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3-in-1 Gloves
This item is currently not available.
Additional Information
Exclusive | Three-in-One Gloves and Handwarmers
- Warm hands, three ways!
- Includes gloves and handwarmers
- Wear separately or together
- Choice of Charcoal or Pumpkin
More than just a stylish pair of gloves, these keep hands warm three ways! Includes a pair of mid-weight gloves and a pair of handwarmers. Wear the extra-long gloves alone on a cool day to chase away the chill, wear the handwarmers alone when you need fingers free to type or text, or wear the handwarmers over the gloves for extra coziness.
Product Details
- 70% nylon/30% merino wool
- One size fits most
- Gloves are approx. 12-1/2" L
- Handwarmers are approx. 8-1/2" L
- Hand wash, dry flat
- Imported
- Gardener's Supply Exclusive
REVIEW SNAPSHOT®by PowerReviews
- Versatile (4)
- Soft (3)
Best Uses
- Was this a gift?:
- No (9), Yes (9)
Reviewed by 20 customers
Displaying reviews 1-10
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- Beautiful practical
- Snug Finger Fit
Best Uses
- Cool and cold weather
Love the arm/wrist coverage. You can stretch your arms and not expose your skin in a gap between coat and glove. Pretty color/design. Finger fit is tight, however; I have to turn my rings towards my palm to slide the gloves on.
- Was this a gift?:
- No
- Lovely and soft
Best Uses
I have only worn them twice so I can't comment on durability, but they are beautiful and soft and flow with your hands. I bought two pairs - one for my daughter and the other for myself - and we both like them. I like to wear them just as hand warmers when I knit or crochet in the car. As for durability, only time and wearing them will tell.
- Was this a gift?:
- No
- Gave Several As Gifts
- Good color combinations
- Looking Forward To Mine
Best Uses
- Variety Of Ways To Wear
Gave several to relatives last Christmas, and all liked them plus the different ways to wear on needs
- Was this a gift?:
- Yes
- Soft and Comfortable
Best Uses
These gloves will be used daily in the Fall and Winter months. Great anytime gloves.
- Was this a gift?:
- No
- Comfortable
- Quckly Warm Fingershands
- They keep their shape
- Absolutly NONE
Best Uses
- Keep Hands Warm Sleeping
I love these! I got one pair for Christmas and I ordered 2 more this past month. Super comfortable, cute style, fits my fingers, overall just great!
- Was this a gift?:
- Yes
The gloves will be nice and snug in damp, cold weather.
- Was this a gift?:
- No
- Easy To Don And Doff
- Hold their shape
- Nice color combinations
- Soft and warm
- Very practical
Best Uses
- Can Garden In Them
- Good For Very Cold Temps
- Nice For A Soccer Game
- Wear Walking Your Pups
- Wear While Driving The Ca
I wear both layers at a time and slip off the fingers when needing to text. They can be worn at the same time and with the fingers free and covered with the other on top or vice versa. When it is warmer, just wear the fingers free glove. They are smooth and warm and do not snag on the velcro of your coat. Easy to wash and just lay flat to dry. They dry in an hour over a heat vent or in the laundry room. Buy a second pair just for gardening or outdoor use. They are too cute for getting dirty in the garden so have a pair for wearing in public. I love to drive with the fingers free so after cleaning the windows of my car, I slip off the fingers and remove that glove only while still wearing the thumb glove.
- Was this a gift?:
- No
My fault for not reading the description more carefully. I wanted these for winter use to help with my Raynauds but the fabric is 70% NYLON and only 30% wool. These are of no use keeping your hands warm in cold weather. Very disappointed with my purchase.
- Was this a gift?:
- No
- 3 Way To Keep Your Hands
- Easy to care for
- Found None
Best Uses
- General yard work
- Outdoors
- Pruning
- Raking leaves
She loves them.
- Was this a gift?:
- Yes
- Appealing color
- Easy To Don And Doff
- Fingers Fit Perfectly
- Keep The Forearm Warm
- Soft material
Best Uses
- Drive With Them On
- Easy To Hold A Dog Leash
- Texting is Easy
- Wear At A Soccer Game
I wear them all over and they are easy to don and doff. They do not snag on velcro from the coat or dog sweaters. The material is warm and soft making my hands feel comfortable in below freezing weather. The color I chose goes with all my accessories.
- Was this a gift?:
- No
Displaying reviews 1-10
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Get away and play. Travel with confidence knowing your golf clubs are protected with a golf travel bag.
Shop golf travel bags at Golf Galaxy. Discover options that offer ease of use and durability.
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Depend on brands like TaylorMade, Titleist, Nike, Callaway, Bag Boy, Club Glove, Maxfli, Samsonite, Top Flite and more to safeguard your possessions.

subset: commoncrawl


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Winchester Ghost Walk
Fri 20/05/16 7:30 pm
The popular return of the Original Ghost Walk of the ancient capital of England.
As the ancient capital of England the historic streets of Winchester are heavy with myths and legends. But beyond the tourist trail lies a dark trail of secrets, ghosts and of an underclass or murderers and thieves. Mixing with the wealth of the merchants and clergy the streets were the hiding place of highwaymen, smugglers and politics. Join Dark Encounters bringing these stories to life in a truly immersive experience as ghosts of the past come to tell their tales.
You will learn a little, you will laugh a little - but hopefully you will scream a lot.
There are tours at 7.30pm and 9.00pm and last approximately 1 - 1.5 hours. They involve interaction with actors and group participation - this tours offers a unique perspective to the city after dark. Suitable for 12 years and up when accompanied by an adult.
Places are very limited, so early booking online is essential. After you have placed your order you will receive an order confirmation email. No tickets are sent as there will be a list of names of everyone attending at each event and you will be asked to sign in at the beginning. You will receive an itinerary email detailing everything you need to know about event. If you do not receive either the order confirmation or itinerary email please check your Spam email.
|Contact Info
|Email Contact: firstname.lastname@example.com
Phone Enquiries: 01962 435 020
|Pricing Details
Trafalgar Street
|Dark Encounters website


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Drivers are reminded advance construction work starts tonight, Tuesday, April 22, ahead of a new scheme aimed at improving journeys at the Dartford Crossing.
Dart Charge – a remote payment system being introduced from October 2014 – will reduce congestion and ease traffic flow at the Crossing.
Instead of stopping at barriers to pay the crossing charge, drivers will pay online, by text, at one of numerous retail outlets, or by phone.
From tonight work starts to install the signage which will help drivers understand the new system.
To minimise disruption the work will be carried out mostly overnight, when traffic flows are lowest, and using lane closures already in place for routine maintenance work.
The work to install the signs will be completed over the summer. Some sign faces will remain covered until the new payment arrangements are introduced.
It will take place overnight, on the A282 on both approaches to the Crossing, the M25 both directions between junction 29 and junction 3, the A13 both directions approaching junction 30, and the M20 westbound between junctions 3 and 1.
On the A1306 both directions approaching junction 31, the A2 both directions approaching junction 2, the eastbound Bob Dunn Way in Dartford, and the southbound Crossways Boulevard in Dartford, it will take place during off-peak daytime hours.
The vast majority of the construction work taking place before Dart Charge is introduced from October will be carried out overnight, with minimal impact on road users.
The main construction work will take place after October when the existing payment booths will be removed and the road layout changed. This work will be completed by Spring 2015.


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Freeman says right eye discomfort is gone
ATLANTA -- Braves first baseman Freddie Freeman returned to Turner Field on Friday confident that he would no longer have to deal with the right eye discomfort that plagued him as he struggled throughout the Marlins series earlier this week.
"When I woke up this morning, it didn't feel like there was a crumpled up piece of paper in my eye like it has been," Freeman said. "Everything feels good today."
Freeman felt some dryness in his eyes as he took batting practice before last Saturday's game against the Mets at Citi Field. He ignored the problem as he notched three hits that evening. But Freeman went 1-for-5 the next afternoon and then felt his right contact lens break while it was still in his eye just before Monday night's series opener against the Marlins.
Freeman said the Braves' medical staff used a Q-Tip to locate and remove the broken contact lens from his eye approximately seven minutes before Monday's first pitch. This likely added to the irritation he felt as he went 0-for-12 with six strikeouts during the three-game series against the Marlins. He had batted .397 with nine strikeouts in the 81 plate appearances he had compiled before Monday.
After going 0-for-4 with three strikeouts in Tuesday's matchup against Jose Fernandez and the Marlins, Freeman visited Dr. David Ross, who had treated Freeman when he dealt with dry eyes throughout May during the 2012 season.
"It's very frustrating," Freeman said. "I thought I had put the eye problems in my past and gotten behind it. It's just one of those things that I'm going to have to battle the first few months of every season with the cold and the wind. If we can just manage it the rest of my career, I think we'll be OK. I think we caught it quick enough. This is a lot better than two years ago.
"Two years ago, I couldn't see with my glasses on. Now, I can see with my glasses on. Everything feels good. I feel great today and hopefully I can get some results."
Mark Bowman is a reporter for MLB.com. Joe Morgan is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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The most interesting draft rumor flying around this weekend had the Blazers and Celtics talking about a deal that would send Paul Pierce to Portland for the No. 3 pick in the draft and Nick Van Exel.
On Tuesday, Celtics director of basketball operations Danny Ainge shot that rumor down, telling Insider it was "ludicrous." Ainge said he had no intention of trading Pierce, especially for a draft pick.
Still, it's an interesting idea.
Van Exel has a team option on his contract this year. That means the Celtics could trade for his $12.7 million contract, and essentially waive him without owing him a penny. In other words, the Celtics would get the draft pick and cut their cap by more than $13 million (Pierce makes a little more than Van Exel).
It's obvious why the Blazers would do it. Adding an All-Star like Pierce at the two would be a major upgrade. If Portland could find a veteran point guard in free agency to back up Sebastian Telfair, it could be back in the playoff mix next year.
The Celtics also have motivation to do a deal like this. Pierce is unhappy. The Celtics don't sound like they're bringing back Antoine Walker and Gary Payton (both are free agents) next season, which is only going to make matters worse with Pierce.
By not re-signing Walker and Payton and by trading Pierce, the Celtics could accomplish a couple of things.
First, by making the move, Boston would be around $10 million under the cap going into the summer. That would allow Ainge to be aggressive on the free agent market. The Celtics would love to have a long, athletic shot blocker like Samuel Dalembert, Tyson Chandler or Stromile Swift. They would have enough cash to be a contender for one of these players by trading Pierce.
Second, the Celtics would be in a position to draft a potential superstar such as North Carolina swingman Marvin Williams or Wake Forest point guard Chris Paul. One of these two should be on the board at No. 3. They'd also retain their No. 18 pick in the draft.
While making these moves would likely mean the Celtics slip a little in the standings next year, Ainge would be putting together a pretty awesome long-term foundation for the Green. Both Paul and Williams have the potential to be superstars. Al Jefferson looks like he could be an All-Star someday. Delonte West and Tony Allen also appear to have bright NBA futures.
The downside of the deal is just as troubling. Ainge would be trading a proven star and scorer for potential and cap room. Given how lopsided the trades of Shaquille O'Neal, Vince Carter and Tracy McGrady have looked in hindsight, you can understand the hesitation.
How about GP and NVE on the same team.............


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- Product Details
- Wind proof petrol lighter
- Lights in all weather
- Supplied without petrol
- Comes with silver metal padded gift box
- Lighter measures approx. W:3cm, H:6cm x D:1.3cm
- Box measures approx. W:6cm, H:8cm x D:2cm
Show your dad, your best man and the other all-important members of the wedding party how much you appreciated their help and support on the big day, by treating them to a Personalised Yellow Lighter - Moustache as a really original and unique thank you gift.
Ideal as a wedding day thank you to your friends and family thanks to the fact that each individual present will be linked and yet still unique, each lighter also comes in a handy gift tin which can be used to display it when not in use.
Eye-catching and stylish in a bright yellow colour, each lighter features a handy flip up hinged lid and is expertly and lovingly decorated in a fun and personal style.
Each one features the humorous moustache design that gives the item its name but then allows you to make your own personal mark by choosing exactly what all of the surrounding text displays.
- Delivery & Returns
We are aware of how important it is for you to receive your gifts in time. Therefore, once you place your order we will process straight away and dispatch as soon as they are ready to go. We usually dispatch all items within 24-48 hours, however, this may be a little longer during special occasions such as Mother's Day, Father's Day, Christmas, etc. If multiple items ordered, we may dispatch items separately or all together, depending on the process.
*2nd CLASS ROYAL MAIL
Sent via 2nd Class Mail for only £3.99.
*1st CLASS ROYAL MAIL
Sent via 1st Class Mail for only £4.99.
Sent via Royal Mail Tracked for only £5.99.
Orders received by 2pm, sent via next working day courier tracked service for only £7.99.
Orders received by 2pm, sent via Royal Guaranteed Saturday Delivery for only £9.99.
The cost for delivery to European countries is calculated based on the destination. Please allow approx. 2-5 working days from dispatch, however, this is not guaranteed.
Below areas will incur a remote area surcharge - £30
*Italy: Livigno & Trepalle, San Marino, Vatican City
*Spain: Ceuta, Melilla
*Finland: Aland Islands
*Free delivery excludes items that are on offer or discounted from the original price and sent via 2nd Class Royal Mail, only UK.
*2nd Class Royal Mail - Royal Mail aim to deliver within two to three days, however, this is not guaranteed by Royal Mail, only UK.
*1st Class Royal Mail - Royal Mail aim to deliver your order one to two days, however, this is not guaranteed by Royal Mail, only UK.
*Premium Tracked - Royal Mail aim to deliver your order the next day, however, this is not guaranteed by Royal Mail, only UK.
*Next Working Day - All Orders placed before 2pm will be delivered next working day (Excludes Northern Ireland, Overseas UK addresses, and Parts of Scotland).
*Saturday Delivery - All Orders placed before 2pm will be delivered Saturday (Excludes Northern Ireland, Overseas UK addresses, and Parts of Scotland).
*All our items require production time and this is stated on individual product pages.
We're sure that you will be satisfied with your purchase and we also understand that sometimes you may want to return. We keep this process simple! Just contact us if you wish to return goods. Please note: personalised, made-to-order and perishable items are non-refundable.
- Ask a Question
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i cant believe there's not a yoga thread yet...
so I'll start it.
I'm gonna start practicing yoga next week i think (Monday) those yoga for meditation videos really inspired me. my wife has done yoga for years and i think it's time i gave it a shot, though i'm not using those videos. maybe after awhile I'll try those.
who else here does yoga. has it helped your practice?


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DePuy Synthes Select offers surgical device systems designed for your ASCs most common orthopedic and podiatric procedures. Our compact systems feature the same high-quality DePuy Synthes products used in hospitals, but combined into consolidated sets to help improve your efficiency.
For more information, call 800-523-0322, visit email@example.com or click on "Learn More" below.
Your product information request has been received and we will forward information to the contact information you provided shortly.


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Breast cancer survivor offers wisdom at Faulkner satellite center
Call 877-422-3324 today to make an appointment
Make your appointment or second opinion with Dana-Farber today to meet with an onsite specialist.
Adult Patients:877-442-3324
Pediatric Patients:888-733-4662
Can't get to Boston? Explore our Online Second Opinion service to get expert advice from Dana-Farber oncologists.
Email Dana-Farber
Main Number617-632-3000
Toll-Free Number866-408-DFCI (3324)
Discover the ways to give and how to get involved to support Dana-Farber.
Poet Richard Fox gains insight – and material – through cancer treatment
A family faces cancer in an unfamiliar city – with help
Choosing mastectomy or not: Studying young women's surgical choices
Jeff's targeted therapy has kept his advanced lung cancer at bay.
A low-grade glioma is a slow-growing cancer of the brain that begins in glial cells, which surround and support nerve cells. Learn about low-grade gliomas and find information on how we support and care for children and teens with low-grade gliomas before,
during, and after treatment.
The Brain Tumor Center at Dana-Farber/Boston Children's Cancer and Blood Disorders Center cares for children with many different types of common and rare brain and spinal tumors, including astrocytomas, medulloblastomas, ependymoma, glioblastomas, and primitive neuroectodermal tumors (PNET).
Your child will receive care from some of the world's most experienced pediatric brain tumor doctors and internationally recognized pediatric subspecialists.
Our team works closely together to develop a care plan that offers your child the highest possible quality of life after treatment, and takes the needs of your child and your family into account.
Children treated at the Brain Tumor Center have access to some of the most advanced diagnostics and therapies, including:
Thanks to refined surgical techniques and improved chemotherapy and radiation therapy, the majority of children with brain and spinal cord tumors are now long-term survivors. However, they may face physical, social, and intellectual challenges that require specialized care.
Learn more about our Brain Tumor Center.
Low-grade gliomas are brain tumors that originate from glial cells, which support and nourish neurons in the brain. Glial tumors, or gliomas, are divided into four grades, depending on their cells' appearance under a microscope. Grade 1 and 2 gliomas are considered low-grade and account for about two-thirds of all pediatric tumors.
In addition to their grade, low-grade gliomas are also classified based on their location and by the kind of glial cell — astrocytes, oligodendrocytes or ependymocytes—from which they arise. Most low-grade gliomas are both highly treatable and highly curable. The most common kind of low-grade glioma, called a pilocytic astrocytoma, has a cure rate over 90 percent.
Children and adolescents with glioma are treated at Dana-Farber/Boston Children's through the Brain Tumor Center's Glioma Program, one of the largest and most experienced pediatric glioma programs in the world. Our glioma specialists — a team of neuro-oncologists, surgeons, pathologists and radiation oncologists — focus solely on the care of children diagnosed with gliomas. The Glioma Program also offers families the chance to have their child's tumor molecularly profiled (as long as a biopsy can be taken), which may help identify opportunities for targeted treatment.
Find in-depth information on low-grade gliomas on the Dana-Farber/Boston Children's website, including answers to:
Primary brain tumors are a diverse group of diseases that together constitute the most common solid tumor of childhood. Immunohistochemical analysis, cytogenetic and molecular genetic findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification. Brain tumors are classified according to histology, but tumor location and extent of spread are important factors that affect treatment and prognosis.
The PDQ childhood brain tumor treatment summaries are organized primarily according to the World Health Organization (WHO) classification of nervous system tumors.[1][2] For a full description of the classification of nervous system tumors and a link to the corresponding treatment summary for each type of brain tumor, refer to the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.
The term brain stem glioma is a generic description that refers to any tumor of glial origin arising in the brain stem, inclusive of the midbrain, pons, and medulla. The following two histologies predominate:
Approximately 300 to 400 pediatric brain stem tumors are diagnosed each year in the United States. DIPG accounts for approximately 75% to 80% of pediatric brain stem tumors.[3] Most children with DIPG are diagnosed between the ages of 5 and 10 years. Focal pilocytic astrocytomas in the brain stem occur less frequently.[4]
In children with DIPG, a classic triad of symptoms (cranial neuropathies, long tract signs, and ataxia) is often described. However, children often present with only one or two of these findings. Obstructive hydrocephalus due to expansion of the pons can also be a presenting symptom. Nonspecific symptoms may also occur, including behavioral changes and decreased school performance.
Focal pilocytic astrocytomas in the brain stem present in multiple ways depending on tumor location. Common presenting symptoms include the following:[4]
Primary tumors of the brain stem are most often diagnosed based on clinical findings
and on neuroimaging studies using magnetic resonance imaging (MRI).[5] Histologic confirmation of presumed DIPGs is usually
unnecessary. However, histologic confirmation is currently performed for research studies and may be more routinely recommended in the future.[6] Biopsy or resection may be indicated for brain stem tumors that are not diffuse and
intrinsic or when there is diagnostic uncertainty based on imaging findings. New approaches with stereotactic needle biopsy may make biopsy
Children with neurofibromatosis type 1 (NF1) are at an increased risk of developing a brain stem glioma. They may present with a long history of symptoms or be
identified by screening tests.
The median survival for children with DIPGs is less than 1 year.[9] In contrast, focal pilocytic astrocytomas have a markedly improved prognosis, with 5-year overall survival exceeding 90%.[4]
Prognostic factors include the following:
For children with brain stem tumors and anticipated long-term survival, standard follow-up tends to include interval clinical assessments and periodic imaging with MRI. The required duration of follow-up with MRI varies; it largely depends on the presence or absence of residual imaging abnormalities and the original histology of the tumor after treatment.
Louis DN, Ohgaki H, Wiestler OD, et al., eds.: WHO Classification of Tumours of the Central Nervous System. 4th ed. Lyon, France: IARC Press, 2007.
Louis DN, Ohgaki H, Wiestler OD, et al.: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114 (2): 97-109, 2007.
Warren KE: Diffuse intrinsic pontine glioma: poised for progress. Front Oncol 2: 205, 2012.
Klimo P Jr, Pai Panandiker AS, Thompson CJ, et al.: Management and outcome of focal low-grade brainstem tumors in pediatric patients: the St. Jude experience. J Neurosurg Pediatr 11 (3): 274-81, 2013.
Liu AK, Brandon J, Foreman NK, et al.: Conventional MRI at presentation does not predict clinical response to radiation therapy in children with diffuse pontine glioma. Pediatr Radiol 39 (12): 1317-20, 2009.
Walker DA, Liu J, Kieran M, et al.: A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro Oncol 15 (4): 462-8, 2013.
Cage TA, Samagh SP, Mueller S, et al.: Feasibility, safety, and indications for surgical biopsy of intrinsic brainstem tumors in children. Childs Nerv Syst 29 (8): 1313-9, 2013.
Grill J, Puget S, Andreiuolo F, et al.: Critical oncogenic mutations in newly diagnosed pediatric diffuse intrinsic pontine glioma. Pediatr Blood Cancer 58 (4): 489-91, 2012.
Cohen KJ, Pollack IF, Zhou T, et al.: Temozolomide in the treatment of high-grade gliomas in children: a report from the Children's Oncology Group. Neuro Oncol 13 (3): 317-23, 2011.
Ballester LY, Wang Z, Shandilya S, et al.: Morphologic characteristics and immunohistochemical profile of diffuse intrinsic pontine gliomas. Am J Surg Pathol 37 (9): 1357-64, 2013.
Wu G, Diaz AK, Paugh BS, et al.: The genomic landscape of diffuse intrinsic pontine glioma and pediatric non-brainstem high-grade glioma. Nat Genet 46 (5): 444-50, 2014.
Taylor KR, Mackay A, Truffaux N, et al.: Recurrent activating ACVR1 mutations in diffuse intrinsic pontine glioma. Nat Genet 46 (5): 457-61, 2014.
Buczkowicz P, Hoeman C, Rakopoulos P, et al.: Genomic analysis of diffuse intrinsic pontine gliomas identifies three molecular subgroups and recurrent activating ACVR1 mutations. Nat Genet 46 (5): 451-6, 2014.
Warren KE, Killian K, Suuriniemi M, et al.: Genomic aberrations in pediatric diffuse intrinsic pontine gliomas. Neuro Oncol 14 (3): 326-32, 2012.
Broniscer A, Laningham FH, Sanders RP, et al.: Young age may predict a better outcome for children with diffuse pontine glioma. Cancer 113 (3): 566-72, 2008.
Pascual-Castroviejo I, Pascual-Pascual SI, Viaño J, et al.: Posterior fossa tumors in children with neurofibromatosis type 1 (NF1). Childs Nerv Syst 26 (11): 1599-603, 2010.
Albers AC, Gutmann DH: Gliomas in patients with neurofibromatosis type 1. Expert Rev Neurother 9 (4): 535-9, 2009.
The genomic characteristics of DIPGs appear to differ from those of most other pediatric high-grade gliomas and from those of adult high-grade gliomas. A number of chromosomal and genomic abnormalities have been reported for DIPG, including the following:
The gene expression profile of DIPG differs from that of non–brain stem pediatric high-grade gliomas, further supporting a distinctive biology for this subset of pediatric gliomas.[9]
Wu G, Broniscer A, McEachron TA, et al.: Somatic histone H3 alterations in pediatric diffuse intrinsic pontine gliomas and non-brainstem glioblastomas. Nat Genet 44 (3): 251-3, 2012.
Fontebasso AM, Papillon-Cavanagh S, Schwartzentruber J, et al.: Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma. Nat Genet 46 (5): 462-6, 2014.
Schwartzentruber J, Korshunov A, Liu XY, et al.: Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma. Nature 482 (7384): 226-31, 2012.
Shore EM, Xu M, Feldman GJ, et al.: A recurrent mutation in the BMP type I receptor ACVR1 causes inherited and sporadic fibrodysplasia ossificans progressiva. Nat Genet 38 (5): 525-7, 2006.
Zarghooni M, Bartels U, Lee E, et al.: Whole-genome profiling of pediatric diffuse intrinsic pontine gliomas highlights platelet-derived growth factor receptor alpha and poly (ADP-ribose) polymerase as potential therapeutic targets. J Clin Oncol 28 (8): 1337-44, 2010.
Paugh BS, Broniscer A, Qu C, et al.: Genome-wide analyses identify recurrent amplifications of receptor tyrosine kinases and cell-cycle regulatory genes in diffuse intrinsic pontine glioma. J Clin Oncol 29 (30): 3999-4006, 2011.
Khuong-Quang DA, Buczkowicz P, Rakopoulos P, et al.: K27M mutation in histone H3.3 defines clinically and biologically distinct subgroups of pediatric diffuse intrinsic pontine gliomas. Acta Neuropathol 124 (3): 439-47, 2012.
There is no generally applied staging system for childhood brain stem
Brain stem gliomas are classified according to the following:
Brain stem gliomas may occur
in the pons, midbrain, tectum, dorsum of the medulla at the
cervicomedullary junction, or in multiple regions of the brain stem. The tumor
may contiguously involve the cerebellar peduncles, cerebellum, the cervical spinal cord, and/or thalamus.
The majority of childhood brain stem gliomas are diffuse astrocytomas that
involve the pons (diffuse intrinsic pontine gliomas [DIPGs]), often with contiguous involvement of other brain stem
It is uncommon for these tumors to have spread outside the brain
stem itself at the time of initial diagnosis. Spread of malignant brain stem tumors is usually contiguous, with
metastasis via the subarachnoid space. Such dissemination may occur prior to local relapse
but usually occurs simultaneously with or after local disease relapse.[4]
Freeman CR, Farmer JP: Pediatric brain stem gliomas: a review. Int J Radiat Oncol Biol Phys 40 (2): 265-71, 1998.
Laigle-Donadey F, Doz F, Delattre JY: Brainstem gliomas in children and adults. Curr Opin Oncol 20 (6): 662-7, 2008.
Khatua S, Moore KR, Vats TS, et al.: Diffuse intrinsic pontine glioma-current status and future strategies. Childs Nerv Syst 27 (9): 1391-7, 2011.
Sethi R, Allen J, Donahue B, et al.: Prospective neuraxis MRI surveillance reveals a high risk of leptomeningeal dissemination in diffuse intrinsic pontine glioma. J Neurooncol 102 (1): 121-7, 2011.
Many of the improvements in survival in childhood cancer have been made as a
result of clinical trials that have attempted to improve on the best available,
accepted therapy. Clinical trials in pediatrics are designed to compare new
therapy with therapy that is currently accepted as standard. This comparison
may be done in a randomized study of two treatment arms or by evaluating a
single new treatment and comparing the results with those that were previously
obtained with existing therapy.
Because of the relative rarity of cancer in children, all patients with brain
tumors should be considered for entry into a clinical trial. To determine and
implement optimum treatment, planning by a multidisciplinary team of
cancer specialists who have experience treating childhood brain tumors is
required. Radiation therapy (including 3-dimensional conformal radiation therapy) of pediatric brain tumors is technically very
demanding and should be carried out in centers that have experience in that
area in order to ensure optimal results.
Standard Treatment Options
Newly diagnosed childhood brain stem gliomas:
Diffuse intrinsic pontine gliomas
Radiation therapy
Focal or low-grade brain stem gliomas
Surgical resection (with or without radiation therapy and chemotherapy)
Observation (with or without cerebrospinal fluid diversion)
Radiation therapy, chemotherapy, and alternative approaches for inoperable focal or low-grade tumors
Recurrent/progressive childhood brain stem gliomas:
Palliative care
Repeat surgical resection
While numerous clinical trials are available for children with newly diagnosed DIPGs, the utility of any therapy besides radiation therapy in the treatment of patients with newly diagnosed DIPG remains unproven.[1][2][3][4][5][6]; [7][8][Level of evidence: 2A]; [9][Level of evidence: 3iiiA]
Currently, no chemotherapeutic strategy—including neoadjuvant, concurrent, postradiation therapy, or immunotherapy—when added to radiation therapy has led to long-term survival for children with DIPGs.[10][11][12]; [13][Level of evidence: 2A] This includes studies utilizing high-dose, marrow-ablative chemotherapy with autologous hematopoietic stem cell rescue, which have also been ineffective in extending survival.[14]
Standard treatment options for newly diagnosed DIPGs include the following:
Conventional treatment for children with DIPGs
is radiation therapy to involved areas. The conventional dose of radiation
ranges between 54 Gy and 60 Gy given locally to the primary tumor
site in single daily fractions. Such treatment will result in transient
benefit for most patients, but more than 90% of patients will die within 18 months of diagnosis.[15]
Radiation-induced changes may occur a few months after the completion of radiation therapy and may mimic tumor progression. When considering the efficacy of additional treatment, care needs to be taken to separate radiation-induced change from progressive disease.[16]
Research studies evaluating the efficacy of hyperfractionated and hypofractionated radiation therapy and radiosensitizers have not demonstrated improved outcomes using these radiation techniques.
Similar to the treatment of other brain tumors, radiation therapy is often omitted for infants with DIPGs, and chemotherapy-only approaches are utilized. However, published data supporting the utility of this approach is lacking.
Early-phase therapeutic trials may be available for selected patients. These trials may be available via Children's Oncology Group phase I institutions, the Pediatric Brain Tumor Consortium, or other entities.
Standard treatment options for newly diagnosed focal or low-grade brain stem gliomas include the following:
In general, maximal surgical resection is attempted.[21][22]
Patients with residual tumor may be candidates for additional therapy, including 3-dimensional conformal radiation therapy approaches, with or without adjuvant chemotherapy.
Patients with small tectal lesions and hydrocephalus but no other neurological
deficits may be treated with cerebrospinal fluid diversion alone and have follow-up
with sequential neuroradiographic studies unless there is evidence of
progressive disease.[21]
A period of observation may be indicated before
instituting any treatment for patients with neurofibromatosis type 1.[23] Brain stem gliomas in these children may be
indolent and may require no specific treatment for years.[24]
In selected circumstances, adjuvant therapy in the form of radiation therapy or chemotherapy can be considered in a child with a newly diagnosed focal or low-grade brain stem glioma.[25][26][Level of evidence: 3iDi] Decisions regarding the need for such therapy depend on the age of the child, the extent of resection obtainable, and associated neurologic deficits.
Alternative approaches for the treatment of inoperable brain stem gliomas include the following:
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with untreated childhood brain stem glioma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Mandell LR, Kadota R, Freeman C, et al.: There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: results of a Pediatric Oncology Group phase III trial comparing conventional vs. hyperfractionated radiotherapy. Int J Radiat Oncol Biol Phys 43 (5): 959-64, 1999.
Jennings MT, Sposto R, Boyett JM, et al.: Preradiation chemotherapy in primary high-risk brainstem tumors: phase II study CCG-9941 of the Children's Cancer Group. J Clin Oncol 20 (16): 3431-7, 2002.
Allen J, Siffert J, Donahue B, et al.: A phase I/II study of carboplatin combined with hyperfractionated radiotherapy for brainstem gliomas. Cancer 86 (6): 1064-9, 1999.
Broniscer A, Leite CC, Lanchote VL, et al.: Radiation therapy and high-dose tamoxifen in the treatment of patients with diffuse brainstem gliomas: results of a Brazilian cooperative study. Brainstem Glioma Cooperative Group. J Clin Oncol 18 (6): 1246-53, 2000.
Doz F, Neuenschwander S, Bouffet E, et al.: Carboplatin before and during radiation therapy for the treatment of malignant brain stem tumours: a study by the Société Française d'Oncologie Pédiatrique. Eur J Cancer 38 (6): 815-9, 2002.
Wolff JE, Westphal S, Mölenkamp G, et al.: Treatment of paediatric pontine glioma with oral trophosphamide and etoposide. Br J Cancer 87 (9): 945-9, 2002.
Korones DN, Fisher PG, Kretschmar C, et al.: Treatment of children with diffuse intrinsic brain stem glioma with radiotherapy, vincristine and oral VP-16: a Children's Oncology Group phase II study. Pediatr Blood Cancer 50 (2): 227-30, 2008.
Cohen KJ, Heideman RL, Zhou T, et al.: Temozolomide in the treatment of children with newly diagnosed diffuse intrinsic pontine gliomas: a report from the Children's Oncology Group. Neuro Oncol 13 (4): 410-6, 2011.
Jalali R, Raut N, Arora B, et al.: Prospective evaluation of radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma. Int J Radiat Oncol Biol Phys 77 (1): 113-8, 2010.
Frappaz D, Schell M, Thiesse P, et al.: Preradiation chemotherapy may improve survival in pediatric diffuse intrinsic brainstem gliomas: final results of BSG 98 prospective trial. Neuro Oncol 10 (4): 599-607, 2008.
Frazier JL, Lee J, Thomale UW, et al.: Treatment of diffuse intrinsic brainstem gliomas: failed approaches and future strategies. J Neurosurg Pediatr 3 (4): 259-69, 2009.
Hargrave D, Bartels U, Bouffet E: Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7 (3): 241-8, 2006.
Warren K, Bent R, Wolters PL, et al.: A phase 2 study of pegylated interferon α-2b (PEG-Intron(®)) in children with diffuse intrinsic pontine glioma. Cancer 118 (14): 3607-13, 2012.
Bouffet E, Raquin M, Doz F, et al.: Radiotherapy followed by high dose busulfan and thiotepa: a prospective assessment of high dose chemotherapy in children with diffuse pontine gliomas. Cancer 88 (3): 685-92, 2000.
Janssens GO, Jansen MH, Lauwers SJ, et al.: Hypofractionation vs conventional radiation therapy for newly diagnosed diffuse intrinsic pontine glioma: a matched-cohort analysis. Int J Radiat Oncol Biol Phys 85 (2): 315-20, 2013.
Liu AK, Macy ME, Foreman NK: Bevacizumab as therapy for radiation necrosis in four children with pontine gliomas. Int J Radiat Oncol Biol Phys 75 (4): 1148-54, 2009.
Freeman CR, Krischer JP, Sanford RA, et al.: Final results of a study of escalating doses of hyperfractionated radiotherapy in brain stem tumors in children: a Pediatric Oncology Group study. Int J Radiat Oncol Biol Phys 27 (2): 197-206, 1993.
Negretti L, Bouchireb K, Levy-Piedbois C, et al.: Hypofractionated radiotherapy in the treatment of diffuse intrinsic pontine glioma in children: a single institution's experience. J Neurooncol 104 (3): 773-7, 2011.
Freeman CR, Kepner J, Kun LE, et al.: A detrimental effect of a combined chemotherapy-radiotherapy approach in children with diffuse intrinsic brain stem gliomas? Int J Radiat Oncol Biol Phys 47 (3): 561-4, 2000.
Bradley KA, Zhou T, McNall-Knapp RY, et al.: Motexafin-gadolinium and involved field radiation therapy for intrinsic pontine glioma of childhood: a children's oncology group phase 2 study. Int J Radiat Oncol Biol Phys 85 (1): e55-60, 2013.
Vandertop WP, Hoffman HJ, Drake JM, et al.: Focal midbrain tumors in children. Neurosurgery 31 (2): 186-94, 1992.
Kestle J, Townsend JJ, Brockmeyer DL, et al.: Juvenile pilocytic astrocytoma of the brainstem in children. J Neurosurg 101 (1 Suppl): 1-6, 2004.
Bilaniuk LT, Molloy PT, Zimmerman RA, et al.: Neurofibromatosis type 1: brain stem tumours. Neuroradiology 39 (9): 642-53, 1997.
Molloy PT, Bilaniuk LT, Vaughan SN, et al.: Brainstem tumors in patients with neurofibromatosis type 1: a distinct clinical entity. Neurology 45 (10): 1897-902, 1995.
Ronghe M, Hargrave D, Bartels U, et al.: Vincristine and carboplatin chemotherapy for unresectable and/or recurrent low-grade astrocytoma of the brainstem. Pediatr Blood Cancer 55 (3): 471-7, 2010.
Ruge MI, Kickingereder P, Simon T, et al.: Stereotactic iodine-125 brachytherapy for treatment of inoperable focal brainstem gliomas of WHO grades I and II: feasibility and long-term outcome. J Neurooncol 109 (2): 273-83, 2012.
Rush S, Foreman N, Liu A: Brainstem ganglioglioma successfully treated with vemurafenib. J Clin Oncol 31 (10): e159-60, 2013.
Given the dismal prognosis for patients with DIPGs, progression of the pontine lesion is anticipated generally within 1 year of completing radiation therapy. In most cases, biopsy at the time of clinical or radiologic progression is neither necessary nor recommended. To date, no salvage regimen has been shown to extend survival. Patients should be considered for entry into trials of novel therapeutic approaches because there are no standard agents that have demonstrated a clinically significant activity.
Palliative care is provided for these patients whether or not disease-directed therapy is administered.
At the time of recurrence, a complete evaluation to determine the extent of the relapse may be indicated for selected low-grade lesions. Biopsy or surgical resection should be considered for confirmation of relapse when other entities such as secondary tumor and treatment-related brain necrosis, which may be clinically indistinguishable from tumor recurrence, are in the differential diagnosis. Other tests, including positron emission tomography, magnetic resonance spectroscopy, and single-photon emission computed tomography, have not yet been shown to be reliable in distinguishing necrosis from tumor recurrence in brain stem gliomas. Radiation-induced changes may occur a few months after the completion of radiation therapy and may mimic tumor progression. When considering the efficacy of additional treatment, care needs to be taken to separate radiation-induced change from progressive disease.
Treatment considerations at the time of recurrence or progression are dependent on prior treatment. Treatment options for recurrent focal or low-grade brain stem gliomas include the following:
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood brain stem glioma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Bowers DC, Krause TP, Aronson LJ, et al.: Second surgery for recurrent pilocytic astrocytoma in children. Pediatr Neurosurg 34 (5): 229-34, 2001.
Packer RJ, Lange B, Ater J, et al.: Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol 11 (5): 850-6, 1993.
Ater JL, Zhou T, Holmes E, et al.: Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children's Oncology Group. J Clin Oncol 30 (21): 2641-7, 2012.
This information is provided by the National Cancer Institute.
This information was last updated on May 19, 2014.
Many children with cancer receive treatment in the outpatient setting, which allows them to stay in school and continue to develop intellectually and socially. However, returning to school can be an emotional experience; our Back to School Program is designed to ease your child's transition back to the classroom.
Concierge Services is your one-stop place to learn about Dana-Farber programs, services and resources, as well as information on getting around Boston, finding lodging or restaurants, and activities in the area.
The Expressive Arts Therapy program, sponsored by the Leonard P. Zakim Center for Integrative Therapies, provides adult patients, family members, and caregivers with a variety of options to support well-being during cancer treatment. From live music meditation to painting technique workshops, the program offers a range of creative outlets to suit every interest.
Dana-Farber and Children's Hospital, including parking facilities, are fully accessible to people with disabilities. There are wheelchairs at the main entrance, and security staff can provide personal assistance. We also have many educational materials available in large print and audiotape formats.
The Ethics Consultation Service is available for patients and families who may be facing difficult decisions and choices regarding care. Our goal is to bring together patients, families and health care providers to talk about ethical concerns and help everyone involved arrive at a resolution that is right for all.
Find practical tips and suggestions for individuals caring for a family member or friend with cancer, including creating a caregiving plan, finding community resources, and looking after your own well-being.
Friends' Place provides personal consultations to help cancer patients of all ages cope with changes in physical appearance that result from cancer treatment. Our experienced, compassionate team provides fittings for compression garments or breast prostheses, helps with wigs and other head coverings, and offers make-up and skincare advice.
The Friends' Corner Gift Shop, located on the first floor of the Yawkey Center for Cancer Care, offers a wide selection of unique gifts and everyday items for patients, families and staff.
Every year, thousands of patients with cancer from around the world come to Dana-Farber for their care. We provide a wide array of logistical and other services for individuals who live outside the United States.
Dana-Farber provides interpreting services for patients whose first language is not English. Interpreters may be requested for any activity, including registration, booking appointments, attending treatments and exams, support groups, and meetings with doctors and other members of your health care team.
Just for Teens provides programs and activities for teens and young adults with cancer at the Jimmy Fund Clinic and Children's Hospital Boston. We offer activities and events both inside and out of the hospital so that you have creative ways to pass the time and can meet other teens who are going through similar experiences.
Our nutritionists are registered dietitians who can assist you in planning an optimal diet during any stage of your cancer journey, cope with any side effects you may experience, and answer your questions about the latest findings on cancer and nutrition.
The Eleanor and Maxwell Blum Patient and Family Resource Center and its satellite resource rooms are staffed by health care professionals and provide computer stations, books, brochures, videos, and CDs to help you find information and support on a variety of issues about cancer treatment and care.
Patients websites help friends and family members stay up-to-date on their loved ones' condition and write messages of support and encouragement.
The Dana-Farber pharmacy fills prescriptions for all pediatric and adult patients. Our pharmacists are an extension of the patient care team and work closely with your physicians to provide seamless, convenient, safe care.
More than 1,200 Dana-Farber patients and their families have enjoyed free trips to baseball games, theater shows, museums, and other attractions this year through the Recreational Resources program.
The School Liaison Program is for pediatric patients who are diagnosed with or have completed a treatment that involves the central nervous system. We provide consultation about the cognitive late effects of treatment to help parents understand and advocate for their child's learning needs.
Through all stages of cancer treatment and survivorship, our Spiritual Care staff is available 24 hours a day to provide emotional and spiritual support for adults and pediatric patients and family members.
Integrative therapies, also known as complementary therapies, range from acupuncture and massage to nutritional guidance and music therapy. Patients treated at the Zakim Center credit its services with easing nausea, improving circulation, and reducing pain, stress, and anxiety associated with cancer treatment.
In this video webchat, Mark Kieran, MD, PhD, and Peter Manley, MD, discuss the latest treatment options and research for pediatric brain tumors.
Kieran is clinical director of the Pediatric Brain Tumor Center at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Manley is a pediatric neuro-oncologist at Dana-Farber/Boston Children's and director of the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic for survivors of pediatric brain tumors. Both are also on the faculty of Harvard Medical School. Dana-Farber is partnering with the Team Jack Foundation for this webchat.
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NeighborsLogic puzzles require you to think. You will have to be logical in your reasoning.
There are two people, Meg and Kat. Meg lives in Florida, Kat lives in Georgia. They're next-door neighbors.
How is that possible?
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text:
(AP) – A mix of winter snow and springtime tornadoes is likely across Oklahoma and the southern plains as a massive storm system moves across the region.
Meteorologist Greg Carbin of the National Weather Service's Storm Prediction Center in Norman said Tuesday that a winter storm that dropped large amounts of snow in Colorado is moving east into western Kansas and northwestern Oklahoma. It will collide with a spring storm that is moving north from northern Texas.
Carbin says the storm will create heavy snow in the northern Midwest as well as thunderstorms and the risk of tornadoes and large hail in the southern plains.
Severe weather is possible Tuesday afternoon and evening in central Oklahoma, North Texas, western Kansas and in Missouri. More severe weather is likely further east on Wednesday.


text:
I feel this is really the make or break year for Brandon. With all our expirings we will be starting to look for players that can help us win.
We know that hibbert and granger are players for the future. Collinson was brought in early because we had the chance to do it.
A Stud PF is our main concern at this current time. But if rush has another season where he looks lost and content with not being aggressive on the offensive end do we continue to wait for him?
The positives. We know he is a defensive stud. I think he will be even better this year on that side of the court. That has never been his problem though.
He was the 15th best 3 point shooter last year. In a offense that is designed to jack up three pointers he took on average between 3 and 4 a game.
Shooting only 89 free throws last season that means he really only got to the line EVERY OTHER GAME. Is this acceptable from your starting shooting guard? I would like to see that number tripled from our starting shooting guard. On comparison in about the same number of minutes Danny granger in his second year got to the line 294 times. That being said, I do not know if I would want rush at the line any more than he is. Only shooting a amazing 62 percent. This is from one of the better 3 point shooters in the league. How can you shoot above 40 percent behind the arc yet only shoot 60 percent at the charity stripe.
At the 2 position he is the perfect height 6'6 and has the perfect athletic body weighing in at 210. But for some reason he does not use his gifts. I can tell he is not confident in himself in games, and if he does not make some easy shots early he often fades away from the ball. I would really like to see him start to take it to the rack. It seems its three ball or nothing for him, which is disappointing because he has the tools to finish in traffic.
This is a stat that I cannot figure out. He may average 1-2 assists per game. Should we expect more from him since he has limited output in ppg? If he is not putting the ball through the hoop shouldn't he be finding ways for his teammates to do so? Once again I believe this has to do with the 3 ball or nothing mentality.
I would like to sit here and think maybe its bad coaching. But from what I see JOB loves to have him on the court. I honestly think there is just a switch in his head that is not flipped to the up position.
I really hope he is training hard this season and is looking to turn his career around. Because as it sits now I am afraid he is going to be at the end of someones bench or out of the league here in a few years because he will no longer have potential.


text:
|Latest & Greatest
Skin Shield
By Elizabeth A. Ginns — October 2003
Sunburn or unprotected exposure to the sun's UV rays causes skin damage, and just one sunburn increases the odds of developing skin cancer. The American Cancer Society reports that about 80 percent of skin cancers could be prevented by protecting skin. But let's face it: It's nearly impossible for boaters to avoid all sun exposure.
Enter Solartex Sun Gear. The newest line of sun-protective swimwear and active wear from Australia-based Cwear provides 50 SPF against both UV-A and UV-B rays, wet or dry. The clothing is made of lightweight, tightly woven, chlorine-resistant polyester fabric that shields your skin from the sun without the hassle of applying--and worse, reapplying--sunblock. And it never wears off!
I have extremely fair and sensitive skin, so I tested the polo-style shirt and wide-brim hat for two days on the water, without sunblock. I never felt hot and, more important, didn't get sunburned. Both washed easily.
The clothing comes in a wide range of sizes (including children's) and styles to suit most everyone's body-type. Prices range from $15 to $50.
Solartex Sun Gear Phone: (877) 476-5789. www.solartex.com.
Is there something you would like to know more about or see PMY put to the test? Write: Latest & Greatest, Power & Motoryacht, 260 Madison Ave., 8th Fl., New York, NY 10016. Fax: (917) 256-2282. e-mail: email@example.com. No phone calls, please.
Previous page > Kaenon sunglasses > Page 1, 2, 3
This article originally appeared in the September 2003 issue of Power & Motoryacht magazine.


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With five years service as a volunteer with the Lake County Sheriff's Department, under two sheriffs, I think I can speak on behalf of Frank Rivero. I've worked visiting hours at the county jail, but most of my time I staffed the Middletown substation. Prior to Rivero being elected Sheriff, I was lucky to see one sheriff's patrol car a week pass through Middletown. Since Rivero took office, I now see several LCSO cars in the Middletown area almost every day. I read about more arrests involving illegal drugs since Rivero took office. I understand he has taken steps to reduce department expenses, including cutting duty shifts from 12 to eight hours. This is a safety measure with deputies more likely to stay mentally alert working shorter shifts. I suggest the hullabaloo raised by District Attorney Don Anderson is political, and nothing more.
Lyle La Faver
Hidden Valley Lake


text:
HIV-Target Cell Response in Women Initiating Various Contraceptive Methods in High HIV-Incidence Areas: Zim CHIC (Zim CHIC)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
This study is being done to understand if using birth control causes changes in the immune cells within the reproductive tract of healthy women. Immune cells are important because they help prevent infections from starting and help fight infections that have started. Immune cells are also the type of cells that HIV (human immunodeficiency virus) infects so understanding more about them will help to better understand how to prevent the spread of HIV.
Immune cells will be studied from the reproductive tract of women who want to start using one of the following contraceptives: Depo-Provera (DMPA), NET-EN, MPA/E2 (Cyclofem®), the levonorgestrel subdermal implant (Jadelle® ), the etonogestrel subdermal implant (Implanon® or Nexplanon® ) and the copper IUD.
|Contraception HIV Immune Cells (Mucosal and Systemic) Microbiota
|Drug: DMPA Drug: NET-EN Drug: MPA/E2 Device: LNG-I Device: ENG-I Device: Cu-IUD
|Study Type:
|Study Design:
|Observational Model: Cohort
Time Perspective: Prospective
|Official Title:
|HIV-Target Cell Response in Women Initiating Various Contraceptive Methods in High HIV-Incidence Areas: Zim CHIC
- Genital tract CD4 cells (number and % expressing CCR5) [ Time Frame: Change from baseline at 3 months ]To quantify and characterize immune cell populations and HIV-tropic receptor expression in the genital tract and blood at baseline and after 1, 3 and 6 months of typical contraceptive use. Immune cell populations will be quantified and characterized using flow cytometry.
- Vaginal microbiota (key microbes) [ Time Frame: Change from baseline at 3 months ]To describe the microflora of the genital tracts of healthy asymptomatic women before and after 1, 3 and 6 months of typical contraceptive use and to assess changes in the vaginal ecology within the first 6-months of contraceptive use. qPCR for key microflora and Nugent scores will be used.
- Serum hemoglobin [ Time Frame: Change from baseline at 6 months ]To objectively assess blood count before and at 1,3,and 6 months following initiation of each contraceptive method. Standard clinical complete blood count (CBC) will be obtained at each visit.
- Serum concentration of estradiol and progesterone/progestin [ Time Frame: Change from baseline at 3 months ]To assess relative serum concentrations of endogenous and exogenous sex hormones before and after contraceptive use. Hormonal concentrations will be assessed by measuring blood levels of estrogen and progesterone as well as blood levels of the contraceptive progestin corresponding to the cohort group for that participant.
Biospecimen Retention: Samples With DNA
|Actual Study Start Date:
|February 2014
|Estimated Study Completion Date:
|April 2018
|Primary Completion Date:
|June 2016 (Final data collection date for primary outcome measure)
|Assigned Interventions
Depot medroxyprogesterone acetate
Drug: DMPA
Depot medroxyprogesterone acetate
Other Name: Depot medroxyprogesterone acetate (DMPA)
Norethisterone enantate
Drug: NET-EN
Norethisterone enantate
Other Name: Norethisterone enantate (NET-EN)
Medroxyprogesterone acetate and estradiol cypionate
Drug: MPA/E2
Medroxyprogesterone acetate and estradiol cypionate
Other Name: Medroxyprogesterone acetate and estradiol cypionate (MPA/E2)
Levonorgestrel subdermal implant
Device: LNG-I
Levonorgestrel subdermal implant
Other Name: Levonorgestrel subdermal implant (LNG-I)
Etonogestrel subdermal implant
Device: ENG-I
Etonogestrel subdermal implant
Other Name: Etonogestrel subdermal implant (ENG-I)
Copper IUD
Device: Cu-IUD
Copper IUD
Other Name: Copper IUD (Cu-IUD)
|Ages Eligible for Study:
|18 Years to 34 Years (Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
|Sampling Method:
|Non-Probability Sample
Inclusion Criteria:
- Age 18 through 34 years (inclusive) at screening
- Non-pregnant women in general good health as determined by the site clinician
- Premenopausal with history of regular menstrual cycles (regular cycles defined as occurring every 21-35 days when not using hormones and with a variation of typical cycle length of no more than 5 days)
- Able and willing to provide written informed consent to be screened for and to take part in the study. Including willingness to undergo all study-related assessments and follow all study-related procedures
- Able and willing to provide adequate locator information
- HIV-uninfected based on testing performed by study staff at screening
- At screening and enrollment, agrees not to participate in other research studies involving drugs, medical devices, or vaginal products while enrolled in this trial
Exclusion Criteria:
- Use of any hormonal or intrauterine contraceptive method within 30 days of enrollment
- Use of DMPA or NET-EN within 10 months of enrollment
- Pregnancy or breastfeeding within 60 days of enrollment
- Surgical procedure involving the pelvis in the 30 days prior to enrollment (includes dilation and curettage, cryosurgery and biopsy of the vagina, vulva, cervix, and endometrium)
- Internal vaginal use of any device (includes sex toys, cervical caps, diaphragms, menstrual collection devices, and pessaries; excludes tampons and condoms) or product (includes N9, microbicide, douche, antifungal, steroid, or hormone) in the 30 days prior to enrollment
- New sexual partner within 90 days of enrollment
- Urogenital infection or suspected infection within 30 days of enrollment including:
symptomatic candidiasis, trichomoniasis, and symptomatic BV; or cervical infection, including N. gonorrhoeae, Chlamydia trachomatis, or mucopurulent cervicitis; syphilis; HSV lesions, or other sores (Note: seropositive HSV without active lesions will not be excluded); acute pelvic inflammatory disease; urinary tract infection; recent exposure to a partner with GC, CT, Trichomonas, syphilis, or NGU. Women who have had diagnosed genital infections should have completed treatment at least 30 days before the time of enrollment.
- Any history of immunosuppression (includes diabetes, HIV infection, and chronic steroid use)
- Antibiotic or antifungal therapy (vaginal or systemic) within 30 days of enrollment
- Menses or other vaginal bleeding at the time of Enrollment* (*Women who have vaginal bleeding at the scheduled Enrollment Visit may return at a different date to be re-examined and possibly enrolled provided they are still within the 90-day screening window and meet all criteria).
- Vaginal or anal intercourse within 2 days (48 hours) prior to enrollment
- Heterosexual intercourse since last menses that places the participant at risk of pregnancy (without condom use or sterilization of at least one partner)
- History of hysterectomy
- History of malignancy within the pelvis (includes uterus, cervix, vagina, and vulva)
- Contraindication, allergy or intolerance to use of the contraceptive desired by the participant
- Any condition that, in the opinion of the Investigator, would preclude provision of consent, make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives
Please refer to this study by its ClinicalTrials.gov identifier: NCT02038335
|Harare, Zimbabwe
|Study Chair:
|Sharon Achilles, MD, PhD
|University of Pittsburgh
|Principal Investigator:
|Felix Mhlanga, MD
|University of Zimbabwe, University of California San Francisco
|Responsible Party:
|Sharon Achilles, Principal Investigator and Protocol Chair, University of Pittsburgh
|ClinicalTrials.gov Identifier:
|NCT02038335 History of Changes
|Other Study ID Numbers:
|Study First Received:
|January 8, 2014
|Last Updated:
|July 21, 2017
Keywords provided by Sharon Achilles, University of Pittsburgh:
immune cells
intrauterine device
subdermal implant
Additional relevant MeSH terms:
Polyestradiol phosphate
Estradiol 3-benzoate
Estradiol 17 beta-cypionate
Estradiol valerate
Contraceptive Agents
Medroxyprogesterone Acetate
Norethindrone acetate
Norethindrone enanthate
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Reproductive Control Agents
Contraceptive Agents, Female
Contraceptives, Oral, Synthetic
Contraceptives, Oral
Trace Elements
Growth Substances
Contraceptive Agents, Male
Antineoplastic Agents, Hormonal
Antineoplastic Agents
ClinicalTrials.gov processed this record on September 21, 2017


text:
Chesapeake Bay TMDL Focus of Letter and Public Meeting on Dec. 14
Dec. 10, 2009
News Highlights
A letter from Fairfax County Board of Supervisors Chairman Sharon Bulova provides comments on the U.S. Environmental Protection Agency's (EPA) Total Maximum Daily Load (TMDL) Development for the Chesapeake Bay. The EPA is holding a public meeting to discuss the TMDL on Monday, Dec. 14, 6:30 to 8:30 p.m. at Falls Church High School, Little Theater, 7521 Jaguar Trail, Falls Church.
"Fairfax County is the most populous local jurisdiction in the Chesapeake Bay watershed," said Bulova in the letter to the Water Protection Division, EPA Region III. "The county has a long history of progressive environmental management, and we are following with great interest recent developments at the federal level to increase the pace of efforts to restore the Chesapeake Bay."
"Improvements can and should be made in how urban and suburban stormwater is managed," Bulova said. "But they must be made in a sustainable manner by working collectively towards a common goal." She added, "Goals should be realistic and attainable, focusing on parameters reasonably within the control of local governments and organizations to influence."
The EPA's multi-state initiative would set restrictions on nutrient and sediment pollution throughout a 64,000-square-mile watershed. The TMDL is a regulatory tool of the federal Clean Water Act that will be backed by a series of accountability measures to ensure cleanup commitments are met. The Chesapeake Bay TMDL will be the largest and most complex ever developed, involving six states and the District of Columbia.
The full text of the letter is online.
Contact: Merni Fitzgerald, Director, Office of Public Affairs
703-324-3189, TTY 711, Media Pager: 703-324-NEWS (6397)
To request this information in an alternate format, call 703-324-3187, TTY 711


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Marketing Information
The Targus 21.5" Widescreen LCD Monitor Privacy Screen is designed to fit 21.5" widescreen LCD monitors. To protect your information, tiny vertical blinds on the surface of the screen narrow the viewing angle so data is only visible directly in front of the monitor up to 45 degrees away from the center of the screen. Onlookers will only see a dark unclear screen when attempting to view the information from a side angle. In addition to providing security, the privacy screen also blocks the glare to help reduce eye strain. The Targus LCD Monitor Privacy Screen can be easily attached by using clear adhesive strips designed for LCD screens or with the included tab guides that stick to the edge of the LCD screen to hold the screen in place. Users can position the tabs so the screen easily slides on and off. Highly portable and easy to use, the Targus privacy screen protects valuable information on a laptop and LCD monitor from onlookers.
General Information
|Product Type
|Privacy Screen Filter
|Manufacturer Part Number
|Manufacturer Website Address
|Targus Group International
|Product Name
|21.5" Widescreen LCD Monitor Privacy Screen (16:9)
|Brand Name
Technical Information
|Device Supported
|Display Type Supported
|Display Size Supported
Physical Characteristics
|Weight (Approximate)
|13.76 oz
|Package Contents
|Limited Warranty
|1 Year
This product is shipped only within Canada and Warranty valid for Canada only.
Computer Valley makes every effort to provide accurate specifications, descriptions, images and price on all products that are found on www.computervalley.ca
However for complete and updated descriptions, compatibilities, specifications and actual photo we recommend our clients to consult with manufacturer's websites or simply call us for proper clarifications. Computer Valley is not responsible and will not accept returns for items purchased that are not compatible with your system. Please ensure that you have verified compatibility and actual photo with your system by visiting the manufacturer's web site prior to purchase or give us a call to make sure what you are purchasing.
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Computer Valley wants to provide you with the best and fastest possible service. We try to ship in stock orders placed before 2:00pm EST the same day. For in stock orders placed after 2:00pm EST they are usually shipped the next business day. However there are always exceptions. Please contact us prior to placing your order if you need your purchase by a certain date.
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Since the Falcon 2000's introduction in 1996, Dassault has debuted several variants that built on its winning formula of combining a good-sized cabin, attractive fuel economy and range, plus pleasant flying qualities and strong resale value. In 2004, the French manufacturer unveiled the 2000EX, which featured enhanced avionics and a better cabin pressurization system. The DX followed in 2007 with the updated EASy digital cockpit. The LX came in 2009, with standard winglets, and pushed the model past the $30 million price point while delivering 4,000 nm (7,400 km) of range–enough for a nonstop trip from, for example, Beijing to Abu Dhabi in the Arabian Gulf.
While the 2000 is widely recognized as the first super-midsize business jet, it was really in a niche slightly larger than that. Its cabin, which uses the same fuselage cross section as the company's larger model 900 and 7X three-engined jets, is just over 10 inches (25 cm) wider and two inches (5 cm) taller than the tube of a large-cabin Gulfstream G450. In this regard, the 2000 was really more than a super-midsize model and its price ($18.1 million in 1996) reflected this. Fill it with fuel, load eight passengers in back and you can fly 3,400 miles (6,300 km).
The 2000 was followed into the market by the Gulfstream G200 and Bombardier Challenger 300. Embraer began delivering the Legacy 600 in 2002. After a decade of development, Hawker Beechcraft received certification for the Hawker 4000 in 2006. These are all fine aircraft with differing strengths and weaknesses, but none boast quite the balance of performance and economy that the 2000 offers.
The 2000 also has a reputation for durability and has proven itself with high-use fractional and corporate operators. Customers could custom-order its cabins, which can seat up to 10 passengers. The highly individualized interiors helped to drive up the price, but buyers didn't seem to mind because of the brand's value proposition.
However, times have changed. The 2000S is Dassault's recently announced, value-added entry into the super-midsize market. Slated for service in 2013, the $25 million model has shorter range (3,350 nm or 6,200 km) than the $32.1 million Falcon 2000LX. And unlike the 2000LX, it has standardized interiors.
Dassault claims the 2000S "is a large-cabin aircraft with fuel economy and operating costs that are much less than smaller aircraft in the mid-sized business jet category." However, the 2000S is more than just a stripped-down and shorter-legged 2000LX. The new aircraft can access airports not previously available to other models in the 2000 series, thanks to its lighter weight–a fuselage fuel tank was removed–and the addition of inboard wing slats that allow it to fly steeper approaches into shorter runways. The slats–extendable portions of the wing's leading edge that can be deployed at slower speeds–combined with standard autobrake cut the approach speed to 108 knots (200 km/h).
Performance on hot days at high-altitude airports also improves, as does time-to-climb performance. The Pratt & Whitney Canada PW308C engines feature new Talon II combustors that cut emissions by up to 40 percent. The tweaked engines, along with the 2000LX's winglets, help the 2000S to burn "10 percent less fuel than aircraft that are 20 percent smaller," according to Dassault.
The 2000S's interior was standardized into three distinct color/fabric/material combinations and one seating configuration: 10 passengers. The forward cabin features a traditional executive "club 4" seat grouping followed by six smaller single executive seats arrayed in a conference grouping around a table. Dassault claims this is the most popular seating configuration.
Dassault developed the 2000S cabin and modernistic, streamlined cockpit in collaboration with BMW Group DesignworksUSA, the same firm that fashioned highly creative interiors for the Embraer Phenoms and the new optional interiors for the Falcon 7X long-range aircraft. Dassault and BMW came up with three initial interior designs: Alpine, Sedona and Havana. Alpine contrasts white with dark stone tones, Sedona is a collection of "earthy beige" colors and Havana uses warm browns.
Creative lighting and color contrasts give the illusion that the cabin is even larger than it is. According to the BMW designers, they leveraged their work from the 7X and employed influences from the European furniture and kitchen industry to give the interior a thoroughly modern look. Their biggest challenge was fashioning a solution that cut costs while keeping the premium look and feel of a Falcon.
At first blush, it appears they have succeeded, not just aesthetically but functionally. The new-look passenger seats not only appear more stylish than those on the previous model; they offer better comfort. The Falcon HD cabin-management system is based on the new Rockwell Collins' Venue system with all the latest conveniences and features, including Blu-ray, Iridium satellite communications, widescreen HD monitors and the ability to control it all through a passenger's wireless mobile device.
The restyled cockpit will be fitted with Dassault's latest EASyII digital avionics, which are built on the Honeywell Primus Epic system. The equipment includes SmartView synthetic vision, satellite-based augmentation system with precision GPS approach capability, runway navigation display and electronic navigation charts.
The 2000S represents a serious challenge to the super-midsize market. In addition, it is the first aircraft to benefit from design and build efficiencies that could make Dassault's future offerings very price competitive. The design of the fuselage tube on the 2000S may be old but the thinking inside of it definitely is not.
Read the Report
ABACE2012_Dassault2000S.pdf (510K)
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It's midnight, the end of a day out in the market, and the freeways have been moved, the entrances have been blocked off. During the day, the roads are jammed and at night they disappear.
This isn't like California, where the roads seem to make sense for this native Californian now living in Texas for too long. While there is a lot to miss about California, today in Houston was about as good as it gets.
First stop: Spec's off of downtown. Joseph Kemble, the Italian wine buyer, needs a few minutes of my time. Spec's has an array of wines where I can always find something I want to take home. Large selection, low prices, a flea-market, let's-find-a-bargain kind of atmosphere. Joseph has a good aura about him, he's a good guy, loves the wines, not that interested in scores, wants the personal connection. Pretty unusual in such a big operation. Kudos to Joseph and Spec's.
A new wine bar nearby, 13 Celsius. That would be the perfect cellar temperature. An old building, basically stripped and cleaned, minimalism and non-interventionist interior design, coffee roaster and Wi-Fi.
Towards the evening a last stop at Catalan, a restaurant that combines small plates with fresh food, an unusually good and well priced wine list and good energy. Tonight we compared Savennières and Kerner.
Long day, bona notte.


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Criminal Justice is an interdisciplinary major formulated within a solid liberal
arts framework.
Besides leading to the obvious career paths (e.g., law enforcement and
corrections), the major in Criminal Justice will provide an appropriate foundation
for students interested in pursuing a career in other areas. These might include
positions in the public service arena or governmental professions including law
and the judicial system, and involvement in local or regional politics or public
policy activities. As well, the major would provide a good background for
individuals seeking opportunities in human services including probation and
delinquency or rehabilitation counseling.
Student Opportunities
Since criminal justice is a new major, no students have participated in internships. However, criminal justice students will typically intern with law enforcement agencies (Highway Patrol, local police, sheriff departments) as well as with judicial agencies (prosecutors, defense attorneys, probation departments) and correctional agencies (jails and prisons) in the public sector. Students may also intern in the private sector, in internships with loss prevention, security and safety organizations and private investigators.
As in all other degree programs, Criminal Justice students might engage in research of various types throughout their term of study at Muskingum, but will be required to complete their senior seminar (one-on-one research with faculty) before graduation. There may also be the possibility to do research through collaboration with the Center for Regional Planning, an initiative created through the political science department at Muskingum University.
There will be employment opportunities for students to work with the Criminal Justice faculty, providing administrative support and possibly research.
Professional Activities
One goal of the program is to create a Muskingum chapter of Lamda Alpha Epsilon, a national criminal justice honorary, which would allow the students to attend both regional and national conferences. Students would compete with other students from across the region and nation for recognition in several fields, including physical agility and firearm performance, as well as in academic areas.
After Graduation
Our Criminal Justice program is designed to prepare students for a broad array of opportunities upon graduating from Muskingum, from law enforcement to law school. Our graduates are well prepared for success in advance degree programs, or for immediate entry into the job market.
Mission Statement
Courses; Major/Minor Requirements
List of All Majors
Maps & Directions
Academic Affairs
Undergraduate Admission
Financial Aid
Graduate & Continuing Studies
Business Office
Academic Catalogs


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Hamilton racking up hits with relaxed approach
CINCINNATI -- With a 3-for-5 performance in Friday night's 6-5 win over the Pirates, center fielder Billy Hamilton became the third Reds rookie over the past 60 years to register 10 games of at least three hits in his first 88 games of a season, joining Tommy Helms in 1966 and Joey Votto in 2008 (both also achieved the feat in 88 games).
"Me and [Ryan Ludwick] say every day, 'Just get one hit a game,' and then once you get another one, mentally it's about getting hits," Hamilton said. "You want to come in there relaxed in big situations. It's always good to get a hit in the first at-bat, and then you can be more relaxed during the rest of the game and definitely get more hits. It's all about that first at-bat."
In the all-important first at-bat in Friday's game, Hamilton got a hit, but one that couldn't have been more unorthodox. He pushed a bunt single up the first-base line against Pittsburgh starter Jeff Locke, which was fielded by first baseman Gaby Sanchez, who moved toward Hamilton for the tag.
But Hamilton made an incredibly acrobatic leap away from Sanchez, causing him to whiff on the tag. As Sanchez recovered his footing and tried to dive back toward the base for another tag attempt, Hamilton beat him there with a head-first slide.
"I've never done it before [on any level]," Hamilton said of the move. "It was a football move. It's just instincts, you've just got to make something happen. So the first thing that came to mind was just to juke."
Hamilton got the first walk-off hit of his career in Tuesday's 6-5 comeback win in the nightcap of a day-night doubleheader against the Cubs, and he said that as he finds himself in more pressure-filled situations while the season progresses, he is able to relax and produce better results at the plate.
"Coming through the Minor Leagues, I've always struggled with men in scoring position," Hamilton said. "I would think too much. And this year, coming up, I just told myself I'm going to relax and not worry about trying to do too much."
Not worrying about doing too much has led to Hamilton doing much more offensively than anyone could have hoped, particularly with men in scoring position. Going into Friday's game, he was batting .357 (25-for-70) in those situations.
Manny Randhawa is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Avery® White Metal Rim Tags 14313, Strung, 1-1/4" Diameter, Pack of 500Product Number: 14313
Get ready for a tag that stands up to pressure. These Metal Rim Tags are constructed of white cardstock with a rim of durable metal. The cardstock provides a smooth, clean surface for writing, while the non-tarnish metal rim reinforces the tag to keep it from bending, twisting or tearing, making the tags ideal for situations where they will be handled frequently or roughly. The knotted white string lets you easily attach the tag to your item. For strength and durability, this tag is the answer.
Product Description:
Reviewed by 4 customers
This review is from Metal Rim Tags 14315:
I have found that the Avery tags hold up much better than any other brand, especially when getting wet.
This review is from Metal Rim Tags 14315:
Strong and durable. lasts surprisingly long and is really nice to have around for all avery intended uses.
This review is from Tag-Pak Metal Rim Tags 11030:
All my employees use these on their file cabnet keys. When they are hung up on the wall, they look very professional. They do not fall apart and are easy to slip the key on. I would highly recommend this product to anyone looking for an easy, professional, realible key ring!
This review is from Metal Rim Tags 14315:
As an apartment manager, these are priceless! You can quickly and easily organize everything! There are durable and hold up well.


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DAYTON, Ohio — Interbrand, a consultancy, has named Walmart the most valuable retail brand for 2013. The retailer retained its top spot from 2012.
Rising through the ranks were Macy's, which increased brand value by 62% and moved up nine spots on the list to #40 and Amazon.com, which moved up to #4 on the list, growing brand value by 46%.
While consumer confidence continues to ebb and flow, energy abounds in the U.S. retail sector. The total brand value of this year's top 50 brands is up 1.8%. Of the brands that are on the list again this year, 36 of them increased brand value while only 11 declined. The average brand on the list increased its value by over 6%, up from 4% in 2012. The threshold to earn a spot on the U.S. ranking has increased to $836 million; last year it took a brand value of $ 771 million to make the top 50.
There are some notable shifts in the U.S. top 10, but the top three brands hold their positions. Walmart maintains its #1 position by a huge margin with a brand value more than $141 billion, up 1% from last year. Target is in the #2 position with a value of $25 billion, up 7% from 2012. The Home Depot is solid at #3 with a brand value of nearly $23 billion. Amazon makes a big jump to #4 from last year's #9. CVS/pharmacy is down one spot to #5; its brand value decreased 8%. Coach moves up one position to #6 with an 8% jump over last year, while Walgreens drops one notch to #7 with a 4% decline. Sam's Club increases brand value by 5% and holds on to the #8 position. eBay ups its rank to #9 and Nordstom increases 7% to join the top 10. Best Buy falls out of the top 10 for the first time in the five years that we've ranked the top 50 most valuable retail brands with a brand value decline of 52%, which puts it at #13 on the list.
Three brands—Express, Cabela's and Anthropologie—join the U.S. Most Valuable Retail Brands this year, while Toys "R" Us, Abercrombie & Fitch and Advance Auto Parts fall out of the ranking.
"The brands that make our list define the retail ecosystem and determine where it's going," says Justin Wartell, managing director of Interbrand Design Forum. "Their relevance combined with the influence of new brands with unique business models brings the evolving world of retail into focus—interconnected, immediate, always on, dynamic, memorable and sometimes unexpected."
Visit BestRetailBrands.com to download the complete report.


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Damn we could really be 13-2
6 Indiana
Last Week: 9 Who had Indy as one of the last two teams, along with Chicago, to be unbeaten at home? Who had the Pacers winning games like Sunday night's in Lakerland when Granger is shooting 35.5 percent? The schedule has been kind, but the truth is they could (and should) be 13-2.


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A Pivotal Study of a Facet Replacement System to Treat Spinal Stenosis
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
|Lumbar Spinal Stenosis
|Device: ACADIA® Facet Replacement System Device: Instrumented posterolateral fusion
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:
|The Investigational Plan for the Evaluation of the ACADIA® Facet Replacement System
- Improvement in Zurich Claudication Questionnaire Physical Function and Symptom Severity Scores [ Time Frame: 24 months ]
- Lack of device related serious adverse events [ Time Frame: 24 Months ]
- Maintenance or improvement in Neurological status. [ Time Frame: 24 months ]
- No device failures requiring revision, removal, re-operation or supplemental fixation. [ Time Frame: 24 Months ]
- Improvement in pain as measured by Visual Analog Scale [ Time Frame: 24 months ]
- Radiological evidence of fusion in Investigational Group [ Time Frame: 24 months ]
|Study Start Date:
|October 2006
|Estimated Study Completion Date:
|August 2017
|Estimated Primary Completion Date:
|August 2017 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: ACADIA®
Investigational surgical treatment using the ACADIA Facet Replacement system
Device: ACADIA® Facet Replacement System
Investigational ACADIA Facet Replacement System used for the treatment of lumbar spinal stenosis
Active Comparator: Control Instrumented PLF
Control surgical treatment using an instrumented posterolateral fusion
Device: Instrumented posterolateral fusion
Control treatment using an instrumented posterolateral fusion for the treatment of lumbar spinal stenosis
Detailed Description:
Spinal Stenosis continues to be a major cause of back and leg pain. The condition is attributed to narrowing of the space around the nerves in the lumbar spine. This is often caused by the degenerative process in the spine and the facet joints. The current treatment calls for removal of bone around the affected nerve including the facet joints and fusing the posterior of the spine to ensure the segments remain stable.
The ACADIA® Facet Replacement System (AFRS) allows for an anatomic reconstruction of the facet joint after decompression and removal of the degenerated facet. Like the original facet joint, the replacement implant is designed to reproduce facet motion while restoring normal stability and motion.
The ACADIA® Facet Replacement System (AFRS) has been designed on the principals that have allowed other total joint replacement procedures to provide significant patient benefits. These guiding principals include:
- Anatomically based implant design
- Reproducible surgical technique
- Elimination of pain
The ACADIA® Facet Replacement System allows the surgeon to remove the offending bone while preserving the motion of the facet joint.
This study will evaluate the outcomes of patients using the AFRS™ investigation compared to those receiving instrumented posterior fusion procedure. Patients will be required to complete study visits before the procedure and at 6 weeks, 3, 6, 12, 24 months post procedure and annually thereafter as required by FDA. Follow up visits consist of administration of questionnaires, radiographs and neurological assessment.
|Ages Eligible for Study:
|21 Years to 85 Years (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- 21-85 years of age and skeletally mature;
- Have undergone 6 months of non-operative treatment prior to surgery;
- Lateral, lateral recess and/or central canal stenosis;
- Disc height measuring ≥ 4 mm at the operative level;
- Persistent leg, thigh and/or buttock symptoms,including pain,numbness, burning or tingling with a minimum leg pain score of 40mm as measured with the Visual Analogue Scale (VAS) Index;
- A score greater than 2 on a scale of 1-5 on the Zurich Claudication Questionnaire (ZCQ) Symptom Severity (SS) Score-Candidate;
- A score greater than or equal to 2 on a scale of 1-4 on the ZCQ Physical Function (PF) Score;
- A candidate for a decompression with full facetectomy at the operative level
- Candidate for a posterior lumbar fusion;
- Physically and mentally willing and able to comply evaluations;
- Lives in the immediate area and has no plans to relocate;
Exclusion Criteria:
- Previous surgical procedure at the operative or adjacent level except for one of the following: Micro-discectomy, laminectomy, lamino/foraminotomy, rhizotomy, IDET, and/or interspinous spacer;
- Previous lumbar fusion or disc replacement procedure;
- Osteoporosis;
- greater than Grade I spondylolisthesis or retrolisthesis;
- Spondylolisthesis at levels other than at the operative level;
- Scoliosis of the lumbar spine (defined as more than 11 deg Cobb angle) as indicated by plain X-ray films;
- Primary diagnosis of discogenic back pain due to torn, herniated, inflamed or irritated disc or other pathology where the patient exhibits axial back pain from degenerative disc disease;
- Acute traumatic pars fracture at the operative/adjacent level vertebral body;
- Spinal stenosis at more than three lumbar segments;
- Acute trauma to the lumbar spine within the last 24 months;
- Active infection at the operative level, or a systemic infection;
- Physically / mentally compromised;
- Systemic disease that would affect the patient's welfare or the research study.
- Immunologically suppressed or immunocompromised;
- Insulin-Dependent Diabetes Mellitus (Type I Diabetes);
- Currently undergoing long-term steroid therapy;
- Metabolic bone disease;
- Active malignancy: (except non-melanoma skin cancer), unless treated with no clinical signs or symptoms of the malignancy for at least 5 years;
- Known allergy to cobalt chromium or titanium;
- Used any investigational drug or device within the past 30 days;
- Pending litigation related to back pain or injury;
- Is a prisoner.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00401518
Show 29 Study Locations
|Responsible Party:
|Globus Medical Inc
|ClinicalTrials.gov Identifier:
|NCT00401518 History of Changes
|Other Study ID Numbers:
|Study First Received:
|November 17, 2006
|Last Updated:
|March 16, 2017
Keywords provided by Globus Medical Inc:
Spinal Stenosis
Lumbar Spinal Stenosis
Facet Arthroplasty
Posterior Fusion
Facet Arthritis
Additional relevant MeSH terms:
Constriction, Pathologic
Spinal Stenosis
Pathological Conditions, Anatomical
Spinal Diseases
Bone Diseases
Musculoskeletal Diseases
ClinicalTrials.gov processed this record on September 21, 2017


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From GoGriffs.com
Canisius head coach Jim Baron announced today that the Golden Griffin men's basketball team has accepted a bid to play in the 2014 CollegeInsider.com Postseason Tournament (CIT). This will mark the second-straight year the team has played in the CIT after advancing to the tournament's quarterfinal round in 2013. This also marks Canisius' first back-to-back postseason berths since 1994-95 and 1995-96 when the program went to the NIT and NCAA Tournaments in consecutive seasons.
Canisius will host a home game in the first round of the CIT on Tuesday, March 18. Tipoff inside the Koessler Athletic Center is set for 7 p.m. The Griffs' opponent will be announced Sunday evening. Tickets will be on sale starting Monday, March 17, at 10 a.m. through the Canisius Ticket Office by calling (716) 888-2885. Reserved seats will be $15 and general admission tickets will cost $10. Canisius season ticket holders can purchase their seats for $10 and any additional ticket purchases will be either $15 or $10, pending on seat location. Canisius students are able to claim one ticket with a valid Canisius student ID.
The Griffs are currently 21-12 on the year and the team posted a 14-6 record in MAAC play this season. The 21 wins are the most for the Canisius program since the 1994-95 season and the team is one win shy of matching the school's single-season win record of 22, which is held by both the 1956-57 and 1993-94 teams. Canisius earned the No. 4 seed in last week's MAAC Championship in Springfield, Mass., and advanced to the semifinal round of the conference tournament with a 71-65 win over Siena. That semifinal appearance was Canisius' first since 2002.
Canisius is led by senior guard Billy Baron, who currently ranks fourth in the nation in scoring average with 24.2 points per game. The 2014 Pepsi MAAC Player of the Year, Baron was a finalist for the 2014 Bob Cousy Award, presented annually to the top point guard in Division I men's basketball, and last week, he became the first Canisius player in 12 years to be named to the MAAC All-Championship Team after he averaged 20.0 points, 5.5 assists, 3.5 steals and 2.5 rebounds per game in the team's two MAAC Tournament contests. Canisius, which ranks 32nd in the nation in scoring average at 77.6 points per game, has three players averaging in double-figures in the scoring column this season. Senior guard Chris Perez is chipping in 12.4 points per contest, while senior center Jordan Heath is good for 10.3 points per game. Senior Chris Manhertz ranks sixth in the MAAC with his 7.1 rebounds per game. Manhertz is averaging 10.7 points and 11.7 rebounds per game in the team's last three contests.