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Managing the Peritoneal Surface Component of Gastrointestinal Cancer: Part 2
Managing the Peritoneal Surface Component of Gastrointestinal Cancer: Part 2
ABSTRACT: Until recently, peritoneal carcinomatosis was a universally fatal manifestation of gastrointestinal cancer. However, two innovations in treatment have improved outcome for these patients. The new surgical interventions are collectively referred to as peritonectomy procedures. During the peritonectomy, all visible cancer is removed in an attempt to leave the patient with only microscopic residual disease. Perioperative intraperitoneal chemotherapy, the second innovation, is employed to eradicate small-volume residual disease. The intraperitoneal chemotherapy is administered intraoperatively with moderate hyperthermia. Part 1 of this two-part article, which appeared in the January issue, described the natural history of gastrointestinal cancer with carcinomatosis, the patterns of dissemination within the peritoneal cavity, and the benefits and limitations of peritoneal chemotherapy. Peritonectomy procedures were also defined and described. Part 2 discusses the mechanics of delivering perioperative intraperitoneal chemotherapy and the clinical assessments used to select patients who will benefit from combined treatment. The results of combined treatment as they vary in mucinous and nonmucinous tumors are also discussed.
Part 1 of this two-part article, which appeared in the January issue of ONCOLOGY, described the natural history of peritoneal carcinomatosis including the dissemination associated with its evolution. Treatment issues related to the use of intraoperative intraperitoneal chemotherapy and peritonectomy procedures were also described. In part 2, the mechanics of delivering perioperative intraperitoneal chemotherapy are reviewed, and factors affecting the success of the combined treatment approaches are presented. Four clinical assessments that assist patient selection for combined treatment protocols are also discussed.
Techniques for Perioperative Intraperitoneal Chemotherapy
Hyperthermic Intraoperative Intraperitoneal Chemotherapy
In order to initiate hyperthermic intraoperative intraperitoneal chemotherapy, a series of tubes and drains (four drainage tubes and a single inflow catheter) must be placed within the peritoneal cavity through the abdominal wall (Figure 1). To prevent leakage of these tubes as they exit the abdominal skin, a purse string suture is used. Generally, the inflow catheter is placed at a site thought to be at highest risk for recurrent disease, because the greatest heat will be generated at this site.
Following tube placement, the selfretaining retractor is partially dismantled. It is reassembled to construct a frame approximately 4 in. above the anterior abdominal wall. A heavygauge monofilament suture is used to elevate the skin edges on the selfretaining retractor, and thereby, create a reservoir for chemotherapy solution within the abdomen (Figure 2).
A perfusion circuit is necessary to maintain a temperature of approximately 41.5oC within the peritoneal cavity (Figure 3). Inflow and outflow tubes are connected to roller pumps and a heat exchanger. A heater/cooler, which maintains a water temperature of 48oC flowing through the heat exchanger, is part of the apparatus. For most drugs, a 90-minute perfusion is indicated to achieve a maximal cytotoxic effect.
The drugs used intraoperatively for hyperthermic chemotherapy are mitomycin (Mutamycin), cisplatin, and doxorubicin or oxaliplatin (Eloxatin). The standardized orders utilized at the Washington Cancer Institute for this therapy are shown in Table 1. Following the completion of the intraoperative chemotherapy, the self-retaining retractor is again positioned. At this time, all intestinal anastomoses are completed, seromuscular repairs of the bowel are performed, and the abdomen is closed. Usually, a fifth closedsuction drain is placed within the subcutaneous space. The skin is closed with a watertight, running monofilament suture so that no leakage of fluid occurs from the abdomen postoperatively.
Most patients who receive heated intraoperative intraperitoneal chemotherapy are also given early postoperative intraperitoneal fluorouracil (5-FU) or paclitaxel. The catheters for drug instillation and abdominal drainage must be kept clear of blood clot, fibrin clot, and tissue debris. To accomplish this, an abdominal lavage utilizing the same tubes and drains as used for the heated intraoperative chemotherapy is initiated in the operating room. Large volumes of fluid are rapidly infused and then drained from the abdomen after a short dwell time. The standardized orders for immediate postoperative lavage are shown in Table 2.
Early Postoperative Intraperitoneal Chemotherapy
If the patient recovers well from the cytoreductive surgery and intraperitoneal heated chemotherapy, then early postoperative intraperitoneal chemotherapy is initiated. At the Washington Hospital Center, early postoperative chemotherapy is initiated in all patients except those with very early disease and a low likelihood of tumor recurrence. The drugs employed in this chemotherapy are cell-cycle-dependent drugs. The standardized orders for early postoperative intraperitoneal 5-FU and early postoperative intraperitoneal paclitaxel are presented in Table 3. All the intra-abdominal catheters are withdrawn after fluid drainage is substantially reduced prior to the patient's discharge from the hospital.
Selection of Patients for Treatment Using Quantitative Prognostic Indicators
The greatest impediment to achieving long-term benefits from combined treatment with cytoreductive surgery and perioperative intraperitoneal chemotherapy is improper selection of patients. Patients with advanced disease experience minimal benefit and significant morbidity and mortality. Given the risks and benefits for patients with a large volume of invasive cancer, elective cytoreductive surgery should be withheld in this subgroup unless performed by the most experienced surgical teams.
Excluding pseudomyxoma peritonei and cystic mesothelioma, extensive cytoreductive surgery and aggressive intraperitoneal chemotherapy are not likely to produce a lasting benefit in patients with advanced peritoneal surface cancer from a gastrointestinal primary. Rapid recurrence of the peritoneal surface disease combined with progression of lymph nodal, liver, or systemic disease are likely to interrupt any long-term benefit. Asymptomatic patients with small-volume peritoneal carcinomatosis should be referred for treatment.
In the past, peritoneal carcinomatosis was a fatal disease process. The only assessment required was the presence or absence of carcinomatosis. Currently, four important clinical assessments of peritoneal surface malignancy are used to select patients who will benefit from the combined treatment: (1) histopathologic typing to assess the invasive character of the malignancy, (2) preoperative computed tomography (CT) of the chest, abdomen, and pelvis with maximal oral and intravenous contrast, (3) peritoneal cancer index determination, and (4) completeness of cytoreduction (CC) score.
Histopathologic Type and Biologic Aggressiveness of a Peritoneal Surface Malignancy
Noninvasive tumors arising in the appendix (pseudomyxoma peritonei) or from the peritoneal surface itself (cystic mesothelioma) may have largevolume accumulations within the abdomen and pelvis, and yet, may be made visibly disease-free with the use of peritonectomy procedures. Also, these noninvasive malignancies are extremely unlikely to metastasize via lymphatic channels to lymph nodes or via the bloodstream to liver or other systemic sites. Therefore, combined treatment with curative intent in patients with a large mass of widely disseminated pseudomyxoma peritonei or minimally aggressive peritoneal mesothelioma is appropriate. Pathology review and an assessment of the invasive vs nonaggressive nature of a malignant process are essential to treatment planning.[1]
Preoperative CT Scan
A preoperative CT scan of the chest, abdomen, and pelvis is required in planning treatment of a peritoneal surface malignancy. This radiologic examination is essential to exclude liver or systemic metastases and pleural surface spread. Unfortunately, the CT scan is an inaccurate test by which to quantitate nonmucinous carcinomatosis distribution and volume. The malignant tissue progresses as a layer on the peritoneal surfaces and conforms to the normal contours of the abdominopelvic structures-quite different from the metastatic process in the liver or lung, which show up as three-dimensional spherical tumor nodules and can be accurately assessed by CT.[2]
Fortunately, the CT scan is helpful in imaging mucinous adenocarcinoma on peritoneal surfaces.[3] These tumors produce large volumes of mucoid material, readily distinguishable from normal structures by anatomic location, shape, and density. A knowledgeable radiologic interpretation can also distinguish patients with a high likelihood of complete cytoreduction from those who would be designated for incomplete resections. The CT scan excludes patients who are unlikely to receive the benefit of a potentially curative approach from an elective operative intervention. Interventions in patients with advanced disease would be performed for symptom management, and the surgery would be of a palliative, minimally aggressive nature.
The two radiologic criteria found to be most useful in excluding carcinomatosis patients from elective intervention are segmental obstruction of the small bowel and the presence of tumor nodules greater than 5 cm in diameter on small bowel surfaces or directly adjacent to small bowel mesentery in the jejunum or upper ileum. Tumor involvement of the small bowel at the terminal ileum is not thought to be a contraindication to elective surgery, because disease at this site can be resected as part of the cytoreductive surgery.
These criteria reflect radiologically the pathobiology of carcinomatosis. Obstructed segments of bowel indicate an invasive malignancy where portions of small bowel lack peristalsis or become narrowed. Large, greater than 5 cm, mucinous tumor nodules on the small bowel or its mesentery indicate that the cancer is not redistributed away from the intestinal surface by peristaltic motion. Difficulties with dissection of the mucinous tumor from the small bowel signify the need for a palliative effort (Figures 4 and 5).
Peritoneal Cancer Index
The third prognostic assessment of peritoneal surface malignancy is the peritoneal cancer index, which is a quantitative indicator of prognosis derived from the integration of the size of the peritoneal implant and the distribution of nodules on the peritoneal surface (Figure 6). This index should be used in the treatment decision-making process while the abdomen is being completely explored. The choice between a definitive cytoreduction and a palliative debulking is greatly influenced by the peritoneal cancer index.
To arrive at a score, the size of the intraperitoneal nodules must be assessed in all abdominopelvic regions; the number of nodules is not scored, only the size of the largest nodule. A lesion score of zero (LS-0) means that no malignant deposits are visualized; an LS-1 signifies the presence of tumor nodules less than 0.5 cm in size; an LS-2 indicates that tumor nodules between 0.5 and 5.0 cm are present; and an LS-3 indicates the presence of tumor nodules greater than 5.0 cm in any dimension. If there is a confluence (layering) of tumor, the lesion size is scored as 3.
To assess the distribution of peritoneal surface disease, an LS is determined for each of the 13 abdominopelvic regions. The summation of the LS score is the peritoneal cancer index for that patient. The maximal score is 39 (13 * 3).
To date, the peritoneal cancer index has been validated in four separate situations: Ottow and colleagues used it successfully to quantitate intraperitoneal tumor in a murine peritoneal carcinomatosis model.[4] Portilla and coworkers showed that it could be used to predict long-term survival in patients with peritoneal carcinomatosis from colon cancer who are undergoing a second cytoreduction.[ 5] Berthet and coworkers showed that it predicted benefits for the treatment of peritoneal sarcomatosis from recurrent visceral and retroperitoneal sarcoma.[6] Sugarbaker showed that it could be used to predict the likelihood of long-term survival in colon cancer patients undergoing combined treatment.[7] In these studies, patients with a favorable prognosis had a peritoneal cancer index of less than 13.
• Exceptions to the Rule—Exceptions to the rules for using the peritoneal cancer index have been established. First, noninvasive malignancy on peritoneal surfaces may be completely cytoreduced even though the peritoneal cancer index is as high as 39. Diseases such as pseudomyxoma peritonei, cystic peritoneal mesothelioma, and grade 1 sarcoma fall into this category. With these minimally invasive tumors, the status of the abdomen and pelvis at completion of cytoreduction may have no relationship to the volume recorded at the time of abdominal exploration; ie, even though the surgeon explores an abdomen with a maximal peritoneal cancer index, it can be brought to an index of 0 by cytoreduction. In these diseases, the prognosis is only related to the condition of the abdomen after the cytoreduction (CC score).
A second caveat for using the peritoneal cancer index is related to cancer at crucial anatomic sites. For example, a small volume of invasive cancer incompletely resected from the common bile duct will result in a poor prognosis despite a low peritoneal cancer index. Invasion of the base of the bladder or unresectable disease on a pelvic sidewall may, by itself, result in residual invasive disease after maximal cytoreduction and eventuate in a poor prognosis. In other words, invasive cancer at crucial anatomic sites may function as systemic disease in the assessment of the prognosis with invasive cancer. Because only patients who undergo a complete cytoreduction can achieve long-term survival, residual disease at anatomically crucial sites will supersede a favorable peritoneal cancer index score.
Completeness of Cytoreduction Score
The most definitive assessment of prognosis to be used with peritoneal surface malignancy is the CC score. This information, however, is of less value to the surgeon in planning treatment than the peritoneal cancer index, because it is not available until after the cytoreduction is complete (the peritoneal cancer index is available at the time of abdominal exploration). If, during exploration, it becomes obvious that the cytoreduction will not be complete, the surgeon may decide that a palliative debulking, which will provide temporary symptomatic relief, is appropriate and may discontinue plans for an aggressive cytoreduction with intraperitoneal chemotherapy.
In both noninvasive and invasive peritoneal surface malignancy, the CC score is the major prognostic indicator. It has been shown to function with accuracy in mucinous appendiceal malignancy, peritoneal carcinomatosis from colon cancer, sarcomatosis, and peritoneal mesothelioma.[5-8]
For gastrointestinal cancer, the CC score has been defined as follows: A CC score of zero (CC-0) indicates that no peritoneal seeding occurred during the complete exploration. A CC-1 score indicates that tumor nodules persisting after cytoreduction are smaller than 2.5 mm. (This is a nodule size thought to be penetrable by intracavitary chemotherapy.) Both CC-0 and CC-1 scores would, therefore, be designated for complete cytoreduction. A CC-2 score indicates residual tumor nodules between 2.5 mm and 2.5 cm. A CC-3 score indicates residual tumor nodules greater than 2.5 cm or a confluence of unresectable tumor nodules at any site within the abdomen or pelvis. CC-2 and CC-3 cytoreductions are considered incomplete (Figure 7).


text: Fort Constitution has guarded Portsmouth Harbor since the eighteenth century, yet most of the fortifications date from about the time of the Spanish American War through World War II. Visitors gain access to the historic site through the Coast Guard station. Make sure to follow the blue line to the fort and don't try to explore the station or its... More

subset: commoncrawl


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Oh, Thank Heaven! 7-Eleven Gets
In on the Roasted Chicken Act
Move over, Boston Market. There's a new bird in town. 7-Eleven, home of the Slurpee, is adding roasted chicken, for the low, low price of $7.99, to its menu, according to a report in the Chicago Sun-Times. This comes on the heels of the Dallas-based convenience store chain's other new food options, among them rigatoni covered in Alfredo sauce. This means that those poor saps unable to afford a four-star restaurant's tasting menu can have a slumming très chic three-course meal.
For example, an appetizer of cream cheese jalapeños, followed by four-cheese ravioli with marinara and the roasted fowl, finished off with a package of fresh fruit. All of this can be paired with a 24-ounce bottle of crisp, refreshing Game Day Light, the store's brand brewski, which won the gold medal in the American Light Beer category at the 2010 U.S. Open Beer Championships. No kidding.
Unfortunately, the roasted chicken is only available in Chicago. The company calls it testing. It's unknown when it will arrive in the Dallas market (calls to 7-Eleven were not returned), but we're sure when it does, Dude Food will take one for the team and taste this potentially dry, life-threatening poultry.
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BOSTON ( TheStreet) -- Looking to build a career for yourself where there's healthy demand for you skills? Consider construction or health care. The U.S. Labor Department found recently that the building and medical trades boast eight of the 10 professions the agency expects will see the fastest job growth during the current decade. In fact, construction and health care host nine of the 10 fastest-growing jobs, if you count veterinary work as part of the medical field. "We see a large number of health care occupations on the list because there's going to be greater demand for medical care as baby boomers grow older," says Teri Morisi of the Labor Department's Bureau of Labor Statistics. Morisi says the BLS also expects construction jobs to boom as the building business rebounds from a big hit it took during the Great Recession. "We don't expect
the building industry to recover all of the jobs it lost during the steep decline of the most recent recession," she says, "but some construction occupations are expected to grow rapidly as the economy recovers." Unfortunately, junior-level positions such as home health aides and carpenter's helpers make up most of the jobs the BLS predicts will have the greatest growth rates. That means many fast-growing professions will pay less than the $34,460 median wage U.S. workers enjoyed last year, the latest period with BLS data available. Morisi believes companies are adding lots of lower-paying positions because bosses are shifting work to the least-costly employees capable of performing any given job duty. "Helpers or aides or assistants are less expensive to employ, but they can take on some higher-paid workers' tasks," she says. The expert also theorizes that employers can "offshore" some high-skills jobs, but can't move lower-paying, hands-on work such as home-health-aide duties overseas. Here's a look at the 10 professions the BLS predicts will enjoy the greatest percentage expansion of available jobs during the current decade. All projected increases refer to 2010-20 as a whole, a decade in which the BLS forecasts the average U.S. occupation will grow 14.3%. Median-pay figures refer to annual wages as of 2011.


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Tag: tartan
Tartan: Its Journey Through the African Diaspora
Our Collaboration The exhibition 'Tartan: Its Journey through the African Diaspora', opened with a BANG last Monday 4th August 2014 at Craft Central Gallery in Farringdon, London. Colourful Caribbean dancers, Caribbean and African musicians and a superb Scottish piper celebrated the exhibition opening in a most stupendous fashion. Sun and rum welcomed the guests, as did Designer Laura […]Keep reading
Burns Night
It is soon to be Burns Night, providing The Factory with the perfect opportunity to dig out some of the best Caledonian-related objects in our collection, and provide a little party inspiration. Burns Night is a delicious celebration held on the25th January, celebrating the life and works of the Scottish poet Rabbie Burns. The merriment […]Keep reading


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Isuzu N-Series / Elf I 11959 - ...
Model: N-Series / Elf (1959 - ...)
Wikipedia (N-Series / Elf): http://en.wikipedia.org/wiki/Isuzu_Elf
The cab-over 2-tonne (4,400 lb) Elf (TL221) was originally introduced in August 1959. It was originally only available with the 1.5 litres (1,491 cc) GL150 petrol engine with 60 PS (44 kW). It had single headlights and rear-hinged doors. A longer wheelbase version, on 2,460 mm (97 in) versus the 2,180 mm (86 in) of the regular version, was also available. This carries the TL251 chassis code.
In March 1960 a 2-liter diesel engine with 52 PS (38 kW) was introduced (TL121/151), a first for the class in Japan - this was soon followed by diesel models from Isuzu's competitors. In 1962 the engines were updated, and now have 72 and 55 PS (53 and 40 kW) respectively. The chassis codes were changed to TL321/351 for the diesel version, reflecting the installation of the all new DL201 engine. A little later, the chassis codes were reorganized and were now TLG10/11 for the petrol models and TLD10/11 for the diesels. In 1964 the long wheelbase model became the standard version. In 1964 the diesel was also upgraded to the larger 2.2 litre C220 with 62 PS (46 kW). In 1965 the front was redesigned, now with twin headlights.
Isuzu ended up offering a very wide variety of bodyworks for the first Elf. There was the original integrated bed, as well as a separate truckbed with dropsides. There was a double-cab version available, as well as special bodywork for dedicated purposes such as a soda truck, a dumper, and a tanker. There was also a "Route Van" model with a glazed rear compartment and seating either three or six, as well as the "Elf Bus" which was available in two models from 1960. The Elf Light Bus has integrated bodywork and the long wheelbase and seats 21 passengers (chassis codes BL171/271 for the diesel/petrol) while the Elf Micro Bus fit into the very narrow slot between the Route Van and the Light Bus. The Micro Bus originally had the Route Van's bodywork but was more passenger oriented (seating 12 or 15). It carried the TL121/151/21/251B chassis codes, and from 1961 it received its own rear bodywork with bigger glazing. The Elf Bus later became its own line, called the Isuzu Journey.
|Isuzu N-Series / Elf I
|800 x 547 ... 71 KB
|2016-01-16 udm


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Ciccarelliĺs Sports Bar Theater in Shelby Township will be the site of a live feed for tonightĺs ôThe X Factorö finale featuring Clinton Township vocalist Jeff Gutt.
The bar will host a hometown viewing party for Guttĺs family and friends, although the 37-year-old single father was raised in St. Clair Countyĺs Marine City.
There will be several live shots from the bar featuring Guttĺs sign-waving supporters, said the barĺs owner, Dino Ciccarelli, a former Detroit Red Wings star and hockey Hall of Famer.
ôThe place will be packed with everybody cheering and pulling for the hometown guy,ö Ciccarelli said. ôAnd some of Jeffĺs family members will be here to do live interviews.ö
Gutt is in competition with Alex and Sierra, who are currently at the top of the iTunes song list with ôGravity,ö and Carlito Olivero. Guttĺs song ôHallelujahö is in fourth place on the iTunes list.
The three finalists will square off on tonightĺs two-hour performance episode, and a winner will be chosen on Thursdayĺs two-hour finale, which will also feature performances by One Direction and Mary J. Blige.
Ciccarelliĺs Sports Bar Theater features 50 50-inch plasma TV monitors and surround-sound for optimal viewing of the vocal competition. Ciccarelli said he was hooked up with producers through a mutual friend and the production team liked what they saw in photos and video of the venue.
ôItĺs an enormous venue that can fit all of Jeffĺs family and friends and they have all this open space and huge TV screens, so itĺs a perfect place to come out and watch the show,ö said Breanna Theriault, an associate producer.
A satellite truck was at the venue on Tuesday as preparations were underway for the event. Producers have been in town for several days preparing video packages of people talking about Gutt that will air during the show.
ôThis is a special moment for Jeff,ö Theriault said. ôHe is so far away from home but heĺll be able to look at all of the support he has behind him from across the Detroit area.ö
Ciccarelliĺs has room for about 600 people who must be in place by 6 p.m.
Other bars in Macomb and St. Clair County are also getting in on the act.
Anitaĺs Riverfront Grill in Marine City held a sign-making party on Sunday and will host a viewing party at 6 p.m. today.
On Thursday, the Detroit Pub in Clinton Township will host a finale-viewing party with a performance by Guttĺs cover band, Punch. The event starts at 7 p.m.
ôThe X Factorĺsö two-night finale airs at 8 p.m. tonight and Thursday on WJBK-TV (Channel 2).
In a Facebook posting from over the weekend, Gutt expressed appreciation for the local support.
ôI know Iĺm late but just wanted to thank everyone who voted for me to get me into the finale! I had to go straight to work on next weeks songs and literally just got back to my room. Iĺve never been so happy & exhausted at the same time,ö he wrote.


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source GAIA package: Sx_MilitaryTimes_M6201110111210315_5675.zip Origin key: Sx_MilitaryTimes_M6201110111210315 imported at Fri Jan 8 18:18:05 2016
The Secret War: Fourth in a series
This series is the result of a six-month investigation by Army Times senior staff writer Sean D. Naylor. Naylor reached out to dozens of current and former diplomatic and military leaders and special operators about their activities in the Horn of Africa. It is a war few will acknowledge and even fewer will discuss. Nevertheless, Army Times was able to piece together a mosaic that shows the level of involvement by U.S. forces in Africa and the significant resources that have been employed — with mixed success — to hunt terrorists in Africa. Read parts 1-3
His tour over, John Bennett was preparing to fly home. The CIA's station chief in Nairobi, Kenya, Bennett had been running the United States' secret war in East Africa, negotiating with Somali warlords while hunting al-Qaida members across the region. On his watch, the United States and its proxies had managed to capture or kill at least 10 or so al-Qaida militants.
However, the most wanted al-Qaida figure in East Africa, who went by a variety of aliases but whom U.S. officials called Harun Fazul, was still on the loose. A native of the Comoros Islands wanted in connection with al-Qaida's 1998 attacks on the U.S. embassies in Nairobi and Dar es Salaam as well as the November 2002 attacks on Israeli targets in Kenya, Fazul had proved "a very savvy" enemy, according to an intelligence source with long experience in the Horn of Africa.
As Bennett made final preparations for his flight out of Kenya the evening of Aug. 1, 2003, his officers and Kenyan authorities were keeping tabs on an Internet café 274 miles to the southeast, in the city of Mombasa, where someone using an email address the CIA associated with al-Qaida in East Africa had been logging on. "There was a pattern of communications, so they were kind of on standby," the intelligence source said. "The pattern was the date, time and location at which somebody was accessing the Internet."
"Clearly, it was a favorite spot of somebody's," the source said.
Bennett had a case officer in Mombasa coordinating with the local police, the source said. That case officer was present when the Kenyan authorities arrived at the café to arrest the suspected al-Qaida emailer, only to find two suspects — both male, one larger than the other — instead of one. With the case officer on the phone with the Nairobi station reporting events in real time, the police placed both under arrest and were about to put them into a paddy wagon when the larger suspect, later identified as a young Kenyan named Faisal Ali Nassor, suddenly gave his companion a sharp shove and then pulled a grenade from his clothes. "One guy pushes the smaller guy away from him," said a special operations source with firsthand knowledge of operations in the Horn. "The [larger] guy blows himself up and takes the police out."
The explosion killed Nassor and a policeman. In the ensuing chaos, the other suspect made a run for it. To the surprise of the CIA and the Kenyan authorities, that man turned out to be Harun Fazul, East Africa's most wanted man with a $5 million bounty on his head. "Clearly we didn't expect to get Fazul himself," the intelligence source said. "We figured we'd get just his courier."
But rather than just being a courier, Nassor was "a suicide bodyguard," said the special ops source.
Security forces converged on the scene, but Fazul was too smart for them. He ran into a mosque and emerged disguised as a woman, wearing a hijab or some other form of Islamic facial covering. "He walked right out as a woman and nobody touched him," the intelligence source said.
Fazul had moved in with Nassor that July. Using an ID seized from one of them, the security forces went straight to their apartment. There they found Fazul's passport, a machine for making visas, "bits and pieces of other passports," as well as a light anti-tank rocket hidden in a couch, said the special ops source. But of Fazul himself, there was no sign. The wily operative had again given the authorities the slip. It would be another eight years before Fazul's tradecraft — and his luck — would fail him.
The search for Fazul typified much of the U.S. man-hunting campaign in the Horn: It combined CIA and special operations personnel (often working through local forces), high-tech gear alongside low-tech human intelligence skills and raw courage. And yet it was often characterized by frustration and near-misses.
For sheer drama, Fazul's escape with the help of his "suicide bodyguard" was rivaled by a similar disappearing act he pulled off a year earlier. On July 12, 2002, Kenyan police picked Fazul up in a Mombasa shop for purchasing jewelry with a credit card stolen during an armed robbery. But, according to a June 2004 Associated Press story, the cops had no idea of his true identity.
The next day, seven armed police officers took Fazul to what they thought was his apartment, hoping to find stolen goods. Instead, they discovered three women and a mentally handicapped man yelling at them. Fazul, who was not handcuffed, took advantage of the chaos to sprint out. "The man was well-trained, I tell you," one of the police said. "He dashed to the door like a monkey, then, like a flash, he slides down the stair rail like lightning." Fazul ran out and lost his pursuers in Mombasa's narrow streets.
Four months later, Fazul allegedly was a key participant in al-Qaida in East Africa's Nov. 28, 2002, twin attacks in Mombasa: the truck bombing of the Israeli-owned Paradise Hotel, which killed about 15 civilians, and the firing of two SA-7 man-portable anti-aircraft missiles at an Arkia Airlines Boeing 757 as it took off carrying 261 passengers bound for Israel. (Published reports said both missiles missed the plane, but the special ops source said a missile went through the tail without exploding.) No one was hurt.
Another near-miss in the hunt for the cunning al-Qaida operative occurred in the first half of 2003 during an operation in northeastern Kenya by Joint Special Operations Task Force - Horn of Africa, which fell under Combined Joint Task Force - Horn of Africa, based in Camp Lemonnier, Djibouti. JSOTF-HOA's search for Fazul, Operation Bowhunt, was a mission to develop intelligence and was "completely separate" from Operation Black Hawk, the CIA hunt for the members of al-Qaida in East Africa, according to the special ops source. "The other fellows [the CIA] were only going up north [i.e., into Somalia]. They weren't spending a great deal of effort down south [i.e., in Kenya] at all."
Key to Bowhunt was the high-speed vessel Joint Venture, an Australian-built catamaran designed for shallow-water access and leased by the U.S. military. JSOTF-HOA used it to probe the islands near the Kenya-Somalia border, looking for "the number-one HVT [high-value target]," as the source described Fazul.
"They actually met [Fazul's] wife down on one of the islands," but her husband slipped the net again, said the source. "They missed him by 24 or 48 hours."
Throughout the rest of the decade and into the next, as his colleagues in al-Qaida in East Africa and their local allies died in U.S. air and missile strikes or in combat with Somali Transitional National Government security forces or Ethiopian invaders, Fazul's status — and his legend — only grew. He escaped another dragnet Aug. 2, 2008, when dozens of Kenyan police raided a house in which he was believed to be staying in the coastal town of Malindi. The cops found two non-Kenyan passports bearing Fazul's photograph and a computer that had not been turned off, but the al-Qaida man was nowhere to be seen, according to the Kenyan newspaper The Daily Nation.
The following year, Fazul took command of al-Qaida in East Africa. In a speech in the Somali city of Kismayo marking his appointment, he vowed to spread jihad to Somalia's neighbors. "Praise be to Allah, after Somalia we will proceed to Djibouti, Kenya and Ethiopia," he said, according to a translation posted on the Long War Journal website.
When it came for Fazul earlier this year, the end was sudden, violent and completely unexpected. Late on the night of June 7, troops loyal to the Somali government (which controls little territory outside Mogadishu) stopped a black Toyota SUV carrying Fazul and driven by another militant, Musa Hussein, at a checkpoint on the outskirts of the Somali capital. When Hussein produced a pistol and reportedly fired a round, the government troops shot back, killing both militants. The Somali authorities did not initially realize they had killed Fazul, who was reportedly carrying a forged South African passport, $40,000, laptops and telephones, and buried the two militants quickly, before exhuming the bodies and comparing them to photos of Fazul.
Most published reports described the incident as simply the result of Fazul and Hussein getting lost, but a detailed account on somaliareport.com said Fazul was set up by Ahmed Abdi Godane, the leader of al-Shabaab, a Somali Islamist militia allied with al-Qaida.
Godane had learned that senior al-Qaida figures had lost faith with al-Shabaab's Somali leaders, who they blamed for recent defeats by Somali government and African Union forces. Fazul's mission was to effect this change, replacing Godane and other Somalis with foreign leaders, according to somalia-report.com, which attributed the information to al-Shabaab intelligence officials and other sources. Godane directed Fazul and Hussein to an al-Shabaab checkpoint. He then ordered the fighters manning the checkpoint to break it down and abandon the position, meaning that when Fazul and Hussein, neither of whom knew the area well, arrived, they continued down the road, running into the government checkpoint as Godane had planned.
This account would explain why, when first stopped at the checkpoint, Hussein told the soldiers the car was carrying "the elders," an honorific term for al-Shabaab leaders, according to an AP interview with the soldier who stopped the vehicle. That comment, indicating at least two passengers, along with the fact that, in the aftermath of the incident, one of the SUV's rear doors was found open, also suggests that there might have been a third militant who escaped.
The United States has been monitoring cellphone conversations in Mogadishu since at least the 2003-2004 time frame but had no role in Fazul's death, according to a senior U.S. intelligence official. "It would have been a much better ambush had it been planned," the official said. "Had it been set up, nobody would have gotten away, they might even have captured him."
When the Kenyan police arrested Fazul in the Mombasa store in July 2002, they also took a man pretending to be his taxi driver into custody. That man was a 23-year-old Kenyan named Saleh Ali Saleh Nabhan, a senior al-Qaida in East Africa figure. Not realizing his value, the police allowed him to post bail, after which he promptly disappeared. The United States had been tracking Nabhan since early 2002, according to the intelligence source with long experience in the Horn. But after Nabhan reunited with Fazul — four months after skipping bail — and conducted the Mombasa attacks, finding him and the others connected to the incidents became a U.S. priority.
To crack the Mombasa case, U.S. investigators proceeded from "an assumption" that the militants had used cellphones, based on the attacks being "two near-simultaneous events relatively close together, geographically — probably no more than 20 miles apart," the intelligence source said. The next step was to get the records of all the cellphone calls made during the period just before the attacks and determine "all the numbers that never made a call again," the source said. In addition, investigators "went back and looked at where they bought the scratch cards and where they bought the phones," he added.
It took "a few months" for U.S. intelligence agents to figure out which cellphone numbers were associated with the attackers, the source said. The key to the breakthrough was the militants' sloppy tradecraft: One of them was apparently given money to buy two sets of phones and SIM cards, but figured he could keep some cash for himself by just buying one set of phones, mistakenly thinking that switching out the SIM cards provided enough operational security. "They used the same phones but different SIM cards," the source said. "They didn't understand you could track the phone too."
Israeli intelligence agents also gave the Americans a lot of information and asked the U.S. agents to work with them, the source said. "The Israelis were key initially," the source said. "Clearly, they had their own sources in the region."
The Kenyans also conducted "some very good investigative work," the source said. "They were brought in and made to feel like they were valuable." The Kenyan authorities used information provided by U.S. intelligence to get the lower-level al-Qaida operatives involved in the attacks. "They made some arrests," the intelligence source said. "That was all U.S.," the source said of the intelligence that resulted in the arrests. Col. Mike Garrison, then the U.S. Defense and Army attaché to Kenya, ended up with the expended SA-7 launcher tube from the airport attack, the source added. (Garrison declined to be interviewed for this story.)
But Nabhan got away. "He was very clever; he understood how to communicate under the radar," the source said."
One way Nabhan evaded his enemies for so long was by "rarely" communicating himself. "He'd send a message with somebody [and] they'd go to an email or hotmail account and send that message," the source said. Al-Qaida in East Africa used a very basic "10 code" when passing on numerical information, the source said. The code involves replacing each digit with the number that would be required to bring the replaced number up to 10 — for instance, they'd write 539 instead of 571. "It's really simple, but it took people a while to figure out they were doing it," he said.
Perhaps aware of the growing U.S. ability to monitor their cellphone conversations, al-Qaida cell members switched much of their conversation to the Internet, the source said. But they didn't change their email addresses often enough, allowing U.S. intelligence to track them, the source said. Eventually, "we were able to find ways to break into" Nabhan's communications, the source said.
Pushing particularly hard for the authority to go after Nabhan was Joint Special Operations Command, the organization that conducts the military's most sensitive special operations. (Units that fight under JSOC include the Army's 1st Special Forces Operational Detachment- Delta, also known as Delta Force; the Naval Special Warfare Development Group, also known as DevGru and SEAL Team 6; and a special mission unit based at Fort Belvoir, Va., often known as Task Force Orange, which specializes in gathering human and close-in signals intelligence.)
Between 2001 and 2004, JSOC never had more than three people at a time in Somalia, according to the intelligence source. During the latter part of that period, those operators were supporting CIA missions in Mogadishu to liaise with Somali warlords and install cellphone monitoring equipment, the source said.
JSOC was the junior partner on the first Mogadishu missions, but its strength in the Horn was slowly expanding. During those early years, Orange provided the core of JSOC's presence in the region, including personnel assigned to the U.S. Embassy in Nairobi as well as a few in Camp Lemonnier, Djibouti, who functioned as liaisons to CJTF-HOA. In mid-2003, an "interagency node" staffed with intelligence and law enforcement personnel was established in the Nairobi embassy under JSOC auspices, said a special operations officer. Manned at first by "maybe six" people, it quickly grew and now has about 20 people, the intelligence source said.
This reflected the growth of JSOC's wider presence in Kenya. The command started out with three people in Nairobi, a number that grew to five or six and now is reputed to be in the "scores," the source said. "The writing was on the wall that eventually this was going to become a DoD-centric effort," he added.
JSOC's effectiveness in the Horn "really ramped up in the 2004-2005 time frame," when it "doubled" its resources in Kenya and focused more tightly on intelligence collection and target development, the senior intelligence official said. As a result of JSOC's efforts, "we gained a lot of understanding of what was going on," the official said.
The elite command continued to "thicken" its network in the Horn, a process that included placing a small team in the Ethiopian capital of Addis Ababa, according to the intelligence official. JSOC commander Maj. Gen. Stanley McChrystal also began conducting Horn of Africa-specific video-teleconferences that connected U.S. ambassadors and CIA chiefs of station in the region with officials in Washington, the official said.
In 2006, JSOC began to run its own operations in Somalia, a senior military official said. At the time, the JSOC task force in the Horn was called Task Force 88, but that has since changed, sources said. The task force was headquartered in Nairobi, but also operated out of a small base at Manda Bay in northeastern Kenya, about 50 miles from the Somali border.
Some in the intelligence community wondered whether JSOC and, by extension, its Defense Department bosses, were too focused on Nabhan. "I think there was a fixation certainly at DoD," said the intelligence source, adding that while some intelligence personnel thought "that a movement doesn't really center on one person," JSOC saw the Nabhan hunt as a way to validate the mission it was trying to carve out in non-combat theaters. "JSOC saw Nabhan as a way to shore up that third leg of the stool," the source said.
The United States and its regional allies hunted Nabhan for the rest of the decade. "There were several times we've gotten close to him," said the special operations officer, adding that he meant "close" in terms of surveillance, not missions to kill or capture the al-Qaida figure. Meanwhile the JSOC operators chafed under what they viewed as political restrictions that prevented them from going after Nabhan.
But on Sept. 14, 2009, they were given the green light. "We'd been tracking him for years," the senior military official said. Finally, according to the official, JSOC had both human and signals intelligence leads on Nabhan's location as he joined several other militants in two vehicles to make the 300-mile trek from Merka to Kismayo in southern Somalia. "We knew his travel route, we knew the vehicles he was using," the official said.
When the convoy was near the coastal town of Barawe, JSOC struck. Multiple 160th Special Operations Aviation Regiment AH-6 Little Bird helicopters flew ashore from a Navy ship and attacked the militants as they were breakfasting, killing six, including Nabhan, according to news reports. One helicopter landed and operators jumped out and loaded the bodies of Nabhan and three others into the aircraft.
The Associated Press contributed to this report.


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Jordan Uda
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Jordan Uda Search Terms:


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By Amanda Schwarze
Staff Writer
Growing thousands of pounds of vegetables to deliver to people who otherwise would have difficulty obtaining fresh produce takes a lot of manual labor.
The volunteers who work on the donation garden behind Long Lake Fire Station 1 on Willow Drive are about to embark on their second year of working in the 100-foot by 100-foot garden. April Wysocki volunteers her time in the garden, which has been referred to as the Firehouse Garden, and she said that volunteers are always being sought to help with the gardening.
The garden differs from a community garden. In community gardens, plots are sectioned off from a larger piece of land for individuals to garden as they see fit. In the donation garden, all of the produce grown is donated to organizations such as food shelves and senior living homes.
Wysocki said that last year the garden yielded 1,600 pounds of fresh produce such as watermelon, squash, beans and peppers. The soil in the garden then was "horrible," she said and they had been warned not to expect much to grow in it. For the current growing season, Wysocki said, the group had the soil amended and they are hoping to grow about 6,000 pounds of produce this year.
A core group of about nine people regularly volunteer their time in the garden, Wysocki said. On top of that, a lot of volunteers spend shorter stints, such as a week or two, in the garden and groups such as scouts, church groups and school children also help for short periods of time.
Wysocki said that all volunteers are appreciated, but that people who can commit to a steady schedule of helping throughout the growing season are most in demand. She also said that people who don't have time to volunteer, but would like to help may donate money for the effort. All of the people who work on the garden are unpaid and the seeds and plants are donated by area stores such as Otten Bros. and Tonkadale, but the group is trying to raise money to install a sprinkler system at the site.
The produce grown this year will be sent to places such as Western Communities Action Network (WeCAN), Meals on Wheels, the Gillespie Center, the Maple Plain Area Food Shelf, Orono Woods and Interfaith Outreach and Community Partners (IOCP). In addition, Wysocki said, the group is looking to deliver to the Long Lake Assisted Living Facility and if the yield is great enough they could branch out to the Rockford Food Shelf.
Wysocki said that the donation garden volunteers try not to waste any of the produce. She said that they try to cater their deliveries to provide the type of food that people want. That way, she said, they are not delivering peppers to someone who doesn't eat them and would rather have tomatoes. In addition, the group also drops off baskets of produce and that food is gone before the next delivery to the location.
People who would like to volunteer or donate money to the garden may contact either the Long Lake or Orono city halls. Long Lake City Hall may be reached at (952) 473-6961. Orono City Hall may be reached (952) 249-4600.


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The Moscow International Urban Forum is the first international forum about Globalization that held in Moscow in 9–7 December 2011 and talks about Russian cities. the "Global Solutions for Russian Cities" was serve as a global communications platform for an open dialogue among representatives of the government, the managers of architectural and urban planning bureaus, development and construction companies, as well as leading foreign and Russian experts on urban planning.
Tender project
Thank You!


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Friday, August 1, 2014
Revolv Rolls Out Android App, Connects Into Nest
Boulder-based Revolv, the developer of a smart home "hub" to help consumers manage all of their smart home and automation equipment from a single smartphone app, has rolled out a new, Android app. Revolv also said it has updated its iOS application, and added official support for Google's Nest smart thermometers and other products. Revolv's apps let users manage and coordinate all of their smart home devices, so that users could--for example--automatically turn off the lights and turn down the temperature when they leave the house, even when those devices are being managed through different interfaces. The company's app even uses a phone's location to determine if a user is or isn't at home, to help drive those automated actions. Revolv is venture backed by the Foundry Group.


text: The National Coalition of STD Directors (NCSD), in partnership with the Sylvie Ratelle STD/HIV Prevention Training Center of New England and other STD/HIV Prevention Training Centers, is pleased to announce the availability of the "Managing STDs in the Correctional Setting: A Guide for Clinicians." This is the 2nd edition of a guide developed to assist clinicians in the prevention and management of STDs in correctional settings. It is meant to be a concise resource guide for clinicians in busy settings. The six chapter curriculum includes content on:


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F-777 - Not Afraid
Credits & Info
- Uploaded
- Mar 26, 2012 | 1:28 AM EDT
- File Info
- Song
- 3 min 31 sec
- Score
- 4.49 / 5.00
Related Content
Licensing Terms
Please contact me if you would like to use this in a project. We can discuss the details.
- Score:
- Rated 4.49 / 5 stars
- Plays & Downloads:
- 56,576 Plays | 7,437 Downloads
- Share Links:
- Genres:
- Electronic - Dance
- music
- not
- afraid
- f-777
Author Comments
Rated 5 / 5 stars
You just defined the definition of spot-on music! Spectacular job!
Rated 5 / 5 stars
I haven't listened to newgrounds for a little over 3 years ago for lack of good content, i would drop in everynow and normally i would find nothing but trash. I recognized ur name since i remember seeing you back when i was a regular. I was never really impressed with you music, but this changes that I will definitly check out what you submitted in the last 3 years but i think you finally found a style that suits you.
Rated 4 / 5 stars
stunning. i always love your work. the it was a perfect mix. not to heavy and not too soft.
Rated 5 / 5 stars
The piano part is WOW!
Honestly that with the mixing of the DnB elements and
excitement of this vibe throughout brings out not only a
fun to listen to and uptempo and positive track -- but equally
a thrill-ride of amazement! ^_^
The title by the way... "Not Afraid" is as catchy as the song. =)
All around, a SLAMIN' track F-777! =3
But what more should be expected?
You're F-777! =D
Still rocking Your 30-track CD by the way ^_^
Keep up the amazing work! And keep the music
and keep the passion! ^_~
Love & Peace Through Art! ^_~*
Forever In Love With All That Which Exists
(That Which Is Seen & Unseen, Known & Unknown),
- Writer, Artist, Musician, DJ, Eternal Student & Being of Existence,
-WAM! TIGER M [This-Way Tuesday! ! ~ ~ ~(- - ->) ~ ~ ! ]
-2:14 PM (4/3/2012) [Eastern Standard Time, North-of-Equator]
Who Is TIGER M? O.O
Someone who Digs this song! XD
Five star, vote of 5~! =D
Rated 5 / 5 stars
This is really amazing, I really like the vibe.


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Australians are continuing to shop, with the latest figures from the Bureau of Statistics showing national retail trade figures rising 1.3 per cent in February.
The seasonally adjusted growth following a rise of 1.2 per cent in January.
The trend estimate rose 0.4 per cent in February and follows a rise of 0.3 per cent in January and a rise of 0.3 per cent in December.
The ABS said through the year, Australian retail turnover rose 4.6 per cent in February, seasonally adjusted, compared to February 2012. Some economists had predicted a negative trend for February.
The largest contributor to the rise in February was food retailing (1.1 per cent) followed by household goods retailing (1.6 per cent), other retailing (1.6 per cent), cafes, restaurants and takeaway food services (1.3 per cent), department stores (1.6 per cent) and clothing, footwear and personal accessory retailing (1.2 per cent).
It was the largest monthly percentage increase since December 2009.
CBA economist Gareth Aird said: ''Sales have come roaring back over the first two months of 2013.
The bounce in retail sales since the turn of the year is consistent with other indicators of the domestic economy. Equities have been trending higher and this improves household net worth and consumer confidence.''
Mr Aird said the latest readings of consumer sentiment suggest that optimism amongst consumers was at its highest level since December 2010.
''Confident consumers are more likely to spend. Add to this low interest rates and a labour market that is holding up very well, and you get an environment that is conducive to consumer spending.''
Over the longer term, the largest contributor to growth was household goods retailing (up 0.7 per cent in trend terms) followed by food retailing (up 0.3 per cent in trend terms).
New South Wales was the largest contributor to the increase (1.4 per cent), followed by Queensland (1.9 per cent), Victoria (1.1 per cent), Western Australia (1.8 per cent) and the Australian Capital Territory (2.6 per cent).
It's not like there is a one-off payment stimulating housing related spending or food. It is actually across the board which makes it look very solid
These rises were partially offset by falls in South Australia (-0.4 per cent), the Northern Territory (-1.4 per cent) and Tasmania (-0.6 per cent).


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One the angry young man of Tollywood, Rajasekhar had to wait for 2 years for the release of his recent movie, 'Mahankali'. The movie took 2 years to clear all the financial tangles and see light. It did not bring respite to him even after the release having failed to even recover publicity costs. And now Rajasekhar is depending on director Teja to stage a comeback. The movie is going to be in the backdrop of a social problem just like Teja's Nijam. The movie will be important to both of them as their careers are reeling under the pressure of heavy flops.
Teja is currently directing a movie titled '1000 abaddhalu'. He will begin the script work of this project after the release of 1000 abaddhalu and the movie is expected to go on to sets in the second half of the year.


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NADA: Auto Dealers Provide THEIR Customers a Safety Net and More
Editors Note: The Auto Channel applauds the contributions that local franchised auto dealers make to their communities, and the good job(mostly) they have provided to their local car buyers for over 100 years.
With all of the noise causing public focus on Tesla's fight to bypass local dealers, I remind everyone out there of the lack of responsiveness and individual concern of the monolithic car companies and promoted mistruth that without dealers, vehicles will be cheaper to buy and service.
Elton Musk is a genius when it comes to engineering but is on the wrong side of the selling and servicing by the manufacturer argument...Go Dealers!
Washington DC April 28, 2014; The Associated Press reported that automakers have recalled about 9 million vehicles in the U.S. through the first four months of the year, and "if that pace continues, the nation would break the record of 30.8 million recalled vehicles set in 2004."
When something goes wrong on the assembly line, automakers turn to their franchised auto dealers and the dealerships' service departments to make things right – all at no cost to the customer. The franchise system is a network that consists of more than 17,700 new-car dealerships across the country which support their customers beyond the point of sale.
General Motors' dealers are now assisting their customers everywhere—from New York City to Yuma, Arizona. Car and truck owners know they have a dealership in their community to directly turn to. But, the current GM recall is just one example. Over the past few years, dealerships nationwide have remedied engineering problems that span a range of problems.
How can auto manufacturers ensure that millions of their cars in any model year will be fixed in a safe and timely manner?
The answer is the franchised dealer system.
The effective handling of vehicle recalls is one of the important reasons why state policymakers adopt the franchised dealer system for the distribution, sale and service of new motor vehicles. Matters of public safety, such as vehicle recalls, truly underscore the value of the franchised dealer network in times of crisis.
With wide distribution and service channels, franchised dealers can respond to recalls faster and more efficiently than a single manufacturer or factory store ever could. When dealers are called upon to address a recall, they see an opportunity to help get their customers back on the road and restore confidence in the brand.
The franchised dealer network will always be a model that benefits both our customers and manufacturers alike. And it's a network that is irreplaceable.


text:
Trial of Endoscopic Ultrasound (EUS) - Guided Celiac Plexus Neurolysis
This study has been completed.
Centre hospitalier de l'Université de Montréal (CHUM)
Information provided by:
Centre hospitalier de l'Université de Montréal (CHUM)
ClinicalTrials.gov Identifier:
First received: September 10, 2009
Last updated: NA
Last verified: September 2009
History: No changes posted
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
No Study Results Posted on ClinicalTrials.gov for this Study
|Study Status:
|This study has been completed.
|Study Completion Date:
|December 2008
|Primary Completion Date:
|December 2008 (Final data collection date for primary outcome measure)


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Effect of Chia Seeds (Salvia Hispanica L.) on Glucose Control in Patients With Type 2 Diabetes
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
|Type 2 Diabetes
|Behavioral: Salba diet
|Phase 2
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single
Primary Purpose: Treatment
|Official Title:
|Effect of Chia Seeds (Salvia Hispanica L.) on Glucose Control in Patients With Type 2 Diabetes
- Hemoglobin A1c
- Efficacy - major and emerging risk factors for cardiovascular disease (blood pressure, Hs-C-reactive protein, coagulation factors)
- safety (liver, kidney and haemostatic function)
- compliance (plasma fatty-acids, returned supplements, diet records, body weight).
|Study Start Date:
|March 2001
Cohort studies have linked consumption of whole grain with a reduction in the risk of developing diabetes and heart disease. Grain of the plant Salvia hispanica alba (Salba) contain a high concentration of ω-3 fatty acids in addition to being a rich source of vegetable protein, fiber, calcium and antioxidants which have cardiovascular protective effect. To address the paucity of randomized, well-controlled clinical studies supporting the long-term cardioprotective benefits of whole grain we investigated the effects of a novel grain Salba in type 2 diabetes.
Comparison(s): Participants on a conventional diabetes diet (50% carbohydrate, 20% protein, 30% fat) receive either addition of Salba or matched control supplement for 12 weeks separated by a 4-week washout period.
|Ages Eligible for Study:
|35 Years to 75 Years (Adult, Senior)
|Sexes Eligible for Study:
Inclusion Criteria:
- All men or postmenopausal women with Type 2 diabetes optimally or suboptimally controlled (HbA1C < 9.0%) on oral hypoglycemic agents or diet only were asked to participate.
Exclusion Criteria:
- Those receiving insulin, alpha-glucosidase inhibitors, or hormone replacement therapy, with BMI>38 kg/m2, smoking or significant alcohol intake (>2 drinks/day), serum TG >4.0 mmol/L, and those with complications of diabetes were excluded. Subjects were also excluded if they regularly took fish oil and flax seed supplements or used steroids. Subjects were excluded during the course of the study if there were any changes to their regular antihypertensive, lipid, or oral hypoglycemic medications, if unable to consume >50% of supplements provided, had a significant weight change (defined as >2.5 kg), or if their level of physical activity did not remain constant over the course of the study.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00362011
|Canada, Ontario
|St. Michael's Hospital
|Toronto, Ontario, Canada, M5C2T2
|Principal Investigator:
|Vladimir Vuksan, PhD
|St. Michael's Hospital, Toronto
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
|ClinicalTrials.gov Identifier:
|NCT00362011 History of Changes
|Other Study ID Numbers:
|Study First Received:
|August 8, 2006
|Last Updated:
|August 8, 2006
Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
ClinicalTrials.gov processed this record on August 18, 2017


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Carl Zeiss Scopes
Carl Zeiss scopes:
I have a Zeiss Conquest 3-9 x44 on my 223 and am very impressed with it. As compared with my Burris Fullfield II on my 7 mm mag there is no comprising the two. The Burris is not even close to the class to me.
I am looking to maybe get a Zeiss Conquest 6.5-20x50. I have looked through several scopes at the pawn shop, Nikon, Leupold, Pentex, & Millett. All of them loose sharpness at 10x and up, some worse than others. From your experience will the Zeiss stay clear up to the 20x? And what about the Victory, what difference would I see between the Conquest Vs the Victory
I have a Conquest 6.5 - 20x50 and i have noticed no lose in sharpness form what i can tell, its an excellent scope. I have it on my .308 and it feels like a match made in heaven. It was worth every penny. According to their documentation you do want to make sure you get a 20 MOA riser for it to allow for elevation adjustments.
I've had great success w/ Sightron scopes. The Big Sky series are really impressive. When I bought an SII 3-12x42mmAO I brought it to the range. It really pissed off my buddy using a Leupold markIII. Mine was much nicer w/ an equal guarentee at 1/2 the price at the time. I put an SII big sky 6.5-20x42mmAO for my .223 HB, it is outstanding.
The Zeiss Conquest line is a very high quality scope.Even though it has Japanese glass instead of the German glass,it is one of the front runners of the upper priced lower tier scopes.
The Victory line is a far superior scope than the Conquest.The quality of the scope is in another dimmension.
Kind of like comparing a base Volkswagon to a top of the line BMW. But the price tag is in another dimmension also with the Victory line scopes.
Like JP stated,Sightron scopes are very high quality optics. I really like the Sightron SIII series scopes,and have 4 of their 6-24x50 scopes as well as a 4-16x42 SII scope.The SIII series will run right with the Conquest in any catagory,plus has a great deal more adjustment range for long range work.
Another brand that will impress you with optic clarity and brightness,and is also a well built scope is Weaver.The Super Slam line is their top scope and is a very good scope.The Classic Extreme line that was discontinued for the Super Slam line is also a very good scope.Both lines have some neat features,and will also run with the Conquest in any catagory.
I mounted a Super Slam on my 458 SOCOM,and have been very impressed with the quality of it,and I recently purchased two 6-24x50 Classic Extreme's from Natchez Shooters Supply for my varmint rigs,and have also been very pleased with them.For the price,they are too good to pass up-Closeout priced at $350.
|All times are GMT. The time now is 12:04 PM.
Copyright ©2000 - 2017, Jelsoft Enterprises Ltd.


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(0 holds on 1 copy)
|Call Number
|Item Status
|Due 08-23-17
Edition: Widescreen version
Description: 2 videodiscs (103 min.) : sd., col. ; 4 3/4 in
ISBN/ISSN: 6307771577 a,
Language: English
Special features: commentary by director Mark Steven Johnson and producer Gary Foster; theatrical trailer; text commentary; enhanced viewing mode; 6 multi-angle scene studies; "Beyond Hell's Kitchen: making Daredevil" documentary with optional enhanced viewing mode; "The men without fear: the art of Daredevil" documentary; HBO First Look special; Daredevil #1 virtual comic book; "Shadow world": an in-depth look at "Daredevil's sight"; modeling sheet; bios for your favorite heroes and villains; Kingpin featurette; 3 music videos: "Won't Back Down" by Fuel, "For You" by the Calling, "Bring Me to Life" by Evanescence; Jennifer Garner screen test bio; still gallery; full-length screenplay
Ben Affleck, Jennifer Garner, Micheal Clarke Duncan, Colin Farrell, Joe Pantoliano, Jon Favreau, David Keith
By day, blind attorney Matt Mudock toils for justice in Hell's Kitchen. By night, he's Daredevil, a man without fear. He's a masked vigilante stalking the dark streets with an uncanny "radar sense" that allows him to see with superhuman capabilities. When the love of his life is targeted by New York City's ruthless Kingpin and his deadly assassin, Bullseye, Daredevil may be about to meet his match
MPAA rating: PG-13; for action/violence and some sensuality
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Murdock, Matt (Fictitious character) -- Drama
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Problem Mathematical Analysis Items61 textbooks were found
Problems and Theorems in Analysis II: Theory of Functions. Zeros. Polynomials. Determinants. Number Theory. Geometry (Classics in Mathematics)RentList Price:$69.99
Asymptotic Analysis of Soliton Problems: An Inverse Scattering Approach (Lecture Notes in Mathematics)RentList Price:$39.95
Linear and Complex Analysis Problem Book: 199 Research Problems (Lecture Notes in Mathematics) (German and French Edition) (English, German and French Edition)RentList Price:$69.95
Study of solving word problems in teaching of mathematics: From atomic analysis to the analysis of situationsRentList Price:$78.00
Mathematical Analysis of Decision Problems in Ecology: Proceedings of the NATO Conference held in Istanbul, Turkey, July 9-13, 1973 (Lecture Notes in Biomathematics)RentList Price:$129.00
Harmonic Analysis Techniques for Second Order Elliptic Boundary Value Problems (Cbms Regional Conference Series in Mathematics)List Price:$25.00
Mutational Analysis: A Joint Framework for Cauchy Problems in and Beyond Vector Spaces (Lecture Notes in Mathematics)List Price:$119.00
Asymptotic Analysis and Singularities: Elliptic and Parabolic PDEs and Related Problems (Advanced Studies in Pure Mathematics)List Price:$62.00
Numerical Analysis of Viscoelastic Problems (Recherches en Mathematiques Appliquees Research Notes in Applied Mathematics)List Price:$49.95
Noncompact Problems at the Intersection of Geometry, Analysis, and Topology: Proceedings of the Brezis-Browder Conference, Noncompact Variational ... Rutgers, the State (Contemporary Mathematics)List Price:$80.00
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Owens Corning's Wolf Receives Phoenix Award (6/1/06)
June 5, 2006
Warren W. Wolf, Ph.D., has been named the recipient of the 2006 Phoenix Award, which is presented annually to recognize outstanding individuals who have made noteworthy contributions to the glass industry. In making the announcement, the Phoenix Award Committee said Wolf's recognition is richly deserved. Wolf retired as vice president and chief scientist emeritus from Owens Corning in 2001 after 33 years with the company. Throughout his career, he held both senior scientist and technical management positions in research, engineering, and environmental and health sciences. He holds 15 patents in glass fiber process and composition. Owens Corning presented Wolf with numerous awards for his patent contributions, as well as a lifetime achievement award.
For more information on the Phoenix Award, including a list of past recipients, click on the website links below.
For more information on the Phoenix Award, including a list of past recipients, click on the website links below.
Did you enjoy this article? Click here to subscribe to Ceramic Industry Magazine.


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Researchers from Rice University develops a process as part of a $6.6-million project supported by the USDA that aims to produce renewable biodiesel, animal, feed, biopower, and bio-lubricants from lignocellulosic biomass.
The bioengineers from the university made use of a special E. coli to produce fatty acids from some hyrdrolysates. The team is already able to get roughly 80% to 90% fatty acid yield from the model sugars and hopefully even improve this in the coming years. Adding a few more percent to the yield may not sound much but it is very significant when you are talking about millions of tons a year.
The projected conducted at Rice University is just one of the USDA-supported scientific projects.THese projects are focused on coming up with infrastructure-compatible fuels for the transportation industry. Aside from coming up with diesel-like blends from sugars, all you can really look into are fatty acids.
The scientists are looking into how they can make the E. coli be more efficient in the production of fatty acids and at the same time work into building strains that can help in higher yield production of biofuels.
The team looked into different strains of E. coli and combined their best qualities for the best possibile yield.
Since the kick off of the research, the bioengineers were able to up their production from 0.4g for every liter to about 14g/liter.


text: Judge's mining order ignored? By Ken Ward Jr. August 9, 2004 Story Share A battle is brewing among environmental groups, the coal industry and regulators over enforcement of a July mountaintop removal ruling by U.S. District Judge Joseph R. Goodwin.Last week, citizen groups sought federal inspections of several sites where they believe coal operators may be violating Goodwin�s decision.The U.S. Army Corps of Engineers has asked the state Department of Environmental Protection � the only agency that has inspectors patrolling the sites regularly � for help. But so far, the Wise administration has declined to get involved.The dispute could end up in Goodwin�s courtroom if it is not resolved soon.�We�ve heard rumors that operators may be trying to circumvent the court�s order, but I would be surprised if either the Army Corps of Engineers or coal operators are not complying with Judge Goodwin�s order,� said Joe Lovett, a lawyer and executive director of the Appalachian Center for the Economy and the Environment.In the case before Goodwin, Lovett�s organization and Trial Lawyers for Public Justice represented the Huntington-based Ohio Valley Environmental Coalition, Coal River Mountain Watch and the Natural Resources Defense Council.On July 8, Goodwin ruled that the corps could no longer approve mining valley fills through a streamlined permit process meant only for activities that cause minor environmental damage.Rather than these �general� or �nationwide� permits, Goodwin said, coal companies must go through more rigorous individual permit reviews when they propose to bury streams with waste dirt and rock.The judge ordered the corps not to issue new Clean Water Act permits for valley fills without individual reviews.As for 11 specific general corps permit authorizations challenged in the suit, Goodwin ordered the agency to suspend those for valley fills �on which construction has not commenced as of today, July 8, 2004.�In mountaintop removal, coal operators blast off entire hilltops to uncover valuable, low-sulfur coal seams. Leftover rock and dirt � the stuff that used to be the mountains � is shoved into nearby valleys, burying streams.Last year, federal regulators issued a report that concluded that 1,200 miles of Appalachian streams have been buried or otherwise �directly impacted� by valley fills between 1992 and 2002. That 4 1/2-year study found that past, present and future mining in the region could destroy 1.4 million acres of forest, or 11.5 percent of the study area.The Bush administration, which has made several moves to make it easier for companies to obtain mountaintop removal permits, has not issued a final version of the study.Construction commencedQuestions surfaced about compliance with Goodwin�s ruling on July 30, when Massey Energy Co. President Don Blankenship was asked about the decision in a quarterly conference call with industry stock analysts. Massey holds five of the 11 specific permits that were cited in the lawsuit. Those permits are for Massey subsidiaries Alex Energy, Elk Run Coal and Independence Coal.While he complained that the judge�s decision �will further complicate and slow the already complicated permit process,� Blankenship also indicated that Massey didn�t expect to stop its operations.�While what constitutes the commencing of construction has not yet been specifically defined, Massey has started some construction on all five permits by the date of the ruling,� Blankenship told the analysts. Asked by one analyst for further details, Blankenship said, �It varies a little bit, but in all cases we are, at a minimum, building ponds and in some cases, we are dumping material into the fills.�Four days after Goodwin issued his ruling, corps District Engineer William E. Bulen sent letters to Massey and other companies whose already-issued permits were cited in the decision.In the letter, Bulen told companies that their permit authorizations were �suspended for valley fills and surface impoundments on which construction has not commenced as of� July 8. The other companies who received the letters were Kingston Resources, Horizon Resources and Fola Coal Co.In all, the permits halted by Goodwin would have buried or otherwise impacted 26.5 miles of West Virginia streams, according to government records filed with the court.Chuck Minsker, a corps spokesman in Huntington, said that his agency is considering plans to inspect mining operations to confirm that they have complied with Goodwin�s order.DEP asked to helpThe corps, though, does not regularly inspect strip mines. So, the agency has sought help from DEP.Ken Politan, an assistant chief for permitting at the DEP Division of Mining and Reclamation, said that the corps asked him for help from state inspectors during a July 20 meeting. Politan said that he told corps officials that he wasn�t in charge of inspectors, and that they should talk to Joe Parker, DEP�s mining chief, or to Jeff McCormick, assistant chief for inspection and enforcement.Last week, Politan said that he also forwarded the corps� request to Parker and McCormick in an e-mail message.Parker did not return phone calls Thursday and was not in his office Friday.Perry McDaniel, chief of the DEP Office of Legal Services, said that it appears that environmentalists and the coal industry disagree about what constitutes starting construction of a fill under Goodwin�s ruling.In some cases, McDaniel said, coal companies believe that they are exempt from the ruling if they started construction of sediment ponds downstream of the areas that will eventually become valley fills. Environmentalists, McDaniel said, apparently believe that starting the pond is not sufficient for a company to get around the injunction.McDaniel said that he advised DEP officials that they should steer clear of that dispute.�We prefer not to be caught in the middle,� McDaniel said. �At best, we would provide some basic information, and let Judge Goodwin and the parties to that lawsuit sort it out.�One problem for environmentalists is that they do not have complete information about what was happening on the ground at each of the mine sites cited in Goodwin�s injunction. That�s the sort of information, environmentalists say, that DEP could easily provide.On Friday, McCormick said that he�s not sure he wants his inspectors to even do that.�We would have to discuss it internally and see if it was something we wanted to do or not,� McCormick said.McCormick added that the in-person request to Politan is not sufficient for DEP to consider helping the corps. DEP wants something in writing, McCormick said.�To my knowledge, the corps has not made a request,� McCormick said. �I have not been contacted. Unless we get something official, we would not consider that sort of request.�Citizen inspection?On Thursday, Vivian Stockman of the Ohio Valley Environmental Coalition asked the federal Office of Surface Mining to arrange a citizen inspection � allowed under federal strip mining law � of seven of the operations cited in Goodwin�s ruling.In a letter to Roger Calhoun, director of the OSM field office in Charleston, Stockman said that she has �reason to believe� that Goodwin�s ruling is �not being followed by certain coal operators in West Virginia.��Because there is an immediate danger to the environment, I request an immediate inspection,� Stockman said.Also last week, environmentalists asked the U.S. Environmental Protection Agency, which handles Clean Water Act enforcement, to look into the situation.Officials from OSM and EPA could not be reached late Friday.Earlier, Lovett on July 19 asked the judge to expand the ruling to cover six other permits that may not have started filling streams before the July 8 decision. Goodwin has not yet ruled on that request.Two of those six permits are for Massey operations.In court papers filed last week, Massey lawyers said that an expansion of Goodwin�s ruling would cause those operations �a disruption of their reasonably based investment expectations, a disruption to and possible loss of their employees, and a potential inability to meet contractual obligations.�By contrast, Arch Coal Inc. President Steven Leer told industry analysts on July 26 that the Goodwin decision would not cause major problems for three of its permits specifically cited in the injunction.�Arch has been anticipating that this could be a likely outcome for a number of years,� Leer said in a conference call.Leer noted that Arch Coal is the only coal company that has gone through the process of obtaining individual permit authorization from the corps.�We felt pretty comfortable with the individual permit process,� Leer said.�It was a potential outcome that was likely,� he said. �We had planned for it.�I think it will make it more difficult for people to get permits,� Leer added. �It will lengthen the time of the permit process, which is already lengthy. But we�ve built that in and made it part of our modus operandi.� Story Share Story Share Trending Now 1 Pair pleads not guilty in Garrison Ave. murders 2 Problems mount for Poca funeral home owner 3 Manchin, Puccio listed in company's $15M debt complaint 4 Drug giant blasted for placing WV baby rehab clinic on fault list in opioid crisis 5 Charlottesville victim's mother: 'Make my child's death worthwhile' TRUSTS: A way to control your assets from the grave Previous Story Goodwin expands ruling on permits for valley fills Next Story


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Cultivate Restaurant
Whether your travels bring you to Detroit for business or pleasure, we offer convenient, delicious Romulus restaurant options at our Detroit airport hotel. Simply discover the delightful cuisine of Cultivate for breakfast or dinner. Elegant but by no means formal, our 60-seat restaurant offers American favorites, exquisite wines, and scrumptious desserts. Be sure to try one of our hand-cut steaks or fresh seafood entrees.
Breakfast- Every day from 6:30 - 11:00AM
Dinner- Monday - Saturday: 6:00 - 10:00PM - Closed Sunday evening


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Trainee guide dog saves choking woman's life
A heroic trainee guide dog saved a woman's life by knocking a chocolate out of her throat while she was choking.
Nell, just 17 months old, rescued Lesley Hailwood, 61, on New Year's Eve after a sweet from a Thorntons continental chocolate box got stuck.
Ms Hailwood, an IT technician who looks after Nell while she is training, told MailOnline how the insightful animal seemed to know exactly what to do when she got into trouble.
She said: 'It was new Year's Eve, about 11.30pm. Nell was flat out asleep by then because we'd gone out for the afternoon and she'd had a long walk.
'I'd gone into the dining room, and on my way back there was a box of chocolates. I picked one up, put it in my mouth and immediately it got stuck in my windpipe. And it didn't seem to matter what I did, I couldn't get rid of it. I was choking.
'So I then walked from the dining room back into the living room where Nell was – she was still fast asleep. I was standing there, still with my back to her and I was facing the settee. By this time I was starting to panic because I couldn't breathe.
'But she had obviously heard me, and jumped up, ran past me, jumped onto the settee – which is not what she does at all – looked straight at me, got up onto her back legs – she's quite a big dog – and with her two front paws she just lurched at me and hit me in the chest. And it dislodged the chocolate.'
Nell, a cross-breed between a German Shepherd and Golden Retriever, is almost at the end of her training, which can take between 17 and 20 months.
She is cared for by Ms Hailwood – a so-called 'boarder' – while she is not training at a guide dog centre in Liverpool. She lives alone other than Nell.
As part of their training guide dogs are often taught to interact physically with the people they help – for example to stop them walking into the road.
But knowing how to deal with a person who is choking would not be part of their training, and is instead down to Nell's instincts and intelligence, according to Ms Hailwood.
She said: 'The more I tell the story the more I wonder how she knew to do that. It was instantaneous, she didn't panic or anything. It was immediate what she did.'
'They are very clever, intelligent dogs, and Nell is particularly clever. I've had her since November, while she was doing her training. I've had a couple of dogs before Nell, but I knew straight away she was very quick.
'It doesn't bear thinking about what might have happened if Nell hadn't been there. The chocolate might have dislodged itself, it might not have done.
'I sat there afterwards in shock for a while – but when it dawned on me what she'd actually done I just gave her a big cuddle. She was quite nonchalant.
'I love all the dogs that I have, but Nell particularly is such a clever guide dog. I wish I could keep her. That won't happen – she has to do the job she's trained to do. But because of what she's done she'll always be a bit special for me.'
~Via UK Daily Mail
Tags: dog hero, dog proves training, dog saves choking woman, dog saves woman, service dog, service dog in action


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Shakers snap up Coke
Bury have signed Sheffield Wednesday midfielder Giles Coke on loan until the end of the season.
By Pete O'Rourke - Follow me: @skysportspeteo
Last Updated: 13/01/12 10:39am
Bury have signed Sheffield Wednesday midfielder Giles Coke on loan until the end of the season to help the club's tilt at the League One play-offs.
Coke enjoyed a fruitful two-month loan spell with the Shakers earlier this season, scoring three goals in 11 appearances.
Shakers boss Richie Barker has moved to bring Coke to Gigg Lane and the player's agent, Alex Cowdy of Touchline Soccer, admits the midfielder is relishing the chance of regular first-team football.
"Giles was a regular for Wednesday last season, winning League One Player of the Month in August, and subsequently being scouted by several Premier League clubs," Cowdy told Sky Sports.
"He's found himself on the periphery this season, and he's far too good a player to be sitting in the stands each week.
"Bury wanted to extend his loan after his last stint expired, but Giles had a desire to fight to regain his place in the Wednesday side.
"Despite impressing on loan, he has not been able to force his way back into the manager's plans.
"By going back to Bury and working with Richie Barker and Peter Shirtliff, who know his game inside out from their time at Mansfield together, he's got the chance to impress again and put himself in the shop window for a move to the Championship in the summer."


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America Trusts No One. Except Tom Hanks.
Tom Hanks is your dad. Tom Hanks is your president. Tom Hanks is your king. According to a poll conducted by Reader's Digest and The Wagner Group, Tom Hanks is the most trusted person in America.
What's unclear is why people trust Tom Hanks. I mean, I guess he doesn't seem particularly untrustworthy, but it's just that he's not poison testing my food or reporting the news or really performing any societal function in which my level of trust in him would be important. Granted, the sample group is only 1,000 people so it's hardly scientific. Reader's Digest proclaims the poll's results to be "revealing, hopeful and sometimes shocking," they are none of the three.
Here are the top ten:
- Tom Hanks
- Sandra Bullock
- Denzel Washington
- Meryl Streep
- Maya Angelou
- Steven Spielberg
- Bill Gates
- Alex Trebek
- Melinda Gates
- Julia Roberts
It's not until number 12 that a journalist comes up (Robin Roberts) and the first politician (sort of) on the list is Michelle Obama. You can see the full list of 100 here.


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[My Computational Complexity Web Log] One-Way Functions
Expand Messages
What is a one-way function, intuitively a function that is easy to compute and hard to invert? Taking this intuitive idea to a formal definition has yield two quite different meanings, sometimes causing confusion.
The first directly tries to translate the intuition. A function f is one-way if
- f is 1-1 (so an inverse is unique),
- f is length increasing (so the output of the inverse function is not too large),
- f is computable in polynomial time, and
- there is no polynomial-time computable g such that for all x, g(f(x))=x.
A function is r(n)-secure one-way if
- There is a function l(n)≥n such that f maps strings of length n to strings of length l(n),
- f is computable in polynomial time, and
- for all probabilistic polynomial-time algorithms A, the probability that f(A(f(x)))=f(x) is at most r(n) where the probability is taken over x chosen uniformly from the strings of length n and the random coins used by A.
At one point I tried using complexity-theoretic one-way functions and cryptographic one-way functions to distinguish the two, but this only caused confusion. So we have to live with the fact that we have these two definitions with the same name and we'll have to just use context to figure out which definition is appropriate. If you give a talk or write a paper about one-way functions, it never hurts to distinguish which version you are talking about.
Posted by Lance Fortnow to My Computational Complexity Web Log at 9/29/2003 04:21:30 PM
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6-21 is a reference to my first project, The 6:21 Theory
19/20 is my upcoming project
bare (bear) hands I got the game in a Goldilocks = Goldilocks and the 3 bears reference
It's alot of small lines in this part.
No equal, top of the food chain but below, zero = on some boasting type shitm just me holding myself highly and saying on the top but skill level is cold , like below zero.
zero , the ghost dog = is a reference from Nightmare Before Christmas
and also a reference to Ghost Dog: The Way of the Samurai
which stars Forest Whitaker
whittier than Whitaker, Forest run =
a Forest Whitaker line that goes into a Forest Gump line
Dark Knight = batman reference , he wears all black
hard white = crack , which means Im dope
Taper is a type of haircut
Shit finna be hot as fuck. lol
F is the 6th letter and u is the 21st letter in the alphabet.
Also a reference to Fonz-E Mak's first tape, The 6:21 Theory.
Crystal Lake = Friday The 13th
Elm Street = Nightmare on Elm Street
Silent as the lamb = Silence of the Lambs
chainsaw is a talker = Texas Chainsaw Massacre
jig is up, buddy lookin puzzled as I rip em up = Jigsaw, Saw
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