text:
Figure 1. Distant degree connectivity effects. A, Main effects in the orbitofrontal cortex (OFC) displayed for unmedicated patients with obsessive-compulsive disorder (OCD) and matched healthy controls (HCs). B and C, Significantly greater degree of connectivity in the subthalamic nucleus and in the orbitofrontal cortex, respectively, in unmedicated patients compared with HCs. Detailed information regarding signal quality in the OFC is available in eFigure 1 and Author Figure 1. The minimum t value threshold of 3.3 used for display of between-group effects is equivalent to a threshold of P < .001, uncorrected. MNI indicates Montreal Neurological Institute.
Figure 2. Local degree connectivity effects, considering exclusively a 12-mm sphere around each voxel for computation of degree connectivity. A, Main effects in the orbitofrontal cortex (OFC) displayed for unmedicated patients with obsessive-compulsive disorder (OCD) and matched healthy controls (HCs). B and C, Significantly greater local degree of connectivity in the right dorsal putamen and in the orbitofrontal cortex, respectively, in unmedicated patients compared with HCs. The minimum t value threshold of 3.3 used for display of between-group effects is equivalent to a threshold of P < .001, uncorrected. MNI indicates Montreal Neurological Institute.
Figure 3. Positive correlation between overall obsessive-compulsive disorder (OCD) symptom severity (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] total scores) and degree connectivity (peak voxels derived from correlational analyses between Y-BOCS scores and distant maps). A, The posterior/lateral orbitofrontal cortex (Montreal Neurological Institute [MNI]XYZ = –34, 20, –16; z = 4.07, r = 0.74, R2 = 0.55, P < .001). B, The left dorsal putamen/pallidum (MNIXYZ = –18, 2, 4; z = 3.65, r = 0.69, R2 = 0.48, P < .001). C, Medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC) (MNIXYZ = –10, 44, 22; z = 3.52, r = 0.67, R2 = 0.45, P < .001) in unmedicated patients. The minimum t value threshold of 3.3 used for display of correlational effects is equivalent to a threshold of P < .001, uncorrected.
Figure 4. Reduced local connectivity of the ventral striatum in patients with obsessive-compulsive disorder (OCD) treated with antidepressants (Med) (n = 23) in comparison with unmedicated (Unmed) patients with OCD (n = 23). A, Sagittal, coronal, and axial slices displaying the peak of group differences at Montreal Neurological Institute (MNI)XYZ = –14, 14, and –8. B, Simple bar graph shows effects in both OCD groups and healthy controls (HC). Effects are displayed relative to the mean of the respective groups, revealing high similarity between local connectivity of the ventral striatum in medicated patients and HCs. β Values are negative in all 3 groups because the ventral striatum does not represent an extensively locally connected hub in comparison with previously described local hubs, which are, for example, found in motor, somatosensory, and auditory areas.4 The minimum t value threshold of 3.3 used for display of between-group effects is equivalent to a threshold of P < .001, uncorrected.
Beucke JC, Sepulcre J, Talukdar T, et al. Abnormally high degree connectivity of the orbitofrontal cortex in obsessivecompulsive disorder.. JAMA Psychiatry.. Published online April 17, 2013. doi:10.1001/jamapsychiatry.2013.173.
eTable, A. Demographic comparison between medicated OCD patients and healthy controls
eTable, B. Demographic comparison between unmedicated and medicated OCD patients
eFigure 1. Coordinates of group differences (unmedicated OCD patients > healthy controls) displayed on averaged mean BOLD images of all participants
eFigure 2. Deriving an OFC seed for seed-based functional connectivity analysis
eFigure 3. Results from seed-based functional connectivity analysis
Beucke JC, Sepulcre J, Talukdar T, Linnman C, Zschenderlein K, Endrass T, Kaufmann C, Kathmann N. Abnormally High Degree Connectivity of the Orbitofrontal Cortex in Obsessive-Compulsive Disorder. JAMA Psychiatry. 2013;70(6):619–629. doi:10.1001/jamapsychiatry.2013.173
© 2017
Author Affiliations: Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany (Messrs Beucke and Kaufmann, Drs Endrass and Kathmann, and Ms Zschenderlein); Department of Psychiatry, Massachusetts General Hospital, Charlestown (Mr Beucke); Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts (Dr Linnman); Department of Radiology, Massachusetts General Hospital, Boston (Dr Sepulcre); Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts (Messrs Beucke and Talukdar and Dr Sepulcre); and Department of Psychology and Center for Brain Science, Harvard University, Cambridge, Massachusetts (Dr Sepulcre and Mr Talukdar).
Importance Neurobiological models of obsessive-compulsive disorder (OCD) predict hyperactivity in brain circuits involving the orbitofrontal cortex and the basal ganglia, but it is unclear whether these areas are also characterized by altered brain network properties.
Objectives To determine regions of abnormal degree connectivity in patients with OCD and to investigate whether connectivity measures are affected by antidepressant medication in OCD.
Design Case-control cross-sectional study using resting-state functional magnetic resonance imaging and a data-driven, model-free method to test for alterations in the degree of whole-brain, distant, and local connectivity in unmedicated patients with OCD compared with healthy controls.
Setting Outpatient clinic for OCD.
Participants Twenty-three patients with OCD (12 women, 11 men) receiving no medication, 23 patients with OCD (14 women, 9 men) treated with antidepressant medication, and 2 equally sized control samples matched for age, sex, handedness, educational level, and IQ.
Main Outcome Measures Statistical parametric maps testing the degree of distant and local functional connectivity of each voxel (hub analysis at voxel level) and OCD symptom severity.
Results Unmedicated patients with OCD showed greater distant connectivity in the orbitofrontal cortex and subthalamic nucleus and greater local connectivity in the orbitofrontal cortex and the putamen. Furthermore, distant connectivity of the orbitofrontal cortex and the putamen positively correlated with global OCD symptom severity. Medicated patients with OCD showed reduced local connectivity of the ventral striatum compared with the unmedicated patients.
Conclusions and Relevance Consistent with neurobiological models of OCD, the orbitofrontal cortex and the basal ganglia are hyperconnected in unmedicated patients. The finding of distant connectivity alterations of the orbitofrontal cortex and the basal ganglia represents initial evidence of greater connections with distant cortical areas outside of corticostriatal circuitry. Furthermore, these data suggest that antidepressant medication may reduce connectivity within corticobasal ganglia-thalamo-cortical circuits in OCD.
The cerebral cortex is organized into functional networks in which a particular set of regions has disproportionately numerous connections, called "cortical hubs" of connectivity.1- 3 Recent methodologic developments allow characterization of cortical hubs in the human brain from structural or functional magnetic resonance imaging (fMRI) data.2- 4 For example, estimation of degree connectivity, a fundamental network measure indexing the number of connections that link one network component to the rest of the network,3 allows for identification of cortical hubs on the basis of blood oxygen level–dependent (BOLD) signal voxel time-series data.2 Moreover, assessment of degree connectivity allows testing for alterations in network integrity or hub topography in neuropsychiatric populations.3 For instance, network alterations and correlation with pathophysiologic mechanisms have been demonstrated in Alzheimer disease and schizophrenia.2,3,5 More precisely, degree connectivity correlated with amyloid β deposition in Alzheimer disease,2 and in schizophrenia, network integrity was globally reduced, consistent with dysconnection hypotheses.5 The present study sought to test for degree connectivity alterations in obsessive-compulsive disorder (OCD) and to determine whether altered network properties are present in areas predicted by neurobiological models of OCD.6- 8
In the functional neuroanatomy of OCD, a critical role has been assigned to the orbitofrontal cortex (OFC),6- 8 a brain region crucially involved in reward-guided learning and decision making.9 Evidence supporting this view comes from neuroimaging studies identifying lower OFC activity during reversal learning10,11 and from early12,13 and recent14,15 findings of OFC hyperactivity during symptom provocation in OCD. In addition to experimental data, initial evidence of abnormal OFC activity has been identified in resting-state positron emission tomography (PET) studies examining patients with OCD.16- 24 In this setting, patients displayed elevated glucose metabolism in the OFC,16- 18,22,23 decreases in OFC metabolism correlated with symptom improvement associated with treatment,20 and correlations between OFC and thalamic activity before but not after treatment.19,24 In addition, a consistent observation in resting PET data is that antidepressant medication decreases caudate nucleus metabolism in patients with OCD,19,24 but more heterogeneous treatment responses have been shown for the putamen.22 Taken together, these resting-state abnormalities, along with symptom provocation data,12,13 essentially contribute to the empirical fundament for neurobiological models of OCD, postulating dysfunctional hyperactive corticobasal ganglia-thalamo-cortical (CBGTC) circuits.6- 8 Noteworthy recent theoretical considerations suggest that we revise assumptions involving CBGTC circuitry in OCD, given that consistent functional and structural abnormalities were also identified in dorsal prefrontal,25 parietal, and occipital areas outside of CBGTC circuitry.26
Despite the assumption of dysfunctional loops or circuits in the pathophysiologic characteristics of OCD, fMRI studies have only recently started to assess abnormal interregional connectivity of CBGTC regions in this patient group. Consistent with predictions of abnormal CBGTC connectivity, abnormally high connectivity with the OFC was found for seed regions (ie, the BOLD signal time series in a region of interest, used as a regressor for all other BOLD signal time series) in the ventral striatum in patients with OCD under resting-state conditions.27,28 However, seed-based approaches exclusively consider connectivity of a single region, thereby limiting potential insights regarding fundamental network alterations. For instance, abnormal connectivity could be present outside of CBGTC circuitry and/or concern not only one but multiple CBGTC areas. This is particularly relevant given anatomic evidence that CBGTC circuits, initially viewed to be functionally segregated,29 interact in the context of complex behaviors.30
To test for fundamental network alterations in OCD and relationships to the pathophysiologic characteristics of the disease, the present study applied a novel approach2,4 that uses resting-state fMRI data to identify areas displaying a high degree of connectivity, representing cortical hubs.2 Furthermore, recent developments allow differentiation between the degree of local and distant connectivity of all brain areas.4 In summary, these methods test for extensive whole-brain, distant, or local connectivity in every brain region and, in contrast to traditional seeding approaches, do not require a priori selection of a particular region.2,4 Thus, these methods automatically achieve simultaneous testing for hub alterations in OFC and CBGTC areas in an unbiased manner as well as testing for network alterations outside of CBGTC circuitry. The approach further allows observation of whether antidepressant medication affects striatal connectivity as suggested by decreases in striatal activity in response to treatment.17,19,24
Aside from exploring cortical hub alterations in OCD using a model-free analysis of brain connectivity, 3 hypotheses were tested in the present study. First, we tested the hypothesis that OFC and basal ganglia display a greater degree of connectivity in unmedicated patients with OCD compared with pair-matched healthy individuals serving as controls. Second, we hypothesized that the degree of connectivity in OFC and basal ganglia regions would correlate with global OCD symptom severity. Third, we predicted that the degree of striatal connectivity would be lower in medicated compared with unmedicated patients with OCD, since antidepressant medication has been shown19,31 to reduce activity in the striatum.
Forty-six adult outpatients with a DSM-IV diagnosis of OCD recruited from the OCD outpatient clinic at the Humboldt-Universität zu Berlin and 46 healthy controls who were matched for demographic variables (age, sex, handedness, and educational level) participated in the study. The total sample was divided into one sample containing 23 unmedicated patients with OCD and 23 matched healthy controls and an additional patient group consisting of 23 patients with OCD treated with antidepressants (20 receiving selective serotonin reuptake inhibitors, 2 receiving selective norepinephrine reuptake inhibitors, and 1 receiving a tricyclic antidepressant) and 23 matched healthy controls. Unmedicated patients did not receive medication related to OCD symptoms for at least 6 weeks before the imaging study. Patients were interviewed by a licensed clinical psychologist and their condition was diagnosed using the German version of the Structured Clinical Interview for DSM-IV.32 Comorbid lifetime diagnoses for the unmedicated sample included major depression (n = 12), specific phobia (n = 1), hypochondria (n = 2), substance abuse (n = 2), social phobia (n = 6), dysthymia (n = 1), bulimia (n = 1), anorexia (n = 1), generalized anxiety disorder (n = 1), panic disorder (n = 2), and somatoform disorder (n = 1). Comorbid depression was remitted in 4 unmedicated patients at the time of the study. Five unmedicated patients had OCD as their single diagnosis. Comorbid lifetime diagnoses for the medicated sample included major depression (n = 12), specific phobia (n = 2), hypochondria (n = 1), social phobia (n = 1), dysthymia (n = 1), bulimia (n = 1), anorexia (n = 1), generalized anxiety disorder (n = 4), panic disorder (n = 2), agoraphobia (n = 1), and adjustment disorder (n = 1). Comorbid depression was remitted in 6 medicated patients at the time of the study. Four medicated patients had OCD as their single diagnosis. Table 1 reports demographic data on the unmedicated patient and control groups; the eTable reports data on the OCD subgroups.
Exclusion criteria for participants included cardiac pacemakers or other metallic implants or artifacts and pregnancy. Patients could have no significant neurologic illness, prior neurosurgery, dementia, delirium, schizophrenia, delusional disorder, or other psychotic disorder. In addition, no patient could have received benzodiazepines within 4 weeks prior to the scanning session. Healthy controls did not fulfill the criteria of any DSM-IV diagnosis (lifetime) as indicated by negative results of the Structured Clinical Interview for DSM-IV screening questionnaire. All participants gave written informed consent according to the institutional guidelines before enrollment. The local ethics committee approved the study.
Severity of OCD symptoms was evaluated using the German versions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)33 and the Obsessive-Compulsive Inventory–Revised.34 In addition, the State-Trait Anxiety Inventory–Revised,35 the Beck Depression Inventory,36 and the Montgomery-Åsberg Depression Rating Scale37 were administered before the imaging study. The Edinburgh Handedness Inventory38 was used to classify handedness. All participants completed a German vocabulary test39 as a brief measure of verbal intelligence.
A total of 160 volumes (T2*-weighted, single-shot, gradient-echo planar imaging sequence) were acquired on a 1.5-T system equipped with a circular-polarized headcoil (Magnetom Sonata; Siemens) using the following parameters: repetition time, 2000 milliseconds; echo time, 40 milliseconds; 35 consecutive slices; isotropic 3-mm voxel size; flip angle, 90°; field of view,192 mm; 64 × 64 matrix, aligned parallel to the anterior-posterior commissure line; and 176 anatomical slices acquired using the Modified Driven Equilibrium Fourier Transform sequence40 (spatial resolution 1 × 1 × 1 mm; repetition time, 12.24 milliseconds; echo time, 3.56 milliseconds; flip angle, 23°; and 256 × 224 matrix). Participants were instructed to close their eyes, relax, and not think of anything specific during this 5-minute, 20-second run. Simultaneous electroencephalogram (32 channels, BrainAmp MR; Brain Products) recordings were monitored online by an experimenter trained in sleep stage scoring (C.K.) to ensure that participants did not fall asleep. A vacuum head cushion was used to achieve immobilization. Earplugs were provided to attenuate scanner noise.
The fMRI data were processed using the identical hub analysis stream that has been described in detail.2,4 In brief, image preprocessing included removal of the first 4 volumes, slice time correction, and spatial normalization to the atlas space of the Montreal Neurological Institute (MNI). Temporal filtering was used to retain frequencies below 0.08 Hz. Spurious or regionally nonspecific variance was removed by regression of nuisance variables, including 6-parameter rigid body head motion, the signal averaged over the whole brain (to account for respiratory effects), the lateral ventricles, and over a region centered in the deep cerebral white matter. The fMRI data were then spatially smoothed using a 4-mm full width at half maximum kernel.
The degree of connectivity in the entire brain was determined through correlation of each voxel's BOLD time series to the BOLD time series of all other voxels and by counting the number of voxels where the correlation with the BOLD time series exceeds a predefined statistical threshold that will be given below.2 More precisely, preprocessed functional runs were subjected to voxel-based whole-brain correlation analysis, ie, correlation of each voxel's BOLD time series to every other voxel's BOLD time series, resulting in a Pearson correlation coefficient (r) matrix. From this correlation matrix, 3 different kinds of degree connectivity maps were computed: (1) whole-brain total maps, derived by counting for each voxel's BOLD time series the number of voxels where the correlation with the BOLD time series exceeded a predefined optimized threshold2 (r > 0.25) for the entire brain; (2) local maps, derived by the same procedure but exclusively considering voxels inside a 12-mm sphere around each voxel; and (3) distant maps, also derived by the same procedure but exclusively considering voxels outside the 12-mm sphere. Crucially, total maps are the union of local and distant maps, and distant and total maps are highly correlated given that the local degree has a small contribution to the total counts compared with the distant degree.4 Histograms of all degree connectivity maps were derived on the individual level to check for normal distribution. Statistical parametric mapping (SPM8; Wellcome Department of Cognitive Neurology) was used to smooth connectivity maps with an 8-mm kernel and to analyze degree connectivity maps at the group level. First, group comparisons (2-sample, 2-tailed t tests) involving whole-brain, local, and distant hub connectivity maps between patients with OCD and controls were performed. Here, the main interest was to determine degree connectivity differences in unmedicated patients with OCD (n = 23) compared with matched controls (n = 23). Comparisons between the entire OCD sample (n = 46) vs all controls (n = 46) and between medicated patients with OCD (n = 23) vs controls (n = 23) are reported as supplemental material (Author Tables 2-5; http://www.psychologie.hu-berlin.de/prof/kli/mitarbeiter/AuthorMaterial_JAMA_Psychiatry_2013_173.pdf).
Second, we tested for correlations between the degrees associated with distant and local connectivity maps and symptom severity by including Y-BOCS total scores as a covariate in a random-effects model containing hub maps of patients with OCD. Again, the emphasis was on the unmedicated patients, but correlations in the entire sample and medicated sample are available as supplemental material (Author Table 7C-F). In accordance with a recent functional connectivity study in OCD,28 only clusters exceeding a threshold of P < .001 (uncorrected) and an extent threshold of 8 contiguous voxels were used for further post hoc assessment (ie, correlation between peak voxel values and Y-BOCS scores in SPSS, version 19; SPSS, Inc). All variables used for post hoc assessment were tested for normal distribution using Kolmogorov-Smirnov tests.
Third, we sought to further characterize the networks associated with greater whole-brain connectivity by means of conventional seed-based functional connectivity analyses.2,41,42 Because hub analyses exclusively determine the number of voxels correlating with a given voxel above the threshold level, seed-based functional connectivity analysis can be used to reveal the regions correlating with a hub area. To use separate samples of unmedicated patients with OCD for seed generation and seed-based connectivity estimation to avoid circularity (double dipping),43 we split the unmedicated OCD group in 2 subsamples showing no significant differences in demographic variables (Author Table 1) and determined OFC distant connectivity differences (distant maps) between one subsample (n = 12) and pair-matched healthy controls (2-sample t test), followed by computation of connectivity maps of the identified OFC peak voxel in the second subsample of unmedicated patients with OCD (n = 11) and their pair-matched healthy controls, and subsequent comparison of the resulting OFC connectivity maps between groups (2-sample t test).
Fourth, the effects of antidepressant medication on degree connectivity in patients with OCD were assessed by comparing degree connectivity maps between unmedicated patients (n = 23) and the distinct subgroup of medicated (n = 23) patients (2-sample t tests). For all between-group contrasts, a threshold of P < .05, corrected for multiple comparisons at the cluster level, was considered significant. In addition, small-volume searches were performed for basal ganglia regions using one combined mask of bilateral caudate, putamen, pallidum, and midbrain masks generated from the Automatic Anatomic Labeling tool44 of the Wake Forest University WFU PickAtlas (http://fmri.wfubmc.edu/software/PickAtlas)45 and a familywise error–corrected threshold of P < .05.
Addressing potential confounds involved calculation of each participant's mean interscan movement to exclude head motion as a confounding factor affecting functional connectivity group differences.46 Mean interscan movement was compared between groups (Table 1 and the eTable) and entered as a covariate in group comparisons of degree connectivity, revealing no effect on the observed group differences. Furthermore, maps of signal to noise ratio were calculated for all participants (eFigure 1 and Author Figure 1), revealing no significant differences between OCD participants and controls. Finally, potential confounding resulting from differences in demographic variables were addressed using t tests for independent samples. Values of the t tests, means (SDs) of questionnaire data, and demographic comparisons are available in Table 1 and the eTable.
Patients with OCD and the corresponding healthy control group showed significant within-group (ie, main) effects (P < .001, corrected) regarding distant degree connectivity in areas previously identified as cortical hubs (ie, parietal, posterior cingulate, and medial prefrontal areas) (Table 2 and Author Tables 2 and 4). Furthermore, hub effects were observed in the orbitofrontal cortices in both groups (Figure 1A and Author Table 17). Two-sample t tests revealed that unmedicated patients with OCD had significantly greater distant connectivity in the OFC (Table 2 and Figure 1C) and the subthalamic nucleus (STN) (Figure 1B) compared with healthy controls. Differences in the entire combined OCD sample and in the medicated patients are reported in Author Table 2 and Author Table 4. No regions were observed indicating a significantly lower degree of connectivity in patients with OCD than in controls. Total and distant degree connectivity maps were highly correlated4; therefore, total maps are presented only as supplemental material (Author Table 6).
Both groups showed high local connectivity in parietal, posterior cingulate, and medial prefrontal areas (Table 3 and Author Table 3 and Author Table 5) and hub main effects in orbitofrontal areas (Figure 2A). Two-sample t tests revealed a greater degree of local connectivity in the OFC (Figure 2C) and the right dorsal putamen (Figure 2B and Table 3) in patients with OCD compared with the healthy controls. The reverse contrast (control > OCD, 2-sample t test) revealed greater local connectivity in the control group in an area encompassing the inferior frontal gyrus and insula (Table 3). Local connectivity differences in the entire OCD sample and the medicated patients, derived using 2-sample t tests, are reported in Author Table 3 and Author Table 5.
Voxelwise correlational analyses between degree connectivity and overall OCD symptom severity (Y-BOCS total scores) were conducted. In unmedicated patients with OCD, this revealed significant positive correlations (P < .001, uncorrected) between overall OCD symptom severity (Y-BOCS total scores) and the degree of distant connectivity in the OFC (MNIXYZ = 34, 20, and –16, respectively), putamen (MNIXYZ = –18, 4, and 2), and medial prefrontal cortex (MNIXYZ = –10, 44, and 22) (Figure 3 and Author Table 7A). Negative correlations with Y-BOCS scores were observed for occipital (cuneus, MNIXYZ = –20, –88, and 40), superior temporal (MNIXYZ = –62, –30, and 6), and cerebellar (culmen: MNIXYZ = –32, –38, and 34 and declive: MNIXYZ = –16, –76, and –8) areas in unmedicated patients. Degree connectivity estimates for coordinates of regions showing positive correlations (as hypothesized) were extracted for post hoc assessment. Pearson correlation coefficients (2-tailed in SPSS) revealed significant correlations between OCD overall symptom severity and the degree of distant connectivity in the OFC (r = 0.74, P < .001), the putamen (r = 0.69, P < .001), and the medial prefrontal cortex (r = 0.67, P < .001). Additionally, positive correlations between Y-BOCS scores and local OFC connectivity were observed in unmedicated patients (Author Table 7B). Correlations between degree connectivity and OCD symptom severity in the entire OCD sample and in medicated patients with OCD are reported in Author Table 7D-I.
A significant reduction in local ventral striatal connectivity was observed in medicated compared with unmedicated patients (2-sample t tests; medicated < unmedicated, Author Table 9 and Figure 4). There were no significant differences between medicated and unmedicated patients with OCD with respect to demographic variables (eTable, B).
For seed-based functional connectivity analysis, the unmedicated sample of patients with OCD (n = 23) was split in 2 subgroups (hub and seed-based) that did not differ significantly with respect to demographic variables (eTable) to avoid bias in seed-based analyses with findings from hub analyses. First, the degree of distant connectivity (distant maps) was compared between the hub subgroup (n = 12) and their pair-matched controls (n = 12). Two-sample t tests revealed a significantly greater degree of connectivity in the OFC (MNIXYZ = 24, 44, and –18) (eFigure 21 and Author Table 10) in patients with OCD compared with healthy controls. Subsequently, this coordinate was used for seed-based functional connectivity analysis in the remaining 11 unmedicated patients with OCD and pair-matched healthy controls (no significant demographic differences) (Author Table 1). This analysis revealed that patients with OCD were characterized by significantly greater OFC connectivity with precentral and superior temporal cortices (eFigure 3 and Author Table 11).
This study investigated network alterations in patients with OCD under resting-state conditions and aimed to determine whether degree connectivity differences concern areas that are predicted by pathophysiologic models6- 8 of OCD, that is, the OFC and regions of the basal ganglia. In unmedicated patients, the OFC displayed a greater local and distant degree of connectivity. Furthermore, the STN displayed greater distant connectivity and the putamen displayed greater local connectivity. The degree of distant connectivity of the OFC, the putamen, and the medial prefrontal cortex/anterior cingulate cortex correlated with global OCD symptom severity in unmedicated patients, providing a link between CBGTC connectivity and OCD symptom severity. Finally, a reduction in local ventral striatal connectivity was evident in patients receiving antidepressants compared with unmedicated patients. These results, revealing degree connectivity alterations in CBGTC areas using an unbiased, data-driven method, support the assumption of greater orbitofrontal and CBGTC loop function in OCD.6- 8
The finding of a higher degree of local connectivity of the OFC and putamen under resting-state conditions, indicative of more areas showing correlated activity in the immediate regional neighborhood (≤12 mm), is consistent with the frequent observation of elevated metabolism of these regions in PET studies during the resting state,16,17,20,31 which is further supported by the correlations between OFC degree connectivity and symptom severity given that similar associations are known for metabolic activity of the OFC.12 Degree connectivity in the posterior/lateral OFC correlated with symptom severity, whereas group differences were found in the medial OFC, which might be interesting given that dissociable roles for these 2 OFC regions are subject to research on reward-guided decision making.9,47 In summary, the present functional connectivity data extend previous PET findings in OCD by adding the observation that the OFC and putamen show greater connectivity with locally adjacent regions to findings of local hyperactivity during rest.15,16,19,44
In addition to consistencies with previous resting metabolism studies in OCD, the present findings converge with structural local alterations identified in this patient group.48,49 More precisely, recent meta-analyses49 revealed greater bilateral striatal volume in patients with OCD, which is consistent with a greater local degree connectivity of the putamen and correlations between OCD symptom severity and distant connectivity of the putamen identified in the present study. Furthermore, the correlation between medial prefrontal cortex/anterior cingulate cortex distant degree connectivity and symptom severity converges with the finding of reduced gray matter volume in this area.48,49 Thus, positive relationships between symptom severity and degree connectivity in areas known to exhibit structural abnormalities in OCD were evident in this study. At the same time, correlational findings should be interpreted with caution given that the initial correlations were derived with uncorrected statistics and that the reported correlation coefficients observed might be inflated because of the voxelwise regression approach.50
Similar to local connectivity effects, distant degree connectivity differences occurred in regions of the OFC and the basal ganglia. The STN, the region revealing greater distant connectivity in addition to the OFC, is known to receive multiple cortical inputs, thereby representing the only entry point into the basal ganglia other than the striatum.8 Despite its pivotal role in Parkinson disease,51,52 the STN is not simply a motor area but instead shares connections with associative dorsolateral prefrontal CBGTC loops in addition to connections with the OFC.8 Considering these connections, greater distant connectivity of the STN found in this study may suggest that CBGTC loops in patients with OCD receive greater cortical input via the STN. Furthermore, greater STN connectivity might affect communication within the basal ganglia in the sense that greater cortical input into the STN alters processing in the indirect pathway within the basal ganglia,6,8 which is particularly interesting in the light of theoretical considerations suggesting an imbalance between direct and indirect basal ganglia pathways in the neurobiological models of OCD.6
Although local degree connectivity abnormalities converge with findings of altered local metabolism and volume, the present distant degree connectivity results offer new insights into the functional neuroanatomy of OCD because they indicate that OFC and basal ganglia are more connected with distant areas outside of CBGTC circuitry. Accordingly, the OFC showed greater functional connectivity with precentral and superior temporal regions rather than CBGTC areas in unmedicated patients relative to healthy controls (eFigure 3 and Author Table 11). Both results contradict the initial conception of specific segregated CBGTC circuits,29 which has been refined on the basis of neuroanatomic evidence suggesting that these loops interact to allow information transfer among CBGTC circuits.30,53- 55 In fact, the present findings might provide an integrative perspective on alternating theoretical positions with respect to the functional neuroanatomy of OCD. In agreement with traditional CBGTC models of OCD,6- 8 the unbiased search for regions of abnormal connectivity revealed OFC and basal ganglia. At the same time, greater distant connectivity of OFC and basal ganglia with areas outside of CBGTC circuitry was evident, which may relate to more recent models emphasizing consistent abnormalities outside orbitofrontal-striatal circuitry in OCD.26
Serotonin was originally suggested to be involved in OCD on the basis of therapeutic effects of selective serotonin reuptake inhibitors56 and also on the basis of PET studies consistently showing that antidepressant medication leads to reduced metabolism in CBGTC areas (ie, the OFC and the caudate head).19,20,31 Testing for the effect of antidepressant treatment (mostly selective serotonin reuptake inhibitors) on the connectivity of the striatum in this study revealed that medicated patients with OCD exhibited reduced local striatal connectivity in comparison with the unmedicated patients (Figure 4). Although stronger connectivity in unmedicated compared with medicated patients is generally consistent with studies finding that antidepressants reduce functional connectivity,57,58 the evidence provided for medication effects on degree connectivity is preliminary, and longitudinal assessments of degree connectivity in patients with OCD undergoing treatment are required to directly address the effects of antidepressants on corticostriatal connectivity.
Limitations of the present study concern sample sizes and the fact that measures of functional connectivity do not inform about causal interactions among brain regions.59 A central issue that arises from these findings is how resting-state connectivity abnormalities translate into OCD behavior. The correlations between the degree of connectivity in the OFC and putamen and OCD symptom severity in unmedicated patients suggest effects of resting abnormalities on OCD behavior. This question could be addressed directly by a collection of resting and experimental data in the same OCD population and controls. Individual resting connectivity parameters could be included in modeling of experimental data to determine how variance in neural responses to symptom provocation could be explained by resting-state abnormalities. This could lead to an improved understanding of how the greater degree of connectivity of the OFC and CBGTC components contributes to the established abnormalities in response to confrontation with OCD-related stimuli12- 15 and reversal learning demands.10,11 In a similar vein, associations between lower distant degree connectivity in the inferior frontal gyrus identified in the present study and inhibitory deficits in patients with OCD60- 62 could be examined. In addition, testing the potential specificity of the identified degree connectivity alterations to OCD is an important subject for future research. Although there is evidence that abnormalities in OFC metabolism16,56 and striatal volume49 are specific to OCD, investigation of OFC degree connectivity in a clinical control group of patients with mood or anxiety disorders is required to elucidate this issue. Similarly, given the clinical heterogeneity of OCD and its influence on regional resting-state brain abnormalities, including the OFC,63- 65 the degree connectivity abnormalities associated with the major OCD symptom dimensions require investigation.
In conclusion, this study applied a data-driven, unbiased search for brain regions displaying a high degree of local and whole-brain connectivity. The findings demonstrate network alterations in patients with OCD that are highly consistent with neurobiological models of OCD. Areas of greater connectivity identified in this analysis involved the OFC and the basal ganglia, consistent with the assumption of pathophysiologic changes in orbitofrontal CBGTC circuits and numerous findings of greater metabolism in orbitofrontal and striatal brain regions. At the same time, these data open novel perspectives on certain aspects of CBGTC models in OCD. Preliminary evidence is provided that antidepressant medication affects local CBGTC connectivity, and hyperconnectivity was not only identified locally (ie, within CBGTC circuits) but also for the distant connections outside of CBGTC circuitry.
Correspondence: Jan C. Beucke, MS, Humboldt-Universität zu Berlin, D-12489 Berlin, Germany (email@example.com).
Submitted for Publication: February 10, 2012; final revision received July 27, 2012; accepted August 21, 2012.
Published Online: April 17, 2013. 10.1001/jamapsychiatry.2013.173. Corrected April 22, 2013.
Author Contributions: Mr Beucke had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was supported by grant BMBF-01GW0724 from the Federal Ministry of Education and Research of Germany. Mr Beucke is supported by a PhD scholarship from Evangelisches Studienwerk e.V. Villigst and is a European Recovery Program scholar of the German National Academic Foundation. Dr Linnman was supported by the Swedish Society for Medical Research.
Online-Only Material: The Author Tables and Author Figures are available at http://www.psychologie.hu-berlin.de/prof/kli/mitarbeiter/AuthorMaterial_JAMA_Psychiatry_2013_173.pdf.
Additional Contributions: David Borsook, MD, PhD, Lino Becerra, PhD, and the P.A.I.N. group at McLean Hospital provided insightful comments and discussion. The Cognitive Neuroscience Lab at Harvard University and the Athinoula A. Martinos Center for Biomedical Imaging provided space and tools for fMRI analyses, and Koene Van Dijk, PhD, assisted with head motion analyses. Eva Kischkel, PhD, and Rüdiger Spielberg, PhD, performed clinical assessments; Susanne Schwab, MS, recruited patients; Rosa Grützmann, MS, and Miriam Sebold, MS, assisted in data acquisition; Rainer Kniesche provided technical assistance; and scanning facility access was provided by Charité Universitätsmedizin Berlin.


text:
US State & Territorial Coalitions
NNEDV represents the 56 U.S. state and territorial coalitions against domestic violence. Domestic violence coalitions serve as state-wide and territory-wide leaders in the efforts to end domestic violence. These organizations connect local domestic violence service providers and are valuable resources for information about services, programs, legislation and policies that support survivors of domestic violence.

subset: commoncrawl


text:
Welcome to SM4!
St Paul's Cathedral has been here for over 1,400 years. It has been built and rebuilt five times, and always its main purpose has been as a
place of worship and prayer.
For more than 1,400 years, a Cathedral dedicated to St Paul has stood at the highest point in the City. The present Cathedral is the
masterpiece of Britain's most famous architect Sir Christopher Wren.
Behind the scenes, the cost of caring for St Paul's and continuing to deliver our central ministry and work is enormous and the generosity of
our supporters is critical.
March 2013
© 2017 Copyright The Chapter of St Paul's Cathedral
Designed and built by Redwing Interactive


text:
End user license agreements
Thank you for shopping at the Microsoft Store. End User License Agreement ("EULA") information is available below for many of the products we sell. If you have questions regarding the EULAs that came with your purchase, please contact an in-store Microsoft Store sales associate or call customer service at 1-877-MY-MS-STORE (1-877-696-7786).
Microsoft EULAs
Manufacturer and third party EULAs (please visit the manufacturer's site for additional details)


text:
Jerrod Lopes wrote:Respectfully, those who already understand non-self don't need an explanation of the process of rebirth. All they need is to think on it momentarily and it is quite clear in all its anticlimactic and boring glory, IMO.
Many people in the world who believe in re-birthing also believe in Supreme Self, rather than understand non-self.


text:
Toggle navigation
Place an ad
Sign in with Classifieds account
Sign in with Classifieds account
Place an ad
Search All Classifieds
Auctions / Sales
Business Services
Garage Sales
Pets & Animals
Real Estate
Find a job
Post a job
Find a car
Post a car
Hire Freelancers
Find Freelance Work
Featured Ads
Boykin Spaniel Pups
BSS reg males $900. Females $900-$1200. http://careysboykinandbrittanyspaniels.weebly.com Good hunters and great pets. 229/868/8382 Mcrae GA Health guaranteed.
Also reserving Pup for Fall and December pickup.
American Cocker Spaniels
Full Blooded American Cocker Spaniel Puppies needing their forever loving homes. Tails Docked And Dew Claws removed. Shots UTD and Dr-wormed. Parents on site. Tri-Colors/Part-Colors. Deposit Required. God Bless each of y'all. Please contact 803-457-0756.
ADVERTISE! You can place your own Classified ad at http://columbiathestate.adperfect.com/
Farmstead Estate Sale
5443 Farmstead Dr
Aiken, SC 29803
Sept 22 10 - 4
Sept 23 9 - 2
Sept 24 11 - 3
Beautiful 6 bedroom Estate in the Farmstead Private Gated Community. Everything MUST be sold, Furniture,Waterford Crystal, China, Clothes, Riding Lawn Mower, Outdoor...
5YO Orange Tabby.All shots up to date.Call 8032304137
Champion Sire White...
CHAMPION SIRE - Labrador Retriever AKC Labs
Working Dogs-POLAR BEAR WHITES AND IVORY WHITES ********CHAMPION SIRE ****** Sire is beautiful Huge male Large Blocky head OFA Good Hips and OFA Elbows - Sire and Dam are EIC clear - PRCD negative and PRA negative. We have Beautiful...
West Columbia Duplex
2BR, 1 Ba duplex in older, established residential, safe area. Freshly painted, hardwood floors, ceiling fans, washer/dryer connections. New HVAC package unit, new hot water heater. NO PETS. Convenient to downtown, Lexington, St. Andrews; close to shopping, grocery and medical services. City...
Lexington Old Mill Space...
One of a kind space that includes high wooden ceilings, exposed original brick walls. 5500 sq ft and can host various business opportunities. Only space available at the Mill. Right in the heart of growing downtown Lexington.
2nd Predestined to Survive...
We're pleased to announce our 2nd Annual "Predestined To Survive" walk a thon benefiting Far Above Rubies non profit organization. All proceeds will go towards our longterm healing programs.
Registratin begins at 7:30am and the walk will begin at 8am. There will be snacks and...
View all featured ads
Recent ads
garage/estate sale
Usual garage sale items - home decor, bedding, housewares, etc. PLUS lots of vintage and newer good glass serving dishes and glass decor, china/dinnerware, table lamps, ceramics, wall decor, decorative accent pillows, collector bells, all kinds of "pretties." ALSO, Lots of Christmas things -...
TV Stand
Good condition
Handicap Scooter
Pride Handicap Scooter - 3 wheel Good condition
West Columbia
Help center
Give us a call
Request Help


text:
Fiscal cliff, dairy cliff….. I am tired of hearing about impending doom.
Why in the world would voters decide to keep the same people in office, as they did on Nov. 6, when those people have taken us to this point?
Every day, there are dire warnings of milk prices in the grocery store going to $6 per gallon because of the "dairy cliff." Read this story from The (Syracuse) Post-Standard.
I have resisted the temptation to run a new story every day. We first mentioned the possibility of higher milk prices in September, with these comments by U.S. Rep. Collin Peterson (D-Minn.), ranking member of the House Agriculture Committee. Nothing much has changed since that time ― a new farm bill that would avert the dairy cliff is still stalled in Congress.
Some of the people who commented on the story in September were excited about the possibility of $38 milk for farmers. At first blush, a $38 price does seem very attractive. And, it could happen. In the absence of a new farm bill, dairy policy will revert to a 1949 law which would essentially quadruple federal price supports for cheese, butter and powder. That, in turn, would bring milk prices up to the $38 to $40 per hundredweight level.
But do we really want that to happen? Many consumers would balk at paying $6 for a gallon of milk, and consumption would go down. It's really the last thing the dairy industry needs at a time when fluid milk consumption is dropping like it is. See "Milk consumption about to fall below an important threshold."
So, what could happen?
First, Congress could pass a new farm bill by Dec. 31, which would get things back on track. I believe the version of the farm bill passed this summer by the U.S. Senate and House Agriculture Committee contains key reform measures that would help dairy farms, but those measures can't be implemented until a final version is passed by the full House. Unfortunately, the possibility of that happening by Dec. 31 is growing more and more unlikely.
A more likely scenario is that Congress will link the pending farm bill with some kind of resolution to the fiscal cliff dilemma that it is currently facing, as well. It makes a certain amount of sense, since the farm bill has already been targeted for spending cuts. It would be a hybrid approach, possibly buying some time and taking us far enough into 2013 to allow Congress to pass a free-standing farm bill without going over the "dairy cliff."
We shall see. Frankly, I am losing confidence in the White House and Congress with each passing day.


text:
Attend IBM Security Systems training in Atlantic City. NetCom Learning provides more than 1500+ IT and Business training courses throughout Atlantic City, NY and the country. Whether you're looking for customized onsite ibm-security-systems training for a private group throughout Atlantic City area or a public instructor-led online ibm-security-systems class, NetCom Learning has the solution for you.
IBM Security Systems with Tivoli provides a comprehensive portfolio of security, risk and compliance management software, hardware and services to meet the challenges of securing a dynamic infrastructure. Tivoli manages risk by developing and managing a secure infrastructure that allows organizations to support business change. Tivoli also improves service by delivering superior business and IT services with agility and speed and preventing outages. In addition, Tivoli reduces cost of management, administration and operation of the secure infrastructure while increasing productivity.
Private training is an excellent corporate solution to achieve maximum value for your training funds. Private group training is ideal for situations requiring more than 1 student taking the same training. NetCom Learning has been helping our clients achieve their private group training objectives since 1998. Our goal is to meet your learning requirements, with a strong focus on achieving excellence in all your interactions with us.
We can deliver any classroom or online course in a private format - at your facility, ours or online, in any time zone and anywhere in the world.
Since students in your group have similar goals, we can customize and streamline your training program, which means a more relevant education and often enables us to discount the training by 10-30% or more.
Discover your exact savings with a Free Private Training Consultation today! Your dedicated NetCom Learning Consultant will determine your needs, answer your questions and present you with a complimentary quote for your private training program.
Request Free Private Training Consultation »


text:
Crocs Minion Clogs – Toddler Boys 5-10
$11.99 SALE orig. $40.00 70% OFF
Online Exclusive
Crocs Minion Clogs – Toddler Boys 5-10
- 4/5
- 6/7
- 8/9 (Out Of Stock)
- 10/11 (Out Of Stock)
- Blue
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
Comfort and fun connect in the Crocs™ minion clog! This kids' clog has a durable, lightweight foot bed that molds to feet and ventilation for breathability.
- Croslite™ material upper
- Slip-on
- Round toe
- Minion theme print
- Advanced toe box ventilation for breathability
- Heel strap
- Odor resistant
- Lightweight, non-marking Croslite™ material outsole
- Imported
- Free Standard Shipping On Orders Over $75
- Free Shipping On Orders Placed With A Platinum Stage Stores Credit Card
- Flat Rate Shipping
- Shipping Surcharges
- Delivery Estimate
- Shipping Details
Free Standard Shipping on Orders Over $75
All orders $75 or more qualify for our everyday offer of free standard shipping. No code is required for this offer. The order total will be calculated after all discounts and coupons have been applied and before taxes. This free shipping offer applies only to the standard flat rate shipping fee and does not apply to Shipping Surcharges. We reserve the right to withdraw or change the terms of the free standard shipping offer at any time.
Free Shipping on Orders Placed With A Platinum Stage Stores Credit Card
Bealls, Goody's, Peebles, Palais Royal, and Stage platinum credit cardholders will qualify for free standard shipping when using their store credit card to make an online purchase. No minimum purchase is required to qualify for free shipping. This offer does not apply to Shipping Surcharges. We reserve the right to withdraw or change the terms of the offer of free shipping for platinum members at any time.
There is a flat rate shipping charge of $8.95 for all orders that are not eligible for any current shipping promotion.
Shipping Surcharges apply to certain hard-to-ship items. The actual charge varies depending on the cost of shipping the item. Shipping Surcharges, if applicable, are listed on the "Details" tab of the product page. Additionally, when an item is added to shopping cart, any Shipping Surcharges will be reflected in the order summary. Shipping Surcharges are not refundable
Estimated delivery time for all packages is 7-10 business days, but varies based on location and weather conditions and does not include holidays or weekends. Items shipped directly from the manufacturer may require additional delivery time. Items shipped direct from the manufacturer include but are not limited to select furniture, TVs, exercise equipment, and rugs. To determine if your item could require additional delivery time and what that time might be, please contact Customer Service at 1-800-743-8730.
Shipping is only available within the continental U.S. and we cannot ship to P.O. Boxes or APO/FPO addresses. Packages are generally shipped by FedEx. Depending on weight of the package, it may be delivered by the U.S. Postal Service. At this time, we do not offer expedited shipping or pick up in store options. Items from your order may arrive at different times and in different packages. In this case, you will receive an email confirmation for each package, but you only be charged once for shipping.
Last Updated: July 15, 2016
Stage Return Policy
Last updated: March 19, 2016
If you are not completely satisfied with your purchase, simply return it to us within 180 days and we will gladly issue a refund or credit to you. Return options and terms vary depending on the method of purchase. Please see below for details.
Please note that if you receive a free gift or a bonus gift ("GWP") when purchasing an item, you must return the GWP when returning or exchanging the item that qualified you to receive the GWP. If you choose to keep the GWP, we will charge you for the value of the GWP when processing your return.
Additionally, unless the item is defective, the items that you return must be unused and in the original box and/or packaging. All Social Dresses have special tags that indicate the dress cannot be returned once the tags have been removed; Social dresses must have the original tags attached when you return them.
Shipping fees are not refundable. However, if your order is damaged upon arrival or the wrong item was shipped to you, you may call Customer Service to request a refund of the shipping charges.
Returns and Exchanges at Our Stores
(applies to all merchandise)
Merchandise purchased in one of our retail store locations or online may be returned or exchanged at a store. To find the store location nearest to you visit: www.stage.com/store/findyourstore
You will receive a refund for the full amount of your purchase when you bring your original receipt or the packing slip received with your online purchase. Refunds will be issued in in the original form of payment. Credit card refunds can only be applied to the card used to make the purchase.
Refunds for items purchased with a gift card will be made in the form of a merchandise credit. Merchandise credit will also be provided for gift returns, including gifts purchased online. Merchandise credit is redeemable in store and online.
If you do not have your original receipt, you may still be eligible to receive a full refund if we are able to locate your purchase transaction. If you do not have your original receipt and we are not able to locate your purchase transaction, we will issue you a merchandise credit for the returned items at their lowest selling price within the past 30 days.
Returns of Online Purchases by Mail
(for merchandise purchased online only; no exchanges by mail)
To return any item purchased online, you need to locate the packing slip sent with your order. That packing slip is both your receipt and a return form. If an item that you are returning was damaged when you received it, you must write "damaged" on the return form. Repackage the item(s) that you want to return along with the completed return form and send the package to us and send it to the following address:
Stage Return Center
1237 East Rusk
Jacksonville, TX 75766
You may choose the shipping method for your return. USPS, FedEx, and UPS are all acceptable shipping methods, but you should make sure that you receive a tracking number. We will not be responsible for any packages that are lost by the shipping carrier in transit. Carefully repackage all items as we will not accept returns of items that are damaged during return shipping.
Once your return is received, we will process a refund to the credit card that you used to make your purchase. If there are any issues with your return, we will contact you. Otherwise, you should expect a refund to the credit card used to make the purchase within 5 days from the day we receive your return package.
Please note that Return by Mail is not available for the following transactions:
· In Store Purchases. Merchandise purchased at a store must be returned in store and cannot be shipped back to us for a refund.
· Exchanges. At this time we do not offer exchanges by mail.


text:
Boten te koop in Italië
Riva 122' Mythos2017Op aanvraag
It is 122' Mythos, Riva's new flagship: an over 35 ton aluminum construction, of 38 meter overall length and 7.60 meter beam. The 122' Mythos draws inspiration from the 86' Domino - a real long seller of Riva coupe yacht range – whose main stylistic features have been taken up and revamped on this almost 38 meter long yacht. The 122' Mythos is the outcome of the collaboration between yacht Designer Mauro Micheli – the founder, together with Sergio Beretta, of Officina Italiana Design (which designs Riva's entire range), AYT&D - Advanced Yacht Technology & Design, Ferretti Group's research, style and product development centre, and the Interior Design and Technical Department of CRN, which was in charge of the interior and naval project development. This flagship is a '100% Riva' model, as confirmed by its clean lines, a painstaking care for details, the selection of traditional and yet 'evergreen' materials - like steel, wood and leather -, which give every Riva yacht a unique, timeless flair. The standard version proposed by the shipyard has 3 or 4 cabins, and an additional optional layout with 5 cabins is also available. The aluminum planning hull can reach top recorded speed of 28,5 and a cruising speed of 26 knots , thanks to two MTU 12 V 4000 M 93L, 3510 mhp engines. This is a high-tech planning yacht ensuring great comfort and top performance in its class.Hoger46
Pershing 1082017Op aanvraag
Pershing 108 is ready to plough the waves as one of the most prestigiousrepresentatives of the world boating industry. This first three-engine model in the fleet combines excellent performances with environmental friendliness thanks to very limited fuel consumption. Thanks to 3 surface drives, it can reach a maximum speed of over 42 knots in blissful silence. The design of interiors can be extensively customized, making this yacht a true forerunner.Hoger38
Ferretti Yachts 9602017Op aanvraag
The Ferretti Yachts 960 is the largest planing pleasure boat ever built by Ferretti Group. The flagship of the brand results from the collaboration between Studio Zuccon International Project, Ferretti Group Engineering, the team of engineers and architects of the Group, and AYT&D (Advanced Yacht Technology & Design), the research center of the Group. With its 29.20 meters of length overall and 23.97 meters of hull length it can be managed as a pleasure boat, even without a professional captain. Ferretti Yachts 960 features an unparalleled livability. It is the first yacht of the brand with the owner cabin located on the main deck and four VIP cabins on the lower deck each equipped , with its own en-suite facility, enormous glazing for natural light and portholes for ventilation. The vessel offers numerous solutions and attributes which usually are reserved for vessels over 100' including 3 crew cabins of which 1 is exclusively for the captain as well as a separate access to the crew quarters directly from the galley. The flybridge at the stern area are entirely devoted to leisure. The garage door is fitted with cushions, while the bathing platform can be immersed in the water to allow for the launching of the tender in just a matter of minutes from the floodable garage without the need of a davit: a system which has set the benchmark in the industry for a never before seen solution on a vessel of this size…until now. The flagship model of the Ferretti Yachts range will be available with three different engine options, offering a minimum of 2218 hp to 2638 hp, the latter ensuring performance characteristics which make the 960 the quickest vessel in its class by reaching speeds up to 30 knots. The vessel is equipped in the standard version with electro-hydraulic fins with both the zerospeed and the underway features, giving owners an incredibly elevated level of stability to reduce roll and ensure maximum comfort onboard, at anchor and during navigation.Hoger30
Pershing 922017Op aanvraag
Forget the design standard and constraints you are used to as the Pershing 92 is a brand-new open way of enjoying the sea. Interiors and exteriors form an interrupted continuum, brightness reaches unprecedented levels and liveability is unmatched. The upper deck, the perfect embodiment of style, is now larger which ensures maximum privacy and yet is very easily a new trendsetter for La Dolce Vita.Hoger12
Riva 88' DOMINO Super2017Op aanvraag
The coupé evolution. It's called Super, as it's amazing, and because this suffix is well-known as the mark of evolution within the Riva brand. 88' Domino Super, aimed to set new standards in the industry in terms of style, comfort and performance, had its début in Monte Carlo, before being worldwide reveald to the public in September at the Cannes Yachting Festival. With an overall length of 26.84 metres (88 ft.) and a maximum beam of 6.29 metres (20.7'), its racy and aerodynamic profile wins you over from first glance, enhanced by the shade of the hull, the dark "London Grey" contrasting with the light "Moon Grey" of the superstructure. Added to this are other important style choices: the new sun deck adds to the sportiness of the yacht, offering increased comfort to guests; the single large window on the hull is characterized by a bold design; and the revamped stern completes the dynamic feel of the yacht. The swimming platform on the stern, which can be moved and submerged, is a convenient spot to get into the water and back on board, as well as making the launch and towing of the tender very easy. The cockpit is like an outdoor living room, with a large C-shaped sofa/chaise longue, beyond which a sofa faces the dining table. Beyond the glass you come to the interior, organized into the living and dining areas and bridge. The lounge is an open space with an unrivalled view of the sea; a perfect example of the unmistakable style of Riva. The shift of the helm station to the starboard side has enabled storage to be installed, separating the two sets of stairs which lead to the kitchen and below deck. The pilot station, with two seats, is hidden by a full-height wall with TV screen, equipped with an electric mechanism enabling it to be swivelled towards the dining area. Going down the first flight of stairs leads to the lobby, then to the three guest cabins, while on the starboard side, towards the stern, a door opens to the full beam master suite. The room is airy and beautifully lit. The starboard side is furnished with a low unit including a vanity/desk area, with the optional extra of freestanding units. On the port side is a double berth with TV on the facing wall. The cabin has an en-suite bathroom and spacious walk-in wardrobe. The sporty feel of the 88' Domino Super is enhanced by the new sun deck. A large C-shaped dinette at the bow faces the external helm station, which is positioned centrally to allow optimum command of the yacht. There are spacious areas for relaxation on the stern. The performance of the new coupé is best in its class. The standard version of the yacht comes fitted with two 2435-Mhp MTU 16V 2000 M93 engines, allowing the yacht to reach a maximum speed of 38 knots and a cruising speed of 34 knots. The optional configuration comprises two MTU 16V 2000 M94 engines with a power of up to 2638 Mhp. These engines push the yacht up to 40 knots, while the cruising speed touches 35 knots (preliminary data).Hoger56
Riva 88' Florida2017Op aanvraag
New Riva 88' Florida. Spiritual successor of the Riva Bahamas, 88' Florida is a revolutionary yacht which perfectly blends an open and a coupé model into one single vessel. The hull # 1 will be completed and launched by the end of 2014, with its official world première scheduled in the first months of 2015. The 88' Florida features a cutting-edge innovation with an exclusive Ferretti Group patent installed on this new project for the very first time. Convertible Top is the name of the innovative system, designed and developed by AYT&D in collaboration with the technical partners of the Group, Besenzoni Spa and Centro Stile Srl. It turns this model into a multifunctional yacht, "convertible" because it can be transformed into an open or a coupé with one single and easy movement. The convertible top offers three different functions into one single system, due to the function that handles the aerodynamic hard top into three different positions. This new project features excellent performance, with a choice opportunity of the engines by MTU. As the standard version, 88' Florida is fitted with two MTU 16V 2000 M93, 2435 mhp, which allow reaching a maximum speed of 38.5 and a cruising speed of 34 knots, with a range of 315 and 340 nautical miles, respectively. As an alternative option, as in the case of hull number 1, 88' Florida, can be fitted with two MTU 16V 2000 M94, 2638 mhp. This new project by Riva, with these engines, can reach a maximum speed of 40.5 knots and a cruising speed of 36 knots, with a range of 300 and 325 nautical miles, respectively (preliminary data).Hoger18
Ferretti Yachts 8702017Op aanvraag
Ferretti Yachts 870, in its roll bar standard version, or with hard top as an option, was presented to the Cannes Boat Show in 2012. This model results from the collaboration between Studio Zuccon International Project, Ferretti Group Engineering, the team of engineers and architects of the Group, and AYT&D (Advanced Yacht Technology & Design), the research center of the Group. It features both the bronze dome over the helm station and the large glazed surfaces. Beside the two open-view windows at the level of the owner cabin, large windows for the guest cabins and a double window in the fore VIP cabin have been added. The glazed surface of the main deck has been increased and renewed, thanks to the lowering of the gunwale. The outer look is characterized by outstanding lightness, elegance and aggressiveness, also thanks to the three 'shark branchiae' windows separating the salon's glazing from the helm station's one. On the main deck, living and dining areas, galley and helm station have been effectively separated: the latter two, extensively modified too, are located at bow, completely divided from the rest. On the lower deck the yacht makes the best of the increased volumes, thanks to the shifting of all cabins towards the larger stern area. Without changing the engine room, the crew area and the garage, this yacht offers wider spaces, in particular in the owner cabin and in the portside gest cabin. Three double cabins, a fourth one with twin beds with en-suite heads and separated shower box.Hoger24
Ferretti Yachts 8502017Op aanvraag
A maxi loft surrounded by the sea. Simply said, some yachts just leave you breathless with the feeling you have witnessed a brand new aesthetic standard and level of pleasure in sailing. Setting new standards in engineering and design is only possible for leaders in the industry like Ferretti Yachts and its fantastic team of engineers, designers and industry professionals, heirs of the Made in Italy boat building tradition, who are carrying forward this glorious heritage. The Ferretti Yachts 850 is exploring new waters with its combination of power and beauty, aggressive appeal, elegance and luxury. Ferretti Group's Product Strategy Committee, Studio Zuccon International Project, and the Group's Engineering Department joined forces to design the yacht, which will be built at the Cattolica site ahead of its public debut in early September 2016.Hoger5
Pershing 822017Op aanvraag
The pleasure of yachting is taken to new extremes. Pershing 82 is the most brilliant response to the toughest of challenges: combining large size and sporty features. In spite of its 24-metre length and 5.50-metre width, the Pershing 82 can reach a maximum speed of 45 knots and boast a range of more than 300 miles. It s outer profile is aggressive enough to let one sense the performance this yacht is capable of and the upper deck with its retractable helm station results in very slender lines with an unusual height.Hoger40
Ferretti Yachts 8002017Op aanvraag
Innovation matched with a classic-contemporary design, the perfect recipe of Ferretti Yachts 800, penciled by architect Gianni Zuccon from Studio Zuccon International Project in collaboration with Ferretti Group Engineering, the team of engineers and architects of the Group, and AYT&D (Advanced Yacht Technology & Design), the research center of the Group. The result is a yacht featuring wide interior spaces, with a layout generally adopted in larger vessels, blended with catchy external lines, enhanced by the use of color, in which wide windows characterize the external design, plunging interiors into an amazing quantity of light. The external profile of Ferretti Yachts 800 features to distinguishing characteristics: the use of the bronze color for the dome and the graphic lines of windows, which alternate curvy and smooth lines with sharp 'cuts'.Hoger23
Riva 76' Perseo2017Op aanvraag
Riva 76' is the brand new project of the sporting range of the brand. This project has been conceived preserving the family feeling with the other models in the brand's sporty range, and deservedly joins other true masterpieces in Riva's recent production: the 68' Ego Super, the 88' Domino Super, and the 122' Mythos. The Riva 76' has a 22.74-metre (74.7 ft.) overall length and a beam of 5.75 metres (18.10 ft.). This yacht immediately strikes for its sporty features and elegance, further enhanced by its colour shades. The first hull boasts a new shade of metal silver, the already well-known Moon Grey, combined with Riva's classical dark shade, Bright Black. The sporty look is further highlighted by the over 40 square meters of glazed surfaces: the large hull glazing, the side glazing on the main deck, the wide windshield. The spacious sun deck perfectly harmonizes with the aerodynamic design and ensures the utmost privacy and relaxation, besides allowing to pilot the craft from a privileged position. The fore area is characterized by a wide lounge. The new coupé is extremely refined, and perfectly embodies the idea of 'simple complexity' that characterizes every single Riva yacht. Officina Italiana Design has worked with the Ferretti Group's 'Interior & Décor' team to conceive original furnishing solutions, combining the brand's traditional materials - wood, lacquered surfaces, leather, and stainless steels - with mirrored surfaces and marble. The Riva 76' comes with two V-drive MAN V12, 1,550 MHP engines, which allow it to reach a maximum speed of 33 knots and a cruising speed of 29 knots. The Owner can also choose more powerful engines, i.e. two MAN V12, 1.800 MHP each, that will push the yacht to a maximum speed of 37 knots and a cruising speed of 32 knotsHoger3
Riva 76' Bahamas2017Op aanvraag
With the 76' Bahamas the iconic Riva brand writes another page in the story of yachting. The art of yachting is enriched by a new masterpiece that brings together the charm of timeless design with the sophisticated pleasure of technological innovation. This is the idea behind the patented "C-Top" system, which enables a yacht to be transformed from open to coupé mode and vice versa. On the 76' Bahamas, it effectively doubles the comfort and fun to be enjoyed on board. "Written into the 76' Bahamas is Riva's current DNA: a perfect synthesis of history and tradition, of innovation and technology, of elegance and performance" says Alberto Galassi, Chief Executive Officer of the Ferretti Group. "The new convertible epitomises the synergy between excellence in yacht design and excellence in naval engineering that has produced a super sports boat. With graceful lines and rich in technical features, it is built using cutting-edge materials and sails like a dream. Owners will enjoy an unforgettable experience thanks to the sophisticated Mediterranean lifestyle offered by this yacht."Hoger101
Riva 75' Venere Super2017Op aanvraag
The 75' Venere Super is a restyling of one of Riva's most widely appreciated models. The flybridge of the new 75' Venere Super - specifically designed to offer guests the utmost comfort thanks to a comfy sofa sitting up to six people - is completed by an elegant, slender hard top resulting in incredible versatility and livability. The aft door allows obtaining a large swimming platform, perfect to relax and practice sea sports. On the lower deck, the wide hull glazing offers an unusual view just at the sea level, letting through plenty of light into the guest cabins and the full-beam master stateroom, which fitted with an office area, a vanity and a walk-in wardrobe. Every cabin has direct access to its en-suite head; the guest cabins are furnished with twin beds that can be replaced by a French bed.Hoger25
Ferretti Yachts 7502017Op aanvraag
Ferretti Yachts 750 represents another step forward in the development of the Ferretti Yacht range over 70 feet, featuring a 22.75 m overall length and a 5.70 m full beam. Evolution of the successful Ferretti Yachts 720, it features many relevant innovations, both inside and outside. Result from the settled collaboration between Studio Zuccon International Project, AYT&D – Advanced Yacht Technology & Design and the Ferretti Group's team of engineers, architects, and designers, Ferretti Yachts 750 immediately strikes the attention for its outer profile, which is even sleeker and sportier, thanks to the new flybridge with an elongated tail. The model will be presented in its standard version, without hard top; upon request, it can be equipped with a large bimini top, approximately 5 meter long. The flybridge is even more spacious, since it is davit-free. The sunbathing area of Ferretti Yachts 750 is available in other two versions, fitted with roll bar and built-in bimini top, or with hard top and awning. In the outer stern area the distinguishing feature is the electrohydraulic swim platform, more than 1.5 meter long. It can be lowered 50 cm underwater, making the launching of the tender easier. The swim platform can lift up to 450 kg and it can host a tender of approximately 4 meters. Ferretti Yachts 750 will be available with two different engines: two 1381 mph MTU 10V 2000 M84, or, as optional version, two 1524 mph MTU 10V 2000 M93. As for performance, with the standard engines the top speed is 30 knots, with a cruising speed of 27 knots, while with the optional engines, the maximum speed is 32.5 knots and the cruising speed is 29 knots.Hoger19
Te koop viaX
Uw zoekopdrachtReset alle filters
Soort bij
- Toerboten
- Motorjachten
- Flybridge
- Megajachten
- Sportcruiser
- Kruiser
- Catamaran
- Centercockpit
- Kruiser/racer


text:
Furthur is a rock band founded in 2009 by former Grateful Dead members Bob Weir and Phil Lesh. The band's lineup also includes John Kadlecik of the Dark Star Orchestra on guitar, Jeff Chimenti of RatDog on keyboards, and Joe Russo of the Benevento/Russo Duo on drums. Jay Lane left Furthur after the March 12, 2010 show to rejoin American funk metal/rock band, Primus.
In 2008, for the first time in four years, Bob Weir and Phil Lesh began performing together, with a reunion of The Dead. A few months after The Dead's 2009 tour the musicians announced that they had formed a new band with Kadlecik, Chimenti, Lane, and Russo.
The band debuted with performances on September 2009, at the Fox Theatre in Oakland, California. They followed those shows up with a handful of more dates during 2009 including 5 shows in the northeast, as well as live rehearsal sessions and two New Years shows in California. During the New Years eve performances the band was joined by backing vocalists Zoe Ellis and Sunshine Garcia Becker. Ellis and Becker remained in the line up for the remainder of the tour. The band then toured the U.S. from the 2nd of February through the 8th of March 2010, and performed in San Francisco to celebrate Phil Lesh's 70th birthday. In February 2010, official announcements were released that the group would be performing at three music festivals in the summer of 2010, first at the Nateva Music & Camping Festival in Oxford, ME on July 4th, followed by the All Good Music Festival in Masontown, WV the next weekend July 8 and 9. July 10 and 11th they performed at the Mann Center in Philadelphia PA. Then Gathering Of The Vibes in Bridgeport, CT July 29th-Aug 1. In addition to the three festivals on the east coast Furthur brought back the "Furthur Festival" at Mountain Aire in Angels Camp, CA on Memorial Day weekend May 28-30th, 2010. On March 18, 2010, Phil Lesh posted on popular fan site PhilZone.com announcing that drummer Jay Lane had left the group to rejoin Primus. Furthur will be touring up and down the east coast starting March 4th, 2011 in Boston. This tour will include multi-night runs in smaller venues than the late winter 2010 tour this past November. The 2011 tour will include a 5 night run in NYC at the Best Buy Theater, a 3 night run at Radio City and another 5 night run at the Tower Theater in Upper Darby, PA and many more dates on the east coast in March.
Current Members:
Bob Weir - rhythm guitar, lead vocals (Sept. 2009-present)
Phil Lesh - bass guitar, lead vocals (Sept. 2009-present)
John Kadlecik - lead guitar, lead vocals (Sept. 2009-present)
Jeff Chimenti - keyboards, backing vocals (Sept. 2009-present)
Joe Russo - drums (Sept. 2009-present)
Sunshine Becker - backing vocals (Dec. 2009-present)
Jeff Pehrson - backing vocals (May 2010-present)


text:
A U.N. report measuring the livestock industry's contribution to global warming says emissions can be reduced with practices already utilized by the most efficient operators.
The U.N. says its report, "Tackling climate change through livestock: A global assessment of emissions and mitigation opportunities," is the most comprehensive estimate on the topic to date.
The report claims 14.5 percent of all human-caused greenhouse gas emissions stem from livestock supply chains, with feed production and processing, outputs of GHG during digestion by cows, and manure decomposition listed as the primary contributors.
The study shows improvements to the industry can cut its greenhouse gas emissions by as much as 30 percent.
That percentage can be reduced through technologies in feeding, manure and health and husbandry management in addition to the best animal handling practices.
Changes to the system require solutions from all stakeholders, bringing together the private and public sector, civil society research and academia and international organizations.
The United Nations Food and Agriculture Organization (FAO), established the Global Agenda of Action in Support of Sustainable Livestock Sector Development and identified three priorities for improvement: promoting more efficient practices, improved grassland management and better manure management.
Improved practices wouldn't require livestock operators to change production systems, but increased demand for livestock products, especially in developing countries, will require some updates and modifications to offset increases in overall emissions.
Changes to the system not only benefit the environment, but livestock producers as well. The U.N. claims many of the recommendations for improving efficiency and reducing greenhouse gas emissions also boost production, providing people with more food and higher incomes, with benefits for food security and poverty reduction.
One under-utilized technology named is higher production from biogas generators and energy-saving devices.
"These new findings show that the potential to improve the sector's environmental performance is significant – and that realizing that potential is indeed do-able," said Ren Wang, FAO Assistant Director-General for Agriculture and Consumer Protection.


text:
Receive news about exclusive sale eventsand new product introductions.
Call to place orders
Customer Service is available Monday through Friday,8AM to 5:00PM Mountain Time
Zanier HEAT-GTX Heated Ski Gloves
Zanier HEAT-GTX heated ski gloves are now lighter, heat better and last longer than ever before.
Battery Heated Socks
Up to 14 hours of warmth. Rechargeable. 3 heat settings. Austrian designed & tested.
On Sale: $299.95
The World's Safest Electric Blanket!
Operates with non-hazardous low voltage, providing the safest electric blanket ever produced.
From: $89.95
Outdoor Heated Dog Bed
Our soft outdoor heated dog bed is weather proof for outdoor & indoor use. 3 Sizes.
From: $54.95
WinterGrips Ice Cleats
Stretch them on under shoes or boots to significantly improve traction & safety on Ice or Snow.
On Sale: $13.95
The PowerGrip Storage Rack
A customer favorite. The wall mounted PowerGrip holds just about anything you can wedge into the opening.
Cyclone Boot Dryers
Cyclone Boot Dryers for Home, Shop and Commercial use. Custom built in the USA.
From: $899.99
CozyWinters is your source for unique, top quality winter products to keep you safe, warm, cozy & happy. We value your business and offer: Fast Shipping. Great Prices. No Hassle Returns! Our customer service team is here to care for you.
Sign up for CozyWinters News,Sales, and Deals
Orders usually ship samebusiness day.
International Orders Welcomed! We ship to over 200 Countries. All prices are in U.S. Dollars.
FREE Shipping Offer*on orders over $75.00 (More...)


text:
Zooey Deschanel Photo 277x400
Zooey Deschanel
Zooey Claire Deschanel (born January 17, 1980) is an American actress, musician, model, and singer-songwriter. Deschanel became known for her deadpan supporting roles in films such as Elf (2003), The Hitchhiker's Guide to the Galaxy (2005) and Failure to Launch (2006). She then began playing lead roles in films, including Yes Man (2008) and (500) Days of Summer (2009).
Zooey Deschanel news
Zooey Deschanel Reveals Baby Daughter's Name
Zooey Deschanel Welcomes Baby Girl
Zooey Deschanel opens up about Career and Pregnancy
Subscribe to our weekly celebrity newsletter and receive the week's trending celebrity photos and wallpapers.


text:
Shop By Category
Home::Soccer::SHOP BY TEAM::Los Angeles Galaxy
Los Angeles Galaxy
Browse our team section for a great selection of replica jerseys, shirts, jackets, balls and bags. We also carry team scarves, key chains, bracelets, and more. Sport your team's gear as you support them all season long. Free shipping on all clubwear orders of $100 or more.
Los Angeles Galaxy


text:
Tu sei qui
Aquarian Age
Yogi Bhajan came to the West during the counter-culture movement of the late 1960's and 1970's. For the first time in history, a master shared the ancient, secret science of Kundalini Yoga freely and openly. The counter-culture initiated the start of a profound evolution in human consciousness. This expansion in awareness will continue into the future, during what is called, "The Aquarian Age." Kundalini Yoga as taught by Yogi Bhajan gives people practical tools to navigate and integrate this incredible shift.
The Age of Aquarius began on November 11, 2011. We can see evidence all around us of how the horizon of the human mind is growing. Space ships fly to other planets, land on their surfaces and send back information to the entire human race. The Internet has created a cyber space that is truly limitless in size and experience. The human mind processes more information in one day than people had to process during an entire lifetime in the 1700's. The demands on the human brain and the nervous system have never been as great as they are today.
In response to these demands, humans are beginning to evolve a sensory system that allows them to live as intuitive, multi-faceted beings. However, evolution is a tricky process and not everyone will be capable of making the change. Yogi Bhajan often said that what worked in the past will no longer work in the future. Those who cannot make the shift will freak out and fall apart. He taught Kundalini Yoga so that people would have techniques to consciously develop the sensory system. He also encouraged those who practiced Kundalini Yoga to become teachers, so they could serve and heal others.
Yogi Bhajan's teachings on the Aquarian Age is vast and comprehensive. Sometimes he would lecture on this subject, and say that people will not understand for another 500 or 1000 years what he was discussing. Because of this, 3HO has an entire microsite devoted to the topic of the Aquarian Age. There, you will find Yogi Bhajan lectures, kriyas, meditations, and articles by community members about this timely and important subject.
We invite you to explore the wealth of knowledge that Yogi Bhajan shared about the future of the human race, and how to prepare yourself to be a part of it.
Questions and Answers on the Sensory Human in the Aquarian Age
The Self Sensory Human of the Aquarian Age
You may also be interested in:
- 5 Ways to Get Rid of Judgment with Meditation for Inner Conflict
- Living Your Destiny
- Yogi Bhajan Lecture: What is the Age of Aquarius?
- Cosmic Insight into the Aquarian Age with Nam Hari
- Overcoming Cold Depression
- Yogi Bhajan Lecture: The Sensory Human in the Aquarian Age
- Yogi Bhajan Lecture: Happy 31st Anniversary to 3HO!
- The Power of Mantra in the Aquarian Age
- Yogi Bhajan Lecture: You Within You
- Manifesting through the Chakras
- 1 di 13
- ›


text:
FONTANA - Ever since Jacqueline Williams was a little girl growing up in St. Louis, she couldn't stand to see people in need.
"It broke my heart," said Williams, a 59-year-old pastor at the Good Samaritan A.M.E. Zion Church in Fontana.
"There were always children hungry in our neighborhood; I'd pick up kids for church and knew they hadn't eaten. We'd always feed them when we got to church. At least they would have had something good to eat that day."
Williams, her husband, Jonathan, and their grandson, Devin, 19, moved to California about 12 years ago.
Although Williams has a bachelor's degree in education and had taught in middle school, she felt a pull toward spiritual ministry.
The family immediately joined the Good Samaritan church, and Williams soon became an assistant pastor.
"I am still teaching, I'm just not in a classroom," said Williams, who is an ordained minister.
"I always loved serving God and knew he had a special plan for me. At the time, I just didn't know what it was."
Williams' passion became feeding the hungry. She spearheaded a twice-a-year holiday food giveaway, which turned into a monthly event eight years ago.
On the fourth Saturday of each month, Good Samaritan church offers a hot meal, enough groceries for a week and quality, gently used clothing to anyone who shows up - no strings attached.
"We let them come free - we don't preach to them and they don't have to come in to listen to anything," she said. "We feel that they'll see God in our giving."
Williams as well as her assistant pastor, the Rev. William Giden, and church members feed and clothe about 40 people each month - no small feat considering that total is 10 more than the church's congregation.
Donations of food and clothing are always appreciated, but the church could never accomplish its monthly ministry without a partnership with Pomona's No Empty Table, a similar food distribution effort.
"We go there on the third Saturday of the month and help them bag their food and they give enough food for us to give out," said Williams, who became Good Samaritan's pastor three years ago.
Williams arrives at 7 a.m. for each food giveaway. It's important to her to take an active role in the event, helping whereever she's needed and offering a friendly face to those who may not be use to seeing many.
For its Dec. 22 food giveaway event, Williams is hoping for community donation of turkeys and toys.
"There's such joy in helping others," she said.
"Some people are so grateful just knowing they'll be having a good meal that night."
While there may be other creature comforts and interior fix-ups that the Good Samaritan church could use, Williams prayers go for none of those.
Her thoughts are of others.
"I just wish so much we could do this more than once a month," she said.
"In this economy, when so many people are out of work, are losing their homes and are homeless, the least we can do is give them something to eat."
Reach Diana via email, or call her at 909-483-9381.


text:
A stock with a high "days to cover" value compared to its peers would be considered to have a higher level of short interest as compared to those peers. This could mean short sellers are using the stock to hedge a long bet elsewhere, or could also mean that short sellers believe the price of the stock will decline. When short sellers eventually cover their positions, by definition there must be buying activity because a share that is currently sold short must be purchased to be covered. So investors tend to keep an eye on that "days to cover" metric, because a high value could predict a sharper price increase should the company put out some unexpectedly good news — short sellers might rush to cover positions, and if the "days to cover" number is high, it is more difficult to close those positions without sending the stock higher until the higher price produces enough sellers to generate the necessary volume. Below is a three month price history chart comparing the stock performance of REGN vs. DRI: At last check, REGN was off about 1.2%, while DRI was off about 0.1% on the day Friday.
- Log In
- Newsletters
Access insights and guidance from our Wall Street pros. Find the product that's right for you.
- Action Alerts PLUS
- Daily Swing Trade
- Income Seeker
- Quant Ratings
- Real Money
- Real Money Pro
- Stocks Under $10
- Top Stocks
- Trifecta Stocks
- Real Money Pro Portfolio
- Chairman's Club
- Compare All


text:
Great Brit: Wiggins creates history
The Sky team was formed at the start of the 2010 season and the intention was clear from the very beginning: to have a British winner of the Tour de France within five years. It's taken just three. Bradley Wiggins had achieved all there is to do as a track rider and he escaped what he called his «comfort zone» and set himself a new challenge after successfully defending his Olympic title in the individual pursuit in 2008. With three gold medals from the Olympics in his trophy cabinet - one each from the solo 4,000m effort (which is no longer on the program for the Games), and one...Read more Key moments
Le Tour in videos
- Best of n°1
- Best of n°2
- Best of n°3
- Summary of the race
- Interview - Stage Winner
- Image of the day
- Landscape of the day
- Analysis of the stage
- The day's route
- Magazine
- Jean-François Pescheux's analysis of the...
- The towns 2012 : visit Rambouillet
- Through the geologist eyes
- Archive - 2011
- Archive - 2010
- Archive - 2009
- Archive - 2008
- Archive - 2007
- Archive - 2006
- Archive - 2005
- Archive - 2004
- Archive - 2003
- Archive - 2002
Rambouillet / Paris Champs-Élysées
At fifty kilometres from Paris, Rambouillet is the doorway to the Haute Vallée de Chevreuse Regional Nature Park. It is like a glade in the heart of the Rambouillet...
Paris loves the Tour de France and is delighted to welcome once again the arrival of "La Grande Boucle" to the most beautiful avenue in the world. Each year, the last...
Le Tour 2012 route
Tour de france 2012
Running from Saturday June 30th to Sunday July 22th 2012, the 99th Tour de France will be made up of 1 prologue and 20 stages and will cover a total distance of 3,497 kilometres.
These stages have the following profiles:
- 9 flat stages
- 4 medium mountain stages - one with a summit finish
- 5 mountain stages - two with a summit finish
- 2 individual time-trial stages
- 1 prologue
- 2 rest days
9 new stage towns
Abbeville, Annonay Davézieux, Bellegarde-sur-Valserine, La Planche des Belles Filles, Peyragudes, Porrentruy, Samatan, Tomblaine, Visé
Publicity caravan
Each year it is much awaited and lights up the roadside... we are talking of course about the Tour de France sponsor's parade! Discover the crazy cars of our partners and try your luck at winning gifts on...
Jersey wearers after the stage 20
- yellow jerseyWIGGINS B.SKY
- polka-dot jerseyVOECKLER T.EUC
- white jerseyVAN GARDEREN T.BMC
- the day's winnerCAVENDISH M.SKY
- teamRADIOSHACK-.RNT
- super-combativeSORENSEN C.STB
Key moments
- 23:00Summary of the race
- 17:39Great Brit: Wiggins creates history
- 16:00Interview - Stage Winner
- 19:02Sagan: «I want to finish this season...
- 18:56Froome: «I couldn't be happier»
- 18:49Van Garderen: «It's been a huge three...
- 18:43Cavendish: «You've seen my sprint is...
- 18:31Wiggins: «It's very surreal»
- 11:45Analysis of the stage
- 10:30The day's route
Receive exclusive news about the Tour de France
Will Mark Cavendish his fourth stage on the Champs-Elysées today?
- Yes73.07%
- No26.93%


text:
However even people who prescribe these medications have very poor success with and very little knowledge about these medications, and when and where to use them. My main concerns are mentioned above, so I won't get too into the drugs now, though they are very much related, but if we get into the drugs, there is a wealth of information about how harmful they are, and how they often make people have more problems and exacerbate the old ones. Also, if one wants to reserve medication to times when only medication is helpful, if it ever is, modern psychiatry and professionals should be avoided. Hospitals use them not only when they are necessary for subduing a patient, but use them almost immediately, often without having seen a doctor, on harmless patients. I think outside of hospitals they are encouraged in the absence of hallucinations. After being put on them, patients are usually discouraged incredible amounts, or forbidden, from getting off of them for months or years, even in the (numerous) cases with bad reactions.We are not skilled enough to deal with people who are seriously ill where ONLY medication can reduce the onslaught of hallucinations or great desperation, I am sorry I have to say this.
And while recovering, he may study and find out how to avoid circumstances which bring him back into the hospital.
altar wrote:Manapa,
For the most part this sounds okay, however an attitude has been espoused here, including by a moderator, that people here are not able to give advice on this issue
however advising one to seek assistance from doctors seems regularly permitted or encouraged. Doctors in this case means psychiatrists I think.
I think this results from unfamiliarity with just how our modern psychiatric system works and ignorance regarding how deficient and harmful, and misinformed it is.
So, some kind of rewording of the TOS might be a good idea, otherwise I guess leave it as is...
TOS are following generally accepted standards, advising members to direct people to their doctor, or mental health provider.
but who would you advise people to see as a standard TOS?
it is obvious, that you have a bone to pick with psychiatric hospitals and specialists, perhaps from own sad experience, who knows, and no system is perfect, and you also may have points, but again, there is little or no alternative, and this forum is not it.
Heavy doses of very potent drugs for someone actively psychotic may be far better than the alternatives. As for the rest, cultivation of healthier states of mind are very much in keeping with the Dhamma.I guess I am suggesting that in this case the TOS deviate from generally accepted standards, in favor of a more helpful, realistic approach. Modern mental health systems often fly in the face of dhamma. I.E. heavy doses of very potent drugs, "positive thinking," self-affirmation, frivolous socialization, not thinking about death, and some more.
Heavy doses of very potent drugs for someone actively psychotic may be far better than the alternatives. As for the rest, cultivation of healthier states of mind are very much in keeping with the Dhamma.
altar wrote:Laurens, I am not insisting that we are qualified to treat them (some of us might be, some might not). I am insisting that the mental health system's competency in this area be taken into question, or else not recommended. The techniques used today have poor success rates, and are not as tried and true as more physically related medicine. It is a simpler issue with physical health; the problem is more or less confined to the body. For instance, you have frostbite, you cut off the foot. In mental health, most doctors wish to treat the mind through the body. As for the other half--treating the mind with the mind; this is very much a part of the Buddha's teaching, so it's really not so inapplicable as people are making it out to be.
Even many doctors criticize common psychiatric practices.
I think that it is actually maybe necessary for someone to research modern psychiatry before recommending people go to them, and I would appreciate if people would take the time to do this before saying, "doctors are the appropriate place to go if you have mental health issues." Most likely they will find that it is not something as reliable as other fields of science, and that, whereas in some fields of science, I think, studies support their methods, in psychiatry, this is often not the case.
People are insisting that doctors are the right place to go. Doctors who deal with mental health are generally psychiatrists, I think. So I'm simply questioning psychiatrical practices, stating that they are often harmful and not in accordance with the dhamma, and people should not be pointed towards them [exclusively and unreservedly] as the by-line.
Laurens wrote:I think those rules are in place simply because we are Buddhists, not doctors. If a person is suffering from mental health issues we are not qualified to offer advice. Because the majority of us are unqualified to treat or offer advice to people suffering from mental illness, it could potentially result in someone giving harmful advice (I don't mean that people here might offer malicious advice, rather that the person due to their mental health issues may interpret advice wrongly and this could create more problems etc).
I believe the most compassionate advice a Buddhist can give to anyone who is ill, is to say 'go to the doctor', there is no exception with mental health problems, just because we meditate doesn't mean we are qualified to treat them.
All the best
Users browsing this forum: No registered users and 20 guests