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Erectile dysfunctionImpotence; ED
An in-depth report on the causes, diagnosis, treatment, and prevention of erectile dysfunction.
Erectile Dysfunction
Erectile dysfunction (ED), formerly called impotence, can affect men of all ages, although it is much more common among older men. It is normal for men to occasionally experience erectile dysfunction. However, if the problem becomes chronic, it can have adverse effects on relationships, emotional health, and self-esteem. Erectile dysfunction may also be a symptom of an underlying health condition. If erectile dysfunction becomes an on-going problem, it is important to talk to your doctor.
Causes of Erectile Dysfunction
- Physical causes are the main reasons for erectile dysfunction. They include atherosclerosis (which also causes heart disease and peripheral artery disease), high blood pressure, diabetes, neurological disorders, medication side effects, and other health conditions.
- Psychological causes of erectile dysfunction include anxiety, depression, stress, and problems in relationships.
- Lifestyle factors that increase risk for erectile dysfunction include smoking, alcohol use, and other substance abuse.
PDE5 Inhibitors
Erectile dysfunction is usually treated with a PDE5 inhibitor drug such as: :
- Sildenafil (Viagra)
- Vardenafil (Levitra, Staxyn)
- Tadalafil (Cialis)
- Avanafil (Stendra)
These drugs are generally safe and effective for most men. They may not be appropriate for men with certain health conditions, such as severe heart disease, heart failure, history of stroke or heart attack, or uncontrolled high blood pressure or diabetes. Men who take nitrate drugs cannot use PDE5 inhibitors, and these drugs can also interact with other medications. Talk to your doctor about whether PDE5 inhibitor drugs are a safe choice for you.
Other Treatments
Other treatments for erectile dysfunction include:
- Alprostadil injections or suppositories
- Testosterone replacement therapy (for men with low testosterone levels)
- Vacuum devices
- Penile implants
- Vascular surgical procedures
It is very important to treat any underlying health conditions that may be causing erectile dysfunction. It is also important to engage in healthy lifestyle behaviorsby eating right, staying physically active, reducing stress, and stopping smoking and substance abuse.
Erectile dysfunction (formerly called impotence) is the inability to achieve or maintain an erection sufficiently rigid for sexual intercourse. Sexual drive and the ability to have an orgasm are not necessarily affected. Because all men have erection problems from time to time, doctors diagnose erectile dysfunction if a man fails to maintain an erection satisfactory for intercourse on at least 25% of attempts.
Erectile dysfunction is not new in either medicine or human experience, but it is often not easily or openly discussed. Cultural expectations of male sexuality inhibit many men from seeking help for a disorder that can usually benefit from medical treatment.
The Penis and Erectile Function
The Structure of the Penis. The penis is composed of the following structures:
- Two parallel columns of spongy tissue called the corpus cavernosa, or erectile bodies.
- A central spongy chamber called the corpus spongiosum, which contains the urethra, the tube that carries urine from the bladder through the penis.
These structures are made up of erectile tissue. Erectile tissue is rich in tiny pools of blood vessels called cavernous sinuses. Each of these vessels are surrounded by smooth muscles and supported by elastic fibrous tissue composed of a protein called collagen.
Erectile Function and Nitric Oxide. The penis is either flaccid or erect depending on the state of arousal. In the flaccid, or unerect, penis, the following normally occurs:
- Small arteries leading to the cavernous sinuses contract, reducing the inflow of blood.
- The smooth muscles regulating the many tiny blood vessels also stay contracted, limiting the amount of blood that can collect in the penis.
During arousal the following occurs:
- The man's central nervous system stimulates the release of a number of chemicals, including nitric oxide, which is essential for producing and maintaining erection.
- Nitric oxide stimulates production of cyclic GMP, a chemical that relaxes the smooth muscles in the penis. This allows blood to flow into the tiny pool-like cavernous sinuses, flooding the penis.
- This increased blood flow nearly doubles the diameter of the spongy chambers.
- The veins surrounding the chambers are squeezed almost completely shut by this pressure.
- The veins are unable to drain blood out of the penis and so the penis becomes rigid and erect.
- After climax and ejaculation, cyclic GMP is broken down by an enzyme called phosphodiesterase-5 (PDE5), causing the penis to become flaccid (un-erect) again.
Important Substances for Erectile Health
A proper balance of certain chemicals, gases, and other substances is critical for erectile health.
Collagen. The protein collagen is the major component in structural tissue in the body, including in the penis. Excessive amounts of collagen can, however, form scar tissue, which can impair erectile function.
Oxygen. Oxygen-rich blood is one of the most important components for erectile health. Oxygen levels vary widely fromvery lowlevels in the flaccid state to very high levelsin the erect state. During sleep, a man can normally have three to five erections per night, bringing oxygen-rich blood to the penis. The primary cause of oxygen deprivation is ischemia -- the blockage of blood vessels. The same blood flow-reducing conditions that lead to heart disease, such as atherosclerosis, may also contribute to erectile dysfunction.
Testosterone and Other Hormones. Normal levels of hormones, especially testosterone, are essential for libido (sex drive) anderectile function, although their exact role is not clear.
Over the past decades, the medical perspective on the causes of erectile dysfunction (ED)has shifted. Common belief used to attribute almost all cases of ED to psychological factors. Now doctors believe that up to 85% of ED cases are caused by medical or physical problems. Only 15% are completely psychologically based. Sometimes, erectile dysfunction is due to a combination of physical and psychological causes.
A number of medical conditions share a common problem with erectile dysfunction -- the impaired ability of blood vessels to open and allow normal blood flow.
Heart Disease, Atherosclerosis, and High Blood Pressure
Heart disease, atherosclerosis, high blood pressure, and high cholesterol levels are major risk factors for erectile dysfunction. Peripheral artery disease (PAD), a form of atherosclerosis, is very common in men who have erectile dysfunction. In fact, erectile problems may be a warning sign of these conditions in men at risk for atherosclerosis. Men who experience ED have a greater risk for angina, heart attack, and stroke.
Erectile dysfunction is a very common problem in men with high blood pressure. Many of the drugs used to treat hypertension (such as diuretics, calcium channel blockers, and beta-blockers) may also cause ED.
Diabetes is a major risk factor for erectile dysfunction. Blood vesseland nerve damage are both common complications of diabetes. When the blood vessels or nerves of the penis are involved, erectile dysfunction can result. Diabetes is also associated with heart disease and chronic kidney disease, other risk factors for ED.
Obesity increases the risk for diabetes, heart disease, and erectile dysfunction.
Metabolic Syndrome
Metabolic syndrome -- a cluster of conditions that includes obesity and abdominal fat, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance -- is also a risk factor for erectile dysfunction in men older than 50 years.
Benign Prostatic Hyperplasia
Although benign prostatic hyperplasia (BPH or"enlarged prostate") does not cause erectile dysfunction, surgical and drug treatments for the condition can increase the risk for erectile dysfunction.
Neurologic Conditions
Diseases that affect the central nervous system can cause erectile dysfunction. These conditions include Parkinson's disease, multiple sclerosis, and stroke.
Endocrinologic and Hormonal Conditions
Low levels of the male hormone testosterone can be a contributing factor to erectile dysfunction in men who have other risk factors. (Low testosterone as the sole cause of erectile dysfunction affects only about 5% of men. In general, low testosterone levels are more likely to reduce sexual desire than to cause ED.) Pituitary gland abnormalities that cause high levels of the hormone prolactin are also associated with erectile dysfunction. Other hormonal and endocrinologic causes of erectile dysfunction include thyroid and adrenal gland problems.
Physical Trauma and Injury
Spinal cord injury and pelvic trauma, such as a pelvic fracture, can cause nerve damage that results in ED. Other conditions that can injure the spine and cause erectile dysfunction include spinal cord tumors, spina bifida, and a history of polio.
Certain types of surgery and radiation treatments can increase the risk for erectile dysfunction:
- Surgery for Prostate Diseases. Radical prostatectomy for prostate cancer is a common cause of erectile dysfunction. Nerve-sparing techniques can help reduce the loss of sexual function. Radiation treatments for prostate cancer also cause erectile dysfunction. Some surgical treatments for benign prostatic hyperplasia (BPH) can also cause ED, but this complication is relatively uncommon.
- Surgery for Colon and Rectal Cancers. Surgical and radiation treatments for colorectal cancersmay cause ED.
- Fistula Surgery. Surgery to repair anal fistulas can affect the muscles that control the rectum (external anal sphincter muscles), sometimes causing ED. (Repair of these muscles may restore erectile function.)
- Orthopedic Surgery. Erectile dysfunction can sometimes result from orthopedic surgery that affects pelvic nerves.
Note: Vasectomy does NOT cause erectile dysfunction.
Erectile dysfunction can be a side effect of certain medications. They include:
- High blood pressure medications, particularly diuretics, beta-blockers, and calcium-channel blockers.
- Heart or cholesterol medications such as digoxin, gemfibrozil, or clofibrate.
- Finasteride (Proscar, generic) and dutasteride (Avodart), which are used to treat benign prostatic hyperplasia (BPH). A lower-dose form of finasteride (Propecia), which is used to treat male pattern baldness, may also cause ED. Erectile dysfunction may persist even after these medications are stopped.
- Psychotropic medication used to treat depression and bipolar disorder such as selective serotonin-reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors, and lithium. Certain types of antipsychotic medication, such as phenothiazines (like compazine) and butyrophenones (like haloperidol), can also cause erectile dysfunction.
- Gastroesophagelal reflux disorder (GERD) medications, used to reduce stomach acid, such as rantidine (Zantac) and cimetidine (Tagamet).
- Hormone drugs such as estrogens, corticosteroids, and 5-alpha reductase inhibitors.
- Chemotherapy drugs such as methotrexate.
Psychological Causes
Anxiety. Anxiety has both emotional and physical consequences that can affect erectile function. It is among the most frequently cited contributors to psychological ED.
Stress. Even simple stress can affect sexual function.
Depression. Depression can reduce sexual desire and is associated with erectile dysfunction.
Relationship Problems. Troubles in relationships often have a direct impact on sexual functioning.
Risk Factors
For most men, erectile dysfunction is primarily associated with older age. Nevertheless, ED is not inevitable with age. Severe erectile dysfunction often has more to do with age-related disease than age itself. In particular, older men are more likely to have heart disease, diabetes, and high blood pressure than younger men. Such conditions and some of their treatments are causes of erectile dysfunction.
Lifestyle Factors
Smoking. Smoking contributes to the development of erectile dysfunction, mainly because it increases the effects of other blood vessel disorders, including high blood pressure and atherosclerosis.
Alcohol Use. Heavy drinking can cause erectile dysfunction. Alcohol depresses the central nervous system and impairs sexual function.
Drug Abuse. Heroin, cocaine, methamphetamines, and marijuana can affect sexual function.
Weight and Sedentary Lifestyle. Obesity is a risk factor for erectile dysfunction. Lack of exercise and a sedentary lifestyle can lead to obesity and other health problems associated with erectile dysfunction.
Your doctor will ask about various physical and psychological factors that may be causing erectile dysfunction. The doctor will also perform a physical exam.
Medical History
The doctor will ask about:
- Past and present medical conditions, surgeries, and medications
- Any history of psychological problems, including stress, anxiety, or depression
- Lifestyle factors such as alcohol, drug, and dietary supplement use
In addition, the doctor will ask about your sexual history, which may include:
- When problems with sexual function began
- The frequency, quality, and duration of any erections, including erections that occur during sleep or on awakening in the morning
- The specific circumstances when erectile dysfunction occurs
- Details of sexual technique
- Whether problems exist in the current relationship
If appropriate, the doctor may also interviewyour sexual partner.
Physical Examination
The doctor will perform a physical exam, including examination of the genitals and a digital rectal examination (the doctor inserts a gloved and lubricated finger into the patient's rectum) to check for prostate abnormalities. The doctor should check your blood pressure, and evaluate your blood circulation by checking the pulses in your legs.
Laboratory Tests
Because erectile dysfunction and atherosclerosis are often linked, it is important to check cholesterol levels. Similarly, the doctor may order tests for blood sugar (glucose) levels to check if diabetes is a factor. In some cases, blood tests may be used to measure testosterone levels to determine if there are hormone problems. The doctor may also test for thyroid and gland dysfunction. For more sophisticated tests, the doctor may refer the patient to a urologist or endocrinologist.
Many physical and psychological situations can cause erectile dysfunction, and brief periods of ED are normal. Every man experiences erectile dysfunction from time to time. Nevertheless, if the problem is persistent, men should seek professional help, particularly since erectile dysfunction is usually treatable and may also be a symptom of an underlying health problem. It is important to treat any medical condition that may be causing erectile dysfunction.
Treatment Choices
Drug therapy with PDE5 inhibitors is the main treatment for erectile dysfunction. Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis), and avanafil (Stendra) are the PDE5 inhibitor drugs approved for treating erectile dysfunction. In general, if a man is a candidate for PDE5 inhibitor therapy and is satisfied with the results, no further treatment is necessary.
PDE5 inhibitors are not safe or effective for all men. Men who cannot or choose not to take the drugs may have other options, including:
- Medications inserted or injected into the penis
- Vacuum devices
- Surgery (limited to rare cases)
Ultimately, how successful the medical treatment is and how well it is accepted depends, in large part, on the man's expectations and how he and his partner both adapt to the procedure.
Psychotherapies. Some form of psychological, behavioral, or sexual therapy may be recommended for certain patients.
Lifestyle Changes. No matter what the treatment, a healthy lifestyle is important for restoring and maintaining erectile function. This includes a heart-healthy diet, regular exercise, and engaging in activities that help reduce stress.
Oral Medications (PDE5 Inhibitors)
PDE5 inhibitor drugsare generally the first choice of treatment for erectile dysfunction.They are:
- Sildenafil (Viagra)
- Vardenafil (Levitra, Staxyn)
- Tadalafil (Cialis)
- Avanafil (Stendra)
All of these drugs are known as phosphodiesterase-5 (PDE5) inhibitors and are approved for treatment of erectile dysfunction. By blocking the PDE-5 enzyme, these drugs help the smooth muscles of the arteries in the penis to widen and increase blood flow.
PDE5 inhibitor drugs come in pill form and are taken by mouth. Vardenafil is available as a standard pill (Levitra) or as a quickly dissolving tablet (Staxyn).
These drugs all work equally well. A doctor usually selects one of the brands based on the patient's individual preference, ease of use, and cost of medication.
Candidates for PDE5 Inhibitors
PDE5 inhibitors are a good choice for men of any age who are in good health and who do not have conditions that prevent taking them.
However, PDE5 inhibitors are not suitable for everyone. Men who take nitrate drugs for angina cannot take PDE5 inhibitors. The PDE5 inhibitors are less effective in men with diabetes and in men who have been treated for prostate cancer. Men who take certain alpha-blockers for high blood pressure or benign prostatic hyperplasia (BPH) should take PDE5 inhibitors with extra care if at all. [Tadalafil (Cialis) is approved to treat symptoms of enlarged prostate in men who have both BPH and erectile dysfunction.]
Men with the following conditions should not take PDE5 inhibitors:
- Heart problems, including chest pain (angina), irregular heartbeat (arrhythmias), or heart failure
- Recent history of heart attack or stroke
- High or low blood pressure (hypertension or hypotension)
- Uncontrolled diabetes
- Liver or kidney problems
- Blood cell problems (sickle cell anemia, leukemia)
- Retinitis pigmentosa. (With this genetic disease, people do not produce phosphodiesterase-5 and do not respond to PDE5 inhibitors.)
Administration and Effect
PDE5 inhibitors work only when the man experiences some sexual arousal. The pill should be taken about 1 hour before sexual intercourse. It generally starts to work within 10- 30 minutes. The effects of these drugs may last for several hours, and tadalafil may last for up to 36 hours.
Do not take more than one pill a day. Sildenafil should be taken on an empty stomach. Vardenafil, tadalafil, and avanafil may be taken with or without food.
Success rates increase with the number of attempts, so don't be discouraged if the drug does not work at first.
PDE5 inhibitors are also sometimes used in combination with testosterone replacement therapy for men with hypogonadism (low testosterone levels). Some research indicates that the addition of testosterone provides little benefit.
Side Effects
Common side effects of PDE inhibitors include flushing, upset stomach, headache, nasal congestion, back pain, and dizziness.
Effects on the Heart. There have been reports of fatal heart attacks in a small percentage of men taking PDE5 inhibitors. These medications can cause sudden and dangerous drops in blood pressure when the drug is taken with nitrate drugs, which are used for angina. Common nitrate drugs include nitroglycerine, isosorbide mononitrate, isosorbide dinitrate, erythatyl tetranitrate, pentaerythritol tetranitrate, and sodium nitroprusside. No one taking nitrates, including related substances such as amyl nitrate ("poppers"), should take sildenafil, vardenafil, tadalafil, or avanafil.
Intercourse itself involves an increase in physical exertion and a very small risk of heart attack for patients with heart disease or heart disease risk factors. If you have heart disease or have recently had a heart attack, talk with your doctor about whether you can safely have sex.
Visual Effects. In rare cases, men who take these drugs develop vision problems that include seeing a blue haze, temporary increased brightness, and even temporary vision loss in a few cases. The effect is usually temporary, lasting a few minutes to several hours. Men at risk for eye problems who take PDE5 inhibitors should have regular eye examinations with an ophthalmologist. Men should also see an eye doctor if visual problems last more than a few hours.
In a few cases, these drugs have been associated with partial vision loss. The vision loss is caused by non-arteritic anterior ischemic optic neuropathy (NAION), a condition that occurs from poor blood flow to optic nerves. However, erectile dysfunction is itself linked to the same vascular problems that cause NAION. Patients who suffer from diabetes, high blood pressure, and heart disease are at higher risk for erectile dysfunction as well as other vascular problems such as NAION. Although the risk of blindness appears small, men who experience a sudden loss of vision should immediately stop taking the drug and contact their doctors.
Hearing Loss. A small number of men have experienced sudden hearing loss in one ear, sometimes accompanied by ringing in the ears and dizziness. If you have this symptom, immediately contact your doctor.
Priapism. PDE5 inhibitors pose a very low risk for priapism in most men. (Priapism is sustained, painful, and unwanted erection.) Exceptions are young men with normal erectile function. Priapism is an emergency situation that requires prompt treatment to prevent permanent damage to the penis.
DrugInteractions. In addition to serious interactions with nitrates, PDE5 inhibitors may also interact with certain antibiotics, such as erythromycin, and acid blockers, such as cimetidine (Tagamet, generic). Patients should tell their doctor about any other medications they are taking.
Other Concerns. Some recent data indicate that men who take drug treatments for erectile dysfunction are at increased risk for contracting sexually transmitted diseases (STDs), including HIV. This risk is due to unsafe sexual practices, not the drugs themselves. Still, it is important for men of all ages to be aware of the risks of STDs and how to prevent them through safe sex interventions.
Injections and Topical Treatments
Treatments Using Alprostadil
Alprostadil is derived from a natural substance, prostaglandin E1, which opens blood vessels. This medicine is an effective treatment for many men with ED. It can be administered by:
- Injection into the erectile tissue of the penis (such as Caverject or Edex)
- Suppository pellets placed in the urethra through an applicator (MUSE system)
Candidates. Alprostadil is not an appropriate choice for men with:
- Penile implants or abnormally shaped penis
- Conditions that may cause priapism (long-lasting erections) such as sickle cell anemia, leukemia, or multiple myeloma
- Bleeding abnormalities or the use of medications that thin the blood, such as heparin or warfarin
Injected Alprostadil. Injected alprostadil (Caverject, Edex) uses a very small needle that the man inserts into the erectile tissue of his penis. Although this treatment is very effective, some men find the injections to be painful or uncomfortable.
The drug should not be injected more than 3 times a week or more than once within a 24-hour period.
Suppository Alprostadil. The MUSE system delivers alprostadil through the urethra using suppository pellets. It works in the following way:
- The device is a thin plastic applicatortube with a button at the top.
- The man inserts the tube into his urethral opening right after urination. (Urinating or urine leakage right after administration may reduce the amount of medication.)
- He presses the button, which releases a pellet containing alprostadil.
- The man rolls his penis between his hands for 10 - 30 seconds to evenly distribute the drug. To avoid discomfort, the man should keep the penis as straight as possible during administration.
- The man should be upright, (sitting, standing or walking), for about 10 minutes after administration. By that time, he should have achieved an erection that lasts 30 - 60 minutes. (If a man lies on his back too soon after administration, blood flow to the penis may decrease and the erection may be lost.)
- The erection may continue after orgasm.
The MUSE system should not be used more than twice a day and is not appropriate for men with abnormal penis anatomy.
Side Effects of Most Alprostadil Methods. Certain side effects are common to all methods of alprostadil administration, although they may differ in severity depending on how the drug is given:
- Pain and burning at the application site.
- Scarring of the penis (Peyronie's disease), which is most likely to occur with injections.
- Sudden, low blood pressure. Symptoms include dizziness, lightheadedness, and fainting. If these symptoms occur, the man should lie down immediately with his legs raised.
- Priapism (prolonged erection). Possible with any method, but less chance with the MUSE system than with injections. If priapism occurs, applying ice for 10-minute periods to the inner thigh may help reduce blood flow. Erections that last 4 hours or longer require emergency care.
- Women partners may experience vaginal burning or itching. For the suppository form of alprostadil, be sure to use a condom if you have sex with a pregnant woman to help protect the fetus from the drug..
- Other side effects may include minor bleeding or spotting, redness in the penis, and aching in the testicles, legs, and area around the anus.
Testosterone Replacement Therapy
Studies have been inconclusive as to whether testosterone replacement therapy is helpful for men with erectile dysfunction. Men with hypogonadism (clearly low testosterone levels) may benefit, but men who have ED and normal testosterone levels are not likely to benefit from testosterone therapy. Before considering testosterone therapy, men should be sure their hormone levels have been measured correctly and accurately.
Forms of testosterone therapy include:
- Muscle injections using testosterone enanthate (such as Andryl or Delatestryl) or cypionate (Andro-Cyp, Depo-Testosterone, or Virion).
- Skin patch (Testoderm, Testoderm TTS, Androderm). Depending on the brand, patches may be applied daily to the skin of the scrotum or to the abdomen, back, thighs, or upper arm.
- Skin gel (such as Androgel or Testim). The gel is applied only to the shoulders, upper arms, or abdomen, not directly to the penis. It is extremely important that men thoroughly wash their hands with soap and water after applying the gel, and cover the application site with clothing once it dries. Testosterone gelcan causeserious side effects (premature development, genital enlargement) in children who come in contact with it through secondary exposure. Pregnant women must avoid contact with the gel because the testosterone can harm the fetus.
- Oral forms of testosterone are not recommended because of the risk for liver damage when taken for long periods of time.
Side effects may include acne, breast enlargement, headache, and emotional instability. Testosterone therapy may increase the risk for the following serious side effects:
- Rapid growth of prostate tumors in men with existing prostate cancers. (It is not clear if testosterone increases the risk for prostate cancer, but doctors remain concerned.)
- Benign prostatic hyperplasia (BPH), enlargement of the prostate gland
- Liver disease and possibly liver cancer
- Worsening of sleep apnea, especially in men who are obese or who have lung conditions
Surgery and Devices
Vacuum Erection Devices
Vacuum erection devices, also called vacuum constriction devices, are another option for men with erectile dysfunction. They are available without prescription and have a high success rate, but are cumbersome and may be difficult to use for some men. They typically work as follows:
- The man placeshis penis inside a plastic cylinder.
- A vacuum is created, which causes blood to flow into the penis, thereby creating an erection.
- Once an erection is achieved, the man places an elastic ring around the base of the penis to retain the erection. The ring should remain in place for no more than 30 minutes.
Lack of spontaneity is this method's major drawback. There are few side effects.
Penile Implants
Penile implants are an option for men who cannot take medication or haven't been helped by less invasive treatments. In general, they work well in restoring sexual function, and men are usually satisfied with the results.
Two types of surgical implants are used for the treatment of erectile dysfunction:
- A hydraulic implant consists of two cylinders placed within the erection chambers of the penis and a pump. The pump releases a saline solution into the chambers to cause an erection, and removes the solution to deflate the erection.
- A penile prosthesis is composed of two semi-rigid but bendable rods that are placed inside the erection chambers of the penis. The penis can then be manipulated to an erect or non-erect position.
Erectile tissue is permanently damaged when these devices are implanted, and these procedures are irreversible. Although uncommon, mechanical breakdown can occur, or the device can slip or bulge. In addition, a less than optimal quality of erection may result. Infection is a rare, but serious, complication.
Vascular Surgery
In rare cases, penile vascular surgery may be considered as treatment for erectile dysfunction. Two types of operations are most commonly performed: revascularization (bypass) surgery, and venous ligation. Some insurance carriers consider these procedures experimental and will not pay for them.
According to the American Urologic Association, men who smoke or who have the following conditions are not candidates for penile vascular surgeries:
- Insulin-dependent diabetes
- Widespread atherosclerosis
- Consistently high blood cholesterol levels
- Injured nerves or damaged blood vessels
Revascularization. The revascularization procedure usually involves taking an artery from a leg and then surgically connecting it to the arteries at the back of the penis, bypassing the blockages and restoring blood flow. Penile arterial revascularization is appropriate only for young men (under age 45) who have blood vessel injury at the base of the pain that was caused by events such as blunt trauma or pelvic fracture.
Venous Ligation. Venous ligation is performed when the penis is unable to store a sufficient amount of blood to maintain an erection. This operation ties off or removes veins that are causing an excessive amount of blood to drain from the erection chambers. Long-term success rates for this procedure are less than 50 percent.
Arterial Stents. Doctors are investigating the use of drug-coated stents (similar to those used in angioplasty for heart blockages) for treating ED in patients who have not been helped by drug therapy. The stents are tiny, expandable metal mesh tubes that are implanted in an artery that provides blood flow to the penis. Preliminary studies have been promising, but only men with specific types of blood flow blockages caused by atherosclerosis are candidates for this procedure. These stents are currently only being studied in clinical trials. They have not yet been approved for ED treatment.
Lifestyle Changes
Because many cases of erectile dysfunction are due to reduced blood flow from blocked arteries, it is important to maintain the same healthylifestyle habits used to prevent heart disease.
Diet and Exercise
Diet. Everyone should eat a diet rich in fresh fruits and vegetables, whole grains, and fiber and low in saturated fats and sodium. Because erectile dysfunction may be related to circulation problems, diets that benefit the heart are especially important.
Foods that some people claim to have qualities that enhance sexual drive include chilies, chocolate, scallops, oysters, olives, and anchovies. No evidence exists for these claims.
Weight Control. Being overweight can contribute to erectile dysfunction. Try to achieve and maintain a healthy weight.
Exercise. Regular exercise is helpful for weight control, stress reduction, and a healthy heart.
Alcohol and Smoking. Men who drink alcohol should do so in moderation. Quitting smoking is essential.
Stay Sexually Active
Staying sexually active may help prevent erectile dysfunction. Frequent erections stimulate blood flow to the penis.
Change or Reduce Medications
If medications are causing ED, discuss with your doctor whether to change to a different medication or reduce the dosage.
Psychotherapy and Behavioral Therapy
Even if erectile dysfunction is caused by a physical problem, interpersonal, supportive, or behavioral therapy are often helpful for patients and their partners.
Herbs and Supplements
Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should always check with their doctors before using any herbal remedies or dietary supplements.
There is no evidence that any herbal product, vitamin, or dietary supplement can improve erections or sexual performance in men or women. Despite this, many herbs and dietary supplements are marketed as aphrodisiacs. Aphrodisiacs are substances that are claimed to increase sexual drive, performance, or desire. There are several special concerns for people taking alternative remedies for erectile dysfunction.
Yohimbe. Yohimbe is derived from the bark of a West African tree. Side effects include nausea, insomnia, nervousness, and dizziness. Large doses of yohimbe can increase blood pressure and heart rate and may cause kidney failure.
Viramax is a commercial product that contains yohimbine, the active chemical ingredient of yohimbe, and three other herbs: catuaba, muira puama, and maca. It has not been proven to be either effective or safe, and interactions with medications are unknown
Gamma-Butyrolactone (GBL). GBL is found in products marketed for improving sexual function (such as Verve and Jolt). This substance can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma.
Gingko Biloba. Although the risks for gingko biloba appear to be low, there is an increased risk for bleeding at high doses and interaction with vitamin E, anti-clotting medications, and aspirin and other NSAIDs. Large doses can cause convulsions. Commercial gingko preparations have also been reported to contain colchicine, a substance that can be harmful in people with kidney or liver problems.
L-arginine (also called arginine). Arginine may cause gastrointestinal problems. It can also lower blood pressure and change levels of certain chemicals and electrolytes in the body. It may increase the risk for bleeding. Some people have an allergic reaction to it, which in some cases may be severe. It may worsen asthma.
Dehydroepiandrosterone (DHEA). DHEA is a supplement related to certain male and female hormones. Studies show inconclusive results in its treatment for erectile dysfunction. DHEA may interact dangerously with other medications.
Spanish Fly. Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac but can be particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening. No one should try any aphrodisiac without consulting a doctor.
Other Dietary Supplements Marketed for Erectile Dysfunction. There are numerous products marketed as "all-natural" dietary supplements and promoted as treatments for erectile dysfunction and sexual enhancement. The FDA has not approved any of these products. In recent years, the FDA has banned from the market many of these dietary supplements and warns that they contain the same or similar chemical ingredients used in PDE5 inhibitor prescription drugs.
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Gupta BP, Murad MH, Clifton MM, Prokop L, Nehra A, Kopecky SL. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med. 2011 Nov 14;171(20):1797-803. Epub 2011 Sep 12.
Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010 Feb 1;81(3):305-12.
Jena AB, Goldman DP, Kamdar A, Lakdawalla DN, Lu Y. Sexually transmitted diseases among users of erectile dysfunction drugs: analysis of claims data. Ann Intern Med. 2010 Jul 6;153(1):1-7.
Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007 Aug 23;357(8):762-74.
McVary, K. T. Clinical practice. Erectile dysfunction. N Engl J Med. 2007 Dec; 357(24): 2472-81.
Melnik T, Soares BG, Nasselo AG. Psychosocial interventions for erectile dysfunction. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004825.
Miles CL, Candy B, Jones L, Williams R, Tookman A, King M. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005540.
Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc. 2009 Feb;84(2):139-48.
Nehra A, Jackson G, Miner M, Billups KL, Burnett AL, Buvat J, et al. Diagnosis and treatment of erectile dysfunction for reduction of cardiovascular risk. J Urol. 2013 Jun;189(6):2031-8. Epub 2013 Jan 9.
Prabhu V, Alukal JP, Laze J, Makarov DV, Lepor H. Long-term satisfaction and predictors of use of intracorporeal injections for post-prostatectomy erectile dysfunction. J Urol. 2013 Jan;189(1):238-42. Epub 2012 Nov 20.
Rogers JH, Goldstein I, Kandzari DE, Köhler TS, Stinis CT, Wagner PJ, et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. 2012 Dec 25;60(25):2618-27. Epub 2012 Nov 21.
Qaseem A, Snow V, Denberg TD, Casey DE Jr, Forciea MA, Owens DK, et al. Hormonal testing and pharmacologic treatment of erectile dysfunction: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2009 Nov 3;151(9):639-49.
Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007 Feb;120(2):151-7.
Shamloul R, Ghanem H. Erectile dysfunction. Lancet. 2013 Jan 12;381(9861):153-65. Epub 2012 Oct 5.
Spitzer M, Basaria S, Travison TG, Davda MN, Paley A, et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med. 2012 Nov 20;157(10):681-91.
Tsertsvadze A, Fink HA, Yazdi F, MacDonald R, Bella AJ, Ansari MT, et al. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: a systematic review and meta-analysis. Ann Intern Med. 2009 Nov 3;151(9):650-61.
Tsertsvadze A, Yazdi F, Fink HA, MacDonald R, Wilt TJ, Bella AJ, et al. Oral sildenafil citrate (viagra) for erectile dysfunction: a systematic review and meta-analysis of harms. Urology. 2009 Oct;74(4):831-836.e8. Epub 2009 Jul 9.
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Related Informationec
Review Date: 9/17/2013�
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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Search Deals
What type of tickets?
This deal is for a 1 day open-close ticket to ski or ride at Crystal Mountain in Thompsonville, Michigan.
Lift tickets for children 6 & under are free with the purchase ... of an adult lift ticket. Please mention at the ticket window.
9am-4:30pm Read More
Pickup Instructions
You may pick up your tickets at the designated e-ticket ticket window located outside the lower level of the Crystal Center.
Mobile Friendly
You can redeem your order at the resort using your mobile device or a printed voucher.
About Crystal Mountain
Named the #1 Resort in the Midwest by SKI Magazine, Crystal Mountain is northern Michigan's premier ski and snowboard resort destination. Ski and ride on 50 trails - including four
terrain areas. Tour rolling terrain and wooded valleys on 30 kilometers of groomed cross-country skiing trails. Award-winning kids programs and a nationally certified ski and snowboard school can get you started or help you fine-tune your skills.
A wide range of off-mountain adventures and activities ensure fun-filled days for everyone in the family. Don't forget to make time to relax and renew at Crystal Spa which is one of only six LEED-certified spas in the U.S. and the only such spa in the Midwest. While you're here you can dine in four onsite eateries and relax in some of the Midwest's finest accommodations.
Experience all that northern Michigan has to offer at your mountain... Crystal Mountain. Please note this is Crystal Mountain in Michigan, not in Washington State. Read More

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The Nebraska track and field team saw the men's distance medley relay squad compete at the Alex Wilson Invitational in Notre Dame, Ind., on Friday night. The team of Connor Gibson, Cody Rush, Tommy Brinn and Trevor Vidlak posted a time of 9:31.71 to finish 14th in the event. The time marks the fastest time in Nebraska history for an oversized track. Penn State won the event with a time of 9:26.60.
Photo Courtesy BreAnna Haessler/NU Media Relations


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Washington : Government Printing Office
|Public Law 85-86
|67 Stat. 590.
Page 781
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That section 1157 of title 18 of the United States Code, as amended, is repealed.
Approved, July 10, 1957.


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Life After Maimonides: Our Alumni החיים אחרי ישיבת רמב''ם: הבוגרים שלנו
If a measure of a school is its graduates, Maimonides School has clearly earned its considerable reputation. Some 1,700 students have earned diplomas since the first high school class of 1953. Nearly all have gone on to further education, many at some of the nation's top universities and colleges. Scores leave Maimonides with impressive academic honors, including Presidential Scholar awards and National Merit Scholarships. A few graduates have gone on to become Rhodes Scholars, and one received a Marshall Fellowship.
Academic honors and prestigious universities, however, tell only a fraction of the story. Maimonides graduates have a deep connection to Jewish tradition and a desire to strengthen it. To that end, each year approximately 80% of Maimonides graduates defer college matriculation to devote a year or more to Torah study in Israel. Many are active in synagogue and community life, philanthropic endeavors, day school education, adult Torah education, and chesed organizations. They sit on boards of directors and then roll up their sleeves, turning words into deeds. Some 150 have made aliyah. Wherever they are, they become pillars of their communities.
Maimonides graduates have a rich legacy of distinguishing themselves and honoring their alma mater through a diversity of professional and personal achievements. They excel as educators and writers, communal workers and diplomats, artists and scientists. More importantly, they fulfill the vision of Rabbi Joseph B. Soloveitchik, described by one teacher as "role models of a new type of Orthodox Jew, modern as tomorrow, educated in the best universities and yet firmly rooted in the eternal truth of the Divine Torah."
Whatever their endeavors, in public or private life, building strong families or effective organizations, Maimonides School graduates are committed to action. They are indeed the next link in an unbroken chain of Jewish tradition, building on a firm foundation with a clear sense of the future.


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I feel fairly at ease attempting the basics in the kitchen – sautéing, roasting, chopping, boiling, broiling. I've got those on lock.
And then there are other kitchen endeavors that I've learned to avoid. Pastry, for example, is not something I'm down with on a regular basis. Nor is deep-frying or preserving.
Normally something like making one's own cheese seems like dicey territory, but yogurt cheese – or labneh – is where it's at for us novices. All that's involved is a little stirring and a bit of patience.
Labneh is almost like a Middle Eastern cream cheese, spreadable, creamy and a little tart. And super easy to make.


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A DOG attacked a retired woman last week as she was walking home, forcing her to be admitted to hospital, and she now says she is worried it could injure again.
Anne Shayler, from Seeleys Road, in Beaconsfield, was walking home from a nearby supermarket when the dog, which was on a lead, lunged for her leg.
The lady was left in shock and when she confronted the pet's owner, he reportedly offered her a small amount of money for her ripped trousers, and walked away.
Mrs Shayler said: "My main concern is what if this happens again? Had I been walking with my granddaughter it would have been at face height, it isn't worth thinking about what could have happened.
"(At the time) I was in such shock. I couldn't believe what had happened. I was walking home from Waitrose on the Penn Road and I was going past the dog and the walker and it suddenly just went for my leg.
"It sank its teeth right into me and ripped all the bottom of my trousers. I have never been scared of dogs and I couldn't believe it could do that completely unprovoked.
"I said to the man walking the dog 'it has just bit me', he said he knew and after talking he offered to pay me £10 for my trousers and walked off."
After the attack she was approached by two other shoppers, who saw the man walking away, Mrs Shayler tried to follow but she said he disappeared around Seeleys estate.
She added: "I had to go to the hospital to have it all cleaned up and make sure I was okay, I have had to go back since and have also had to make two trips to my doctors.
"Since it bit me, I have been around the area with my husband to see if we could see him, but we cannot find him."
Mrs Shayler had reported the incident to police officers and they are now looking for witnesses.
She described the walker as someone in his 60s, with a peak cap and silver hair. He was reportedly wearing an emerald green t-shirt and dark trousers.
The dog itself is believed to have been similar to a Spaniel, which was of a greying colour.
Anyone who witnessed the incident or who had information should contact police on 101.


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1 Min Read
TOKYO (Reuters) - Former Major League Baseball player Andruw Jones's Christmas morning arrest on a battery charge will not endanger his move to Japan's Rakuten Eagles, the club's president said on Thursday.
The Curacao-born outfielder was taken into custody in an Atlanta suburb on Tuesday after police were called to his home following a domestic dispute with his wife.
"We received a report it was a domestic fight which escalated," Eagles president Yozo Tachibana told Japanese media of the former Atlanta Braves and New York Yankees slugger.
"Unless there is any more big surprises, we intend to go ahead as planned with his contract."
The 35-year-old Jones began his stellar MLB career at Atlanta and won 10 Gold Glove awards, cracking 434 home runs in MLB with five different clubs.
He joined Japan's Eagles, based in the country's quake-hit northeast, earlier this month on a one-year contract worth $3.5 million.
Reporting by Alastair Himmer; Editing by John O'Brien


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In the News
Original journalism from the Center's OpenSecrets Blog
Ranking the RINOs: Who Does the Tea Party Hate Most?
April 4, 2014 | Outside spending tells us something about the incumbents that tea partiers most want to dump off the side of a boat.
Art Pope's National Political Influence
October 6, 2011 | Art Pope, a conservative multimillionaire profiled in this week's New Yorker, used his wealth and nonprofit empire to intervene in 22 state races in North Carolina last year, 18 of which resulted in Republican victories. The man the New Yorker alleges purchased North Carolina's state legislature in the 2010 elections has steered significant sums to national Republicans as well, according to research by the Center for Responsive Politics.
Support for Charles Rangel Wanes In Midst of Alleged Ethics Scandals
October 15, 2009 | Republican members of the House last week attempted to oust Rep. Charles Rangel (D-N.Y.) from his powerful chairmanship of the House Ways & Means Committee for the duration of a House Ethics Committee investigation into alleged ethical misconduct surrounding his real estate investments and dubious personal financial disclosure reports. And although the effort failed and Rangel can sit tight for now, signs that he's sustained political damage are emerging.
Obama, Ney and DeLay Also Among Stanford's Investments
February 18, 2009 | As the story behind the embattled investment company Stanford Financial Group develops, we thought we'd take an even closer look at the seeds the company may have tried to plant in Washington via campaign contributions. When looking at ALL lawmakers to collect money from the company's PAC and employees (not just members of the current Congress), some additional, important names appear at the top of the recipient list.
Embattled Lobbying Firm PMA Targeted Members of Defense Committees
February 12, 2009 | The close ties between Rep. John Murtha and a Washington lobbying firm raided by the FBI have put the powerful Pennsylvania Democrat under greater scrutiny. The lobbyists at PMA Group have been Murtha's fifth most generous campaign donor over time, but he is just one of 284 members of the 111th Congress who have collected money from the firm, which specializes in securing federal earmarks for its clients. In total, PMA Group's employees and its political action committee have given current members of Congress $3.4 million since 1989.
Congressmen Hear from TARP Recipients Who Funded Their Campaigns
February 10, 2009 | The eight CEOs testifying Wednesday before the House Financial Services Committee about how their companies are using billions of dollars in bailout funds may find that the hot seat is merely lukewarm. Nearly every member of the committee received contributions associated with these financial institutions during the 2008 election cycle, for a total of $1.8 million.
Money and Votes Aligned in Congress's Last Debate Over Bank Regulation
September 23, 2008 | The last time Congress seriously debated how to regulate the financial industry, the result was legislation that allowed the nation's largest banks to get even larger and take risks that had been prohibited since the Great Depression. A look back at that debate, which was over the 1999 Financial Services Modernization Act, reveals that campaign contributions may have influenced the votes of politicians who, a decade later, are now grappling with the implosion of the giant banks they helped to foster.
Can You Help Us Identify These Mystery PACs?
May 29, 2007 | Politicians set up so-called leadership PACs to raise even more money. But they don't want you to know what they're doing. __________________ Currently, a leadership political action committee, or leadership PAC, is not required to disclose the lawmaker with whom it is affiliated. North Carolina Rep. Walter B. Jones is hoping to shine more light…
Feel free to distribute or cite this material, but please credit the Center for Responsive Politics. For permission to reprint for commercial uses, such as textbooks, contact the Center.


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University Home > SLUCare Home > What Should You Know about Genetic Risk Testing?
Angelina Jolie's decision to have a double mastectomy after learning she had a gene that increased her chances of getting breast cancer has sparked an interest in the Saint Louis University Cancer Center's hereditary cancer screening program.
Suzanne Mahon, DNSc, an advanced practice nurse and genetics expert who directs SLU's program, said Jolie's public disclosure of such a personal decision was a wakeup call to women who know cancer runs in their family and felt ready to find out if they carried the gene putting them at high risk for the disease.
"Her public announcement was a really good thing. Not all of these people who called me need genetic testing, but it's a good thing for them to find out. They can understand their risk and make an informed choice," Mahon said.
Women who typically are at genetic risk for breast cancer have a close relative who developed the disease when young, often before age 50. Women also should consider having a genetic risk assessment if they have family members from multiple generations -- grandmother, mother, aunt, sister and daughter -- who have breast and/or ovarian cancer.
Mahon said many of her callers fell into two groups -- those with members of their families who have received genetic screening but were undecided before about getting tested and those who have a strong family history of cancer.
"In deciding whether or not to have the screening, patients should ask if that is something I really want to know about myself," Mahon said. "If I know I am at high genetic risk of developing cancer, am I going to do something with that information?"
Genetic screenings for those without insurance or in financial need are underwritten by the St. Louis Men's Group Against Cancer and private donors. Counseling services are free of charge to all.
"Genetic counseling and testing can clarify your risk of cancer. If you under-estimate your risk, you might not have the information you need to make good decisions about prevention and early detection. If we prove you don't have the risk, that can be a big relief," Mahon said.
To learn more about the SLU Cancer Center's heredity risk assessment program, call 314-268-7055.


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Hugh Hewitt falsely claimed people under 30 will "get no money" under current Social Security system
Research ››› ››› ANDREW SEIFTER
On the February 6 edition of the syndicated Chris Matthews Show, author, Weekly Standard online columnist and nationally syndicated radio host Hugh Hewitt falsely claimed that President Bush's plan to partially privatize Social Security "appeals to people who are 30 and under. ... [b]ecause they know they'll get no money if they stick with the current plan."
In fact, according to the Social Security trust fund's 2004 report, the current system could pay out full benefits until 2042, 73 percent of currently scheduled benefits immediately thereafter, and 68 percent of benefits in 2078; and according to the nonpartisan Congressional Budget Office's 2004 projections, the current system could pay out full benefits until 2052, 81 percent of currently scheduled benefits in 2053, and 71 percent in 2100. Moreover, recent polling indicates that support for private accounts among young people drops significantly when the potential realities of such a system -- decreased guaranteed benefits and $2 trillion in transition costs -- are included in the poll questions.
From the February 6 edition of The Chris Matthews Show:
HEWITT: This [Bush] plan appeals to people who are 30 and under. It revitalized the [Republican] party in terms of innovation and being --
MATTHEWS: Why would a young person like the plan for privatization?
HEWITT: Because they know they'll get no money if they stick with the current plan. They know it's not there -- after 2042 it's, what, $600 billion a year in a shortfall. So they know they're going to get shortchanged paying for my retirement, paying for yours.
Hewitt's radio show, syndicated by Salem Radio Network, airs on more than 75 stations nationwide. His books include If It's Not Close, They Can't Cheat: Crushing the Democrats In Every Election and Why Your Life Depends On It (Nelson Books, July 2004) and In, But Not Of: A Guide to Christian Ambition (Nelson Books, 2003).
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- Economy, Social Security
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The Arizona Real Estate Achievement (AREA) Awards — selected by a panel of industry experts — honor the state's best and brightest real estate companies, real estate agents, real estate brokers, mortgage companies, bankers, home builders, individuals who give back to the community, and those in the real estate business whose careers have left an indelible mark on the community and on the industry.
Winner: TEAM Investments
As founder and President of TEAM Investments, Tanya Marchiol has built an empire on coaching others how to make money and prosper. Marchiol teaches professional athletes, entrepreneurs, investors and individuals how to not only maintain their current financial status but also create generational wealth. Her business acumen, sharp strategies, personalized approach, and attention to detail have earned her a reputation for excellence. A sought after expert and motivational speaker, Marchiol's repertoire includes experience as a host and special correspondent for Sirius Satellite Radio, NFL Networks, Fox News, CNN, FOX Business News, and most recently a recurring personality on HGTV.
Honorable Mention: Kirans & Associates
Kiran Vedantam, a first-generation immigrant from India, came to Arizona in 1988 to pursue his Master's degree at ASU. After working for eight years as a software engineer at Intel, he followed his dream of becoming an entrepreneur. He used his engineering background to develop a dynamic loan modification software that has the intelligence of a professional loan modifier. He started his own real estate company in 2010, and in 2011 — just his second year in business — he ranked No. 4 in Maricopa County for the most short sale closings.


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Back to Articles
College Football Recap, Sept. 3
Tuesday, September 3, 2013
COLLEGE FOOTBALL RECAP - September 3, 2013
Football is finally back! After what seemed like a long offseason, on-field action returned with a lot of excitement. Here's a brief look at the results of the Top 25 from the opening weekend. The rankings used in this recap are the preseason AP rankings.SEC-ACC CHALLENGES
#1 Alabama 35, Virginia Tech 10: The Crimson Tide get special teams touchdowns from Christian Jones (72-yard punt return and a 94-yard kickoff return) as well as an interception return score as it handles the Hokies in Atlanta.#6 South Carolina 27, North Carolina 10: The Gamecocks open the scoring with a 65-yard touchdown pass by Connor Shaw and then close the Thursday evening game with a 75-yard Mike Davis touchdown run as they cruise to a 27-10 win over the Tar Heels.
#8 Clemson 38, #5 Georgia 35: Tajh Boyd jumps to the top of Heisman projections in another key SEC-ACC challenge by throwing for three scores and running for two more in a shootout against Georgia, giving the Tigers their second straight win over a top-10 SEC team - they also topped LSU in last year's Chick fil-A Bowl.#9 Louisville 49, Ohio 7: Teddy Bridgewater, last year's Sugar Bowl MVP, is exceptional, matching his career-high with five touchdown passes as the Cardinals outgain the Bobcats, 615-273.#11 Florida State 41, Pittsburgh 13: It's way too early to truly call Jameis Winston a Heisman contender, but some predicted he was capable of a Johnny Manziel-like freshman season - and his opening game was dazzling as he was 25-of-27 with four passing and one rushing touchdown to spoil Pitt's ACC debut.
Eastern Washington 49, #25 Oregon State 46: Vernon Adams throws for 411 yards and four touchdowns while running for two more scores as the Eagles shock the Beavers, becoming just the third FCS team to beat a ranked FBS squad.Washington 38, #19 Boise State 6: Bishop Sankey ran for 161 yards and two touchdowns and Keith Price became the school's all-time leader in TD passes as the Huskies handed the Broncos their worst loss in coach Chris Peterson's tenure. #18 Nebraska 37, Wyoming 34: The Cornhuskers survive a late rally by the Cowboys as Ameer Abdullah and Imani Cross both run for over 100 yards to offset a 383-yard passing day from Brett Smith.
#7 Texas A&M 52, Rice 31: With six defensive starters suspended for the game and Johnny Manziel for the first half, the Aggies only lead 28-21 at the break, but Manziel is exceptional in the second half and the A&M's defense settles down in a blowout.#10 Florida 24, Toledo 6: Despite having six players suspended, the Gators win their 24th straight season opener, holding the Rockets to just 205 yards and 12 first downs while Mack Brown rushes for 112 yards and two scores. #12 LSU 37, #20 TCU 27: LSU showed it didn't need running back Jeremy Hill, who was held out after an offseason arrest, as Terrence Magee ran for 95 yards and two touchdowns while the Tiger defense held the Frogs to just 259 total yards.
#13 Oklahoma State 21, Mississippi State 3: The Cowboys are known for being an offensive juggernaut, but this time, their defense stepped up, allowing just three points, it's best effort against an FBS team since 2003.#14 Notre Dame 28, Temple 6: Tommy Rees throws for 346 yards and three touchdowns while the Irish defense holds Temple to just one touchdown (while blocking the PAT).#16 Oklahoma 34, UL-Monroe 0: Bob Stoops picked up his 150th career coaching victory as the Sooner defense held the Warhawks to just 166 total yards and nine first downs.#22 Northwestern 44, California 30: While this game was no defensive gem, Collin Ellis has a memorable evening, intercepting two tipped passes and returning them both for second-half touchdowns as the Wildcats overcame an injury to their starting quarterback.#23 Wisconsin 45, Massachusetts 0: New head coach Gary Andersen relies on the old Badger formula - defense and rushing - as Wisconsin pitches its first shutout since 2011 and has a pair of 100-yard rushers.#24 USC 30, Hawaii 13: With uncertainty at the quarterback position, the Trojans turn to defense, forcing four interceptions and tallying seven sacks while holding the Warriors to just 231 total yards.
#2 Ohio State 40, Buffalo 20: The Buckeyes jump to a 23-0 lead as they extend the nation's longest winning streak to 13 games behind Jordan Hall's 159 rushing yards and two passing scores from Braxton Miller. #3 Oregon 66, Nicholls State 3: Marcus Mariota throws for one touchdown and runs for two more to lead the Ducks to 772 yards of offense in Mark Helfrich's head coaching debut.#15 Texas 56, New Mexico State 7: David Ash throws for 343 yards and four touchdowns as the Longhorns score 56 unanswered points after trailing 7-0 in the second quarter.#17 Michigan 59, Central Michigan 9: The Wolverines rush for six touchdowns as they have their highest-scoring opening game since 1905.#21 UCLA 58, Nevada 20: The Bruins explode for 41 second half points as Brett Hundley passes for two touchdowns and runs for two more in a blowout of Nevada.
Allstate Sugar Bowl, January 2, 2014 CBS Sports (Jerry Palm): Georgia vs. Louisville CBS Sports (Dennis Dodd): Georgia vs. Florida State SI.com (Stewart Mandel): South Carolina vs. Louisville SI.com (Andy Staples): South Carolina vs. Florida State SI.com (Pete Thamel): South Carolina vs. Louisville SI.com (Zac Ellis): South Carolina vs. Louisville SI.com (Martin Rickman): Georgia vs. Louisville SI.com (Lars Anderson): Georgia vs. Texas SI.com (Ben Glicksman): Texas A&M vs. Louisville Phil Steele: Georgia vs. Notre DameAssociated Press (Ralph Russo): South Carolina vs. Louisville ESPN.com (Mark Schlabach): Georgia vs. Oklahoma State ESPN.com (Brad Edwards): Georgia vs. Texas WDSU Offsides Blog (Fletcher Mackel): Alabama vs. TCU SB Nation (Jason Kirk): Georgia vs. Oklahoma StateOrlando Sentinel (Matt Murschel): LSU vs. Notre Dame College Football News: Alabama vs. Ohio State Athlon Sports: Georgia vs. Louisville Yahoo! Sports (Dave Miller): LSU vs. Florida State www.Al.com (Jon Solomon): South Carolina vs. Notre Dame Bleacher Report (Josh Sachnoff): South Carolina vs. Stanford Prediction Machine: Georgia vs. Stanford SB Nation (Byron Kewel): Texas A&M vs. Oklahoma State
College football fans, be sure to "like" the official Allstate Sugar Bowl Facebook page (linked above) and vote each week for the Manning Award Player of the Week. The top quarterback performances from each week will be posted giving you the chance to vote for that you think was the best effort each week of the college football season.
While 30 quarterbacks are on the Manning Award Watch List, additional players may be added later in the season and every quarterback in the country remains eligible for the honor. Here's a look at some of this week's top quarterback performances:Vernon Adams, Eastern Washington23-of-30, 411 yards, 4 TDs, 0 INT, QBR: 97.0Adams also rushes for two touchdowns as the Eagles shock Oregon State, 49-46, becoming just the third FCS school to defeat a ranked FBS program.
Tajh Boyd, Clemson18-of-30, 270 yards, 3 TDs, 0 INT, QBR: 78.6Boyd also rushes for a pair of scores as he leads the Tigers to a critical 38-35 victory over Georgia in the only opening weekend match-up between top 10 teams.
Teddy Bridgewater, Louisville23-of-28, 355 yards, 5 TDs, 1 INT, QBR: 97.2Bridgewater threw two touchdowns before his first incomplete pass and matched his career-high for TD passes in a 49-7 rout of Ohio.
Derek Carr, Fresno State52-of-73, 456 yards, 5 TDs, 1 INT, QBR: 82.2Carr stars in a wild 52-51 overtime victory against Rutgers, tallying the 10th 300-yard game of his career, breaking the Mountain West record for completions and tossing a 25-yard TD to clinch the win.
Baker Mayfield, Texas Tech 43-of-60, 413 yards, 4 TDs, 0 INT, QBR: 78.5Believed to be the first true freshman walk-on to start a season-opener for a BCS school, Mayfield throws for four scores and runs for another as the Red Raiders cruise to a 41-23 victory over SMU.
Corey Robinson, Troy30-of-32, 319 yards, 1 TD, 0 INT, QBR: 91.9Robinson sets the NCAA record for accuracy (minimum 30 completions) and becomes the Sun Belts career leader in passing yards and completions in a 34-31 win over UAB.
Jameis Winston, Florida State25-of-27, 356 yards, 4 TDs, 0 INT, QBR: 96.3Winston has one of the top debuts in Florida State history as the redshirt freshman is near-perfect tallying five touchdowns in a 41-13 ACC road victory to open the season.
Connor Wood, Colorado33-of-46, 400 yards, 3 TDs, 0 INT, QBR: 82.8Trailing entering the fourth quarter, Wood leads the Buffaloes to a 41-27 win over Colorado State, capping the day with a 75-yard TD connection - after opening the game with an 82-yard scoring strike.
Top Upcoming Games
(current AP rankings, all times Central)#12 Florida at Miami, Fla. (11 a.m., ESPN): The Gators and the Hurricanes meet up for their annual showdown in the Sunshine State.
#2 Oregon at Virginia (2:30 p.m., ABC/ESPN2): The high-octane Ducks travel across the country for a battle with the ACC's Cavaliers.
#6 South Carolina at #11 Georgia (3:30 p.m., ESPN): Despite the touch loss to Clemson, Georgia is still a very viable contender in the SEC, however, the Gamecocks looked strong in their opener and with a victory can seriously wound the Dawgs' hopes for a big-time season.
#14 Notre Dame at #17 Michigan (7 p.m., ESPN): The last scheduled game in a rivalry that dates back to 1898, with the last four meetings being wild and unpredictable and all being decided by seven points or less.
Arkansas State at Auburn (6:30 p.m., ESPN3): New Auburn coach Gus Malzahn hosts the Red Wolves, the team that he directed to 10 wins and a bowl win over Kent State last season.
Western Kentucky at Tennessee (11:20 a.m., ESPN3): Former Arkansas coach Bobby Petrino was passed over by both Kentucky and Tennessee when they had coaching vacancies this offseason; instead, he was hired by Western Kentucky - and defeated Kentucky in his first game.
Each week the Allstate Sugar Bowl will make its YouTube Pick of the Week, top highlights, impressive off-field performances, great games and amazing plays. This week, we're linking to GamecocksOnline for its highlights of the opening game against North Carolina - primarily to show the first TD of the college football season, a 65-yard connection between Connor Shaw and Shaq Roland.
© 2012 Allstate Sugar Bowl. All rights reserved. Privacy Policy "SUGAR BOWL" is a registered trademark of the Sugar Bowl


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Ever notice some of the strange scores that come out of bowl games?
A lot can happen when you have more than a month between games.
In a similar vein, the Chiefland 13-15 Babe Ruth All Stars will go nearly a month between games.
Chiefland's finest won the District 6 Tournament on June 21. They won't open State Tournament play until July 17.
It is manager Kyle Parnell and his staff?s task to keep the team sharp during a three-and-a-half week layoff.
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reaumur thought he had seen one with eighteen prolegs upon Erysimum alliaria (v. 91), but he does not speak positively.
As a matter of interest, I subjoin it, changing the degrees from reaumur to Fahrenheit.
reaumur received one from Arabia which was nearly cylindrical.
King; but we are indebted for the most complete account of the procedure, to reaumur.
reaumur mentions a countryman who preserved bees in the same hive for thirty years.
We often saw them flying about in the forests, feeding on the fruit of the plane, when reaumur's thermometer was at 11 below zero.
One of them issues from the source at a temperature of 67° of reaumur.
The heat was moderate enough, seldom reaching 28° or 29° reaumur.
Thus reaumur tells us of the Upholsterer-bee, Anthocopa papaveris, who fashions her cells with poppy-petals.
At noon the temperature in the cool passages of our house was at 23 or 24 reaumur (86 Fahrenheit).


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April 2013
Calendar of
Earth Month Events
more details in newsletter text
Through April 10:
April 1:
Open Forum – Valuing and Preserving our Campus' Wooded Areas (7pm, C175)
April 2:
Film: The Story of Stuff (noon, Student Center Forum).
April 3:
Sustainable Iron Chef Competition (2-4 pm, Student Center Forum)
April 4:
Film: No Impact Man (11am, Student Center Forum)
April 6:
ECO and Synergy present "Earth Day Celebration" (4:30 SC Patio, 6-8 ERC Atrium)
April 10:
ARAMARK's Local Foods Dinner (Ross Brooks Cafeteria 4:30-8 pm)
April 12: Deadline for Earth Day Photo Competition
April 13:
Spectrum hosts a local sustainability focused TEDx conference (pre-registration required)
April 20:
Clarkson Serves! A CU alumni and student service event.
April 24:
Three Clarkson Teams compete in NYSP2I's Go Green on Campus Competition (Albany NY)
End of April -
Take It or Leave It Campaign Don't trash it! Donate end-of-semester used clothing and goods in bins in residence halls or CUSA office. Or stop by and peruse donated material for FREE STUFF.
More events are located at the bottom of the newsletter
Clarkson's Sustainability Newsletter
Earth Day has become Earth Month on our campus and throughout the North Country. Opportunities abound to celebrate, learn about and create a sustainable region and future. Join us and learn what you can do!
Clarkson Commits!
There are still a few days left to show your commitment to effective solid waste management through reducing and recycling all appropriate materials. A student group is working to get over 50% of our campus community to pledge your commitment. Check it out and sign now! RSVP online.
ECO and Synergy Invite You to an Earth Day Celebration – April 6
4:30pm Tie-dye T-shirts - student center patio until supplies out, CUB will have music playing outside during this event
6-8pm-ERC Atrium - Local music, food, club tables/activities- 4 local bands will be playing, free snack foods from the co-op. Environmental Clubs will have tables with educational activities/demonstrations.
Campus Dining Services Commits to Local Food
Clarkson Dining is hosting its third "Sustainable Iron Chef" competition in the Student Center Forum (April 3rd 2-4 pm). This event promotes the use of locally sourced, seasonal ingredients and allows for a friendly culinary challenge between Students, Faculty and Staff. Each team will receive their "mystery basket" of local ingredients, and have 90 minutes to cook and plate their dishes. Judges will chose winners based on taste, presentation and creativity. Additional points can be earned by the "audience vote," where a lucky few will have the opportunity to sample the final creations. Refreshments and samples from the Adirondack Kitchen line of products will be served and prizes will be given for correctly answering "green" trivia questions.
Ross-Brooks Dining Hall will be hosting a Local Foods Dinner on Wednesday, April 10th from 4:30pm – 8:00pm showcasing ingredients from both New York State vendors and our own Potsdam community. The menu will include Kilcoyne Chili with Aged NY Cheddar, Tempura Perch with Sweet Maple Soy, North Country Waldorf, Poutine and Tourtière (Canadian Meat Pie). For dessert, the featured items will be Greek Yogurt with Spiced Wild Blueberries and Granola and Maple Crème Caramel.
Clarkson Serves!!!
Join Clarkson alumni around the country as well as alumni, students, faculty and staff for a community and campus service event on Saturday, April 20th from 9:00 am to 12:00 pm. To join us please RSVP online.
You may choose to work:
Bags and gloves and other necessary equipment will be provided in both locations. If you have your own work gloves and reusable water bottles, please feel free to bring them to help reduce waste.
If you have questions, please email Suzann Couts in the Alumni Office at firstname.lastname@example.com.
Mac-Gray Sponsors Earth Day Photo Competition
Show your Earth Day pride for the chance to win a $500 American Express gift card! Mac-Gray Corp., which operates Clarkson's laundry facilities, is sponsoring the "What Does Being Green on Campus Mean To You?" contest. Take photos of a place, object, event or person that captures the spirit of being green on campus! Submit your contest entries to www.campusclothesline.com/earth-day ; in addition, Tweet and Instagram those photos to #clarksonearthday, or email Social Media Manager Brian Hayden at email@example.com so we can create a Clarkson Facebook photo gallery of those same photos. Second and third place win a $50 American Express card. The contest deadline is 11:59 p.m. on April 12; Happy Earth Day!
Off Campus Opportunities:
April 27:
Local Living Festival (Cornell Cooperative extension Farm, Canton NY)
April 11-13
SUNY Potsdam "Making the Future" Conference (check website for details)
Apr. 10 - Dr. John Warner - "Green Chemistry: New Eyes and New Ideas in Science" (7:30 pm, Kellas Hall Rm 106)
Apr. 11 - Panel – "A Sustainable Future: The Promises and Pitfalls of Individual Action" (9:30-11am)
Apr. 11 - John Warner and Dominic Frongillo (panel) – "A Sustainable Future?" (11am – 12 ) Noon)
Apr. 12 - Dominic Frongillo – "Youth activism and the environment" (1pm)
"A Fierce Green Fire" (film, 4pm)
April 19:
SLU hosts 'North County Folk Fest' (3-10pm, outside near the Student Center) featuring local folk musicians and booths hosted by North County farmers and sustainability organizations.
SUNY Canton Sustainability Lecture Series (Nevaldine North 102, 6:00pm)
April 3 - Back to the Land - Rich Douglas is a "Back to the Lander," living off the grid without electricity on his farm in Russell, NY. He teaches about the connection between the philosophy and realities of Sustainable living.
April 17 - Photovoltaics Plus Electric Vehicles. Richard Burns from National Grid will be speaking about reducing oil dependency.
Apr. 24 - Nicholas C. Kocher, an assistant professor for Business and Public Administration at SUNY Canton, will discuss Marketing Sustainability.
Keep up with Sustainability Initiatives and News at


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As a leading pediatric orthopedic center, TSRHC has treated more than 245,000 children since its inception, with more than 40,000 clinic visits each year. The hospital takes a multidisciplinary approach to care, tailoring treatment to the individual needs of each child and family.
TSRHC is proud of the healing, hope and happiness we have shared with thousands of patients and their families. At TSRHC, every staff member is dedicated to creating a positive hospital experience for our patients – so that they can create their own experiences out in the world.
Help make dreams possible. Your gift allows the hospital to continue its mission of helping children regardless of the family's ability to pay.
Within a unique caring environment, patients at TSRHC benefit from a world-renowned medical staff and the promise of a brighter future, through the research and innovation driven by the hospitals five centers of excellence. TSRHC is consistently recognized as one of the premiere pediatric orthopedic hospitals in the world.
Contact Us
800.421.1121 ext. 7565
Send Us An Email
Donate Now
Your support allows the hospital to continue its mission of helping children.
English / Spanish
To order a copy of the hospital's Progress Report Calendar or any of the publications featured below or in our archives, please call the Public Relations department at 214-559-7656 or 800-421-1121, ext. 7656.
2016 Progress Report / 2017 Calendar
2017 Volume 2
Special Edition: Groundbreaking
2017 Volume 1
2016 Volume 3
2016 Volume 2
2016 Volume 1
2015 Volume 3
2015 Volume 2
2015 Volume 1
2014 Volume 3
2014 Volume 2
2014 Volume 1
Fall Edition 2013
Spring Edition 2013
Winter Edition 2013
Fall Edition 2012
Spring Edition 2012
Winter Edition 2012
Fall Edition 2011
Summer Edition 2011
Share Your Story!
2222 Welborn Street
Dallas, Texas 75219
North Campus
7000 W. Plano Pkwy
Plano, Texas 75093


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Was going over the form again today and I wanted to know if anyone knew exactly what special requests meant. Does that mean like asking for a corner table (if possible) or putting that you want a power drop? Or is it something to do with the art you are offering?
Thanks much!
This post has been edited by IcyPanther: 12 December 2011 - 02:27 PM


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[BBFC: 3+] Local Multiplayer 2-4, HD (High Definition). Chomp your way through an underwater mystery! Play solo or with friends to dodge predators and eat your way up the food chain to save the sea in this Feeding Frenzy sequel. Play wild, wacky Party Games. Stay alive in Time Attack! Sixty spectacular levels, brand-new fish and underwater scenes await! There are no refunds for this item. For more information, see www.xbox.com/live/accounts.
Buy Xbox content on Xbox.com. Your Xbox 360 console will automatically download the content next time you turn it on and connect to Xbox Live.Learn More
Click to create and send a link using your email application


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Jessica Simpson & Jennifer Hudson Join Forces in Weight Watchers Ad
Posted Wednesday January 2, 2013 5:15 PM GMT
Teaming up with fellow Weight Watchers spokesperson Jennifer Hudson, Jessica Simpson stars in a new ad for the diet company shortly after announcing she is pregnant.
In the commercial, the 32-year-old "Fashion Star" host shows off her slimmer figure in an all black outfit and high heels while she explains, "I obsessed about my weight my whole life. I was always on some new life-stopping diet."
Praising the product, she continued, "It lets me be me" before joining the "Dreamgirls" star for a friendly chat.
Last week, the diet company confirmed that though she'll keep her spokeswoman gig, she won't be following the plan during her pregnancy and will consult her physician before resuming the program afterwards.
Photo Credit: Weight Watchers
filed under Jessica Simpson, Jennifer Hudson, Television


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Texas Tech Takes Two From Manhattan
SOUTH ORANGE, N.J. - On Saturday morning, the Manhattan College softball team concluded round robin play at Seton Hall's Strike Out Cancer Tournament with a 13-2 loss to Texas Tech at Ivy Hill Park. The Jaspers (1-13) then drew Texas Tech (25-7) again in the semifinals, when the Red Raiders notched a 7-2 victory.
After the Red Raiders got on the board in the top of the first in game one, Manhattan responded with a run of its own in the bottom half of the inning. Amanda Babcock (Haverstraw, N.Y.) started the rally with a one-out single to left, and she came across on an RBI single by Amanda Paxson (Cedar Grove, N.J.). However, Texas Tech broke the game open in the top of the second, scoring eight runs on eight hits. The Red Raiders added two in the fourth and two more in the fifth.
Jen Keller (Woodridge, N.J.) led off the bottom of the fifth with a double to center and Heather Leone (Brick, N.J.) followed with an infield single. Keller then scored on Anna Gallacher's (New Fairfield, Conn.) RBI groundout. The Jaspers put runners on first and second when Kate Bowen (Newtown, Conn.) was hit by a pitch, but the rally stalled on a strikeout and a groundout, giving the Red Raiders a 13-2 victory.
Paxson went 2-for-2 with an RBI in game one, while Babcock was 1-for-3 with a run scored and Keller had a hit in her only official at-bat to go along with a run. Mickayla Romero (Las Vegas, Nev.) made her first career start in the circle and took the loss. Romero (0-2) surrendered the first seven Texas Tech runs and seven hits in 1.2 innings. Bowen allowed four runs (two earned) and seven hits while striking out two and walking one in two innings of work, and Kelsi Redding (Tucson, Ariz.) finished up, yielding two runs and a hit over the final 1.1 innings.
Texas Tech's Emily Bledsoe had two doubles in the game. She ended up 3-for-4 with a run scored and two RBIs. Logan Hall was 2-for-3 with three runs scored, while Raven Richardson went 2-for-2 and scored twice. Richardson and Adriana Perez belted home runs for the Red Raiders. Mikey Kenney also scored a pair of runs. Kelsey Dennis (2-0) went three innings in the circle, giving up one run on three hits, striking out one and walking one. Chandler Moore worked the final two innings, allowing one run on three hits while striking out two.
For the afternoon games, the four teams were seeded 1-4 based on their tournament record. Texas Tech earned the No. 1 seed with a 3-0 mark in the event. The Jaspers were seeded fourth, meaning they'd face the Red Raiders again in the semifinals.
Perez and Richardson both had RBI hits for the Red Raiders in the first inning of game two, and Bledsoe drove in a run with a sacrifice fly in the bottom of the second.
Trailing 3-0, the Jaspers rallied for a run in the top of the third. Bowen singled through the right side to get the inning started, then Amanda Berrios (Carteret, N.J.) dropped down a bunt single. The runners moved to second on third on Babcock's sacrifice bunt, then Manhattan got on the board when Meghan McDevitt (Nutley, N.J.) reached on an error. However, Texas Tech got that run right back in the bottom of the third, then added another in the fourth.
The Jaspers trimmed their deficit to 5-2 with a tally in the top of the sixth. Keller walked leading off the inning, and she moved all the way to third on a throwing error. After Sydney Weedon (Santa Ana, Calif.) dropped down a bunt to put runners on second and third, Keller scored on Jocelin Whitmore's (La Habra, Calif.) groundout. Bowen flied out to end the inning. Texas Tech tacked on a pair in the bottom of the sixth, and the Jaspers were unable to rally against Kermitra Ward in the seventh.
Manhattan managed just four hits in game two, a pair of which were by Bowen. Berrios went 1-for-3 with a run scored, while Babcock had a single. Redding (0-6) went the first 5.1 innings before being relieved by Romero. She allowed seven runs (four earned) on eight hits and struck out two. Romero retired both batters she faced.
For the Red Raiders, Kenney was 2-for-3 with a run scored, while Melisa Ryba went 2-for-2 with a run scored and an RBI. Sandy James scored twice, and Taylor Powell had a pair of RBIs. Ashley Brokeshoulder (1-0) got the start in the circle and went the first five innings. She surrendered an unearned run on four hits, struck out four and walked two. Chandler Moore gave up a walk and an unearned tally in the sixth, and Ward recorded a strikeout in a hitless seventh.
With the loss, Manhattan dropped into the consolation game. The Jaspers will face Monmouth (6-6) at 12:30 p.m. on Sunday. The Hawks defeated the Jaspers 8-0 in each team's first game of the tournament.
To follow Manhattan Athletics on Twitter, go to twitter.com/GoJaspers or visit Manhattan's Facebook fan page.


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- 06/13/2006
"Maintaining the security of student and employee records, academic and administrative information and medical records is an issue of increasing importance," Milliken said. "Security breaches at universities across the country have put students and employees at risk of identity theft and universities and other institutions at risk of losing essential information. We have a significant number of safeguards already in place, and we will continue to assess risks and improve the overall security of our systems."
Mauk's responsibilities will include developing and communicating policies and best practices relating to information security across all four University of Nebraska campuses. In collaboration with the campuses, he will develop a proactive security program to protect data and to increase employee awareness of security issues. "In a university environment, thousands of people have legitimate access to the network and systems," Mauk said. "Our challenge is to maintain access while safeguarding sensitive information."
Mauk served most recently as director, internal audit for Gap Inc. in San Francisco. He has also worked in information security for Safeway Inc., Charles Schwab, PeopleSoft and Deloitte Touche. "Joshua's extensive background and expertise in this area will be a valuable resource to the university," Milliken said.


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I think another problem is having it as a UK1 fight on TV, seriously outside of these forums and the hardcore, will anyone watching have a clue what UK1 actually is? I know they may not be up on all MMA rules but if they are tuning in to see cage fighting, they probably have some idea what it is, this will only muddy the waters more, not sure its a big issue but still, market it as MMA and then have a non MMA main event?
Sig awaiting witty quote from someone.
I don't necessarily have a problem with UK1 rules, it's just like two fighters in MMA who stand for the full 15 minutes and bang, look at the fight with Piotr and Bahari on this forum, or look at the majority of Phil BAroni fights, I don't agree it should be the Main Event on live television.
I think if you take BAMMA's top star (Jack) or another and put up against the A) Minor Celebrity (Alex) you still bring in those extra viewers the choice above would of (granted they might not be gypsy fans, but they will be non-mma fans) *AND Jack gets a huuuuuge boost in popularity. This is the way BAMMA should go....I can't see Jude booking Alex/Tony. If you told me that match was happening A) you would instantly think UK1, because Giles has ZERO ground game and B) a UCMMA fight NOT a BAMMA fight.
Tony Giles in UCMMA is bad enough. Just no BAMMA
...and, FUCK UK1, it brings MMA (wether intentionally connected to it or not) down a few pegs, which is something the british scene could seriously do without.
Why not 8oz or 10oz gloves like normal K1? with the thumb strapped in so you can't poke eyes? UK-1 is daft!
the problem you have is in combat sports serious brain injuries can occur as a result from a double concussion, this is likely why brain injuries are more common in boxing due to both the size of the glove surface area and the standing 8 count. This is why MMA also has medical suspensions in santioned mma countries to stop fighters recieving multiple concussions in such a short space of time.
Its a matter of time before there is a serious accident in UK MMA, without a governing body things like Mike Persil, UK1 and Ultimate ball will always crop up.


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Sharron Angle
Isaac Brekken/Associated Press
News about Sharron Angle, including commentary and archival articles published in The New York Times.
Selected Articles About Sharron Angle
Nevada Challenger Lifted by Tea Party Ardor
Sharron Angle, a largely unknown former state lawmaker, won over the Republican Party base.June 10, 2010 usNews
The Republican Party's Senate Problem
In a close race, reasons to bet against the G.O.P....
April 23, 2014, Wednesday
MORE ON SHARRON ANGLE AND: Landrieu, Mary L , O'Donnell, Christine , Cotton, Tom , Hagan, Kay R , Angle, Sharron E , Bennet, Michael Farrand , Pryor, Mark , Akin, Todd , Arkansas , North Carolina , Louisiana , Kentucky , Republican Party , States (US) , Polls and Public Opinion
Sharron Angle Endorses Santorum
Sharron Angle, the Nevada Republican and Tea Party favorite, calls Rick Santorum "a strong fiscal and social conservative who stands on principles above politics."...
February 2, 2012, Thursday
MORE ON SHARRON ANGLE AND: Tea Party Movement , Santorum, Rick , Angle, Sharron E , Senate , News , Nevada
Year of the Immigrant
Will the increasing power of the Latino and Asian-American vote lead us toward the elusive goal of immigration reform?...
January 12, 2012, Thursday
MORE ON SHARRON ANGLE AND: Immigration and Emigration , Cruz, Rafael Edward , Illinois , Hispanic-Americans , California , Georgia , Boxer, Barbara , New York City , Angle, Sharron E , Arizona , Senate , Nevada , Republican Party , United States , Fiorina, Carleton S , House of Representatives , Texas , News , Lee, Edwin M , San Francisco (Calif) , Democratic Party , Reid, Harry , Voting and Voters , Asian-Americans , Elections , Voter Registration and Requirements
Angle Calls McCain 'Lord of the TARP'
Sharron Angle responded to Senator John McCain of Arizona, who mocked Tea Party conservatives on Wednesday....
July 28, 2011, Thursday
MORE ON SHARRON ANGLE AND: Tea Party Movement , McCain, John , Angle, Sharron E , Republican Party , News , Arizona , Nevada
Angle Pulls Out of Nevada House Race
Sharron Angle pulls out of the Nevada special election for Congress after a judge ruled against an open ballot....
May 25, 2011, Wednesday
MORE ON SHARRON ANGLE AND: News , Angle, Sharron E , United States Politics and Government , Nevada
Nevada Official Rules Special Election Must be Open
Nevada's Secretary of State rules that a special election to replace Representative Dean Heller, about to be appointed to the Senate, should be open to all candidates....
May 2, 2011, Monday
MORE ON SHARRON ANGLE AND: Elections , Heller, Dean , Angle, Sharron E , Nevada , News
Resignation Has Nevada Sorting Out the Fallout
With the announcement of John Ensign's resignation, Representative Dean Heller is widely expected to be appointed to the Senate and catapulted onto a national stage overnight....
April 23, 2011, Saturday
MORE ON SHARRON ANGLE AND: Nevada , Ensign, John , Heller, Dean , Republican Party , Angle, Sharron E , Sandoval, Brian , Senate , United States Politics and Government , House of Representatives
Nevada: Angle Announces She Is Running for Congress
It would seem that Sharron Angle is running for a House seat in Nevada....
March 17, 2011, Thursday
MORE ON SHARRON ANGLE AND: Angle, Sharron E , United States Politics and Government , House of Representatives , Tea Party Movement , Nevada
Senator, After Scandal, Won't Run Again
The two-term Nevada Republican, caught up in a sex and ethics inquiry, said he would not seek re-election....
March 8, 2011, Tuesday
MORE ON SHARRON ANGLE AND: Ensign, John , Nevada , Senate , United States Politics and Government , Presidential Election of 2012 , Ethics , Hampton, Douglas , Angle, Sharron E
Ensign's Retirement May Actually Help the G.O.P.
A Republican incumbent pulls out of a Senate battle, and the party may benefit....
March 7, 2011, Monday
MORE ON SHARRON ANGLE AND: Dorgan, Byron L , Berkley, Shelley , Angle, Sharron E , Ensign, John , News , Elections , Republican Party , Senate , Nevada
In Nevada, a Battle for Every Vote
Will the tea party wave swamp Harry Reid's organization? The answer lies in the hard-hit suburbs of Las Vegas.
CNBC: An Interview With Harry Reid
John Harwood interviewed Senate Majority Leader Harry Reid of Nevada about his challenging race against Sharron Angle, his Republican candidate and Tea Party favorite.
The Caucus
Two off-the-cuff moments captured on video in Nevada and Kentucky show how intense the campaigns have become in the last days before the midterm elections.
Rss Feeds On Sharron Angle
Subscribe to an RSS feed on this topic. What is RSS?


text:
Career Profile:
Field Sales Agronomist #1129
This field sales agronomist grew up on a farm and intended to join the family farm after high school graduation. Difficult times in farming prevented this from happening, so he decided to go to college and study agriculture business. After graduation he became a crop consultant. When he learned about an opening for a field sales agronomist he jumped at the opportunity. He would no longer just publish crop information, but would have direct contact with the producers and farmers in the field. He supports farmers through education and offers recommendations based on research. His main job responsibilities include supporting sales staff with needed information, educating producers and farmers on growing the most profitable crop, and researching different products for the farm. His company works with biotechnologies to control pests, improve herbicide tolerance of crops and to aid conventional breeding efforts. It's important for him to help growers extract the greatest value from the seeds he sells. He says because some companies have not been careful about the sale of unsafe biotech products, it's imperative that he educate growers about the benefits of safe biotech crops. He enjoys the "freedom" of controlling his own schedule, even though he says it is sometimes difficult trying to prioritize his tasks.
Return to the Agronomist page.
The views presented on this site do not necessarily reflect those of Iowa Public Television; nor does IPTV endorse the businesses represented. Our mission is to make students aware of a variety of careers with as much objective information as possible.


text: My initial guess is "yes" assuming that the driver provides you with the strength of the signal. If you saw the same SSID but with two different average strength, you should be able to ignore the higher strength SSID. I can see lots of problems due to variables partially out of your control. For example, your proximity to the devices and intervening objects would change the relative strength you experience from your point of view. Depending on where you stand, you might see the lower power device as the biggest strength. Since tools like Kismit provide relative stength, the drivers must provide this information.


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Bookmark this site
Wamos Cookies, which recently launched a new bite-size chocolate chip cookie in retail packaging, has developed a 2-oz. vend pouch and is lining up single-serve distribution.
Containing 32% pure semi-sweet chocolate chips and Watkins vanilla extract, Wamos cookies are the latest baked-goods venture by legendary "cookie man" Wally Amos. They are described online at wamoscookies.com.


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Samsung Electronics has introduced an LED-backlit LCD monitor, the BX2231, in the Taiwan market.
The BX2231 features 2ms response time, 5 mega:1 contrast ratio, 1,920x1,080 resolution and Samsung's latest technologies including Magic Angle, Magic Eco and Magic Return.
The monitor will be released in the market in the first half of October with a selling price of NT$6,290 (US$202.31).
- Wireless broadband developments in Southeast Asia markets
As of 2013, the 10 ASEAN nations had a total of over 700 million mobile subscriptions, with the CAGR from 2003-2013 reaching 24%. This Digitimes Research Special Report analyzes the various mobile broadband markets in ASEAN and looks at the respective trends in 4G LTE development for those markets.
- 2015 global tablet demand forecast
This Digitimes Research Special Report provides a 2015 forecast for the global tablet market and analyzes the strategies of key market players such as Google, Apple, Intel, and Microsoft.
- 2015 China smartphone panel trend forecast
This Digitimes Research Special Report analyzes the strategies of key China-based major panel makers BOE, Tianma and IVO for attacking the different market segments through technology and pricing, and their relationship to local vendors Huawei, Lenovo, ZTE, Xiaomi and Coolpad.


text: All related characters and elements are the trademarks of The Ed Gein Collection ®2000 -2006. All material and artwork on this page and all linked pages are the property of The Ed Gein Collection and are protected under United States and International Copyright Laws. All Rights are Reserved. No permission is granted and, in fact, it is strictly forbidden to make use of this material, in whole or in part, for any purpose without obtaining written permission. For site security purposes, this computer system employs software programs to monitor network traffic to identify unauthorized attempts to upload or change information, or otherwise cause damage. Unauthorized attempts to upload information or change information on this website are strictly prohibited and may be punishable under the Computer Fraud and Abuse Act of 1986 and the National Information Infrastructure Protection Act. Information from the above mentioned software may also be used for authorized law enforcement investigations.