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Between 25% and 35% of infants born to HIV-infected mothers become HIV-1 infected. One potential route of mother-to-child transmission (MTCT) could be through a breakdown in the placental barrier (i.e., maternal–fetal microtransfusions).
Methods and Findings
Placental alkaline phosphatase (PLAP) is a 130-kD maternal enzyme that cannot cross the intact placental barrier. We measured PLAP activity in umbilical vein serum as an indicator of maternal–fetal microtransfusion, and related this to the risk of HIV-1 MTCT. A case-cohort study was conducted of 149 women randomly selected from a cohort of HIV-1-infected pregnant Malawians; these women served as a reference group for 36 cases of in utero MTCT and 43 cases of intrapartum (IP) MTCT. Cord PLAP activity was measured with an immunocatalytic assay. Infant HIV status was determined by real-time PCR. The association between cord PLAP activity and HIV-1 MTCT was measured with logistic regression using generalized estimating equations. Among vaginal deliveries, PLAP was associated with IP MTCT (risk ratio, 2.25 per log10 ng/ml PLAP; 95% confidence interval, 0.95–5.32) but not in utero MTCT. In a multivariable model adjusted for HIV-1 RNA load, chorioamnionitis, and self-reported fever, the risk of IP MTCT almost tripled for every log10 increase in cord PLAP activity (risk ratio, 2.87; 95% confidence interval, 1.05–7.83).
Citation: Kwiek JJ, Mwapasa V, Milner DA Jr, Alker AP, Miller WC, Tadesse E, et al. (2006) Maternal–Fetal Microtransfusions and HIV-1 Mother-to-Child Transmission in Malawi. PLoS Med 3(1): e10. https://doi.org/10.1371/journal.pmed.0030010
Academic Editor: Laura Guay, Johns Hopkins Medical School, United States of America
Received: August 2, 2005; Accepted: October 7, 2005; Published: November 22, 2005
Copyright: © 2006 Kwiek et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: CI, confidence interval; IP, intrapartum; IU, in utero; MHP, Malaria and HIV in Pregnancy; MTCT, mother-to-child transmission; PLAP, placental alkaline phosphatase; RR, risk ratio
By the end of 2004, sub-Saharan Africa was home to 13.3 million HIV-1-infected women, and in many sub-Saharan countries, the HIV-1 prevalence in antenatal women exceeded 20% [1]. In the absence of interventions such as antiretroviral drug prophylaxis, elective cesarean sections, and replacement feeding, between 25% and 35% of the children born to HIV-1-positive women themselves become infected [2]. Of the infant infections, approximately one-half occur during labor and delivery through an unknown mechanism [3].
One potential mechanism of HIV-1 mother-to-child transmission (MTCT) is through direct contact of infant mucosa with HIV-1-infected maternal blood, amniotic fluid, or cervical/vaginal secretions (the "all mucosal" mechanism) [4]. Evidence for the importance of this mechanism during intrapartum (IP) MTCT includes the observations that elective caesarean sections reduce HIV-1 MTCT [5], and that higher quantities of HIV-1 secreted into the birth canal are associated with increased HIV-1 MTCT [6,7]. On the other hand, both birth canal disinfection and emergency cesarean sections reduce birth canal exposure to HIV-1, but neither intervention significantly reduces HIV-1 MTCT [5,8–11].
In addition to the "all mucosal" hypothesis, HIV-1 MTCT could also occur via a breakdown in the maternal–fetal barrier followed by placental microtransfusions. Placental microtransfusions have previously been suggested as a route of HIV-1 transmission [12–15], and they are considered a plausible route of hepatitis B, C, and G vertical transmission [16–18]. Recently, an assay has been developed to quantify placental microtransfusions based on the detection of placental alkaline phosphatase (PLAP) activity in umbilical cord serum [13,15]. PLAP is a 130-kD glycoprotein synthesized from the eighth week of gestation until parturition, and its large molecular size is believed to preclude its passive diffusion across the placental barrier. Based on these characteristics and the observation that infants produce small amounts of PLAP compared to pregnant women, cord PLAP can be used as a surrogate marker of placental microtransfusions [13].
Although the cause of placental microtransfusions is unknown, they are hypothesized to arise during the first stage of labor, when uterine contractions intensify and membranes rupture [3,12,13]. In support of this hypothesis, cesarean sections performed before the onset of labor result in significantly less cord PLAP activity than both emergency cesarean deliveries and spontaneous vertex deliveries [13,15]. To build on these observations and to expand our knowledge of the biological mechanism of HIV-1 MTCT, we measured cord PLAP activity in Malawian mother–offspring pairs and evaluated placental microtransfusions as a risk factor for HIV-1 MTCT.
Participant Recruitment
This case-cohort study was derived from the Malaria and HIV in Pregnancy (MHP) prospective cohort study that was approved by the College of Medicine Research Committee at the University of Malawi and the Institutional Review Boards of the University of Michigan and the University of North Carolina at Chapel Hill. From December 2000 until March 2004, women in the Antenatal Ward at Queen Elizabeth Central Hospital in Blantyre, Malawi, were screened for eligibility to participate in a prospective cohort study designed to determine the association between malaria and HIV-1 MTCT. Women were ineligible for the study if they were in the active phase of labor, were participating in other research studies, lived outside the Blantyre district, were less than 15 y of age, were hypertensive, or had altered consciousness. Consenting women received HIV pre- and post-test counseling, and all HIV-1-infected women and their offspring received nevirapine according to the HIVNET 012 protocol [19]. The association between malaria and HIV-1 viral load in the MHP cohort has been described previously [20].
Case-Cohort Design
We constructed a case cohort study from the parent MHP prospective cohort. With this study design, a rare disease assumption is unnecessary and the odds ratio provides a direct estimate of the risk ratio (RR) [21]. Between December 2000 and February 2003, 2,557 pregnant women were recruited in the MHP study, of whom 744 (29.1%) were HIV infected. After identifying all cases of in utero (IU) and IP MTCT in the parent cohort, we randomly selected 160 women, regardless of their HIV-1 transmission status, from the 744 HIV-1-positive women to serve as a reference cohort. Of these mother–offspring pairs, three were excluded because of multiple gestations, six were excluded because they delivered at home (therefore cord serum was unavailable), and two were excluded because the mother died during delivery; the remaining 149 HIV-infected women formed the reference cohort of the case-cohort study (Figure 1). All cases of IU MTCT were selected from women enrolled in the MHP study through February 2003, and all cases of IP MTCT were selected from women enrolled in the MHP study through June 2003. IP transmission cases selected from February to June 2003 did not differ from the other IP transmission cases in terms of age, peripheral HIV-1 RNA load, PLAP activity, hemoglobin concentration, placental malaria infection, or mode of delivery (data not shown). HIV-1 MTCT cases were considered IU transmissions if the infant was positive for HIV-1 DNA within 48 h of birth, and were considered IP transmissions (i.e., HIV-1 infection occurring at or around the time of delivery) if the infant was both negative for HIV-1 DNA within 48 h of birth and positive for HIV-1 DNA 6 wk after delivery [22].
Laboratory/Pathology Testing
Chorioamnionitis was assessed by a board-certified pathologist (DM) according to the methods described in [23]. Peripheral malaria infection was assessed on thick blood films stained with field stain. Placental malaria was diagnosed from formalin-fixed placental biopsies as described in [24]. Maternal hemoglobin concentration was determined by HemoCue hemoglobinometer (HemoCue, Ängelholm, Sweden), and CD4-positive T cells were quantified by FACScan (Becton Dickinson, San Jose, California, United States).
HIV-1 Testing
Within the MHP cohort, maternal HIV-1 status was determined concurrently with both the Determine HIV-1/2 Rapid Test (Abbott Laboratories, Abbott Park, Illinois, United States) and the SeroCard HIV-1/2 Rapid Test (Trinity Biotech, Bray, Ireland). HIV-1 RNA was quantified using Amplicor HIV-1 Monitor v1.5 (Roche Diagnostics, Branchburg, New Jersey, United States), with plasma HIV-1 RNA concentrations less than 400 copies/ml assigned a value of 400 copies/ml. Infants were considered HIV-1 infected based on the detection of HIV-1 DNA with a real-time PCR assay against the HIV-1 long terminal repeat [25]. Maternal HIV-1 proviral load was quantified according to the methods presented in [6].
PLAP Assay
Immediately after delivery the umbilical cord was clamped and cut. A section of the umbilical cord 3 cm from its point of insertion into the placenta was washed with saline, the umbilical vein was located, and cord blood was aspirated with a large-bore needle. Serum was prepared from the blood and stored at −80 °C. PLAP was isolated from 100 μl of cord serum using an isoform-specific anti-PLAP antibody (clone B431, Biomeda, Foster City, California, United States), and its activity was measured with an immunocatalytic assay according to the methods of Hirano et al. [26] with the following modification: a fluorescent alkaline phosphatase substrate (5 μM fluorescein diphosphate, Molecular Probes, Eugene, Oregon, United States) was used, and its fluorescence was measured on a PerkinElmer (Wellesley, Massachusetts, United States) fluorimeter (excitation λ = 490 nm, 10-nm slit width; emission λ = 514 nm, 2.5-nm slit width, 515-nm cutoff filter). Cord PLAP concentration was determined by interpolation from a standard curve of purified human PLAP (Sigma, St. Louis, Missouri, United States). The standard curve was linear from 12 ng/ml to 3,250 ng/ml (R2 = 0.992), with PLAP activity less than 12 ng/ml assigned a value of 12 ng/ml.
Statistical Methods
IU and IP MTCT cases were analyzed as independent outcomes. We used generalized estimating equations with a logit link, binomial distribution, and an independent correlation structure to conduct bivariable and multivariable assessments of the relationship between maternal features and MTCT, while accounting for the lack of independence of the 23 MTCT cases included in the sub-cohort. To reflect the monotonically increasing risk of IP transmission as PLAP increased, log10 cord PLAP was coded as a continuous variable. In the multivariable models, prior to the outcome analysis, we assessed heterogeneity of the odds ratio by testing for interaction terms at α = 0.1. Subsequently, confounding was assessed by the backward elimination method [21] based on the change in the point estimate; variables that changed the estimate (RR) more than 10% were retained in the final model, with the exception of maternal HIV-1 viral load, which was included a priori. Variables assessed for interaction and potential confounding of HIV-1 MTCT prior to the outcome analysis include the following: HIV-1 RNA load, HIV-1 DNA load, CD4 T cell count < 200 cells/μl, chorioamnionitis (present or absent), episiotomy, self-reported fever in the week prior to enrollment, gestational age, placental malaria (any Plasmodium falciparum–infected erythrocytes on placental histology), and rupture of membranes more than 4 h prior to delivery. Owing to the correlation between HIV-1 RNA load, HIV-1 DNA load, and CD4 T cell count, the multivariable model of MTCT contained only one of these measures of HIV burden. Before the analysis of the association between maternal features and log10 cord PLAP, we eliminated duplicate values by removing the 23 cases included in the sub-cohort. The relationships between PLAP and dichotomous maternal factors were assessed with a two-tailed unpaired t-test (α = 0.05), and with continuous maternal factors the relationship was assessed with Pearson's correlation coefficient (α = 0.05). Statistical analysis was performed with S TATA v8.2 (StataCorp, College Station, Texas, United States).
We designed a case-cohort study to independently compare 36 IU and 43 IP MTCT cases to a sub-cohort of 149 HIV-positive mothers. The IU and IP MTCT cases were similar to the sub-cohort in terms of maternal age, infant birth weight, maternal hemoglobin concentration, gestational age, and gravidity (Table 1). The groups did not differ in the proportion of chorioamnionitis infections, nor in the proportion of peripheral or placental malaria infections. Of 205 deliveries, 149 (73%) were spontaneous vertex deliveries, 40 (20%) were emergency cesarean sections, seven (3%) were instrumental vaginal deliveries, five (2%) were elective cesarean sections, and four (2%) were breech deliveries; the mode of delivery did not differ significantly between study groups.
As expected, HIV-1 RNA concentration was associated with MTCT. The median HIV-1 RNA load of the mother in IU MTCT cases was twice the median HIV-1 RNA load of the sub-cohort (67,646 copies/ml versus 35,241 copies/ml), and in a univariable regression, the risk of IU transmission increased 65% for every log10 increase in HIV RNA load (RR, 1.65; 95% confidence interval [CI], 1.06–2.58). Similarly, the median HIV-1 RNA load of the mother in IP MTCT cases was approximately twice the median RNA load of the sub-cohort (76,544 copies/ml versus 35,241 copies/ml), and the risk of IP MTCT increased 76% per log10 increase in HIV-1 RNA (RR, 1.76; 95% CI, 1.10–2.81). No statistically significant association between MTCT and either HIV DNA level or CD4 count was observed.
To validate PLAP as a marker for placental microtransfusions, we determined whether cord PLAP was associated with mode of delivery and gestational age. Cord serum was available for 177/205 (87%) of the enrolled mother–offspring pairs. Mean cord PLAP activity was lower in elective cesarean deliveries than in spontaneous vertex deliveries (1.43 log10 ng/ml versus 1.82 log10 ng/ml, t = −2.09, p = 0.039), and it was also lower in elective cesarean deliveries than in emergency cesarean sections (1.43 log10 ng/ml versus 1.81 log10 ng/ml, t = −1.78, p = 0.083). In addition, cord PLAP activity was directly correlated with gestational age (n = 174, correlation coefficient = 0.18, p = 0.017), and therefore preterm deliveries (<37 wk) had lower cord PLAP than term deliveries (37–40 wk) (1.68 log10 ng/ml versus 1.84 log10 ng/ml, t = 1.91, p = 0.058). In contrast, log10 cord PLAP was not associated with the following maternal variables: rupture of membranes more than 4 h prior to delivery (n = 163, t = 0.74, p = 0.46), placental malaria (n = 167, t = −0.12, p = 0.90), chorioamnionitis (n = 162, t = 0.85, p = 0.40), duration of labor (n = 177, correlation coefficient = −0.0001, p = 0.99), log10 HIV-1 RNA load (n = 170, correlation coefficient = 0.012, p = 0.88), or CD4 T cell count (n = 171, correlation coefficient = 0.12, p = 0.105). Therefore, the only maternal factors associated with cord PLAP were mode of delivery and gestational age.
The association between IP HIV MTCT and cord PLAP concentration was also measured. This association varied by the mode of delivery (p = 0.058), so prior to the analysis, the data were stratified by mode of delivery. In a univariable model of 119 spontaneous vaginal deliveries, elevated cord PLAP activity increased the risk of IP MTCT (RR, 2.25 per log10 ng/ml PLAP; 95% CI, 0.95–5.32); a bivariable model that included log10 HIV RNA load yielded a similar association (RR, 2.01; 95% CI, 0.84–4.79; n = 115). After adjusting the model for self-reported fever and chorioamnionitis, cord PLAP activity was significantly associated with IP MTCT (RR, 2.82 per log10 increase in cord PLAP; 95% CI, 1.04–7.67; n = 103; Table 2). The risk of IP MTCT associated with cord PLAP increased slightly if maternal CD4 T cell count or HIV-1 DNA load was substituted for HIV-1 RNA load, although the precision of the estimates varied (Table 2). For emergency cesarean section deliveries (n = 32), although the trend of the data suggests an inverse relationship, log10 PLAP was not associated with IP MTCT (RR, 0.32; 95% CI, 0.04–2.68). Small sample sizes precluded the analysis of an association between cord PLAP and HIV MTCT during instrumental vaginal, elective cesarean section, and breech deliveries. Thus, among vaginal deliveries, placental microtransfusions appear to be a risk factor for IP HIV-1 transmission.
Finally, we analyzed the risk of IU MTCT from placental microtransfusions. In a univariable analysis of 159 mother–offspring pairs, log10 cord PLAP activity was not significantly associated with IU MTCT (RR, 0.54; 95% CI, 0.26–1.13). Inclusion of HIV-1 RNA load, preterm delivery, syphilis infection, chorioamnionitis, and placental malaria infection as covariates in the model did not change the magnitude of the relationship between cord PLAP and IU MTCT, which remained nonsignificant (data not shown). Thus, these data provide no evidence of an association between placental microtransfusions and IU HIV transmission.
In this case-cohort study of Malawian mother–offspring pairs, we tested the hypothesis that placental microtransfusions, as measured by cord PLAP activity, are an additional mechanism of HIV-1 MTCT. In support of this hypothesis, our data show that for every log10 increase in cord PLAP, the risk of IP transmission during vaginal deliveries almost tripled. Importantly, this increased risk of transmission remained after adjustment for HIV-1 RNA load, which is the most consistently reported risk factor for HIV-1 vertical transmission (reviewed in [27]).
In contrast to IP transmission during vaginal deliveries, placental microtransfusions were not significantly associated with IU HIV-1 transmission. The lack of association between IU MTCT and placental microtransfusions may result from the short half-life of PLAP in infants (~5 d) [13]; therefore, because PLAP activity is measured at the time of delivery, PLAP that passed into fetal circulation in the weeks prior to parturition might not persist until the time of delivery, and an association with IU MTCT, if it existed, would be missed.
Although a possible inverse relationship between PLAP and IP MTCT during emergency cesarean sections was observed, the small number of IP transmission cases in this stratum (n = 6) and the wide confidence intervals of this association (95% CI, 0.04–2.68) preclude a reliable conclusion.
The cord PLAP measurements in this study are consistent with previous studies in two ways. First, gestational age was directly correlated with cord PLAP activity, which is a result of the increase in maternal PLAP production over the course of a pregnancy [28]. Second, compared to both vaginal and emergency cesarean section deliveries, elective cesarean sections produced the smallest amount of microtransfusion [13,15]. Because only elective cesarean sections eliminate labor, the relationship between mode of delivery and cord PLAP activity has been attributed to a disruption of the placental barrier by labor and contractions. In support of this theory, Kaneda and colleagues reported a direct correlation between cord PLAP activity and prolonged labor (≥5 h) [13]. We did not observe a similar correlation among women who entered labor, and this could be explained in two ways: recording the duration of labor was not the primary concern of the study, so it is possible that our measurements were imprecise, or other features of labor such as the frequency and/or intensity of contractions may more strongly influence maternal–fetal transfusions.
Besides labor, placental infection or inflammation could also compromise the maternal–fetal barrier. A common source of placental pathology in sub-Saharan Africa is malaria, and although 17% of the women in this study had active placental malaria at the time of delivery, we detected no association between cord PLAP and placental malaria. A second potential source of placental inflammation is chorioamnionitis, which has been associated with HIV-1 MTCT [29]. Although 30% of the women in this study had chorioamnionitis, it also was not associated with cord PLAP. Based on these observations, there is no evidence from this study that placental malaria or chorioamnionitis increases placental microtransfusions.
The most probable confounding factor in this study is gestational age, which has been associated with both HIV transmission and maternal PLAP concentration. However, although the gestational age differed between the case-cohort groups, inclusion of gestational age in our IP transmission model did not change the risk estimate.
Two potential sources of uncertainty in our RR estimate are the use of PLAP as a marker of placental microtransfusions and the misclassification of HIV-1 transmission. Any measurement error in the PLAP assay (exposure) is likely to be nondifferential among the cases and the sub-cohort. Owing to the timing of infant blood collection (48 h and 6 wk after delivery), it is also possible that some of the HIV-1 transmission classified as IP was actually acquired late IU or during early breastfeeding [3]. This misclassification should be independent of PLAP activity, and therefore our RR estimate is most likely biased towards the null [21].
In this study investigating the role of maternal–fetal microtransfusions in HIV-1 MTCT, our data suggest that, independent of maternal HIV-1 viral load, placental microtransfusions during spontaneous vaginal deliveries increase the risk of IP HIV-1 MTCT. Future studies on the etiology of placental microtransfusions should provide greater insight into the mechanism of HIV-1 MTCT and suggest new strategies to prevent IP HIV-1 transmission in the developing world.
We thank the Malawian mothers who participated in this study. We thank Chin-Yih Ou for his technical assistance; Debbie Kamwendo, Paul Wilson, Patrick Mkundika (deceased), Benson Thindwa, and Visopo Harawa for their logistical and technical support; Ebbie Chalaluka and the study nurses for their invaluable contributions to participant recruitment, data collection, and patient care; and Marc Bulterys for his critical reading of the manuscript. This research was presented in part at the 53rd annual meeting of the American Society of Tropical Medicine and Hygiene and at the 11th Annual Conference on Retroviruses and Opportunistic Infections.
Support for this research was provided by the University of North Carolina at Chapel Hill Center for AIDS Research (P30-AI50410) and the National Institutes of Heath National Institute of Allergy and Infectious Disease (AI07151–26, AI065369–01, and AI49084). MEM is supported by a Research Leave Fellowship and SJR is supported by a Senior Fellowship, both from The Wellcome Trust. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Author Contributions
JJK participated in hypothesis generation, data collection, and data analysis, and was the primary author of this study. VM participated in the study design, data collection, and the writing of the manuscript. DAM diagnosed chorioamnionitis. APA contributed to the data analysis. WCM suggested the case-cohort design and participated in data analysis and manuscript preparation. ET contributed to data collection and was the Chief Obstetrician. MEM participated in participant recruitment and study management/supervision. SJR diagnosed placental malaria, developed the hypothesis, participated in data analysis, and provided study oversight. SRM developed the hypothesis; participated in the study design, data analysis, and study coordination; and was the Principal Investigator. All of the authors edited and revised the final manuscript.
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- 25. Luo W, Yang H, Rathbun K, Pau CP, Ou CY (2005) Detection of HIV-1 DNA in dried blood spots using a duplex real-time PCR Assay. J Clin Microbiol 43: 1851–1857.W. LuoH. YangK. RathbunCP PauCY OuDetection of HIV-1 DNA in dried blood spots using a duplex real-time PCR Assay.J Clin Microbiol20054318511857
- 26. Hirano K, Matsumoto H, Tanaka T, Hayashi Y, Iino S, et al. (1987) Specific assays for human alkaline phosphatase isozymes. Clin Chim Acta 166: 265–273.K. HiranoH. MatsumotoT. TanakaY. HayashiS. IinoSpecific assays for human alkaline phosphatase isozymes.Clin Chim Acta1987166265273
- 27. Bulterys M, Nolan ML, Jamieson DJ, Dominguez K, Fowler MG (2002) Advances in the prevention of mother-to-child HIV-1 transmission: Current issues, future challenges. AIDScience 2.M. BulterysML NolanDJ JamiesonK. DominguezMG FowlerAdvances in the prevention of mother-to-child HIV-1 transmission: Current issues, future challenges. AIDScience 2.2002Available: http://www.aidscience.org/Articles/aidscience017.asp. Accessed 17 October 2005. Available: http://www.aidscience.org/Articles/aidscience017.asp. Accessed 17 October 2005.
- 28. Contractor SF, Holmes-Ievers E, Morgan A, Oakey M, Staines NA (1985) A monoclonal antibody based solid-phase enzyme-binding assay to measure levels of placental alkaline phosphatase in serum of women during pregnancy. J Immunol Methods 79: 99–108.SF ContractorE. Holmes-IeversA. MorganM. OakeyNA StainesA monoclonal antibody based solid-phase enzyme-binding assay to measure levels of placental alkaline phosphatase in serum of women during pregnancy.J Immunol Methods19857999108
- 29. Goldenberg RL, Vermund SH, Goepfert AR, Andrews WW (1998) Choriodecidual inflammation: A potentially preventable cause of perinatal HIV-1 transmission? Lancet 352: 1927–1930.RL GoldenbergSH VermundAR GoepfertWW AndrewsChoriodecidual inflammation: A potentially preventable cause of perinatal HIV-1 transmission?Lancet199835219271930
Patient Summary
Without intervention, between 25% and 35% of the children born to HIV-positive mothers will themselves be infected. In about 50% of the cases, transmission from mother to child occurs during labor and delivery. Scientists don't yet understand how exactly this transmission happens. Even so, they have found that some treatments can prevent most of the mother-to-child transmission of HIV. The problem is that for many of the HIV-positive pregnant women in developing countries, these treatments are not available or not acceptable.
Why Was This Study Done?
The hope is that better understanding of mother-to-child transmission will lead to more effective, more available, and more acceptable treatments. One possible way children are infected is through placental microtransfusions, which are exchanges of small amounts of blood between the mother and the baby. Some degree of placental microtransfusion occurs in most pregnancies once labor starts, because the contractions cause small areas of rupture in the placenta, but the overall amount of blood exchange is likely to differ from delivery to delivery. Until recently, it was not possible to measure the extent of these microtransfusions for a particular delivery, but now scientists have developed an assay in umbilical cord blood that can do this. In this study, the researchers made use of this new assay to ask whether there is a link between the extent of placental microtransfusion and the likelihood of HIV transmission.
What Did the Researchers Do and Find?
They studied a group of mothers and children in Malawi. All of the mothers were HIV-positive, and some of them transmitted the virus to their children. This transmission occurred either during the pregnancy or around delivery, and the researchers knew the timing for each case. They also knew how the children were born: approximately three-quarters by vaginal delivery and one-fifth by emergency caesarean section. They determined the level of placental microtransfusion from the umbilical cord blood and then looked for correlations between HIV transmission and level of microtransfusion. They found no correlation for the cases where HIV was transmitted during pregnancy. For cases of transmission around delivery, however, higher levels of microtransfusion were associated with a higher risk of HIV transmission for vaginal deliveries.
What Does This Mean?
This suggests that better understanding of what causes microtransfusions might help researchers devise new strategies to prevent transmission. However, this will take some time. Because effective ways to prevent transmission already exist, the immediate goal must be to make them available to women in developing countries where transmission still occurs at high frequencies.
Where Can I Find More Information Online?
The following Web sites provide information on mother-to-child transmission of HIV.
World Health Organization pages:
Joint United Nations Programme on HIV/AIDS pages:
Unversity of California at San Francisco HIV inSite pages:
Centers for Disease Control and Prevention page:
Los Alamos HIV database:


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I can now confirm what in detail will be in the documentary that will be in four parts. Mrs. Jose has an incurable STD (Herpes) and has been and is sleeping with men knowingly willfully and intentionally without disclosing the disease she carries, exposing these gentlemen, to her disease. It has been confirmed that she has indeed passed this disease on to men who did not know her STD status. The documentary is comprised of 70 hrs. of video footage of Mrs. Jose talking candidly of her disease, the man she got it from (who is in the industry), the men she has been slept with, emails, texts, pictures, a copy of her prescription her medical records have also been obtained.
Although her own commentary is quite good enough. She also discusses Emily B who apparently knows of her disease as she states in her commentary, Kim K, and Amber Rose all in a bad light. There is also a copy of her marriage license! Yes Tahiry is married. She married for money and was paid monthly. A copy of her marriage license has been obtained. There are also 3 sex tapes of well-known entertainers who are engaged in sex with her unprotected. To name a few of the many she will mention Trey Songz, French Montana, Vado, Von Smith, Play from Play N Skillz and Drake who she actually has a heated argument with a female about how she is trying to get pregnant to have a come up… Shocking yes!
Tahiry knowingly and willful exposure of this disease falls under the "Willful exposure" laws which typically apply only to persons who have intentionally affected others through unprotected vaginal or anal sexual activity. The accused person must know they have Herpes, (which she does) must have failed to tell their partner of their disease status. This is punishable by law and carries a prison term; Civil Action is also a remedy. Please take note there is one gentleman contemplating bringing a civil suit against Tahiry. That brings us to Joe Budden who through our investigative research also has the disease and has passed it on to young woman who have come forward. Tahiry speaks on Joe in the footage and confirms he does indeed have it also. So now you have a double edged sword.
u know who...joe buddens hoe..who?
dalyricalbandit wrote: »

subset: commoncrawl


text:
|Wang, Yi-hong
|Garvin, David
|Kochian, Leon
Submitted to: Plant Physiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/20/2002
Publication Date: 11/1/2002
Citation: WANG, Y., GARVIN, D.F., KOCHIAN, L.V. RAPID INDUCTION OF RESULATORY AND TRANSPORTER GENES IN RESPONSE TO PHOSPHORUS, POTASSIUM NAD IRON DEFICIENCIES IN TOMATO ROOTS. EVIDENCE FOR CROSS TALK AND ROUT/RHIZOSPHERE-MEDIATED SIGNALS. PLANT PHYSIOLOGY. 2002. v. 130. p. 1361-1370. Interpretive Summary: Mineral nutrient fertilizer inputs are a major cost for agriculture as mineral deficiencies limit crop production on many soils worldwide. There are also negative environmental consequences for the extensive use of fertilizers in crop production, as fertilizer not absorbed by crop plants can subsequently leach into and contaminate water supplies. Therefore, it would be desirable to develop strategies to reduce fertilizer input while simultaneously maintaining productivity. A more complete understanding of the molecular and physiological basis of mineral nutrient uptake and metabolism in plants may reveal strategies for accomplishing these goals. In this study, we employed molecular and genomic approaches involving arraying root genes on nylon membranes to study those genes turned on in tomato roots by imposition of K, P or Fe deficiency. Recovery of genes previously reported to be induced by these mineral deficiencies validated the strategy we used. In addition to these genes, we identified a series of new genes that exhibit inducibility very rapidly after imposition of the specific mineral deficiency, including genes involved in transmitting and transducing signals resulting from environmental stimuli, genes involved in the regulation of other genes, several different mineral transporters genes, and general stress response genes. The identification of these genes is providing new avenues of research into the molecular basis of plant mineral nutrition, including the possible linkages and networking between regulation of K, P, and Fe nutrition, as well as processes and mechanisms by which plants sense and respond to changes in plant mineral status, and the connections between mineral ion transporters and plant metabolic pathways.
Technical Abstract: Mineral nutrient deficiencies constitute major limitations for crop plant growth on agricultural soils around the world. Thus, there is considerable interest in gaining a better understanding of the molecular basis for mineral nutrient acquisition and utilization, in order to develop mineral nutrient-efficient crops better suited for agricultural production with less fertilizer inputs. In this paper, we have employed a genomics approach to identify novel genes involved in P, K, and Fe nutrition with particular interest in candidate genes involved in mineral nutrient homeostasis. We recently generated a high-density array consisting of 1280 mineral nutrition-related genes from tomato roots which was used for gene expression profiling and resulted in the identification of a number of novel nitrate-induced genes that play roles in N nutrition. In the current study, we used the same cDNA array as a preliminary screening tool to identify genes induced by specific mineral nutrient deficiencies (P, K, an Fe). Subsequently, RNA gel blot analysis was used to study the time courses for expression of these genes in response to withholding P, K or Fe. A set of novel genes associated with P, K and Fe nutrition were identified, including genes that could play a role in mineral nutrition signal transduction such as a transcription factor, MAP kinases, and 14-3-3 proteins, as well as ion transporters, genes involved in plant metabolism and several genes with unknown functions.


text:
Metaphysical UFOs
The UFO phenomenon is being taking all over the place, especially into realms that smack of quantum theory.
(We're guilty of a quantum evaluation ourselves.)
Once the UFO epithet replaced the term "flying saucers," the phenomenon was opened to conjectures that have become more bizarre by the day.
Tangible objects that once dominated the unidentified flying scenario have been substituted by amorphous blobs of light and/or skimpy drones of a TinkerToy kind.
And now an article – one of many recently – in SEED magazine (June 2008, Page 50) presents the results of tests in Austria that seem to confirm reality is the result of observation.
We, Mac Tonnies, and others, have presented the hypothesis – hardly new – that reality may be chimera, created by someone of something, and we (humankind or each of us singularly) are a concoction from the mind of a master computer geek. (Some would call that geek God.)
The idea that UFOs are creations of the mind is not unique to ufology. Swiss psychologist Carl Jung posed the idea way back in 1958 in his work, Flying Saucers: A Modern Myth of Things Seen in the Skies.
But many, if not most ufologists, such as Stanton Friedman and Richard Hall, think UFOs are flying saucers – physical, metal-oriented craft, and they have the weight of evidence in their favor – or they did.
UFOs of late have shown up as anything but tangible, touchable objects; they've appeared, as noted, in forms that belie anything concrete or firm.
This allows UFO theorizers to expand their hypotheses into areas once considered arcane, or metaphysical.
Does this do justice to the phenomenon? Perhaps.
But it also removes the possibility of actually getting proof of the UFO reality, which is the bugaboo that haunts the topic.
Ufologists keep trying to prove to "outsiders" that UFOs are real, when any commonsense view of sighting reports and legitimate photos/film/videos indicates that UFOs are indeed real – that is a given, or should be.
The question that should be, must be focused upon is "What are UFOs?"
This is where the door is opened to all kinds of crackpot ideas, along side some valid querying.
And thus the investigation or research into the UFO reality has become very muddied.
Fortunately a few UFO devotees – mostly outside the UFO mainstream – have taken the quackery in stride, ignoring it pretty much, and have begun to look at the phenomenon in unique ways, often scrapping the whole ball of UFO wax that has accreted over the past 60 years.
This new group of "ufologists" -- they eschew that title – can be found in links at the right of your monitor screen here.
Seek them out if you really want a more "scientific" view or approach to the UFO mystery.
And skip the party-going UFO conventioneers and UFO socialites. They'll merely waste your time and divert you from a real scrutiny of UFOs.
They are named at our companion blog – UFO Provocateur(s).


text:
Gargoyles® Shakedown Polarized Sunglasses, Black Frame / Smoke Mirror Lenses
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Contact us 24/7: +1 877 678 9627
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- Length 109cm
- Width 112cm
Handmade in Nepal from a beautifully soft cashmere and silk blend, Bajra pieces are steeped in a rich ethnic background. In a luxe neutral tone with shimmering gold embellishments this piece is perfect for the season's deluxe spin on the boho trend. Shown here with a Bottega Veneta bag, top and shoes and Chloé pants. 75% cashmere, 25% silk. Dry clean.
- Albatross white cashmere and silk blend scarf. Bajra scarf has a fringed trim with gold disc embellishment.
Product Code: 31193
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Hard water?
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Join Date: Oct 2012
Posts: 310
Sunday, January 20, 2013 at 03:19PM
I agree with adding a filter to your shower head...I have hard water and I dont have a filter yet (been meaning to for months now) I do feel that I need to clarify my hair more often..However the wonderful KathyMack mentioned that you need a cleanser with EDTA high on the ingredient list to remove the chemical build up you get from hard water...By using this every 2-4 washes; my hair hasnt looked better .Almost every time I style, Im getting consistent results .of course I am also trying new stylers, which are amazing..So Im sure the combo has improved my hair drastically...My hair feels light and full, not coated, heavy with HUGE amounts of frizz...KathyMack also stated a good way to test your hair...Is when its wet, is there noticeable frizz...If so then your hair needs to be clarified with the EDTA product...Hope this helps...good luck
2b/c CG since 8/12
I have low porosity and fine/med texture.
weighed down and VERY frizzy crown, with straighter under layers
Low-poo:TJ TTT, CJ GCS
LI/RO/DC: CK Satin Roots,Sevi Pumpkin, SSI Okra reconstructor, CJ SAC,CJ RM
Stylers: AG Recoil, JC SS
Jellies: CK Coil Jam, Okra gel
Gel: JC CC, Ouidad H&H gel, Ouidad moisture lock gel
Hair loves moisture
MUST Pixie diffuse.
My hair dose NOT like oils, butters or polyquats
Or glycerin in high dews


text:
Letter to our Pilots and Aircraft Owners
I am sharing with you all my husband's recent experience flying commercially so that you can get a better understanding of how much you help out not only us, but also veterans across America.
My husband, Jack Zimmerman, was asked by a foundation that wanted to support him, and his passion for hunting and send him on a weeklong elk, and white tail deer hunt. Being that we have only flown privately through Veterans Airlift Command, I was tentative about hearing he would be flying commercially. He was injured last March 2011 after stepping over an IED in Afghanistan while serving a 12-month deployment with the 101st Airborne Division. He lost both his legs, above the knee, and most of his right hand and arm. I called the airline he would be flying on ahead of time and went through all my concerns with them, and they assured me, everything would be taken care of.
We arrived to the airport extra early, as I knew with having a 24" metal rod running down his right arm, and an 8" metal plate in his left elbow, along with loose shrapnel throughout his legs, getting through security would be a nightmare. He only had two bags, one, for his medications and other necessities in case the airline lost his luggage, the other, his carry on- easily small enough to fit in the overhead compartments. However, since he was flying alone, and since he had to push his own wheelchair, we were forced to pay and check his extra bag in just because he couldn't carry it to his gate from security.
We got to the security checkpoint, and with no one assisting him, and myself not being allowed any farther, he had to push himself through while trying to take everything out of his pockets, and get everything out of his backpack attached to his wheelchair. Being that he doesn't have any fingers on his right hand, he has to wear a splint that covers from his wrist to his elbow, and allows him to push himself in his wheelchair. After airport security tested his splint, and it came back as an "explosive" they were not going to allow him to take it with him. This splint, being the ONLY way he can move himself and being a necessity, they finally allowed him to bring it on the plane. This may have been the part of the days complications that got to me the most because, here sits a veteran, completely helpless in his wheelchair, who has given America the ultimate sacrifice in DEFENDING our country against terrorists and these people are actually going to question his motives going aboard a plane?
My husband is not dangerous.
My husband is a big guy, being 6'3" when he was blown up, and I was worried about how they would actually get him onto the plane. To my understanding, he could take his own wheelchair up to his gate and then "transfer" into one of the airport wheelchairs, where an airport personal would push him aboard the plane. The wheelchairs the airport provided that fit up the aisles of the plane were so narrow, and small, that his shoulders hit the seats as they wheeled him down the aisle, and he couldn't fit past the first row of economy seats. I would like to add in though, he COULD fit through first class, but there were obviously more important people aboard the plane. So, to get to his seat, he had to get out of the wheelchair and scoot on his bottom down a dirty plane isle that millions of people have walked across until he got to his seat on the plane. He had to do the same when exiting the plane.
Did I mention he had a layover for 3 hours in Denver, where he had to again, scoot on his bottom on and off the plane, and then push himself around an airport looking for his connecting gate, and then sit and wait for 3 hours, just to scoot onto the plane again.
Finally, after a grueling travel day, and upon arriving at his destination, he now received notice that his bags were left behind- his bag, which included the extra battery to his, now dead, wheelchair, and the battery charger.
In this, I didn't even include the millions of stares from people around you, and the completely terrified person who has to sit next to someone who is missing their legs, and how un human it makes you feel.
I just wanted to write you about our only experience thus far in his injury flying commercially so that you can truly understand how difficult it is for a wounded veteran to fly.
Veterans Airlift command is truly the greatest organization we had ever heard of, and cannot be more thankful for all the pilots who fly for us. Eliminating the security, and layovers, and transportation onto the plane.
I hope that from this, you all know how much we really appreciate your service to us, and how you really are the heroes, and the ones to be thanked.
Megan Zimmerman
5 comments:
- A Splett said...
No one should have to go through what Jack Zimmerman did! I think the VAC is so wonderful for what they do for our veterans. It seems so wrong for him to have been treated by a commercial airline in the manner he was treated.
- November 16, 2011 at 3:01 PM
- Cozmo said...
Agreed. First of all, nobody with any sort of disability should be treated like that, but especially once it's learned that it came about in defense of our nation and of freedom and liberty. What they SHOULD have done is had a special guide to take him through to the terminal, ensured that he gets on the plane safely, explained to the passengers that they have the privilege of sitting next to a hero, and saluted him before leaving the plane.
I understand the need for security, but I'm appalled by the number of wounded warriors who have been harassed by TSA employees.
- November 16, 2011 at 3:30 PM
Reading of this experience this made me mad and sad, and I want to say "unbelievable"...but I know better. Thank you Veterans Airlift Command for providing an alternative to our Wounded Warriors.
- November 16, 2011 at 5:12 PM
This is disgusting. The airlines needs to get it together. If we have a wounded warior travelling on commercial airline this warriors Military I.D. should be enough for him to get all the help he needs and absolllutly no charge for baggage. These are the guys fighting for our freedom and we disrespect them.The problem starts with this administration they are not providing adequatly for them.
- November 17, 2011 at 1:09 AM
What are there-typically 16 to 20 fist class seats? You would think somebody would have offered to give up their seat -
- December 8, 2011 at 7:20 AM


text:
Working with different community groups in Nottingham, this project explores young people's relationships with dance. The photographs focus in particular on the social aspect of being involved in a shared creative experience. Central to the story of these adolescents' experiences, a sense of place is imbued throughout, recalling a connection between young people and their surroundings.
For one week in May 2013, I collaborated with Birmingham Royal Ballet whose community outreach team were running ballet workshops in the St Ann's and Sneinton neighbourhoods of Nottingham. Many involved in these sessions had never been exposed to a dance class before and I sought to capture them tentatively making sense of the new experience, one that is rare in underprivileged communities due to its elitist perception and appeal.
The project was commissioned and coordinated by The Renewal Trust, a community development trust who work to improve the social conditions in their neighbourhood. Community groups involved included the St Ann's Scouts, Nottingham Brazilian Soccer Squad and students from Nottingham Academy School.
David Severn is a social documentary and fine art photographer based in Nottingham, UK. His work is concerned with the relationship between people and place. More specifically, how individuals and communities interact with or are affected by their environment. Within this context, he is particularly interested in working class culture and the places associated with it, both historically and today.


text: Whether working with fields or gardens, you may be giving thought to what you can do this fall to help make things grow better next summer. With any application of fertilizer, be it manure or otherwise, it is best to apply it based upon crop needs (following soil test recommendations) and in a way to ensure utilization of the nutrients by the crop to minimize environmental impacts. Manure has at times been considered a waste product, but should be treated as a nutrient resource since it can provide all the nutrients required for growing plants. As such, soil tests should dictate if manure nutrients should be applied and how much is needed. Even if it seems convenient and economical to apply the manure to the field closest to the source, this is not always the best agronomic or environmental practice.For commercial growers, in addition to soil testing, the manure should also be tested. This allows you to make an informed decision on how much manure to apply to a field. The equipment used to apply the manure should also be calibrated so the quantity of manure actually applied can be determined.Additionally, quantifying the amount of manure that a field receives allows you to take credit for the manure applications when it comes time for commercial supplementation. You should know about how much has been applied, so that you can properly figure additional needs.With any fertilizer application, it is important to consider runoff potential. Observe setbacks from surface features such as ditches, surface tile inlets, etc. when applying manure or commercial fertilizer. Considering field slope and surface residue (high percent residue reduces runoff) will also help minimize potential water quality impacts. More loss will happen when rainfall occurs shortly after fertilizer application, thus avoid applications that may coincide with significant rainfall events. Incorporating the manure will also help to reduce the nitrogen loss.For additional information, see Chapter 6 of the Ohio Livestock Manure Management Guide at http://ohioline.osu.edu/b604/pdf/b604.pdf. Fall is also an excellent time to lime your fields or gardens, as it gives time for the lime to react with your soil before the growing season. Again, the amount applied should be based on a soil test.And if you are considering applying anhydrous ammonia to your fields this fall, it is not recommended due to the risk of nitrogen loss. But even though we do not recommend it, we do provide guidelines if you are going to do it anyhow. Soil temperatures should be below 50° F. to minimize soil microbial activity slowing the conversion of ammonia to nitrate. The goal is to keep ammonia/ammonium in the soil as long as possible because it is not as susceptible to loss as nitrate is. Consider the use of a nitrification inhibitor. This is especially critical if soil temperatures are warmer. The inhibitor will slow the conversion of ammonia to nitrate. Realize that the inhibitor does provide inhibition indefinitely, so still try to make applications in cooler soil temperatures.Ron Becker is an OSU Extension program coordinator.


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text:
Canton First Monday Trade Day This Weekend
This weekend looks like it's going to be perfect weekend to get out and stroll the thousands of vendors in Canton during First Monday Trade Days! According to Mark Scirto at KLTV, we should see sunny to mostly sunny skies this weekend with a cool start but getting up to around 70 on Saturday and mid-70's on Sunday. With this type of weather, the shoppers will be out in full force looking for that perfect treasure for their home or gift.
Canton Trade Days offers up a little something for everyone, so if you're looking for hair bows for your little girl you'll find them, if you're looking for a part for a farm tractor you'll find it, if you're looking for a new pet you'll find it, if you're looking for stained glass windows you'll find it! I think you get the idea now oh, if you're looking for some "fair" style food, you'll find in Canton too!
When shopping Canton First Monday Trade Days be prepared though with some good walking shoes and some cash, because with good old cash you can always strike a great deal – cash talks!


text: JOHN - Unregistered June 03, 2012 5:00 PM Yes we all know the first year or 2 in F1 is all learning. Jackie Stewart once said that. Unfortunately these days (in these recessionary times) teams are under pressure to perform and the 'patience' is not there to allow the driver to learn. Having said this much I wish Bruno all the best for this year but unless he delivers something it'll be his P45 next year. 6 agree 0 disagree


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New Winter styles just in!
October 14th, 2013
Although the nights are getting long, we've resorted to turning on the heating and we're all enjoying one too many hot chocolates, we hope that our handful of new lingerie styles will help to put a smile on your face. With a mix of new shapes and styles for you to try, as well as trusted favourites in new colours, we hope there is something you love from this selection from Winter.
Look out for the full collection from the 4th November!


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At Global Healthcare Exchange (GHX), we have what you're looking for—great career opportunities that will utilize your skills and experience, tools and resources to further your professional development and a great work environment where you'll always find a helping hand.
Our customers have come to rely on our high standards and quality products to help them focus on what matters most—patient care. Because of this, GHX understands that our successful employees deserve to be recognized for their hard work. With a competitive pay and benefits package and plenty of room for growth, we help our employees get the most out of their career.
When you join the GHX team, you'll find educational opportunities to support your development, and other personal benefits (like a gym in the office) to make sure you have time to juggle all the aspects of your busy life.
So keep reading to find out more about who we are, what we do and how you can start your exciting career at GHX.


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Childless and childfree women come in lots of shapes and sizes. We are all colors, all cultures, and all ages. As much as we have in common, we are also very different. Some people say it is strange to define ourselves by things that we are not, so let's determine what we are instead.
Childfree blogger Laura LaVoie interviews women bloggers without children who answer the question, "If you're not a Mom, then what are you?
Interview 9 introduces fantasy and science fiction author Jill Valuet who's been published in several short story anthologies. In her blog, Making It Up As I Go Along, she shares her writing process, what she's reading, and her life in general. As it turns out, not having children influences her work.
Tell us about yourself and your blog.
I write fantasy and science fiction short stories and am also working on 2 novels. Currently, writing is a hobby, but I hope to someday turn it into a profession. I use the blog to talk about my progress in writing, any submissions I make and some of the hurdles I encounter along the way. I also use the blog to keep track of the books I read.
Does being a NotMom affect the way you develop characters?
I would have to say yes, though I admit I never thought about it quite like that. I don't think I have a single main character that has children.
What makes you want to write?
I've been writing for as long as I can remember. Stories take up a lot of space in my brain, so I have to write to get them out. It's a creative outlet that I find immensely satisfying, no matter the quality of the story. I like the escapism of creating my own worlds and figuring out what the characters' everyday problems would be.
Do you have a NotMom who inspires you?
There are real people that I find inspiring, but not because they don't have children. I find inspiration in people who do the things I want to do.
What about fictional NotMoms in fantasy?
Initially, I thought, 'Oh sure, there's plenty'. Laura Roslin from Battlestar Galatica, Buffy the Vampire Slayer, Egwene al'Vere from the Wheel of Time series, and…. well, and then I was stumped.
What those 3 [NotMom] characters have in common holds true with the ones that have kids: I find inspiration from independent heroines who save the day. As it turns out, a lot more characters have kids than I thought. I guess it means I need to keep writing the kinds of characters that don't have children and hope they can be an inspiration to others someday.
How important is it for NotMoms to be represented on the Internet?
It's absolutely critical. There are plenty of NotMoms out there and we are full of interests and hobbies that have nothing to do with children. Advertisers are missing out on reaching people like me.
What do you want advertisers and readers to know about women without children?
Every NotMom has her own reasons for not having children. For me, I never wanted them. So, seeing ads for kid-related things is a guaranteed way to turn my attention elsewhere. Advertising that is catered more towards what I do and what I enjoy is going to garner much more favorable results. It's as simple as that.
If you're a blogger who happens to be a NotMom, share your story with us.


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Animoto takes video and slideshows to the next level
Animoto is a really cool website that allows you to create engaging and professional-quality videos from your photos and music you have online or on your computer. I immediately see the value in Animoto for advertising professionals, artists, teachers, photographers and those looking to beef up their Facebook page. The mashup of photos, music and effects produce videos like the one I made below. In total it took me about 10 minutes to complete. Let me know what you think and if you would like to share your video! Today, Animoto launched a site especially for professional photographers. Animoto for Photography allows professional photographers to easily create professional-quality videos that can be emailed, burned to DVD and resold, or distributed online via blogs, websites, social networks and mobile devices. Click here for all of the details. In this video, Animoto CEO Brad Jefferson tells Beat TV more about the company. View our Friend FeedFollow DigItAll Consumer and Digital Cribs on TwitterClick here to learn more about Cisco for consumers.
In an effort to keep conversations fresh, Cisco Blogs closes comments after 60 days. Please visit the Cisco Blogs hub page for the latest content.
3 Comments
Mike Covington
What a cool app w/ a fantastically easy and intuitive interface. This made my day.
Thanks John! Admittedly, I thought it would take longer to put together but now I'm super excited to make more! : D I wonder if history will find us more or less creative than the past, because of the artistic assistance we get from technology. Either way, sites like Animoto give the consumer a sense that they created something unique and that is valuable.
John Earnhardt
very cool vid, hanna...i think making vids and putting them on web are going to get easier and easier...or, at the very least, they'll make them more and more idiot proof...i'm living proof of that...


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- Home
- Poems & Poets
- Browse Poems
- The Slave Mother by Frances Ellen Watkins Harper
Related Poem Content Details
Related Poem Content Details
Born in Baltimore, poet, fiction writer, journalist, and activist Frances Ellen Watkins Harper was the only child of free African American parents. She was raised by her aunt and uncle after her mother died when Frances was three years old. She attended the Academy for Negro Youth, a school run by her uncle, until the age of 13, and then found domestic work in a Quaker household, where she had access to a wide range of literature. After teaching for two years in Ohio and Pennsylvania, she embarked on a career as a traveling speaker on the abolitionist circuit. She helped slaves escape through the Underground Railroad and wrote frequently for anti-slavery newspapers, earning her a reputation as the mother of African American journalism.
A prolific writer, Harper published many collections of poetry, including Autumn Leaves (also published as Forest Leaves) (1845); Poems on Miscellaneous Subjects (1854), which was reprinted 20...
Poems By Frances Ellen Watkins Harper
Poem CategorizationIf you disagree with this poem's categorization make a suggestion.


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Men carry animal fat that will be turned into glue, in the Hazaribagh neighbourhood of Dhaka, Bangladesh. Hazaribagh has been listed in a report by Green Cross Switzerland and Blacksmith Institute as the fifth most polluted place on earth. It houses 95 per cent of Bangladesh's leather tanneries, which every day dump 22,000 cubic litres of toxic waste, including the cancer-causing hexavalent chromium, into the capital city's main river and key water supply, the Buriganga.
© The Financial Times Ltd 2016 FT and 'Financial Times' are trademarks of The Financial Times Ltd.


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Sep 28, 2010 #087
Contact: Laura Byerley
(816) 235-1592
UMKC Libraries receive Missouri Library of the Year awardThe Missouri Library Association (MLA) has selected UMKC Libraries as the 2010 Library of the Year. Recognizing Miller Nichols Library's efforts to provide superior services, MLA will present the award at its annual conference at 7 p.m. on Thursday, Oct. 7 at the Lodge of Four Seasons in Lake Ozark, Mo.
MLA applauded Sharon L. Bostick, Dean of Libraries, and the UMKC Libraries staff for their commitment to improving and expanding student spaces and installing the region's first robotic book retrieval system. Once the robot is fully loaded, it will hold about 80 percent of the library's collection, freeing up space for student, researcher and community use. By the spring of 2011, the library will feature more areas for individual and group study, collaborative learning areas, a new space for presentations and performances and an expanded cafe.
MLA also commended UMKC Libraries for the following:
- Housing exemplary collections and services in a time of economic stress
- Supporting continuing staff education and involvement in professional associations
- Exemplifying participation in networks, systems and cooperative planning with other libraries
- Supporting staff outreach efforts and being open to new ways of offering services
"As president of the Missouri Library Association, I appreciate the leadership of UMKC librarians in state professional activities," said Sharon McCaslin, MLA president. "Having served on professional boards with Sharon Bostick, I believe that her support of the library profession is exemplary."
Established in 1900, the Missouri Library Association exists to facilitate the exchange of information and provide professional education for Missouri's librarians, career library workers and library trustees and friends.
An essential partner in intellectual discovery, knowledge creation and empowerment, UMKC Libraries serves as the hub of learning activities for students, researchers and UMKC's urban neighbors. Not only the home of books and print materials, the UMKC Libraries also provide access to a wide range of audio-visual media, over 300,000 sound recordings and rare and unique collections of books, photographs, manuscripts and maps. UMKC Libraries also link users to a world of scholarly information available through licensed online databases and journals and a vast network of reciprocal borrowing agreements with libraries around the world.
The University of Missouri-Kansas City (UMKC), one of four University of Missouri campuses, is a public university serving more than 14,000 undergraduate, graduate and professional students. UMKC engages with the community and economy based on a four-part mission: life and health sciences; visual and performing arts; urban issues and education; and a vibrant learning and campus life experience. For more information about UMKC, visit http://www.umkc.edu/. You can also find us on Facebook, follow us on Twitter and watch us on YouTube.


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Chartering in Australia's Whitsundays
I was enjoying a sunset cocktail on Tutu, our chartered Lagoon 380, when a flock of birds descended, hoping for a handout. They perched on the grill, the lifelines, anywhere they could find a foothold. But these were not your ordinary sea birds: they were cockatoos, large white cockatoos, with bright yellow Mohawks—cockatoos like those kept as pets in the rest of the world. Welcome to sailing in Australia!
We had boarded Tutu a few days earlier for a seven-day charter in the Whitsunday archipelago, a group of more than 70 islands off the coast of Queensland, 30 miles west of the southern tip of the Great Barrier Reef. My first surprise, considering these are sub-tropical islands, was the complete absence of palms, sea grapes or other tropical vegetation. The Whitsundays are not atolls, but rather the tops of a mountain range that was flooded over 10,000 years ago—craggy, windswept hills covered by hoop pines, vine thickets and casuarina trees. The only things "tropical" are the coral reefs fringing some of the islands. We all agreed the area resembled Maine or Canada more closely than any of the tropical destinations we'd seen.
The first European sailor to set foot in the Whitsundays was Capt. James Cook, in 1770. Thanks to the large number of designated national parks with mooring fields, hiking trails and campsites, most of the islands remain in the same natural state as when he found them. Although there are plenty of safe anchorages in sheltered bays, there are also many "no anchorage" zones, both for reef protection and to prevent boats from anchoring at high tide and ending up aground. (The Whitsundays have a large tidal range—10 feet—and it definitely affects your ability to visit or overnight on many of the islands.)
Navigation throughout is line-of-sight, although we were warned not to rely too heavily on navigational markers, the GPS or the compass: some markers had been missing for decades, the GPS showed our correct location, but used old charts that sometimes put Tutu on land, and the compass was affected by a high concentration of iron ore in the makeup of the islands. 100 Magic Miles, the local cruising guide, became our reference bible, with charts, aerial photos and specific directions to each and every island.
Our last stop was the Long Island Resort on Long Island. Boats anchor well off the beach because low tide creates a sand flat between the hotel and the anchorage. The resort is pretty rundown, but has a beach bar where a flock of wild lorikeets arrive promptly at 1600 to be hand-fed fresh mango by locals and visitors alike.
My last surprise of the trip occurred during my way back to our dinghy on Long Island, when a kangaroo hopped past me on the beach without a second glance in my direction. Such is sailing in Australia.
Whitsunday Charter Contacts
Dream Yacht Charter: dreamyachtcharter.com
Cumberland Charter Yachts: ccy.com.au (Airlie Beach)
Queensland Yacht Charters: yachtcharters.com.au (Airlie Beach)
Sunsail: sunsail.com.au (Hamilton Island)
Whitsunday Rent a Yacht: rentayacht.com.au (Schute Charter)
Lifelong sailor and freelance writer
Vera Cole is alwas searching for new
places to explore under sail
Photos courtesy of Sunsail and Vera Cole


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Re: Inspired by (Nature's Harmony)
As a musician, this annoys me. The flats are randomly strewn on the staffs, the stems are only correct about half the time, and there are no measures. In the future I would suggest using an actual piece of music for reference, because this really does not look like one.
thewayisshut wrote:Not the shape of the bones, but the pose. I just find it... cheap that it's exactly the same as the picture I posed. The legs are in the same place, the head's in the same place, the tail... There are many ways to draw a horse skeleton, if one is creative. I see no creativity here. Furthermore, he didn't have to use a skeleton for his joke...
what are you some sort of intellectual property lawyer? The theme and focal content of the two are completely different. No one would wear that picture you posted on a shirt. Crediting this drawing to that picture would be like crediting It takes a Nation of Millions to Hold Us Back to the copyright holders of the samples (or bittersweet symphony to Mick Jagger and Keith Richards, heh)
Re: Inspired By The Dandy Lion
So cute :D
DianaSprinkle wrote:LOL, I was thinking I should have added two more cute spirit kitties for the whole "9 lives" thing as well. =D
I was referencing more about the nine tailed fox from Japanese anime Naruto.
Hattey wrote:Love it! It's an awesome idea and it's beautifully rendered!
I'm glad you like it. :-) I'm apparently right on the cusp of the fog... hopefully I get a burst of life.
Re: Inspired by King of the Beasts
Awesome, fantastic work!!!
Re: Inspired by One of those days
Really fantastic, great work!!!
anidi79 wrote:Your artwork is ALWAYS an inspiration!! GMV!!
Thank you. That is a very nice complement. I knew this entry wasn't a winner but I had the illustration and wanted to share it with the community. I like her
Re: Inspired by It's a trap!
Awesome :D
Spens is in a creative groove lately, Wonderful shirt design as usual sir.
Re: Inspired by Dragon Slayer
Great work ;)
Re: Inspired by 1984 Duck Hunt
Hahaha, funny :D
Re: Inspired by Coffee Stain Cats
Hahaha, fantastic!!!
Re: inspired by spicy meal
Great work
Re: Inspired by the binge
Re: inspired by you'll catch your death
Great style :D
Re: Inspired by: Error-Cuteness Overflow
Awesome!!! I love it
Re: Inspired by The Extinct
Re: [url=http://shirt.woot.com/Derby/Entry.aspx?id=52630]Inspired by
Re: inspired by minor modifications
Hahaha, funny idea.
Re: Inspired By Night of the Puppets
Yes, it may be too bloody. My intention was to show that the cat only wanted to play, was not his intention to harm
Thanks ;)
Re: Inspired by Acquired Taste
Lovely work, kev. :^)
ochopika wrote:LOL. I voted because I love fart jokes. You should totally try to sell this on other sites when you can.
I would wear it to school (I am a teacher) it would be hilarious.
Re: Inspired By Revenge is Mine
I absolutely love this Tee
make it glow in the dark and I'll buy a dozen!
But the little people skeletons are what makes it awesome.
So awesome!!!
Crush3r07 wrote:I was referencing more about the nine tailed fox from Japanese anime Naruto.
LOL yes. I'm just amused that it works for both.
kschlege wrote:Me too ... as far as I know, I've never seen a hummingbird anywhere near a rose.
I actually love the addition of the hummingbird. I think it makes it more interesting and compositionally brings the illustration back around. As for a hummingbird and a rose. http://videos.birdsandblooms.com/image/The-hummingbird-and-the-rose-jp
gmv and hopefully my purchase
Re: Inspired by Flora and Phonograph
I'm not 100% sold on the wood texture in the middle... but I like everything else. Looks really great on a tshirt.
GAAAAAAAH! Curlz! Why? WHY??
collinvh wrote:Thank you. That is a very nice complement. I knew this entry wasn't a winner but I had the illustration and wanted to share it with the community. I like her
I like her too. I somehow think she'll fare better in another medium. Too much class for a T-shirt perhaps? I could see her as a book cover, or a magazine illustration.
earballs wrote:My wife do wants. That is not a typo or poor english. DO WANT! she says.
He's right, do want! I really hope this wins because I would love to buy this. It's adorable.
Awesome job on this Bass, looks like you may have another print soon. Needless to say I think your print drought is over The only thing thats kinda tickling the back of my brain when I look at this though is the fact that the tree trunk gets so narrow near the middle then at the top (where I'm guessing it's supposed to be a crown) it gets really thick looking again. Almost like one tree fell from the sky and landed top down on the first one :S Other then that though it's beautiful. +1
kushalm wrote:I don't know why but I just feel this tee would look a lot better if the design placement was off centre...maybe a little smaller and moved to the top right
You know, there was something I couldn't quite put my finger on...a little itch in the back of my mind that said "despite it's awesomeness, something is bothering me about this design."
You nailed it.
It's probably way too late for a resub though, no? And I still want one, as-is, anyway...maybe more than one so I don't feel bad wearing it (like I might wreck it). It's still such an incredible design even without being off-centered...
just makes me smile. +1
Hope it prints
Re: Based on Walking Through The Forest Ver2
Yes! Yes! A thousand times yes! Well, I guess I can only vote for it once, so...
Yes! Yes! One time yes!
I love how it's a full-shirt design :D
Spiritgreen wrote:Lovely work, kev. :^)
dwnmoser wrote:GAAAAAAAH! Curlz! Why? WHY??
Haha, don't like curlz? Don't worry--the font's just on the image; it doesn't go on the shirt.
View All →


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Only at Foodland - We Provide Carryout
Carryout Service Guaranteed!
Serving YOU is the most important thing we do. And that's why in addition to ending long lines, we also promise to carry out your groceries and help you load them into your car.
If you have 3 or more bags and we DON'T offer to carry them out for you, you'll receive a free drink on us!


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UPDATE :: NSW Government Home Construction Grants For Buyers Agents Clients in Brisbane, Melbourne & Sydney
Queensland Government Home Construction Grants
Home Construction Grants abound in many Australian cities. These are primarily intended for people who have plans of purchasing an Australian home for the first time. The beauty with home grants is that they carry no interest and the recipient is not required to repay them in the future.
Home Construction Grants are particularly helpful for Australians intent on building their first homes. The eligibility requirements for these grants can be strict though. Given this, it is important that compliance to existing laws on home construction is observed as this could influence any pending application for a home grant.
For example, when the construction involves paving and property conveyancing, it is best to seek the advice of the city council where the new house is to be registered. Generally, the city council usually determines if a building project will require prior approval. In this regard, basic rules need to be observed when doing paving works as part of a home construction project. These include the use of materials with solid and non-slip features like asphalt and concrete.
Meanwhile, when it comes to architects, the basic rule is to choose one that will be comfortable to work with. Of particular importance though is the architect service rate. Home Construction Grants can be affected in cases where the service fee of the architect is beyond the pre-determined budget level and additionally you will always need to provide building inspections reports. Generally though, the standard architect charges should only be around one percent of the entire costs incurred while completing the construction of the house.
Other than architects, the services of professional designers like patio builders will also have to be considered when building a home.. Just like architects, patio builders and related home designers are regulated and must be duly-registered in the state where they are practicing their profession.
This is especially true , and homeowners should make it a point to inspect the indemnity insurance of a prospective patio builder. This is a basic requirement that all registered home designers must present prior to getting hired.
Plumbing, on the other hand, can be a bit complex when it involves new home construction. Briefly, however, any plumbing project will not be allowed to proceed unless an assigned member of the city council has assessed and inspected the area in question. Additionally, the council has to approve the plumbing project before actual work can commence.
Depending on the type of plumbing that will be done, a duly-licensed plumber may have to be hired (vocational education in business and trades can be verified here) . In this case, he needs to present the notification of service that will be issued to him by the Plumbing Industry Council.
The issue on how much the plumber will charge for his services will depend on a number of factors. When contacting a plumbing expert, he will most likely charge the homeowner for visiting his home. Once hired, he will be asking for an hourly rate.
Other factors that will come into the calculation of the plumbing charges include the area where the house is located and the skill level of the plumber. Home Construction Grants should thus be used wisely when dealing with plumbing issues.
Home Construction Grants should also consider the cost of installing an air condition unit in the total expenses for new home construction. As with other Brisbane home professionals, air condition installers need to have the required license. Other than that, the unit itself should be properly certified in accordance with existing Australian laws.
The needed air conditioning license can be secured from the ARC or the Australian Refrigeration Council approved repairs contractors, the government agency tasked to issue certifications for all air condition units being sold in Australia. The licensing has to do with the fluorocarbon refrigerant gas content of many air con units which has been found to be a key player in the deterioration of the environment.
Home Construction Grants need not be significantly affected with the issuance or non-issuance of these licenses. Still, it does point out the need for residents to be aware of the current issues involving fluorocarbons and what they can do to prevent environmental problems from further worsening.
Development Projects funded by ADC
More: health care workers in development overseas: treatment of alcoholism and drug abuse in the Asia Pacific Region & how drug rehab works.


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NOW® 100% Pure Shea Butter has a rich, luxurious texture
that penetrates deep to condition and moisturize every type of
skin, regardless of tone or texture. As a natural derivative of the
karite trees that grow in Western and Central Africa, pure Shea
Butter is a wonderful emollient that's perfect for daily use. It
has a warm, subtle aroma that is both light and pleasant. 7 oz. jar
is $9.99.
Ingredients: 100% Shea butter
Very rich and does a great job
From Anonymous of saint paul, Minnesota on 12/10/2007.
This is a thicker, creamier emoilent that really does a great job on dry, chapped, or wind burned skin. My husband and I both use this at night and put on our feet, elbows, and hands to help make the skin soft and full of moisture. I also put it around my eyes at night to reduce lines. A small jar lasts a very long time. I use it daily for best results.
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Have Ford Questions? Ask a Mechanic for Answers ASAP
Hi Customer,
I am John Mc, a Ford dealer technician.
I hope I can help solve your problem quickly and accurately.
To bleed the clutch in the truck you have to take the slave loose from the transmission and hold it with the line straight up. Now you pump the slave push rod to get the air out. I am posting the procedure from the Ford manual to further assist you.
Click here for instructions
If you have any more questions please feel free to ask, it's what I'm here for!
important to me so please leave accurate feedback for others to see my job performance.
Thank you,
John Mc
JustAnswer Expert
I understand this, if you read the procedure in the link it describes how to do this. The air will bleed up through the lines and to the reservoir.


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Idaho State University
assistant/associate professor
Primary Purpose: To contribute to the teaching, scholarship and service expectations of a faculty role in the School of Nursing; the emphasis is on graduate teaching, research productivity with external funding and the continued development of doctoral education.
Key Responsibilities:
- Teach online graduate courses
- Work with administration to continue the development and implementation of doctoral nursing programs (PhD and DNP).
- Assume a major lead in the preperation of graduate students for oran and comprehensive examinations.
- Advise graduate nursing students and work with doctoral students to prepare and defend dissertations.
- Active engagement in research and contribute to acquisition of external research and development funding.
Minimum Qualifications: Doctoral degree in nursing or related field required with two years teaching experience at the graduate level. Demonstrated skills and abilities to conduct research. Demonstrated leadership skills and ability.
Preferred Qualifications: 5-8 years teaching in an academic faculty role or equivalent at the doctoral level. NIH, HRSA or comparable history of research funding.
Closing Date: Open Until Filled
Location: Pocatello
Anticipated Start Date: 08/15/2013
Salary/Pay Information: Salary and rank commensurate with education and experience; competitive benefits package.
Term of Employment: 9 Month, Full time
Special Instructions to Applicants: Please submit a cover letter, current curriculum vitae, and a list of three references with contact information.
For all of the School of Nursing position postings and application information please see https://isujobs.net. Posting Number: 2011293
EEO: ISU is an equal opportunity/affirmative action employer. We have an institution-wide commitment to inclusion and diversity and encourage all qualified individuals to apply. Veterans' preference. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.


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Morris to Offer Green Summer Opportunities for the Community
Posted by Jenna Ray on Wednesday, May. 15, 2013
The University of Minnesota, Morris will be hosting a youth camp and renewable energy tours again this summer. University Green Summer staff have designed hands-on experiences that will help people of all ages to develop a deeper understanding of renewable energy technologies and sustainability practices. Registration for these activities is now open.
Children entering grades 4 and 5 are invited to consider their relationships with nature by embarking on a quest that will explore gardening, tree identification, building a wind turbine, and more. This four-day Nature Quest Camp will take place on the Morris campus July 15-18 from 8 a.m.-2 p.m. The cost for the camp is $95. Children should bring a lunch each day and may be dropped off in the Welcome Center lobby. Families are invited to attend a Parent's Night on Thursday, July 18, at 6 p.m. at Pomme de Terre Park.
The public is also invited to tour the University's renewable energy facilities, including the biomass plant. These free, guided tours are intended for all ages and are offered on the following days: July 13, (departing from East Side Park), July 26 (departing from the campus Welcome Center), and August 10 (departing the Stevens County Fairgrounds from the Lee Community Center). Tours begin at 2 p.m. and end at 4 p.m.
Additional information on camps and green tours is available online or by phone 320-589-6468. Because seats are limited, pre-registration is encouraged.