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Tuberculosis and Human Immunodeficiency Virus (HIV) Immune Reconstitution Syndrome Trial (THIRST) (THIRST)
This study has been completed.
Duke University
Kilimanjaro Christian Medical Centre, Tanzania
Kibongoto National Tuberculosis Hospital, Tanzania
Information provided by:
Duke University
ClinicalTrials.gov Identifier:
First received: February 25, 2009
Last updated: May 2, 2010
Last verified: May 2010
- Full Text View
- Tabular View
- Study Results
- Disclaimer
- How to Read a Study Record
The purpose of this study is twofold: (1) to assess the feasibility and safety of fixed dose combination zidovudine/lamivudine/abacavir in HIV infected subjects with tuberculosis in a resource-limited setting, and (2) to assess the impact of delayed versus early initiation strategies for fixed dose combination zidovudine/lamivudine/abacavir on the rate of tuberculosis-associated immune reconstitution inflammatory syndromes.
|HIV Tuberculosis
|Drug: Fixed dose combination zidovudine/lamivudine/abacavir
|Phase 4
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|A Pilot Study Of Open-Label Fixed Dose Combination Zidovudine/Lamivudine/Abacavir In HIV-Infected Persons With Tuberculosis In Moshi, Tanzania; Tuberculosis And HIV Immune Reconstitution Syndrome Trial (THIRST)
Resource links provided by NLM:
MedlinePlus related topics: HIV/AIDS Tuberculosis
Drug Information available for: Zidovudine Lamivudine Abacavir Abacavir sulfateU.S. FDA Resources
Further study details as provided by Duke University:
Primary Outcome Measures:
- Number of Serious Adverse Events (SAEs) [ Time Frame: 104 weeks ]Feasibility and safety of fixed dose combination zidovudine/lamivudine/abacavir in HIV-infected subjects with tuberculosis in a resource-limited setting as assessed by the number of serious adverse events. Serious adverse events included any untoward medical occurrence that resulted in death, was considered life-threatening, required inpatient hospitalization or prolongation of existing hospitalization beyond what was required in the study, or resulted in persistent or resulted in significant disability/incapacity.
- Tuberculosis-immune Reconstitution Inflammatory Syndrome Events [ Time Frame: 104 weeks ]Tuberculosis-immune reconstitution inflammatory syndrome was defined by the protocol as: a) new persistent fevers (temperature >101.5 degrees Fahrenheit) developing after the initiation of antiretroviral therapy, and not believed to be associated with antiretroviral therapy and without an identifiable source, b) marked worsening or emergence of intrathoracic lymphadenopathy, pulmonary infiltrates or pleural effusions on radiologic examination, or c) worsening or emergence of lymphadenopathy on serial examinations or worsening of other tuberculous lesions.
Secondary Outcome Measures:
- Plasma HIV Ribonucleic Acid (RNA) Level < 400 Copies/ml [ Time Frame: 104 Weeks ]The number of subjects with plasma HIV RNA level <400 copies/ml.
- HIV RNA Level < 50 Copies/ml [ Time Frame: 104 Weeks ]The number of subjects with plasma HIV RNA level <50 copies/ml.
|Study Start Date:
|June 2004
|Study Completion Date:
|September 2007
|Primary Completion Date:
|September 2007 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Early
Initiation of fixed dose combination zidovudine/lamivudine/abacavir 2 weeks after commencing antituberculous therapy
Drug: Fixed dose combination zidovudine/lamivudine/abacavir
All subjects will receive fixed dose combination zidovudine(300 mg) / lamivudine (150 mg) / abacavir (300 mg) by mouth twice daily. Medications will be provided as long as deemed beneficial by the site investigator and study subject for up to two years. Toxicity substitutions are allowed per protocol.
Other Name: Trizivir
Experimental: Delayed
Initiation of fixed dose combination zidovudine/lamivudine/abacavir 8 weeks after commencing antituberculous therapy
Drug: Fixed dose combination zidovudine/lamivudine/abacavir
All subjects will receive fixed dose combination zidovudine(300 mg) / lamivudine (150 mg) / abacavir (300 mg) by mouth twice daily. Medications will be provided as long as deemed beneficial by the site investigator and study subject for up to two years. Toxicity substitutions are allowed per protocol.
Other Name: Trizivir
|Ages Eligible for Study:
|13 Years and older (Child, Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- HIV Infection is documented by rapid HIV test or any licensed enzyme-linked immunosorbent assay (ELISA) test kit and confirmed with a different sample.
- Men or women admitted to Kibongoto or Marangu Hospitals with (a) recent (within 56 days) smear positive tuberculosis (pulmonary or extrapulmonary,) (b)total lymphocyte count <1,200/mm3, and (c) less than 14 days of antituberculous therapy.
- Antiretroviral naive with the exception of regimens used to prevent mother-to-infant transmission of HIV during pregnancy.
- The following laboratory values obtained within 45 days prior to study entry: absolute neutrophil count (ANC) >=700/mm³, hemoglobin > 8 g/dL in women; >9 g/dL in men, serum creatinine <= 1.5 times upper limits of normal, AST <5 times upper limits of normal.
- For all women of reproductive potential (who have not reached menopause or undergone hysterectomy, bilateral oophorectomy, or tubal ligation), a negative urine pregnancy test within 48 hours of to study.
- All subjects must agree not to participate in a conception process (e.g., active attempt to become pregnant or to impregnate) and if participating in sexual activity that could lead to pregnancy, the female subject/male partner must use condoms (male or female) without a spermicidal agent.
- Not intending to relocate out of area for the duration of study participation.
- Willingness of subject to adhere to follow up schedule.
- Men and women >= age 13.
- Ability and willingness of subject or legal guardian/representative to give written consent.
Exclusion Criteria:
- Serious illness, other than tuberculosis, that requires systematic treatment and/or hospitalization, until either completion of therapy or clinical stability on therapy in the opinion of the investigator for at least 14 days prior to study entry. Oral and vaginal candidiasis, mucocutaneous herpes simples, and other illnesses which are minor in the opinion of the site investigator are exceptions
- Diagnosis of or suspicion of tuberculosis of the central nervous system.
- > 14 days of antituberculous therapy prior to screening.
- > 28 days of antituberculous therapy for active tuberculosis within the 6 months prior to screening.
- Recent past (within 28 days of study entry) or planned use of corticosteroids.
- Any condition that in the opinion of the investigator would compromise the subject's ability to participate in the study.
- Radiation or systemic chemotherapy within 45 days of entry.
- Any immunomodulator, HIV vaccine, or other investigational therapy within 30 days prior to study entry.
- Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.
- Allergy/sensitivity to any study drugs or their formulations.
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00851630
Please refer to this study by its ClinicalTrials.gov identifier: NCT00851630
|Kilimanjaro Christian Medical Centre
|Moshi, Tanzania
Sponsors and Collaborators
Duke University
Kilimanjaro Christian Medical Centre, Tanzania
Kibongoto National Tuberculosis Hospital, Tanzania
|Principal Investigator:
|Nathan M Thielman, MD, MPH
|Duke University
More Information
Keywords provided by Duke University:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on September 25, 2017
Shao HJ, Crump JA, Ramadhani HO, Uiso LO, Ole-Nguyaine S, Moon AM, Kiwera RA, Woods CW, Shao JF, Bartlett JA, Thielman NM. Early versus delayed fixed dose combination abacavir/lamivudine/zidovudine in patients with HIV and tuberculosis in Tanzania. AIDS Res Hum Retroviruses. 2009 Dec;25(12):1277-85. doi: 10.1089/aid.2009.0100.
|Responsible Party:
|Nathan Thielman, MD, MPH, Duke University Medical Center
|ClinicalTrials.gov Identifier:
|NCT00851630 History of Changes
|Other Study ID Numbers:
|Study First Received:
|February 25, 2009
|Results First Received:
|March 15, 2009
|Last Updated:
|May 2, 2010
Keywords provided by Duke University:
Treatment Naive
Additional relevant MeSH terms:
Acquired Immunodeficiency Syndrome
HIV Infections
Immune Reconstitution Inflammatory Syndrome
Mycobacterium Infections
Actinomycetales Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Slow Virus Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Reverse Transcriptase Inhibitors
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Retroviral Agents
Antiviral Agents
Anti-Infective Agents
Anti-HIV Agents
ClinicalTrials.gov processed this record on September 25, 2017


text:
While the Chico city manager hired his old friend and co-worker as assistant Chico city manager, seven department heads were eliminated. This is quite disappointing.
I thought that by eliminating seven department heads, it would give the city of Chico millions of dollars. It only helped to secure a new assistant city manager.
I guess the seven department heads that were eliminated can now apply to the FCC for free cellphones, along with others who are on the unemployment lines.
— Sharon Chambers, Chico

subset: commoncrawl


text:
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An allegedly intoxicated woman was arrested early Sunday after falsely reporting her car stolen, police said.
While patrolling the area of Sacramento and Tennessee streets at about 2:45 a.m., officers saw an empty car which had hit a nearby parked car, police said.
Soon, police received a call from Carolina Carias, 28, of Vallejo reporting that her car had been stolen. The car matched the description of the one that the officers had seen earlier.
After further investigation, police determined that Carias had allegedly driven the vehicle while intoxicated, and abandoned the car after striking the parked car, police said.
She was arrested and booked into Solano County jail.


text:
Buenos Aires Tours and Travels
About Buenos Aires
The cosmopolitan capital of Buenos Aires is one of South America's most seductive cities. Almost European in design with tree-lined streets, lively plazas and innumerable parks and gardens where colourful parrots roost, the city claims an unbelievable array of restaurants, bars, cafes and nightclubs with its interest in the arts evident in the myriad theatres, cinemas and galleries. Amongst the glamorous neighbourhoods you'll find traditional Buenos Aires in the old-world watering holes and fine colonial architecture. With several barrios distinct in character, it's a city that lends itself beautifully to aimless wandering. San Telmo is the most traditional of all with crumbling facades and cobbled streets, popular on a Sunday when the antiques market comes vividly to life.Read More
In any such charismatically eclectic city it's hard to whittle down a list of highlights but the remarkable La Recoleta Cemetery surely must feature. Giant vaults, grandiose tombs and marble sarcophagi line the avenues of the necropolis where many famous Argentineans rest, most notably Evita. Further architectural wonder can be found in the Teatro Colón boasting a French Renaissance exterior and sumptuous interior where opera, ballet and classical music are all performed.
No visit to Buenos Aires would be complete without experiencing tango – an emotion that is danced. Enjoy dinner whilst watching professional dancers put on an intricately choreographed display at an espectáculos held throughout town or for something less touristy, seek out a milonga, a more social event held in venues ranging from a local sports hall to an elegant, traditional salon.
Buenos Aires Tours
Here are some popular itineraries that include a visit to Buenos Aires. Alternatively, if you would like to include a visit to Buenos Aires on a bespoke touring itinerary to Argentina, take a look at our tailor-made holiday planning section.


text:
Communication Modification Program for Transgender People to be Offered at Ithaca College
ITHACA, NY — A new program at Ithaca College offering voice and communication modification instruction for transgender people from the college and the broader community will start in February. Beginning on Tuesday, Feb. 14, in the Sir Alexander Ewing Speech Clinic on the Ithaca College campus, the program will take place on Tuesday evenings throughout the spring 2012 semester. The meetings are free to Ithaca College students, faculty and staff; others will be charged a nominal fee. For more information, contact Mary Pitti at (607) 274-1765 or firstname.lastname@example.com.
"The program will focus on developing voice, articulation, language, nonverbal communication and self perception," said Pitti, clinical assistant professor and clinical program director in the college's Department of Speech-Language Pathology and Audiology. "It is open to both male-to-female and female-to-male transgender people."
Joe Zanfordino, adjunct clinical faculty and a local speech-language pathologist, will lead the group and share his expertise and experience of speech, language, voice and nonverbal communication considerations specific to this population. Pitti will assist by instructing the group on voice modification techniques. Three speech-language pathology graduate students will train the transgender participants under Zanfordino's direction and supervision.
"The program is designed to provide a concrete communication program in a supportive environment," Pitti said. "The sessions will be individually designed for the goals of each participant."
The program is a collaboration between the Ewing Speech Clinic; Ithaca College Center for LGBT Education, Outreach, and Services; and Planned Parenthood of the Southern Finger Lakes.


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Signs of Fatigue
The market is still overbought, and since there have been no changes in the Oscillator, I won't harp on it anymore. There were, however some other statistics you should note from Monday's trading.
In the morning, when the S&P 500 climbed to make a higher high vs. last week, we also saw fewer stocks making new highs in comparison to last week's numbers. On the NYSE there were 163 new highs last week, and there were only 147 Monday. The Nasdaq saw 75 new highs last week and 59 Monday. That is not what you want to see when a market is overbought, as it displays fatigue....414 more words left in this article. To read them, just click below and try Real Money FREE for 14 days.
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text:
Westbrook dealing with left knee contusion
JUPITER, Fla. -- Jake Westbrook's first Grapefruit League start was an abbreviated one, as he followed Carlos Beltran with an early exit due to injury.
Westbrook was struck on the inside part of his left leg -- just below his knee -- on a comebacker off the bat of Casey Kotchman, who was the first Marlins hitter to bat in the second. That brought a trainer and manager Mike Matheny out of the dugout, and after a lengthy conference, Matheny made the decision to end Westbrook's day.
"He wanted to stay out there, but the first time out, why?" Matheny said. "He was getting close to 20 pitches. It was still a little cool at that point. None of it made sense to me."
Westbrook, who was diagnosed with a left knee contusion, later said that he was eventually able to walk off the pain. He doesn't expect to be slowed in the coming days by the issue.
"They said there was no reason to push it, and I had no intention of arguing in the first game of Spring Training," Westbrook said. "It's precautionary. I have a lot of time to get my work in."
Because Westbrook's workload was lighter than anticipated on Thursday, Matheny said that the right-hander could throw more pitches in his next side session to help increase his endurance in advance of his next scheduled start.
In his one inning on Thursday, Westbrook allowed one run on four hits, the last of which was the ball that struck him.
"I felt like I was on the right track," Westbrook said. "The biggest part is not getting my first workload in as far as the number of pitches that I needed to throw to progress. But we'll figure something out and make adjustments."


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Longboards Wall Mural
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Lanvin Spring 2013 Accessories
Major Eye Candy Alert: Lanvin's Spring 2013 Accessories
Now that the Fall 2013 shows have wrapped, we can finally turn our attention to more pressing matters: what to wear this Spring. Lanvin's latest batch of accessories, which have just arrived at the brand's stores and at the flagship online, may be just the thing.
Made up of tough-chic jewels, bags, and shoes (the same ones that accented the house's strong-shouldered runway collection last October), these are pieces that certainly showcase Alber Elbaz's "clever game between classicism and modernity" — but they won't go unnoticed either. The new Platform Pump, for example, features a sky-high heel, pointed toe, and comes in green, black, and iridescent python, while the Partition shoulder bag features a serpent chain strap, stone, metal, or wood hardware, decorative screws, and calfskin textures like croc or brushed metallics. The new Oracle jewels are also major statement-makers; in the form of geometric cuffs and brass breastplates that shine like mirrors, they're especially head-turning.


text:
Note: This item is more than 12 years old. Please take the publication date into consideration for any date references.
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News Release
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Sept. 23, 2005
More Texas State Parks Close, Others Hosting Rita Evacuees
AUSTIN, Texas — Since Hurricane Rita has changed course, more Texas state parks in East Texas are now closing temporarily, while others are hosting hundreds of hurricane evacuees free of charge. (See state park closure list below.)
For the latest information on state park temporary closures and state parks able to host hurricane evacuees, people should phone the TPWD state park Customer Service Center reservations line at (512) 389-8900. A complete list of state parks, including a statewide map and regional maps showing park locations, is on the TPWD Web site.
The state park reservation center continues to serve as a clearinghouse to place evacuees in available campsites. Many park customers who had existing reservations for this weekend are voluntarily canceling or postponing trips, giving up their campsites to Rita evacuees. In other cases, the center is relocating people to less crowded state parks. Many evacuees are now traveling to state parks as far away as West Texas and the Texas Panhandle. Although no firm estimate is yet available, anecdotal reports indicate there are now more than 1,000 Rita evacuees in state parks across Texas.
Effective Tuesday, all Texas state parks were notified that Hurricane Rita evacuees will be allowed to use state parks as evacuation centers for the duration of the storm. Campsite and entrance fees are being waived during this time. Additional state parks not shown below may also close as conditions change.
- Atlanta — CLOSED 9/23–9/30
- Brazos Bend — CLOSED 9/21–9/25
- Caddo Lake — CLOSED 9/23–9/30
- Caddon Mounds — CLOSED 9/24–9/30
- Ft. Boggy — CLOSED 9/22–9/30
- Fulton Mansion — CLOSED 9/21–9/28
- Galveston — CLOSED 9/21–9/25
- Goliad — CLOSED 9/22–9/25
- Goose Island — CLOSED 9/22–9/25
- Huntsville — CLOSED 9/22–9/25
- Inks Lake — CLOSED 9/22–9/25
- Lake Corpus Christi — CLOSED 9/22–9/25
- Lake Houston — CLOSED 9/22–9/25
- Lake Texana — CLOSED 9/22–9/25
- Martin Creek Lake — CLOSED 9/23–9/30
- Martin Dies — CLOSED 9/22–9/25
- Matagorda Island — CLOSED 9/22–9/25
- Mission Tejas — CLOSED 9/23–9/30
- Monument Hill — CLOSED 9/24
- Mustang Island — CLOSED 9/22–9/25
- Rusk — CLOSED 9/23–9/30
- Sabine Pass Battlegrounds — CLOSED 9/21–9/25
- San Jacinto — CLOSED 9/21–9/25
- Sea Rim — CLOSED 9/21–9/25
- Sheldon Lake — CLOSED 9/21–9/25
- Stephen F. Austin — CLOSED 9/22–9/25
- Starr Family Home — CLOSED 9/23–9/30
- Texas State Railroad — CLOSED 9/24 & 9/25
- Tyler — CLOSED 9/23–9/30
- Varner Hogg — CLOSED 9/21–9/25
- Village Creek — CLOSED 9/22–9/25
- Washington On The Brazos — CLOSED 9/23–9/25
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text:
Exclusives, panels, special guests, more...
For a great selection of action figures and collectibles, check out BigBadToyStore.com, BriansToys.com, ToyWiz.com, SmallJoes.com, PastGenerationToys.com, Urban-Collector.com, ZoloWorld.com, MonkeyDepot.com, HobbyLinkJapan.com, and Sekaido.com.
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Shocker Toys returns to San Diego Comic-Con Booth #3849 with six summer exclusive figures, live celebrity interviews, artist signings and more.
Shocker's Comic-Con exclusives include Indie Spotlight figures of Barry Hubris (The Tick), The Blank (Dick Tracy) and Dan Garret (The Blue Beetle). All are 6" fully articulated action figures and all are limited piece runs. Exclusive Mallows will also be offfered, including limited designs from Hunter Rose (Grendel), Lord Death (Soul Eater) and Luffy (One Piece). For a full details on Shocker's Comic-Con exclusives, CLICK HERE! For those that can not attend the event, all these exclusies are being offered at shockertoys.com in limited quantities.
Appearing at the Shocker Toys booth courtesy of Coolwaters Productions and Retro Radio Live will be Doug Jones, Kane Hodder, Neil Kaplan, Billy Dee Williams and many more of your favorite celebs. Among the comic book favorites, the creators of Zen, the Intergalactic Ninja will be signing a one-of-a-kind 3-D poster, Gumby himself will be available for photos and there will be other surprise guests.
Shocker Toys iwll also be hosting a panel featuring their staff, print artists, customizers and 3d modelers in room 24ABC 6:30pm, Thursday July 22nd. There will be a limited Shocker shirt giveaway at the panel as well as Shocker shirts available for sale at the booth.


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By Jaideep Varma and Jatin Thakkar
Chennai Super Kings 187/5; Mumbai Indians 149/9
(Chennai Super Kings won by 38 runs)
The scorecard of the match is here.
KKR would probably not be very happy. There is a very distinct possibility now of them having to try for their first title against rejuvenated defending champions, clearly fired up and perhaps very close to their best by then, in their backyard.
It wasn't that MI had never lost an IPL match in Bangalore before this (in 4 years). It wasn't that CSK were 4-2 in 3 overs when the match began. Or 114-5 in the 16th over (after what had been quite a recovery). It wasn't that their highest impact batsman was out first ball today. Or that Mumbai were 47-0 before the 5th over ended. Or that the prospect of defending anything against a strong batting line-up with bowlers who had all palpably failed in the league stages was not very inviting.
More than anything else, it was the fact that CSK were setting a target that was their biggest obstacle – as Dhoni said at the toss, he would definitely have fielded because chasing on this pitch has been "easy" (he actually used this word). In the last 2 years itself, 62% of the matches had been won chasing, and if you look at the matches closely, you'd see it's actually been even easier than that.
This awareness probably drove Dhoni more than anything else when he walked out to bat at 95-3, which would become 114-5, with just 29 balls left. Dhoni produced one of the great T20 innings, as he strove to overcome a handicap with a desperation that brought out his very best. He found power, timing and gaps in the field with breathtaking regularity (and that magnificent helicopter shot too)…and when Bravo at the other end began to do the same, it turned the tide so comprehensively that you could see it with the naked eye.
In the end, this was the biggest achievement of this match – that CSK won the match setting a target on a pitch like this, after the start they had. This is as much proof as possible that the Champions are getting their groove back.
Here is the match through the Impact Index prism.
This is a slightly cruel one perhaps, but the facts suggest that the highest impact player of the match was not Dhoni but Dwayne Bravo. His 33 off 14 balls (Batting IMPACT 3.26) almost matched Dhoni's batting but he was actually additionally the highest impact bowler in the match for his 2-10 in 3 overs (Bowling IMPACT 4.23 – even higher than his batting). It is not quite right to say that he bowled when the match was won, because MI were always just 2 big overs away from taking charge again. Bravo got Franklin and
Pollard after choking them up. His was also the only all-round performance in the match (except, well, Dhoni's, who also kept wickets).
MS Dhoni produced his most memorable performance after the World Cup final – his 51 off 20 balls was the highest impact batting performance in the match (5.10) and more than the spectacular assault that characterised it, it was the way he transformed the game in a very short time that made it the most outstanding performance in this year's IPL (so far). Even with his wicketkeeping and captaincy impact accounted for, he does not cross Bravo on IMPACT tally.
Given how close their IMPACT numbers are, and given that the match turned when they batted in tandem, perhaps it would have been apt to give them the MoM award jointly.
S Badrinath (47 off 39 balls; Batting IMPACT 4.59) and Michael Hussey (49 off 39 balls; 4.75) had a huge role to play in setting this platform for CSK to take off on. They came together with the score at 1 for 2 wickets – a shock start that threatened to end the match very quickly. They both registered a Pressure IMPACT of 1.24 – the only batsmen to successfully absorb the pressure of falling wickets in the match.
Besides the 4 highest impact batting performances coming from CSK, together they also had the highest impact in all batting parameters in the match – Hussey and Badrinath absorbed the most pressure, Dhoni and Bravo had the highest Strike Rate IMPACT – some complementing of skills in a team. Incidentally, the highest two Economy IMPACT performances also came from CSK – Bravo and Jakati.
Dhawal Kulkarni (3-46 in 4 overs; Bowling IMPACT 3.19) had the highest impact for MI – but 4 CSK players had a higher impact than him. Only 4 players from MI managed to cross an IMPACT of 1, while 7 CSK players did so (with 2 of them crossing 5).
Kulkarni and Morkel both registered Pressure Building IMPACT in the match with their quick wickets. Kulkarni reduced CSK to 1 for 2 in the 2nd over of the match. Morkel took wickets of Karthik and Sharma to reduce MI to 77-4 in the 11th over of their innings. They added a lot to the general drama in the match.
CSK had taken the field with 9 tournament-defining players. MI had 4. Looks like CSK may add to that tally yet.
In the end, despite the high thrills and the tension-fraught scrap, this was a thrashing. CSK had a Team IMPACT of 2.44 whereas MI produced 1.07. CSK's 3rd best performance this IPL, MI's 3rd-worst. A nice symmetry for two teams that had exactly the same Team IMPACT in IPL 2012 before this match.
CSK proved that they still have a lot left in that tank of theirs, despite actually being nowhere near their best yet. That would be DD's hope in the next match (preview tomorrow).
For more information, please go to www.impactindexcricket.com.


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Okun's Law
This lesson printed from:
What will happen to a nation's output when workers are unemployed? In this lesson you will learn how much GDP must grow to maintain the natural rate of unemployment. You'll need to perform some simple algebra, so grab a pencil, marker, and paper (or use an iPod APP!). The insights you will gain from this lesson will make you an expert at discussing unemployment!
By the end of this lesson, you will be able to [1] Determine the natural growth rate of GDP from empirical data; [2] Use an algebraic expression relating GDP growth to changes in the unemployment rate; [3] Interpret unemployment and GDP data to make predictions about output growth; [4] Discuss why changes in employment are not matched by equal changes in GDP.
Complete the worksheet, "Okun's Law Worksheet." Your teacher will guide you through the steps and correct mistakes while providing insight about the data. Feel free to use colored pencils or a marker to make your graphs professional. At the end of the worksheet, you will be asked to write a short summary of the major concepts and take a quiz.
Okun's law relates the change in the unemployment rate to the natural GDP growth rate of 3%. When the economy is experiencing unemployment or inflation, GDP deviates from ithe natural rate. What would the approximate unemployment rate be if the economy was growing at 4%? At 2%?
The interactive below will quiz you on your knowledge of Okun's Law. Type in your answers and click the arrow to proceed from question to question!
Please read the article, "The Sun Also Rises ." After reading this article, submit a written comment to your teacher.


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This page is about the slang term poof | poofter
Meaning: an offensive, derogatory word meaning a gay man
For example:
- Everybody thought Gavin was a poof because he liked classical music and going to the ballet.
- Boys in my high school used to go "poofter bashing". They'd find a guy in the park they thought was gay, and they'd beat him up.
Quick Quiz:
The words "poof" and "poofter" are offensive words used by hateful bigots in order to insult
This entry is in the following categories:
Contributor: Matt Errey


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Now there's a more economical way to protect your boat in higher-wake areas. BoatGuard's new mooring whips employ large, 3/4"-dia., solid fiberglass poles that withstand rugged environments and provide Spring Action to create a "safety zone" between your boat and dock. Optimized for fresh water use, low-wake areas, and nontidal areas, whips are crafted specifically for boats up to 25' and under 10,000 lbs. CAD-designed Whip Base is injection-molded from high-impact, reinforced plastic for impressive strength and durability. All lines and hardware for installation included. Sold in pairs.


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BP Comment Quick Links
|Strength of Schedule Report
December 19, 2013
Skewed Left
The Company They Tweet, The Sequel
When we last undertook this exercise, it brought us to some pretty unfortunate depths. Using the list of Twitter follows to probe baseball's greats and sideshows taught us more than we'd ever like to know about Wade Boggs' taste in porn stars, Magic Johnson's apathy toward baseball, and Major League Baseball's thirst for the 140-word dispatches of a company called Credit Donkey.
One year later, we're back with a bunch more—some active players, a power-on-power couple of retired players, and one of your favorite writers and mine. What can we learn from only the list of people they follow?
A.J. Burnett (@wudeydo34): Free agent pitcher
Yasiel Puig (@YasielPuig): Dodgers outfielder, savior, scourge
Roger Clemens (@rogerclemens): Future Hall-of-Famer, former Sugar Land Skeeter
Taijuan Walker (@tai_walker), Mariners pitcher, hairstyling victim
Fool him twice, though…
Sam Miller (@SamMillerBP), Baseball Prospectus writer, podcast hater, Californian
Am I doing something wrong? Does he have needs that my feed isn't meeting? Do I not use enough lowercase? That's what it is, Sam, isn't it? Sullivan uses all lowercase and acts all too good for convention and you just eat that right up. "Why can't he just be more like Sullivan," you probably always say.
But come on, you're only at 117 follows. What's one more? I mean, you have room to follow KG, and he's dead. So will you follow me on Twitter and pretend this never happened? No big deal, though. I'll just be waiting over here.
Jose Canseco (@JoseCanseco): Free agent pitcher, American hero, hugger
· NBC News Chief Foreign Correspondent
Zachary Levine is an author of Baseball Prospectus. Follow @zacharylevine
2 comments have been left for this article.
BP Comment Quick Links
I was feeling special that Jose Bautista followed me till I read this. Thanks for the buzz kill.
Dec 19, 2013 07:53 AM
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Highlights of the year at SBC included welcoming tenants big and small, the success
of its inaugural Open Innovation Summit, launch of an Experts Panel, news of an
innovative tie-up with Cambridge University, and a funding collaboration with Kurma
Life Sciences Partners. SBC is pleased to have hosted many events and networking
meetings for a range of organisations, and is building strong links with the local
Reflecting on the previous year, and looking ahead, CEO Martino Picardo said, ''I'm
delighted that Stevenage Bioscience Catalyst's first year of operation has been such
a success, as we've worked to bring the academic, pharma, bioscience and investor
communities closer together. I'd like to thank our stakeholders for their input and
ongoing support, as well as the SBC team and our advisers. Our second year is
expected to be just as busy and fruitful, especially around the Convergent Medical
Technologies conference we are planning for May.'
For more information, please contact:
Stevenage Bioscience Catalyst
Martino Picardo, CEO +44 (0)1438 906906
Emma Palmer Foster, Strategic Communications Consultant +44 (0)7880 787185
About Stevenage Bioscience Catalyst
Stevenage Bioscience Catalyst is the UK's first open innovation bioscience campus,
pioneering a unique culture to drive early stage bioscience technology and company development, and building a thriving community. It is backed by £38m of funding from its
founding partners – GlaxoSmithKline, the Wellcome Trust, the Department for Business,
Innovation and Skills, the Technology Strategy Board
and the former East of England
Development Agency. Consisting of an Incubator, an Accelerator and a Hub, covering
60,000 sq ft of laboratory, office and networking space, the independent facility houses a
range of companies, from virtual and start-up firms to those which are more established, as
well as other organisations. Located on the GlaxoSmithKline Stevenage site, Stevenage
Bioscience Catalyst is in the unique position of operating in proximity to the expertise and
resources of a major pharmaceutical company, close to both London and Cambridge. For
more information, please go to www.stevenagecatalyst.com.
About Open Innovation
Firms using Open Innovation (OI) combine their own R&D with externally sourced ideas and
expertise. OI is characterised by highly effective use of connections and networks to
exchange knowledge and ideas, external partners being involved at all stages of product
development, equitable win-win business relationships, and new business models to
maximise the value of intellectual property and other assets. Examples in various sectors
have shown that the benefits of OI include reduced time to market for new products and
services, access to new markets, improved innovation success rates and increased profits.
SBC will promote use of Open Innovation within the life sciences sector, connecting SMEs
with an active network consisting of GlaxoSmithKline and its other stakeholders, academia,
charities, other businesses and funding bodies. The term 'Open Innovation' and related
research into its practice have been developed extensively by Professor Henry Chesbrough,
Executive Director of the Program in Open Innovation at the University of California,
Berkeley (http://openinnovation.berkeley.edu).
About Stevenage Bioscience Catalyst's stakeholders
Stevenage Bioscience Catalyst's stakeholders are GlaxoSmithKline (www.gsk.com), the
Wellcome Trust (www.wellcome.ac.uk), the Department of Business, Innovation and Skills
(www.bis.gov.uk), the Technology Strategy Board (www.innovateuk.org) and the former East
of England Development Agency (www.eeda.org.uk)


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"We have met the enemy… and he is us" …Walt Kelly
America's greatest enemy is willful ignorance; or is that willful political correctness?
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On November 5, 2009, Army psychiatrist Maj. Nidal Hasan, an American Muslim of Palestinian descent, opened fire on unarmed soldiers and their families at the Fort Hood Soldier's Readiness Processing Center. They were there to receive routine medical treatment immediately prior to and on return from deployments. The Major, who was wounded during the action, became paralyzed from a gunshot wound. He is currently awaiting trial by court-martial for 13 counts of premeditated murder and 32 counts of attempted murder. His trial date is August 20. An additional count of murder of unborn child under the Unborn Victims of Violence Act and Article 119a of the Uniform Code of Military Justice has not been filed at this time. We can only suspect why.
Political correctness
A report released by former FBI Director William Webster blames the FBI for not acting on information about an Army officer having regular communication with known terrorists. Webster reported that the FBI looked away from a genuine threat to fellow soldiers. Did the FBI fail to act in a professional manner because they didn't want to be seen as targeting an American Muslim?
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The FBI and the Army had all of the indicators that Maj. Hasan was a ticking time bomb but did not act because of political correctness. Because of their fecklessness, people got killed. When you are afraid to point out the enemy, you become the enemy. Far too often, political correctness is willful ignorance. The White House classifying this terrorist act as "workplace violence" comes to mind.
Hillary Clinton's top aide, Huma Abedin, has an interesting family history. Her late father, mother, and brother had and still have connections to the Muslim Brotherhood; yet it seems that by being close to Hilary, Miss Abedin (aka Mrs. Anthony Weiner) had no problem getting a security clearance in spite of her family connections. There is a legitimate concern that Huma may have influenced State Department policy concerning the Brotherhood led revolts in Egypt, Libya, and Syria.
Five members of Congress lead by Michele Bachmann (R-MN) have called on the Inspectors General of the Office of the Director of National Intelligence, the Department of Defense, the Department of Homeland Security, the Department of Justice, and the Department of State to investigate the possible involvement of the Muslim Brotherhood in the U.S. Government. Rep. Bachmann must be over the target because she is catching flak from the Kool-aid drinkers sipping from the well of political correctness. What the politicians don't have the courage to say is that if the CIA had someone similar to Huma's position within the Russian Foreign Ministry, they would call her a well-placed spy.
Follow Coach at twitter.com @KcoachcCoach
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The views expressed in this opinion article are solely those of their author and are not necessarily either shared or endorsed by the owners of this website.


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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Monday, September 25, 2017
Dental Hygiene
Lump IN the tip of my tongue?...
Yesterday, I woke up with my tongue feeling very sore. So looked in the mirror to see if I could see anything, but nothing was there, then I felt the tip of my tongue and noticed that there is a hard lump. It is about the size of a pea. It stopped hurting today, but when I squeeze it, it becomes very painful.
I have done a little research, but they all say that a lump means cancer but they say it is on the outside not inside. what should i do? I am only 13 years old and female???
XX thank you
p.s. i found another woman on this sight with this exact problem but it only said to see a dentist but i am in foreign country and won`t be able to see anybody very soon...
If the lump is as you describe it, there are several things that this could represent. While most are not cancer (benign), it is impossible to exclude the slight chance that this COULD be an early cancerous growth. And even if the growth is benign, it may continue to get bigger.
If you can't see a dentist, then you should see a physician as soon as you can. It is likely that you will eventually need a biopsy to diagnose this lump and to guide any further treatment, if needed.
Good luck!
John R Kalmar, DMD, PhD
Clinical Professor of Pathology
College of Dentistry
The Ohio State University


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This game was classified by the community with the following category scores - Violence=1/3, Sex=0/3, Mature Content=3/3. Fiskal Clif is the Cat to save the U.S. of A! Drive your prototype AmeriCar along a cliff of certain doom, where you earn more Money the faster you go! How much fiscal risk will you assume? Try to set your best Global High Score and earn enough cash to unlock helpful items and Medals of Honor! Driving this car may be a worse job than working for Congress, but only you can prevent a default!
Buy Xbox content on Xbox.com. Your Xbox 360 console will automatically download the content next time you turn it on and connect to Xbox Live.Learn More


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Tick Tock Bad ClockMath brain teasers require computations to solve.
Your friend gave you a clock for your birthday, but unfortunately, it's very unreliable. This one gains exactly 12 minutes every hour.
It is now showing 10pm and you know that it was correct at midnight, when you set it.
If the clock stopped four hours ago, what is the correct time now?
AnswerSince the clock gains 12 minutes every hour, for every real hour that has passed 72 minutes will pass on the clock. It has been 22 fake hours from midnight to the time the clock stopped, so in order to find the number of real hours we must first find the number of fake minutes, then divide the number of fake minutes by the number of minutes that pass by in an hour for the clock (72) to find the number of real hours that have passed from midnight to when the clock stopped. The following shows arithmetic work:
22 x 60 = 1320 (clock minutes that have passed from midnight to when the clock stopped)
1320 / 72 = 18.333333... (real hours that have passed from midnight to when the clock stopped)
18.333333... hours = 18 hours 20 minutes. Therefore it was 6:20pm when the clock stopped. And because the clock stopped four hours ago, it is now 10:20pm!
What Next?
See another brain teaser just like this one...
Or, just get a random brain teaser
If you become a registered user you can vote on this brain teaser, keep track of
which ones you have seen, and even make your own.
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When looking for serious ethnic spots, I find if you're the only white anglo dude in the joint, you're probably in the right place. Khan BBQ, on Chicago's Devon street—a strip of Pakistani, Indian and orthodox Jewish bakeries, restaurants, and clothing shops—is one of those places.
It shouldn't be, as I and a few others have written about the perfume of coriander from the tandoors, the puffy stacks of Naan bread, and the grilled succulent meat over the last couple of years. Yet, last week when I stopped by for a bite, the dining room was filled with the usual smattering of cabbies and Pakistani families.
I wonder what keeps the mainstream away? It's not like Khan is some dingy backwater filled with live animals and criminals on the lam. It's a peach colored palace sporting a grand chandelier outfitted with more bling than a Tiffany and Co.
It's not like food is unfamiliar either. There's no shortage of dal, naan, and paneer. The tandoori meats including crispy and succulent chicken boti featuring flakes of char and pale green streaks from crushed peppers, are the best around. The seekh kababs, skewered round cylinders of ground beef, onion and coriander, are crunchy outside and moist inside. Chappli kebabs glisten in rich ghee and sport a nose tickling waft of cumin. The fare is so good that it's amazing to think that owner Amjad Khan, an immigrant from Faisalabad, Pakistan's third largest city, got his culinary start in a sub shack near Chicago's defunct south side project, the Robert Taylor Homes.
Considering the evidence, there's no excuse not to stop in. I implore the huddled masses of my white anglo and non-Pakistani bretheren to check Khan out. If you choose to stay away, I guess that means these just more karai gosht for me.
About the author: Michael Nagrant writes for Serious Eats from Chicago, where he also publishes Hungry magazine. Michael never met an organ meat he didn't like. He hopes to meet many more.
Khan BBQ
Address: 2401 W Devon Ave, Chicago, IL 60659 (map)
Phone: 773-274-8600


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Sunday BBQ: Grilled Beef Sirloin and Famer's Market Skewers
Sunday BBQ: Grilled Beef Sirloin and Famer's Market Skewers
If you're like me, you probably have a tendency to turn your meat into kabobs. However, sometimes a primal craving strikes and all you want is a nice, big, juicy steak. So why not keep your meat intact and skewer only the veggies? This grilled beef sirloin is slathered in a fragrant mustard-thyme glaze and the farmer's market inspired skewers will keep you from feeling guilty. Pair it with some garlic bread and you'll be set. Oh and did I mention that it's simple enough you could make it for dinner tonight, tomorrow or any other day of the week? To get the recipe,
Grilled Beef Sirloin and Famer's Market Skewers
From Beef, It's What's For Dinner
Image Source
Makes 4 servings
1 boneless beef top sirloin steak, cut 1 inch thick (about 1-1/4 pounds)
1 medium yellow squash, sliced (1/2-inch)
1 medium zucchini, sliced (1/2-inch)
1 small red onion, cut into 1/2-inch thick wedges
8 medium mushrooms
1 tablespoon Dijon-style mustard
1 tablespoon olive oil
For Glaze:
2 tablespoons Dijon-style mustard
2 tablespoons apricot preserves
1 teaspoon lemon juice
1/2 teaspoon dried thyme
1/4 teaspoon pepper
- Combine glaze ingredients in 1-cup glass measure. Microwave on HIGH 45 seconds, stirring once. Brush on beef steak.
- Alternately thread vegetables onto four 12-inch metal skewers. Combine mustard and oil; brush on vegetables.
- Place steak and skewers on grid over medium, ash-covered coals. Grill steak, uncovered, 17 to 21 minutes for medium rare to medium doneness, turning occasionally. Grill vegetables 6 to 10 minutes or until tender, turning occasionally.
- Carve steak; season with salt. Serve with vegetables.
Nutrition information per serving:
296 calories; 11 g fat (3 g saturated fat; 5 g monounsaturated fat); 62 mg cholesterol; 362 mg sodium; 15 g carbohydrate; 2.5 g fiber; 36 g protein; 10.0 mg niacin; 0.8 mg vitamin B6; 1.8 mcg vitamin B12; 3.2 mg iron; 39.6 mcg selenium; 6.4 mg zinc.


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|Room Description
Our basic room, perfect for a short visit to Lima. Every standard room has colorful linens, wooden floors, and a homey feel that differentiates us from other hotels. When walking to your room, you will not find yourself staring down rows of similar corridors or opening the door to a room designed in corporate. Every standard room has been lovingly created by the hotel owner Lucy with the same care she brought to designing her children's rooms. The standard includes a flat screen television, private bath, safe, queen bed, refrigerator, cutlery, and sink. Most standards also include a flowerbed connected to the windowsill and a terrace view.
|Amerities in Brief


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University Art Collection
- Tour the publicly accessible art collection, with information on how to find pieces of artwork
- Tour artwork not currently available for public viewing
- TWU's poster art collection
Chancellor and President Ann Stuart revived interest in the University Art Collection in 2001 with plans to support through annual acquisitions the work of TWU students, alumni, faculty and staff. There are now more than 200 pieces of artwork in the collection, including selections that can be toured online or when visiting the TWU campus.
TWU is proud of its commitment to support the arts:
- The Department of Visual Arts at TWU was one of the five original departments of the school in 1903.CD1
- When the department moved into its current building in 1936, TWU was the first institution in the state to have a separate building dedicated to the study of studio arts.
- TWU has hosted distinguished artists such as Lazlo Moholy-Nagy, Hans Hoffman and Alexander Hogue as visiting artists and teachers. Noted photographer Carlotta Corpron was the head of the photography area for more than 30 years.
- In the late 1930s, Eleanor Roosevelt dedicated the University's Little Chapel-in-the-Woods, a prairie-style structure designed by O'Neil Ford. Under the direction of Professor Dorothy Antoinette LaSelle, the art students designed and fabricated the stained glass windows, metal work, wood carvings and mosaics adorning the structure.


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SHEPHERDSVILLE - A great local high school football season is now in the rear view mirror and what a season it was.
Obviously, Bullitt East reaching the Class 4-A state championship game heads the list of accomplishments, but perhaps just as important is the fact that for the first time in at least 15 years, all three Bullitt County football programs posted winning records.
Yes, there have been seasons where all three have been below .500, but marks of 9-6, 8-3 and 8-5 this fall might just be the best combined mark in Bullitt County football history.
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Consolation centers: Who's left on the market with Dwight Howard headed to Houston
Dwight Howard is so outstanding a player that his free agency essentially brought the NBA world to a halt. Some unrelated signings managed to slip through the cracks in the interim, but overall the most prominent teams with cap space waited on Howard, and by extension so did the bulk of the league's free agents. General managers, players, agents and fans alike all checked their watches and Twitter feeds as Howard deliberated, knowing full well that many of the teams with max-level room wouldn't budge until Howard was officially off the market.
That stage of the offseason is now over. It was reported on Friday that Howard intends to sign with the Rockets, leaving the Mavericks, Hawks and a host of other teams to make do with less appealing options. That hunt begins with the following players -- those center options next in line with Howard now accounted for, and waiting for the right offer in a now-furious race for teams to scoop up talent as quickly as possible.
Traditional options
Bynum is the gambling GM's consolation prize. The path of creating cap space, chasing Howard and going all-out to land him in free agency is a taxing enterprise, and one that can understandably lead to teams quickly taking their resources and efforts to the next talent in line. Bynum may well be that, though his worrisome injury history and refusal to work out for teams this summer make him a huge risk to any team desperate enough to sign him. If all were to go well with Bynum, the team that lands him could get an All-NBA caliber center at a relative discount. If fate were to turn the other way, a team could be locked into a multi-year salary with a no-show on the court, just as Bynum was in missing the entire 2012-13 season while (if only technically) with the Sixers.
That's a terrifying call to make, with stakes so high that they could define a team's workings for a 3-4 year stretch, if not longer. Teams generally can't dig themselves out of troublesome contract situations all that quickly, and if Bynum undergoes yet another knee surgery it may prove difficult to move him without sacrificing future draft picks or other assets. A 25-year-old former All-Star could be reduced to dead contractual weight with but a single pop and tear in his reconstructed joint.
Still, Bynum possesses such a rare combination of size and skill that some team will undoubtedly test its fortune by acquiring him. He isn't the defender that Howard is by any means, but has the length, hands and mobility to influence the game in a way that so few can, with a season of outstanding production (18.7 points and 11.8 rebounds per game with L.A. in 2011-12) to serve as precedent.
Nikola Pekovic
Pekovic is a slightly more conservative option for teams in search of a free agent center, but would demand an oversized contract offer on the basis of being a restricted free agent. Minnesota won't likely let Pekovic walk for any reasonable sum, and thus any interested team with cap space would need to stretch its resources and complicate its roster construction just for the sake of acquiring him. That might make sense for some teams, but Pekovic is also a bit light on the glass, a good-not-great scorer and merely a solid interior defender -- considerations that require a certain type of frontcourt complement. That the Wolves' Kevin Love is something of an optimal fit (save, perhaps, on the defensive end) should only make him that much more difficult to pry from Minnesota.
But if it can be done, Pekovic would be a nice get on the basis of his low-post offense and surprising pick-and-roll game, which could rather wonderfully complement the work of star-level perimeter players. Pekovic is strong enough to battle down low but mobile enough to avoid causing consistent problems in terms of spacing, and with that would give any team a useful offensive piece. That Pekovic is no slouch defensively can only help matters, though the fact that he's not quite good enough to be a defensive cornerstone makes him a difficult sell for his likely price point.
Kaman is an established name, if only for the fact that he's been around for a bit and has a track record of fairly decent box score production. Most recently: Kaman averaged 18.3 points and 9.8 rebounds per 36 minutes for the Mavericks, though that Kaman averaged a mere 20.7 minutes per game on a team without many center alternatives should be rather telling. He's a decent option for post-up scoring, but not quite efficient enough (nor a good enough passer) from the block to be trusted as a prominent component of an offense. That's a shame, because things only tend to get worse as we look to the other elements of Kaman's game; he's a decent rebounder, but a shaky defender with a terrible knack for pulling himself out of position as opponents drive to the rim. Some interior defenders lack for athleticism, some for height, and some for nuance. In Kaman's case, it's a bit of the former but mostly the latter -- he just doesn't ever seem to quite be on the same page with his teammates, and thus surrenders open looks at the rim at an alarming frequency.
Kaman can work well still as a reserve, as he's big enough to get to the rim and get consistent points against second-unit bigs. But among teams for whom Howard once seemed a realistic option, Kaman is hardly of any consolation.
It seems unlikely that Andersen would bail on Miami, but if the money is good enough he might be enticed. That could be to the benefit of any number of teams, as Andersen's highly efficient finishing could easily be ported over to any roster with an effective dribble penetrator. Things may not be quite as easy without LeBron James and Dwyane Wade to work off of, but players who can get to the rim consistently can still set up Andersen as he stalks around the baseline, or set him up more frequently as the primary big in pick-and-roll scenarios.
Anderson also has a knack for impact defensive plays, though his tendency to chase them makes him a shaky defender in the post (he gives up position too readily to chase after entry passes) and an easy sell on pump fakes. When harnessed correctly, though, Andersen's energy is a huge asset, though it's unquestionably more difficult to sustain over longer stretches of playing time relative to the short bursts he played for the Heat.
Brand shouldn't be playing starter's minutes due to his age and diminished offense, but stands as one of the most accomplished defenders on the market and could be had at a fairly reasonable price. Brand couldn't make up for all that went wrong with Dallas' perimeter defense last season, but still made the Mavs noticeably better as a back-line defensive team whenever he was on the court.


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Product Description
The EnerSys NP24-12 is a 12V, 24Ah, maintenance free rechargeable sealed lead acid battery ideal for stand-by power applications. This battery can be mounted on its side with no performance loss. This product is a part of the Genesis range by EnerSys.
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The 193 guest rooms and suites at our Westford, MA hotel will be of utmost comfort during your stay. Rise and shine with our hearty and healthy full breakfast buffet and relax in our beds that will provide a peaceful night's rest. We have handicapped accessible rooms, as well as several rooms that are pet-friendly.
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NetWellness is a global, community service providing quality, unbiased health information from our partner university faculty. NetWellness is commercial-free and does not accept advertising.
Tuesday, September 19, 2017
Alzheimer's Disease
Finding Assistance for Mild Dementia
My 72 year old father was recently diagnosed by a neurologist as having mild dementia and was told to come back in 6 months to see how he his doing. My question is, when does he start taking any medication? When I talk to him, it certainly seems much more than "mild." I`m very concerned and am trying to get a second opinion. Some simple tasks were given to him that he could not complete, i.e. draw a clock (he had to keep looking at his watch as reference) and have it read a certain time - could not complete this task and became extremely agitated. There are so many other signs that are typical of much more than "mild", he is also extremely belligerent and I know that my mother is afraid of him. Getting him to go for a second opinion is going to be a battle. Please advise. Thank you for your time
Dementia is an umbrella term used to indicate a change in memory and thinking, behavior, and day to day functioning. It can be caused by a number of different medical conditions and neurological disorders. Alzheimer's disease is one form of dementia. It is important for every patient with mild dementia to have a thorough evaluation to look for signs of reversible dementia (hypothyroidism, b12 deficiency, depression, medications, systemic illness, etc). If all reversible, or other causes of dementia are ruled out, a person can be diagnosed with Alzheimer's disease. If the diagnosis of Alzheimer's disease is made, the appropriate medications should be started. We cannot be sure what your father's diagnosis is based on email communication alone. There are cases where a doctor is not sure of a diagnosis and will give it time, such as 6 months, to see how he does before starting medication. However, it appears that you have many concerns. Even though it may be a challenge to get your father to a doctor for a second opinion, we suggest that you have him see another doctor with more interest and experience in these problems. It is essential for both you and your father to see a doctor who you are comfortable with and is able to address all of your concerns and questions. There are also medications available to treat the behavior and personality changes that accompany dementia, such as belligerence.
Robert P Friedland, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University
Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University


text: With over 92 years of experience creating designer eyewear, we've learned that a work's truest beauty is in the layers of work that most will never see. The A Work of Persol project celebrates this dedication to the artistic process by joining the works of seventeen artists of varying fine art disciplines from around the world. Together, their artwork will become part of a moving Persol gallery. Seventeen original works of art. An entire line of eyewear. All A Work of Persol.


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Scientific Name: Order Phasmida
Description: Stick insects, or walking sticks, are a group of highly camouflaged insects. They escape predation by blending into plant material. As their name implies, they look just like sticks with legs, and even sway back and forth to more closely resemble a twig moving in the wind. When camouflage isn't enough, some species have evolved the ability to release foul-smelling chemicals to deter predators, and others can secrete a liquid that temporarily blinds their foe. Others drop their legs when a predator attacks but can re-grow the appendages. Some species are winged and flash bright color patches under the wings to confuse predators.
Size: Depending on the species, stick insects can grow from 1 to 12 inches long, with males usually bigger than the females. The biggest insects in the world are stick insects—one species measures over 20 inches long with its legs outstretched.
Diet: Stick insects are herbivores that eat leaves.
Typical Lifespan: They reach maturity between three months and one year and usually live up to two years.
Habitat: Stick insects live in woodlands and tropical forests.
Range: Found on every continent except Antarctica, mostly in temperate and tropical regions.
Life History and Reproduction: Stick insects are a favorite food of many animals, but perhaps their most effective predators are bats. Most bats hunt by echolocation rather than sight, so they aren't fooled by the insect's stick-like appearance. Stick insects are one of many species that can reproduce parthenogenetically, meaning that the females can produce unfertilized eggs that hatch and grow into new females. Females lay eggs that are seed-like in appearance, and they have numerous egg-laying mechanisms to keep predators away. Some lay eggs in places that are hidden or hard to get to. Others drop eggs one by one on the ground so that they're not all in one place for a predator to find. Newly hatched stick insects reach adult size once they've undergone several molts, whereby they shed their old exoskeleton.
Fun Fact: Stick insects are found in the same group as leaf insects, which also display fantastic camouflage.
Conservation Status: There are over 3,000 species of stick insect, many of which are susceptible to habitat destruction, pesticide use, and collection for the pet trade.
San Diego Zoo Animal Bytes
National Geographic Society


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City budgets have always been a challenge, and the current fiscal crisis with the state budget that depletes standard revenue sources has made municipal budgeting even more difficult for cities in California. Like all organizations in a recessive economy, cities are being asked to do more with fewer resources, while they are forced to stay current on emerging trends and use current technologies to give the public what it wants.
One of the advantages of new technologies is that they can increase the efficiency and speed of information to your selected audience. Yet, the challenge to the effective deployment of any new information and communication technology is that you have to invest resources into learning how they work most efficiently, establish systems to implement them, then acquire and maintain the equipment and services that make them work, and commit the staff resources to carve out the time to actually do the work.
So you can imagine the challenge of deploying a social media strategy for any organization, especially one like a small municipal government that must operate with transparency and exists in a sea of scrutiny and competing priorities. But despite the challenge, cities in the Glendale/Pasadena region have embraced social media as a new way of reaching their constituencies with contemporary style.
Pasadena was one of the first are cities that fully embraced social media. That city's Public Information Officer, Ann Erdman (recently retired and now a lady of leisure) is an independent blogger and an accomplished writer with a lot of technological savvy. With her personal skill set, she was able to start deploying a popular Twitter account and Facebook posting strategy, after having earlier mastered both a web site initiative and government television channel production effort. And she managed to integrate all these technologies into the rigors of a municipal system of approvals, authorizations, and sometimes heated politics. And she, like all PIOs, did this amid all the other established responsibilities of informing a demanding public through newsletters, annual reports, press releases, speeches and personal appearances to handle routine and emergency notices all while negotiating media relationships for commercial newspapers, magazines, and television and radio outlets; and all this amidst the demands of bureaucratic bosses and sometimes egotistical politicians. Makes you wonder who would want such a career, doesn't it?
But, many people want to operate as these techno-public servants, and find the combination of high stress and pressure coupled with social responsibility to be extremely fulfilling. But few have all the skills necessary to roll out the wide range of emerging communications technologies on a daily basis. In Pasadena, for example, the new PIO hasn't yet been able to fulfill the social media strategy component that had been established. But, let me suggest that we just give it time. The public is demanding to gets its information through these new social media strategies – there are even initiatives to deploy texting, instant messaging, and internet systems for 911 and other emergency communications systems. Social media is becoming the norm, not the exception.
The challenge for cities is how to integrate all the new and different technologies into an integrated media strategy. Simply consider the different rules of some of the new social media technologies: Twitter messages are capped at 140 characters, Facebook and Google+ postings can be longer, but the public isn't inclined to read long postings. Compare those messages to the content of a news release that can be hundreds of words long. It is the PIO who must figure out what gets cut, and how to craft the message to the various media being deployed…because the kernal of the message must be consistent across all media.
Other cities in our region are jumping on the social media bandwagon too. Late last year, the City of Burbank launched both Twitter and Facebook services. And they rolled out a system for the public to stay informed with "e-notify me" to get automatic notices of important pieces of city information sent directly to email inboxes.
Other cities that actively use Twitter and Facebook include Glendale, Monrovia and Arcadia. In fact, it is hard to find a city in this region that does not have a social media presence. And in addition to the official social media presence operated by the city administration, elected officials are also getting in on the action.
Many mayors and council members have their own personal Twitter and Facebook accounts that are sometimes operated as part of their civic responsibilities, and sometimes as personal outlets. These are important additions to the political landscape, adding a different dimension to the local political scene.
It is certain that the pressure to deliver information to the public will require that cities deliver information on all the popular media, and as with all things technological, these modes are going to evolve along with the skills necessary to make them work. Figuring out how to prioritize the time it takes to craft messages for all these different media in a time-sensitive environment may be the greatest challenge of all for our area PIOs. Give them a lot of support by "liking" their Facebook pages, and following them on Twitter… you'll be impressed with all the information you can get.


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Shows & ticketsBoutiqueGift Card Group Events
Ultimately, Mystère is a tribute to the artistry of the human body – graceful, athletic, capable of performing feats that challenge our vision of the real world.Las Vegas Sun
Powerful athleticism, high-energy acrobatics and inspiring imagery fill the air. Deemed a theatrical "flower in the desert," Mystère thrills audiences with an exhilarating blend of whimsy, drama and the unimaginable. It offers the ultimate discovery that life itself is a mystery. Exclusive to Treasure Island.
DisclaimerDue to the nature of the acts in the show, changes in the cast may occur. In addition, the content and duration of the show may differ from time to time. Although we try to keep this information up to date, we cannot guarantee its accuracy.


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Secrets Of Sri Lanka DSL
Visiting: Sri Lanka
Trip Duration 14 Days
Sri Lanka Adventure Holiday
Staying in stylish and comfortable hotels, we travel to some of Sri Lanka's greatest sights: from ancient Buddhist monuments to tea plantations and historic cities. We visit the Temple of the Tooth in the central city of Kandy, search for elephants and leopard in Willpaththu National Park and relax by the idyllic Indian Ocean coast.
Tour Highlights
- Dambulla - Explore the painted caves of this temple complex
- Willpaththu - Look out for leopard, elephants and birdlife on a jeep safari
- Polonnaruwa - Visit the Royal Palace and dramatic sculptures of this ancient city
- Sigiriya - Climb to the top of Lion Rock, stopping to see the painted maidens half way up
- Kandy - Visit the Temple of the Tooth
- Galle - Soak up the atmosphere in the historic fort
- Beruwala- Time for relaxation on the beautiful coastline
Itineraries on some departure dates may differ, please select.
1Join tour in Negombo
2Travel to our campsite at Willpaththu National Park
3Take two game drives in search of leopards
4Visit a giant Buddha and the cave temples at Dambulla
5Climb Lion Rock and explore ancient Polonnaruwa
6Drive to Kandy and visit the Temple of the Tooth
7Spend a free day exploring the relaxed town of Kandy
8Visit a tea factory en route to Nuwara Eliya
9Take a walk on Horton Plains or relax in Nuwara Eliya
10Drive to Galle and take a walking tour of the fort
11A free morning in Galle before driving to Beruwala
12Relax on the pristine beaches of Beruwala
13Free time to visit Colombo or take a river safari
14Tour ends at Colombo Airport
Trip notes
Each departure date has its own dedicated trip note, detailing all you need to know about that trip. Whether you've already booked, or weighing up your options, please choose carefully the relevant itinerary for you.
We have the following different versions of the Secrets Of Sri Lanka trip available at present.
Please select a date:
Why Book this trip
This trip is offers the chance to see elephants in the wild, climb to Lion Rock's ancient fortress and relax on quiet beaches while staying in premium accommodation. The trip focusses on some of the best highlights of Sri Lanka and is ideal for travellers interested in history, culture and wildlife. There is plenty of sightseeing as well as free time for you to experience this increasingly popular destination or to simply relax.
|Included meals
Transport4WD, Bus
Accommodation11 nights Premium Hotel
2 nights Premium Camping


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Seven produce distributors have joined the Monterey, Calif,-based Pro*Act.
With these companies joining the group, the distributor network now boasts 49 companies and collectively operates 70 distribution centers nationwide, according to a news release.
The new distributors are:
- Chapman Produce, Tallahassee, Fla.
- Keith Chapman, owner, and Dan Bruijn, partner
- City Produce, Fort Walton, Fla.
- Tommy Sundy, owner
- Gulf Coast Produce, Biloxi, Miss.
- Mike and Christi Alise, owners
- Limehouse Produce Co., North Charleston, S.C.
- Jack and Andrea Limehouse, owners
- McCartney Produce, Paris, Tenn.
- Raymon Randolph, general manager
- Metropolitan Foods, Little Rock, Ark.
- Kevin and Gina Womack, owners
- Sunrise Fresh Produce, Jacksonville, Fla. and Jackson, Miss.
- Andrew Mercier, president
Max Yeater, Pro*Act president, said the addition of the seven family-owned businesses will enhance their coverage in the Southeast.
"We look forward to our partnership with these outstanding companies and to help them thrive with our industry-leading resources from purchasing and food safety, to sustainability and supply chain management that are Pro*Act trademarks," Yeater said in the release.


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Staff Report
Four children were removed from a home and two Milton residents were arrested on Weds. March 26, after troopers from the Kentucky State Police found a meth lab during the search of a home.
Troopers from KSP Post 5 went to the home at 543 School Hollow Road in Milton to assist social services with a child abuse complaint, according to Trooper Brad Arterburn, Post 5 spokesman. After receiving consent to search the residence, the troopers found several active meth labs throughout the property.
Lexington, KY–USDA Kentucky Farm Service Agency State Executive Director John W. McCauley encourages everyone to take a moment to appreciate the hard working farmers and ranchers in Kentucky on March 25, National Ag Day. This year's theme is "Agriculture: 365 Sunrises and 7 Billion Mouths to Feed."
USDA is proud to stand behind the producers who rise before dawn 365 days a year in order to put food on the table for 7 billion people.
Kentucky Farm Bureau joins the Agriculture Council of America and farming organizations across the country to celebrate National Agriculture Day on Tuesday, March 25. This day has been set aside annually since 1973 to highlight the many ways America's food system improves the quality of life for everyone.
FRANKFORT, Ky. – St. Patrick's Day is Monday, March 17, and the Kentucky Office of Highway Safety is reminding drivers not to get behind the wheel if they've been drinking.
The National Highway Traffic Safety Administration reports that since 2007, at least 270 people were senselessly killed nationwide in crashes involving drunken drivers during the St. Patrick's Day holiday. Those fatalities were preventable.
Louisville, Ky.– Volunteers will be out in force next week to spring clean Trimble County's highways. The Transportation Cabinet announces that Adopt-a-Highway Spring Clean Week is March 17-23.
"The Kentucky Transportation Cabinet appreciates the efforts of our Adopt-a-Highway volunteers who help keep our highways and communities beautiful and litter free," Transportation Secretary Mike Hancock said.
A Trimble County man was arrested Sunday night, March 9, after Troopers found a meth lab in his home, said Trooper Brad Arterburn spokesman for the Kentucky State Police.
A tip led Troopers with Kentucky State Police Post 5 to the home of 27-year-old Nicholas Hanson, who lives at 9 Cassell Lane in Bedford. Troopers were able to locate an active lab as well as ingredients used to manufacture methamphetamine. Troopers also found approximately two grams of finished product.
The members of Trimble County Fiscal Court voted Monday to approve a maintenance contract with Kone Incorporated for the courthouse elevator. The county had been paying $301.17 each quarter for maintenance. The county agreed to a maintenance upgrade at a cost of $355.92 per quarter with additional coverage provided by the maintenance contractor.
"With the years that it's been there it would probably be wise to move up to that," Trimble County Judge-Executive Jerry Powell said, "because it's not cheap when they come."
By TODD POLLOCK
Special to The Trimble Banner
There is an open seat on the Milton City Commission following the resignation of former Commissioner Tom Mahoney.
The Bedford City Commission voted Monday, Feb. 17, to start sending a sewer bill to the Bedford Fire Department.
Commissioner Darrell Harmon had reported during the government body's January meeting that the department does not pay for sewer or garbage. Harmon said the Kentucky Public Service Commission advised the city several years ago that everyone, including the Morgan Community Center, should be charged for sewer service.
Copyright © 2017
The Trimble Banner is your source for local news, sports, events, and information in Trimble County, KY and the surrounding area.


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Toyota set a standard for hybrid drivetrains of hitching a low-displacement engine using Atkinson cycle valve timing to an electric drive motor through a virtual continuously variable transmission. Ford's hybrids use similar technology. However, for its first hybrid sedan, Volkswagen threw that formula out the window.
The 2013 Jetta Hybrid goes with Volkswagen's strengths, relying on direct injection, a turbocharger, and a dual-clutch gearbox for the internal combustion part of its hybrid drivetrain. With only 1.4 liters of displacement for its four-cylinder engine, this drivetrain looks like a miniature version of those found in Volkswagen's performance vehicles.
On the electric side, Volkswagen adds in a 20-kilowatt electric motor and 1.1 kilowatt-hour lithium ion battery pack, capable of driving the car under electric power. With regenerative braking and idle-stop, the Jetta Hybrid rates at 42 mpg city and 48 mpg highway, or a combined 45 mpg, according to EPA testing.
By itself, the engine's 150 horsepower and 184 pound-feet of torque should drive the compact Jetta adequately. But the electric drive system helps considerably with fuel economy, especially in city driving conditions. The combined system output rates at 170 horsepower.
Only minor cues distinguish the Jetta Hybrid from its internal combustion-only counterparts. A blue-tinted badge sits on the hood, while hybrid logos adorn the fenders. An aerodynamic treatment modifies the front intake, wheel skirts, and rear spoiler to take the coefficient of drag from 0.3 to 0.28.
The cabin also mirrors that of other Jettas in most respects, such as the heated leather seats, Fender audio system, and basic navigation of CNET's top-trim SEL Premium model. However, Volkswagen trades in the tachometer for a power gauge and adds a button labeled "E-mode." The trunk loses some space to the battery pack, which rides over the rear axle.
Running silent
With the battery reasonably charged, the Jetta Hybrid started quietly, lighting up its gauges and center LCD while leaving the engine alone. The shifter for the seven-speed dual-clutch transmission includes, along with Drive, sport and manual shift positions, neither of which were really much use.
Rolling out, the Jetta Hybrid responded readily to its accelerator, and the electric power steering turned easily, with very little resistance. The engine came on with a noticeable rough-sounding grind whenever I hit the accelerator hard enough to need it. Otherwise I was able to cruise in stealth mode, using up the juice in the battery and replenishing it through judicious braking. The power meter's needle pointed in a green zone to indicate charging or in blue to suggest I might be burning a little gasoline.
One thing I quickly noticed was the car's willingness to coast. When I took my feet off the pedals, it was happy to roll on for an unexpected distance. Volkswagen designed the Jetta Hybrid to decouple its engine when coasting, what the Germans call sailing, to save fuel. Under these circumstances, the power meter showed it was still recharging the battery, albeit not as much as when I applied some brake pressure.
I missed any direct indication that I was driving under electric power in the Jetta Hybrid's instrumentation. Where the Ford C-Max Hybrid showed a green EV icon when electrically propelled, this car offered nothing equivalent. The only indication was through watching the power flow animation on either the instrument cluster or the main LCD, which takes a little mental interpretation and so wasn't as safe as merely glancing down at an indicator light.
In E-mode, the car allows much greater acceleration under electric power than it does normally, while draining the battery pack much more quickly. I played with this mode in San Francisco, but found the engine had to step in when climbing an urban hill. The power flow animation showed the engine driving the front wheels, although the E-mode indicator remained on.
Most of my driving in this car involved a run from Los Angeles to San Francisco, so quite a bit of freeway driving at speeds of 70 mph. In Los Angeles traffic, the Jetta Hybrid showed its worth, seamlessly turning the engine on and off, and shifting through the transmission's seven gears very smoothly. In the stop-and-go, I noticed the trip meter averaging close to 45 mpg.
The freeway ride proved very comfortable, the Jetta Hybrid soaking up the bumps easily. Volkswagen replaced the torsion beam rear suspension of the standard Jetta with a multilink configuration for the hybrid version, making it better able to handle the load shifts associated with the extra weight of the battery pack. However, the suspension felt tuned mostly for comfort, as it leaned readily in turns.
That turn behavior convinced me the transmission's sport mode was out of place in the Jetta Hybrid. Its hybrid drivetrain let me quickly hit freeway speeds while barreling down the on-ramps, but the light steering and tendency to lean suggested this car was really meant as a suburban runabout. Volkswagen makes the Jetta GLI if you want to exercise your inner race car driver.


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|The length of your spinnaker pole is determined by the yachts "J" measurement. This is roughly the straight line distance from the front of the mast at deck level to the headstay. The "J" measurement is available from your sailplan
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text: Dear APUG Members, My name is Francesco Schiavone (www.francescoschiavone.it). I am an Italian assistant professor in Management. I do research on reactions to technological change by old products' users. To this end, I would perform an interview (by email) to 4-5 key members of the APUG community about analogue cameras and the role of film scanners to make them alive. Would anyone of you reply to a short open questionnaire? If so, please send me an email to firstname.lastname@example.com and I will send you back the questionnaire. Another option is to dowload it (attached to this message) and send it back to me to my email address. Thanks for the kind attention and collaboration! PS: Sean Ross supports and is ok with my project! Best Regards Francesco


text: Posted February 2, 2013 · Report post Has anyone here looked into research about small intestinal bacterial overgrowth and it's affect on acne? I'd be really interested to hear any information. I used to be able to control my acne if I eliminated all sources of corn and wheat. I have been eating TONS of probiotic yogurt the past 6 months trying to solve gut issues which could relate to my skin. What I noticed is that once every few months I will break out with a million little whiteheads all over my forehead. These whiteheads are not related to what I eat other than they get worse with the more sugar/starch I consume. The only way I can get them to stop coming is to load up on oil of oregano and coconut oil - both of which are anti-bacterial and anti-fungal. Since stopping consuming yogurt the whiteheads will also stop coming. When I took probiotic supplements I broke out in little white heads as well, mostly on my forehead. I'm starting to believe chinese medicine "facial mapping" isn't just bogus information, as the forehead is related to the small intestine. I believe these whiteheads are related to small intestinal bacterial overgrowth. By consuming too many probiotics and having low stomach acid the bacteria are free to overgrow my small intestine resulting in the acne. I had a friend who primarily broke out on her forehead, I told her to consume apple cider vinegar and not eat any sweet food and she cleared up perfectly from moderate acne. Apple cider vinegar is also an anti-bacterial/anti-fungal and would also stimulate stomach acid production to cure the SIBO. Anyone with acne primarily on their forehead care to also experiment? Stop consuming probiotic foods or supplements and start with natural antibacterials. See what happens. I'm really curious. What I've also noticed is that cysts are mainly caused by an actual allergy, like citrus, coffee or dairy. Cysts on the chin are usually hormonally based for most people. Small whiteheads are usually caused by a food intolerance or related to bacterial/fungal issues. Acne in between the eyes is related to the liver - if my boyfriend drinks too much he always breaks out there and I've noticed it with several other people as well. Dark circles under the eyes are usually related to the adrenals and kidneys or a symptom of a gluten intolerance too. I am really starting to believe that different areas of your face are related to different organs of the body. Let me know your experiences as well! I'm sure some of you will think I'm crazy but I've been piecing things together for myself and people I know and if this information could help just one person I would be very happy. Also, mistakes I've made on the hollistic route that may help others: Fish oil - caused giant cysts and I'm not prone to cysts Spirullina/Seaweed/Iodine rich foods - also caused giant cysts because they detox bromine Probiotics - caused millions of whiteheads all over my face primarily on my forehead Vitamin supplements - being allergic to corn (which is in most pills) made my acne worse Whey protien - caused acne Flax seeds - are too estrogenic and will cause hormone fluctuations resulting in cystic acne on the chin Topical yogurt - completely broke me out all over my face These are just my individual experiences and are not true for everyone at all - we are all individual with different chemistry. But if you notice these things doing/or did the same to you also let me know. I like compiling research. Love and accept yourself for exactly who you are right now. 25, female, moderate acne since age 12. Accutane at least 6 times. Intolerances: corn & wheat & alcohol. 100% clear, if I follow the diet."the absence of flaw within beauty, is itself a flaw." Share this post Link to post Share on other sites