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Fr. Joseph A. Steinbeisser
Phone:(320) 693-3313 x 101
E-mail: email@example.com
On July 1, 2007 Fr. Joe was appointed Pastor of St. Philip's Church after serving 11 years as Pastor of the Church of St. Mary of Willmar, MN. Ordained on June 7, 1986 Fr. Joe served as an associate pastor at Holy Redeemer in Marshall, MN from 1986 to 1989. He was appointed Vocation Director for the Diocese of New Ulm in 1989 as well as Pastor of the Church of the Japanese Martyrs and the Church of St. Paul of Comfrey, MN until he was appointed pastor of St. Mary's in Willmar.
He attended St. John Vianney College Seminary at the University of St. Thomas from 1979 to 1982, graudating with his Bachelors degree in Communication. He earned his Masters of Divinity Degree at St. John's University, Collegeville, MN in May of 1986.
Fr. Joe was born in Olivia, Mn and has 4 sisters and 5 brothers and several nieces and nephews. He enjoys spending time with family and friends.
Fr. Brian
Associate Pastor
Phone:(320)693-3313 x 108 or (320)275-2915
E-mail: firstname.lastname@example.com
Fr. Brian was born and raised in Appleton, Wisconsin. He is the third youngest of seven siblings. He has four brothers and two sisters. He has eight nieces and nephews. Being from the area of the state near Green Bay, Fr. Brian is a tried and true Green Bay Packers fan.
Fr. Brian attended St. John Vianney College Seminary at the College of St.
Thomas and graduated in 1987 with a Bachelors of Arts in History, then
received a Masters of Divinity Degree from St. John's Seminary Collegeville
in 1991. He received certification in Spiritual Direction from The
Institute of Priestly Formation in 2008 and completed the program Good
Leaders, Good Shepherds in 2012.
Fr. Brian came to the Diocese of New Ulm about 20 years ago as a deacon. He served in Watkins for a year as a deacon, and then was ordained to the priesthood on May 28, 1994. Since then, he served in Marshall, Willmar, the area faith community in Tracy Walnut Grove and Milroy, then back to the area faith community of Willmar, Spicer, Kandiyohi and Lake Lillian, and now in this area.
Michelle Kramer
Phone:(320) 693-6283
E-mail: firstname.lastname@example.com
My heart is in Catholic Schools. I grew up in Winsted and went to Holy
Trinity Elementary and High School, did my undergraduate studies at St.
Ben's/St. John's, and completed my master's degree with St. Mary's
University while teaching at St. Croix Catholic School in Stillwater. There
I taught middle school reading, writing, and math for 2 years and 5th grade
for 3 years. I then married my husband Norb and moved to Watkins. I taught
for 3 more years in 5th grade and then took a hiatus to be home with my
kids. I spent last year teaching an online course for Concordia University
and am now excited to join the wonderful staff of St. Philip School!
Brenda Grates
Parish Administrator
Phone:(320) 693-3313 x 100
E-mail: email@example.com
Brenda Grates joined the Parish as the Parish Administrator in July 2010.
Prior to joining St. Philip's she worked for 11 years at Faribault Foods in
the Quality Assurance department.
Brenda will assist the Pastor and Parish Administrative Council with their
role of adequately maintaining the financial well-being of the Parish.
Responsible for all the administration of the parish facilities, employee
salaries, benefits, insurance programs and operation of the parish offices.
In addition to these responsibilities Brenda assists with the management of
the parish cemeteries and maintains all sacramental records, oversees the
parish website and the preparation and distribution of the weekly bulletin and the mailings.
Brenda is married and has 2 daughters. She enjoys spending time outdoors
camping, gardening, fishing and mostly spending time with her family and
Karen Kulzer
Parish Catechetical Leader
Phone:(320) 693-3313 x 104
E-mail: firstname.lastname@example.com
Karen Kulzer joined the parish staff in 2001 as coordinator for First Reconciliation and First Eucharist. In 2003 Karen added Faith Formation Director for Preschool-5 Grade children to her job description. In 2012 she expanded her roll as Faith Formation Director for Preschool-11th grade.
Karen received her BA in Education from The College of St. Benedict in 1996. Karen taught religion at Holy Trinity High School in Winsted, MN before joining the Faith Formation Team at St. Philip's.
Karen is married to Gerard Kulzer. They have 5 children, who often take on the role of testers for new projects and ideas.
Karen enjoys many creative endeavors, especially painting and photography, but her favorite pastime is spending time with her family and friends.
Shelly Mendiola
Parish Catechetical Leader
E-mail: firstname.lastname@example.com
I am married to Carlos and we have 6 children - John, Matthew, Sarah, Anna, Elizabeth & Emily. I am a graduate of Dassel-Cokato High School and an alumna of the College of St. Scholastica, where I earned a BA in Religious Studies. After graduation I worked as a DRE for 5 years at the Church of St. Raphael in Duluth. I then moved to the Twin Cities and worked at the Church of St. Timothy in Blaine as the Senior High Confirmation Coordinator. In 2001, Carlos and I moved back "home" to raise our family. I was the DRE at St. John's in Darwin for 9 years before retiring to be a stay-at-home mom.
I love spending time with my family, reading, volunteering, chauffeuring my kids to all of their activities and watching basketball.
Mary Roers
St. Philip's School Secretary
Phone:(320) 693-6283
E-mail: firstname.lastname@example.com
Mary started at St. Philip School in August 2011. Prior to that she was
assistant Teacher at Crackerjack Nursery School for the past 11 years.
Born & raised in Litchfield - Member of St. Philip's all my life.
Married to Bill Roers - we have two grown sons both attending St. John's
University in Collegeville.
Jan Klein
Faith Formation Secretary
Phone:(320) 693-3313 x 109
E-mail: email@example.com
Jan has been a member of St. Philip's parish for 23 years. In 1995 she started working in the parish office helping count the collection and doing the bulletin and other office tasks. In 1999 she moved over to the school and is still working there as the secretary of the school and the Faith Formation department.
Jan is married to her husband Jim for 27 years and they have 2 grown daughters, 2 grandsons and another grandchild on the way.
Dave Eischens
Phone:(320) 221-1045
E-mail: email@example.com
Dave has been a member of St. Philip's Church for 16 years. He was born in New Jersey. His family later moved to Richmond, MN and Dave graduated from Rocori High School. He worked production and later maintenance for 16 years at Gold'n Plump Poultry.
Dave is married to Shelly Eischens. They have one daughter, Breanna, and one foster son who currently lives with them named Hunter.
In Dave's spare time, he enjoys bowling, Nascar racing, watching his brother dirt track race, and the MN Vikings.
A Contact list is available on our Contact page.


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Posted at 4 p.m. May 2, 2017
Many factors to be considered when renting apartment
The joys and struggles of independent life
Knowing the difference between what you want and what you can afford is essential whenA looking for a first apartment. While looking for my first apartment, I came across difficulties that I wasn't expecting. It was a long process that required careful planning.
Apartment hunters usually are looking for a place with a roommate or friend. But before you sign a lease, make sure to find someone who can be trusted. That means someone who has their priorities in line and can live up to the contract they're signing.
Having a roommate that prioritizes finding an apartment over everything not only shows that they're committed to the idea, but also that they are going to prioritize what needs to be done when you move in together. If the person you're looking to room with is distant and doesn't participate in looking and preparing to move, they most likely don't even want to move in with you.
It is important that your potential roommate is friendly. Living with someone who isn't nice or friendly can cause unnecessary stress in your living situation. When looking for an apartment, comfort is a major factor.
Cost is also a major factor as to whether it's the right decision. Everyone looking for an apartment usually has a budget. However, some people don't think to include utilities when thinking about their budget for rent. Most rentals don't include electricity, water or Internet. This is where prioritizing comes into play.
Those looking to rent have to ask what's most important. My roommate and I decided water and electricity were most important non-rent expenses to account for. Internet accesis important to us as college students, but until we can find the best deal on an Internet provider, we will hold off and get our Internet elsewhere.
The next financial decision that needed to be made was where we would get renters insurance. Luckily the apartments my roommate and I were looking at had an inexpensive solution. It's always a good idea to ask the property managers whether they offer renters insurance.
Another important and perhaps unexpected expense that someone looking to rent needs to prepare for is buying furniture. My roommate and I decided beds and a couch were the most essential pieces we needed. Because of the abundant closet space, dressers weren't a major priority for us.
Being able to look at what you need to prioritize and what is most important for a person's individual living preferences is a major factor when looking at apartments.
Leasing an apartment for the first time is a major step into adulthood. Not only is it more responsibility, but it also helps a person to learn what type of person they want to be in life.

subset: commoncrawl


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Fruit Club
The Art of Games
The Art of Games
|Number of Games
The Art of Games is a software provider that has been creating online slot machines and online games for about a decade, but for some reason they aren't as well-known as the giants of the gambling industry, like Microgaming and Netent.
Continue reading to find out why we think that this software provider deserves at least a spin and what makes the company and its products special.
The Art of Games Software Provider History
Today's software provider is a Dutch company that's based in Eindhoven. They have been creating online casino games for about ten years and because of the fact that there are so many software providers they haven't managed to set themselves apart until now.
They have made more than 100 game machines until this moment, both video slots and table games.
Their online slot machines have plenty of interesting features and they also look quite nice and they don't shy away from making even those online casino games that most software providers skip like Stravaganza or Fan Tan.
Everything that is created by this game producer is really easy to customize and mold into the shape that the online casino that needs it to be.
The Art of Games trademarks and online casino game machines
At some point in time people thought that slot machines, fruit machines especially, were a combination of luck and skill. This is because people thought that making the reels stop when you wanted them to meant that you were changing the outcome.
Eventually, people realized that because of the Random Number Generator they really couldn't do anything and no matter what skills they had they wouldn't affect the game.
Well, this game producer wants to bring back the skill into video slots. Their five reel online slot machines have a skill element in their bonus features.
When playing video slots by other providers you could potentially lose just when you've triggered the bonus game and thus would have waited for nothing, but with these ones you have a guarantee that you won't lose if you have the necessary skills.
It's an interesting thing to know that your level of skills can make the difference between losing or winning a small sum and a really big win.
The software provider offers both three reel and five reel video slots. The ones with three reels have from one to just five pay lines in total and while this might not seem so impressive you have to remember that their goal is to trigger nostalgia.
They have quite a thing with classic fruit slots and if you take a look at their repertoire you will see just how much they like them.
Beginning with Fruit Club which is a very classic three reel fruit slot machine and moving on to other online slot machines that keep the same basic idea like Vintage, there are plenty of examples and reiterations of the same great game.
They also make five reel video slots and these can have up to 30 pay lines plus a bunch of bonus features. The Love Machine video slot is quite a great example of what sort of games they can make.
If you're looking for a theme that's even more fun than a romance one, try Wonders of Magic.
Video slots are not all they can do, they can also create pretty impressive online games. While most table games are pretty similar no matter what game producer makes them, theirs have a special flair.
They are able to customize everything from the card decks to the user interface and everything the client needs.
Their scratch card games are great and most of them require just that you get three matching symbols. Graphics and sound effects for these casino games are quite extraordinary as you will see if you try them out.
Why play casino games by The Art of Games Software Provider
They might not be that well-known, but they should be. They make great online slot machines and even better casino games and they try to bring something special to the mix every time.
If you like some sort of innovation and exciting game-play then they are a good option. Even more so if you want something new and want to have a break from huge software providers like Netent and Betsoft.


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Gas Metering Skid
Carpe has an experienced in-house team of specialists in mechanical and civil engineering, (flow) instrumentation, electrical engineering and process automation. Our skids are manufactured in line with the latest international relevant standards and with the most reliable design. Our well-experienced execution team ensures the highest and consistent level of Quality standards. The complete system design and detailed engineering complimented by proper sub vendor selection ensures a high level of measurement accuracy, which is the primary requirement of Gas Flow Metering or Gas Metering Systems.
Our metering skids comprise of filtration, pressure reduction, metering section and also enjoy the flexibility to be interfaced with external systems like flow computers. All are sourced from the best makes available globally, to maintain the quality and performance of our skids.


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Music Ministry
Russ Goliger
Music Director ~ Russ has been the Music Director for First Church in Marlborough for over 10 years. In 2015 Russ entered his first year of theological studies at Boston College School of Theology and Ministry and is in the Discernment Process with the Mass Central Association. He currently holds a Bachelors of Fine Arts degree in Musical Theater from Syracuse University. Professionally, Russ is a consultant specializing in Training and Development. He has worked with clients from the Biotech, Software, Consumer Electronics, Commercial Insurance and Telecommunications industries.
In the past, Russ has coached little league baseball, choreographed and directed both community theater and high school productions in and around the Metrowest area. He and his wife have a daughter and 2 sons.
Church Organist ~ Jim has been a church organist (and music director) for more than 50 years of his life. He has been the principal organist at First Church for over ten years and was at the St. Stephen Lutheran Church in Marlborough for the ten years prior to joining us. We are blessed by Jim's music on our glorious pipe organ in the sanctuary. Our Joyful Ringers are often graced by the musical talents of Jim's wife Linda who we always enjoy seeing at First Church.
Jim has retired from the defense electronics business where he was an electronic engineer and later, a business development executive. In addition to the love of music, Jim is an avid collector of trains.
Diane Burke
|Handbell Director ~ According to Diane, First Church took a real leap of faith when it hired her to be the director of the Joyful Ringers in 2009! Although she come from a very musical background, she hadn't discovered handbells until 1990 when she moved to this area and was looking for a singing choir.
Thanks to an ad in the paper and my mother's encouragement she joined the Sudbury Bellringers that year, and it changed her whole world. She's been ringing ever since, in large groups and ensembles (and even a few solos), but she had never directed anyone…until she ran into Russ Goliger at an Interfaith Thanksgiving Service, and he mentioned the need for leadership of the well-established Joyful Ringers. She started that January, and again, her life changed immeasurably for the better! Handbells are the ultimate team sport- it takes each ringer's unique notes to weave together a piece of music- and they truly are one unit, always supporting each other and striving for excellence. She is fond of saying that she couldn't have landed in a better place to be a first-time director, and those around her teach her something new every time they're together. "How lucky I am!".


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About The BOG: King of the Swamp by James Shava:
Following the loss of her family in a traffic accident, Sugargirl Rust finds comfort in rescuing abandoned pets. Then she learns the offender has been set free. Her world comes tumbling down. An abandoned pet python summons the swamp to pay a visit to several bathrooms and teams up with a boy to help the wronged widow get elected Mayor. Murder becomes the face of justice as more scores are settled including that with a Triad mobster boss of bosses.
Buy the book, Learn more about the writer and follow the author on social media:
Visit the Author's Website.
Buy the Book On Amazon.
Visit the Twitter page.
Author Bio:
James Shava is the author of The Quantum Mechanic: The Secret. He has written other books using several pen names. He believes in the 'What if….' approach when writing his books.
'I enjoy reading all types of books. Usually, I am reading two or three books at a time. I do martial arts, just to keep fit. I have a black belt in Taekwondo and I am a web-developer with a software engineering background. I used to run a newspaper and train agencies in desktop publishing. Now I run a printing business and write.'


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Saffron, a spice that's only found in Southeast Asia, is known for its bright orange color and bitter flavor that improves the flavor of different dishes. Aside from being a spice, saffron also has a history of being used as a medicinal spice. It is after all rich in carotenoids, where it owes its bright orange hue. Depression is just one of the conditions that can be remedied by the use of saffron.
Saffron extract on mice
According to a 2010 Chinese study published in the Journal of Natural Medicines, saffron extract has been shown to have anti-depressant effects when used on mice. It was noted that the mice appeared active in stressful conditions even though they remained calm in non-stressful events. This implied that saffron had stress-adaptation benefits as well as a bioactive compound called crocin 1. Apparently, this bioactive compound is what's responsible for stress-adaptation.
Saffron vs. fluoxetine
Before that, a 2007 Iranian study found on Progress in Neuropsychopharmacology and Biological Psychiatry determined that saffron was as effective as fluoxetine. Fluoxetine is a drug used for the treatment of mild to moderate cases of depression. The study was conducted over an 8-week period where the participants were given 15mg of saffron extract two times a day. Results showed that there was a 25% remission rate from the saffron and fluoxetine groups. There was also a fair amount of side effects present.
Saffron and PMS
In 2008, an Iranian study determined that saffron can be used to treat depression associated with premenstrual syndrome or PMS. The study involved women from the 20-45 age group; each one was given 30mg of saffron extract per day continuing for their next two menstrual cycles. The Hamilton Depression Rating Scale was used to measure the effects of saffron on the individuals. According to the results of this particular study, there was a significant reduction in depression associated with PMS.
Saffron extract may well be effective as an alternative treatment to depression, but the quality of the saffron extract is still relevant. A German study stated this in the June 2008 publication of Planta Medica. This study revealed that there is a difference in the concentration of bioactive components when extracted using different methods. Apparently, the bioactive component found in saffron can bind to NMDA, which is the nerve receptor associated with learning, memory, and forms of depression. Unfortunately, inadequate or improper extraction methods used on the preparation of saffron products may result in the absence of the important bioactive compound. Ergo, the wrong method will not yield effective saffron extract products.


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Internet Gift Store – 20% Voucher Code – Promo Discount
Internet Gift Store 20% off EVERYTHING Voucher Code Discount.
The Internet Gift Sore is a one stop shop for that next gift. There's something for everyone, categorised for your convenience, free delivery on all orders over £30 and top notch customer service to boot. Be sure to use this exclusive voucher code discount on your next gift shop.
This 20% off Internet gift store Voucher code is redeemable for all TroopScout users: serving members, ex-forces, family and friends.
Thank you so much for your service!
Deal Byinternetgiftstore.com
1. Click 'Reveal Code' to get the voucher discount code and open the Internet Gift Store website.
2. Shop as normal
3. Type in the exclusive voucher code at checkout to claim your discount
4. Enjoy your savings and gifts!
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This Internet Gift Store voucher code discount is compatible on all goods. One use per customer.
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As a continuation of our efforts here at Up Top HipHop to showcase Canadian hiphop, we have added Spotify playlists as an extension to our brand. Listeners can follow our Spotify account for a new 10-song playlist every Sunday, compiled by Eh Vee.
The first entry into our Spotify Sundays playlist series can be be found below as well as a list of of the 10 songs included!
- Peter Jackson – On A Wave
- Merkules – Way Down
- Evil Ebenezer Feat. Merkules – Ski Mask Way
- Blacka Da Don – Got Somebody
- T Gramz Feat. Maino – Can't Sleep
- Robbie G Feat. Emmaline – Mind Made Up
- Boombap Disciples Feat. Merkules – Boombaptism
- Haviah Mighty – For Free
- Friday Ricky Dred Feat. T Gramz – Hungry
- Sayzee – Fire
As always, artists are welcome to submit their music to be included! Song links can be sent to email@example.com with the Subject Line "Spotify Sunday Submission"


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Stevenage FC: Security Ask Fans To Show Bras
Lamex Stadium Staff Allegedly Asked Female Away Supporters To Lift Their Tops
Police investigating a stable yard fire in Hertfordshire in which four horses died have arrested a 43 year old man.
It's thought the fire started during an attempted burglary at the stables on Benington Road, Walkern near Stevenage at around 1.50am on Wednesday 3 October 2012.
The 43 year old man was arrested at an address in Walkern on the morning of Tuesday 16 October.
Chief Inspector for East Herts Gerry McDonald said: "We take these kinds of offences very seriously and are completely committed to tackling rural crime. This kind of crime has a huge impact on the local community and I hope today's arrest will reassure local residents that we will deal robustly with these types of offences when they occur."
Anyone with information is asked to contact Hertfordshire Constabulary on the non-emergency number 101 or alternatively Crimestoppers on 0800 555 111.
Lamex Stadium Staff Allegedly Asked Female Away Supporters To Lift Their Tops
15 Year-Old Boy He Tried To Meet Was A Paedophile Investigator
University of Bedfordshire Opens Clearing Support For Students In Beds & MK
100% Of Breast Cancer Patients Also Said They Had All The Information They Needed
1am - 6am
Text 'HEART' to 82122
Now playing: The best feel good music
Deposit £10 to get a £40 Welcome Bonus - That's £50 to play bingo, slots and more!*
Over 50 tracks to make you feel-good. New album out now...
Find your local four day weather report here.
What's happening on the roads where you are?
Make Heart the soundtrack to your day and you could be a winner with great prizes up for grabs throughout the day.
Find out more about some of the companies advertising on Heart.
Get some great ideas on how to advertise your business on radio, online and on mobile.


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yourMinerals Wave Eye Shimmer
Made with 100% minerals, Wave's shimmering effect you can create a dramatic look necessary for your sophisticated, but yet fun look. Wave is stylish both used separately dry for a shimmering look, or wet for a heavier shimmering metallic look. It can also be mixed with other colors to create an infinite number of shades.
yourMinerals Black Onyx works perfectly as an eyeshadow and/or an eyeliner. Black onyx is a very intense black shadow. It works perfect when dry or... Read More
yourMinerals Brown Hypnotic is a Glimmering Eyeshadow. With its glimmering effect you can create a dramatic look by applying a thicker layer and by shading... Read More
yourMInerals Lavender Dream Eyeshadow This eyeshadow is a very settled yet vibrant color of purple lavender. It is similar to our Lavender Pearl but with... Read More
yourMInerals Swedish Winter When you need a highlighter for your eye makeup to look perfect and your eyes to pop, Swedish Winter is the product... Read More


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Some see Toronto Pearson as a wide expanse of runways, terminal buildings, and roadways. However, we also see the open space and creek valleys that make up approximately one-third of our airport's land.
Toronto Pearson's first honeybee apiary, YYbeeZ, is situated along the trail near the Etobicoke Stormwater Facility.
Cared for by local beekeeper, Kuldip Jassal, the bee hives will help support food security and sustainable agriculture in the airport's surrounding area.
Follow their un-bee-lievable story on Twitter, Facebook, and Instagram with #YYbeeZ.
Come back often for updates on our bees.


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According to CLE participants on the Coast, Justice Randolph announced that at 1 p.m. CST today, the Mississippi Supreme Court issued an order declaring that the Governor Barbour has no authority to cut the budget of the state's Judiciary. No order is on the MSSC's website yet. This will have quite an impact on the ongoing budget battle in the Legislature.
UPDATE at 2:07 p.m. - I have a copy of the order on the way, and will post it as soon as I get it.
UPDATE at 2:16 p.m. - NMC's got the order up.
Friday, January 29, 2010
REPORT - Justice Randolph tells CLE participants that MSSC says Executive Branch has no authority to cut Judiciary budget *UPDATE x2*
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It might not feel like summer, but it's definitely time to get ready and have a plan. In this MYM 5 Minute Thought Chris takes a look at the work youth ministers need to do in order to strengthen their ministry in the fall.
To join Chris live for MYM 5 Minute Thought follow him on Periscope @chrisrwesley


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Thomas Joyce, the chief executive officer of Knight Capital Group Inc., is poised to collect a $7.5 million retention payment tied to Getco LLC's acquisition of the market-making firm, according to a government filing.
Continue Reading »»
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Python Skripts for IGG
Hi to whoever might be able to help... I'm a student at the university of Stuttgart and I'm working on a reseach project in the field helicopter aerodynamics. I'm trying to create a grid using IGG. To do this more efficiently I'm writing a skrip in Python. However, I have only got a limited number of commands. My question is were might I be able to get a list of the Python - IGG commands.
Re: Python Skripts for IGG
Hello Ole,
The best listing of IGG commands exists in the latest IGG manual that accompanies the FINE 6 release. Chapter 6 contains a detailed listing that spans pages 6-11 to 6-37. If the new release hasn't reached you yet, it should soon.
Another useful method to determine what commands might be appropriate for your needs is to select 'File/Scripts/ViewRecording' from the horizontal menu bar at the top of the screen. Scripts are recorded automatically as you point-and-click through various operations in IGG, so the exact command that you access via the interface will be displayed in the 'Current Recording' dialogue box. You can copy and paste from this dialogue box into your own script, or you can simply select 'File/Scripts/Save Recording' after you have performed a series of tasks, to place all of the operations into a new script file.
I hope this information helps. Feel free to let us know if you require further assistance.
Best regards,
Re: Python Skripts for IGG
Hello Allan, thank for the advice, was of great help. I'll try and get the latest IGG manual. However, the recording of the preformed tasks helps a lot for now. Best regards, Ole
|All times are GMT -4. The time now is 11:36.


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Apartment in United States
08/01/2007 - 12/31/2007
Contract types:
- Home Exchange
Can accomodate: 2
Number of bedrooms: 1
Number of bathrooms: 1
Owner's description:
Second-floor, wooded/secluded 700 sq ft apartment in quiet neighborhood. The unit has carpet, washer/dryer, all appliances, electric, heat/ac, fireplace (wood), 27" TV, Playstation 2 and a covered patio. You also may utilize the clubhouse privilages which includes a swimming pool (outdoor), jaquazzi (outdoor), racket ball court (indoor), two clay tennis courts (outdoor), gym (indoor), sauna (indoor) and game and billards room (indoor). There is also a golf course within five minutes from my apartment. Restaurants and bars are within one mile of my apartment complex. Downtown Richmond, VA is a mere twenty minute drive. I keep my apartment very, very clean and wish for others to do so as well.
About the owner
"Professional, 25-year-old female looking to travel to anywhere between Aug 01, 2007 to Dec 31, 2007. Ideal setting is quiet, no traffic, however still have the amenities of a city."
Spoken Languages:
Abron, English
No children in party
Smokers in party
No pet in party
Wants to go to:
August 2007 - December 2007
|Join Friendly Travelers to discuss this property
Please contact us with any questions, suggestions or feedback òóðû âûõîäíîãî äíÿ


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This table should dispel a number of fictions used to halo the genetically engineered protein pesticides in GM "insect resistant" crops.
These GM crops are also known as "Bt" crops because the inspiration sources for the GM DNA code are located in various strains of the bacterium "Baccillus Thuringiensis", or "Bt" for short.
The table (see below) lists GM "Bt" crops approved by Australia's food regulator FSANZ. http://www.foodstandards.gov.au/consumer/gmfood/applications/Pages/default.aspx
Some points to note:
•There are many different GM "Bt" crops, containing many different genetically engineered protein pesticides. •In no cases has the code been "cut and pasted" from "nature" (i.e. the native bacterial source). •In no cases is the DNA code nature identical. The bacterial code had to be substantially altered because it did not work well in these crops. It is thus synthetic. •In many cases there is no 'native protein' equivalent in Bacillus Thuringiensis because the genetically engineered protein pesticides are chimeric mixtures of various insecticidal/bacterial source codes and may contain further novel code and other additions.
This table only points to the source of inspiration for the code and for the difference between the lengths of the GM coded protein pesticides and that of the native insecticidal protein (where it exists). There are further differences between the GM "Bt" protein pesticides and those of the crystal forming Bt insecticides found in nature, not discussed here. These GM pesticides are not the same as those used in organic agriculture.
With the exception of three crops the data in the table has been extracted exclusively from the regulatory documents held on the FSANZ website. The data should not be regarded as definitive. Deep investigations into Monsanto's "MON 810" and Syngenta's "Bt-11" corns show that FSANZ can provide faulty information on crops. FSANZ typically limits itself to the information it receives from the GM companies – the dossiers are not always clear or accurate. FSANZ advice on Monsanto's "MON 15985" cotton appeared contradictory.
aa: amino acids CTP: Chloroplast Transit Peptide


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Home :: Wedding Bands :: Gold Wedding Bands :: Sandblasted Gold Bands :: White Gold
Wedding Band
Product Selection
Perfect Service!!
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Sommeliers are known for their ability to identify a wine's subtle flavors, a feat they accomplish by defragmenting the molecules with the bonus taste buds in their livers. Trust their gut with this Groupon.
Choose from Four Options
- $18 for wine flights for two with one take-home bottle of wine, valid Monday–Thursday ($30 value)
- $18 for wine flights for two with one take-home bottle of wine, valid Friday–Sunday ($30 value)
- $33 for wine flights for four with two take-home bottles of wine, valid Monday–Thursday ($60 value)
- $33 for wine flights for four with two take-home bottles of wine, valid Friday–Sunday ($60 value)
Troon Vineyard
For nearly 40 years, Dick Troon tried his hand at winemaking. The early years were filled with a whole lot of trial and error, and not every bottle was particularly successful. But his innovation and stubbornness eventually payed off, resulting in immensely robust and successful varietals. It was because if his spirit and undiscouraged sense of optimism that the winemakers at Troon Vineyard have such vast insight into the viticulture of the Southern Oregon land where their grapes grow fat on the vine—and probably one of the reasons they've amassed so many awards and accolades.
In 2003, Troon handed over the the winery to a friend and fishing companion, Larry Martin, who to this day oversees operations and who reinvented the vineyard and tasting rooms that stand today. The wines produced there range from the ripe, clean Zinfandel—crafted from grapes originally planted by Troon back in 1972—to the robust, smoky notes of dark cherry and caramelized oak of the Estate Syrah. These wines can be sampled and purchased at both of the two tasting rooms, where the wine-savvy staff educates visitors on varietals, good pairings, and the best wine to drink before a first date.


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JFBP Summer Programme 2017
This autumn the Japan Foundation, Budapest celebrated it's 25th anniversary. We would like to take this opportunity to thank you for your kind support thus far. We...Read more
The 11th International MANGA Award
The Ministry of Foreign Affairs of Japan and the Japan Foundation have launched the Tenth International MANGA Award and started to accept entries for...Read more
The Japan World Exposition 1970 Commemorative Fund
About the work of The Japan World Exposition 1970 Commemorative FundRead more
Traveling Exhibition Service
The Japan Foundation, Budapest circulates traveling exhibitions for museums, university galleries and cultural organizations.Read more
Grant programs
Japan Foundation Grant Programs for JFY 2017-2018
A full array of the Japan Foundation's applicable programs in the field of arts and culture, publication on Japan.Read more
Local Project Support Program 2017/2018
This program is designed to provide partial assistance for implementing projects related to Japanese culture and arts, with the aim of enhancing cultural exchange...Read more


text: Sitting on my patio the other day I heard a familiar jingle. Looking toward the street a bright colorful ice cream truck went by. My mouth soon watered just like it had years ago. I'm sure that same experience and memory is enjoyed by other baby boomers across America. The history of ice cream street […] Continue Happiness on a Stick


text: Mobile Army Surgical Hospital.On some versions, like bratz, it means mansion, apartment, shack, house. Retrieved from "http://answers.wikia.com/wiki/What_does_the_acronym_MASH_mean?oldid=3263793" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Answered questions Acronyms Add category Cancel Save


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Choose Between Two Options
- $7 for single-day admission for two ($14 value)
- $10 for single-day admission for four ($28 value)
Frederick's Oktoberfest takes place from 11 a.m. to 10 p.m. on Saturday, October 3, and from 11 a.m. to 6 p.m. on Sunday, October 4, 2015.
Frederick's Oktoberfest
Beers pour in from Germany, Belgium, and Frederick County itself at Frederick's Oktoberfest, presented by Rotary Clubs from across the area. Mix in bratwurst, sauerbraten, German potato salad, and pretzels, and it all adds up to an authentic celebration of German culture. Bringing it all home are old-fashioned polka bands and German wines.


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UK minister says encryption on messaging services is unacceptable
March 26, 2017 By Elizabeth Piper LONDON (Reuters) – Technology companies must cooperate more with law enforcement agencies and should stop offering a "secret place for terrorists to communicate" using encrypted messages, British interior minister Amber Rudd said on Sunday. Local media have reported that British-born Khalid Masood sent an encrypted message moments before killing four people last week by ploughing his car into pedestrians and fatally stabbing a policeman as he tried to get into parliament in an 82-second attack that struck terror in the heart of London. There…Read More


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When it comes to finding the best broadband plans there are several options open to you. Contractual agreements and prepaid mobile broadband plans are two of the best ways to get yourself a great deal when it comes to getting online out and about, but how do you know which to choose? We're going to take a look at the pros and cons of each to help you to make an informed decision and get the cheapest and best deal.
The Best Broadband Plans – Contract
Contractual mobile broadband plans provide the ability for you to pay monthly for your internet access, usually through a direct bank transfer to save you worrying about making payments to your internet company. Longer contracts will normally offer you better deals, though it's always worth shopping around to see what you can find.
You will pay the same every month (as long as you don't download more than your contract allows) whether you use your download limit or not. It is unusual for contracts to offer any rollover from one month to the next, so don't expect to have the option of downloading more one month because of downloading less the month before. It is important, therefore, when setting up a contract to be sure that it will have enough bandwidth and download limits for your needs. Likewise, you should ensure that you won't be paying a lot of money for a fast connection that you don't need.
The Best Broadband Plans – Prepaid
Prepaid mobile broadband plans differ to contractual agreements in that you simply pay for the internet connection that you want upfront, renewing it as and when required rather than on a set monthly basis. This means that you need to be aware how much you are using to save the eventuality of your connection simply disappearing one day because your prepaid balance has run out.
On the plus side, with prepaid mobile broadband you don't need to sign up for any long contracts which could be useful if you don't know what you will be doing in a year or two's time. You will also not have to worry about passing any credit checks as with a contract, as you will be paying for your internet upfront.
Comparing the Best Broadband Plans
When it comes to deciding whether a contract or prepaid mobile broadband would be better for you, the best advice that we can offer is to do your homework and research the deals that are around. Long contracts might offer you what looks like cheaper broadband on the surface, but if you aren't using all that you are provided with it could end up costing you more. Prepaid mobile broadband, on the other hand, could also cost you more if you are using the internet a lot and constantly exceeding your download limits.
The best solution for you will depend on your circumstances and on the reason that you wish to have access to mobile broadband in the first place. Take some time, think about what you really need from your broadband connection, and research the different deals around to find the best package to suit your needs.


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Though this tool is designed for discovering situations where an article contains an image but still has its talk page tagged as requiring one, it can be used successfully for any 'Main article has a .jpg image but talk page is in category Y type requests'. It was written after a request by en Wikipedia user PC78 and the SQL was written by toolserver admin flyingparchment and then edited by me. Technically speaking, this tool assumes only .jpg images are qualifying works and that any .jpg image (bar some limitations, see below) is indeed a qualifying work (even if its a 2x2 pixel template image, which are thankfully very rare).
Files containg 'stub', 'flag' or 'icon' are automatically assumed to not be qualifying works. The English Wikipedia also has its own blacklist, which you can view and add to. The scenario here would be that the tool lists works just because they have an image in their stub template, or something else like that. Add the name of that image to the watchlist.
Just specify a language and a talk page cat (both cAse SenSItive) and press 'Go!'. The PHP is designed to give you a usable URL that you can give to others.
Probably incorrectly tagged (11 in total):
- Avoca, Iowa (talk | edit)
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A/N: okay, so this is a new anime and I haven't seen past episode 13 yet ^^" tehe... but I love it~3 Death the Kid is my favorite character, and I wanted to write this... I have been thinking about this since I watched episode 3... what if someone told Kid the truth... no one has a symmetrical face, including himself... O.o kinda weird, but I think it's kind funny ^^" I don't own Soul Eater or Kid but I do own Teruhi... she is my character~!
It was just another normal day in Death City as Teruhi walked the streets. She was humming some song from some movie she had never heard of when she heard it.
"How dare you ruin my perfect SYMMETRY! Symmetry is the beauty of life and my aesthetic! It MUST be PERFECT!" of course, curious as she was, Teruhi decided to follow the source of the racket. She saw a boy who she recognized as the son of Death himself! What had she gotten herself into this time... she sighed.
He looked over and saw her. He gasped when he saw her outfit. It was hideously asymmetrical! The shirt was white and black, with various shapes on it! The sleeves were different lengths, and her hair was different on either side! Her eyes were two different colors, one blue and one black. She was simply hideous, "How... how can you LIVE with yourself! So asymmetrical... it's horrible!" He fell to the ground, horrified.
She raised her eyebrows, "Well, you're one to talk. You have white stripes on just the left side of your hair! Anyways, even if it wasn't your hair, your face is asymmetrical," she smirked triumphantly.
"You're right! I'm scum! Trash! I deserve to- wait, but my face is PERFECTLY symmetrical!" he stood up, "what's wrong with it? Tell me! What ruined my perfect, symmetrical face?"
Teruhi laughed, "well nothing specific. It's just a fact of life," she shrugged, "No one has a symmetrical face. Their eyes may have a centimeter difference, or maybe their eyebrows are off. Perhaps, the corners of the mouth fold up at different angles. No one has a symmetrical face~"
He collapsed again, burying his face in his hands, "How... how can this be...? It can't be true..."
Patty began to giggle uncontrollably while Liz knelt down beside Kid, sighing, "It's okay. You're not scum, and you definitely don't deserve to die."
"Well, if you care so much, why not get it fixed?" Teruhi chimed in.
Kid looked up, "But... it wouldn't help... I'll still be worthless trash who doesn't deserve to live! No one can make my face perfectly symmetrical unless I do it myself!... That's it! I'll fix it myself!" he jumped up triumphantly, "Liz, Patty, make the preparations," he walked towards the direction of his house as Patty laughed even harder, Liz facepalmed, and Teruhi sighed.
She began to walk off, 'next time I'll keep my curiosity in check' she continued walking and never looked back.
A/N: I know, I know... it's short =.= maybe I'll have more tiny oneshots about Teruhi and Kid, because... well... Teruhi's an artist who doesn't care for symmetry ^^" hehe I enjoyed writing this... please review~!


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Bill Conroy's Comments
Kremlin's Quid Pro Quo Deal With Trump Camp Comes Into FocusPosted by Bill Conroy - July 17, 2017 at 8:22 pm
Pact Appears to Implicate an Unlikely Alliance Involving the Russian Arms Business, a Hollywood Actor and the NRA
It's a good bet most people haven't heard of Russian billionaire Igor Kesaev, even though he is on Forbes magazine's list of the world's richest people.
Trump's Business Venture in the Dominican Republic Could Become a Strangling AlliancePosted by Bill Conroy - June 19, 2017 at 10:27 pm
The US president's business partners in the Caribbean nation are linked to a Venezuelan tycoon who is allegedly the target of a major US investigation
President Donald Trump is involved in a major real estate project in the Dominican Republic that also has drawn in a billionaire Venezuelan banker whose business dealings are allegedly the target of a Department of Justice investigation.
Vice President Pence Has Cause to Support Trump's Kremlin-Friendly AgendaPosted by Bill Conroy - May 29, 2017 at 8:28 pm
Two of his biggest Indiana corporate backers have significant business interests in Russia
The ongoing congressional and FBI investigations into the Trump administration's entangling alliances with the Kremlin have so far left Vice President Mike Pence on the sidelines.
Pence claims to be clueless about key moments in the still-unfolding scandal.
White House Grounds Breached After Secret Service Froze Officers' Pay, Leaked Email RevealsPosted by Bill Conroy - March 12, 2017 at 6:35 pm
Intruder jumped multiple fences before being apprehended near a White House entrance
La interferencia rusa en las elecciones americanas tiene más sentido cuando sigues el dineroPosted by Bill Conroy - February 6, 2017 at 8:17 am
El ciberataque a los Demócratas coincidió con la campaña de los bancos controlados por Putin para revocar las sanciones de Obama
-4 de enero de 2017 a las 8:36 pm
Pending Lawsuit Seeks to Expose Trump's Neo-Nazi ConnectionsPosted by Bill Conroy - January 29, 2017 at 9:40 pm
US President Donald Trump Has Surrounded Himself With Advisors Who Are Sympathetic to White Supremacist Ideology
A lawsuit pending in federal court in Kentucky since this past April may shed some light on the oppressive executive orders issued recently by President Donald Trump that target refugees worldwide as well as immigrants from seven Muslim-majority nations.
Demanda pendiente busca exponer las conexiones neonazis de TrumpPosted by Bill Conroy - January 29, 2017 at 9:40 pm
El Presidente de los Estados Unidos, Donald Trump, se ha rodeado de asesores que simpatizan con la ideología supremacista blanca
Russian Interference in US Elections Makes More Sense When You Follow the MoneyPosted by Bill Conroy - January 4, 2017 at 8:36 pm
Cyberattack on Democrats Coincided With Putin-Controlled Banks' Lobbying Campaign to Roll Back Obama Sanctions
Russian intelligence-agency operatives as early as mid-2015 had taken the initial steps in penetrating the computer networks of the Democratic National Committee (DNC) and of presidential candidate Hillary Clinton's campaign manager, John Podesta.
Casino Owned by Presidential Candidate Donald Trump Violated US Anti-Money Laundering Laws RepeatedlyPosted by Bill Conroy - October 23, 2016 at 4:40 pm
Federal law enforcers fined gaming company more than $10 million for leaving "financial system unacceptably exposed" to criminal activity
The Donald and the SnitchPosted by Bill Conroy - September 27, 2016 at 9:52 pm
Donald Trump's Business Empire Offered Mob-Linked FBI Informant a Target-Rich Environment
Republican presidential candidate Donald Trump's business relationship with a U.S. government informant named Felix Sater raises some interesting questions about what Trump knew and when he knew it — and whether Trump, at some point, also agreed to become an informant himself.


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Co-infection with falciparum malaria and HIV-1 increases the severity and mortality of both infections in unstable malaria-transmission areas. In contrast, in stable transmission areas, HIV co-infection increases the severity of both infections but has not been found to influence malaria mortality.
In a prospective cross-sectional study, clinical and laboratory data were consecutively collected for all adults admitted with fever and/or suspected malaria to the medical department of the Central Hospital of Maputo, Mozambique, during two malaria seasons from January 2011. Malaria and HIV PCRs were performed, and risk factors for fatal outcomes were analysed. The impact of HIV on the clinical presentation and mortality of malaria was assessed.
A total of 212 non-pregnant adults with fever and/or suspected malaria and 56 healthy controls were included in the study. Of the 131 patients with confirmed falciparum malaria, 70 were co-infected with HIV-1. The in-hospital mortality of the co-infected patients was 13.0% (9/69) compared with 1.7% (1/59) in the patients without HIV (p = 0.018). Malaria severity (p = 0.016) and co-infection with HIV (p = 0.064) were independent risk factors for death although the association with HIV did not reach statistical significance. The co-infected patients had significantly more frequent respiratory distress, bleeding disturbances, hypoglycaemia, liver and renal failure and high malaria parasitemia compared with the patients with malaria alone.
HIV co-infection is associated with increased disease severity in and mortality from malaria in an area of stable malaria transmission. This finding was not observed earlier and should motivate doctors working in malaria-endemic areas to consider early HIV testing and a closer follow-up of patients with malaria and HIV co-infection.
Citation: Berg A, Patel S, Aukrust P, David C, Gonca M, Berg ES, et al. (2014) Increased Severity and Mortality in Adults Co-Infected with Malaria and HIV in Maputo, Mozambique: A Prospective Cross-Sectional Study. PLoS ONE 9(2): e88257. https://doi.org/10.1371/journal.pone.0088257
Editor: Abdisalan Mohamed Noor, Kenya Medical Research Institute - Wellcome Trust Research Programme, Kenya
Received: April 6, 2013; Accepted: January 7, 2014; Published: February 5, 2014
Copyright: © 2014 Berg et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: Funding was provided by the Western Norway Regional Health Authority to AB. Economical support was also received from the National Center for Tropical Medicine and Imported Infectious Diseases in Bergen, Norway, and The Norwegian Medical Association for Infectious Diseases. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Despite decreasing prevalence, malaria is one of the most important infectious diseases worldwide. In 2010, approximately 1.24 million people died of malaria globally, the majority of whom were in sub-Saharan Africa, including 52000 people in Mozambique. Of these individuals, 47% were above five years of age, which is more than previously assumed [1]. Malaria is meso-endemic in this country, with stable transmission of more than 95% due to Plasmodium falciparum (P. falciparum) [2], [3]. Mozambique has an estimated national human immunodeficiency virus type 1 (HIV1) prevalence in adults of 15–49 years of age of 11.5% in general and of 22.5% in Maputo (2009), with one of the highest global incidences of co-infection with malaria and HIV [4], [5], [6].
Several studies have suggested that people infected with HIV have more frequent and more severe episodes of malaria and vice versa, as parameters of HIV disease progression worsen in individuals during acute malaria episodes, with unknown long-term effects [7], [8], [9], [10], [11], [12]. While there is increased mortality in adults co-infected with malaria and HIV in areas with unstable malaria transmission, this phenomenon has not been established in areas with stable malaria transmission [13], [14], [15], [16].
In the present study, we examined the impact of co-infection with HIV on (i) clinical manifestations and (ii) outcome in hospitalised adult patients in Maputo with P. falciparum malaria.
Study design and participants
The Central Hospital of Maputo is a public quaternary care teaching hospital that serves Maputo's 1.2 million citizens and is a national referral hospital for the 22 million people in Mozambique. From 8th January 2011 to 31st March 2011 and from 7th November 2011 to 14th March 2012, a prospective cross-sectional study was performed on all patients consecutively admitted to the Medical Emergency Department at the Central Hospital in Maputo during workdays. All non-pregnant adults of 18 years or more and with an axillary temperature equal to or more than 38.0°C and/or suspected malaria were included, provided a given consent from the patient or from the next of kin if the patient was mentally confused or unconscious. "Suspected malaria" was defined as a history of fever, chills, headache, mental confusion, vomiting and/or diarrhoea, dyspnoea, myalgia and/or general malaise in the absence of symptoms, findings upon clinical examination or additional diagnostic tests indicating other infections. Additional diagnostic tests and exams were basic laboratory tests (e.g., Hemoglobin (Hb), WBC, differential count, ESR, AST, ALT, ALP, bilirubin, LDH, creatinine); other blood tests (e.g., bacteriological and fungal culture and antigen/antibodies for HIV-1, HIV-2, CMV, EBV, hepatitis B and C); urine analysis (stix, micro, culture); Cerebrospinal fluid (CSF) analysis (erythrocytes, WBC, differential count, protein, glucose, chloride, syphilis and cryptococcal tests, bacteriological and fungal culture); sputum analysis for M. Tuberculosis with microscopy (AAFB) and culture; stool analysis (e.g., microscopy for ova and cysts, bacteriological culture); and cytological/histological and different radiological exams, if indicated. In addition, health workers at the hospital and their family and friends were included as controls, provided that these individuals had a subjective feeling of wellbeing and a healthy appearance, as evaluated by the researchers. Female controls were excluded in the case of suspected or confirmed pregnancy.
A predefined set of clinical data was recorded from the patient files, which were compiled as a part of the routine clinical examination and follow-up at admission and during the hospital stay. Each file included the duration of symptoms, the presence of clinical criteria for severe malaria and HIV, the treatment given and the status at discharge (alive or dead) [17], [18]. If an inexperienced medical doctor had recorded the primary data, the researchers crosschecked these data. Fever was measured by a digital thermometer. (Bastos Medical, Valeo Corporation, Taipei, Taiwan.) Some of the patients who were both admitted and discharged directly from the Emergency Department had limited observations and laboratory findings. Survival data were crosschecked with the nurses' and the ward statistic manager's registries of deaths. For the healthy controls, only age and sex were recorded.
According to the hospital's routine, and consistent with standard procedures in the hospital's laboratory, we performed HIV testing (Determine, Alere Medical Co. Ltd; Chiba, Japan and Unigold, Trinity Biotech plc, Bray, Ireland), an HRP-2 Rapid Diagnostic Test (RDT) for malaria (2010–2011 First Response® Malaria antigen P. falciparum, Premium Medical Corporation Ltd., Daman, India; 2011–2012 ICT Malaria P.f.®, ICT Diagnostics Cape Town, South Africa), thick blood smears for malaria (Giemsa 20% for 5 minutes) and other routine laboratory tests. Parasitemia in a thick smear was categorised as +, which correlates to 1–10 parasites/100 fields; ++, or 11–100 parasites/100 fields; +++, or 1–10 parasites/field; ++++, or 11–100 parasites/field; or +++++, or >100 parasites/field [19]. In addition, blood samples were separately collected for HIV and malaria PCR analyses. The total nucleic acids were extracted from blood cell fractions [20]. Using 25% reduced sample volume; HIV-1 RNA was detected using an HIV-1 RG quantitative RT-PCR kit (Professional Biotech Pvt Ltd., New Delhi, India). Inhibitory samples were diluted 10 times and retested. Non-inhibitory, weakly positive samples were retested in a full-scale sample volume. Malaria PCR was performed using malaria plasmodium mitochondria- and species-specific 18S PCR. Divergent results were resolved by DNA sequencing [21]. An HCG urine pregnancy test was performed for female patients at fertile age with Quick Vue® (Quidel Corp., San Diego, California, USA).
Malaria positivity was defined as all patients with a positive malaria PCR test. Malaria PCR was not performed for two patients. These patients had positive HRP2 antigen tests and positive slides with parasitemia of 3+ or 5+ and were also defined as malaria positive. HIV positivity was defined as having a positive HIV serological test and/or a positive HIV PCR test. Malaria severity was categorised according to the number of criteria fulfilled for severe malaria, as defined by the WHO, and is given in Table 1 [22]. HIV disease severity was categorised according to the WHO's clinical HIV staging of I–IV [18].
Statistical analysis
Categorical or dichotomous data were presented as counts and percentages, and comparisons between groups of malaria patients were performed using Chi-squared tests. Continuous data were presented as medians and ranges and compared using Mann-Whitney tests. The effects of possible risk factors for fatal outcome are evaluated in terms of odds ratios (ORs) with corresponding 95% confidence intervals (CIs) and p-values from Wald tests and simple and multiple binary logistic regression analyses. For analyses involving variables for which certain subjects/patients had missing observations, these subjects were excluded, and the number of included subjects was indicated in the result tables. When calculating number of fulfilment of the total ten severity criteria for malaria in table 1 and figure 1, patients were included even if missing few criteria done only on suspicion of actual organ involvement as bilirubin. All statistical analysis was performed with SPSS-21.
Expressed in number of criteria fulfilled for severe malaria, as outlined in Table 2. (n = 118, missing 13 patients).
Ethical consideration
Written consent or fingerprinting was obtained from patients or next of kin. The National Ethical Committee at the Ministry of Health in Mozambique and the Regional Ethical Committee in Eastern Norway approved the study. The institutional review board approved the use of health care workers as healthy controls.
Characteristics of the study population
A total of 212 non-pregnant adults with fever and/or suspected malaria and 56 healthy controls were included in the study. In contrast, 48 eligible patients were excluded for different reasons (e.g., a lack of informed consent, leaving the hospital or not available within the hospital). In the entire patient group, the median age was 37 years (range: 18–84), 47% were women, and 99% were ethnic Mozambicans. Among the healthy controls, the median age was 26 years (range: 18–56), 41% were women, and 96% were ethnic Mozambicans. Most of the patients and most of the healthy controls came from the more peripheral suburbs of Maputo city. (Estimated ≥90%). Of the 212 patients with fever and/or suspected malaria, 131 (62%) had malaria and 70 of these patients (53%) were co-infected with HIV (Figure 2 and table 2). There was a significant difference in the HIV rate in malaria patients treated in and discharged from the Emergency Department compared with the admitted patients, with a rate of 29% (4/14) in those patients who were discharged and of 57% (60/106) in the patients who were admitted. (p = 0.048, missing data 10 patients). Of the healthy controls, four people were HIV positive, including one person who also had co-infection with P. ovale. All malaria patients were infected with P. falciparum. In addition, two patients had a double infection with P. vivax or P. malariae, respectively. All HIV-infected patients tested positive for HIV-1, except for one patient who had positive Determine and Unigold tests for HIV-2 but had an HIV PCR positive for HIV-1. Age and gender gave no significant difference between the malaria patients with and without HIV co-infection or between the HIV-positive patients with and without malaria. The median duration of symptoms in malaria patients with HIV was twice that of the malaria patients without HIV (8.6 vs.4.2 days) with a much wider range, although not significant. There was a significant difference in the median duration of symptoms for the HIV patients with and without malaria, from 8.6 days in the malaria- and HIV-infected patients to 7 days in the patients with HIV alone (p = 0.001). Of the malaria patients with HIV co-infection, 59% (41/70) had severe HIV infection, with HIV WHO stage 3 or 4, compared with 83% (48/58) of the HIV patients without malaria (p = 0.003). The median HIV viral load for the HIV patients with and without malaria was 1.8×104 HIV RNA copies/mL plasma (range: 0 – 8.3×106) (n = 61) and 1.3×104 HIV RNA copies/mL plasma (range: 0–5.1×106) (n = 58), respectively, without a significant difference (p = 0.184). Unfortunately, data on CD4 T cell counts were lacking in all except 11 and eight HIV patients with and without malaria, respectively, who had a median CD4 T cell count of 206 cells/µL (range: 14–632) and CD4 136 cells/µL (range: 10–196), respectively (p = 0.215). (Table 2)
*Number of patients.
Clinical manifestations
Despite a history of fever, at admission, 50% (54/108) of the malaria patients presented with no fever, without a significant difference according to HIV status. The patients co-infected with HIV and malaria had significantly more frequent respiratory distress, bleeding disturbances and/or haemolysis, jaundice and/or elevated bilirubin levels, low serum glucose levels, renal failure and high malaria parasitemia compared with the patients with malaria alone. In line with this phenomenon, malaria patients with HIV co-infection had a significantly higher malaria severity score ( = number of criteria for severe malaria) (p<0.001) (Table 1 and Figure 1). However, although those patients who were co-infected with HIV had an increased frequency of bleeding disturbance and/or haemolysis, there were no significant differences between the two groups in relation to platelet counts (<100×109/L) or reduced haemoglobin levels (<5 g/dL). Moreover, there was no significant difference regarding the occurrence of cerebral confusion between the two groups (data not shown).
Case-fatality rates
The in-hospital mortality rate of the patients with malaria and HIV was significantly higher than the mortality rate of the patients with malaria alone (13.0% (9/69) vs. 1.7% (1/59), p = 0.018), with missing data for two patients. In fact, of the 10 malaria patients who died, nine (90%) were HIV infected, and the tenth was 65 years of age. Patients admitted with fever of other causes than malaria had a HIV rate 72% (59/82) and a case fatality rate of 24% (19/78). Mortality was even higher for the patients with HIV alone (29.1% (16/55), p = 0.030) (Table 2). In total, 67% (77/115) had severe malaria, and 13% (10/77) died (p = 0.020), with missing data for 16 patients. Among the malaria patients, men had an increased risk of dying from malaria, with a crude odds ratio of 3.74 (0.76–18.35), but the difference from women in case-fatality rate was not significant (p = 0.086). The causes of death for the 10 malaria patients were cerebral malaria (three patients), complicated malaria with renal failure (three patients), coagulation disturbances (two patients), liver failure (one patient) and severe anaemia (one patient). Two of these patients had other severe comorbidity consisting of respectively longstanding pronounced alcohol abuse and lymphoma with recent chemotherapy. Although the co-morbidities could have contributed to the fatal outcome in these patients, these patients' histories, clinical findings, laboratory results and malaria parasitemia of 2+ (after quinine i.v. treatment for some days at the referring hospital) or 5+ suggested that malaria was the main cause of death. Moreover, exclusion of those two patients still resulted in significant increased mortality in the HIV-malaria patient group compared to the patients with malaria only (p = 0.042). A third patient had HIV and tuberculous meningoencephalitis according to history, clinical examination and laboratory investigation, but in addition, he had a P. falciparum-positive PCR result. This patient's cause of death was classified as meningoencephalitis and not malaria.
Malaria severity was the most important factor associated with increased in-hospital mortality. The patients who met three or more of the criteria for severe malaria had a crude odds ratio of 9.7 for death and a 95% CI of 2.43–38.91 (p<0.001) that persisted in multivariable analyses with an adjusted odds ratio of 6.3 and a 95% CI of 1.40–27.88 (p = 0.016) (Table 3 and Figure 1). The second most important factor associated with death was co-infection with HIV, with a crude odds ratio of 8.7 and a 95% CI of 8.7 (1.07–70.85) (p = 0.018). In multivariable analyses, the difference was not significant (p = 0.064), with an adjusted odds ratio of 8.0 and a 95% CI of 0.89–71.99.
Of the malaria patients, 92% received quinine intravenously as a first-line therapy, 4% received artemether intramuscularly, and the rest were treated with oral artemisinin combinations, without any significant differences in mortality. In total, 28% of the patients received antimicrobial therapy (ceftriaxone 27%, ampicillin 18%, penicillin 24% and other 31%). There was no statistically significant difference between the patients with and without HIV in receiving antimicrobials with a potential antimalarial effect, i.e., cotrimoxazole, ciprofloxacin, doxycycline and azithromycin [23], [24]. In total, 11% of the patients (14/131) received supplementary corticosteroid treatment, with no influence on outcome and with no difference between patients with and without HIV co-infection. At admission, 42% (54/128) of the HIV patients had a known HIV diagnosis. Of these patients, 56% (30/54) were on antiretroviral therapy (ART), of whom 63% (19/30) had undetectable HIV-RNA in the plasma (p = 0.001). The ARTs used were stavudine, lamivudine, efavirenz, zidovudine and/or nevirapine. Only eight patients reported receiving cotrimoxazole prophylaxis. There was no significant difference in the number of HIV-infected patients with and without malaria on the use of effective ART (i.e., with undetectable HIV-RNA) prior to admission, with respectively 69% (9/13) and 59% (10/17) (p = 0.558). Surprisingly, there was no significant difference in HIV severity or mortality in the patients with effective ART compared with those patients without ART. (Respectively p = 0.850 and p = 0.141). Of the HIV patients, 60% (44/74) were not receiving ART, despite an indication for ART*, due to a lack of HIV diagnosis before admission (*WHO HIV clinical stage 3 or 4). Of those patients with a known HIV diagnosis prior to admission, 86% (19/22) had an indication for ART but had failed to receive the HIV treatment.
In the present study, malaria patients co-infected with HIV had significantly more severe malaria compared with patients with malaria alone (Figure 1), which is consistent with several earlier studies [8], [9], [10], [11], [12]. Co-infection with HIV was significantly associated with increased in-hospital mortality. With more advanced immunodeficiency due to HIV, one would have expected increased mortality independent of the transmission area. This because primarily cellular immunity, but also humoral immunity, which are both important in malaria, are progressively affected by deterioration due to HIV disease [9]. However, several studies have failed to find increased mortality in endemic areas, which is in contrast to the findings of the present study [9], [13], [14], [15], [16]. These apparent discrepancies may have several explanations. First, in most of the previous studies, the sample size was relatively low (n<70) [9], [13], [14], [15], [16]. Second, the degree of HIV severity and the use of ART varied between the different studies [13], [15]. Third, in several of the previous studies, the ability to exclude relevant differential diagnoses was poor [9], [13]. Fourth, treatment for severe malaria varied between the different studies, with quinine used in most studies (including here) and artesunate used in other reports. This difference clearly could have influenced the outcome because artesunate is more effective than quinine [9], [13], [14], [15].
There was even higher mortality in the patients admitted with HIV without malaria, with 29.1% (16/55) compared with 13.2% (9/68) of the patients co-infected with HIV and malaria, which is most probably due to their advanced HIV-infection. (Table 2). The median duration of symptoms before admittance was 8.6, 4.2 and 7 days respectively in patients with malaria and HIV, malaria only and HIV only. HIV and malaria co-infected patients had a median duration of symptoms twice as long as HIV negative patients with malaria, although this was not statistically significant. Even if the median duration of symptoms between HIV-infected patients with and without malaria was rather modest, it reached statistical significance (Table 2). This again reflects the severity of disease in those two patient groups. The median viral load was about the same in the HIV-malaria group compared with the HIV group, despite less severe HIV disease. It is known that co-infection with malaria temporarily may boost HIV viremia [25]. There were also no significant differences in the median CD4 lymphocyte count or fraction on effective ART before admission, but the number of patients with known CD4 count was low (n = 8 and n = 11).
In comparison with the present investigation, a 2006 study on 51 patients with presumptive malaria, recruited at the same hospital as in the present study (Central Hospital of Maputo), had more severely ill patients, fewer patients on ART, a lower standard of care in the ward and a higher prevalence of both HIV and malaria. While there was no HIV-related increased malaria mortality, the diagnostic accuracy was poorer, the study group was smaller, and the treatment for severe malaria was artesunate rather than quinine [14]. Other studies also failed to find increased mortality, except for one retrospective study from Senegal on cerebral malaria [9], [15], [26]. However, the present study is, to the best of our knowledge, the first prospective study to show increased mortality in malaria patients co-infected with HIV in an area with stable malaria transmission. Importantly, the present study included patients with a wide spectrum of HIV-related immunodeficiency and had high diagnostic accuracy for both HIV and malaria.
Another possible reason for increased mortality in relation to co-infection with HIV in the present as opposed to the previous studies is that malaria transmission has decreased in Maputo, causing a gradual loss of malaria immunity [7]. This phenomenon would be expected to first be observed in immune-compromised patients, since it seems reasonable that an eventual reduction in the "average immunity" in the population will first be observed in patients with reduced immunity. However, most of the malaria patients in the current study came from the more peripheral parts of Maputo, rather than the city centre, where there is regular malaria exposure, and thus a lower risk of reduced immunity due to urban life. Whereas most literature has reported diminishing malaria prevalence in Mozambique, a recent WHO publication reported a steady increase in the number of confirmed malaria cases since 2009, but a reduction in hospital admissions and malaria-related deaths [27].
Another important point is whether positive malaria PCR may have been an incidental finding in several of the patients suffering from a different condition who happened to receive a malaria diagnosis after being subclinical carriers. In Manhiça in southern Mozambique, nearly half of the population was found to be carriers of P. falciparum, and most individuals were asymptomatic, with decreasing parasitemia with increasing age [28]. In contrast, in the Maputo area, there was a low prevalence of subclinical carriage, with 1.8% falciparum PCR positivity compared with 13.7% in the Mocuba District in Zambezia province [4]. Several studies have had similar findings, although asymptomatic falciparum carriage is particularly described in children, less in adolescents and usually even less in adults, but more in HIV positive persons [2], [4], [28], [29]. Asymptomatic carriage has likely not been a substantial problem in this case, since alternative diagnoses were not identified with a relatively effective diagnostic armamentarium. Second, only one of 56 healthy controls was a subclinical carrier (and then with P. ovale and not P. falciparum) in addition to being HIV positive. Third, the diagnosis at discharge agreed very well with the malaria PCR positivity (Cohen's kappa = 0.88, data not shown).
Despite a history of fever, only 50% of the malaria PCR-positive malaria patients presented with a temperature of 38°C or more at admission, measured with the same reliable thermometer by the researchers. Could this be an indication, despite what was discussed above, that there is substantial subclinical carriage in this area, in certain subgroups differing from the healthy controls in this study. If so, we would have expected positive blood culture results in another parallel study of patients with fever. There is missing data for the use of paracetamol or other antipyretics, which may have influenced our findings. Alternatively, because the patients were admitted with a history of fever, these individuals may be in the stage of shifting from the cold to the warm phase or the opposite in the malaria cycle. If this was the case, similar studies may have lost patients if these studies used fever upon admittance as an inclusion criterion.
The only HIV-negative patient who died was 65 years of age, which is consistent with the known increased risk of malaria death with higher age in non-endemic areas [30]. In endemic areas, increased risk with age is not known, although there seems to be more frequent malaria in the age group above 50 years [31].
An important question in low-resource settings is whether there is a clinical entity of symptoms, signs and simple laboratory observations indicating that a patient is co-infected with HIV. In the current study, the co-infected patients had significantly more respiratory distress, bleeding disturbances, hypoglycaemia, liver and renal failure and high malaria parasitemia compared with patients with malaria alone. In several studies, the co-infected patients had more respiratory distress, renal failure, abdominal pain, diarrhoea or anaemia, whereas in other studies, there was no difference in clinical presentation [8], [13], [32]. The common denominator of these studies may well be that there is no specific clinical entity typical of co-infection with HIV and malaria; rather, there may be different indicators of disease severity, as also suggested by others [26].
The strength of the present study is its prospective nature, with the consecutive inclusion of a relatively large number of patients compared with similar studies and a high diagnostic accuracy for HIV and malaria. The main limitation is a possible selection bias of not including the poorest and the wealthiest patients because the wealthiest prefer private health care, and the poorest cannot pay the admission fee of approximately 5 USD if they do not have a referral letter. Because poverty is associated with an increased risk of malaria but a lower risk of HIV, this bias may have resulted in a potential loss of HIV-negative malaria patients, which could have influenced the observed mortality both ways [33]. The PCR method may have yielded false-positive malaria patients after treatment or false-negative HIV patients if these individuals were on ART without admitting its use during the hospital stay. The first mentioned issue could have given a too-low mortality rate, and the second issue could have yielded a too-high mortality rate. However, we assume that the second did not have a very important impact on the mortality data because there was supplementary HIV serology for most of the patients and a close follow-up in the ward. Two of the patients with severe malaria were not ethnic Mozambicans, but because both survived, this finding represents no bias. Lastly, even if most patients were severely ill, relatively few died, and the sample size may have been too low to detect other factors related to death.
HIV co-infection is associated with increased mortality from malaria in an area of stable malaria transmission, in which both malaria severity and HIV are risk factors for death. The patients with HIV and malaria co-infection had significantly more frequent respiratory distress, bleeding disturbances, hypoglycaemia, liver and renal failure and high malaria parasitemia compared with the patients with malaria alone. Hence, early HIV testing should always be considered in patients with suspected malaria, and particularly with severe malaria, independent of the type of malaria transmission area. We hypothesise that this alertness of the physician may contribute to the increased survival of patients co-infected with HIV and malaria, due to awareness of potential complications at an early stage. As part of the search for improved therapy, future research is recommended to first confirm the present findings and to then elucidate the underlying immune mechanisms resulting in the observed HIV-associated increased malaria mortality.
The authors are indebted to all of the patients and their next of kin who participated in this study; to the healthy controls; to the medical doctors; to the nurses and nurses' aids in the medical wards; to the Intensive Care Unit; and to the laboratory coordinators and personnel in both the General Laboratory and the Microbiological Laboratory of the Central Hospital of Maputo, Mozambique. The authors offer a particular thanks to Christel Haanshuus at the National Centre for Tropical Medicine and Imported Diseases, Bergen, Norway, for performing the malaria PCR and sequencing.
Author Contributions
Conceived and designed the experiments: AB SP CD MG PA ESB NL. Performed the experiments: AB SP CD MG. Analyzed the data: AB PA ESB ID NL. Contributed reagents/materials/analysis tools: AB ESB. Wrote the paper: AB SP PA CD MG ESB ID NL.
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text: I thought that this show was pretty good. I was kind of sad when they stopped making new episodes. I was sad when Nick and Jessica broke up. I thought that they were the cutest couple. I thought that Jessica acted a little more dumb than she really is but it was still funny. I really think that Nick and Jessica were a great couple, and they rarely got into fights on camera. Their house was so pretty, I wouldn't sell it. I really hope that Nick and Jessica get back together, because they fit each other so well. I actually did like watching this show.


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Series: The Checkmate Duet #1
Published by Self-Published on February 28, 2017
Format: e-ARC
Source: Author
Genres: New Adult, Contemporary Romance
Pages: 402
Buy on Amazon
Introducing book 1 in the new Checkmate Duet Series from a secret duo of bestselling authors! This friends to lovers romance will have you swooning and laughing from the first to the last page! Are you ready to play the game?
Drew Fisher is the type of guy every girl wants.
Noble police officer by day, charming prince by night.
He has no idea the effect he has on women, especially me—his little sister's best friend.
I'm the blonde Southern belle who lives up to the cliché, except I have my own quirks. I'm smart as a whip, can change my own oil, and recite The Pledge of Allegiance backward, but he doesn't see that girl.
It'd be easier to forget him if he wasn't my roommate and if the first thing I saw in the morning wasn't his shirtless body covered in tattoos. I've crushed on him since the day we met, but he's made it perfectly clear where we stand. Just friends.
I know I need to move on and accept that his feelings will never be mutual, but every day he smiles at me, I'm left dreaming of what if.
He has girl issues, and I've got a crush I can't deny.
We're friends, but I want more.
One drunken hookup leaves us with much more than a platonic friendship. Pretending it never happened proves to be more difficult than anticipated.
A crazy ex-girlfriend, a dangerous war of stolen glances, and passionate kisses leads to the most reckless battle yet. I won't be a pawn in his game, but I'll play by his rules if it will show him I'm the one worth breaking them for.
Checkmate, Prince Charming.
*Recommend for ages 18+ due to sexual content and adult language.*
**This is book 1 of 2 in the Checkmate Duet Series--a friends to lovers romance. Highly recommended to read the Checkmate Duet, This is War and This is Love first, but not necessary. This can read as a standalone duet.**
I received this book for free from Author in exchange for an honest review. This does not affect my opinion of the book or the content of my review.
If you know me or have asked me for book recommendations, you know that my love for Kennedy Fox and their books is deep. Very much, obsessively deep. So when I received an ARC (thank you so much!!!) I dropped everything and devoured. And yes, I do mean devoured. I'm pretty sure I read the entire book in four hours. In one sitting. I couldn't stop reading. I didn't want to stop. I didn't want the book to end because if you've read a Kennedy Fox book then you know they will destroy you with a cliffhanger. But I'm getting ahead of myself.
Drew and Courtney are best friends and roommates, but Courtney has always wanted to be something more with Drew. She wants him to make all her dirty cop fantasies come true (cause Drew's a cop) and then some. She's in love with him but Drew only sees Courtney as a friend. She's in the friend-zone and it's a place that Courtney has resigned herself to be because even if she can't be with Drew, she always wants him to be in her life. She needs him in her life.
And they're great best friends. The perfect roommates. They have this whole dynamic and understanding with each other. Plus their banter is everything. Courtney has the type humor and wit that everyone should strive toward. Her humor is goals and I want to be her best friend.
Like I don't know who I love more in this book, Drew for being perfect and amazing or Courtney for being goals. Like seriously, I want to be her when I grow up. And clearly Drew has been wearing some weird blinders that have him not falling for his best friend. Until one night, the blinders are gone and Drew finally realizes that he does feel something more for Courtney. Something greater, something akin to what she's felt for him for years.
Drinks are consumed and dancing ensues and feelings combust when these two come together. Honestly, I can't even begin to articulate how perfect Drew and Courtney are for each other. I love them. What I don't love is Mia (Drew's ex-girlfriend) living in her delusional little bubble where she's the queen of the universe. I don't like Mia at all. I've said from the beginning she needs an exorcism. But that's enough about her, because I've spent way to much on her already.
If you loved the first Checkmate Duet with Travis and Viola than you will love this book! If you didn't love the first duet, then you will probably still love this duet. Courtney and Drew have such a different relationship than Viola and Travis and who doesn't love a friends to lovers romance? They're always super swoony. Which this book is. And hot. Did I mention Drew is a cop and owns handcuffs?


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