text:
Syndrome of inappropriate antidiuretic hormone secretion
|Syndrome of inappropriate antidiuretic hormone secretion
|Schwartz-Bartter syndrome, syndrome of inappropriate antidiuresis(SIAD)
|Explanation of SIADH
|Classification and external resources
|emerg/784 med/3541 ped/2190
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by excessive release of antidiuretic hormone from the posterior pituitary gland or another source. The increase in blood volume (hypervolemia) often results in true hyponatremia in which the plasma sodium levels are lowered and total body fluid is increased. Although the sodium level is low, SIADH is brought about by an excess of water rather than a deficit of sodium.
It was originally described in people with small-cell carcinoma of the lung, but it can be caused by a number of underlying medical conditions. The treatment may consist of fluid intake restriction, various medicines, and management of the underlying cause. Salt administration may help prevent brain swelling by increasing attractive force to keep water in the bloodstream, preventing fluid buildup in tissue.[1] SIADH was first described in 1957.
Signs and symptoms[edit]
|This section needs more medical references for verification or relies too heavily on primary sources. (June 2017)
- Muscle aches
- Generalized muscle weakness
Patients with SIADH will be euvolemic with:
- low serum osmolality
- hyponatremia (low serum sodium)
- and a normal serum creatinine[2]
Urinalysis will reveal a highly concentrated urine with a high fractional excretion of sodium (high sodium urine content compared to the serum sodium).Certain prominent physical findings may be seen only in severe or rapid-onset hyponatremia, such as seizure and other neurological signs.[3]
Causes of SIADH include conditions that dysregulate ADH secretion in the central nervous system, tumors that secrete ADH, drugs that increase ADH secretion, and many others. A list of common causes is below:[4]
- Central nervous system-related causes
- Infections
- Meningitis, Encephalitis, brain abscess, rocky mountain spotted fever, AIDS
- Perinatal asphyxia
- Mass / bleed
- Trauma, Subarachnoid hemorrhage, subdural hematoma, cavernous sinus thrombosis
- Hydrocephalus
- Guillain–Barré syndrome
- Acute porphyria (acute intermittent porphyria, hereditary coproporphyria, variegate porphyria)
- Multiple sclerosis
- Infections
- Cancers
- Carcinomas
- Lung cancers (small-cell lung cancer, mesothelioma)
- Gastrointestinal cancers (stomach, duodenum, pancreas)
- Genitourinary cancers (bladder, urethral, prostate, endometrial)
- Lymphoma
- Sarcomas (Ewing's sarcoma)
- Carcinomas
- Pulmonary causes
- Infection
- Asthma
- Cystic fibrosis
- Drugs
- Chlorpropamide
- Ciprofloxacin[5]
- Clofibrate
- Moxifloxacin[5]
- Phenothiazine
- Ifosfamide
- Cyclophosphamide
- Carbamazepine
- Oxcarbazepine
- Valproic Acid
- Selective serotonin reuptake inhibitors (SSRIs, a class of antidepressants)
- 3,4-Methylenedioxymethamphetamine (MDMA, commonly called Ecstasy. SIADH due to taking ecstasy was cited as a factor in the deaths of Anna Wood and Leah Betts)
- Oxytocin
- Vincristine
- Morphine
- Amitriptyline
- Transient causes
- Endurance exercise
- General anesthesia
- Hereditary causes
- Sarcoidosis
The normal function of ADH on the kidneys is to control the amount of water reabsorbed by kidney nephrons. ADH acts in the distal portion of the renal tubule (Distal Convoluted Tubule) as well as on the collecting duct and causes the retention of water, but not solute. Hence, ADH activity effectively dilutes the blood (decreasing the concentrations of solutes such as sodium), causing hyponatremia; this is compounded by the fact that the body responds to water retention by decreasing aldosterone, thus allowing even more sodium wasting. For this reason, a high urinary sodium excretion will be seen.[6]
ADH is secreted to prevent water loss in the kidneys. When water is ingested, it is taken up into the circulation and results in a dilution of the plasma. This dilution, otherwise described as a reduction in plasma osmolality, is detected by osmoreceptors in the hypothalamus of the brain and these then switch off the release of ADH. The decreasing concentration of ADH effectively inhibits the aquaporins in the collecting ducts and distal convoluted tubules in the nephrons of the kidney. Hence, less water is reabsorbed, thereby increasing urine output, decreasing urine osmolality, and normalizing blood osmolality.[citation needed]
In SIADH, the release of ADH is not inhibited by a reduction in plasma osmolality when the individual ingests water and the osmolality of the plasma drops. As the main solute of plasma is sodium, this hypoosmolar state is usually detected as a low sodium level on laboratory testing. SIADH is therefore primarily a condition that results in the abnormal handling of water loading and not a problem with excessive solute loss. This is why it is usually treated with fluid restriction. Diuretics (furosemide specifically) may also be given to decrease reabsorption of water, but care must be taken not to correct water imbalances too rapidly.[5]
This causes dilutional hyponatremia and all the consequences associated with that condition: headache, nausea, vomiting, and confusion may ensue. Severe hyponatremia may cause convulsions or coma.[5]
The abnormalities underlying type D syndrome of inappropriate antidiuretic hormone hypersecretion concern individuals where vasopressin release and response are normal but where abnormal renal expression and translocation of aquaporin 2, or both are found.[7] It has been suggested that this is due to abnormalities in the secretion of secretin in the brain and that "Secretin as a neurosecretory hormone from the posterior pituitary, therefore, could be the long-sought vasopressin independent mechanism to solve the riddle that has puzzled clinicians and physiologists for decades."[7]
In general, increased ADH causes water retention without interstitial fluid volume expansion and without edema or hypertension. The water retention causes hyponatremia, which is a key feature in SIADH. This is purely a problem of water metabolism with no abnormalities in total body sodium metabolism.[8] Hyponatremia and inappropriately concentrated urine (UOsm >100 mOsm/L)[9] are seen, as well as no signs of edema or hypovolemia. When hyponatremia is severe (sodium <120 mOsm), or acute in onset, symptoms of cerebral edema become prominent (irritability, confusion, seizures, and coma).
Laboratory findings in diagnosis of SIADH include:
- Euvolemic hyponatremia <134 mEq/L, and POsm <275 mOsm/kg OR ( POsm - Serum [Urea]mmol/l < 280 mOsm/kg )
- Urine osmolality >100mOsm/kg of water during hypotonicity[5]
- Urine sodium concentration >40 mEq/L with normal dietary salt intake
Other findings:
- Clinical euvolemia without edema or ascites
- Low blood urea nitrogen (BUN)
- Normal serum creatinine[10]
- Low uric acid
- Normal Acid-Base, K+ balance
- Normal Adrenal, Thyroid function
Differential diagnosis[edit]
Antidiuretic hormone (ADH) is released from the posterior pituitary for a number of physiologic reasons. The majority of patients with hyponatremia, other than those with excessive water intake (polydipsia) or renal salt wasting, will have elevated ADH as the cause of their hyponatremia. However, not every patient with hyponatremia and elevated ADH has SIADH. One approach to a patient with hyponatremia is to divide ADH release into appropriate (not SIADH) or inappropriate (SIADH).[11]
Appropriate ADH release can be a result of hypovolemia, a so-called osmotic trigger of ADH release. This may be true hypovolemia, as a result of dehydration with fluid losses replaced by free water (seen sometimes in Marathon runners[12] as well as in acutely ill patients). It can also be perceived hypovolemia, as in the conditions of congestive heart failure (CHF) and cirrhosis in which the kidneys perceive a lack of intravascular volume. The hyponatremia caused by appropriate ADH release (from the kidneys' perspective) in both CHF and cirrhosis have been shown to be an independent poor prognostic indicator of mortality.[13][14]
Appropriate ADH release can also be a result of non-osmotic triggers. Symptoms such as nausea/vomiting and pain are significant causes of ADH release.[15] The combination of osmotic and non-osmotic triggers of ADH release can adequately explain the hyponatremia in the majority of patients who are hospitalized with acute illness and are found to have mild to moderate hyponatremia. SIADH is less common than appropriate release of ADH. While it should be considered in a differential, other causes should be considered as well.[citation needed]
Cerebral salt wasting syndrome (CSWS) also presents with hyponatremia, there are signs of dehydration for which reason the management is diametrically opposed to SIADH.[16] Importantly CSWS can be associated with subarachnoid hemorrhage (SAH) which may require fluid supplementation rather than restriction to prevent brain damage.[17]
Most cases of hyponatremia in children are caused by appropriate secretion of antidiuretic hormone rather than SIADH or another cause.[18]
Management of SIADH includes:
- Treating underlying causes when possible.
- Long-term fluid restriction of 1,200–1,800 mL/day[19] will increase serum sodium through decreasing total body water.
- For very symptomatic patients (severe confusion, convulsions, or coma) hypertonic saline (3%) 1–2 ml/kg IV in 3–4 h should be given.[citation needed]
- Drugs
- Demeclocycline can be used in chronic situations when fluid restrictions are difficult to maintain; demeclocycline is the most potent inhibitor of Vasopressin (ADH/AVP) action. However, demeclocycline has a 2–3 day delay in onset with extensive side effect profile, including skin photosensitivity, and nephrotoxicity.[20]
- Urea: oral daily ingestion has shown favorable long-term results with protective effects in myelinosis and brain damage.[20] Limitations noted to be undesirable taste and is contraindicated in patients with cirrhosis to avoid initiation or potentiation of hepatic encephalopathy.
- Conivaptan – an antagonist of both V1A and V2 vasopressin receptors. Its indications are "treatment of euvolemic hyponatremia (e.g. the syndrome of inappropriate secretion of antidiuretic hormone, or in the setting of hypothyroidism, adrenal insufficiency, pulmonary disorders, etc.) in hospitalized patients."[21] Conivaptan, however, is only available as a parenteral preparation.[20]
- Tolvaptan – an antagonist of the V2 vasopressin receptor. A randomized controlled trial showed tolvaptan is able to raise serum sodium in patients with euvolemic or hypervolemic hyponatremia in 2 different tests. Combined analysis of the 2 trials showed an improvement in hyponatremia in both the short term (primary sodium change in average AUC: 3.62+/- 2.68 and 4.35 +/-2.87) and long term with long term maintenance (primary sodium change in average AUC: 6.22 +/- 4.22 and 6.20 +/- 4.92), at 4 days and 30 days, respectively. Tolvaptan's side effect profile is minimal. Discontinuation of the Tolvaptan showed return of hyponatremia to control values at their respective time frames.[22]
No head-to-head study is currently available to quantify and compare the relative efficacies of V2 vasopressin receptor antagonists with demeclocycline or other treatment options.[citation needed]
Care must be taken when correcting hyponatremia. A rapid rise in the sodium level may cause central pontine myelinolysis.[23] Avoid correction by more than 12 mEq/L/day. Initial treatment with hypertonic saline may abruptly lead to a rapid dilute diuresis and fall in ADH. Rapid diuresis may lead to over-rapid rise in serum sodium, and should be managed with extreme care.[citation needed]
The condition was first described by researchers from Boston, Massachusetts and Bethesda, Maryland (including Dr Frederic Bartter) in two patients with lung cancer.[24] Criteria were developed by Schwartz and Bartter in 1967[25] and have remained essentially unchanged since then.[26] The condition is occasionally referred to by the names of the authors of the first report - Schwartz-Bartter syndrome.[27]
- ^ Ramming, Scott; Shackford, Steven R.; Zhuang, Jing; Schmoker, Joseph D. (1994). "The relationship of fluid balance and sodium administration to cerebral edema formation and intracranial pressure in a porcine model of brain injury". The Journal of Trauma. 37 (5): 705–13. PMID 7966466. doi:10.1097/00005373-199411000-00003.
- ^ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474650/
- ^ Syndrome of Inappropriate Antidiuretic Hormone Secretion at eMedicine
- ^ Ellison, David H.; Berl, Tomas (2007). "The Syndrome of Inappropriate Antidiuresis". New England Journal of Medicine. 356 (20): 2064–72. PMID 17507705. doi:10.1056/NEJMcp066837.
- ^ a b c d e Babar, S. M. (2013). "SIADH Associated With Ciprofloxacin". Annals of Pharmacotherapy. 47 (10): 1359–63. PMID 24259701. doi:10.1177/1060028013502457.
- ^ Le, Tao, Vikas Bhushan, Matthew Sochat, Max Petersen, Goran Micevic, and Kimberly Kallianos. "Endocrine." First Aid for the USMLE Step 1 2014: A Student-to-Student Guide. Pg 326. Print.
- ^ a b Chu, J. Y. S.; Lee, L. T. O.; Lai, C. H.; Vaudry, H.; Chan, Y. S.; Yung, W. H.; Chow, B. K. C. (2009). "Secretin as a neurohypophysial factor regulating body water homeostasis". Proceedings of the National Academy of Sciences. 106 (37): 15961–6. Bibcode:2009PNAS..10615961C. JSTOR 40484830. PMC 2747226 . PMID 19805236. doi:10.1073/pnas.0903695106.
- ^ Onitilo, A. A.; Kio, E.; Doi, S. A. R. (2007). "Tumor-Related Hyponatremia". Clinical Medicine & Research. 5 (4): 228–37. PMC 2275758 . PMID 18086907. doi:10.3121/cmr.2007.762.
- ^ Adrogué, Horacio J.; Madias, Nicolaos E. (2000). "Hyponatremia". New England Journal of Medicine. 342 (21): 1581–9. PMID 10824078. doi:10.1056/NEJM200005253422107.
- ^ Modric, Jan. "SIADH". eHealthStar.com. Retrieved 21 October 2015.
- ^ Ishikawa, San-e; Saito, Takako; Fukagawa, Akinori; Higashiyama, Minori; Nakamura, Tomoatsu; Kusaka, Ikuyo; Nagasaka, Shoichiro; Honda, Kazufumi; Saito, Toshikazu (2001). "Close Association of Urinary Excretion of Aquaporin-2 with Appropriate and Inappropriate Arginine Vasopressin-Dependent Antidiuresis in Hyponatremia in Elderly Subjects". The Journal of Clinical Endocrinology & Metabolism. 86 (4): 1665–71. PMID 11297601. doi:10.1210/jcem.86.4.7426.
- ^ Almond, Christopher S.D.; Shin, Andrew Y.; Fortescue, Elizabeth B.; Mannix, Rebekah C.; Wypij, David; Binstadt, Bryce A.; Duncan, Christine N.; Olson, David P.; Salerno, Ann E.; Newburger, Jane W.; Greenes, David S. (2005). "Hyponatremia among Runners in the Boston Marathon". New England Journal of Medicine. 352 (15): 1550–6. PMID 15829535. doi:10.1056/NEJMoa043901.
- ^ Baldasseroni, Samuele; Urso, Renato; Orso, Francesco; Bianchini, Bianca P.; Carbonieri, Emanuele; Cirò, Antonio; Gonzini, Lucio; Leonardi, Giuseppe; Marchionni, Niccolò; Maggioni, Aldo P. (2011). "Relation between serum sodium levels and prognosis in outpatients with chronic heart failure". Journal of Cardiovascular Medicine. 12 (10): 723–31. PMID 21873881. doi:10.2459/JCM.0b013e32834ae87e.
- ^ Kim, W. Ray; Biggins, Scott W.; Kremers, Walter K.; Wiesner, Russell H.; Kamath, Patrick S.; Benson, Joanne T.; Edwards, Erick; Therneau, Terry M. (2008). "Hyponatremia and Mortality among Patients on the Liver-Transplant Waiting List". New England Journal of Medicine. 359 (10): 1018–26. PMC 4374557 . PMID 18768945. doi:10.1056/NEJMoa0801209.
- ^ Fisher, RD; Rentschler, RE; Nelson, JC; Godfrey, TE; Wilbur, DW (1982). "Elevation of plasma antidiuretic hormones (ADH) associated with chemotherapy-induced emesis in man". Cancer Treatment Reports. 66 (1): 25–9. PMID 7053263.
- ^ Petzold A (2015). "Disorders of plasma sodium". N Engl J Med. 372 (13): 1267. PMID 25806925. doi:10.1056/nejmc1501342.
- ^ Sen J, Belli A, Albon H, et al. (2003). "Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage". The Lancet Neurology. 2 (10): 614–621. PMID 14505583. doi:10.1016/s1474-4422(03)00531-3.
- ^ Rivkees, Scott A (2008). "Differentiating appropriate antidiuretic hormone secretion, inappropriate antidiuretic hormone secretion and cerebral salt wasting: the common, uncommon, and misnamed". Current Opinion in Pediatrics. 20 (4): 448–52. PMID 18622203. doi:10.1097/MOP.0b013e328305e403.
- ^ Schürer, Ludwig; Wolf, Stefan; Lumenta, Christianto B. (2010). "Water and Electrolyte Regulation". In Lumenta, Christianto B.; Di Rocco, Concezio; Haase, Jens; et al. Neurosurgery. European Manual of Medicine. pp. 611–5. ISBN 978-3-540-79565-0. doi:10.1007/978-3-540-79565-0_40.
- ^ a b c Zietse, R.; van der Lubbe, N.; Hoorn, E. J. (2009). "Current and future treatment options in SIADH". Clinical Kidney Journal. 2 (Suppl_3): iii12–iii19. PMC 2762827 . PMID 19881932. doi:10.1093/ndtplus/sfp154.
- ^ "Vaprisol (conivaptan hydrochloride) Liquid [Astellas Pharma US, Inc.]". Archived from the original on 2009-07-18. Retrieved 2007-06-08.
- ^ Schrier, Robert W.; Gross, Peter; Gheorghiade, Mihai; Berl, Tomas; Verbalis, Joseph G.; Czerwiec, Frank S.; Orlandi, Cesare (2006). "Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia". New England Journal of Medicine. 355 (20): 2099–112. PMID 17105757. doi:10.1056/NEJMoa065181.
- ^ Ashrafian, H.; Davey, P. (2001). "A review of the causes of central pontine myelinosis: yet another apoptotic illness?". European Journal of Neurology. 8 (2): 103–9. PMID 11430268. doi:10.1046/j.1468-1331.2001.00176.x.
- ^ Schwartz, William B.; Bennett, Warren; Curelop, Sidney; Bartter, Frederic C. (1957). "A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone". The American Journal of Medicine. 23 (4): 529–42. PMID 13469824. doi:10.1016/0002-9343(57)90224-3. reproduced in Schwartz, William B.; Bennett, Warren; Curelop, Sidney; Bartter, Frederic C. (2001). "A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. 1957". Journal of the American Society of Nephrology. 12 (12): 2860–70. PMID 11729259.
- ^ Bartter, Frederic C.; Schwartz, William B. (1967). "The syndrome of inappropriate secretion of antidiuretic hormone". The American Journal of Medicine. 42 (5): 790–806. PMID 5337379. doi:10.1016/0002-9343(67)90096-4.
- ^ Verbalis, Joseph G.; Goldsmith, Stephen R.; Greenberg, Arthur; Schrier, Robert W.; Sterns, Richard H. (2007). "Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations". The American Journal of Medicine. 120 (11 Suppl 1): S1–21. PMID 17981159. doi:10.1016/j.amjmed.2007.09.001.
- ^ Schwartz-Bartter syndrome at Who Named It?


text:
Fine Bordeaux less than a fine investment in 2012
By Leslie Gevirtz
(Reuters) - Wine sales at auction houses were flat to lower in 2012, with lower prices for the top Bordeaux weighing on results.
Values for Burgundies, which have long been in short supply and as a result command high prices, vaulted to new peaks. But, even so, the Burgundies could not make up for the Bordeaux disappointments.
Several major auction houses have released their final sales totals for the year, and only Christie's seemed to have been able to hold its ground. It said this week it expected to report its global wine sales were more than $90 million, the same level as in 2011.
Sotheby's said its total global wine sales were $64.5 million in 2012, down from the $85.5 million it reported last year. Acker Merrall & Condit said its total wine sales were $83.3 million. That was down from the $110 million it reported in 2011.
Bordeaux prices headed lower all through the year. The top Premier Crus - Chateaux Lafite Rothschild, Margaux, Latour, Haut-Brion and Mouton Rothschild - were all down, in some cases as much as 40 percent from the previous highs.
At Spectrum Wines' Hong Kong auction two weeks ago, cases of 1982 Chateau Lafite went for between $33,860 and $38,115, all below their pre-sale estimate of $40,000. A year ago, such cases of Lafite were selling for about $45,000.
The lots of '82 Margaux at Spectrum's auction sold for between $6,655 and $7,865 a case, missing their presale estimates of $8,000 to $9,000. Prices for the '82 Latour held up a bit better. One 12-bottle case went for $15,730, still below its estimate of $16,000; the other case went for the same price, above its presale estimate of $11,000.
Spectrum wine specialist Dan Rhodes blamed part of the slide in Bordeaux prices on the glut of inventory - there is quite a lot of Bordeaux in Asia - as well as the producers themselves, who have priced their current releases at historic highs that he said "leave little room for appreciation..." Continued...

subset: commoncrawl


text:
Quick Links
A-Z | Portals | Blackboard | eCollege | Web Mail
Ryan Yee is currently entering his second year as an undergraduate
student at Colorado State University in Fort Collins. He is majoring in
Biomedical Sciences in the College of Veterinarian Medicine and
Biomedical Sciences. Ryan aspires to be a physician one day and own
his own family practice in the state that he was born, Hawaii. As a
member of the Undergraduate Pre-Health Program for the summer of 2013,
Ryan will be placed in a Family Practice Clinic at Kaiser Permanente as
a student intern. He hopes to understand disparities in healthcare and
help eliminate some of them in the future. Ryan feels honored to be a
part of this program along with his older brother Jordan who is a great
role model to him.
In his first year at Colorado State University, Ryan was involved in
Habitat for Humanity and the Braiden Activity Crew. Through diligent
study, Ryan maintained good grades and was placed on the Dean's List.
Ryan has a passion for sports playing basketball and soccer in his
spare time. He hopes to join the CSU Track team in the Fall as a Pole
Office of Inclusion and Outreach
University of Colorado Anschutz Medical Campus
13120 East 19th Avenue | Educaton 2 North 3118
Aurora, CO 80045
o 303.724.8003 | f 303.724.8006 | e email@example.com
Like Us on Facebook!
Join Our Group on Facebook!
Follow Us On Twitter!
Map Us on Bing!
Map Us on Google!
© The Regents of the University of Colorado, a body corporate. All rights reserved.
Accredited by the Higher Learning Commission. All trademarks are registered property of the University. Used by permission only.


text:
Gear Up for Spring
Forget tulips: The new harbingers of spring in Denver are big red bikes. The B-cycle program will return for its third year tomorrow. But Denver Bike Sharing, the nonprofit that operates the program, wants you to help distribute some of the organization's 520 bikes today at the 2012 Launch Party & Ride. Show up at B-cycle's Larimer Street headquarters, grab a bike and ride it to any one of 52 stations.
"It's a good opportunity to bring people together in the community and have fun and get riding to start the season," says Denver Bike Sharing spokesman Ben Turner. B-cycle closed out the season in a similar fashion last December.
The offices will open at 11 a.m., and riders will head out at noon. But before that happens, there will be brunch foods, drinks from Honest Tea, music and a group photo. And although anyone can participate -- not just B-cycle members -- Turner points out that Denver Bike Sharing will be selling memberships at the office that day (annual memberships are $80, but you can pay for individual rides, too).
B-cycle headquarters are at 2737 Larimer Street, Suite A; for more information and to register, go to http://denver.bcycle.com.
Sun., March 11, noon, 2012
Get the Things to Do Newsletter
Sign up for our weekly guide to events in Denver, and never be bored again. With suggestions for every day of the week, our recommendations will keep you busy on any budget.
Popular Stories
Upcoming Events
Bruce Bruce
TicketsFri., Jul. 28, 7:30pm
Van Wholen (Tribute to Van Halen and the Who)
TicketsFri., Jul. 28, 8:00pm
Colorado Rockies vs. New York Mets
TicketsTue., Aug. 1, 6:40pm
Against All Odds Tour
TicketsTue., Aug. 1, 7:00pm
Sponsor Content


text:
Madame Scodioli
Boheme - Vanilla Oak - Perfume Oil Spray
310 kr
|Measure your size:
Cut a thin strip of paper or get yourself a piece of string of several centimeters. You can also use a tailor's tape.
|Measure the size of a ring:
|Measure the inner diameter of one of your rings with a ruler, note the size.
Ring Size Conversion Chart
Wild & Arrow Jewelry
We love to use solid silver / brass / bronze in Wild & Arrow pieces; mostly recycled or vintage. All brass / bronze chains are new with protective coating unless otherwise stated. Your jewelry is made to be beautiful for years to come. The solid metal in our jewelry is recyclable.
We avoid gold-plating because of the harmful chemicals that needs to be used and because the solid silver/bronze/brass metal can be polished over and over if you want your jewelry to shine.
Golden raw brass / bronze
The Wild & Arrow golden pieces are made of raw solid brass / bronze, unless other stated. The metal will change it´s color over time, fade or darken. We really love this natural result which will make your Wild & Arrow jewelry truly unique. If you prefer a golden look it´s easy to clean and polish brass and bronze.
Ring that are used frequently will remain golden and shiny and darken in corners.
Brass and Bronze pendants will usually darken over time.
Bronze & Brass // Rings & Earrings
Does your skin darken by the copper in brass/bronze?
Avoid wearing rings/earwires with moisturizer or around water. Also a layer of clear nail polish works nicely inside of a ring and on the back of an earring.
If you want us to add a protective layer on your piece, or change earwire to silver/gold just get in touch!
Store your Wild & Arrow jewelry in a cool dry place. Most jewelry can be gently rinsed with soap and water if needed. Make sure to dry completely before storing your jewelry.
If you want your bronze/brass pieces to darken and oxidize you can speed up the process and do the opposite; if you store them in your bathroom around humidity they will darken faster. But be aware of any fingerprints. They don´t look pretty in our opinion..
Polishing // Brass / Bronze / Copper cleaning // Eco friendly
Golden brass/bronze is easy to polish back to it´s original shiny state. Ketchup is a great cleaner, yes really! Apply a thick layer. Let your Wild & Arrow piece soak for a few minutes. Rinse with water. Voila!
A kitchen sponge with some dish washing detergent will help if you want a matte brushed finish or if the jewelry was in really bad shape.
We can also clean the jewelry for you, just get in touch!
Avoid using harsh cleansers (don´t rub with any cleanser) on our brass chain as this may cause the protective coating to wear off.
Polishing // Silver / Gold cleaning // Eco friendly
Sterling Silver and Gold is easy to clean back to it´s shiny state with a bath of hot water, salt and a piece of aluminium foil.
Add a tablespoon salt above a small piece of foil. Pour in hot water and let your silver jewelry soak for a minute! Rinse with water.
This will probably not work on our dark oxidized pieces.
Another way of polishing your silver is to use baking soda (bikarbonat in Swedish) and water.
Add enough baking soda so you get a paste. Then use a toothbrush or a piece of cloth and rub your silver. Rinse with water and always dry your silver throughly.
A kitchen sponge will help if you want a matte brushed finish or if the jewelry was in really bad shape. Also a small rinse with dish-washing liquid and a tooth brush can be helpful.
If you don´t want to be bothered, we can clean your Wild & Arrow jewelry for you. Get in touch with us!
Boheme :: Vanilla Oak
Perfume oil Spray, vegan friendly.
Shown in the second photo. If you prefer this style, simply select the option in the dropdown box, and you will receive both the regular spray top with cap AND an atomizer bulb.
A most enchanting complex blend of creamy vanilla and warm oak with sandalwood, amber, cedarwood and a slightest touch of clove. Top notes include bergamot and cassia, the perfect scent to satisfy your wandering Bohemian spirit. The Madame highly recommends this one to lovers of her Cloven scent..
Generously sized glass spray bottle with waterproof label.
30 ml
Sample sizes available if you want to try before buying a full size perfume.
Madame Scodioli
A line of unusual bath and beauty products, conceptually modeled around the American traveling carnival from the late nineteenth century through the dust-bowl era. Drawing inspiration from gypsies, carnival folk, restless spirits of all kinds.
The Madame
Rumor has it that Madame Scodioli, our line's iconic bearded lady, began her business while traveling the carnival circuit with her troupe. Nomadic types tend to get a little ripe on the road, so after the gates closed and all was quiet on the midway, Madame would retire to her wagon and spend her evenings making soap and other curiosities for the performers.
But what would a bearded lady know about hygiene? Goodness, plenty! After a long day of displaying her petit goatee to the crowd, the Madame loves nothing more than to climb into her clawfoot tub. Then, naturally, she emerges to brush her face one hundred times on each side. The Madame is all about fine grooming.
We view the Madame as an icon for unconventional beauty as well as individuality and confidence. The Scodioli line focuses on distinctly unique unisex scents for those who march to the beat of their own drum.
Read our interview with Riley one of our favorite makers and the designer genious behind the Madame Scodioli brand!


text:
Reset My Password
This will send a password reset to your email address on file. A reminder that your email address on your account must be valid and working to receive the reset request.
We would love to hear your feedback and any suggestions you may have for our new VWVortex store.
Let us know if there is a color option you would like added or a particular merchandise item you would like to see in the store. Have you had a chance to buy an item from our store? Then we want to hear what you think about the merchandise you bought.
If you would like to provide feedback/suggestions please post in here in the Store Feedback forum.
Just in case you missed it, Audi of America President Johan de Nysschen visited the Fourtitude forums yesterday. The point of the visit, part of our Q&A series of well-known Audi personalities, was to provide an opportunity to ask the questions. Our readers didn't disappoint, and neither did de Nysschen who dropped
For 2011 we have big plans regarding the evolution of Fourtitude. Much of these changes will begin this summer though one change we plan to implement next week (and before the 24 Hours of Le Mans) is the return of a feature whereby we invite a special guest to visit and take part in our forums. Given the timing and
Here in the offices of Fourtitude and its parent Vortex Media Group we're planning a major overhaul of this website and some of its sister websites. Expect a major redesign and new functionality by early this summer and that'll be just the beginning as we move to increase Fourtitude's usefulness and offerings amidst an ever-growing field of Audi enthusiast outlets. While it's a bit premature to announce any of our larger changes


text: Doctor Who Christmas special 2012 - first shot of Matt Smith and Jenna-Louise Coleman unveiled The Doctor's clearly trying to tell his new companion something important here - but we're just as interested in what's going on in the background... Comments Written By Paul Jones 12:01 AM, 17 November 2012 There's a sense of urgency to this first shot of the Doctor and his new companion in this year's Christmas special. The Time Lord is clearly trying to communicate something of importance to Clara Oswin (if that is, indeed, her name). And while we're desperate to know what it is, we're also slightly distracted by what's going on in the background – snow! Of course, a Doctor Who Christmas special without the stuff was pretty unthinkable but it's still good to have confirmation that, on TV at least, it will be a white Christmas after all... To view a full-size version of the photo, click on the image, left. And to find out what we know so far about the Doctor Who Christmas special, see our roundup here. Like this? Share it. Facebook Twitter Google Tumblr Pinterest Blogger Reddit VKontakt Print Email


text:
a place for zinesters - writers and readers
We still need just a few folks that can lend their wit and writ to interview a handful of artists for our rad/ical arts magazine. We love folks that can ask probing, pointed questions with a critical eye. Are you that somebody? (thanks aaliyah)
Too, we're looking for people to climb aboard as members of the core collective. Right now we exist as a compact unit of three and would love more hands/…
© 2017 Created by Krissy Ponyboy Press.
Powered by
Badges |
Report an Issue |
Terms of Service
Please check your browser settings or contact your system administrator.


text:
April 4, 2001
BIRMINGHAM, Ala. - The UAB softball team's game against Alabama, scheduled for 7 p.m. in Tuscaloosa, Ala., has been canceled due to rain.
The Blazers (19-21, 3-3 Conference USA) return to George Ward Park Field No. 6 this weekend as the team will face eighth-ranked DePaul (26-7-1, 6-0 Conference USA) in a three-game Conference USA series. Saturday, the two teams will square off in a doubleheader, starting at 1 p.m. Sunday will feature a single game at 1 p.m.


text:
53927 Classement
123 J'aime
11 Photos
35 Abonnements
88 Suiveur
Hi! I'm a 19 year old cosplayer from the South West of the UK! I've been cosplaying since 2006 and have made some amazing friends from it. At this point I've mostly done cosplays from anime, but have started branching more into video games and western movies and comics!


text:
CableTV.com Recommends DIRECTV for your TV service
We want to help you find the best television services available in your area, which is why we've compiled results from a number of independent consumer surveys—to make it easy for you to find the best cable companies and other TV services for your home. Between all of the satellite TV and cable companies in Royal City, WA, these surveys show that DIRECTV is considered to be the best TV service provider in the area.
Figuring out which is the best cable company in Royal City, WA can be a challenge. Cost is always a key factor, but you also need to consider other important details, like the quantity and quality of the channels being offered. While major networks are included in virtually all TV packages, TV packages in Royal City may offer a different selection of local channels and smaller networks compared to packages in other areas. Opting for a premium, channel-rich package can ensure that you won't miss a single or Seattle Seahawks game or episode of your favorite show. We've compiled data about the highest rated providers available in Royal City—including info on the channels and premium features offered by each package—so you'll be able to find the service that best fits your needs.
If you want to know more about a cable company in Royal City, WA, start your search at CableTV.com. When compiling our TV provider ratings, customer service and reliability are just two of the factors we consider. That means you have a higher chance of finding a provider with a channel line-up and customer service record you can be happy with.


text:
Popular, well-known poetry: "The Passionate Shepherd to His Love," "Shall I compare thee to a summer's day?" "Death, be not proud," "The Raven," "The Road Not Taken," plus works by Blake, Wordsworth, Byron, Coleridge, Shelley, Emerson, Browning, Keats, Kipling, Sandburg, Pound, Auden, Thomas, and many others.
REVIEW SNAPSHOT®by PowerReviews
Reviewed by 1 customer
Best Uses
Comments about 100 Best-Loved Poems:
A bit too conservative and traditional a collection for me but then it is the best-loved so that probably explains it. I would like to have seen some difference in the collection all the same. not boring poems but perhaps boring altogether. HOWEVER has some gorgeous stuff in it.
Series: Dover Thrift Editions
Audience: General
For Ages: 11+ years old
For Grades: 6+
Format: Paperback
Language: English
Number Of Pages: 96
Published: October 1995
Publisher: Dover Publications Inc.
Country of Publication: US
Dimensions (cm): 20.8 x 0.8 x 0.7
Weight (kg): 0.09


text:
Pivot: Supreme Court Ruling Will Be A Big Headache For Public Sector Unions
posted at 6:54 pm on June 21, 2012 by Patrick Ishmael
While the U.S. Supreme Court did not hand down the long-anticipated decision on 2010's health care overhaul today, it did publish a ruling that could be a huge problem for public employee unions (PEUs) both now and down the road.
More to the point, this is a big victory for freedom of speech, and probably just the first of many in this policy area.
The case, Knox v. SEIU, arose from a California law that allows PEUs to charge nonmembers for nonpolitical services related to the collective bargaining activities PEUs undertake for both union members and nonmembers. At issue: Did the SEIU violate the First Amendment rights of non-members by the manner in which it levied special charges, which in some cases were used to promote union political activities?
The Court's answer: Yes. (PDF at the link.) Not only did the Court reject the idea that "lobbying the electorate" was a chargeable activity – which the SEIU argued – but the Court also did not accept the argument that PEUs could basically guess at how much they would spend on political activities, charge nonmembers accordingly and without violating nonmembers' First Amendment rights effectively appropriate nonmember funds for political activities due to the union's own imprecision, even if only temporarily.
Justice Alito, writing for the majority:
Unless it is possible to determine in advance with some degree of accuracy the percentage of union funds that will be used during an upcoming year for chargeable purposes—and the SEIU argues that this is not possible—there is at least a risk that, at the end of the year, unconsenting nonmembers will have paid either too much or too little. Which side should bear this risk?
The answer is obvious: the side whose constitutional rights are not at stake.
Alito, in his conclusion (emphasis mine):
The First Amendment creates a forum in which all may seek, without hindrance or aid from the State, to move public opinion and achieve their political goals. "First Amendment values [would be] at serious risk if the government [could] compel a particular citizen, or a discrete group of citizens, to pay special subsidies for speech on the side that [the government] favors." United Foods, 533 U. S., at 411. Therefore, when a public-sector union imposes a special assessment or dues increase, the union must provide a fresh Hudson notice and may not exact any funds from nonmembers without their affirmative consent.
That's a big deal; if nonmembers can do nothing and avoid sending dollars to PEUs' political coffers, those nonmember funds might very well dry up. Unions would have to get their political donations the old-fashioned way from nonmembers: by asking them to cut the union a check. And while this decision is being applied very narrowly today, the principle encapsulated by that bolded portion is key and will almost certainly be evoked in future cases involving similar violations of nonmember First Amendment rights.
Bookmark this case. It's a big one.


text:
- Andrea Maciejewski - An essential trait for success in my job
- Andrea Maciejewski - My next big goal
- Andrea Maciejewski - My most prized possession
Andrea Maciejewski
Director of Client Development
2 North LaSalle Street Suite 1300
Chicago, Illinois 60602
- Andrea's Insights
Andrea helps LP attorneys grow their lines of business and develop deeper, more effective relationships with firm clients. She oversees all marketing efforts at LP, including content creation and distribution, website development, seminars and events, public relations, advertising, social media, and all other outward-facing communications.
At LP, Andrea initiated the firm's creation of extensive video content for the firm website, a project that won Legal Marketing Association "Your Honor" awards from both the national organization and Midwest chapter. On her watch, the firm ranked #1 in Marketing the Law Firm's "Magnificent 25," a listing of the top law firm marketing departments and a 2012 website redesign. For the past two years she has directed the firm's client feedback and interview process.
She previously served as Marketing Projects Manager at an AmLaw 100 firm, where, among other duties, she coached attorneys on marketing and was responsible for all firm sponsorships.
Respected throughout the legal marketing community for her ability to make marketing visions a reality, Andrea has been asked to speak at the LMA's national conference (2013) and to serve as co-chair of the Thomson-West Social Media Conference (2013).
Her community activities reflect the same positive and indefatigable spirit that she brings to her work. An organizer of the Riverside Farmer's Market, Andrea was appointed to the Illinois Farmer's Market Task Force, a 25-member body that works with relevant constituencies and develops best practices for farmers markets across the state. She also leads a Brownie troop and serves as a marketing consultant to the board of directors of Trinity High School, the international baccalaureate school from which she graduated.
Andrea earned her B.A., cum laude, in International Relations and Diplomacy from Dominican University and was selected to participate in the Kellogg School of Management's Women's Leadership Workshop. She is an active LMA member, serving as the Chair of the Special Programs Committee (2007-08) and was Treasurer for the Midwest LMA Board (2008-10).


text:
Cap and Traitors on the Run, Smart Grid Next, WTP Keeps up the Pressure
by Jacob Leis
Western Tradition Partnership (WTP) members – along with many other Americans who voiced opposition to the multiTRILLION dollar "Cap and Trade" energy tax – should be proud of themselves for derailing H.R. 2454, which was on its way to a speedy Senate vote after being rammed through the House in late June.
While this debate is now somewhat overshadowed by the Obama Adminstration's attempt to take away the private insurance and health care freedoms of millions of citizens, we believe that Cap and Trade legislation is still the greatest and most overarching overall threat to the American way of life, and must be vigorously opposed.
The dirty little secret being withheld from the "little folks" like you and me? Our opposition campaign is working, and with continued action at this level, WTP's Congressional insiders and Senate staff contacts tell us we could beat back a Senate Cap and Trade vote until this session, and maybe even kill the bill until after the 2010 mid term elections!
Liberal blogger Ezra Klein (who started his career with wunderkind blogger Matt Singer of Left in the West) confirms our suspicions with this Washington Post quote posted earlier today (responding to a question about going on in D.C.):
Washington, D.C.: Has the Senate set a time table for when they're going to debate Cap-and-Trade? Obviously, it will be after the recess, but I'm nervous that if they dither and delay it much later than that, they'll start to use the 2010 elections as an excuse to blow it off entirely.
Ezra Klein: I would bet a lot of money that we don't see the Senate pass a serious cap-and-trade plan before the 2010 midterms.
These guys are onto something. They are seeing Senators in swing states get hammered over Cap and Trade. But we cannot be satisfied with knocking our opponents down – we must finish the job. That's why even as the Feds throw the kitchen sink at us with radical natural resource and environmental legislation, WTP continues to sound the public alarm while we ramp up our opposition campaign to reach the elderly, business owners, farmers and ranchers, and hundreds of thousands of plain old taxpayers. The response has been very encouraging. Anyone who has the least interest in not becoming a de facto slave to the government elite should be very concerned about the implications of this bill. Here's why:
As you know, Cap and Trade puts federal police power behind collecting "carbon taxes" – a tax on consumption of energy – which not a single person funtioning in our society could escape. Yes, this tax will cost you and me trillions of dollars and includes the laugable "cow flatulence" fee, but that's not the half of it. The more sinister side of such legislation is the ability to control individual behavior through coercion.
You see, when combined with rapidly advancing "smart grid" technology, which is supported by big business (corporations that actually may be "evil") — and which will likely be VERY appealing to Americans, who genuinely want to help the environment and increase energy efficiency, so long aas it doesn't destroy their way of life in exchange for nothing — the Dynamic Duo of Cap and Trade/Smart Grid would allow government bureaucrats (and their computers) to ratchet up their carbon taxes at will, bureaucratically, without even the charade of a Congressional vote. [Read more about that angle below.]
And if at some point you can't pay? Said bureaucrat's computer would simply shut off power to your home or business. No hearing, no trial. A new, and very personal Dark Age.
Therefore it is critical you continue to fight Cap and Trade from now until the summer reccess is over! Western Tradition Partnership will be alerting constituents via mail and email, and while politicians are in their districts, holding rallies as YOUR cap and trade petitions (click here to sign – we'll hand-deliver) are brought by the thousands to their local offices.
Please consider joining WTP today as we fight the anti-taxpayer, anti-jobs agenda of the Radical Environmental Left. And please SIGN OUR "NO CAP & TAX" PETITION today – your petition and personal comments on it will be hand-delivered to your U.S. Senator by our staff, and we'll report progress to you along the way. We are winning this fight, but must stay vigilant!
To further understand the impact of Cap and Trade on the U.S. — and particularly on places far from New York and San Francisco — read this excellent, detailed article:
Cap and trade — tough questions By David Bennett, Farm Press Editorial Staff, Jul 30, 2009
During July 22 Senate Agriculture Committee hearings on cap and trade legislation it became quickly apparent that major questions have yet to be answered by proponents….
Also read: Cap and Trade Charade by Ken Blanchard over at the the South Dakota Politics Blog
Finally, for an excellent analysis of the Smart Grid Scam by analysts at the Gerson Lehman Group, check out:
Smart Grid is Big Brother and the Scam of the Century and can't be stopped
July 24, 2009
Join ATP, Stop Gang Green!
American Tradition Partnership (ATP) is a no-compromise grassroots organization dedicated to fighting the radical environmentalist agenda. We support responsible development of natural resources and rational land use and management policies. Only together can we protect access, private property rights, and affordable energy for all Americans!


text:
Your Dog, Your Life
The Scoop
Dog News, Politics
Bark-Out-Loud Humor
Doggie Style
Gear and Glam
Wildebeest creates the perfect present for new dog parents.
Dog Breeds
Foods & Treats
Health & Care
Behavior & Training
Dogs & Cleaning
Dog of the Day
Photo Comments
We started the day at Emma's. While he was inside picking her up, the people from the cleaning company had come out so I barked at them. I didn't realize it but Dad had come out with Emma. He got mad at me for barking. I know that I'm not supposed to bark at everything so I only do it when I know he's not around. While we were walking I saw Bristol eating goose poop so I thought I would try some. Dad didn't like that very much. I should probably only do that when he's not around.
When we were coming back from our walk with Stasha and Jesse, we saw Maureen (the other dog walker) with her dog. He's fully intact so I barked at him. Dad didn't like that very much. One of these days I'm just going to stop barking all together.
Copyright © I-5 Publishing, LLC. All rights reserved.
Visit Catster


text:
Revolution (aka "Rev") is a game mode centred around crew uprising. In it, certain members of the crew (Head Revolutionaries) start out with the goal of recruiting other crew members and overthrowing, replacing, or killing the station heads.
Revolution Leaders (of which there will be one to three) start with a flash and access to all the Uplink Items traitors get. Revolution Leaders can convert people by right-clicking on an adjacent individual and using the appropriate verb, which will provide a popup prompt. When someone converts, he will have a red R over hishead to identify him as a revolutionary to his comrades in arms.
During a Revolution round, it's the job of the Head Revolutionaries to run around recruiting their fellow team members to the cause and finding inventive ways to kill or depose the Captain, Head of Security, Head of Personnel, Chief Engineer, and Research Director. If the Revolutionaries manage to kill all of the ORIGINAL heads, they win. If everyone else manages to kill the Head Revolutionaries, the station wins. Pretty simple, although this shouldn't be considered the only method of winning. Heads are considered dead if they leave the z-level of the station or enter a locker. They will be listed as having abandoned the station.
Tips and Tricks
Heads of Staff
You may receive some directives from Central. How you handle this can vary for your character- During Revolution, Heads of Staff can be considered to be an antag to the degree of engaging in mildly antagonistic behavior, but keep in mind you are still a character- You are more than capable of mitigating this by being fair and reasonable!
Remember that turtling (boxing up in an area and making yourself an almost impossible target) is in incredibly poor form, though it can be acceptable in some instances.
Station Staff
As a member of the general staff, Revolutionary rounds should be treated like any other round; if you see someone trying to robust a Head to death, try to stop them or call Security. Remember that mutiny is legally punishable by the corporation.
Head Revolutionaries
You have a hard job ahead of you. Convince your fellow crew to join your cause to overthrow the tyrannical rule of the heads, while keeping covert until your ranks are swelled enough for an overt assault. Subtlety is key early on, for getting captured by Security before getting a loyal and broad following set up is detrimental to the cause. It might also be useful and constructive to RP to come up with some caveat and backstory to the revolution. Also, if you're short on weapons or can't access them, why not make your own?
Remember that initial fluff can be up to you, although you can be in possession of contraband(Your PDA uplink) or outright employed by an enemy corporation to start causing trouble - If you have reason to be a traitor, you can definitely have reason to be a revolutionary! However, the people onstation may have significantly less reason to side with you- They're not exactly employed on a deep space research facility for no reason! Nonetheless, you can find a variety of ways to appeal to crewmembers, and you should be willing to use your imagination. None of this is foolproof, and remember- People can most assuredly betray you! Try bribery - Go get some funds from the ATM, and set about trying to pay off those with questionable loyalty. Offer them contracts outside of NT if something goes wrong. Others can be persuaded by convincing them that they can get a promotion themselves out of this, as long as they remember who they owe the favor to... Give people reasons to think they can change NanoTrasen by doing this! Offer to them what their work is contributing to- And that it's nothing good, rake muck! Give personal blackmail, true or false out, on the heads of staff. Maybe they already have a chip on their shoulder regarding some of the command. Were they treated poorly, or perhaps it's something more petty? Consider it also an excellent RP impetus to get to know your coworkers!
It's heavily recommended you try to personalize your approaches- Proselytizing often fails. Try not to get caught lying to two different revs as to your intentions! They might turn on you...
Your first course of action should be to start convert. Do not randomly flash them; use the convert verb. Flashing remains in case of a bug - If you do not follow this policy, you will be antag-banned or worse. Be a bit covert about it, but you still want results. As a rev head, your primary turning targets are Robotics, Genetics, Scientists, and the Quartermasters; Robotics has can make you wonderful mechanical contraptions to 'announce' your point, Geneticist can lock down the cloner, Scientists can make explosives and guns, and Quartermasters serves as a great base of operations (not to mention that they can order you nifty toys if you Emag their supply computer). Your number one concern, at least until things get moving, is to STAY LOW. Keep your identity a secret if possible - Mutiny and sedition are serious charges, much less conspiracy to murder...
Genetics is very helpful here, if you've already incapacitated a station head; The geneticists can save the heads UI's and inject you with them, making you look exactly like that guy. Have fun with that!
Converted Revolutionaries
If you did not join the revolution willingly and were just flashed for no reason, or if you were disillusioned from the revolution (aka don't want to be rev anymore ICly), ADMINHELP IT. If you did agree to it, then your new job is to find a way to get back at those jerk-ass heads of staff without getting caught. Also remember that your game isn't necessarily over if you get caught; Roleplay doesn't end, and if you're treated unfairly you can find more sympathy, sometimes from within security itelf! You cannot see who the other revolutionaries are. Only the head revolutionaries can.
Game Over
- If all of the Command Staff die or convert, the Revolution wins. This includes the Head of Personnel, Head of Security, Research Director, Chief Engineer, Chief Medical Officer, and Captain.
- If all of the Revolution Leaders die, the Heads win.
- Leaving the station z-level counts as "Abandoned the station/Abandoned the Cause", in which they are treated as dead.
|Antagonists on Baystation 12
| Basics
Game Modes - Identifying Antagonists
| Antagonists


text:
Call 800-522-2025M-F 8:30am - 7pm EST
Shopping Cart($0.00)
FREE SHIPPING No Minimum Order!
SHOP MARKERTEK EVERYDAY for all of your needs. Free shipping on almost every order placed on our website.
Special order & oversized freight intensive items ship at an additional cost. Continental US orders only.Ask about our new Economy International Shipping Options.
Secure LoginClose X
Returning Markertek Customers
New Markertek Customers
Why Create an Account?
Creating a Markertek account now will save you time on future orders. You'll have full access to your order history and a personalized shopping experience.
Home > Product Categories > Test & Measurement > Multimeters & AC Testers > FLUKE-233
Item #: FLUKE-233 MFG #: FLUKE-233
List Price:$349.99Our Price:$349.99Quantity Pricing
+ Add to Wishlist + Add to Quote
The Fluke 233 remote display digital multimeter allows you to be 30 ft away from the measurement point with the innovative wireless display. With the 233, you can perform two man jobs alone and remove the hazard from the job.
Add Accessories for your FLUKE-233:
Recently Viewed Items:
Newsletter Sign Up
Weekly email with exclusive deals, unique new products, how-to videos and so much more!
Download the Newest Catalog!
© 2017 Markertek, Division of Tower Products Incorporated • Legal Notice & Code of Ethics


text:
CFCC Budget Trimmed, No Job Losses
Published April 29th, 2009
Loading Video...
He's trimming the budget without sacrificing jobs - a feat he says is just "part of his job".
On the eve of the state budget being approved by lawmakers Central Florida Community College's President met with his Board of Trustees to go over a few cost cutting moves, but the clincher? Using a closed door as a new window of opportunity.
Related Stories
- CFCC Faces Increased Enrollment, Under Staffing, And $1M Budget Cuts
- Alachua County Department of Public Safety Facing Cuts, Job Losses
- UF Budget Plan Includes Job Cuts
- Nearly Two Years After Tree Trimming Accident, Mom Speaks Out
- Tree Trimming Accident Kills Father
- CFCC Donation
- CFCC Campus Plans to Permanently Move After Large Donation
- Mourning the Loss of Officer Killed in the Line of Duty
- Power loss threatens Gainesville man's life
- Weight Loss Programs


text:
« Local Home
Ratings and Reviews
Pet Valu Discount Pet Food [view the full listing]
Belleville, ON K8P 5A5
(613) 962-6580
We luff Pet Valu!!!
This is where we buy Kongs!!
The Pet Lodge [view the full listing]
Spencerville, IN 46788
(260) 238-4911
A very posh boarding location, looks very clean
Serramonte Pet Shop [view the full listing]
They gots loads of toys for cats and dogs here!!
Trenton Comfort Inn [view the full listing]
Pet Friendly!
You can stay with your pets here!!
Alliance of Canada [view the full listing]
"Animal Protection through Education and Advocacy"
Animal Alliance of Canada is committed to the protection of all animals and the promotion of a harmonious relationship among people, animals and the environment. Animal Alliance of Canada brings together dedicated professionals with proven records in animal protection. Together we work on local, national, and international educational and legislative advocacy initiatives to protect animals and our environment.
Merry PAWppins [view the full listing]
They walk, they sit, they visit!!!
Merry PAWppins does several things to add to the superior care and handling provided by our caregivers. All of our staff members are trained in pet first aid, should the unforseen happen. Our vehicles contain first aid kits. Each customer (four-legged that is) has a picture and information sheet which includes information such as veterinarian of choice, on hand during walks/visits. Should something happen such as an injury requiring a veterinary visit, or should your pet some how get away from us, we have a photo to show during the frantic search. (Please note, neither of these situations have ever happened nor do we expect them to, but we want to be prepared to give the best possible care in the worst possible cases!) Pets are transported in a heated/air conditioned vehicle, secured either in a crate or in a specially designed safety harness.
Indigo Books, Music & Café [view the full listing]
They let pets in!!posted: February 22nd, 2007
1 pet found this review helpful
Sandy Pines Wildlife Centre [view the full listing]
a wonderful local rescue organizzation!
The Mandate of the facility is to help all injured and orphaned wildlife, both mammals and birds and release them back into the wild. We also give advice and assistance to property owners who are having problems with their wild animal neighbours and can offer humane alternatives to solve these conflicts. We work closely with the Napanee Humane Society.
KINGSTON HUMANE SOCIETY [view the full listing]
Kingsaton humane Soc
your new best friend could be here waiting!!
Dogster HQ [view the full listing]
San Francisco, CA 94115
We love you guys!!!
You guys ROCK, we love Catster and Dogster soooo much!! *headbonks and purrs, and nice pat on the heads for the hoomans*
Loyalist Veterinary Hospital [view the full listing]
belleville, ON K8P 5H8
(613) 966-2519
They do EVERYTHING here!
This is where our dog Gloria goes to get ejukated. They hold obediance classes here.posted: February 22nd, 2007
Barlee [view the full listing]
AWESOME recue group!!
Barlee's has helped soooo many pets!!posted: February 22nd, 2007
Animal Aide of St. Thomas Elgin [view the full listing]
St. Thomas, ON N5P 1B5
(519) 633-3788
Cats and Dogs for adoption
Your new best friend might be waiting her for you!!
Prince Edward Dog Park Association [view the full listing]
AWESOME dog park!!
great bunch of people, and a fun group to play wifposted: February 22nd, 2007
Napanee Humane Society [view the full listing]
Napanee, o K7R 3Z7
(613) 354-249
You might find your new best buddy here!!
You might find your new best buddy here!!posted: February 22nd, 2007
HandicappedPets.com [view the full listing]
A wonderful place for pets with disablities
Thousands of us are caring for elderly and disabled pets with special needs; senior, geriatric, disabled, injured, recovering from surgery, cancer, terminal illness, and handicapped pets. You've come to the right place.
Super pet [view the full listing]
belleville, ON K8N 4Z5
(613) 966-9922
we LOVE Superpet!!
they have alll kinds of yummy treats, plus they have an adoption center for kitteis from the Belleville Humane Society AND a wonderful storecat named Goliath!!
Humane Society of Canada [view the full listing]
Toronto Humance society of Canada
LOAD of information here for people who want to learn how to help animals of all kinds.
Petcetera [view the full listing]
Belleville, ON K8P 3E1
(613) 966-2760
they have pretty coats here!
I bought A PRETTY coat here, and they have the fake miceies that i loke :)posted: February 22nd, 2007


text:
Plumbing Questions? Ask a Plumber and Get Answers ASAP.
How would I check this to know what type of switch to use. I'd rather start with the least expensive item first. I have a Red Jacket pump. 1/2 HP, 60 ph/hz, 6.0 amps. I ran water for 1 minute full throttle from the tube faucet and got 4 gallons in a minute. Would this cause a low pressure switch to kick off? If I replaced the present switch with a regular switch might I alleviate the problem of the present switch kicking off?
In regards XXXXX XXXXX questions. No there is no decimated 3 positions. Just auto at the 9' o clock position. Start @ 10 o'clock and then if you continue to the off position, it snaps to Off @11o'clock position.
Yes I do need to hold the switch until pressure builds up. But there are times when the pressure gets to about 30, I let go of the lever and the pressure will drop to 0.


text:
Road closed in Dunbar Township after suspected bomb found
State police at Uniontown closed a portion of West Crawford Avenue near the intersection with Ridge Boulevard in Dunbar Township for about 5 1⁄2 hours on Monday after a woman reportedly discovered what was thought to be a bomb under her vehicle.
Police said that at 8:36 a.m., the woman, whom they declined to identify, contacted police after she located what she believed was a bomb under her vehicle.
Troopers secured the area by blocking the roadways, evacuated neighbors and alerted neighboring schools to the potential threat.
The Allegheny County Bomb Squad arrived about 12:30 p.m. and took the suspected device, which was believed to possibly be a pipe bomb, to a safe area to attempt to detonate it.
The scene was cleared and the roadway reopened just before 2 p.m. No injuries were reported.
The incident is under investigation by state police at Uniontown as well as the FBI and the Bureau of Alcohol, Tobacco, Firearms and Explosives.
As of press time, no suspects had been named and the victim's information was not being released by authorities.
Mark Hofmann is a staff writer for Trib Total Media. He can be reached at email@example.com or 724-626-3539.
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.


text:
Scranton, PA lease to own buy here pay here autos. Car dealer used car loan finance for people with any credit situation: poor credit, bad credit, bankruptcy, no credit, medical bills, tax liens, even recent foreclosure. Financing or leasing is available with pay here bad credit dealership cars.
BuyAndPayHere.com's car dealerships have lease to own programs, which are perfect for people with terrible credit that need a 2nd chance. So instead of driving around to main street motors or the local auto mart apply with us today. In most cases, everyone qualifies for a guaranteed approval with terrible credit or poor credit. Get a fresh start at one of our in house credit auto outlet car centers with tote the note we finance auto sales.
Get Approved for Dealer Financing Online Today!
Get started now by filling out the form below. The process is fast, easy, and secure!
Apply By Phone (855) 769-3482
Townsend from Johnsonburg, NJ has been approved for a car loan with $1100 down.
Jun 27, 2017 - 10:04 am
Easter's car loan has just been received and processed by an in house financing dealer in Dalton, PA.
Jun 27, 2017 - 08:53 am
Brittnie has just applied for a auto loan in Springville, PA.
Jun 26, 2017 - 10:20 pm
We're often asked, Can I lease a car with bad credit in Scranton?. The answer is yes. Since the economy tanked a few years ago more and more car dealerships entered the lease here pay here arena. Lease to own car lots in Pennsylvania approve consumers directly, there is no need for a credit check or a good credit score to approve the transaction, just a job or consistent income.Leasing a car with bad credit Scranton, PAApproved lease payments are based on your disposable income, not your credit score. Typically the first lease payment is due at signing. If you purchase instead of lease, tax, title, and license fees are due at signing.
"I really enjoyed being treated as a person, not at all like the other dealership I went to. No pressure was shown. They cared about the person, not just making the sale." Matt B.
"What a great experience. Our rep was very excellent to work with. We thank you very much for working with us." Jessica K.
"Excellent service and great car. Very satisfied!" Roger P.
Increase your search radius
Increase your max price
BHPH Financing Get Approved at an In-House We Finance Car Lot.
We understand you were looking for a specific vehicle in your neck of the woods. Sorry we didn't have the car you were searching for. By changing your make preferences you can view hundreds of other available vehicles from our trusted dealership network that may suit your needs. Good luck and happy car hunting.


text:
Two weeks left to help us decide which finalists from the 2010 Talent Search will be the grand prize winner! Take a look at a few of the finalists in the Cutest Baby, Cutest Family, Cutest Pet and Owner, Cutest Couple and Cutest Kid categories.
"Like" Tiny Prints on Facebook and vote for your top picks at tinyprints.com/talentsearch!


text:
Risk Management Director Salaries
View Risk Management Director Hourly Wages
Alternate Job Titles: Director of Risk Management, Risk Management Director
How much does a Risk Management Director make? The median annual Risk Management Director salary is $127,634, as of May 30, 2017, with a range usually between $110,764-$147,310, however this can vary widely depending on a variety of factors. Our team of Certified Compensation Professionals has analyzed survey data collected from thousands of HR departments at companies of all sizes and industries to present this range of annual salaries for people with the job title Risk Management Director in the United States.
This chart describes the expected percentage of people who perform the job of Risk Management Director in the United States that make less than that annual salary. For example the median expected annual pay for a typical Risk Management Director in the United States is $127,634, so 50% of the people who perform the job of Risk Management Director in the United States are expected to make less than $127,634.
Source: HR Reported data as of May 30, 2017
Refine by:
This chart describes the expected percentage of people who perform the job of Risk Management Director that make less than that salary. For example 50% of the people who perform the job of Risk Management Director are expected to make less than the median.
Source: HR Reported data as of June 2017
Develops and administers risk management programs. Creates and modifies policies to comply with safety legislation and industry practices. Coordinates and develops organization-wide programs for risk-free services. Acts as the liaison to attorneys, insurance companies, and individuals. Investigates any incidences that may result in an asset loss. May require a bachelor's degree in a related area and at least 10 years of experience in the field. Familiar with a variety of the field's concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. Leads and directs the work of others. A wide degree of creativity and latitude is expected. Typically reports to top management. View full job description
View Financial Services Jobs by Salary Range: <$30K, $30K–$50K, $50K–$80K, $80K–$100K, >$100K
- MFG Nondurable
- Energy & Utilities
- Telecom
- Financial Services
- Edu., Gov't. & Nonprofit
- Internet
- Aerospace & Defense
- Hospitality & Leisure
- MFG Durable
- Retail & Wholesale
- Construction
- Chemicals
- Business Services
- Media
- Software & Networking
- Healthcare
- Biotechnology
- Transportation
- Pharmaceuticals
- Insurance
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming


text:
Contact Us
AAC Vision & Mission
AAC Values and Objectives
Committee of Management
AAC History
Past Presidents
Breakdown Services
Information Services
Mechanical Services
Free Legal Defense
Ensuring Road Safety
Other Services
Become a member
Our Facilities
The Galle Face Lounge
Hire the Auditorium
Weerawila Holiday Bungalow
Anuradhapura Holiday Bungalow
kalpitiya Holiday Bungalow
Kandy Holiday Bungalow
Trinco Holiday Bungalow
Affiliated Organizations
FIA Foundation
Motoring Advice
How to protect your vehicle
Driver fatigue
Child Safety
Pre-Trip Checkup
What is a Catalytic Converter?
Did you know?
AAC Values and Objectives
AAC Values
The AAC reflects and promotes its members' image of integrity and independence.
The AAC is recognised by and works with all relevant organisations, governmental and non-governmental.
The AAC defends the interests of international motoring members visiting Sri Lanka.
The AAC offers reciprocal services to all international motorists whose clubs are affiliated to the FIA.
The AAC is governed by an experienced Executive Committee and managed by a highly motivated general and technical staff.
AAC Objectives
To increase the political influence of the AAC at international and regional levels, with particular regard to issues surrounding sustainable mobility and tourist facilities.
To disseminate relevant data and club-related information to its members.
To improve reciprocal services for the benefit of international FIA affiliated members.
To secure the financial structure and future services to members by regular review of membership fees and document charges and costs.
'Simoniz' products 15%
'Champion' Spark Plugs 15%
Discounts on motor insurance
Optional membership of the international SYC&S program
Lucas Electrical Spares 15%
About Us
Become a member
Our Facilities
Motoring Advice
Terms and Conditions
Copyright © 2017 AA Sri Lanka.
Solution by :


text:
Drive Dirt 7.18.14
Jason Biggs is in some hot water over a tweet he wrote, kinda poking fun at the Malaysian airlines thing. Get more info.
1). Hey all- ok, so- I am deleting my previous tweets. People were offended, and that was not my intent. Sorry to those of you that were.
— Jason Biggs (@JasonBiggs) July 17, 2014
Kanye is apparently doing very well in his anger management counseling. Read more here.
Scott Disick was hospitalized last month for alcohol poisoning. Get more info.
Jenny McCarthy had to have the sex talk with her 11 year old son. Read more here.
The Walking Dead creator says hold onto your seats, fans, because Season 5 is going to be the best yet, and is very fast paced. Get more info.
Another day, another Weird Al parody. Check out his version of Fancy by Iggy Azalea, Handy:


text:
Cystic fibrosis (CF) affects approximately 30,000 children and adults in the US, and about 10 million Americans are carriers for the condition. Ambry Genetics is committed to caregivers and patients in the CF community through diagnostic testing, research, education, and support for advocacy groups.
Cystic fibrosis (CF) affects approximately 30,000 children and adults in the US, and about 10 million Americans are carriers for the condition. Ambry Genetics is committed to caregivers and patients in the CF community through diagnostic testing, research, education, and support for advocacy groups.
Founded in 1999, Ambry Genetics was the first commercial laboratory to offer clinical genetic testing for cystic fibrosis using gene sequencing technology. Since then, Ambry has analyzed the complete CF gene (CFTR) for more than 35,000 patients. As a result, Ambry has the most robust single-laboratory database in the world from which to accurately and carefully interpret patient results. Due to CFTR's large size and the wide genetic heterogeneity seen in CF, this powerful database is highly valuable to clinicians.
Ambry has developed a range of genetic testing options to meet a variety of clinical needs.
CFTR sequencing and deletion/duplication analysis is the most comprehensive test available, detecting ~99% of disease-causing CFTR changes (or mutations), including gross deletions and duplications. Testing begins with CFTR full sequence analysis, which detects 97-98% of mutations. If two pathogenic or likely pathogenic genetic alterations are found in a symptomatic patient, or if one is found on a carrier screen in a patient without symptoms, results are presumed to be informative and no further analysis is performed. If results are not informative or if clinical suspicion for CF remains, testing proceeds to gross deletion/duplication analysis. These options may also be run concurrently.
CFTR sequencing and deletion/duplication analysis may be optimal for:
CF 102 is a screening panel of >100 CFTR disease-causing mutations carefully selected to provide the highest overall mutation detection rate (91%) of any screening option. This test includes the 23 mutations defined as "common mutations" by the American College of Medical Genetics and Genomics (ACMG). CF 102 offers a high analytic sensitivity, with a quick turnaround time and low cost.
CF 102 may be optimal for:
508 FIRST provides a quick and cost-effective screen for deltaF508, the most common CFTR mutation. This test analyzes the deltaF508 mutation first, with a potential reflex to full gene sequence analysis and deletion/duplication analysis, if necessary.
508 FIRST may be optimal for:
508 ONLY provides analysis of only the deltaF508 mutation.
508 ONLY may be optimal for:
Ambry also offers Specific Site Analysis (SSA) for known familial CFTR mutations or alterations. When analysis of a specific mutation or alteration in the CFTR gene is requested, sequencing of the specific region can be performed.
Cystic fibrosis (CF) is a relatively common genetic condition that affects about 30,000 children and adults in the United States.1 About 1 in 25 non-Hispanic Caucasians is a CF carrier, and this frequency is typically lower in other ethnic groups.2
CF is caused by mutations in the CFTR gene; this gene codes for the cystic fibrosis transmembrane conductance regulator. CF runs through families in an autosomal recessive inheritance pattern. People with the most common type of CF have two CFTR gene mutations, which usually cause the body to produce very thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections. People with CF have persistent coughing, wheezing or shortness of breath. Thick mucus secretions can also obstruct the pancreas and prevent natural digestive enzymes from reaching the intestines to help break down and absorb food. This can cause pancreatitis, pancreatic insufficiency, and poor weight gain. 10-15% of newborns with CF have meconium ileus found at birth.3 In addition, babies with echogenic bowel on ultrasound have a higher risk of having CF (the risks increase as the degree of echogenicity increases).4
People with CF often have other symptoms including high sweat chloride levels, chronic sinus disease, and an excessive appetite but low weight gain. CFTR mutations may also lead to congenital absence of the vas deferens (CAVD) and infertility in males, who may not have pulmonary or gastrointestinal symptoms of CF.3 Exact symptoms can vary widely between people with CF, and more is being learned every day – for those with CF and those who are CF carriers – through ongoing research and clinical trials. This variability in symptoms is, in part, due to the large size of the CFTR gene and the more than 1,900 different CFTR mutations and variants described to date.5
Treatment/prevention of complications may be implemented if a diagnosis is suspected or confirmed, and these treatments can involve many organ systems. In addition, regularly scheduled visits to CF care providers (if available) for ongoing surveillance and management are critical for those with the condition.
Genetic testing for CF may be offered for:
|(Genomic deoxyribonucleic acid (gDNA) is isolated from the patient's specimen using standardized methodology and quantified by agarose gel electrophoresis)
|Specific Site Analysis (SSA)
|Traditional Sanger dideoxy terminator DNA sequencing and/or MLPA are used if testing for specific mutation(s) in the CFTR gene (other than deltaF508) is requested
|CFTR Sequencing and Deletion/Duplication
|CFTR full-gene sequence analysis is performed using next generation sequencing (NGS). The analytical range includes: exons 1 to 27, as well as at least 20 bases into the 5'- and 3'-ends of all introns, 5'- and 3'-untranslated regions (5'UTR and 3'UTR). This assay is also capable of assessing the poly-T tract within intron 10 and identifying the c.1679+1634A>G (c.1811+1634A>G or c.1811+1.6kb) mutation in intron 12 and the c.3717+12191C>T (c.3849+10kbC>T) mutation in intron 22. Test includes full-gene sequence analysis plus reflexing to gross deletion/duplication. Gene deletion/duplication analysis is performed using Multiplex Ligation-dependent Probe Amplification (MLPA, MRC Holland). Gross deletion/duplication analysis determines gene copy number for any of the 27 exons.
|Detection of the following specific mutations in the CFTR gene:
|1078delT (c.948delT)
1154insTC (c.1022_1023insTC)
1248+1G>A (c.1116+1G>A)
1288insTA (c.1153_1154insAT)
1471delA (c.1340delA)
1717-1G>A (c.1585-1G>A)
1898+1 G>A (c.1766+1G>A )
1898+3A>G (c.1766+3A>G )
1949del84 (c.1817_1900del84)
2055del9>A (c.1923_1931del9insA)
2143delT (c.2012delT)
2183AA>G (c.2051_2052delAAinsG)
2184delA (c.2052delA)
2184insA (c.2052insA)
2307insA (c.2175_2176insA)
2347delG (c.2215delG)
2585delT (c.2453delT)
2622+1G>A (c.2490+1G>A)
2789+2insA (c.2657+2_2657+3insA)
2789+5G>A (c.2657+5G>A)
3120+1G>A (c.2988+1G>A)
3120G>A (c.2988G>A)
3199del6 (c.3067_3072delATAGTG)
3272-26A>G (c.3140-26A>G)
3600G>A (c.3468G>A)
3659delC (c.3528delC)
3849+10kbC>T (c.3717+12191C>T)
3876delA (c.3744delA)
3905insT (c.3773_3774insT)
394delTT (c.262_263delTT)
4005+2T>C (c.3873+2T>C)
405+1G>A (c.273+1G>A)
406-1G>A (c.274-1G>A)
4209TGTT>AA (c.4077_4080delTGT- TinsAA)
|621+1G>T (c.489+1G>T)
663delT (c.531delT)
711+1G>T (c.579+1G>T)
935delA (c.803delA)
p.A455E (c.1364C>A)
p.D1152H (c.3454G>C)
p.E116K (c.346G>A)
p.E1371X (c.4111G>T)
p.E384X (c.1150G>T)
p.E585X (c.1753G>T)
p.E60X (c.178G>T)
p.E92X (c.274G>T)
p.G1061R (c.3181G>C)
p.G1244E (c.3731G>A)
p.G178R (c.532G>A)
p.G330X (c.988G>T)
p.G480C (c.1438G>T)
p.G542X (c.1624G>T)
p.G551D (c.1652G>A)
p.G551S (c.1651G>A)
p.G85E (c.254G>A)
EX2del, EX2_3del
deltaF508 (c.1521_1523delCTT)
deltaI507 (c.1519_1521delATC)
p.L1077P (c.3230T>C)
p.L467P (c.1400T>C)
p.M1101K (c.3302T>A)
p.N1303K (c.3909C>G)
p.P67L (c.200C>T)
p.Q1042X (c.3124C>T)
p.Q220X (c.658C>T)
p.Q414X (c.1240C>T)
p.Q493X (c.1477C>T)
p.Q552X (c.1654C>T)
p.Q98R (c.293A>G)
|p.Q98X (c.292C>T)
p.R1066C (c.3196C>T)
p.R1066H (c.3197G>A)
p.R1070W (c.3208C>T)
p.R1158X (c.3472C>T)
p.R1162X (c.3484C>T)
p.R117C (c.349C>T)
p.R117H (c.350G>A)
p.R334Q (c.1001G>A)
p.R334W (c.1000C>T)
p.R347H (c.1040G>A)
p.R347P (c.1040G>C)
p.R553X (c.1657C>T)
p.R560T (c.1679G>C)
p.R709X (c.2125C>T)
p.R75X (c.223C>T)
p.R764X (c.2290C>T)
p.S1196X (c.3587C>G)
p.S1251N (c.3752G>A)
p.S466X (c.1397C>G and c.1397C>A)
p.S489X (c.1466C>A)
p.S549N (c.1646G>A)
p.S912X (c.2735C>A)
p.S945L (c.2834C>T)
p.T338I (c.1013C>T)
p.T351I (c.1052C>T)
p.V520F (1558G>T)
p.W1089X (c.3266G>A)
p.W1204X (c.3612G>A)
p.W1282X (c.3846G>A)
p.Y1032C (c.3095A>G)
p.Y1092X (c.3276C>A)
p.Y563N (c.1687T>A)
if p.R117H is detected, then reflex poly T / TG repeat analysis is performed.
|*Novel variants are always reported. Polymorphisms and the poly T status will be reported upon request. The following sites are used to search for previously described CF mutations and polymorphisms: Toronto Sick Children's CF database, HGMD, CFTR2, and online search engines (i.e., PubMed). Sequence analysis is based on the following NCBI reference sequence: NM_000492.
Special Notes:
Poly T and TG tract results will be included on the report in the following situations:
For sequencing:
a. The "Report PolyT / TG Status" box is checked on the Test Requisition Form
b. Anytime a 5T is found, TG status will automatically be reported
For screening panels:
a. The "Report PolyT / TG Status" box is checked on the Test Requisition Form (additional cost)
b. The R117H mutation is detected (no additional cost)
|CF Carrier Risks and CFTR Mutation/Alteration Detection Rates[6]
|Individuals with CF and
|Ethnic Group
|Estimated Detection Rate***
|Before Tests
|Carrier Risk** After Negative Test
|No CF Mutations
|One CF Mutation
|CF Gene Sequence
|CF Gene Sequence and Del/Dup
|CF Gene Sequence
|CF Gene Sequence and Del/Dup
|CF Gene Sequence and Del/Dup
|Ashkenazi Jewish
|~1 in 959
|~1 in 2301
|Non-Hispanic Caucasian
|~1 in 1001
|~1 in 2401
|African American
|~1 in 2501
|~1 in 6001
|Hispanic American *
|~1 in 2376
|~1 in 5701
|Asian American
|~1 in 3876
|~1 in 9301
* This is a pooled set of data and requires additional information to predict risk accurately for specific Hispanic populations.
** Based on a negative family history.
*** Based on Ambry's empirical data.
Ambry in the Field
Most recent CFTR Publication:
Replacing CFTR Sanger Sequencing in the Clinical Lab with a Reliable, Targeted Next-Generation Sequencing Assay
View our CFTR educational webinar recorded on January 22, 2015:
Analyzing Historical Mutations in the CFTR gene Reveals a High Number of Reclassified Variants
View our educational webinar recorded may 26, 2015:
Cystic Fibrosis Newborn Screening: What you need to know
Mauli Ola Foundation
The Mauli Ola Foundation (MOF) was founded in 2007 to promote awareness of genetic disorders, and has a special relationship with the CF community and Ambry Genetics. The Foundation began as a group of surfers that banded together to introduce surfing as a natural treatment for people with CF. MOF raises funds to support programs for those with life-threatening illnesses and provide direct, immediate ways for children with genetic disorders to enjoy healthy lives through natural treatments.
Mauli Ola Surf Experience Days get kids with CF into the ocean (high in saline) with professional surfers to experience what natural therapies can do for their lungs. The saline in the air and water breaks down lung congestion and is a healthy, fun alternative to the typical regimen of medications and other therapies for CF. Since 2007, MOF has taken over 2,000 patients with CF surfing during Surf Experience Days. It has now expanded its reach by adding hospital visits and other activities that touch the lives of children with a variety of health issues.
To learn more about MOF, please visit www.mauliola.org.
Clinical sensitivity for CF genetic screening depends on the test ordered and the ethnic background of the patient. Gene sequencing and deletion/duplication anaylisis can detect mutations in 99% of people with a clinical diagnosis of CF (clinical sensitivity). Ambry's cystic fibrosis testing can detect >99.9% of described mutations in the CFTR gene, when present (analytic sensitivity).
|CFTR Gene Sequence Analysis
|508 First
|CFTR Deletion/duplication analysis
|CFTR Gene Sequence with reflex to Deletion/Duplication Analysis
|CFTR Gene Sequence and Deletion/Duplication Analysis (concurrent)
|CF102 screening panel
|CFTR specific site analysis (also use for 508 ONLY)
|Poly T/TG repeat analysis


text:
Related Suppliers
A new version of a four-year old expandable bead foam for packaging electronics has 25% smaller beads that are expected to expand its range of applications. The new Arcel 730 interpolymer (70% PS/30% PE) from Nova Chemicals Corp., Pittsburgh, has a bead size similar to EPS, enabling finer molding detail, thinner part walls, and reduced cushion thickness. Greater manufacturing efficiency through easier and faster mold fills and reduced molding scrap is also claimed. According to Nova, the smaller beads contain the same polymer and have the same properties as previous grades.
Nova Chemical Ltd.
1550 Coraopolis Heights Rd. Moon Township, PA 15108
Phone (412) 490-4000 Fax


text:
Maybe you don't know this about me, but i'm a 'retired' dancer. I've been missing the dance part of my life lately because my daughter has recently started ballet. All those little leotards are making me remember 1)the time when i could fit into such a thing and 2)the sheer joy of movement. For the past 12 years or so, the yen to dance again has come and gone in seasons. This time, in looking at dance studios for my kid, i found one that had an adult Zumba class, and figured I'd try it. I've … [Read more...]
Archives for February 2013
Zumba-dy Stop Me
Those Guys are Awesome
Like many Americans, I spent a small slice of my life in the service industry. Several summers waiting tables, and nearly a year at hotel. I could spend days telling stories--good, bad and ugly--of the people i encountered in that time of my life. But in the interest of the broader message here, I'm going to share just two:The Bad Tip: It was a Sunday lunch shift. The 'after church' crowd who, in southeastern Kentucky and elsewhere in the Bible belt, are also known as the worst tippers e … [Read more...]


text:
It's good to see the president has hit the ground running since being granted another four-year opportunity to right the fiscal mess our nation is in. His latest proposal floated by his Treasury secretary, is to usurp our Constitution by having the Congress relinquish its Constitutional powers over the purse and hand those powers over to the Executive Branch; in perpetuity.
Someone once said to me, "Tim, if you ain't cheatin, you ain't tryin'". Well boy is our president trying. The president of Egypt recently enacted similar "reforms" there as well. But this should come as little surprise to most of us. After all, the liberals make no effort to hide their disdain for rules when the rules hinder their liberal agenda.
Former Democrat Presidential nominee Howard Dean believes a leap over the fiscal cliff would be in the best interests of liberals because it would trigger the automatic 10 percent cuts in defense spending the liberals want and produce an across the board increase for all who pay taxes. What would be done with the increased revenue remains a question.
The Military-Industrial complex would be hard hit. This would have far reaching effects based on the practice of defense contractors to cast as wide a congressional-district net as possible when fulfilling contracts. Not to mention the thousands of military personnel who will be told their services are no longer affordable.
Of course if we did need the bodies we could always re-institute compulsory service and establish a pay scale that is relatively low until one achieves a level of competence in the higher ranks in order to retain corporate knowledge if it were needed. Compelling the citizenry to bear arms in defense of this nation at a considerable cost savings should be a no-brainer.
If you survive the experience you earn the privilege of living in the greatest nation on earth and perhaps a hiatus on paying federal taxes for the same number of years served. Congress should be handled in like fashion but in reverse. The longer a problem festers like solvency of SSI, balancing the federal budget etc., the less pay a longer serving legislator would receive. Since we can't stop them from running for office we just make it less lucrative for them to do so.
Soldiers hand the nation a blank check payable with their lives, politicians rarely earn their pay.
Tim Bible
West Salem
Roadster is right. We need a refund. Republican, Democrat, or whatever-the American people are not getting a fair deal for the taxes we pay to a government that shows little production
Ignorance makes loonville a very happy place,doesn't it jwood?
If I can sum this up, Tim thinks the President lies; I'm assuming Tim's referring to the debt ceiling as being a congressional perogative and is ignoring the Constitution; Tim's in favor of the $2T defense pork the Pentagon doesn't want or the cuts they do want; and compulsory military-industrial complex service for everyone starting at below minimum wage, bloating the military ranks and employment at less cost than it is today. And since the budget hasn't been balanced since Clinton, Bush and his fellow republicans owe the people their money back. Enough said.
Wow. My head hurts just reading that. Do you really even understand what you've written? I certainly don't.


text:
Yeah, and how many people (not cops in a L.A. shootout) have had to use 10+ rounds? Very few, I bet.
There's absolutely nothing wrong with a revolver. In 99.99% of the cases where a weapon is needed, they will suffice, and admirely so. I don't think the business end of a .38 is any less scary than a .44 Mag.


text:
Sexual Assault & Relationship Violence Support Groups — Aurora Center, University of Minnesota (open to Augsburg students)
Rape and Sexual Abuse Center/Cornerstone Groups – Rape survivor support group and concerned persons support group. 612-374-9077
The Joy Project — support group for eating disorders
Young Adult NAMI Connection groups For ages 16-20. Facilitated by young adults who live with mental illnesses who are doing well in recovery. National Alliance on Mental Illness.
Tubman Support Groups Support groups for women on depression, self-esteem and other topics. Check their website for current offerings.
Family-to Family Support Groups — National Allliance for the Mentally Ill – Support for families and friends of persons with mental illness. Groups available around the metro area. 651-645-2948
Emotions Anonymous – 651-647-9712 Emotions Anonymous is a 12-Step group for people who want to get support for recovery from emotional difficulties. This site describes the program and has a group finder so you can locate a group near you. You may also call the AA Intergroup number for the Twin Cities at 952-922-0880.
Anxiety/Panic Disorder Support Groups – Information about Open Door Outreach, Inc., an organization offering information and support groups for anxiety disorders in the Twin Cities.
Depression and Bipolar Depression Support Groups through the Depression & Bipolar Support Alliance
Depression Support Coalition Faith-based depression support
Mental Health Minnesota — online listing of support groups


text:
Advertising Technology
Building advertising products and ad-serving systems that handle billions of queries every day.
We build next-generation advertising products by leveraging Amazon's world-class personalization technologies, unparalleled data, and emerging media content.
Our Ad Tech team develops publisher products, platform and ad serving systems that handle billions of advertising queries every day and deliver results in milliseconds. The result is better quality advertising for publishers and more relevant ads for customers. Our infrastructure supports millions of internet and mobile device users. Our data platform processes massive data sets to develop business intelligence and analytics that are critical for the efficiency and profitability of our advertising business.
Engineering works actively with the Business and Product teams to develop solutions. At the pace at which we work, we all count on each other's expertise.-Lionel B. Advertising Technology
Serving Our Customers
The Advertising Technology team is integral to Amazon's advertising efforts and focuses on delivering scale to web publishers, mobile app developers and advertisers through our key product offerings.
Publisher Display Products: Builds solutions that support the largest web publishers, including Amazon.com, to the smallest bloggers and mobile app developers. Programs include the Amazon Mobile Ads Network for app developers and specialized products for web publishers. Our unique set of rich data allows us to deliver highly relevant, quality ads to help publishers and developers monetize their content.
Ad Tech Platform: Manages critical capabilities—high availability, cross-platform, scalable advertising systems that serve advertisers and publishers alike—for our parent company Amazon and other clients.
Sponsored Links: Optimizes the delivery of text-based ads on web and mobile that support and augment the shopper experience on Amazon's global retail sites.
Personalization, Innovation and Scale
We rely on the most current distributed data processing and machine learning systems to analyze the terabytes of data generated across our services every day.
Advertising is a fast-moving industry. New ideas must be implemented quickly to have an impact, and successful ones must scale to thrive. Many companies know how to innovate, and many know how to work at scale. Our strength comes from our ability to do both.


text:
Home Theatre
Wireless Music Systems
Network Products
Auro 3D upgrade available!
Meet the new SR7011 and AV7703!
EISA Best European Stereo System 2016-2017 Marantz CD/PM6006
Marantz enriches MusicLink Series with new HD-CD1 Premium CD Player
Highly Commended for the CD/PM 6006
Marantz unveils Network AV Receiver SR6011 with 9 power amps
Marantz unveils new full-size Network AV Receiver SR5011
Marantz refines their award-winning budget stereo duo: PM6006 & CD6006
Meet the new Marantz NR1607
Marantz Unveils Auro-3D® Upgrade Offer for Home Theatre Receiver and Preamp/Processor
HD-Amp 1 receives "Editors Choice" Award from Hi Fi Choice
Marantz SR5010 receives Inside CI Recommended Award
DTS:X coming to your receiver
Marantz introduces the HD-AMP1, a Premium Integrated Amplifier with classical elegance and modern connectivity
Online Warranty Registration for Singapore customers
Marantz completes this year's AV line-up with new SR7010 and SR6010 Network AV Receivers, plus a renewed AV7702mkII AV Pre-processor
PM6005 gets What Hi-Fi 5 Stars
Marantz M-CR610 What Hi Fi Award winner
Marantz UD7007 - What Hi Fi Award winner
Marantz CD6005 - What Hi Fi Award winner
[ New Product ] PREMIUM SUPER AUDIO CD PLAYER WITH USB-DAC SA-14S1
[ New Product ] PREMIUM INTEGRATED STEREO AMPLIFIER PM-14S1
[ New Product ] CD Player CD6005
[ New Product ] Integrated Amplifier with digital input PM6005
[ New Product ] NETWORK CD RECEIVER WITH DAB+ M-CR610
[ New Product ] NETWORK RECEIVER M-CR510
[ New Product ] NETWORK AV RECEIVER SR7008
[ New Product ] NETWORK AV RECEIVER SR6008
[ New Product ] NETWORK AV RECEIVER SR5008
Marantz: 60 years – a tribute to music. because music matters.
[ New Product ] AUDIOPHILE USB-DAC / NETWORK PLAYER NA-11S1