text:
The Qualifying Therapeutic Discovery Project program is provided under new section 48D of the Internal Revenue Code (IRC), enacted as part of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148). Only companies with less than 250 employees were eligible for the program. Additionally, projects had to show significant potential to produce new therapies to address areas of unmet medical needs, prevent, detect or treat chronic or acute disease and conditions, reduce the long-term growth of health care costs and advance the goal of curing cancer within the next 30 years. Breakthroughs in biotechnology have helped to significantly reduce mortality from many cancers.
As part of the review process for research projects, the Department of Health and Human Services (HHS) evaluated each project. Preference was given to projects that showed the greatest potential to create and sustain high-quality, high-paying jobs in the U.S. and advance the country's competitiveness in the fields of life, biological, and medical sciences. Only projects that show a reasonable potential to meet these goals were certified as eligible for the credit or grant.
The Axxent System, which delivers non-radioactive, electronic therapy directly to cancer sites with minimal radiation exposure to surrounding healthy tissue, is FDA-cleared for treatment of early stage breast cancer, endometrial cancer, skin cancer, and for the treatment of other cancers or conditions where radiation therapy is indicated, including IORT.
As a platform technology, the Axxent System is designed to deliver localized, isotope-free radiation treatment in minimally-shielded clinical settings under the supervision of a radiation oncologist to help reduce recurrence of cancer and improve survival. Utilizing a proprietary miniaturized X-ray source and mobile controller, accelerated brachytherapy and IORT treatments can be performed without the need for a shielded room, allowing radiation oncologists and medical personnel to be present during treatment, which can minimize patient anxiety.
About Xoft, Inc.
Xoft develops Electronic Brachytherapy (eBx) systems based upon miniaturized X-ray tube technology for the practice of radiation oncology in virtually any clinical setting, eliminating the need for heavily shielded environments. The Axxent® treatment platform provides a therapeutic dose of radiation directly to the region at risk with minimal radiation exposure to surrounding healthy tissue and without the logistics and costs associated with using radioactive isotopes. FDA-cleared for treatment of early stage breast cancer, skin cancer and endometrial cancer, the Axxent System is also cleared for use in the treatment of other cancers or conditions where radiation therapy is indicated including IORT. For information, visit www.xoftinc.com.
Axxent is a registered trademark and eBx is a trademark of Xoft, Inc.
SOURCE Xoft, Inc.


text: Keeper For A Day - Adult Work with animals and real zoo keepers as they tell their amazing stories. From food preparation and animal care to the little known and unexpected jobs such as turning down a zebra's bed or hiding a carnivore's enrichment toys, no day is the same in the life of a keeper! The day includes an "official" Keeper for a Day t-shirt and morning tea. (Program runs at Taronga Zoo Sydney only.)

subset: commoncrawl


text:
Miley Cyrus Flashed It Again
So sometime between this morning and last night's post this occurred which makes me believe I made it happen with my dreams. — That's not creepy!
Here's the latest shot to come out of Miley Cyrus' Much Music Video Award performances and at first I thought this thing had to be doctored, but after comparing it to more shots somebody (her parents) clearly thought it'd be a great idea to send Miley's vagina out there with nothing more than a sheer piece of fabric to prevent it from sending me to jail. Except thanks to the guinea pig known as Perez Hilton, we now know this is entirely legal and I'll be expecting a phone call from the president commending me on my pursuit of justice. *ring-ring ring-ring* Hello? — (See? Look it's the FBI.) Just doing my job, fellas. No need to thank- *takes sniper dart to the face*
Photos: WireImage


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The decision to take small steps now was prompted by the thinking that eventual redistricting might not come soon enough for some schools.
With old schools bursting at the seams and a bond referendum plan to build new ones potentially headed for the November ballot, redistricting talks are on the horizon for New Hanover County Schools.
But school district officials are trying to get a small-scale head start on that. In February, they introduced proposals to the board of education that would move 64 students from Wrightsville Beach Elementary School to Bradley Creek Elementary School and about 75 students from College Park Elementary School to Freeman Elementary School for the 2014-15 school year.
The decision to go ahead and move some students was prompted by the thinking that for some especially overcrowded schools, eventual redistricting might not come soon enough.
Wrightsville Beach Elementary has seven mobile classrooms, more than any other school in the district. The school building can hold 132 students, but when mobile units are added in, the school's capacity rises to 270 students. But at the start of the 2012-13 school year, with about 350 students enrolled, the school still needed more space.
The board's original long-term solution was to add more mobile classrooms. But after pushback from the Wrightsville Beach Board of Aldermen – and district acknowledgment that countywide redistricting will soon be necessary – school officials put together another option: move some Wrightsville Beach Elementary students to nearby Bradley Creek Elementary.
By September and October, the district had worked with the board of aldermen to rent two classrooms from Wrightsville Beach Baptist Church, less than half a mile from the school, and to consider buying two more mobile classrooms for the school.
But the aldermen put deadlines on those solutions. The lease with Wrightsville Beach Baptist Church, costing the district about $2,200 a month, runs only through June 2013. If the district chose to put two more mobile classrooms at the school, with each carrying a $100,000 price tag, the units could be used only until 2016.
Wrightsville Beach Mayor David Cignotti said that request was driven by the aldermen's desire for a better answer to the overcrowding problem. Wrightsville Beach Elementary is situated on the Intracoastal Waterway, so mobile classrooms are in a flood zone.
"We were looking for a long-term, permanent plan that would alleviate the need to keep putting trailers in flood zones as a permanent solution," Cignotti said.
Members of the school board are considering moving 64 Wrightsville Beach Elementary students who live in the Airlie Road area to Bradley Creek Elementary, which is about 5 miles from Wrightsville Beach. District officials would put an extra three mobile classrooms or a modular unit building at Bradley Creek to handle that overflow.
To town officials, the school bond referendum currently in the works may provide that permanent solution, Cignotti said. Cignotti sees the money allocated to Wrightsville Beach Elementary as being used to add permanent classrooms above the flood plain to the school.
The 25-project bond referendum proposal comes with a $284 million price tag. Wrightsville Beach Elementary, which is No. 14 on the list, is slated to receive $7.26 million for additions and renovations. That referendum must go through several more iterations, including approval from the New Hanover County Commissioners, before it can go to a public vote.
Jana Wirtel has a son in second grade at Wrightsville Beach Elementary. Under the district proposal, her son wouldn't have to move to Bradley Creek Elementary. But she still called the proposal "quite unfair and unjust." She wants the board of aldermen and the school board to find a long-term plan that would keep all current Wrightsville Beach Elementary students at their school.
"The new (Wrightsville Beach Police Department and) town hall looks pretty suitable to me," Wirtel said. "Why is it that a new school cannot be built?"
College Park Elementary is at the top of the bond referendum priority list. Right now, it's set to get $16.84 million to raze and replace the current building.
But until then it's overcrowded, and Freeman Elementary, about 4 miles away, has plenty of space that could fix that problem, said Bill Hance, assistant superintendent of operations for the district.
For the 2013-14 school year, College Park Elementary enrolled 566 students in a school built for 469 students. Freeman Elementary, on the other hand, enrolled just 298 students in a school built for 491 students.
Under the district's proposal, about 75 College Park Elementary students living in the Princess Place Drive and Market Street area would move to Freeman Elementary.
"It's an easy move to basically get both schools to their capacity," Hance said.
Pressley Baird: 343-2328
On Twitter: @PressleyBaird


text:
Hey there, time traveller!
This article was published 30/11/2012 (1725 days ago), so information in it may no longer be current.
A fly-over at Kenaston and Bishop Grandin will cost an additional $10 million, according to a city report that explains why construction of major roads in Waverley West is overbudget.
This afternoon, the City of Winnipeg released a report which said the cost of new roads into the residential subdivision has increased by $20 million to a total of $78 million.
Part of the reason for the shortfall, the report said, is the cost of building a fly-over structure at Kenaston and Bishop Grandin is projected to be an additional $10 million, and connecting Kenaston to the south Perimeter Highway could cost an additional $5 million, since the design and engineering has to be approved by the province.
The report said costs associated with a late construction start due to a longer-than-anticipated environmental-approval process will cost another $5 million.
All three levels of government agreed to share an equal part of the cost of the $54.7-million project in 2009. The money was in the city's capital budget in 2010, but work did not begin until the last two summers, in part due to a delay caused by an environmental assessment to ensure the project did not impact fish habitat.
Council's finance committee will review the report at a meeting next week.


text:
Cart is empty
Leupold Mark6 1-6x20mm 7.62 Matte
- Provides everything military, law enforcement and competition shooters need from a riflescope in an amazingly compact and efficient package.
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- Mfg Item Num: 114337
- Category: OPTICS - SCOPES
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- Weight: 17 oz
- Finish: Matte
- Reticle: Illuminated CMR-W 7.62
- Adj Size: 130 in @ 100 yds
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text:
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ishine cleaning solutions ltdCertificate of Excellence 2015
iShine Cleaning Solutions offer a comprehensive range of cleaning services including office cleaning, carpet cleaning, window cleaning and more. We have the skills and experience to carry out your requirements quickly and efficiently. With over 20 years of experience in the cleaning industry, iShine Cleaning Solutions can offer a reliable, cost effective and high quality service for any of your cleaning requirements. Based in Southampton, we have easy access to Eastleigh, Portsmouth, Bournemouth, Andover, Salisbury and Basingstoke. All of our staff are fully insured, highly trained, friendly and reliable.
Clear Vision Window Cleaning Ltd
We are a cleaning company specialising in all aspects of exterior cleaning from Regular window cleaning through to jet washing and soft washing. We also carry out internal window cleaning and carpet cleaning. Our services extend to both Domestic and commercial sectors
We at AquaClearLtd are a professional cleaning company who clean: Windows, solar panels, fascias, soffets, gutters and conservatories.
Allclean prides itself in providing the best service to valued customers. We provideall window cleaning and gutters cleaning services . We always focus on quality service for the best possible price.
Squeegee squadron
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falcon cleaners
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Wessex Maintenance
" We are a cleaning company that provide a range of cleaning services from water fed pole window cleaning, steam cleaning and pressure washing. We also provide professional cleaning "on site" on a contractual or one off basis. We provide regular contract cleaning for offices, nightclubs, hotels and residential properties and provide pre or end of tenancy deep cleans for the rental, holiday let and domestic market". We are based in Bournemouth and predominantly cover Bournemouth, Southampton, Poole, Southbourne, Christchurch, Ringwood and wider areas of Dorset and Hampshire. Providing regular commercial contract cleaning, window cleaning and pressure washing services makes up a large proportion of our business. We fulfil both commercial and residential contracts on a regular basis. Our team is very confident we can fulfil your cleaning requirements, Be that "on site" cleaners, high level pressure washing or steam cleaning you can be assured we have it covered. At Wessex Maintenance, maintaining commercial cleaning contracts and providing professional cleaners is only one part of our business. We aim to build relationships with our clients by way of regular communication and high quality customer service. The Team at Wessex Maintenance aim to work with customers as closely as possible in order to meet and exceed their expectations and we encourage regular reviews of work carried out, both by our team and clients. We pride ourselves on 100% customer satisfaction and will not sign off any job unless the customer is completely satisfied.
Dorset steam cleaning services
We offer a first class and also a unique CHEMICAL FREE deep steam cleaning service to both domestic and commercial clients. Catering to a wide range of cleaning needs which includes start & end of tenancy cleaning, spring/general cleans, regular domestic cleaning, bathrooms, kitchens, as well as ovens, windows, floors, carpets and conservatories. Steam cleaning is an environmentally friendly way to clean and is ideal for all, especially people with children, pets and allergy sufferers! Many cleaning services will use a variety of cleaning products containing harsh chemicals which emit fumes and contribute to indoor air pollution. Ethanolamine, Sodium Hydroxide and Butoxydiglycol are just a few of the chemicals in cleaning products that are poisonous if ingested and can be harmful if inhaled or touched. At Dorset Steam Cleaners we get the job done without exposing you or your family to unnecessary toxins. We only use steam (and elbow grease) to get our fantastic results! Independent testing verifies that Steam Cleaners remove 99.99% of bacteria using just steam, making this a more effectual method in a hypoallergenic environment. It is very effective in combating mould, dust mites, bacteria, viruses, and other forms of bio-contamination.
visual cleaning services
Visual cleaning is a family run business based in Gosport with many years of experience, we pride ourselves on our commitment to provide a professional and reliable service at all times, whilst maintaining the highest quality of work at very competitive prices. We specialise in the Reach & Wash water fed pole cleaning system which has revolutionised the cleaning industry. Although this is the main service we provide we also carry out a range of other cleaning tasks as listed. . WINDOW CLEANING . COMMERCIAL CLEANING . GUTTER CLEANING . DOMESTIC CLEANING . GUTTER CLEARANCE . PRESSURE WASHING . CONSERVATORIES . SOLAR PANELS
BuzzycleanersCertificate of Excellence 2015
Hello, Buzzycleaners is a new exciting cleaning service using Eco friendly high end organic products. We are realible and honest and have tons of experience.We are a friendly bunch of ladies and know how to clean. All staff are uniformed and we supply using our own Eco products ,vaccum &mops. We can offer either a one off clean ,deep clean or help to de clutter. Use us weekly or fortnightly,three weekly or monthly. We are here to help you and support your cleaning needs. Book an appointment with Buzzycleaners and we will pop to see you and go through your requirements and get you booked in for your first clean. Call today on 07754767370. Many thanks Joanne
RW Cleaning Services
Aqua cleaning services
Dorset Window Cleaning Ltd
Claymore Hygiene Ltd
We are a Cleaning and Waste Management Company who cater for everyone from Pubs/Clubs through to Nurseries and even your home. We are based in Bournemouth and cover the whole of the South Coast of England. We provide everything that is required to carry out any requirement to the highest standard.
High spec cleaning
We specialize in all aspects of cleaning such as domestic, commercial, pubs, factories, schools, windows, gutters, driveways and much more.
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First 4 Repairs Ltd
First 4 Repairs are a planned, preventative and reactive maintenance and refurbishment company delivering repairs with a can do attitude striving to deliver ''a service you can trust'' throughout the South West
Revived cleaning services
Commercial and domestic cleaning services call us on 07581353501 for a free quotation
Fairways Property and Grounds Maintenance
Fairways Property and Grounds Maintenance will look after your commercial grounds, commercial property, window cleaning with a reach and wash system, gutter clearance, stud partitioning, basic carpentry work, painting and decorating, laying new turf, end of tenancy works, dilapidation works. We will help you look after your building/site/office/house/garden/grounds.
T.N.W Cleaning Services
We are a small cleaning business with many contracted offices cleans, private house cleans, common way cleans, builders cleans, and end of tenancy cleans. We also clean ovens, carpets, windows, and floors. We have been in business now for 5 years and have a very good rapour with all of our customers. We pride ourselves in being an honest, reliable and affordable cleaning business, we care what our clients want and will always go above and beyond to make sure you (as the client) are very happy with our service. Please if you are in need of any cleaning get in touch.
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Coastal Cleaning have been established since 2007 and are based in Lymington. We provide a wide range of cleaning services to homes and businesses across the New Forest and parts of Dorset and Hampshire. We also offer cleaning contracts for estate, holiday and letting agencies. We are fully insured and use the latest technology in cleaning equipment.
We can clean it
We specialize in commercial & domestic window cleaning, patio & driveway cleaning & uvpc cleaning
Easyklean Facilities LTD
We are a Reading based contract cleaning company offering a range of different cleaning services. Our services include: Daily contracted cleaning One off deep cleans Kitchen hygiene deep cleaning Grease extract system cleaning Window cleaning External cleaning And many more
AllSeal Cleaning Services Limited
Our company offers Office cleaning services, Vinyl floor cleaning and restoration, Stone cleaning, Graffiti removal, Chewing removal, Carpet cleaning, Car park cleaning, window cleaning and kitchen cleans.
DeValtan Hygiene SolutionsCertificate of Excellence 2015
DeValtan Hygiene Solutions provides companies with total cleaning care and comprehensive hygiene solutions. Our services are designed to impress your clients, keep your workers productive and safe, and satisfy the rigorous demands of regulating agencies. We make our assessments and provide our services with HSE, CQC, and other regulations in mind. With a background in specialty cleaning services, our range of expertise includes medical, professional, commercial, and industrial solutions. DeValtan Hygiene Solutions is designed to provide your business with extraordinary cleaning and hygiene services. We combine years of experience - both as contractors and managers - with a growing and far-reaching network of Hygiene Service Managers, providing services across the UK. We believe the best cleaning, hygiene, and waste disposal solutions are provided by people who: * Intimately know the spaces they service. * Expect uncompromising work from themselves and their co-workers. * Enter each project with full knowledge of the necessary standards and regulations.
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For all your redecoration needs come to us for a clean and reliable service. Competively priced Our customer service is second to none and we work with clients to achieve the best for your home. Free quotations and we will beat any legitimate quote. Call us last
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Tree Surgery, Hedge and Landscape Gardening Specialists Certified Tree Surgeons with over 21 years experience in all Trees. Fully Insured and Licenced. At Blue Rose Landscapes we pride ourselves on our reliability, a friendly approach and most importantly, our knowledge of the industry. We have years of experience working for numerous commercial and domestic clients. We know that customer satisfaction is key to business, so we ensure the highest standards of work at a highly competitive and reasonable rate. Our Services are as follows: Tree Surgery Hedge Cutting Garden Maintenance Areas Shingled/Barked Mowing Turfing Landscape Gardening Fencing Patios Decking Driveways Astro Turf Garden and House Clearances Removal of Sheds and Containers Overgrown Garden Makeover For any advice or a free quote please contact us.
Elegance Home Cleaning
Elegance Home Cleaning are a friendly family run business with the aim to offer good value for money and excellent service that really makes a difference. We are equipped for the cleaning of all domestic properties and commercial premises such as B&B`s, offices, Pubs restaurants and many more. Elegance Home Cleaning are able to supply a full range of cleaning schedules such as: daily, weekly, monthly and one off cleans ranging from dusting and vacuuming to full deep clean and specializing in professional oven and carpet cleaning using only non-hazardous bio friendly safe products.
G.S.L Cleaning Solution Ltd
G.S.L Cleaning Solution Ltd are a family run business providing a full range of cleaning services for the commercial and domestic market. We have both the expertise, and equipment to deal with any cleaning need regardless of the nature of the work, or size. Our reputation has been built on hard work, honesty, integrity, reliability, and professionalism. We always offer a warm welcome to any new customers that wish to use our services.
With our Window Cleaning we utilise the Reach & Wash system. This ladderless system is also environmentally friendly as it uses virtually 100% pure water that aggressively pushes away dirt without the need for chemicals or detergents. If you have a 2-4 storey building, and your current window cleaner is still using ladders or hydraulic equipment, then this window cleaning system has five advantages for you: Frames & Sills – In addition to the glass, the window frames and window sills are also cleaned. Quality – This method cleans windows more thoroughly so even when the sun comes out there are no marks and lines like those typically left by squeegees and scrims. nd scrims. Health & Safety – Significantly reduces the risk of an accident to the window cleaner. Cost – It saves having to hire lifting equipment, and reduces the time required (no time is wasted climbing up and down ladders) Damage – It reduces the risk of damage to property typically caused by ladders (eg cars, sills, slates, tiles and gutters.)
Window cleaning using ultra pure harvested rain water
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Commercial cleaning company. We clean offices, factories p, windows, retail units and domestics
Drainage Care UK
Drainage Care UK offers its services across the whole of Southampton, Bournemouth and Salisbury. We can carry out drain unblocking, cctv drain surveys, drain repairs, septic tank emptying and water pipe replacements. 24/7 Emergency call out service all year round
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window cleaning we offer a competitive price and quality service
Hepburn Installations
At Hepburn's we pride ourselves in providing the best possible service to our customers. We are able to take on most job enquiries from building flatpack furniture to loft & garage conversions. We always focus on quality and will always try and do this at the best possible price.
Window cleaning using Harvested rain water then filtered to make it pure for perfect eco friendly clean windows
Pro-Tints & Graphics
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JACKSONVILLE, Fla. - It's a heroic act that's free and easy to do, and you never know who you might be saving.
The purpose of World Blood Donor Day on Thursday is to remind people how important is to donate.
The Blood Alliance said one pint of blood can save three lives, and those lives you're saving are right in your own backyard because all blood donated through The Blood Alliance goes straight to hospitals in Jacksonville.
The summer months are a crucial time for needing blood, according to The Blood Alliance.
MORE ONLINE: The Blood Alliance | LifeSouth Community Blood Centers
"People are off their regular routines and they're not coming into donate blood so you have more people on the roads and perhaps more accidents so the blood usage goes up," said Odette Struys, director of The Blood Alliance. "Coming into hurricane season it's very important to have blood donation on your hurricane checklist, save a life, check! It's very important because we need to have that supply robust before something happens. The blood needs to be there when you need to use it rather than after the fact."
89-year old Mary Love Strum has donated about 150 pints of blood, so much that the people at The Blood Alliance know her by name.
"It does not hurt one bit, if it did I wouldn't go," Strum said. "They do those needles beautifully, just goes right in and it takes only 10 or 15 minutes to give blood."
Copyright 2012 by News4Jax.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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|Kalyn's favorite Phase One Recipe this month was Spicy Mexican Slaw with Lime and Cilantro.
(You can use the label Low-Glycemic Recipe Round-Ups to see all the posts like this one.)
Phase One Appetizers and Condiments:
Double Dill South Beach Diet Friendly Tartar Sauce from Kalyn's Kitchen
Chipotle Lime Deviled Eggs from Kalyn's Kitchen
Ricotta and Herb Stuffed Mushrooms from Eggs on Sunday
Spring Cheese Spread from Palachinka
Phase One Soups, Stews, and Chilis:
Pea and Spinach Soup from Souvlaki for the Soul (skip the croutons)
Mediterranean Eggplant Soup from Bleeding Espresso
Zero Points Asian Soup from A Veggie Venture (a Weight Watchers recipe which also works perfectly for phase one)
Phase One Salads and Salad Dressings:
Hearts of Palm Salad with Tomatoes, Olives, and Feta from Kalyn's Kitchen
Spicy Mexican Slaw with Lime and Cilantro from Kalyn's Kitchen
Tuna and Iceberg Salad from Cooking By the Seat of my Pants
Egg Salad with Mozarella, Asparagus, Capers, and Pesto from Lucullian Delights
Kale and Hearty Salad from Diet, Dessert, and Dogs
Mixed Greens, Cilantro, and Purple Cabbage Salad from Gluten-Free Mommy
Lemony Asparagus Salad with Goat Cheese from Confections of a Foodie Bride
Sesame Chicken Salad from Coconut and Lime
Warm Spinach Salad with Roasted Garlic Dressing from Culinary in the Country
Fennel Remoulade from Cook (almost) Anything At Least Once
Salad of Grilled Shrimp and Wilted Mustard Greens from White on Rice Couple
Seafood Fennel Salad from Kits Chow
Phase One Vegetables:
Grilled Asparagus with Parmesan from Kalyn's Kitchen
Stir-Fried Spinach with Garlic and Parmesan from Kalyn's Kitchen
Green Beans with Garam Masala Butter and Toasted Hazelnuts from Steamy Kitchen (use olive oil instead of butter, or half butter/half olive oil)
Spinach Mousse from Kits Chow
Asparagus with Asparagus Dip from Becks and Posh
Cauliflower Bell Pepper Masala from Daily Musings
Brussels Sprouts in Sour Cream Onion Sauce from Noshtalgia
Mustard Greens from Simply Recipes
Asparagus with Miso-Sesame Sauce from The Perfect Pantry
Soy Lemon Sauce for Broccoli from Peanut Butter Etoufee (replace sugar with Splenda)
Lemon Asparagus from The Cookbook Junkie
Asparagus Noodles from A Veggie Venture (trans-fat free margarine would be more South Beach friendly, but I'd splurge on the tiny bit of butter here)
Phase One Meat, Chicken, or Fish Entrees:
World's Easiest Roasted Tilapia from Kalyn's Kitchen
Pesto Fish with a Side of Green Beans by Gluten-Free Mommy
Sausage and Pepper Skewers from Green Lite Bites
Chicken with Basil and String Beans from Cooked From the Heart
Pan-Seared Tilapia with Avgolemono Sauce from Closet Cooking
Garlic-Lovin' Salmon from Dine and Dish (substitute olive oil for butter)
Grilled Sausage with Peppers and Onions from Delish
Citrus Baked Snapper from Cookie Madness (skip the rice)
Wildly Aromatic Pork Chops from Food Stories (trim fat from pork chops and skip the salad)
Halibut and Red Pepper Souvlaki with Green Herb Sauce from Mediterranean Cooking in Alaska
Asian Infused Tilapia with Baby Bok Choy from Sidewalk Shoes (skip the rice for phase one)
Simple Flank Steak from Daily Unadventures in Cooking
Mushrooms Stuffed with Lamb from Farmgirl Fare
Moroccan Chicken from Kitchen Parade
Spetsofai (Sausage and Peppers) from Kalofagas - Greek Food and Beyond
Spicy Grilled Chicken with Ajwain from Tigers and Strawberries
Garlic Chicken with Balsamic Vinegar from Mele Cotte
Phase One Vegetarian Entrees:
Braised Lentils from Canela & Comino
Sauteed Tofu with Agretti and Cherry Tomatoes from Lucullian Delights
Rajma with Green Peppers from Ahaar (skip the potatoes)
Cumin Spiked Tofu from 101 Cookbooks
Baked Portabello Salad from Tasty Palettes
Pan-Fried Eggplant with Crumbled Feta from Leite's Culinaria
Phase One Breakfasts:
Saturday Morning Egg Muffin Melts from Kalyn's Kitchen
Zucchini and Eggs from Mediterranean Cooking in Alaska
Soft Scrambled Eggs with Fresh Ricotta and Chives from Eggs on Sunday


text:
There's never been a better time
to apply to Otterbein University.
Apply online today!
Check out our schedule of events for a new reason to come to campus every day. From concerts, shows and lectures open to the public to game and movie nights just for students. You'll find it all right here.
Otterbein University faculty and students will come together for a one-day festival that will explore the subject of how athletes might use their notoriety and reputations to bring about social good. The theme of the festival is Good Sports: Playing for Social Change.
The keynote event is a presentation by Brendan Tuohey, the co-founder of PeacePlayers International, in Riley Auditorium of Battelle Fine Arts Center at 3:30 p.m. on Wednesday, February 27.
"We call an athlete a good sport when he plays fair on the field and within his game," says Dr. Jim Gorman, co-director of the Symposium. "But what about beyond the field and outside the game? Might the good sport label also describe athletes who work to improve fair play in the larger society? Brendan Tuohey certainly believes so."
Brendan and his brother Sean use the sport of basketball to overcome deeply entrenched barriers between antagonistic groups. Since the year 2000, PPI clinicshave shown children around the world how to "play together (so they) can live together."
Clinics in Northern Ireland, South Africa, Israel and the West Bank, and New Orleans, have brought the PPI peace curriculum to over 58,000 children.
Brendan Tuohey says: "In communities where one group plays soccer, another Celtic football, we introduce a new sport, basketball. Early on, kids get hooked on just learning the game. Then we mix and match the teams, 'twinning' kids from the opposing groups. Kids start cooperating with each other because winning is fun."
The symposium will also introduce Otterbein students to some local good sport programs. Robin Ungerleider, the Community Development Director and Program Specialist for the Columbus Crew, will speak at 9:15 a.m. in the Otterbein Chapel, describing how the Crew Soccer Foundation works with at-risk youth.
Ungerleider said: "Our missions are literacy, soccer field creation and restoration, and wellness. This summer's new program was a partnership with the Metropolitan Library. It was called "Get a Kick Out of Reading. We challenged kids to read for 90 minutes (the length of soccer match). If they did that each week through the month of August, they earned tickets to our opener. Over 200 kids participated."
Completing the day's events will be a showing of the feature film Invictus, about how newly elected South African President Nelson Mandela used the sport of rugby to promote cooperation between whites and blacks.
Mandela asked the mostly white players of the national rugby team to introduce their game in black townships. The players were surprised and inspired by the enthusiastic acceptance of the game by black youth. They are also inspired by Mandela and his story of personal sacrifice for a higher cause, leading them to inspired play—and victory—in the 1995 Rugby World Cup.
Invictus will be shown in Roush Hall 114 at 6:30 p.m.
Admission is free to all three events, though please call Jim Gorman, 614-823-1133, to discuss seating availability.
Otterbein University, 1 South Grove Street, Westerville, OH 43081 614.890.3000
Otterbein University is a private, non-profit, United Methodist affiliated, regionally-accredited institution.
© 2017 Otterbein University. Otterbein University is an affirmative-action, equal-opportunity employer


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Some Interesting AnagramsLanguage brain teasers are those that involve the English language. You need to think about and manipulate words and letters.
Rearrange the letters to form new words, phrases, places, or names.
The words in parentheses are hints.
ONE ON ALP (conqueror)
SEEK A PHRASE (playful fellow)
KNEE CRUTCH ART (great ballet)
NONE MISTER (soup)
TOXIC NAME (April agony)
AnswerONE ON ALP - Napoleon
SEEK A PHRASE - Shakespeare
KNEE CRUTCH ART - The Nutcracker
NONE MISTER - minestrone
TOXIC NAME - income tax
HE BUGS GORE - George Bush
What Next?
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text:
you can ride a bic better than anyone of us! COOL!
Tragic thing that happened, and children should stay off delicate threads like this one.
Gnargnar please don't respond back because all you will do is make yourself look like a fool, and it wont get a rise out of anyone. Sorry:o


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The Bell application states:
Bell proposes a sports talk format targeting francophone males aged 18 to 54 to be known as RDS Radio. Bell states that the station would respond to the strong demand for sports programming recently created by the loss of CKAC's all-sports format, and would repatriate the lost francophone male 18-54 tuning and advertising revenue to the French-language radio market. Bell added that the service would be complementary, rather than directly competitive, with existing Montréal radio stations.
Here's Jason Magder's Gazette story on the plan to create RDS 690.
RDS's own story on the switch.
English radio broadcasts, which were carried on TSN 990 last season, would be moved to CJAD 800, which Bell is acquiring as part of its proposed purchase of Astral Media, a deal that requires CRTC approval.
Should its purchase of Astral be approved, Bell would become owner of CJAD and two Montreal FM music stations, Virgin Radio and CHOM. These additions to TSN 990, which Bell owns already, would the media colossus in contravention of a CRTC regulation that limits ownership in any market to three stations in the same language.
By switching to French all-sports, Bell's English holdings in Montreal are reduced to the aforementioned trio of Astral stations.
Expect the sewage to hit the ventilation system big-time in Montreal as fans react to the loss of TSN 990.
The move comes less than a year after BEll received CRTC permission to change the English all-sports station's frequency from 990 to 690, citing improved reception at the latter frequency in the western parts of Montreal island.
From the CRTC file:
Bell Media stated that the reception of station's night-time signal is poor in Montréal, especially in the west end, and that the use of 690 kHz, which would result in better night-time protection as well as fewer constraints for protecting third adjacent signals, would bring a significant improvement to CKGM's night-time coverage. As well, because 690 kHz has superior propagation qualities, the applicant indicated that the signal received in Montréal would be of better quality, daytime and night-time.
In seeking the frequency change, Bell told the CRTC technical problems had been a contributing factor in the poor financial performance of the erstwhile Team 990, which almost almost $5 million from 2007 to 2011.
The CRTC will conduct hearings on Bell's latest applications in September.
It's expected the Canadiens broadcasts will remain on TSN 990 for the 2012-'13 season.
French radio coverage of Canadiens games – which used to be on CKAC – is on 98.5 FM, a Montreal station that Bell doesn't own.
• Former Canadiens general manager Pierre Gauthier is joining the Chicago Blackhawks as director of player personnel. He replaces Norm MacIver, who's been promoted to become Hawks general manager Stan Bowman's assistant.
That job was held by Marc Bergevin until the Canadiens hired him to succeed Gauthier.
• NHLPA main man Donald Fehr sounded reasonable after the Tuesday negotiating session. Chris Campoli is standing behind him in the video.
• An idea whose time has come: The Scotch martini


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According to section 102 of Title 17 copyright protection does not extend to ideas, procedures, processes, systems, methods of operation, concepts, principles, or discoveries, regardless of the form in which they are described, explained, illustrated, or embodied.
In other words facts, ideas and slogans cannot be copyrighted; only the expression of ideas. A live performance such as a lecture or a sermon or a concert cannot be copyrighted. The video tape or audio tape of the concert is copyrighted as is a transcript of a lecture or sermon.
The quality of a work, its aesthetics, similarity to another work and even the amount of effort (or lack thereof) put into creating a work is irrelevant to copyright protection. Copyright rewards originality, not effort.
A good example of similarity is the oft told tale of forbidden love. It has been retold over and over again in a variety of scenarios as in Romeo & Juliet vis-à-vis West Side Story. The theme is not copyrightable but the details reinvented with each new telling are.
A good example of effort viz a viz creativity is a telephone book. A telephone book takes a great deal of effort to create but cannot be copyrighted because it is only a list of facts - names, addresses and phone numers. On the other hand a subject arrangement of those same facts are copyrighted because there exists some creativity -- minute though it may be -- in the development of a subject listing of names, address and phone numbers.


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PRBAMR48VC Vertical Carbonized 48" Bamboo Riser Prefinished
5/8" X 7-1/4" X 48" Stair RiserPlaced upon a stair riser's step face, matching the lower stair tread or hardwood floor.
Do you have questions about this product?
AnswerBox - Get answers from Staff Experts and real customers by clicking "Ask a question" or click here to ask our Customer Service Team
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text: Son of Capt. Albert Franklyn Howland and Emma Harvey Hallett, of New Bedford, MA. He was a dealer of library furnishings and, in this capacity, became acquainted with Anne Nicholson Wallace, director of the Carnegie Library of Atlanta, GA, whom he married in 1908. The couple had at least one son, Wallace.


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Balsamic Chicken Thighs
Submitted by: Darlene P.
Oh, this is so delicious and tender. My husband can't wait for me to make it again. If you are serving this with Jasmine rice, cook the rice first. Add a couple pats of butter to the rice when cooking.
- 1 LB of Boneless, Skinless Chicken thighs – about eight pieces
- 2 tablespoons of fresh cillantro, chopped
- 1-1/2 teaspoons of minced garlic
- 1 teaspoon of dried basil
- 1/2 teaspoon of salt
- 1/2 teaspoon of Pepper
- 2 tablespoons of minced green onion
- 1 teaspoon of garlic powder
- 2 tablespoons of EVOO light olive oil
- 1/2 cup of Balsamic Vinegar (buy the expensive one, it is better)
- 1 teaspoon of Worcestershire sauce
- 1/3 cup of Cream Sherry wine.
How to Make it:
- In a plastic bag, Mix the basil, salt, pepper, Sherry, Worcestershire sauce, garlic powder, minced onion, and balsamic vinegar.
- Mix it up, then add chicken to the mixture, be sure to cover the chicken in this sauce and set aside.
- Set your Instant Pot to Saute, add the olive oil and saute the minced garlic, stirring frequently.
- Set your Instant Pot to the Poultry setting, add the chicken and sauce from bag to the existing olive oil and garlic that is already in there. Close the lid, and cook for 15 minutes.
- When serving, sprinkle the chopped cilantro on top for a tasty treat.
- Serve with white Jasmine rice and your favorite vegetable. Your family will ask for more!
Sorry, I don't have a photo, We ate it too quickly!


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ANAHEIM Perusing discounted dresses Saturday, Brigitte Alvarez of Long Beach shopped at the Brides Against Breast Cancer wedding gown sale at the Anaheim Marriott. She's getting married in June in the Dominican Republic, and Alvarez, 24, and her mother, Terri, try to buy products that donate proceeds to cancer research and resources.
Terri, 48, was diagnosed with ovarian cancer 13 years ago.
"Thank God they caught it at an early stage," she said.
Brides Against Breast Cancer is a nationwide tour that offers future brides new and gently used wedding gowns at discounted prices. The tour visits more than 100 cities in a year offering anywhere from 750 to 1,000 gowns ranging from sizes 0 to 28. The dresses cost anywhere from under $100 to $3,500, and 71 percent of the sales fund programs and services that are free to cancer patients and their families
Tour manager Mya Widmyer said a portion of proceeds also goes toward the national organization's headquarters main branch, Center For Building Hope, in Sarasota, Fla., which offers free information, programs and services to cancer patients, caregivers and family members. Since Center for Building Hope acquired Brides Against Breast Cancer in January 2012, the organization has 10 members and three trucks that travel year round to offer the event at three or four different cities a weekend.
"One of my best friend's father passed away from brain cancer when we were in high school," Widmyer said. "I remember how hard it was, and if there were more (cancer support funding and resources) like there, the process would have been so much easier."
Corona resident Leticia Colocho sat in the dressing room with her family waiting for her youngest sister, Elizabeth, to try on six dresses she picked from the sales floor. Colocho, 33, has a grandmother who died of breast cancer five years ago, and has seen the number of patients diagnosed with breast cancer grow in her 13 years as a medical assistant at Kaiser Permanente in Corona.
Colocho has assisted in every stage of breast cancer treatment from the mammogram to plastic surgery after a mastectomy, and said the women who are affected are getting younger. Though breast cancer was once a trend for women in their 30s and 40s, Colocho said she has met girls diagnosed in their teens and 20s.
Daniela Onel, 36, is a Santa Monica resident getting married in Romania, her native country, next April. She came to the event with her best friend, Lauren Ohlsson, 31, who told her about finding a dress at the same event last year. Onel said she recently received news from home that one of her mother's breasts is "changing," but she hopes it is nothing serious.
Discounted prices aside, Onel and Ohlsson were enthusiastic about the charitable benefit of purchasing their dress at Brides Against Breast Cancer.
"You only wear a wedding dress once," Ohlsson said. "For the amount you pay, it's great that part of it can go toward a good cause."
Widmyer expected 60 to 65 brides to attend Saturday's event and saw 45 people walk through the doors Friday. She said every tour stop sees anywhere from 75 to 300 brides, depending on the event's location. Brides Against Breast Cancer's next local stop is the Mount Palomar Winery in Temecula on April 20.
Contact the writer: (714) 796-3543 or firstname.lastname@example.com


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Buy four shows and save. (Don't worry, ticket exchanges are free.)
Subscriptions must comprise an equal number tickets to each show. Prices subject to change after July 23.
Subscription discount applies to Opera House and Harvey Theater presentations only. BAM Fisher presentations are all $25 and are eligible for a subscription package.
Trailers, interviews, and exclusive videos from the 2016 Winter/Spring Season.
Trailers, interviews, and exclusive videos from the 2015 Next Wave Festival.
Watch highlights from the 2015 season of Eat, Drink & Be Literary, featuring Jane Smiley, Lydia Davis, Joseph O'Neill, and more.
Filmmakers, playwrights, scholars, and other luminaries discuss their work at BAM.
Watch highlights from the talk featuring Pumla Godobo-Madikizela, author of the book A Human Being Died That Night, and Bryan Doerries.
Highlights from Dr. Jane Goodall's lecture at BAM on April 15, 2015.
Watch highlights from our March 2 talk with Nathan Lane and Brian Dennehy.
Video from the entire 2014 season of Eat, Drink & Be Literary, featuring Salman Rushdie, Alison Bechdel, Jeffrey Eugenides, and more.
Trailers, interviews, and exclusive videos from the 2014 Next Wave Festival.
The StoryCorps Military Voices Initiative helps bridge the gap in understanding between military families and civilians. It provides a platform for post-9/11 veterans, service members, and their families to share their stories with the public through monthly broadcasts on NPR. These short films honor their voices and experiences.
An all-star tribute to the sounds of contemporary Cuba. Recorded live on December 1, 2012, at the BAM Howard Gilman Opera House.
This documentary series follows the travels of Hubbard Street Dance Chicago, Doug Varone and Dancers, Illstyle & Peace Productions, and Spectrum Dance Theater to Nepal, Ukraine, Morocco, and beyond, using dance to build mutual understanding.
See past live music performances at BAM.
An incredible array of clips from throughout BAM's history.
Trailers and other highlights from the 2013 Next Wave Festival.
Highlights from the 2013 Winter/Spring Season.
See all things related to Philip Glass and Robert Wilson's unforgettable opera.


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Chipmakers wrestle with EOS, ESD and other power-related issues as leading-edge chips are incorporated into industrial and automotive applications.
After two decades of experimentation, the semiconductor industry is scrambling to embrace this approach.
Next-gen embedded memory technology ramps up in wake of flash scaling issues.
Race begins to figure out what else can be done with data. But not all data is useful, and some of it is faulty.
The mundane aspects of a system can make or break a solution, and interfaces often define what is possible.
Device degradation becomes limiting factor in IC scaling, and a significant challenge in advanced SoCs.
How cost-sensitive are IoT edge devices, what are the real drivers for this industry, and what is the impact on EDA and IP?
Dynamic power density and rising leakage power becoming more problematic at each new node.
In a world that favors digital circuitry, analog has increasingly had to cope with processes that have become less favorable to them. But that may be changing
Just relying on faster processor clock speeds isn't sufficient for vision processing, and the idea is spreading to other markets.
Timing and variability have long been missing from automated transistor-level simulation tools. At advanced nodes, an update will be required.
Minimizing power consumption for a given amount of work is a complex problem that spans many aspects of the design flow. How close can we get to achieving the optimum?
System-Level Design
Low Power-High Performance
Manufacturing & Process Tech
Packaging, Test & Electronic
IoT, Security & Automotive


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Police: Man snatches purse from 86-year-old woman
Published: Thursday, April 11, 2013 at 8:38 a.m.
Last Modified: Thursday, April 11, 2013 at 8:38 a.m.
A Gainesville man was arrested Wednesday on allegations he snatched the purse of an 86-year-old woman as she walked along a street, police reported.
Ernest Cook Jr., 49, of 904 NE 18th St., was charged with robbery by sudden snatching and burglary, according to Gainesville police arrest reports.
The woman told police she was walking along Southwest Fourth Place at about 6 p.m. when a man on a bicycle snatched her purse off her shoulder and rode south on Main Street. The purse contained about $300 in cash and other items.
Surveillance video from the nearby St. Francis House homeless shelter shows a man later identified as Cook riding by just before the robbery and then afterward carrying a black purse, the report states.
At 6:23 p.m., police were sent to an area of 1200 SW 14th Ave. regarding a man seen jumping a fence.
GPD Officers, including Officer Matthew Holt with his police dog Rua, caught the man, identified as Cook. Officers retraced his path and found money, items from the purse and the bike, police reported.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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Beauty and the Geek Australia, Channel Seven, 8pm
THE makeovers are the favourite part of this series for me and many others, so spinning them out over two eps works. Tonight it's the turn of Jason, Rich, Chard and Yiran. But before we get there, work needs to be done. The girls must be tutored in geography and, while I know it's wrong, their abject ignorance actually made me laugh out loud. Meanwhile, the challenge for the boys centres around their interpersonal skills, and I've always found something genuinely sweet about these men trying to negotiate their first boy-girl relationships. What a terrifying prospect, but how kindly and sensibly the girls steer them away from ''pick-up'' lines such as ''You're so hot you de-nature my proteins'' and on to a more productive path. When the boys are finally sent on their dates it's not what they - or we - expect.
Redfern Now, ABC1, 8.30pm
THIS second ep isn't quite as strong as the first. It doesn't have quite the light and shade, quite the power, quite the same deftness in the script or performances. But it's still a fabulous hour of drama. It's dominated by Coral (Tessa Rose), a cantankerous ''aunty'' who shows little patience with the local louts and layabouts, isn't afraid to let them know, and is even less afraid to voice her profoundly un-PC and sometimes outright racist views. One of the terrific things about this series is the way it simultaneously showcases the unique aspects of urban indigenous life and highlights the common ground all of us share, and I'm pretty sure most of us have an acerbic, know-it-all elder in the family such as Coral. This is also a story of young love, featuring NIDA and WAAPA graduate Shari Sebbens and impressive new kid Rhimi Johnson Page.
The Unbelievable Truth, Channel Seven, 9.30pm
THESE panel shows stand or fall on the talent behind the desk - and in tonight's ep, The Unbelievable Truth really fires. Lining up to deceive their panelmates are Scott Dooley, Celia Pacquola, Stephen K. Amos and Julian Morrow, and what a fine job they do of it on subjects from Barbies and motorcycles to cakes and stars.
Cougar Town, Channel Seven, 11.30pm
I FINALLY figured out what bothers me about Cougar Town. It's not so much the weird cocktail of mean, dumb people who care deeply about each other. That transgressive dynamic has fuelled sitcoms for years (Married with Children, for instance). And Cougar Town is actually a polished piece, handling its running gags deftly and letting its characters develop beyond their one-liners. No. What really bothers me about Cougar Town is the way it celebrates narcissism, from the opening moments of season one, when a physically perfect Jules (Courteney Cox) pinches disconsolately at her thighs, to tonight's ep where the big through-line is the utter self-obsession of both Jules and Ellie (Christa Miller). The kindest reading is it's satirising contemporary culture's ''me'' agenda. Except we're obviously supposed to adore Jules, and god knows millions do.
CSI: Miami, Channel Nine, 9.30pm
IF YOU tune in to any of the CSI franchises expecting a gritty crime thriller, you're bound to be disappointed. But there's no doubt the various series have created their own universe, and none more so than Miami. There's David Caruso's Horatio Caine for starters, a character so distinctively mannered and larger than life he's been parodied on Sesame Street. There's the rhythms of the dialogue, a combination of in-your-face exposition and terrible gags and puns. (I thought in this ep - all about stables - that they'd missed their chance for a ''roll in the hay'' gag, but no, they went there.) There's the technology, which despite its superpowers, presents as just one step up from Dexter on Perfect Match. And there's the structure, which leads us red herring by red herring to the shocking reveal of the perp in the closing 90 seconds. Tonight's instalment will not disappoint.


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Current Management of Primary Central Nervous System Lymphoma
Current Management of Primary Central Nervous System Lymphoma
Primary CNS lymphoma is rising in incidence in both the AIDS and non-AIDS populations. It is a non-Hodgkin's lymphoma that usually presents as a brain tumor, but the leptomeninges, eyes, and spinal cord also are frequently affected. Systemic lymphoma is not present, and comprehensive systemic staging is unnecessary, but appropriate neurologic staging is imperative. Standard therapy has been whole brain radiotherapy, giving a median survival of 12 to 18 months in non-AIDS patients, but only 2 to 5 months in AIDS patients. In non-AIDS patients, the addition of chemotherapy to radiotherapy has improved the prognosis, with median survivals of 30 to 45 months. Current protocols focus on the development of combination chemotherapy programs and reducing the dose of cranial radiotherapy to minimize late neurologic sequelae. The addition of chemotherapy to brain irradiation prolongs survival in some patients with AIDS-related disease, but median survival is not significantly improved.
Primary central nervous system (CNS) lymphoma is a non-Hodgkin's lymphoma that arises within and is restricted to the nervous system. It usually presents as a brain tumor, but may also involve the leptomeninges, eyes, spinal cord, or any combination of these sites [1]. Formerly, the disease was rare, representing less than 1% of all intracranial tumors, but since 1974 there has been at least a threefold rise in incidence in apparently immunocompetent patients. It has also been recognized for decades that primary CNS lymphoma occurs with increased frequency in patients with congenital (eg, ataxia-telangiectasia) or acquired (eg, renal transplant recipients) immunodeficiencies. It is now most common in patients with the acquired immunodeficiency syndrome (AIDS), as many as 6% of whom develop primary CNS lymphoma during their illness. It is so characteristic of the immunosuppression associated with AIDS that it is classified as an AIDS-defining illness in HIV-infected individuals.
Historically, treatment of primary CNS lymphoma was surgery followed by cranial irradiation; the median survival was 12 to 18 months, and the 5-year survival rate, 3% to 4% in immunocompetent patients; immunosuppressed individuals fared worse. Survival figures with this treatment approach were consistent in numerous retrospective series evaluating small numbers of patients (20 to 30) collected over several decades. These studies also demonstrated the aggressive biologic behavior of primary CNS lymphoma, with untreated patients surviving only a few months. Furthermore, the collected series suggested that surgical resection had no significant therapeutic role in the treatment of this disease, because survival was not worsened if only biopsy for tissue diagnosis was performed. Because the disease was so infrequent, pursuit of more effective therapy seemed neither practical nor necessary.
In the early 1980s, physicians began to see a rising number of immunocompetent patients with primary CNS lymphoma, an increase later confirmed by epidemiologic data. During this time, the full force of the AIDS epidemic led to increased cases of AIDS-related primary CNS lymphoma, and recent studies demonstrate that the incidence continues to rise, as HIV-infected individuals survive longer [2,3]. These factors clearly highlighted the inadequacy of then-current therapy, and clinical trials were begun in an effort to improve treatment.
Biologic Behavior
To design an appropriate therapeutic approach, a number of issues concerning the biologic behavior of primary CNS lymphoma needed to be defined and incorporated into the treatment plan. Using the clinical staging criteria applied to systemic non-Hodgkin's lymphoma, primary CNS lymphoma is a stage IE lymphoma; that is, it involves a single extranodal site, the brain. Most patients with systemic stage Ie non-Hodgkin's lymphoma can be treated effectively with involved field irradiation. Focal radiotherapy achieves a complete response rate of almost 100% and can yield 10-year survival or cure rates of 70% in patients with stage I disease [4]. Using involved field radiotherapy (whole brain radiotherapy) for the treatment of primary CNS lymphoma does not produce comparable control of disease. Two possible reasons are that (1) disease exists outside the radiotherapy field and that (2) pathologically, primary CNS lymphoma has more aggressive biology than identical systemic lymphomas.
The issue of dissemination of disease is more easily addressed than the question of a fundamental biologic difference between primary CNS lymphoma and systemic lymphomas, but systemic and nervous system dissemination must be considered independently.
Systemic Dissemination Not a Factor
It has been hypothesized that an occult systemic lymphoma is the origin of primary CMS lymphoma, because the nervous system has no lymph nodes or lymphatics, and thus the source of malignant lymphocytes in the CNS must be from outside. If an occult systemic lymphoma accounts for disease in the nervous system, then primary CNS lymph- oma would simply be a stage IV lymphoma with an unusual and rare pattern of metastasis to CNS only. However, the evidence argues strongly against this hypothesis.
First, when systemic lymphoma spreads to the nervous system, it spreads to meninges and affects the brain in only 1% of patients [5]. In those few patients with brain metastases, the lesions appear late in the course of their illness and are associated with recurrent or uncontrolled systemic disease, often specifically with bone marrow infiltration or retroperitoneal adenopathy.
Second, patients with primary CNS lymphoma have no evidence of systemic lymphoma, either at diagnosis or at autopsy. At Memorial Sloan-Kettering Cancer Center, more than 100 non-AIDS patients with primary CNS lymphoma had a complete systemic evaluation at diagnosis, including body computed tomography (CT) scans, bone marrow aspiration, and biopsy, and not one had evidence of systemic lymphoma. There are two case reports of patients who presented with apparent primary CNS lymphoma and had systemic lymphoma on evaluation, but one patient had two histologically different lymphomas, and the disease in the second patient likely represented systemic metastases from untreated primary CNS lymphoma [6,7].
Autopsy studies have found systemic lymphoma in only 7% to 8% of primary CNS lymphoma patients, and most of these patients have a single site of microscopic disease believed to be a metastasis from their uncontrolled CNS tumor. Rare patients with primary CNS lymphoma develop clinically obvious systemic lymphoma, which may even develop in the context of undetectable cerebral tumor. In some of these patients, the systemic lymphoma may be a second primary, as primary CNS lymphoma is seen occasionally in patients with a variety of prior systemic neoplasms [8]; however, the development of systemic lymphoma is very unusual and does not represent the typical clinical behavior of primary CNS lymphoma.
These data demonstrate that systemic lymphoma is not a factor in the natural history of primary CNS lymphoma, and that treatment need not include therapy designed to eradicate occult systemic disease.
Nervous System Dissemination
Although systemic dissemination is not a factor when considering treatment of primary CNS lymphoma, dissemination within the nervous system must be considered (Table 1). Primary CNS lymphoma is confined to a single extranodal site, the central nervous system, but is almost always disseminated within it. This dissemination can take many forms and involve different compartments of the CNS. The brain is the most important site of disease and is involved in more than 95% of patients [1]. By magnetic resonance (MR) scan, parenchymal brain lymphoma is multifocal in about half of patients at diagnosis. However, autopsy and some radiographic studies have demonstrated that the contrast-enhancing lesions seen on scan can significantly underestimate the extent of tumor present within the parenchyma [9]. At autopsy, all patients have microscopic infiltration involving regions of brain and occasionally spinal cord that were radiographically normal. Consequently, the tumor burden is always greater than initially appreciated, and if enhancement on CT or MR scan measures blood-brain barrier integrity, all patients have some disease behind a relatively intact blood-brain barrier.
The Brain—The brain is the most important area of involvement by primary CNS lymphoma, but dissemination within other CNS compartments, such as the leptomeninges, eyes, and spinal cord, may also be important, and appropriate neurologic staging, including lumbar puncture and ophthalmologic examination, is imperative (Table 2). Primary CNS lymphoma tends to form mass lesions in periventricular locations. It is a highly infiltrative neoplasm and will usually traverse the ependyma to involve the ventricular surface. Lesions more peripherally located grow into the overlying leptomeninges. Leptomeningeal infiltration is so characteristic of primary CNS lymphoma that Shibata10 has postulated that malignant lymphocytes from the subarachnoid space are the source of primary CNS lymphoma and grow into the brain to form parenchymal mass lesions.
The Leptomeninges—In many patients, leptomeningeal involvement remains localized to areas adjacent to the parenchymal lesions, accounting for the absence of clinical symptoms or signs specifically suggestive of leptomeningeal tumor, such as cranial neuropathies or radiculopathies (!-Figure 1). In spite of the relatively localized leptomeningeal involvement seen pathologically, malignant cells are identified in the cerebrospinal fluid (CSF) of one third of patients at diagnosis; in an additional third, lymphocytes with a suspicious cytology are present [11]. Thus, there is a high incidence of at least microscopic CSF dissemination of primary CNS lymphoma at diagnosis.
In occasional patients, widespread leptomeningeal lymphoma with clinical evidence of subarachnoid tumor may be the presenting problem, but these patients are a distinct minority. Nevertheless, most patients have tumor within the leptomeninges, at the gross or microscopic level, and thus specific therapy must be directed against the CSF.
The Eyes—In addition to the leptomeninges, the eye is another important site of primary CNS lymphoma [12-14]. Embryologically and functionally, the eye is an extension of the nervous system. Occasionally, ocular involvement (as opposed to orbital lymphoma, which always represents systemic disease) occurs by direct extension of brain disease through the optic nerve or meninges, but more commonly it arises as an independent site of this multifocal process [15]. Patients may present with blurred vision or floaters, but clinically this may be hard to distinguish from more common benign ocular conditions, particularly in an older population. In the AIDS population, these symptoms may be confused with ocular infections, particularly cytomegalovirus (CMV) retinitis. In addition, about half of patients with ocular lymphoma have no visual symptoms.
About 12% to 18% of patients in whom primary CNS lymphoma began in the brain have ocular involvement at diagnosis.11 Conversely, lymphoma can begin in the globe, and 50% to 80% of patients with ocular lymphoma develop cerebral involvement during the course of their disease. Frequently, the latency from onset of ocular lymphoma to the appearance of CNS disease is many years. Ocular lymphoma is detected by slit-lamp ophthalmologic examination. Vitrectomy may demonstrate malignant lymphocytes, but such a biopsy may yield a false negative if the patient has been taking corticosteroids [12].
While the relationship between ocular and cerebral lymphoma has been known for years, ophthalmologic examination has only recently become part of the staging evaluation of patients with primary CNS lymphoma, and, therefore, clinically silent ocular infiltration was not detected previously. This has important therapeutic implications, since ocular involvement necessitates specific therapy, which is not administered in the course of standard whole brain radiotherapy. Neglect of ocular lymphoma not only results in progressive ocular disease with visual loss but also can lead to CNS relapse and an apparent failure of standard treatment.
The Spinal Cord—Parenchymal spinal cord involvement is rare and usually clinically evident; however, we have encountered a few patients with spinal cord infiltration missed at diagnosis and not covered by the initial therapy. Complete imaging of the spinal cord is not necessary in every patient with primary CNS lymphoma, but patients with neck or back pain, and symptoms or signs suggestive of myelopathy should have an enhanced MR scan of the entire spine. Very rarely, primary CNS lymphoma originates within the spinal cord, but localization of the disease is usually straightforward, since patients present with progressive paraplegia [1].
In virtually all patients, primary CNS lymphoma is disseminated throughout the nervous system at diagnosis. While almost all patients present with brain tumor(s), many will have involvement of the eyes, leptomeninges, spinal cord, or some combination of these sites. These regions must be incorporated into a treatment regimen or they will serve as a potential reservoir of untreated disease that will lead to subsequent relapse. Nevertheless, failure to cover sites of dissemination accounts for treatment failure in only about 10% of patients.
In about 90%, primary CNS lymphoma relapses occur in the brain, often at sites remote from the original tumor location. Some brain recurrences may be attributed to progression from ocular or meningeal sites, but uncontrolled brain lymphoma is the most likely source for the majority of relapses. Relapse within the irradiated field is common after focal radiotherapy for primary CNS lymphoma, unlike stage IE systemic lymphoma, indicating that primary CNS lymphoma is a more biologically aggressive disease than comparably staged systemic non-Hodgkin's lymphoma [16]. No molecular features responsible for this biologic aggression have been identified.


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Presque Isle…The Shriners Are Coming, The Shriners Are Coming!
It's hard to believe, but just about one year ago, I took the steps to become one of the many Master Masons that proudly don the Fez of the Anah Shrine in Bangor! Last years Ceremonial was held in Newport. The June Ceremonial will be held in Presque Isle at the Forum, this Thursday, Friday and Saturday!