keep homes, clinics and schools standing. Help build a U.S. Movement to Save Palestinian Villages and mirror their message of hope.


text:
What are the key compliance issues specifically for sole practitioners? What are the most effective data protection and security solutions for the sole practitioner? How can sole practitioners build their reputation and brand name through online and offline initiatives?
These questions and many more will be answered in this practical conference, chaired by Peter Scott. The conference focuses on a range of key opportunities and threats for sole practitioners, along with how to manage them effectively and at the same time make your business more commercial.
This conference is taking place in London on 9th December 2014, from 9.30am til 5.15pm.
Please click here for the full conference agenda and speaker details.
We're currently offering Legal Futures readers a special reduced price for this conference – email email@example.com quoting LEGF14 for more details.
Associate News is provided by Legal Futures Associates.
Find out about becoming an Associate
Legal Futures Blog
The rise of the multi-disciplinary lawyer: A challenge for legal education
The legal profession has been on the receiving end of much hype regarding the impact of technology. Recent commentators purport that the aspiring lawyer must be a triple threat, possessing knowledge of the law, coding expertise, and in-depth knowledge of legal technology. Yet, focusing on legal technology risks overlooking the need for skills that transcend latest fads. Legal technology is a means by which to handle data: to organise it, record it, extract it, analyse it, predict from it and leverage it. Quantitative and statistical literacy – the ability to understand, apply, visualise and infer from data – underpins technological literacy and yet receives very little attention from those who encourage innovation in the legal curriculum.
Associate News
Irwin Mitchell to merge Southampton offices
iManage Acquires Leading Artificial Intelligence Pioneer RAVN Systems
Brain Chase Coles replaces retiring cashier with Quill's full-service software and outsourcing support
Future proof your firm against legal aid cuts
Search Acumen comments on HMRC property transactions, April 2017
Property Workshops Continue With Key Insights into What Customers Really Want
'Overwhelming' pace of change in legal costs rules and procedure prompts Burcher Jennings to launch new Costs Masterclass


text:
This one is taken before I bound it.
Nothing fancy, just quilting therapy.
Welcome to the Quilting Board!
This one is taken before I bound it.
Nothing fancy, just quilting therapy.
Very nice, love the denim pockets on the second one. Your quilting on the first one is beautiful.
Busy in Ohio
These are really cute! I love the pockets too. They both look very snuggly.
Great comfy quilts!
Thank you so much. The second one has all but a little bit of an old pair of jeans stitched into it. First one was for one of my grandsons, with "I love grandma" flannel on the back.
Both are fabulous.
Alcyone group: http://www.quiltingboard.com/members...bums18449.html
Electra group: http://www.quiltingboard.com/members...bums18446.html
both are well done, but the first is my fav
Nancy in western NY
before you speak THINK
T is it True? H is it Helpful? I is it Inspiring? N is it Necessary? K is it Kind?
Love them both, great job!!!
I think they're beautiful. Your color combinations are just perfect.
A fabric stash is always missing that one fabric needed to finish the quilt on which you're working.
Your quilts look really nice - like the jeans sewn into the second one. Nice touch.


text:
Bucks formally fire Larry Drew as coach in wake of Kidd hire
As expected, the Milwaukee Bucks have fired coach Larry Drew after trading second-round picks for Jason Kidd to be the coach.
More Offseason Analysis: Coaching changes, news | Free Agency | Draft
Update: It's official, with Bucks general manager John Hammond commenting in a statement:
"Despite the challenging season, Larry always handled himself and represented the Bucks in a first-class manner. Larry did the best he could in a difficult situation, especially given all of our injuries. I want to thank Larry for all of his efforts, and we wish him the best of luck in his future endeavors."
Aaaand the Nets have chimed in with an official statement, too:
Brooklyn Nets General Manager Billy King announced today that the organization has permitted Jason Kidd to pursue a coaching opportunity with the Milwaukee Bucks. In exchange for allowing Kidd to depart, the Nets will receive two second round draft picks (2015 & 2019) from Milwaukee. A search for a new head coach will begin immediately.
Billy King will meet the media at 10 a.m. ET on Tuesday. That won't be awkward or anything.
The Milwaukee Bucks have a new coach after trading multiple second-round picks to the Brooklyn Nets for Jason Kidd. Kidd will take over the Bucks' sidelines after a failed attempt at a power play for personnel control with the Nets in addition to his coaching duties. While the move by Kidd wasn't favorable with the Nets' brass, he managed to avoid punishment and still retain a coaching position by finding his way to the Bucks. There is just one more loose end that needs to be tied up in the ordeal.
The Bucks have to fire their current coach Larry Drew. According to Brian Windhorst of ESPN.com, Drew has been formally fired after a meeting this morning and the sidelines are all Kidd's now.
Larry Drew has been formally fired as coach of the Bucks, sources told ESPN
— Brian Windhorst (@WindhorstESPN) June 30, 2014
Drew took over as the Bucks' coach before the 2013-14 season when he was hired following Jim Boylan's interim coaching stint in the 2012-13 season. Boylan replaced Scott Skiles after Skiles was fired following a 16-16 start. Drew signed a three-year deal to coach the Bucks and lasted just one season. Milwaukee had the worst record in the league at 15-67.
Cavs-Warriors strengths and weaknesses
How they match up with what each team does well, and poorly, headed into the big battle for...
2K17 shows Lonzo schooling Curry, LeBron
LaVar Ball will be happy with this futuristic mix of his son in Lakers gear
LeBron praises Lue's calmness
LeBron had some high praise for his coach
LeBron praises Warriors' addition of KD
The King had some high praise for Warriors' "new" addition
LBJ feels 'very good' about Cavs chances
LeBron and the Cavs are looking for their second straight title
NBA Finals: Cavs vs. Warriors picks
This could be another classic series, and our experts have their picks


text:
It was a dark night as the rain poured down in Ukiah. Sam (my husband) and I were struggling with getting a very heavy, unwieldy treadmill into our home. In our search for help we ended up at one of the local businesses that my husband had become well acquainted with.
While there Sam asked one of the store's employees whom he had befriended, if he could help us with our dilemma. He hopped into the car and came back to our home to assist us. This young fellow showed great ingenuity in helping Sam maneuver the treadmill into our home. On the way back to drop him off, he casually asked my husband, "What do you think of all these vagrants in town?"
My husband looked back at him and exclaimed, "I believe everyone has a story!"
A wave of release swept across the young man's face as he said, "I was one of them," as he began to reveal his story of tragic and unforeseen circumstances.
Similarly, my daughter Amy, an occupational therapist, who works in community mental health, became a certified storyteller to deal with the stresses of her career and as a path to personal healing. As she journeyed through the course, she suggested to her professor that not only was there a story of pain to be threaded together in each life to better understand the, "what and how," but a second story begged to be written.
It is the story of our power. Most often the two are intricately linked.
I am deeply touched when you share your stories with me. Some of you are driven from a deep place as you go through life each day. You have experienced struggles, pain, and loss in a way that is uniquely yours.
The stories of your own life or that of a co-worker, or in our case a patient, move you to come back and support others in this journey through life.
As an organization, Ukiah Valley Medical Center has a story, of which you are uniquely involved. There are indeed chapters of conflict and strife alongside colorful stories of fascinating encounters that happen in caring ways as diverse and unique as every life we touch. We have the fortune of touching every segment of the communities we serve.
Conversely, here before us are empty pages waiting to be written. We have entered a similar stormy night in history of healthcare in this nation where "structure" is hardly earned in this fragmented experience of care.
However, this story is collectively ours to write. We have individuals with a burning passion for our community. A passion that evokes thoughtful consideration about the future design and delivery of the care Ukiah Valley Medical Center provides. Please give your best most creative thinking to this, drawing on your deepest wisdom, and be a part of building this future with me.
In summary, as you give thanks for the blessings you have received throughout this year, remember to laugh, love, and listen - because everyone has a story worth listening too.
Until next week, Happy Thanksgiving, and stay healthy my friends.
Gwen Matthews is the Chief Executive Officer at Ukiah Valley Medical Center. She believes that everyone has a story to tell and is willing to share if you take the time to listen. She also wants to wish each and every one in our community a "Happy Thanksgiving!"


text:
Just Ask Bucket List Getaway Giveaway Official Rules
TodaysMama, LLC (the "Company") may change the dates and/or terms of the Contest without prior notice. Any material changes will be posted online on Company's website (http://www.todaysmama.com/exclusives.php). A purchase will not improve a participant's chance of winning and a purchase is not necessary to participate in and/or win the Contest. The Contest is void where prohibited by law.
ELIGIBILITY. The Contest is open to all legal U.S. residents, 18 years of age or older. Employees or contractors of the Company or any other entity or sponsor associated with the Contest, as well as members of the immediate family or members of the same household of any such employee, contractor or sponsor, may not participate.
CONTEST DATES: Entries are accepted starting Tuesday, October 18, 2011. Contest closes on Saturday, November 12, 2001 at Noon MST. Winners will be announce on this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ on Monday, November 14, 2011.
HOW TO ENTER. To enter to win one of three (3) Grand Prize Trip packages, contestant must publish a post on their blog/website that includes a minimum of 15-items that they would like to accomplish in their lifetime (referred to as a "bucket list"). Post must be linked via the Mr. Linky widget at the bottom of the Just Ask Bucket List Getaway Giveaway located at this URL: http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/. To be eligible for entry the post must include the following copy and links to qualify:
This is my entry in the Just Ask Bucket List Getaway Giveaway. Just Ask <link to: http://www.bracnow.com/> offers a breast and ovarian cancer screening and is encouraging people to share 15 things that I want to enjoy in my lifetime as a reminder to be aware of my health. Want to enter? Head over to TodaysMama.com http://wp.me/pR10l-3Kw to get the details.
To enter to win one of the three (3) $500.00 gift cards for extra entries, contestant must:
1. Go "like" Just Ask on Facebook http://on.fb.me/JustAskHBOC. (Come back to this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ and leave a comment letting us know you did.)
2. Share this tweet via contestants Twitter account: Did you know you can get screened for Breast/Ovarian Cancer http://on.fb.me/JustAskHBOC #justask (Come back to this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ and link to your tweet in the comments.)
3. Go "like" Today's Mama on Facebook http://www.facebook.com/TodaysMama?ref=ts. (Come back to this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ leave a comment letting us know you did.)
To enter to win one of the 14 blog tour gift cards, contestant must visit individual blogs (to be announced during contest flight on TodaysMama.com) and leave a comment on the Just Ask Bucket List Getaway Giveaway post on that website/blog. Specific comment requirements to be determined by the participating blogger.
SELECTION OF WINNER. Grand Prize Trips will be awarded by random selection. The Mr. Linky widget at the bottom of this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ will automatically number each entry. Company will utilize Random.org (www.random.org) to select the number of the winning entry. In the event that the winning entry is ineligible, another number will be selected utilizing Random.org.
Extra entry prizes will be awarded by exporting the comments on this post http://todaysmama.com/2011/10/just-ask-bucket-list-getaway-giveaway/ into a spreadsheet and utilizing Random.org (www.random.org) to select the number of the winning entry. In the event that the winning entry is ineligible, another number will be selected utilizing Random.org.
Blog Tour prizes will be awarded by the individual participating blogger. Random.org (www.random.org) will be used to select the number of the winning comment. In the event that the winning entry is ineligible, another number will be selected utilizing Random.org.
PRIZES. Prize descriptions can be obtained on the Company website. Prize values will vary in each contest. Winners will be contacted via the email address provided in the contest entry form submitted online. If Company is unable to contact the winner within 14 days, prize will be forfeited and an alternate winner may be selected.
Universal Orlando Resort Grand Prize Trip Details: There will be one (1) Prize ("Prize") awarded. Prize winner ("Winner") will receive a four (4) day, three (3) night trip for Winner and up to three (3) guests ("Guest(s)") to Universal Orlando® Resort in Orlando, Florida. Trip will include round trip coach class air transportation for Winner and up to three (3) Guests from a major commercial airport near Winner's home (as determined by Prize Provider in their sole discretion) to Orlando, FL provided by Southwest Airlines*; three (3) nights standard hotel accommodation (one room, quadruple occupancy, room and tax only) at Lowe's Royal Pacific Resort (or another on-site hotel as determined by Prize Provider in their sole discretion); non-exclusive ground transportation to and from airport and hotel in Orlando, FL*; and 3-Day/2-Park Tickets for both Universal Orlando Theme Parks for Winner and up to three (3) Guests. The Approximate Retail Value ("ARV") of Trip is three thousand three hundred and forty-three dollars and ninty-four cents ($3,343.94). If Winner elects to partake in any or all portions of his/her Prize with fewer than thee (3) guests or no Guest, the Prize will be awarded to Winner and each participating Guest and any remainder of the Prize will be forfeited and shall not be subject to further or alternative compensation. All elements of the Prize must be redeemed at the same time, and no changes will be permitted after confirmation of any redemption. If Winner is between the ages of eighteen (18) and twenty-one (21), he/she must be accompanied by an adult of at least twenty-one (21) years of age in order to check into the on-site hotel. Specific travel dates and arrangements are subject to air travel, holiday, blackout dates, and other prize and travel restrictions. Trip must be completed within one (1) year from the end-date of the Promotion or Prize will be forfeited. Reservations are subject to availability. Trip must be booked at least sixty (60) days prior to intended departure date. Travel dates are subject to Prize Provider and Sponsor approval. ARV of Prize may vary depending upon the points of departure, ground transportation, and/or airline fare fluctuations; any difference between stated ARV and final ARV of Prize will not be awarded. Prize consists only of the elements expressly set forth above; no other elements or expenses (including, without limitation, insurance, meals, unspecified ground transportation, phone calls, gratuities, incidentals, souvenirs, gasoline, etc.) are included in the Prize and all such expenses are the sole responsibility of Winner. Winner is responsible for any air travel taxes and/or expenses, including applicable departure taxes or fees, inspection charges, and security charges. Once issued, tickets are nontransferable and may not be reissued once travel has commenced. Open tickets may not be issued and stopovers are not permitted. Travel arrangements must be made through Prize Provider. All Prize elements must be redeemed at the same time.
*Airfare and ground transportation portions of each Grand Prize Consumer package are void if Grand Prize winner resides in Florida.
Las Olas Surf Safari Grand Prize Trip Details: Prize includes one spot for one person in a Las Olas Surf Safari. Safari includes surf lessons, yoga, daily activities and a private bedroom in a shared villa in Mexico. *This trip package does not include air transportation.
Park City Mountain Resort Grand Prize Trip Details: Prize includes two-night lodging at a one-bedroom condo in Park City, Utah. Four people will each receive one lift ticket, one ski lesson, one equipment rental each day for a total of three days at Park City Mountain Resort in Park City, Utah. One $100 gift card for dining at Park City Mountain Resort is included in this prize package. *Blackout dates apply and this trip package does not include air transportation.
Extra Entry Prizes: A total of three (3), Five Hundred Dollar (U.S. $500.00) gift cards will be awarded for extra entry methods. One $500.00 gift card will be awarded for each extra entry method.
Blog Tour Prizes: Fourteen (14) bloggers are participating in the Just Ask Bucket List Getaway Giveaway. Each blogger will award one prize, in the form of a gift card, up to $500.00.
CONDITIONS/RESTRICTIONS. All sales, prize and other taxes along with any other incidentals associated with the prize are the sole responsibility of the prizewinner. Prize cannot be transferred, assigned, redeemed for cash or substituted, except Company reserves the right to substitute a prize of comparable value should prize become unavailable. The Company assumes no responsibility or liability for damages loss or injury resulting from acceptance or use of the prize. Winner will be responsible for any taxes or fees that result from the receipt and/or use of their prize and may receive an IRS Form 1099-Misc. The Company is not responsible for replacing event tickets in the event of cancellation as a result of weather, promoter, team, or performer.
The Company is not responsible for the failure or inability to complete a telephone call, fax, or e-mail whether due to equipment malfunction, busy lines or otherwise. The Company and sponsors are not responsible for incomplete or illegible entries; technical, hardware, software or telephone or other transmission failures of any kind; lost or unavailable network connections; or incomplete, garbled or delayed computer transmissions whether caused by the Company, users, by any equipment, which may limit a participant's ability to participate. The Company reserves the right, in its sole discretion, to cancel or suspend a promotion or contest should a virus, bug, computer or other problem beyond the control of the Company corrupt the administration, security or proper execution of any promotion or contest. TodaysMama, LLC, in its sole discretion, may award prizes to entries received by alternate means.
In exchange for the right to participate in the giveaway, each participate agrees to release and indemnify the Company, and its officers, directors, contractors, and employees, or any other entity affiliated with the Contest (the "Released Parties"), from any and all claims, demands and/or causes of action of any nature or kind whatsoever, whether presently known or unknown, foreseen or unforeseen, that arises out of the participant's participation in the Contest.
By entering the Contest, all participants consent to the use of their name, photograph, likeness, biography, voice and/or video for advertising and promotional purposes, including online announcements, without limitation and without compensation. Anyone using fraudulent means to participate and/or win the Contest will be disqualified.


text:
Posts belonging to Category Configuration Manager 2012
Today Parallels released a brand new version of the Parallels Mac Management plug-in for Configuration Read more
ConfigMgr Hackaton at the MVP Summit 2015
In my blog of a couple of weeks ago I wrote to you that ConfigMgr Read more
Enhanced OSD support in Parallels Mac Management 4.0 for ConfigMgr 2012
Last year I wrote several blogs about a great plugin for Configuration Manager 2012 R2, Read more
Session resources BriForum Denver
Yesterday I was honored to speak at BriForum about managing Mac OS X devices with Read more
Mobile Application Management support arrived in ConfigMgr 2012
A couple of months ago I wrote a series of blogs about the Mobile Application Read more
ConfigMgr 2012 R2 CU5 released
Busy times while Ignite is going forward. Yesterday the Configuration Manager team released Cumulative Update Read more
Custom MDM RBA Roles for Configuration Manager 2012 R2
Together with some customers of mine we are testing and implementing Microsoft Intune connected with Read more
Objects appearing in Microsoft Intune in Hybrid scenario with ConfigMgr
While writing my last blog I realized myself that in Microsoft Intune, where the Mobile Read more
Conditional Access for Exchange Online via Configuration Manager and Intune
Yesterday announced and today a new Intune Extension for Configuration Manager 2012 R2 was available. Read more
Quick ConfigMgr 2012 R2 content troubleshooting tips
Last week I had a couple of content related issues at a customer after a Read more


text: well the Fleetwood is almost done. i saw it today and it looks nice. it turned out kinda purple though. i could see blue on the floor but it is more purple looking. i thought he was usind house of color but infact it is PPG. they are gonna buff it either this weekend or next and a month from now they are gonna put the last layer of clear coat on it. it has clear coat in it but they are gonna spray another layer. it is dull looking right now, that is because it hasnt been buffed. i am supposed to get it back tommorrow, but it will be unfinished.


text:
OFNA Shock O-Ring for X1-CR/9.5 (4)
Discontinued Online
This item is discontinued and no longer available for purchase. You may want to search our site for a similar item.
This is a set of four replacement o-rings from OFNA. These o-rings are use to seal the cartridge to the shock body.
This product was added to our catalog on October 8, 2007.