text:
Department of Surgery
Division of General Surgery
About Us
Conditions & Procedures
Division Chief
Hobart W. Harris, M.D., M.P.H.
Acute Care Surgery
Jonathan Carter, M.D.
Tammy T. Chang, M.D., Ph.D.
Jessica Gosnell, M.D.
Hobart W. Harris, M.D., M.P.H.
Carter Lebares, M.D.
Matthew Y.C. Lin, M.D.
Rita Mukhtar, M.D.
Stanley J. Rogers, M.D.
Bariatric Surgery
Jonathan Carter, M.D.
Matthew Y.C. Lin, M.D.
Stanley J. Rogers, M.D.
Breast Care Surgery
Michael D. Alvarado, M.D.
Laura J. Esserman, M.D., M.B.A.
Cheryl A. Ewing, M.D.
Rita Mukhtar, M.D.
Jasmine M. Wong, M.D.
Colorectal Surgery
Hueylan Chern, M.D.
Emily Finlayson, M.D., M.S.
Edward Kim, M.D.
Ankit Sarin, M.D., MHA
Madhulika Varma, M.D.
Elizabeth C. Wick, M.D.
Endocrine Surgery
Quan-Yang Duh, M.D.
Jessica Gosnell, M.D.
Wen T. Shen, M.D., M.A.
Insoo Suh, M.D.
Gastrointestinal Surgery
Jonathan Carter, M.D.
Tammy T. Chang, M.D., Ph.D.
Hobart W. Harris, M.D., M.P.H.
Kimberly Kirkwood, M.D.
Carter Lebares, M.D.
Matthew Y.C. Lin, M.D.
Stanley J. Rogers, M.D.
Surgical Oncology
Carlos U. Corvera, M.D.
Kenzo Hirose, M.D.
Kimberly Kirkwood, M.D.
Eric Nakakura, M.D., Ph.D.
Robert S. Warren, M.D.
SFVA General Surgery
Carlos U. Corvera, M.D.
Quan-Yang Duh, M.D.
Edward Kim, M.D.
Lygia Stewart, M.D.
Zuckerberg San Francisco General
Rachael A. Callcut, M.D., M.S.P.H.
Andre Campbell, M.D.
Rochelle Dicker, M.D.
Catherine Juillard, M.D., M.P.H.
M. Margaret Knudson, M.D.
Robert C. Mackersie, M.D.
Stanley J. Rogers, M.D.
Christopher Wybourn, M.D.
Basic Scientists
Michael J. Campbell, Ph.D.
David Donner, Ph.D.
Elissa Ozanne, Ph.D.
Valerie M. Weaver, Ph.D.
Clinical Instructors
Sandhya Kumar, M.D.
Global Health
Haile Debas, M.D.
Emeritus Faculty
Orlo Clark, M.D.
Jan K. Horn, M.D.
Thomas K. Hunt, M.D.
Robert C. Lim, Jr., M.D.
James R. Macho, M.D.
Jeffrey M. Pearl, M.D.
William P. Schecter, M.D.
Lawrence W. Way, M.D.
Education & Training
ACGME Residencies
General Surgery Residency Program
Fellowship Programs
Abdominal Transplant Fellowship
Breast Surgical Oncology Fellowship
Fellowship in Trauma & Emergency Surgery at Zuckerberg SFGH
Trauma Training Program - Academic Training in Trauma & Burns
UCSF Endocrine Surgery Fellowship
Advanced GI Minimally Invasive/Bariatric Surgery Fellowship
Lectures & Conferences
Department of Surgery Grand Rounds
Fellowship Experiences
Q&A with Matthew Y.C. Lin, M.D.
Patient Center
Patient Resources
Pancreatic Cancer Update
Appointments & Referrals
Location & Directions
Request an Appointment
Refer a Patient
Patient Stories
Advances in Pancreatic Cancer
Endocrine Surgery Brochure
Clinical Trials
News & Events
General Surgery
Patient Stories
Patient Stories
Ray Martz
International Research Team Awarded $1.2m Grant to Study Small Intestinal Neuroendocrine Tumors
UCSF Surgical Oncology Program
- by
Richard N. Barg
June 03, 2017
Eric Nakakura, M.D., Ph.D., Associate Professor of Surgery at UCSF and a leading authority on neuroendocrine tumors of the gastrointestinal tract and pancreas, is among a team of principal investigators awarded $1.2m grant awarded by the Neuroendocrine Tumor Research Foundation (NETRF) to elucidate the causes of small intestinal neuroendocrine tumors (SI-NETs). Dr. Nakakura said the research would help to unlock the mysteries of the disease and lead to more effective potentially curative treatments: "This project arose from unexpected clinical observations of a rare disease, which has
Story Tags:
Carcinoid Syndrome
Gastrointestinal Neuroendocrine (Carcinoid) Tumors
Liver Metastases
Small Intestine Cancer
Ray Martz
Drs. Eric Nakakura and Emily Bergsland Discuss Treatment of Carcinoid Syndrome on ITV
UCSF Surgical Oncology Program
- by
Richard N. Barg
December 22, 2016
Eric Nakakura, M.D., Ph.D., a UCSF gastrointestinal cancer surgeon and Emily Bergsland, M.D.. a UCSF gastrointestinal oncologist, recently discussed the treatment of carcinoid syndrome on "Healthy Body, Healthy Mind", a series hosted by Information Television Network (ITV), a PBS content affiliate. Dr. Nakakura is an Associate Professor in the UCSF Department of Surgery and Dr. Bergsland a Professor in the UCSF Department of Medicine. The ITV episode, which portrays the struggles of Ray Martz with carcinoid syndrome, recounts the situation he initially faced - that his condition was
Story Tags:
Carcinoid Syndrome
Gastrointestinal Neuroendocrine (Carcinoid) Tumors
Liver Metastases
Mansfield Doi
Surgery Wellness Program Eases Path to Surgery
UCSF Center for Surgery in Older Adults (CSOA)
September 23, 2016
My father Mansfield Doi was undergoing endoscopic retrograde cholangiopancreatography, or ERCP, a procedure used to correct a narrowing in the bile ducts. The advantage of ERCP is that it is non-invasive, but after repeated procedures showed limited effectiveness, his UCSF gastroenterologist suggested surgery. He was referred to Dr. Hobart Harris, Chief of the Division of General Surgery at UCSF, who determined that medically he was a candidate for surgery. However, because of his age – my dad is 86 - Dr. Harris encouraged us to coordinate with the UCSF Surgery Wellness Program, which was a
Lata Mohan
Bouncing Back Fast After Minimally Invasive Surgery
UCSF Medical Center
- by
Catherine Guthrie
July 01, 2014
Lata Mohan tackles life's challenges with grace and humor. In 2012, when a colonoscopy revealed a large tumor in her colon, Mohan's children launched an exhaustive search for the best possible surgeon to treat her. When the family met with Dr. Madhulika Varma, they clicked immediately. Describe your life before your diagnosis. I was living with my daughter and surrounded by my family, including my children and two grandchildren. My husband had been very ill, and I was the one who took care of him. I felt like I could do it all. It never
Story Tags:
Colon Cancer
Herbert E. Barker Jr.
"Exceptional" Care at UCSF Center for Colorectal Surgery for Rectal Cancer Survivor
UCSF Center for Colorectal Surgery
- by
Herbert E. Barker Jr.
September 04, 2013
I too am a rectal cancer survivor. My relationships with the hospital at UCSF and with Dr. Varma's team was like yours: exceptional. I am now nearly four years out from "D Day" (April 17, 2009) and thus far, no recurrence. We are truly fortunate and blessed to have been exposed to this disease when we were. There is now so much that can be done with the number of treatments available. Hope you are now and remain ok. I continue to support the UCSF Center for Colorectal Surgery as I participate in the research project. And, I too got back to a gym routine and feel great. Good luck! -Herbert
Story Tags:
Rectal Cancer
Dan Martin
Minimally Invasive Transanal Endoscopic Microsurgery (TEM) Rules Out Cancer
UCSF Center for Colorectal Surgery
- by
Dan Martin
September 04, 2013
Earlier today Dr. Hueylan Chern called me to let me know that I don't have cancer and that the transanal endoscopic microsurgical (TEM) excision procedure was a success. I really don't know how to say 'Thank You' in a way that relays my true emotions. Obviously, I'm ecstatic and my family is also. You were my first contact at UCSF, you made the recommendation to use this procedure and it will forever positively impact my life. I am also especially happy that we went with the TEM over the more invasive procedure. Along the way you helped reassure me that you thought this was the right
Story Tags:
Transanal Endoscopic Microsurgery (TEM)
Tom Bassett
Hitting Cancer "Hard and Heavy"
UCSF Center for Colorectal Surgery
- by
Tom Bassett
September 04, 2013
I found out I had colorectal cancer at 47. As an otherwise active and healthy person, when I saw traces of blood where they shouldn't be, I chalked it up to my bike riding. Yet because of a family history of colon cancer and a father-in-law in the medical field, I thought I would preemptively get a colonoscopy, which turned out to be a wise decision. Results for patients who discover colorectal cancer early are generally good, and the majority of patients with early stage disease are cured. However, despite my luck at finding the cancer early on, it was staged as III. I would require
Story Tags:
Colon Cancer
Courtney Annotti
Life After Ulcerative Colitis Surgery Feels Amazing
UCSF Center for Colorectal Surgery
- by
Courtney Annotti
September 04, 2013
My name is Courtney Annotti. I'm 22 years old and was diagnosed with ulcerative colitis (UC) eight years ago. UC is a chronic condition that causes long-lasting inflammation in the large intestine. For years I experienced pain that would come and go, and the anxiety of always having to know where a bathroom was. I tried several medications to control my symptoms, but to no avail. Concerned that my condition was worsening day by day, my gastroenterologist referred me to UCSF to meet with Dr. Madhulika Varma, Chief of Colorectal Surgery at UCSF. When I met with Dr. Varma, I immediately felt
Story Tags:
Ostomy Surgery: Ileostomy & Colostomy
Ulcerative Colitis
Sandy Raffi-Rashed
Surgery Ends Decades of Obesity, New Life Begins
UCSF Medical Center
February 28, 2013
Sandy Raffi-Rashed after losing 185 poundsWhen Sandy Raffi-Rashed, a 60-year-old mother of two, went to the airport to pick up her youngest son visiting from Manhatten, he didn't recognize her. "I was waving to him from the car and he thought, 'Who is that strange woman waving at me?" says Raffi-Rashed, of Novato, Calif. "Then, when he saw me, he said, 'Oh my God!'" His mother had undergone a transformation after weight-loss surgery. In July of 2011, Raffi-Rashed had gastric bypass surgery at the Bariatric Surgery Center at UCSF Medical
Story Tags:
Laparoscopic Gastric Bypass
Post-Bariatric Body Contouring
Lindsey Friedberg
Young Woman Reinvents Herself After Weight-loss Surgery
UCSF Medical Center
October 04, 2012
"My personality was being swallowed by the fat just like the rest of me," says Lindsey Friedberg, a 23-year-old graduate student at the Academy of Art University in San Francisco. Friedberg, who grew up in Ocean City, N.J., surrounded by "slender and tan" girls, has battled her weight all of her life. Her high school years were spent counting calories, eating raw food, drinking 12 bottles of water a day and writing down everything she ate, including the gum she chewed and number of mints. But nothing worked. When Friedberg's mother, who
Story Tags:
Clincial & Related Programs
Bariatric Surgery
Breast Care Surgery
Colorectal Surgery
Endocrine Surgery
Gastrointestinal Surgery
General Surgery
Hepatobiliary & Pancreatic Surgery
Melanoma Surgery
Zuckerberg San Francisco General
San Francisco Injury Center (SFIC)
San Francisco Wraparound Project
Acute Care Surgery
Surgical Oncology Program
Research Labs
Vascular Integrated Physiology and Experimental Therapeutics (VIPERx)
Center for Bioengineering and Tissue Regeneration
Cohen Lab
Endocrine Surgical Oncology Lab
Tumor Microenvironment Network (TMEN)
Department of Surgery Websites
Department of Surgery
Abdominal Transplant Fellowship
Acute Care Surgery
Adult Cardiothoracic Surgery
Alaoui Lab
Atherosclerosis Research Lab
Bariatric Surgery
Biodesign Laboratory ("Roy Lab")
Breast Care Surgery
Cardiac Surgery
Cardiac Biomechanics Lab
Cardiothoracic Translational Research Laboratory
Center for Bioengineering & Tissue Regeneration
Center for Global Surgical Studies
Center for Hernia Repair & Abdominal Wall Reconstruction
Center for Limb Preservation & Wound Care
Center for Surgery in Older Adults
Cohen Lab
Conte Lab
Colorectal Surgery
Department Staff
Endocrine Surgery
Endocrine Surgical Oncology Lab
Enhanced Recovery After Surgery
Fetal Treatment Center
Gastrointestinal Surgery
General Surgery
Grenon Lab
Hepatobiliary & Pancreatic Surgery
Immunogenetics and Transplantation Lab
Infection, Injury & Immunity Lab
Ischemic Organ Injury Lab
Kang Lab
Kim Lab
Life Clinic
MacKenzie Lab
Melanoma Surgery
Pediatric Cardiothoracic Surgery
Pediatric Surgery
Pediatric Surgery Lab
Plastic & Reconstructive Surgery
Pomerantz Lab
Resident Portal
Resident Research Program
Sarwal Lab
San Francisco Injury Center (SFIC)
San Francisco VA Medical Center
San Francisco Wraparound Project
Scientific Publications Office
Surgical & Critical Care Nurse Practitioner Fellowship
Surgery Interest Group
Surgical Innovations
Surgical Oncology Research Lab
Surgical Oncology Program
T32 Training Program in Transplant Surgery
Tang Lab
The Better Lab (ZSFG)
The Chang Laboratory for Liver Tissue Engineering
Thoracic Oncology Program
Thoracic Oncology Laboratory
Thoracic Surgery
Tolani Lab
Transplant Surgery
Transplantation Research Lab
Transplant and Stem Cell Immunobiology (TSI) Lab
Tumor Microenvironment Network (TMEN)
UCSF East Bay Surgery Program
Vascular & Endovascular Surgery
Wang Lab
Web Support
Willenbring Lab
Zuckerberg San Francisco General


text:
Arthur Clements, MD, PhD
Arthur Clements, M.D., Ph.D., is a native of Tallahassee, where his father also practiced obstetrics and gynecology for over 40 years. Dr. Clements received his Bachelor of Science from the University of Florida and his Ph.D. from Florida State University in Nutritional Biochemistry. He completed his medical training at the University of Monterrey and residency at Tulane University where he received the Dr. Lee and Dr. Bohm teaching award and served as the Administrative Chief Resident at Charity Hospital.
Dr. Clements has served as Chairman of the Department of Obstetrics and Gynecology at Tallahassee Memorial Hospital. He is a Diplomat of the American Board of Obstetrics and Gynecology, Diplomat of the National Board of Medical Examiners and the District 12 Section 1 Chair of the American Congress of Obstetricians and Gynecologists. He is a member of the American Medical Association, Florida Medical Association, Florida Obstetrics and Gynecology Society, Capital Medical Society, Conrad Collins Society New Orleans, and the American Association of Gynecologic Laparoscopists. Dr. Clements' public service included being appointed by a member to the Florida Cabinet to serve as the state of Florida OB/GYN representative to the Neurological Injury Compensation Association, which administers funds to care for neurologically injured babies. He also volunteers his professional time to serve as a board member of the Florida Obstetrics and Gynecologic Society, where he is the past President. He serves on the faculty of Florida State University Medical School as the Education Director of Obstetrics and Gynecology. He has been recognized as one of Americas Top Obstetricians and Gynecologists.
Dr. Clements enjoys the outdoor activities North Florida has to offer. He and his wife, Patricia Clements, Ph.D., have two outstanding daughters, Claire and Meredith.
Dr. Clements is available for Gynecology patients.
Patient Praise: "Dr. Clements is simply the best. He balances his great bedside manner yet holds no punches. I am constantly referring my female friends to his practice."

subset: commoncrawl


text:
Inspired by Dir en grey's 'dead tree' and the references to the 'girl in red'.
an: i wrote this for an english class, and no longer have the final edited version. Which means this is not beta read so I'm sorry if there are any mistakes
dead tree
Cold metal came, forced against flushed skin, awkwardly poised with evil intentions at the hands of foolish youth. He could see it in the deep blue eyes before him, the lies festering just beyond reach in the deluded young mind. 'Love' they called it, 'a better world' they promised, but all he could smell was death, all he could see were tears. Reality was growing darker the longer he watched.
Resignation flooded his veins as he stood, staring his fate straight in the face. Harsh words pass between virgin lips, the ill-intentioned knife whose rusted edges infect and decimate in one fell swoop. It's the realization of every fear that had dwelled inside him, every fervent whisper passed between unconscious conspirators in his presence, this boy at his door.
The fever of realization brings the smile forth before he can quell it, the red to set off the bull in soldier's uniform. The resounding crack of truth echoes through him, causing the whole world to shudder, to weave in and out between reality and make-believe. Dirt fills his lungs and coats his mouth, the blurry thought that he needed to find a new maid to sweep the stoop flitting over his confused consciousness.
Noise, drilling against his eardrums in a cacophony of bees and bells brings him back to the here and now. He coughs, spitting out the bits of the ground he'd inhaled, then turns a searing eye on the officer, red band standing out starkly against the monotone the world had taken to.
Commands, written in gibberish and yelled by a man only fluent in follow the leader, it all meant so little to him. Infantry men roamed the street, the cause of an escalation in outcries as people were beaten, shot, thrown into trucks.
It was the color that caught his eye, bright red like the flags and badges and blood shamelessly flaunted, this little girl's coat. She stood, still and weeping beside the bodies of her mother and father as a gun was held to her head, the barrel nestled in her golden curls. There was no emotion on the face of the monster as he did his job, no sign of remorse as the small body hit the ground amid the echo of the handheld explosion.
Emotion swelled in his chest, forcing him to look away and back to his own hell in time to see the weapon swing from him to the doorway, to see the flash and flare as it went off. Warmth covered him, encircling him slowly as the hole torn by the bullet spilled forth anything that would flow, the ragged breathing behind him slowing with each cycle. He knew without question who lay dying behind him, the hair brushing against his fingers all the hint he needed.
Muscles strained as he fought against gravity to find ground on his knees, blood not his own slicking his hands. Only a glance did he give the body beside him before turning, head reeling. The heated barrel again at his head, he gazed up into its sinister smile, all the things in his life flashing before his eyes.
Warm summers spent as a youth in his uncles orchard, his first love, his wife and children…So many memories and regrets filling his head, but only one truth remaining: he would die here, on his improperly cleaned stoop beside the body of his dead wife. The only little source of comfort he gleaned was that his children had already been safely tucked away from prying Nazi eyes.
The click of the pistol being cocked sent all thoughts from his mind. There was no mercy today. Inhale, his eyes closed and his arms spread. Exhale, the deafening violence of a fingers twitch tore swift and cut clean. All the world went dark, and somewhere a baby cried….


text:
Yale Young Global Scholars Program
Interested and highly motivated high school sophomores and juniors are eligible to apply to this internationally renowned summer program.
Interested and highly motivated high school sophomores and juniors are eligible to apply to this internationally renowned summer program.
"No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving federal financial assistance." Click on the headline to learn about LAUSD's compliance with policies and procedures.
Indispensible apps you can use to remind parents and students of anything! Easy to use and FREE!!!!
Please click on the headline, and then on the file to read the letter in your language.
click the headline.
Specialty PD (AVID, ICAP, Magnet, etc)
Date: 9/4/2017, 8 AM – 9:15 AM
Location: Library
|Show Calendar »
|Show All Events »
Teachers and Students: In order to ensure sufficiency for Summer School PLEASE RETURN ALL TEXTBOOKS to the textbook room (702) immediately. Thank you for your cooperation.
Cheerleading can help you in the future. It looks good on your college application. You learn how to work with other girls. We support each other through sisterhood. We started a program called "My Sister es mi Hermana" with Girls Build L.A. We serve as Big Sisters and role models for incoming Freshmen, with a vision of the future. Cheer is more than a sport Join us!!! For more info, contact Virginia Watson at email@example.com.
The Publications Staff is thrilled to announce they have completed the yearbook! We have NEVER had such a small staff and producing a yearbook full of photography, copywriting, and graphic design is a huge undertaking, especially when our students (unlike other schools) usually only take the class for 1 year (versus 3 years). Congratulations to Christopher Baldwin, Yasmin Barnes, Valery Betancourt, Dareanne Funes, Divine Ibe, Matthew Martinez, Michela Martinez, Crystal Perez, Adrian Ponce, Paige Wi, and Kathryn Yamamoto on a job well-done. Yearbooks will be available after May 22nd.
Students, download and submit the application for this $24,000 scholarship if you are a graduating senior who has a GPA >3.2 and plan on declaring a STEM major when you are accepted to a 4 year university. Click on the headline to get the application.
Teachers, please click on the headline to access the twelve California Career Ready Practices. See how many of them you are able to incorporate into your curriculum. Students, see how many of these practices you are already engaged in. What do you want to learn?


text:
Michael Makris of South Bend lead the 117th Indiana Amateur Championship wire-to-wire to claim his first title.
Katie Sharp claimed her first IWGA title in dominating fashion beginning with 6-under 66 in stroke play qualifying and rolling through the match play bracket.
Amateur Mike Lee shoots 4-under-par 66 to win the Indiana PGA Northern Open by two shots at Morris Park CC.
Danbi Kim fired a career best even-par in the final round of the 67th Girls State Junior Championship to win the title by five shots.


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New Camera Combinations Using ALPA Silex
New Camera Combinations Using ALPA Silex
Zurich/Switzerland, 17th May, 2017 - The control unit ALPA Silex is a brand new, central element of ALPA's extended modular photographic system. Photographers and soon even videographers will be able to combine ALPA cameras with digital backs of various manufacturers like Hasselblad, Phase One/Leaf and Sinar Photography and lenses from Canon, Contax, Hasselblad, Nikon or Rollei. A variety of functions and operating modes are available to the user.
Handy and flexible - Silex is the Swiss pocket knife of the control units. Under this claim, ALPA presented the product at the Photokina 2016. The name Silex itself, however, goes much further back: it reminds us of the material for the all-purpose tools of the stone-age. ALPA Silex is the new all-purpose tool in the ALPA system. It can be used to convert any model of the classic ALPA-12 series into an electronic camera.
The basis for the development of ALPA Silex is the ALPA 12 FPS, introduced at Photokina 2012, with electronically controlled focal plane shutter. The integrated controller was separated as a standalone module and all functions except for the slot shutter were taken over. All known digital components from Hasselblad, Phase One / Leaf and Sinar can be synchronized and the electromechanical diaphragms of Canon EF, Contax, Hasselblad H, Nikon E and Rollei can be controlled. The leaf shutter in Hasselblad HC / HCD (up to 1/800s, "orange" line even up to 1/1000s) and Rollei 6000 (up to 1/500s) can be used, as well as the focus control of many of the lenses from Canon, Hasselblad H and Nikon E. The integrated web server allows remote control in networks without software installation. The future support of Sinar eShutter systems is already prepared
Together with existing camera models from ALPA, the photographer can use a vast number of third party lenses and, depending on the available image circle, also perform shifts (shifting and stitching). In the future, our back-end adapters will also make it possible to use ALPA cameras for video recording in conjunction with the corresponding digital backs.
Available now (professional prices in CHF, ex Works Switzerland):
● The control unit ALPA Silex, CHF 3,355
● The electronic lens adapter (ELA), CHF 1,468
● As well as the ALPA lens module Hasselblad fix (HAF), CHF 1,993
In addition the ALPA GON modular tripod head (CHF 1,989) and its modules became available in numbers.
Also, immediately available for download is the latest firmware version 4.03, which makes all new functions of ALPA Silex also available for the ALPA 12 FPS. Free as always - as an investment in the ALPA system is sustainable and the term 'planned obsolescence' is alien to ALPA. Even if the environment changes, an ALPA will persist.
You can find the complete press release and product images in the download package: PR20170517_ALPA-Silex_ELA_HAF_GON.zip
Media & Press Contact
ALPA Capaul & Weber Ltd.
Corporate Communications
Neptunstrasse 96
CH-8032 Zürich / Switzerland
Tel: +41 (0)44 383 92 22
Fax: +41 (0)44 382 01 80
Corporate Communications
[email protected]
ALPA Newsletter Subscription and Archive
ALPA on Social Media
ALPA Instagram-Feed
ALPA Press Releases
May 17, 2017 - New Camera Combinations Using ALPA Silex
April 7, 2017 - The Modular ALPA GON Tripod Leveling System
March 2, 2017 - ALPA 12 XY Limited Edition 10 Years
September 17, 2016 - ALPA modularizes bellow and tripod head - ALPA SERPENT and ALPA GON
September 16, 2016 - ALPA introduces new control devices - ALPA SILEX, ALPA eShutter Support Sinarback S 30|45
August 31, 2016 - Hasselblad and ALPA Sharing Expertise
August 25, 2016 - ALPA 70 & Years Anniversary: ALPA launches ALPA Anniversary Edition Set
August 19, 2016 - ALPA Releases Additional Products for Still and Movie Photography


text:
First, are you visiting Detroit, Toledo or Ann Arbor.. do you just want to stay in Monroe... or go shopping in Dundee? I travel a lot... I like places that feel like home. If you are like me.. Then you would love the Del Rio....More
Holiday Inn Express & Suites MONROE


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text:
Of the talented group of players, some are prospects who hold multiple offers, others are commits, and some are up-and-comers that drew some attention. Here's a look at Saturday's top performers.
The quarterbacks
For those unaware, a 7-on-7 is a football game without offensive guards and tackles, and is a pass-only game. Simply put—it's all about the quarterbacks. On Saturday, a group of elite quarterbacks showcased their stuff on the turf of Huskie Stadium. Here's a look at the best of the bunch.
Ryan Bartels- The name Ryan Bartels isn't a well-known name at this point, but his stock could be very much on the rise. The Sycamore (IL) Spartans' standout quarterback made vast improvement in the offseason, which are a credit to his great work ethic.
In the offseason, Bartels changed his throwing motion to a straight over-the-top release, and it has made him into a much better quarterback. Bartels now throws a sharp line drive to his receivers. The thing that makes Bartels standout is his accuracy. He is a great fit to a west coast offense.
Bartels does not have any offers, but has picked up interest from a number of Big Ten and MAC schools.
Drew Hare- One of the talented out-of-state prospects, Fort Zumwalt (MO) High School quarterback Drew Hare showcased his skills at NIU. Hare was consistent throughout the day. Simply put, he's got a very accurate arm and puts some good zip on the ball.
Hare does not hold any offers, but is high on many school's radar, including Northwestern's. He will be in Evanston for camp in two weeks, and will visit a number of other schools during the summer.
Wes Lunt- Coming off a state championship season, Rochester (IL) High School has high aspirations for this season. The Rockets run a spread attack on offense, and the leader of that system is 6-5, 205-lb. quarterback Wes Lunt.
On Saturday, Lunt showcased his stuff with a fantastic performance. He was able to make all kind of throws and caused problems for all opposing defenses. Lunt has 11 offers on the table, and showed why he's getting plenty of division-one looks.
Anthony Maddie- After his first year at Aurora Christian High School, Anthony Maddie made great strides under the tutelage of head coach and former NFL wide receiver Don Beebe.
Maddie has a very strong arm, and is accurate for the most part, but struggled at times. All together, he was very impressive. During the offseason, added some muscle to his 6-3 frame, and has gotten faster as well. With the help of Beebe—a part-time trainer—Maddie is vastly improved. He currently holds four MAC offers, and is likely in line for a Big Ten offer soon. On Saturday, he proved he's worthy.
Matt Williams - For Geneva (IL) High School quarterback Matt Williams, Saturday was a homecoming. The talented gunslinger was one of the few commits on the field, and he was committed to the host school, Northern Illinois.
While throwing in front of new NIU head coach Dave Doeren and his staff, Williams had his highs and lows. He struggled with accuracy at times, but also had his share of head-turning passes. All in all, Geneva's senior-to-be put out an impressive showing for his future coaches.
The up-and-comer: Johnny Daniels
At 6-3, Wheaton North (IL) High School wide receiver Johnny Daniels has the size to be a big-time possession receiver at the college level. On Saturday, Daniels showed his stuff to those in attendance at NIU.
Daniels was very impressive all day long. He uses his height and great vertical to make plays on any ball thrown to him. He currently holds one offer—Ball State—and is picking up interest from a number of division-one schools.
The sleeper: Zach Grant
It's hard to be in a better situation than that of Rochester wide receiver Zach Grant. He is the go-to wideout for the heralded quarterback Wes Lunt. While Lunt draws interest from a number of schools, Grant is along for the ride with every pass. Grant proved that he doesn't deserve to go unnoticed.
On paper, Grant isn't too impressive. He's just 6-1, 185-lbs. But on the field, Grant plays like he's much taller. Grant is a talented possession receiver that makes plays on the other end of Lunt's passes.
As a junior, Grant was a big part of Rochester's state championship. This season, he is bigger and stronger. Thus far, Grant has gone largely unnoticed. As time goes on, that may change.
MVP: Wes Lunt
Wes Lunt was the talk of the tournament at Huskie Stadium. Rochester's standout quarterback was by far the most impressive player at the event. He seemingly was on a different level.
Lunt showcased his gun throughout the day by making all the throws he needed to make. His most impressive moment of the day came on a 40-yard bullet to the corner of the endzone. Rochester's star quarterback is drawing plenty of division-one interest, and on Saturday, proved he's worthy.


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Mary Ann's Kitchen
Welcome to my kitchen
I'm Mary Ann and hopefully this should make a good read about what's happening around the brewery.
David and I started out with a plan 25 years ago. We decided to build our brewery in a dream location planted in the hills of Luppitt.
I am just one of those natural Mums who enjoy every job that's thrown at me. Some of those jobs are better than others, but when David asked me to brew beer, well, I could not have been happier.
I come from a long line of brewers, but as men have it, or certainly my father would have it, 'ladies' didn't brew beer - so I learnt to cook and type and nurse. Then, 25 years ago, my dream came true.
Now of course I'm using my other training as well. I look after everyone here, and take care of the garden, vegetables and willow beds which clean all our dirty water.
I'm always around to help with any job that needs an extra pair of hands and I'm never short of ideas!
On a lovely sunny day like today, I saw a large tractor collecting our spent hops from the top field. We have 3 bays of composting hops at present here, and Nick is taking the rest for his Christmas trees and also making compost. It's a sterile mulching for the beds and looks good when it has rotted down properly, it's a bit smelly if used too young!
All our waste yeast, of which there is a fair amount now (Gus can't use it all) still goes off to the pig farmer and it gets blended into a mixture for the pigs to enjoy. One day we shall get a tanker to transport it, but at present it goes off on the back of our trucks in big plastic containers.
Our spent grains are also going to a local farmer for his cattle, again the collection point is in...
I've long had a love of chickens, and this winter I've had so many lovely tales of chickens and children, that I've taken chance by hand and tomorrow my chickens arrive! They have a lovely run which I hope we have managed to make fox proof.
When we lived in our last house we used to sell free range eggs by the road side. It was...
I thought I'd share something warming with you given the incredibly cold weather we've all been subjected to recently.
This is one of the winter soups I'd dish up for everyone here on cold days to keep them all going. You can use carrots, parsnips, celeriac, beetroot or artichokes.
1). Scrub and...


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Why do you write? That's a question most people ask other writers and a big question writers ask themselves. First let me narrow things a bit and say a writer isn't just someone who writes novels but someone who also writes short stories, poems, plays, movie scripts, and yes even blogs.
Some people will give the vague but common answer, "It's who I am" or "I can't not write." There is the even more common answer "I knew from the time I was a child that when I grew up I would be a writer." Truth be told, though these answers are common and they are true in a sense, they aren't the all defining reason why. I believe they are substitutes for a more surreal answer that maybe the writer just can't understand. Either way it boils down to the fact that writers are driven to do so. As I said it's a vague answer, like saying a Zebra is a Zebra because it can't be anything else but a Zebra.
I believe what people are trying to say but can't is this; we write because we have a need to express our feelings, thoughts, and ideas. We want to express them in a way that gives us some self satisfaction that we have conveyed what we wanted, the way we wanted to and in a way that others can appreciate our feelings, thoughts, and ideas as well. Writers have a need to share what is inside their heart and mind with the world. They can't keep it inside like others can or they feel like they will explode.
The hardest part about writing is coming up with an idea, a single plot or thought to focus on and write around, no matter if it is a novel, poem, or blog. Once a writer has their idea the rest is created from their heart, mind, and soul and put forth on paper. Now this isn't to say that it comes easy because it doesn't. Every writer at some point will experience writers block. Every writer also has their own way to get around writers block too.
Being a successful writer doesn't necessarily mean you have a bestselling novel or your poems are known world wide, or your blog has 4,000 followers. Being successful is when you put to paper what is in your head and what you wrote creates a world inside at least one readers mind. It pulls them into the story. They are invested in the characters. They are emotionally tied to what is happening and what will happen.
Me personally I never thought I would be a writer of anything. I have, however, always loved to read. If you look at my bookshelf at home you will see books upon books that I have read and I'm always buying new ones to read. I, however, never really gave writing anything of a second thought until around 2006. When me and my now wife reconnected 16 years after high school. She had always loved to write stories and poems. This opened my eyes to a part of me I never knew existed. I began writing poems and sexual stories for her. Eventually we started collaborating on a novel together. It is unfinished and we haven't worked on it for a couple years and being the OCD individual I am this has driven me crazy. So I decided to start my own novel. Now I have my blog where I also write the occasional poem, plus a short story that I post a part of every couple days on and then I have my novel I am working on, as well as my personal journal. I have a ways to go on my novel, though, between work, blogging, and life in general it is difficult to dedicate a lot of time to it. My plan is to publish it and turn it into a series.
Now I say all this to answer the question, why do I write? For me, I write for several reasons. It's a means of therapy for me. To vent frustrations that I can't say to people without getting in trouble. It's also a way to express things that have happened to me with my friends, family, and anyone else who wants to hear. A way for me to discuss my ideas and thoughts on certain topics and a way for me to convey my ideas of fiction or fantasy, to gain some satisfaction that what I wrote is well written and enjoyable and to receive feedback that others feel the same as I do about what I have written.
So the next time you are writing a blog, a short story, or a novel ask yourself, why do I write? And think about your answer and try to actually give a thoughtful well defined reason other than "Because it's who I am." So when people as you the same question, you are better equipped to provide them with something thought provoking instead of leaving them feeling they wasted their time asking.


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Lyrics Depot is your source of lyrics to Mosaic by InMe. Please check back for more InMe lyrics.
Mosaic Lyrics
Artist: InMe
Album: Overgrown Eden
Creeping, Stabbing, Heart so hollow,
Too much reality for you to swallow,
Wonder it is cruelty,
To capture it in all it's beauty,
You can break me, entertain me,
Take it all back for the sons,
You can leave me, Incinerate me,
Disfigure my mosaic,
Cure me, melt me, can someone please help me?
Walk away once I am fulfilled,
One day I will find the pieces of my mosaic,
InMe Lyrics
InMe Overgrown Eden Lyrics
More InMe Music Lyrics:
InMe - Daydream Anonymous Lyrics
InMe - Firefly Lyrics
InMe - Here's Hoping Lyrics
InMe - In Loving Memory Lyrics
InMe - Raindrops On Stones Lyrics
InMe - Trenches Lyrics
InMe - Underdose Lyrics
InMe - You'll Get There Lyrics


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|Home | About | Journals | Submit | Contact Us | Français
Approximately 120,000 young women are diagnosed with cancer every year in the USA. Many will have treatment that can reduce their fertility, although few will learn this fact before their treatment commences. This presents a tremendous quality of life issue post-treatment, as evidenced in this Perspectives by a personal account from a 23 year-old woman diagnosed with breast cancer. Clinicians must increase awareness about patients' desires for motherhood and awareness about their individual reproductive potential. We demonstrate novel evidence about the wide variability in ovarian reserve in women of similar age, using assessment by antral follicle count. We show how a unified approach between oncology and fertility teams can help patients better understand their risk of treatment-related infertility, as well as how to take effective measures to mitigate it. Finally, we present options for fertility preservation, based on the time point at which consultation occurs.
In common parlance, a description of cancer treatment often evokes further details about hair loss, decreased appetite, illness, and vomiting. In young women with cancer (aged below 45 years at cancer diagnosis), infertility is a serious concern, although in many cases this issue is not considered by patients in relation to outcomes of chemotherapy or radiation treatment.
According to 2006 Surveillance Epidemiology and End Results (SEER ) statistics, approximately 120,000 women below the age of 50 develop cancer each year in the USA.1 Many of these young women unwittingly face reproductive compromise. 2 As recently as 2009, only 34–72% of reproductive-age women treated for cancer recall having a discussion about the effects of cancer treatment on their future fertility.3 In 2009, a survey of 249 oncologists at major academic centers in the USA reported that 82% had referred a patient to a reproductive endocrinologist at one point, yet more than half reported that they rarely did so.4 The reasons given for lack of referral were: lack of knowledge, insufficient time to discuss the issue, perceptions that patients could not delay treatment, or the perception that if patients did not raise the issue themselves they were not interested.5 In this Perspectives we will posit that these issues can be overcome with an integrated, team approach between oncologists and reproductive endocrinologists.
We offer a case and a patient's letter to help exemplify the unmet need for improved fertility counseling before treatment. In 2002, a 23-year-old, gravida 0 woman presented to a medical center with a breast mass and was diagnosed with an invasive ductal carcinoma. 57 days after surgical therapy, she was treated with chemotherapy. She received four cycles of doxorubicin and cyclophosphamide, followed by four cycles of docetaxel. She then underwent local radiotherapy. The patient desired to have children, but did not have the opportunity to speak with a fertility specialist and was not offered options to preserve fertility. Regular menses returned 3 months after completion of chemotherapy. However, 7 years later, she presented to our tertiary care fertility center after several unsuccessful attempts at both natural conception and at in vitro fertilization (Figure 1).
This deeply personal issue warrants a greater understanding from a patient's perspective. Consider her letter:
"I can still remember the day I was diagnosed with breast cancer. I was 23 and the doctor could barely look me in the eye before he dashed out the door. It took me about 5 years to fully acknowledge and accept the fact that I had cancer; it was a part of my life I had simply closed off. I sit here now and I feel the familiar unsettling sense of uncertainty and apprehension. Do I dare wonder whether another in vitro fertilization (IVF) cycle will work? After three unsuccessful IV F cycles, I have almost lost the luxury of hope that I will have my own biological children. Is it time to relinquish the dream of having a family of my own? The fertility clinic I first visited after cancer treatment did not specialize in cancer patients. The clinic tried to help the best they could, but in the end pointed back to the chemotherapy as the source of my infertility. It doesn't quite feel right that this dream was taken away from me; I was not given the choice to freeze my eggs and at the time all fertility discussions were dismissed.
'You are young.' That seemed to be a recurring theme coming from each doctor I visited. My first doctor told me that I was too young for breast cancer given that there was none in my family history and she sent me away without further evaluation. Once I was diagnosed and I asked about fertility after cancer treatments, a doctor advised: 'you are young, as long as you get your periods back, you'll be fine'. My oncologist advised me that I would most likely be fertile after chemotherapy and there wasn't much data available on fertility in young breast cancer patients— simply because there weren't many young breast cancer patients. My periods came back but I still couldn't get pregnant. What was wrong with me now?
Being called infertile is a cruel reminder of the time I spent with cancer treatments. To be infertile inherently would be devastating, but somehow knowing that it is stemmed from the cancer treatments is a very bitter truth. Almost as if my cancer is still mocking me, 'I might not have taken your life but I have taken something else.' I am truly at a loss knowing that my fertility could have been saved but wasn't, all based on my age at the time. Perhaps it may not been saved completely, but any attempt made then would be better than what I am left with now. I still have dreams of a family of my own. That is why I am here today visiting with yet another set of doctors. Will it be worth it? I don't know. At least at the end of it all, I can say that we tried everything that we could, this is the decision that my husband and I believed in."
As our patient describes, despite her young age at diagnosis and resumption of normal menses after treatment, normal fertility was not restored. Thus, in this Perspectives, we propose a more nuanced clinical approach to considerations about fertility preservation for patients. To improve our understanding of such considerations, we recommend the incorporation and development of new translational research–from an improved understanding of basic ovarian biology to increased awareness of the psychosocial effects of treatment-related infertility.
In the past, when assessing the gonadotoxicity of cancer treatments, most studies used the presence or absence of normal menses as their primary outcome.6 This approach has limitations in terms of improving our understanding of fertility outcomes post-treatment. Albright and colleagues first described primary ovarian insufficiency (also known as premature ovarian failure) in 1942;7 since then an increased understanding has been gained regarding partial ovarian injury. Primary ovarian insufficiency can be overt (menses are absent or irregular) or occult (the ovary is damaged but menses remain regular).8 In our patient, menses resumed, but ovarian injury still manifested as infertility. Young cancer patients may benefit greatly from an improved understanding of the continuum of ovarian damage and, furthermore, from a more-targeted approach from clinicians and researchers regarding fertility after cancer treatment.
Recent studies have shown the loss of fertility—the loss of a potential child—has a profound impact on young women. Among young cancer survivors who are childless at diagnosis, approximately 75% desire children after treatment.9 In one study of survivors from gynecological malignancies, one-third of the patients identified with the statement that "part of ones self had died along with the idea of giving birth".10 Furthermore, a recent qualitative study demonstrated that a lack of fertility preservation services was associated with distress in women with cancer.11 To optimize treatment in young women, evaluation and treatment of cancer must include an assessment of their reproductive potential and a discussion regarding the impact of treatment on ovarian function.
Referral to a reproductive endocrinologist should be offered to any woman younger than 45 years who desires future children and for whom any of the following is recommended: systemic chemotherapy, radiation to the abdomen or pelvis, oophorectomy, and/or pharmacologic delay in fecundity (for example, treatment with tamoxifen). A fertility specialist may be able to estimate the future fertility potential of an individual woman on the basis of the following factors: age, family history, gynecologic history, cancer treatment type and duration, and several diagnostic modalities. The combination of this information may facilitate the medical team's understanding of not only a patient's risk of infertility—independent of her cancer diagnosis—but also her relative chance of significant ovarian compromise after cancer treatment.
Our patient received counseling about future fertility solely on the basis of her age. Generally, the incidence of chemotherapy-related amenorrhea increases as one gets older, which reflects the importance of age.12 A plausible mechanism for this observation is the fact that egg numbers (ovarian reserve) tend to reduce with increasing age, resulting in lower egg quantity and potentially reduced egg quality. Although age is likely the most important predictor of chemotherapy-related infertility, our patient's case highlights the need for additional prognostic tools.
The development of prognostic tools for the assessment of ovarian reserve improves our ability to counsel women undergoing fertility treatment and may also serve to improve counseling in the situation of a cancer diagnosis. Antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) are currently considered the most reliable noninvasive methods for determining the ovarian reserve. This assumption is based on the correlation between these markers with the number of primordial follicles in the ovary, as well as parallel patterns of decline with age.13–15
New evidence from the Ovarian Aging study (NIH R01 HD044876) suggests that there is considerable variation in ovarian reserve in women of similar age (Figure 2).14 For instance, the AFC in women aged 25–30 years ranges from 12 to 37. Some of the variation in ovarian reserve seen in these women may be accounted for by genetics. 16,17 We posit that variability in ovarian reserve may help account for the observed variation in rates of ovarian insufficiency in age-matched individuals who have undergone cancer treatment. AFC can decline notably in premenopausal women who become amenorrheic after treatment with cyclophosphamide regimens. 18 In addition, women with low levels of AMH pretreatment tend to have higher rates of chemotherapy-related amenorrhea than those with high pretreatment AMH.19 Finally, these indices have been shown to identify other subgroups most likely to experience fertility issues and/or chemotherapy-related amenorrhea.20–22
Absolute prediction of fertility outcome is difficult for the following reasons: the unknown risks to fertility of some treatment regimens, the potential for adjustments in cancer therapy, and differences in variability in assessment of reproductive potential. However, the correlation between ovarian reserve and reproductive capacity may allow us to individualize our assessment, and may aid the prediction of an individual's post-treatment reproductive compromise. This information may also help inform patients about their chances for success with the available fertility preservation options. A woman who presents with a diminished follicle number before cancer treatment should be informed that her reproductive potential may be low or that her window of reproductive opportunity may be foreshortened–even in the absence of cancer treatment–and that fertility preservation attempts may have limited success.23,24
Reproductive endocrinologists may be able to use AFC, along with serum markers and clinical history, to make a comprehensive assessment of reproductive potential and better determine women that are suitable candidates for fertility preservation before their cancer treatment starts. Such an assessment by a reproductive endocrinologist might mean that a patient like our own, who missed an opportunity to preserve her fertility 7 years ago, could now receive better counseling.
Today, fertility centers will open emergency slots to evaluate patients with cancer as soon as possible, giving patients with cancer the most opportunity should they choose to cryopreserve oocytes or embryos. Patients may ultimately decide not to pursue these options, but the sooner they are seen, the more options they will have. This protocol allows for an active choice for treatment or not versus the historical passive exclusion of treatment.
The team approach to counseling can be extended further to a team approach to treatment of young cancer patients. Ovarian stimulation with standard fertility medications increases oocyte yield compared with the natural menstrual cycle. From an oncologist's perspective, concerns might arise as to whether hormone stimulation at the start of some fertility preservation protocols (along with potential treatment delays) may worsen prognosis. For example, use of aromatase inhibitors in patients with endometrial carcinoma has been associated with lower estradiol levels than that seen in standard ovarian stimulation cycles.25 This treatment approach has also been studied in fertility preservation for young patients with breast cancer and is unlikely to result in significant increases in recurrence risk.26 Furthermore, a review of 2,600 patients with early-stage breast cancer indicates that onset of adjuvant chemotherapy could be delayed up to 12 weeks after definitive surgery without significant decreases in relapse-free survival.27
Ovarian stimulation takes about 2 weeks and usually starts with the onset of menses. Generally, cancer treatment need not be delayed for more than 2–6 weeks, depending on whether a patient is in the follicular or luteal phase of the menstrual cycle. Gonadotropin releasing hormone (GnRH) antagonists could be used to more quickly prepare the patient for ovarian stimulation. 28 In patients with breast cancer, oocyte retrieval with standard fertility medications can be completed in an average of 33 days from first fertility evaluation. Indeed, ovarian stimulation has been integrated into cancer care without delaying the onset of chemotherapy.29 In our patient's case, 78 days elapsed between diagnostic biopsy and the start of chemotherapy–a window that would have comfortably allowed the opportunity to preserve fertility.
Family and happiness will mean many different things to different patients. Some may choose advanced reproductive technologies while others, of course, may not. However, we emphasize the importance of allowing patients to make their own decisions about family in the presence of the best available clinical data, and, as close to the time of diagnosis as possible, when the most options are available (Figure 3).
An attempt to preserve a patient's fertility before treatment offers the best chance of a successful pregnancy after treatment. Established techniques, such as embryo cryopreservation, or experimental techniques, such as oocyte cryopreservation, ovarian tissue cryopreservation, or ovarian suppression therapy can be used before commencing cancer treatment.
AS CO currently recommends the use of embryo cryopreservation whenever possible. 30 Survival rates per thawed embryo range from 35% to 90% and implantation rates of these embryos range from 8% to 30%.29 Embryo cryopreservation requires a sperm source, whereas oocyte cryopreservation does not, offering a very useful alternative to women who are single at diagnosis. Live birth rates after thawing cryopreserved oocytes were once as low as 2–5% per thawed oocyte, but new freezing techniques have dramatically improved the live birth rate of cryopreserved oocytes to approximately 40% per cycle started, near that of cryopreserved embryos.31–33
Currently available experimental alternatives for fertility preservation include tissue cryopreservation and in vitro maturation (IVM). Ovarian tissue cryopreservation involves a surgical procedure to remove all or part of the ovary, potentially offering an option for prepubertal girls and for women who require emergent treatment and cannot harvest eggs at the time of diagnosis. When thawed, this tissue provides the possibility of re-implantation or perhaps–in the future–complete in vitro growth. In addition to use before treatment, ovarian tissue cryopreservation may be one of the only available procedural options for fertility preservation once treatment commences.34 IVM involves egg harvest before treatment from antral follicles 4–12 mm in diameter, in the absence of stimulation, and subsequent maturation of oocytes in vitro. IVM also offers a viable option for prepurbertal girls and women facing emergent treatment. The procedure can be performed at any time in the menstrual cycle. Implantation rates of embryos from IVM are less than half that of embryos from oocytes matured in vivo.35
The use of ovarian suppression therapy remains controversial. In 2009 a randomized study of 78 patients with cancer reported decreased rates of amenorrhea and normalization of serum markers of ovarian function. 36 This study is interesting, although it is limited by short follow up (8 months after last chemotherapy) and lack of fertility as an outcome. Additionally, the results are considered controversial because of small sample size and higher than expected adverse outcomes in the control group.37 Another small randomized trial investigating the effect of GnRH agonist use together with an escalated chemotherapy regimen known as BEA COPP was stopped early because all patients in both study arms had very low AMH levels at 12 months of follow up.38 This study was limited by lack of a proper control group, by absence of fertility as an outcome, and by concerns that the treatment regimen (escalated BEA COPP) may be particularly gonadotoxic. Until larger randomized trials with longer follow up are conducted and a greater focus on both fertility and recurrence rates are included in trials, we view the use of GnRH agonists as a possible yet experimental option. We do not recommend GnRH agonists as replacement for more proven methods of fertility preservation, and contend that it should be considered only for patients enrolled under experimental protocol.
Following cancer treatment, and after a period of 2–5 years of disease-free survival, natural conception can be attempted. If fertility preservation was not performed, ovarian stimulation and oocyte harvest for embryo or oocyte cryopreservation can be attempted, but this is associated with diminished success.39 If natural conception is unsuccessful, and fertility preservation was performed before treatment, cryopreserved oocytes and/or embryos may be thawed and transferred to the patient. Additionally, cryopreserved tissues can also be transplanted back to the patient. To date, transpositions of cryopreserved tissue have led to approximately 10 births worldwide.40 In patients who do not respond to the abovementioned options, or who electively choose not to undergo fertility preservation before cancer treatment, may also consider options such as oocyte and/or embryo donation or adoption. Patients who either had a hysterectomy or who underwent pelvic radiation may wish to consider surrogacy.
As cancer treatment strategies advance, we must keep an increasingly attentive eye on how we are affecting our patients' quality of life after cancer treatment. We must work together and plan with foresight, rather than working separately, in hindsight, to mend missed opportunities. Increased awareness of the risk of treatment-related infertility is paramount. This awareness must start with both fertility and oncology practitioners. As evidenced by our patient's perspective, advances in the field of fertility preservation have the potential to make a tremendous impact on an individual patient's life. With the development of newer and more-effective fertility counseling and treatments, we must continue to work as a team to provide our patients better access to these technologies.
This project was supported by NIH/NICHD and NIH/NIA Grant Number R01 HD044876 and by NIH/NCRR UCSF-CTSI Grant Number UL1 RR 024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Mr. Letourneau's work was supported by a grant from the UCSF PACCTR Medical Student Research Fellowship. We would like to thank our patient for her generous and heartfelt submission. Without her work this manuscript would not have been possible.
Competing Interests
The authors declare no competing interests.
Author contributionsM. E. Melisko provided a substantial contribution to discussions of the content and to review and/or editing of the manuscript before submission. M. I. Cedar researched the data for the article and provided a substantial contribution to discussions of the content. J. M. Letourneau and M. P. Rosen contributed equally to research, discussion of content and writing the article and to review and/or editing of the manuscript before submission.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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text:
In other news Friday, Libyan leader Moammar Gadhafi's forces continued assaults on opposition forces in the east. Government troops attacked the key oil port of Ras Lanouf for a second day. Also, police in Saudi Arabia stopped attempts at protests in the capital, but hundreds demonstrated in the eastern part of the country. Continue reading
As foreign countries and international organizations continue to consider options for ending the violence in Libya, Moammar Gadhafi denounced the idea of implementing a no-fly zone. Jeffrey Brown talks with former State Department officials Richard Haass and Anne-Marie Slaughter about what could happen if world powers intervene. Continue reading
In other news Tuesday, Yemeni President Ali Abdullah Saleh accused the U.S. of directing unrest in his country from an operations room in Israel. A U.S. State Department spokesman denied the charge, and hundreds of thousands of Yemenis took to the streets for the largest day of protests. Protests also continued in Iran and Oman. Continue reading
In other news Monday, protesters in Bahrain, Yemen and Oman continued pressuring their governments for reforms. In Saudi Arabia, 100 academics and activists called for sweeping changes, including the creation of a constitutional monarchy. In Afghanistan, four NATO troops were killed by roadside bombings and insurgent attacks. Continue reading
In other news Friday, a man wearing an Afghan army uniform opened fire on NATO troops in Afghanistan today, killing two German soldiers, but it was unclear if the attacker was actually an Afghan soldier. Separately, a suicide car bomber hit a Khost police station, killing 11 and wounding 41. The Taliban claimed responsibility. Continue reading
Charles Sennott of GlobalPost sat down with Gen. David Petraeus, commander of American and allied forces in Afghanistan, for an extended interview about where the fight for Afghanistan stands as the spring "fighting season" approaches. Sennott later spoke with the NewsHour's Jeffrey Brown. Continue reading
Cabinet ministers from Hezbollah resigned from Lebanon's governing coalition and Haiti marked one year since a powerful earthquake devastated Port-au-Prince. Continue reading
Friday, two more NATO troops were killed in Afghanistan, bringing the total of foreign troops killed there this year to 711. American deaths this year now total 498. Continue reading
In other news Monday, an Afghan policeman turned his gun on American troops, killing six of them during a NATO training exercise in eastern Afghanistan, before he was killed. Continue reading
In other news Tuesday, peace talks in Afghanistan were dealt a major setback after reports surfaced that a man representing the Taliban was an impostor. Continue reading


text:
Dark angels
Utforsk lignende emner
Broken - Oscuras y Negras Almas: Ángeles Caídos 88
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{pretend it's night time} I take my usual midnight flight around, where there's no humans to catch me. Everything came down on me at once. The realization that I'll never see my parents again, the friends I had, I will never talk to again...i was alone....truly alone. I have no family, no friends, just me. I begin to sob, and land into a creek, letting everything I've kept on for the past 6 years go. I hear footsteps, but don't move. "Are you alright?" I hear someone ask, walking to towards…
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- A. Housing Terms and Conditions
- B. Campus Living Policies and Procedures
- C. Safety and Security
- D. Condition of Facilities
A. Housing Terms and Conditions
1. Housing Application and Contract
The housing application and contract is a legally binding agreement between the university and the resident. All students are responsible for the stipulation of the contract they are entering when a housing application is signed. All specific policies on payments, cancellations, deposits, and refunds will be included in the contract.
2. On-Campus Residency Policy
It is University policy that all single, full-time undergraduates who are under the age of 21 be required to live on campus until they have earned 60 semester hours (junior status) or have lived on campus for four consecutive semesters (excluding summer semesters).
3. Housing Exemption Policy
Any student who lives within a 50-mile radius of Americus with a family member who serves as a guardian will be exempt from this policy if an Exemption from Residency Requirement form is submitted to the Office of Residence Life. Other reasons for exemption from the residency policy include being married or having a dependent child. Failure to submit this request will result in a hold being placed on a student's account until cleared.
4. Payments
Per semester housing fees are due and payable in advance at the prescribed rate per academic term. If payment is not made by the stipulated deadline, the student's registration may be cancelled.
a. New and continuing applicants for campus housing who decide not to enroll at Georgia Southwestern must cancel their housing contract in writing no later than thirty (30) working days prior to the first official day of classes for the affected term.
b. Students who have signed this contract and enroll at Georgia Southwestern are obligated to the contract for the entire academic year and may not cancel this obligation. This obligation requires 100% payment for Fall and Spring semester fees.
6. Right of University to Cancel
a. The University reserves the right to refuse admission or readmission to University housing or to cancel the contract during the academic year for the student's failure to meet University requirements or to follow policies or regulations, or in the event of criminal conviction by civil authorities, or for any other reasonable cause.
b. If the student is removed from the residence halls for judicial reasons the student is responsible for 100% of the fees for that semester. If the student is still under contract for the Spring, the student will be charged 25% of the fees for that semester.
c. If the student fails to pay housing fees, additional fees, or assessments by the dates required by the University, the University is entitled to pursue any or all of the following actions: termination of the contract, evict the student from University housing, cancellation of registration, and withholding transcripts, diplomas or other records or documents maintained by the University.
d. If the student has not checked into his/her assigned room within the first five class days, the student could risk losing his/her housing assignment or be reassigned to a different room or residence hall.
7. Short Term Contract
Short-term housing for commuter students is available up to two nights each week. Cost for the overnight stay is $25 for a single room and $20 for a double-occupancy room. Rooms are issued to commuters and guests only as space is available.
8. Schedule
The University residence halls will open as announced prior to the beginning of each semester. Students shall vacate the halls by the day and time announced in advance of closing of the halls or they will be assessed an improper check out fee and charged for additional days/nights spent in the hall. During official holidays within a semester, or between semesters, the University reserves the right to close all or some of the halls and require students remaining on campus to move temporarily to another hall. The University reserves the right to charge extra rent when housing is provided during breaks.
B. Campus Living Policies and Procedures
1. Occupancy
a. Students may occupy residence hall rooms on the opening date announced prior to each term. Failure to occupy a reserved room within 24 hours of the beginning of classes may result in cancellation of a specific space assignment. Students contracting for housing prior to the first day of the term will be held responsible for payment of the entire term regardless of when they check in.
b. Occupancy of rooms is allowed only by students to whom the room is assigned. Rooms may not be sublet to another person. In all residence halls, rooms shall be vacated by the date published by Residence Life.
c. The University reserves the right to:
- Authorize or deny room and roommate changes,
- Place additional students in a student's assigned room,
- Consolidate vacancies,
- Re-designate building usage, or
- Relocate students for reasons including, but not limited to, renovation, maintenance, construction, roommate conflicts, and disciplinary sanctions.
d. In all residence halls, rooms shall be vacated no later than twenty-four hours after cancellation of the contract.
e. Any items left in the residence
2. Visitation
- The following rules apply to all residence halls:
- a. Guests must enter and exit from the lobby entrance(s).
- b. Guests must be escorted by a resident of that building at all times.
- c. Residents are responsible for the behavior of their guest(s).
- d. During the hours when a desk assistant is on duty, all guests must present a picture ID and sign the visitation log.
- Freshmen students have the following hours of visitation:
- Sunday - Wednesday 10:00 AM. - 1:00 AM
- Thursday - Saturday 10:00 AM - 3:00 AM
- Upper-class students have no limitations on the hours of visitation. However, the 24-hour visitation policy does not allow for cohabitation. Residents may not have an overnight guest more than 3 times per month. If a guest is going to stay past the time that a desk assistant is on duty for that night, the resident must complete an overnight guest registration form and leave it with the desk assistant. If a resident has an overnight guest more than three times during any month, it may result in a loss of all visitation privileges for that resident, and the guest may be banned from visiting the residence hall at all.
- A resident may not have more than two guests at any one time. No suite or apartment may have more than four guests at any one time.
- Due to insurance restrictions and liabilities, children under the age of 12 are not permitted to stay past 10:00 p.m. in residence halls nor at any time for babysitting purposes. Children must be accompanied by the resident being visited while in the residence hall. Children must not be left alone in residence hall rooms or public areas.
3. Liability
The University will not be liable for injury to persons or for loss or damage to items of personal property that occur in its buildings or on its grounds. This includes, but is not limited to, damage from fire, windstorm, vandalism, interruption of utilities, or condition of facilities. Students are strongly encouraged to carry appropriate insurance to cover possible loss of personal property. The RLC for each residence hall can provide you information about obtaining student renter's insurance.
4. Lock Outs, Lost Keys, and Student Responsibility
- The Residence Life Staff realizes that even with the best precautions, students may still lock themselves out of their room. If this happens, the student should:
- i. Contact the RA on duty by calling the duty number listed on the duty board
- ii. Locate any available RA
- iii. If no RA is available, find the Residence Life Coordinator or Residence Hall Director in the building.
- iv. If the Residence Life Coordinator or Residence Hall Director is not available, contact the Office of Residence Life Mon-Fri from 8:00 AM to 5:00 PM or Public Safety during all other times and on holidays.
- A student will receive a key to his/her room from the residence hall staff during check-in procedures. It is the student's responsibility to keep the key secure and return it to the Residence Life staff upon vacating the room. Students should not loan their keys or access card for any reason to any person. Possession of unauthorized keys is prohibited.
- A resident who loses his/her room key will be held responsible for the cost of lock replacement.
- i. Double occupancy room (Oaks/Duncan) - $75.00
- ii. Single occupancy (Oaks/Magnolia/2-Bedroom apartments) - $125.00
- iii. 4-Bedroom Apartments (Pines) - $250.00
- Should the key be broken, a replacement key will be provided when the broken key is returned at the cost of $25.00 per key.
5. Room Entry
While the University will make every effort to respect the privacy of the student, the university reserves the right of entry for inspection, verification of occupancy and repairs, or when there is reason to believe the Student Code of Conduct is being violated. The university also reserves the right of entry without notice in circumstances posing a threat to life or property or as reasonably necessary to preserve campus order and discipline.
6. Solicitation
Solicitation within the residence halls is only permitted in compliance with applicable University policy and the approval of the Director of Residence Life. Research may be conducted in the halls only with the prior written approval of the Director of Residence Life and GSW's Institutional Review Board.
7. Conduct in the Residence Halls
Students and their guests are expected to conduct themselves with proper regard for the rights, property, and privileges of other residents. Pets, solicitation of business, weapons, all tobacco products, controlled substances, alteration of locks, removal of university or other students' furnishings, and tampering with any security or fire system is prohibited. Violations of these regulations may subject the individual to disciplinary action, confiscation of contraband, and removal from University housing or from the University itself.
8. Quiet Hours
Residence Life realizes that part of college is to socialize. However, we also feel that students that choose to study should be able to do that. Therefore, we have come up with the following quiet hours for specific times.
- a. Students must vacate the building lobby by 9:00pm. Students will not be allowed to congregate past this time. (This includes sitting areas outside of the residence hall doors, porches, and courtyards)
- b. Social gatherings in the hall way should NOT go past 9:00 PM. If a group wishes to have an event past 9:00 PM, they should reserve a community multi-purpose room. The group must keep all noise to a minimum.
- c. Quiet hours begin at 9:00 PM and end at 9:00 AM. During finals, these hours are 24 hours a day.
- d. Courtesy Hours are from 9:00 AM to 9:00 PM. During these hours a resident's music should not be heard more than an apartment or room away from their own.
C. Safety and Security
1. Security
For security purposes, the Residence Life staff may, at any time, request proper identification from a student or any person in or around the residence halls.
2. Emergency Door Usage
The emergency exit doors of all residence halls should be used only during an emergency. All emergency doors will be alarmed 24 hours a day.
3. Exterior and Hall Doors
Propping exterior lobby doors and/or hall doors compromises the security of the residence hall and is expressly prohibited unless special permission has been granted by the Residence Life Coordinator/Residence Hall Director.
4. Roofs, Ledges, and Windows
- a. Residents are not permitted on roof areas and window ledges as they are not intended to hold excess weight. The University is not responsible for injuries that result from a fall from a ledge or roof area.
- b. Residents are not to use any residence hall windows as an entrance or exit to the building.
5. Fire Safety
a. All residents and guests are to vacate the building when a fire alarm sounds. They must be at least 100 ft away from the building. No one may re-enter the facility until they are given permission.
b. Tampering with smoke detectors, fire extinguishers, or fire alarms when there is no emergency, is prohibited.
c. Smoking is not permitted in any of the residence halls.
d. No candles, incense, or other items that require burning are allowed in the residence halls. This includes all decorative candles and candles with the wicks removed. The University reserves the right to confiscate candles or other questionable flammable materials and the student will face a judicial hearing.
e. There is no cooking allowed in the residence hall rooms other than in the microwave or a coffee maker (Southwestern Pines excluded). Students may store other cooking appliances in their room, but they are only to be used in the kitchen area of the residence hall. If any student is found using an unauthorized appliance in his or her room, the appliance will be confiscated. Confiscated materials may be returned to the student at the end of the semester for the student to take home per approval of the Residence Life Coordinator/Residence Hall Director.
f. Students may have small refrigerators and microwaves in the residence halls. The following appliances are not permitted in the residence halls: any appliance requiring 220 volts or 1500 watts, space heaters, hot plates, air conditioners, or any appliance with an exposed heating element. If any student is found using an unauthorized appliance in his or her room, the appliance will be confiscated and the student will face a judicial hearing. (Note: Confiscated materials may be returned to the student at the end of the semester for the student to take home per approval of the Director of Residence Life.)
g. All surge protectors, power strips, etc must be used appropriately. Microwaves and refrigerator must be plugged directly into the wall outlet.
D. Condition of Facilities
1. Health and Safety Inspections
a. Only fish are permitted in the residence halls. Fish may be maintained in aquariums no larger than ten (10) gallons. Only one aquarium per resident is permitted.
b. There should be a clear pathway throughout living facilities. Dishes should be cleaned after usage and any food should be stored properly.
c. Trash should be disposed of and taken out to the allocated trash facilities located in the parking lot on a routine basis. During health and safety inspections, unwashed or abandoned dishes, cooking utensils, or food may be discarded to prevent pests.
2. Student Responsibility of Facilities
The student is responsible for the condition and for maintaining the cleanliness of the assigned room and its furnishings. The student shall reimburse the university for all damages to, loss of, and/or special cleaning of these accommodations and furnishings. Residents are required to check out of their assigned room by following procedures posted at the end of each semester. When inspected, the room should be cleared of all personal belongings and debris.
3. Common Areas and Hallways
a. Residents of a hall also may be required to share expenses of repair, replacement, and/or special cleaning of any university-owned property in areas commonly used by residents and their guests.
b. Any use of residence hall furniture other than in public areas of the residence hall is prohibited.
4. Community Areas
In the event of damage in hallways or common areas, students may be charged for repairs or replacement of damaged property when not attributed to a specific individual. Determination of room and common area damage, loss, or cleaning assessments shall be made by the university at its sole discretion. This includes all community kitchens, computer labs, multi-purpose rooms, and lobby areas.


text:
webOS based tablet from HP, i hope its true…
Rumor: HP Hurricane maybe a WebOS Tablet
After the acquisition of Palm by HP there a lot of people have been expecting a webOS based tablet from HP, as the guys at HP have openly admitted that their only interest in Palm is the webOS. According to a source from HP it seems that the company may soon announce a webOS tablet called the HP Hurricane.
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We know that Palm's new Pre had not created a lot of buzz, but the new webOS was really brilliant. HP has seen some really potential in the webOS and I think that this deal may get us some really amazing products in the future.
Source: TFTS.
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text:
Chapter Twenty-Three. The Visual Arts
- John Horne Professor member
Published Online: 19 MAR 2010
DOI: 10.1002/9781444323634.ch23
Copyright © 2010 Blackwell Publishing Ltd
Book Title
A Companion to World War I
Additional Information
How to Cite
Becker, A. (2010) The Visual Arts, in A Companion to World War I (ed J. Horne), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444323634.ch23
Editor Information
Trinity College, Dublin, Ireland
Publication History
- Published Online: 19 MAR 2010
- Published Print: 23 APR 2010
Book Series:
ISBN Information
Print ISBN: 9781405123860
Online ISBN: 9781444323634
- Summary
- Chapter
- References
- the visual arts;
- visual artists - part of the European "front generation";
- 1913–14, artists joining the war;
- French, British, and Russians - competing in anti-Germanism;
- four themes from Europe's shared religious traditions - Massacre of the Innocents, the Apocalypse of St. John, the Passion and Resurrection of Christ and the grief of the Virgin
This chapter contains sections titled:
1913–14: Artists Join the War
Artists between Consent and Sacrifice
Suffering, Mourning, and Disillusionment
Turning to Religious Art
Demobilization within Wartime Mobilization; Mobilization within Postwar Demobilization: from Dada to the New Objectivity
References and Further Reading


text:
Here at the Academy we often talk about the importance of hard work, striving for your goals and managing your time. But it is equally important to take much needed breaks and take time out from work or study to relax and recuperate. It is important to strike some form of work-life balance that works for you to keep your mind, body and soul healthy, thus making theRead More
Monday Motivation
Show Up, Be Seen, Live Brave A couple of weeks ago I quoted one of Academy Advisor Zoe McKeown's Inspire archive posts, on our Wedding Academy Live Facebook page. Zoe referenced one of her family's favourite mantras "Fortune favours the brave". Taking the first steps in making a career change by enrolling with us, or launching your business as an Academy graduate, requires you to be brave andRead More
If You See Something Beautiful in Someone, Speak It In our recent Facebook Live Events we have discussed how to avoid brand or business envy, and channel it in a more positive way. We are all lucky to be part of a very talented industry, with inspiring colleagues and peers. There will always be instances where you see others work and wish you could have done it. But ratherRead More