text:
Creature (25)
Instant (10)
Sorcery (4)
Land (21)
Comments View Archive
October 1, 2012 3:34 p.m.
also, 34 Flames of the Firebrand ? seems a bit excessivealso a bit illegal
October 1, 2012 3:35 p.m.
Khughes496 says... #3
More or less trying to make this a deck I can actually afford :/
When I get the money for Bonfire of the Damned I will have it.
October 1, 2012 3:35 p.m.
Khughes496 says... #4
look again.... it was a typo that was up for maybe 5 seconds...
October 1, 2012 3:36 p.m.
slowtyper77 says... #5
Like the changes! And yeah if a deck can support it Bonfire of the Damned is always good, but obviously it is not the greatest option for those low on money.
October 1, 2012 4:49 p.m.
Khughes496 says... #6
Thank ya :]Yeh. I'm waiting for holiday gift money for maybe 1 or 2 :P
October 1, 2012 8:24 p.m.
squidinspace says... #7
Vexing Devil ? In a RDW no matter what your opponent chooses it should work out for you.
October 4, 2012 3:17 a.m.
Khughes496 says... #8
Yeahh... been kinda thinking Stromkirk Noble s don't fit much.
October 4, 2012 3:21 a.m.
Mizzium Mortars good substitute for Flames of the Firebrand i think other than that a decent cheap deck has some potential.... Faithless lootings would be a nice addition also with the decks i have seen you need a good way to really deal with trostani resto thragtusk combonations bc you have no current manor upon which to truly stop that life gain
October 10, 2012 2:45 a.m.
shinobigarth says... #10
with that many instant and sorcs you really need Guttersnipe on the starting lineup. put Flames of the Firebrand on the bench. put 4 Gutters out there so they can snipe fools! its tacking on an extra 2 damage every time you punch your opponent or one of his guys in the jaw.
also moar Mizzium Mortars
October 14, 2012 3:40 a.m.
Alvn_isnt_Low says... #11
It'd make a great 4-Drop and also fits the "haste" theme... And who doesn't love stealing a creature for a turn.
October 14, 2012 4:10 a.m.
Khughes496 says... #12
Mizzium Mortars is expensive D; Only reason I have Bonfire of the Damned is cuz I managed to trade for 2 of them. I'll try to get some. This is my deck currently. Not a fan of Traitorous Instinct because getting an actual good creature to steal is really circumstantial :/
I will try Guttersnipe out again. Maybe it'll be better with a trade for Flames of the Firebrand
October 14, 2012 4:21 a.m.
thebeardedshuffler says... #13
How about replacing Thunderous Wrath with Burn at the Stake ? It breaks control, ruins enchantment decks, and is a great "win out of nowhere" card. I dislike wrath because if you don't wanna play it when you draw it, or you start with it in hand, it's useless to you until 6 mana. Yes you can pitch it with filter cards but look at it this way: you only need to filter when you have bad cards in hand, so why play bad cards?
October 14, 2012 2:10 p.m.
Alvn_isnt_Low says... #14
With Traitorous Instinct you dont need to steal an "actual good creature"... it doesnt need to be a great creature. whatever creature you take it gets buffed and its also one less blocker... and if you can, its in your best interest to kill the creature so that your opponent doesnt get it back.
But to each their own... just my suggestion.
October 14, 2012 6:43 p.m.
Khughes496 says... #15
I also don't like the card.... And I MIGHT consider Burn at the Stake over Thundermaw and maybe to replace Thunderous Wrath but idk. Never been a huge fan of it. I'll test it.
October 15, 2012 2:05 a.m.
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Local Companies Set For Growth
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"Its a brand new facility and soon we will have a grand opening."said Fotiates
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subset: commoncrawl


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IT question(1 question)
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This is project direction is here 1.docx . Must read it. This is my base scenario 2.docx
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Insulin resistance contributes to the pathophysiology of diabetes and is a hallmark of obesity, metabolic syndrome, and many cardiovascular diseases. Therefore, quantifying insulin sensitivity/resistance in humans and animal models is of great importance for epidemiological studies, clinical and basic science investigations, and eventual use in clinical practice. Direct and indirect methods of varying complexity are currently employed for these purposes. Some methods rely on steady-state analysis of glucose and insulin, whereas others rely on dynamic testing. Each of these methods has distinct advantages and limitations. Thus, optimal choice and employment of a specific method depends on the nature of the studies being performed. Established direct methods for measuring insulin sensitivity in vivo are relatively complex. The hyperinsulinemic euglycemic glucose clamp and the insulin suppression test directly assess insulin-mediated glucose utilization under steady-state conditions that are both labor and time intensive. A slightly less complex indirect method relies on minimal model analysis of a frequently sampled intravenous glucose tolerance test. Finally, simple surrogate indexes for insulin sensitivity/resistance are available (e.g., QUICKI, HOMA, 1/insulin, Matusda index) that are derived from blood insulin and glucose concentrations under fasting conditions (steady state) or after an oral glucose load (dynamic). In particular, the quantitative insulin sensitivity check index (QUICKI) has been validated extensively against the reference standard glucose clamp method. QUICKI is a simple, robust, accurate, reproducible method that appropriately predicts changes in insulin sensitivity after therapeutic interventions as well as the onset of diabetes. In this Frontiers article, we highlight merits, limitations, and appropriate use of current in vivo measures of insulin sensitivity/resistance.
- glucose clamp
- quantitative insulin sensitivity check index
- minimal model
- homeostatis model assessment
insulin is an essential peptide hormone whose metabolic actions maintain whole body glucose homeostasis and promote efficient glucose utilization (3). Insulin stimulates increased glucose disposal in skeletal muscle and adipose tissue, whereas it inhibits gluconeogenesis in liver to help regulate glucose homeostasis. In addition to these classical insulin target tissues, there are many other important physiological targets of insulin, including the brain, pancreatic β-cells, heart, and vascular endothelium, that help to coordinate and couple metabolic and cardiovascular homeostasis under healthy conditions (3, 54, 72, 79). Insulin has concentration-dependent saturable actions to increase whole body glucose disposal. The maximal effect of insulin defines "insulin responsiveness," whereas the insulin concentration required for a half-maximal response defines "insulin sensitivity" (Fig. 1A).
Insulin resistance is typically defined as decreased sensitivity or responsiveness to metabolic actions of insulin, such as insulin-mediated glucose disposal and inhibition of hepatic glucose production (HGP). The concept of insulin resistance was proposed as early as 1936 (52) to describe diabetic patients requiring high doses of insulin. Insulin resistance plays a major pathophysiological role in type 2 diabetes and is tightly associated with major public health problems, including obesity, hypertension, coronary artery disease, dyslipidemias, and a cluster of metabolic and cardiovascular abnormalities that define the metabolic syndrome (32, 76, 86). A global epidemic of obesity is driving the increased incidence and prevalence of type 2 diabetes and its cardiovascular complications (77). Therefore, it is of great importance to develop tools for quantifying insulin sensitivity/resistance in humans and animal models that may be used to appropriately investigate the epidemiology, pathophysiological mechanisms, outcomes of therapeutic interventions, and clinical courses of patients with insulin resistance.
Hyperinsulinemic Euglycemic Glucose Clamp
Procedure and concept.
The glucose clamp technique, originally developed by DeFronzo et al. (33), is widely accepted as the reference standard for directly determining metabolic insulin sensitivity in humans. After an overnight fast, insulin is infused intravenously at a constant rate that may range from 5 to 120 mU·m−2·min−1 (dose per body surface area per minute). This constant insulin infusion results in a new steady-state insulin level that is above the fasting level (hyperinsulinemic). As a consequence, glucose disposal in skeletal muscle and adipose tissue is increased, whereas HGP is suppressed. Under these conditions, a bedside glucose analyzer is used to frequently monitor blood glucose levels at 5- to 10-min intervals while 20% dextrose is given intravenously at a variable rate to "clamp" blood glucose concentrations in the normal range (euglycemic). An infusion of potassium phosphate is also given to prevent hypokalemia resulting from hyperinsulinemia and increased glucose disposal. After several hours of constant insulin infusion, steady-state conditions can typically be achieved for plasma insulin, blood glucose, and the glucose infusion rate (GIR). Assuming that the hyperinsulinemic state is sufficient to completely suppress HGP, and since there is no net change in blood glucose concentrations under steady-state clamp conditions, the GIR must be equal to the glucose disposal rate (M). Thus, whole body glucose disposal at a given level of hyperinsulinemia can be determined directly. M is typically normalized to body weight or fat-free mass to generate an estimate of insulin sensitivity. Alternatively, an insulin sensitivity index (SI) derived from clamp data can be defined as SIClamp = M/(G × ΔI), where M is normalized for G (steady-state blood glucose concentration) and ΔI (difference between fasting and steady-state plasma insulin concentrations) (56).
Assumptions and considerations.
The validity of glucose clamp measurements of insulin sensitivity depends on achieving steady-state conditions. It is often assumed that data from an arbitrary time point at the end of the clamp study (e.g., 2 h) represent steady-state values. However, defining "steady state" as a period >30 min (⩾1 h after initiation of insulin infusion), during which the coefficient of variation for blood glucose, plasma insulin, and GIR is <5%, is a more rigorous approach that may determine more accurate values for M and SIClamp (22, 56).
Another important assumption of the glucose clamp method is that HGP is completely suppressed by steady-state hyperinsulinemia. For subjects with normal insulin sensitivity, this may be achieved with an insulin infusion rate in the range of 40–60 mU·m−2·min−1 (16, 87). However, there may be incomplete suppression of HGP at lower insulin infusion rates or in insulin-resistant populations. To address this issue, it is possible to use radiolabeled glucose tracers under clamp conditions to estimate HGP so that appropriate corrections can be made to M (38, 68, 85, 87). An alternative approach is to choose an insulin infusion rate that is sufficiently high to completely suppress HGP according to the insulin sensitivity/resistance of the population to be studied.
A critical consideration for interpretation of glucose clamp data is that M is routinely obtained at only a single insulin infusion rate. The choice of this rate determines a level of hyperinsulinemia that is roughly comparable among all subjects studied. Comparisons between M or SIClamp among different subjects is valid only if the same insulin infusion rate is used for all subjects. Importantly, the use of a single insulin infusion rate for comparisons of insulin sensitivity/resistance assumes that the steady-state insulin level achieved is in the range where M can vary according to differences in insulin sensitivity. If the insulin infusion rate is not appropriately matched to the insulin sensitivity/resistance of the population being studied, it is possible that erroneous conclusions may be drawn. For example, in an insulin-resistant population, a higher insulin infusion rate is required to avoid missing potential differences in insulin sensitivities among subjects (Fig. 1B, curve c). Similarly, for an insulin-sensitive population, a lower insulin infusion rate is more appropriate (Fig. 1B, curve a). To address these issues, the ideal approach is to generate a full insulin dose-response curve by performing the glucose clamp procedure at multiple insulin infusion rates in a stepwise fashion (16, 87). However, this is rarely done, since feasibility issues arising from this more complete approach are daunting even in sophisticated research settings.
When subjects are nondiabetic, their fasting glucose level is within the normal range. Some investigators will clamp blood glucose at fasting levels (isoglycemic), whereas others will clamp blood glucose at an arbitrary predetermined level of glycemia within the normal range (euglycemic). In the case of diabetic subjects, the difference between euglycemia and isoglycemia may be large. There are pros and cons to choosing either approach for diabetic subjects and nondiabetic subjects. The rationale for performing isoglycemic clamps in diabetic subjects is that large acute changes in glycemia may alter insulin sensitivity. For diabetic subjects under isoglycemic conditions, it may be necessary to correct M for urinary losses of glucose. In addition, even in nondiabetic subjects there is variability in fasting glucose levels. Thus, for isoglycemic clamps, SIClamp is more appropriate to use than M because SIClamp normalizes for differences in fasting glucose levels (as well as for differences between fasting and steady-state clamp insulin levels). With euglycemic clamps in nondiabetic subjects, either M or SIClamp is appropriate to use (although M does not correct for differences between fasting and steady-state clamp insulin levels).
Differences between arterial and venous blood glucose increase in proportion to insulin sensitivity and dose. Therefore, adjusting glucose infusion rates on the basis of venous sampling of glucose may lead to overestimation of insulin sensitivity. To minimize this issue, the hand used for blood sampling may be cannulated in retrograde fashion and warmed with a heating pad (opening arteriovenous anastomoses) to "arterialize" the venous blood (71).
Computer-based algorithms have been developed to help control the GIR in response to frequently measured blood glucose levels (33, 41). However, efficient regulation of GIR may be empirically achieved with an experienced, proficient operator.
Advantages and appropriate usage.
The main advantage of using the glucose clamp to estimate insulin sensitivity/resistance in humans is that it directly measures whole body glucose disposal at a given level of insulinemia under steady-state conditions. Conceptually, the approach is straightforward, and there are a limited number of assumptions that are clearly defined. In addition, the glucose clamp has excellent test characteristics. For example, M typically has a coefficient of variation of 0.10 and a discriminant ratio of ∼6 (a measurement of both reproducibility and the ability to distinguish individual results) (65). When radiolabeled glucose tracers are used under clamp conditions it is possible to simultaneously quantify HGP and whole body glucose disposal (18, 87). Under these conditions, one can study and distinguish hepatic and peripheral (predominantly skeletal muscle) insulin sensitivity/resistance. Similarly, radiolabeled tracers of glycerol or amino acids may be used during the glucose clamp to assess insulin sensitivity with respect to lipolysis or protein metabolism (42, 44). In addition, 31P magnetic resonance spectroscopy may be used in conjunction with the glucose clamp to assess rates of insulin-stimulated muscle mitochondrial ATP synthase flux and insulin-stimulated increases in concentrations of intramyocellular inorganic phosphate (75). Doppler and contrast ultrasound imaging have also been used in conjunction with the clamp to study insulin sensitivity with respect to vascular actions of insulin (24). In research settings where assessing insulin sensitivity/resistance is of primary interest and feasibility is not an issue (e.g., study population <100) it is appropriate and important to use the reference standard glucose clamp technique.
The main limitations of the glucose clamp approach are that it is time consuming, labor intensive, expensive, and requires an experienced operator to manage the technical difficulties. Thus, for epidemiological studies, large clinical investigations, or routine clinical applications (e.g., following changes in insulin resistance after therapeutic intervention in individual patients) the glucose clamp is not appropriate. In addition, if measuring insulin sensitivity/resistance is not a primary study outcome, then the cost/benefit ratio for the glucose clamp may not be favorable. Another limitation is that the clamp utilizes steady-state insulin levels that may be supraphysiological. This results in a reversal of the normal portal to peripheral insulin gradient. Thus, the glucose clamp may not accurately reflect insulin action and glucose dynamics under physiological conditions that a dynamic test such as an oral meal or oral glucose load may determine.
Insulin Suppression Test
Procedure and concept.
The insulin suppression test (IST), another method that directly measures metabolic insulin sensitivity/resistance, was introduced by Shen et. al. (90) in 1970 and subsequently modified by Harano et. al. (50). After an overnight fast, somatostatin (250 μg/h) or the somatostatin analog octreotide (25 μg bolus, followed by 0.5 μg/min) (74) is intravenously infused to suppress endogenous secretion of insulin and glucagon. Simultaneously, insulin (25 mU·m−2·min−1) and glucose (240 mg·m−2·min−1) are infused into the same antecubital vein for 3 h. From the contralateral arm, blood samples for glucose and insulin determinations are taken every 30 min for 2.5 h and then at 10-min intervals from 150 to 180 min of the IST. The constant infusions of insulin and glucose will determine steady-state plasma insulin (SSPI) and glucose (SSPG) concentrations. The steady-state period is assumed to be from 150 to 180 min after initiation of the IST. SSPI concentrations are generally similar among subjects. Therefore, the SSPG concentration will be higher in insulin-resistant subjects and lower in insulin-sensitive subjects; i.e., SSPG values are inversely related to insulin sensitivity. The IST provides a direct measure (SSPG) of the ability of exogenous insulin to mediate disposal of an intravenous glucose load under steady-state conditions where endogenous insulin secretion is suppressed.
Assumptions and considerations.
As with the glucose clamp, the validity of the IST depends on achieving steady-state conditions. However, this is not routinely verified. Moreover, it is assumed that combined effects of hyperinsulinemia, hyperglycemia, and hypoglucagonemia during the IST are sufficient to completely suppress HGP. It is also assumed that the somatostatin infusion is sufficient to completely suppress endogenous insulin and glucagon secretion. The same insulin infusion rate is universally applied in the IST. However, this rate may not be ideal for every population being studied. Thus, for the IST, issues regarding erroneous determinations of insulin sensitivity/resistance in populations with different degrees of insulin resistance are similar to those described above for the glucose clamp. Another consideration is that the insulin infusion rate universally applied in the IST does not result in the same SSPI for all subjects (due to differences in insulin clearance, volume of distribution, etc.). Since SSPG is not corrected for SSPI, this may introduce some error.
Advantages and appropriate usage.
The SSPG is a highly reproducible direct measurement of metabolic actions of insulin that is less labor intensive and less technically demanding than the glucose clamp. Indeed, since there are no variable infusions with the IST, steady-state conditions are more easily achieved with the IST than with the glucose clamp. Estimates of insulin sensitivity determined by SSPG correlate well with reference standard glucose clamp estimates in normal subjects (r = 0.93) and in patients with type 2 diabetes mellitus (r = 0.91) (43, 69). Indeed, SSPG has positive predictive power for cardiovascular disease events and onset of type 2 diabetes (36, 103). In research settings where assessing insulin sensitivity/resistance is of primary interest and feasibility is not an issue, it is appropriate to use the IST. Moreover, the IST can be used for larger populations that may pose difficulties for application of the glucose clamp (102).
Many of the limitations of the IST are similar to those described above for the glucose clamp (with the exception that the IST is less technically demanding). Thus, it is impractical to apply the IST in large epidemiological studies or in the clinical care setting. In exquisitely insulin-sensitive individuals, it is possible that subjects may become hypoglycemic during the IST. In individuals with type 2 diabetes, hyperglycemia may lead to glycosuria and underestimation of insulin resistance by SSPG. The infusion of somatostatin during the IST may independently modulate splanchnic blood flow and peripheral glucose clearance (12, 70, 99). This may potentially affect estimates of insulin resistance determined by SSPG. Finally, SSPG under ideal conditions determines primarily skeletal muscle insulin sensitivity and is not designed to reflect hepatic insulin sensitivity.
Minimal Model Analysis of Frequently Sampled Intravenous Glucose Tolerance Test
Procedure and concept.
The minimal model, developed by Bergman et al. (14) in 1979, provides an indirect measurement of metabolic insulin sensitivity/resistance on the basis of glucose and insulin data obtained during a frequently sampled intravenous glucose tolerance test (FSIVGTT). After an overnight fast, an intravenous bolus of glucose (0.3 g/kg body wt) is infused over 2 min starting at time 0. Currently, a modified FSIVGTT is used where exogenous insulin (4 mU·kg−1·min−1) is also infused over 5 min beginning 20 min after the intravenous glucose bolus (39, 81, 89). Some studies use tolbutamide instead of insulin in the modified FSIVGTT to stimulate endogenous insulin secretion at this time (9, 15, 89, 101). Blood samples are taken for plasma glucose and insulin measurements at −10, −1, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 14, 16, 20, 22, 23, 24, 25, 27, 30, 40, 50, 60, 70, 80, 90, 100, 120, 160, and 180 min. These data are then subjected to minimal model analysis using the computer program MINMOD to generate an index of insulin sensitivity (SI).
The minimal model is defined by two coupled differential equations with four model parameters (Fig. 2). The first equation describes plasma glucose dynamics in a single compartment. The second equation describes insulin dynamics in a "remote compartment." The structure of the minimal model allows MINMOD to uniquely identify model parameters that determine a best fit to glucose disappearance during the modified FSIVGTT. SI is calculated from two of these model parameters and is defined as fractional glucose disappearance per insulin concentration unit.
Assumptions and considerations.
Unlike the glucose clamp and IST, which depend on steady-state conditions, the minimal model approach uses dynamic data. Valid minimal model analysis of the modified FSIVGTT requires several important assumptions. First, instantaneous distribution of the glucose bolus in a monocompartmental space is assumed to occur. Second, glucose disappearance in response to glucose and/or insulin is assumed to occur at a monoexponential rate. Third, the glucose concentration at the end of the FSIVGTT is assumed to be identical to the beginning concentration. Fourth, insulin is assumed to act from a "remote compartment" (extravascular) to promote glucose disappearance. This "remote compartment" may represent an interstitial or extracellular space where insulin directly exerts its metabolic actions (11). Fifth, the mimimal model lumps together effects of insulin to promote glucose disposal in skeletal muscle and suppress HGP. Finally, to obtain a valid estimate of SI the minimal model assumes that total insulin secretion (endogenous plus exogenous) during the FSIVGTT is above a certain threshold (101).
In addition to SI, other minimal model parameters may be used to estimate a "glucose effectiveness" index (SG). SG is defined as the ability of glucose per se to promote its own disposal and inhibit HGP in the absence of an incremental insulin effect (i.e., when insulin is at basal levels). The minimal model was originally developed in dogs that have a delayed insulin secretory response to the FSIVGTT when compared with humans (14). By contrast, in humans, the peak insulin secretion induced by the FSIVGTT temporally overlaps with the period in which high glucose concentrations are the primary determinant of glucose disappearance. Therefore, to increase the accuracy of both SI and SG in humans, a modified FSIVGTT was developed where exogenous insulin (or tolbutamide) is given at a time where glucose levels have decreased to near-normal levels. This allows the minimal model to more effectively distinguish between glucose effectiveness and insulin sensitivity (15, 101). Finally, because the FSIVGTT is a dynamic test, information about β-cell function can also be derived from minimal model analysis (11, 13, 46).
Advantages and appropriate usage.
Minimal model analysis of the modified FSIVGTT is easier than the glucose clamp method because it is slightly less labor intensive, steady-state conditions are not required, and there are no intravenous infusions that require constant adjustment. Unlike the glucose clamp or IST, information about insulin sensitivity, glucose effectiveness, and β-cell function can be derived from a single dynamic test. The minimal model generates excellent predictions of glucose disappearance during the FSIVGTT. The coefficient of variation for SI is comparable to glucose clamp estimates of insulin sensitivity (37, 93). Reasonable correlations between estimates of insulin sensitivity derived from minimal model analysis and the reference glucose clamp method have been demonstrated in healthy subjects (correlations are weaker in insulin-resistant populations) (9, 15, 88). SI is a strong predictor of the development of diabetes in a prospective study of children of diabetic parents (64). Moreover, the insulin-modified FSIVGTT may be used in relatively large-scale population studies. This is evident from the Insulin Resistance Atherosclerosis Study (53), a large (n = 1,624), prospective epidemiological study examining associations between SI and atherosclerosis or other risk factors for cardiovascular disease. Therefore, in research settings where assessing insulin sensitivity along with glucose effectiveness and β-cell function is of interest, minimal model analysis of the insulin-modified FSIVGTT may be appropriate. However, as discussed below, caveats regarding limitations of the minimal model and the availability of simpler, more accurate methods for assessing insulin sensitivity should be noted.
The minimal model approach is simpler than direct methods for determining insulin sensitivity. Nevertheless, it still involves intravenous infusions with multiple blood sampling over a 3-h period that are nearly as labor intensive as the glucose clamp or IST. In addition, many limitations of minimal model analysis stem from the fact that the model oversimplifies the physiology of glucose homeostasis. For example, monocompartmental representation of glucose dynamics results in systematic overestimation of SG and simultaneous underestimation of SI (25, 26, 82). Indeed, two-compartment representation of glucose dynamics improves the results of minimal model analysis. Consequently, better estimates of SI and SG are obtained by using radiolabeled glucose during the FSIVGTT ("hot" FSIVGTT) that simultaneously incorporate a second compartment for glucose into the minimal model (6, 19, 20, 97). Alternatively, it is possible to use a Bayesian approach (using prior knowledge during model identification routines) with addition of a nonaccessible compartment to the original "cold" model (26).
Another oversimplification of the minimal model involves lumping together effects of insulin to promote peripheral glucose utilization and suppress HGP. As insulin sensitivity/resistance varies, the relative contribution of HGP to SI may vary significantly. Since the minimal model relies on a dynamic test to evaluate insulin sensitivity, estimates of SI are much less reliable in individuals with impaired insulin secretion and/or significant insulin resistance (when compared with healthy subjects). Under these conditions, the minimal model may overestimate SG to accurately predict the disappearance of glucose during the FSIVGTT. Indeed, estimates of SG are spuriously affected by differences in insulin secretory capacity (28, 40, 82). Moreover, for similar reasons, minimal model analysis often generates nonsensical negative values for SI in a substantial proportion of subjects with diabetes who have minimal insulin secretory capacity and significant insulin resistance (40, 56, 88). These nonsystematic errors inherent in the minimal model approach are highlighted by calibration model analysis demonstrating that some simple surrogate indexes of insulin sensitivity have better absolute accuracy for predicting SIClamp than the minimal model-derived SI (21).
Oral Glucose Tolerance Test/Meal Tolerance Test
The oral glucose tolerance test (OGTT) is a simple test widely used in clinical practice to diagnose glucose intolerance and type 2 diabetes (4). After overnight fast, blood samples for determinations of glucose and insulin concentrations are taken at 0, 30, 60, and 120 min following a standard oral glucose load (75 g) or a standard meal (4, 30). Oral glucose tolerance reflects the efficiency of the body to dispose of glucose after an oral glucose load or meal. The OGTT or meal tolerance test mimics the glucose and insulin dynamics of physiological conditions more closely than conditions of the glucose clamp, IST, or FSIVGTT. However, it is important to recognize that glucose tolerance and insulin sensitivity are not equivalent concepts. In addition to metabolic actions of insulin, insulin secretion, incretin effects, and other factors contribute importantly to glucose tolerance. Thus, the OGTT and meal tolerance tests provide useful information about glucose tolerance but not insulin sensitivity/resistance per se. Nevertheless, as discussed in the next section, a number of surrogate indexes of insulin sensitivity/resistance incorporate the results of the OGTT or meal tolerance test.
Surrogates Derived from Fasting Steady-State Conditions
Procedure and concept.
After an overnight fast, a single blood sample is taken for determination of blood glucose and plasma insulin. In healthy humans, the fasting condition represents a basal steady state where glucose is homeostatically maintained in the normal range such that insulin levels are not significantly changing and HGP is constant; i.e, basal insulin secretion by pancreatic β-cells determines a relatively constant level of insulinemia that will be lower or higher in accordance with insulin sensitivity/resistance such that HGP matches whole body glucose disposal under fasting conditions.
Assumptions and considerations.
A critical condition and assumption of simple surrogate indexes is that subjects are strictly fasting and in a basal steady-state condition with respect to glycemia, insulinemia, and HGP. Surrogate indexes based on fasting glucose and insulin concentrations reflect primarily hepatic insulin sensitivity/resistance. However, under most conditions, hepatic and skeletal muscle insulin sensitivity/resistance are proportional to each other. In the diabetic state with fasting hyperglycemia, fasting insulin levels are inappropriately low and insufficient to maintain euglycemia. Therefore, definitions of the more useful surrogate indexes take these considerations into account. Due to lack of a standardized insulin assay, it is not possible to use surrogate indexes to define universal cutoff points for insulin resistance.
General advantages and appropriate usage.
Simple surrogate indexes of insulin sensitivity/resistance are inexpensive quantitative tools that can be easily applied in almost every setting, including epidemiological studies, large clinical trials, clinical research investigations, and clinical practice. If a direct measurement of insulin sensitivity is not required, not feasible to obtain, or if insulin sensitivity is of secondary interest, it may be appropriate to use a surrogate index. The relative merits and limitations of individual surrogate indexes are discussed below.
1/(Fasting insulin).
In healthy subjects, elevations in fasting insulin levels (with normal fasting glucose levels) correspond to increased insulin resistance. Indeed, in nondiabetic subjects, 1/(fasting insulin) is a well-known proxy for insulin sensitivity that decreases as subjects become more insulin resistant (and fasting insulin levels rise) (59). However, insulin concentrations are not normally distributed. Thus, linear correlations between 1/(fasting insulin) and estimates of insulin sensitivity from the glucose clamp are not that strong. In addition, this index does not take into account the inappropriately low insulin secretion in the face of hyperglycemia seen in diabetic subjects or glucose-intolerant subjects. Consequently, using 1/(fasting insulin) as a measurement of insulin sensitivity/resistance in patients with glucose intolerance or type 2 diabetes who have diminished pancreatic reserve leads to erroneous results.
Glucose/insulin ratio.
A number of studies (60, 91, 98) have used the fasting glucose/insulin ratio (G/I ratio) as an index of insulin resistance (particularly in patients with polycystic ovarian syndrome). In the case of nondiabetic subjects, the G/I ratio is essentially functionally equivalent to 1/(fasting insulin) since fasting glucose levels are all in the normal range. However, the G/I ratio does not appropriately reflect the physiology underlying the determinants of insulin sensitivity (80). For example, given the same level of relative fasting hyperinsulinemia in a diabetic and a nondiabetic insulin-resistant subject, 1/(fasting insulin) remains unchanged. However, under these same conditions, the G/I ratio paradoxically and erroneously increases in the diabetic subject. Therefore, the fasting G/I ratio is a conceptually flawed index of insulin sensitivity.
Homeostasis model assessment.
Homeostasis model assessment (HOMA), developed in 1985 (67), is a model of interactions between glucose and insulin dynamics that is then used to predict fasting steady-state glucose and insulin concentrations for a wide range of possible combinations of insulin resistance and β-cell function. Both the original HOMA and the updated HOMA2 assume a feedback loop between the liver and β-cell (61, 67, 100); i.e., glucose concentrations are regulated by insulin-dependent HGP, whereas insulin levels depend on the pancreatic β-cell response to glucose concentrations. Thus, deficient β-cell function reflects a diminished response of β-cell to glucose-stimulated insulin secretion. Likewise, insulin resistance is reflected by diminished suppressive effect of insulin on HGP. HOMA describes this glucose-insulin homeostasis by a set of empirically derived nonlinear equations. The model predicts fasting steady-state levels of plasma glucose and insulin for any given combination of pancreatic β-cell function and insulin sensitivity. Computer simulations have been used to generate a normogram from which mathematical transformations of fasting glucose and insulin data from individual subjects determine unique combinations of SI (HOMA%S) and β-cell function (HOMA%B) from steady-state conditions. The updated HOMA2 accommodates assessment of HOMA%S and HOMA%B in subjects with glucose levels ≤25 mM, accounts for renal glucose losses, assumes reduced suppression of HGP and increased insulin secretion in response to glucose levels >10 mM, and allows for the use of total or specific insulin assays. An important caveat for HOMA%B (determined from fasting glucose and insulin concentrations) is that it imputes a dynamic β-cell function (i.e., glucose-stimulated insulin secretion) from fasting steady-state data. In the absence of dynamic data, it is difficult, if not impossible, to determine the true dynamic function of β-cell insulin secretion. In practical terms, most studies using HOMA employ an approximation described by a simple equation to determine a surrogate index of insulin resistance. This is defined by the product of the fasting glucose and fasting insulin divided by a constant. Thus, homeostasis model of insulin resistance (HOMA-IR) = {[fasting insulin (μU/ml)] × [fasting glucose (mmol/l)]}/22.5. The denominator of 22.5 is a normalizing factor; i.e, the product of normal fasting plasma insulin of 5 μU/ml and normal fasting plasma glucose of 4.5 mmol/l typical of a "normal" healthy individual = 22.5. Therefore, for an individual with "normal" insulin sensitivity, HOMA-IR = 1. HOMA-IR has a reasonable linear correlation with glucose clamp and minimal model estimates of insulin sensitivity/resistance in several studies of distinct populations (84, 100). The coefficient of variation for HOMA-IR varies considerably depending upon the number of fasting samples obtained and the type of insulin assay used (17, 35, 67, 100). It is important to note that, over wide ranges of insulin sensitivity/resistance, log (HOMA-IR) transforms the skewed distribution of fasting insulin values to determine a much stronger linear correlation with glucose clamp estimates of insulin sensitivity (56). Log (HOMA-IR) is useful for evaluation of insulin resistance in individuals with glucose intolerance, mild to moderate diabetes, and other insulin-resistant conditions. However, in subjects with severely impaired or absent β-cell function, HOMA-IR may not give appropriate results. HOMA or log (HOMA) is used extensively in large epidemiological studies, prospective clinical trials, and clinical research studies (29, 47, 100). In research settings where assessing insulin sensitivity/resistance is of secondary interest or feasibility issues preclude the use of direct measurements by glucose clamp, it may be appropriate to use log (HOMA-IR). However, as discussed below, other surrogate indexes have certain advantages over HOMA or log (HOMA) in some circumstances.
Quantitative insulin sensitivity check index.
Quantitative insulin sensitivity check index (QUICKI) is an empirically derived mathematical transformation of fasting blood glucose and plasma insulin concentrations that provides a reliable, reproducible, and accurate index of insulin sensitivity with excellent positive predictive power (21, 22, 48, 56, 65). During development of QUICKI, sensitivity analysis of data from the first 20 min of an FSIVGTT revealed that physiological fasting steady-state values of plasma insulin and glucose contain critical information about insulin senstivity as determined by the reference standard glucose clamp (SIClamp) (56). Since fasting insulin levels have a nonnormal skewed distribution, log transformation improves its linear correlation with SIClamp. However, as with 1/(fasting insulin) and the G/I ratio, this correlation is not maintained in diabetic subjects with fasting hyperglycemia and impaired β-cell function that is insufficient to maintain euglycemia. To accommodate these clinically important circumstances where fasting glucose is inappropriately high and insulin is inappropriately low, addition of log (fasting glucose) to log (fasting insulin) provides a reasonable correction such that the linear correlation with SIClamp is maintained in both diabetic and nondiabetic subjects. The reciprocal of this sum results in further transformation of the data, generating an insulin sensitivity index that has a positive correlation with SIClamp. Thus, QUICKI = 1/[log (fasting insulin, μU/ml) + log (fasting glucose, mg/dl)]. Over a wide range of insulin sensitivity/resistance, QUICKI has a substantially better linear correlation with SIclamp (r ≈ 0.8–0.9) than SI derived from the minimal model or HOMA-IR (22, 56, 65). Log (HOMA) is roughly comparable to QUICKI in this regard. QUICKI and HOMA were derived in a completely different conceptual fashion. Nevertheless, these two surrogate indexes are mathematically related; i.e, QUICKI is proportional to 1/log (HOMA-IR). Multiple independent studies find excellent linear correlations between QUICKI and glucose clamp estimates (either GIR or SIClamp) in healthy subjects, obesity, diabetes, hypertension, and many other insulin-resistant states (8, 55, 65, 83, 92, 96, 104). QUICKI performs best in insulin-resistant subjects, whereas SI from the minimal model performs best in healthy, insulin-sensitive subjects. Test characteristics examining repeatability and reliability of QUICKI (including coefficient of variation and discriminant ratio) demonstrate that QUICKI is superior to 1/(fasting insulin), log (insulin), and HOMA-IR and comparable with log (HOMA) and GIR from the glucose clamp. Evaluation of absolute predictive accuracy is also important in the validation of a surrogate index. Calibration model analysis has been used to evaluate the ability of QUICKI and other surrogates to accurately predict the reference standard SIClamp. In this regard, error functions for QUICKI and log (HOMA-IR) are both excellent and significantly smaller than for HOMA-IR, 1/HOMA-IR, fasting insulin, and SI derived from the minimal model (21). Moreover, changes in QUICKI after therapeutic interventions are significantly correlated with changes in SIClamp (22, 55). Under similar conditions, changes in SI derived from the minimal model do not significantly correlate with changes in SIClamp. A large meta-analysis of insulin-resistant subjects demonstrates that QUICKI is the simple surrogate index with the best positive predictive power for determining development of diabetes (48). Taking all of the factors discussed above, it is evident that validation studies for QUICKI and other simple surrogates should use direct estimates obtained from the reference standard glucose clamp for comparisons rather than the indirect SI derived from minimal model analysis. QUICKI is among the most thoroughly evaluated and validated surrogate index for insulin sensitivity. As a simple, useful, inexpensive, and minimally invasive surrogate for glucose clamp-derived measurements of insulin sensitivity, QUICKI is appropriate and effective for use in large epidemiological or clinical research studies, to follow changes after therapeutic interventions, and for use in studies where evaluation of insulin sensitivity is not of primary interest.
Surrogates Derived from Dynamic Tests
Procedure and concept.
Surrogate indexes of insulin sensitivity that use information derived from dynamic tests such as OGTT, meal tolerance tests, and IVGTT have been developed. Procedures for these tests have been described in Oral Glucose Tolerance Test/Meal Tolerance Test. Specific indexes, including Matsuda index (66), Stumvoll index (94), Avignon index (5), oral glucose insulin sensitivity index (63), Gutt index (45), and Belfiore index (10), use particular sampling protocols during the OGTT or the meal. In addition, minimal model approaches have been used to model plasma glucose and insulin dynamics during an OGTT or a meal to determine insulin sensitivity/resistance (27). Glucose disposal after an oral glucose load or a meal is mediated by a complex dynamic process that includes absorption, glucose effectiveness, neurohormonal actions, incretin actions, insulin secretion, and metabolic actions of insulin that primarily determine the balance between peripheral glucose utilization and HGP. Surrogate indexes that depend on dynamic testing take into account both fasting steady-state and dynamic postglucose load plasma glucose and insulin levels.
Assumptions and considerations.
The oral route of glucose delivery is more physiological than intravenous glucose infusion. However, poor reproducibility of the OGTT and meal tolerance test due to variable glucose absorbtion, splanchnic glucose uptake, and additional incretin effects needs to be considered. Thus, distinguishing direct metabolic actions of insulin following oral ingestion of glucose or a mixed meal is more problematic than after FSIVGTT. In addition, as with many other measurements of insulin sensitivity, surrogates derived from dynamic testing generally incorporate both peripheral and hepatic insulin sensitivity. Although OGTT involves considerably less work than FSIVGTT, dynamic testing in general requires more effort and cost than fasting blood sampling.
General advantages and appropriate usage.
Many surrogate measures derived from dynamic data correlate reasonably well with glucose clamp estimates of SI (45, 63, 66). Estimates of insulin sensitivity derived from OGTT predict the development of type 2 diabetes in epidemiologic studies (2, 48, 49). Furthermore, insulin sensitivity (SIOral) estimated from minimal model analysis of OGTT or meal tolerance tests correlates well with glucose clamp measures (27, 31). The advantage of surrogates based on dynamic testing is that information about insulin secretion can be obtained at the same time as information about insulin action. However, if one is interested only in estimating insulin sensitivity/resistance, fasting surrogates may be preferable to dynamic surrogates because they are simpler to obtain.
Insulin sensitivity index-Matsuda.
Originally proposed by Matsuda and DeFronzo (66), insulin sensitivity index-Matsuda [ISI(Matsuda)] is an insulin sensitivity index that reflects a composite estimate of hepatic and muscle insulin sensitivity determined from OGTT data. ISI(Matsuda) = 10,000/√[(Gfasting × Ifasting) × (GOGTTmean × IOGTTmean)], where fasting glucose and insulin data are taken from time 0 of the OGTT and mean data represent the average glucose and insulin values obtained during the entire OGTT. The square root is used to correct for nonlinear distribution of insulin, and 10,000 is a scaling factor in the equation. ISI(Matsuda) correlates reasonably well with estimates of whole body insulin sensitivity determined by the glucose clamp. The fasting component reflects hepatic insulin sensitivity, whereas the mean of the dynamic data primarily represents skeletal muscle insulin sensitivity. This partitioning concept has recently been validated using glucose clamp studies (1). The insulin secretion/insulin resistance (disposition) index calculated as the product of insulin secretion measured with (ΔI0–30/ΔG0–30 or ΔI0–120/ΔG0–120) and ISI(Matsuda) [or modified ISI(Matsuda) using plasma glucose and insulin concentrations at 30 min during the OGTT] had excellent power to predict onset of type 2 diabetes (2).
Gutt index: ISI (0,120).
The ISI (0,120) was adapted from the Cederholm index by omitting the constant terms and using the plasma glucose and insulin concentration from fasting (0 min) and 120-min samples from the OGTT (45). The ISI (0,120) index is defined as: MCR/log MSI = m/MPG/log MSI. The glucose uptake rate in peripheral tissues, m (mg/min), is obtained by the formula: m = [75,000 mg + (Glucose0 − Glucose120) × 0.19 × BW]/120 min, where the term (0.19 × BW) denotes glucose space, and BW is body weight (kg). The metabolic clearance rate (MCR) is obtained by MCR = m/(MPG, mean of the 0- and 120-min glucose values from the OGTT). The mean serum insulin (MSI, mU/l) is the mean plasma insulin concentrations obtained from the 0- and 120-min samples of the OGTT. The index correlates well with direct estimates of insulin sensitivity obtained from the glucose clamp study (r = 0.63) (45). In a large prospective study, this index was the best at predicting onset of type 2 diabetes when compared with other surrogate indexes derived from dynamic tests (including Avignon, Belfiore, and Stumvoll) (48).
Animal models of insulin resistance are helpful for understanding pathophysiology and for developing and evaluating therapeutic agents used for treatment and/or prevention of insulin resistance and its associated diseases. As in humans, the hyperinsulinemic euglycemic glucose clamp is considered the reference standard for measuring insulin sensitivity in animals (7). In addition, various dynamic tests, including IVGTT, OGTT, and intraperitoneal insulin tolerance test (ITT), have been used (23, 34, 73). Several studies (51, 62, 78) also use surrogates derived from fasting conditions, such as fasting insulin levels, HOMA-IR, and QUICKI.
Hyperinsulinemic Euglycemic Glucose Clamp
Procedure and concept.
Conceptually, the glucose clamp in animals is the same as in humans. Briefly, after an overnight fast (∼15 h), constant hyperinsulinemia is achieved by a primed, continuous infusion of insulin (15 pmol·kg−1·min−1), and a variable infusion of 20% glucose is used to maintain euglycemia. Basal and insulin-stimulated whole body glucose turnover is estimated with a continuous infusion of [3H]glucose 2 h prior to and throughout the clamp study. As in humans, the GIR provides a measurement of insulin sensitivity. Rates of HGP and insulin-stimulated whole body glucose turnover are determined as the ratio of the [3H]glucose infusion rate (disintegrations/min) to the specific activity of plasma glucose (dpm/μmol) at the end of the basal period and during the final 30 min of the clamp procedure, respectively. HGP during hyperinsulinemic clamp conditions is determined by subtracting the GIR from whole body glucose turnover.
Limitations and considerations.
Regarding the glucose clamp in animals, additional considerations are needed while conducting and interpreting these studies, especially for rodents (7). Unlike humans, rodents have no true physiological fasting state. Imposing a nonphysiological fasting period leads to significant decrease in body weight, depletion of hepatic glycogen content, and improved insulin sensitivity. Therefore, under these nonphysiological fasting conditions, plasma glucose and insulin levels may not attain steady-state conditions. Furthermore, it is likely that the glucose clamp technique in rodents is not as accurate and reliable as in humans. Rodents have very small blood volumes (∼2 ml in mice). Therefore, limited sampling ability makes it difficult to achieve and rigorously verify steady-state clamp conditions (especially with respect to insulin levels). In addition, the glucose clamp is stressful in mice (even if done under anesthetized conditions).
Advantages and appropriate usage.
The glucose clamp can be used to measure tissue-specific insulin action and glucose metabolism such as 1) basal and insulin-stimulated HGP, 2) insulin-stimulated whole body glucose uptake, glycolysis, and glycogen synthesis, and 3) insulin-stimulated glucose uptake, glycolysis, and glycogen synthesis in individual tissues (e.g., skeletal muscle, adipose tissue, and heart) (58). Additionally, biochemical/molecular assays may be performed to assess tissue-specific insulin-signaling activities and tissue-specific triglyceride contents (57). When assessing insulin sensitivity is a primary objective and feasibility is not an issue, the glucose clamp study is the method of choice in animals.
GTTs and ITTs
Procedure and concept.
After an overnight fast, glucose (∼2 g/kg body wt) is administered orally (OGTT), intraperitoneally [intraperitoneal glucose tolerance test (IPGTT)], or intravenously (IVGTT) into awake rats or mice. During an ITT, animals are fasted for 5 h, and insulin (∼0.5 U/kg body wt ip or iv) is administered. Blood samples are taken at 10, 20, 30, 60, 90, and 120 min following administration of glucose or insulin for measurement of plasma glucose and insulin concentrations. Blood samples are usually obtained from the tail or from an indwelling vascular cannula.
Assumptions and considerations.
As mentioned previously, the OGTT and IPGTT provide useful information about glucose tolerance but not insulin sensitivity/resistance per se. Impaired glucose tolerance is reflected in a larger incremental area under the curve (AUC) of the plasma glucose disappearance curve. For the ITT, the rate and magnitude of decline of plasma glucose concentration in response to an injection of insulin provide an estimate of insulin sensitivity. These tests are frequently used to assess glucose tolerance and insulin sensitivity in mouse models of diabetes or insulin resistance with isolated and specific genetic changes.
Advantages, limitations, and appropriate usage.
ITTs and GTTs can be conducted with more ease than the glucose clamp. However, unlike the clamp, these methods do not provide precise estimates of insulin sensitivity or tissue-specific glucose disposal. IPGTT has an advantage over OGTT in that it excludes incretin effects. In the case of ITT, the possibility of hypoglycemia and ensuing counterregulatory homeostatic mechanisms have the potential to confound estimates of insulin sensitivity. All of these tests can be stressful to the animals. In addition, as discussed before, imposing a nonphysiological fasting state in rodents may complicate interpretation of results. If assessing insulin sensitivity is of secondary interest in the metabolic profiling of animals or if feasibility issues preclude the use of the glucose clamp, ITT and GTT may be appropriate to use. However, investigators should be cognizant of the differences between the concepts of glucose tolerance and insulin sensitivity.
Surrogates Derived from Fasting Steady-State Conditions
Fasting insulin levels, HOMA-IR, and QUICKI have been used as surrogate measurements of insulin sensitivity in animals. However, validation of these surrogates against glucose clamp measurements has not been extensively conducted in animals. All surrogate indexes rely on the assumption that fasting glucose and insulin levels represent a basal steady-state condition. Thus, surrogate measures obtained from "fasting" states in rodents may not be as accurate as in humans. This is evident from modest correlations between surrogates and clamp estimates of insulin sensitivity in rats (95). In animals, where determination of insulin sensitivity is of secondary interest, surrogate indexes may be useful. However, further rigorous validation studies of these surrogate indexes are needed in animals.
This Frontiers article has examined a wide variety of methods currently available for estimating insulin sensitivity/resistance (but is by no means an exhaustive review). These range from complex, time-consuming, labor-intensive, invasive procedures to simple tests involving a single fasting blood sample (Table 1). It is important to understand the concepts underlying each method so that relative merits and limitations are appropriately matched to proposed applications. The glucose clamp method is the reference standard for direct measurement of insulin sensitivity. Regarding simple surrogates, QUICKI and log (HOMA) are among the best and most extensively validated. Dynamic tests are useful if information about both insulin secretion and insulin action are needed. As with all measurement techniques, correct interpretation of data from different methods for measuring insulin sensitivity requires a complete understanding of the technique.
This work was supported by the Intramural Research Program, National Center for Complementary and Alternative Medicine, National Institutes of Health.
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
- Copyright © 2008 by American Physiological Society


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Greensboro, N.C. --You have your guest list, now it's time to send them the invites. But before you do, Nishaka Proctor from Events By Nishaka and Regina Womble from UR Invited tackle some of the most commonly asked questions.
Should I send out Save The Dates?
The purpose of the Save the Date card is to inform family & friends of a significant event. The most popular style is a postcard with the couples engagement photo. However, the electronic version has become very popular along with magnets. Save the Dates are generally sent out at least six to twelve months before the wedding date and are usually followed by a formal wedding invitation.
What is the current trend for invitations?
Anything but the traditional style and matte finishes. The trends include: single double and triple layers; Denali pockets; Pocketfolds; Invites in silk boxes; Invites embellished with Swarovski crystals, ribbons and rhinestone buckles and Acrylic rectangles and squares.
What is a good timeline for invitations to go out?
Six to eight weeks is sufficient from the set RSVP deadline.
How far in advance should RSVP's come back and why?
Your RSVP's should come back 2-3 weeks before the wedding. Most caterers require a head count at least 2 weeks before the wedding. The sole purpose for the RSVP is to reserve your seat at the table and provide a final head count.
What is the best way for Brides to manage their RSVP's?
Use Excel to create a master spreadsheet. The Bride can use it to manage addresses for the invitations, the count from RSVP's, table assignments and she will have the addresses for her thank you notes.
What does a Brides invitation say about her wedding?
The invitation should invoke a feeling or emotion. It should convey a sense of your style and it should speak to the personality of the Bride & Groom.
You can contact Nishaka Proctor at 336-451-1603 or email email@example.com.


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Hey guys. I have to tell you guys a story about my friend Heather. So I invited her over to play a bit, but she had no idea my HUGE cock friends were coming over. I thought she would like the surprise, but she really loves to suck and fuck. She had about eight inches in her mouth and ten in her ass. We fucked in every position an ass could be penetrated. The guys made me squirt like three times, and we swallowed every last cum drop they had to offer. Check it out.


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Feb 11, 2012 - 12:34 pm
Insulin resistance is a precursor to type II diabetes. It is a result of a diet high in sugars and carbohydrates. Essentially, the cells become resistant to the insulin that carries glucose into them. The cells are protecting themselves from too much glucose. In response to the elevated glucose in the blood - since the glucose can't get into the cells - the pancreas releases additional insulin. Insulin is a growth hormone and stimulates cancer growth.
The symptoms of insulin resistance will not send you running to the doctor, and you may have it for years without knowing. If, however, you are overweight or have belly fat, there's a good chance you have it. You can find out through a blood test called a glucose tolerance test which involves a fasting blood sample, and 4 subsequent blood samples after the patient drinks a sugary drink, over the next three hours.
The good news is that both insulin resistance and type II diabetes can be resolved through a low carbohydrate diet. But, I've learned there is more to it than that. I've been avoiding sugars and carbs for months now, but still have the belly fat. I consulted a nurse practitioner and a nutritionist to help me in my efforts.
From the nutritionist, I learned that avoiding sugar means limiting my daily intake to less than 20 grams. My morning half cup of berries just about meets 1/3 of that limit. From both health care professionals, I learned that efforts to resolve insulin resistance will be unsuccessful if your blood oxygen saturation falls at night. My nurse practitioner ordered a nocternal pulse oximmetry test, which was free. I wore a pulse oximmeter on my finger while I slept for one night. The results were surprising. My blood oxygen falls regularly throughout the night and is even low right when I lie down to go to sleep. Now I have a machine that extracts oxygen from the air in my bedroom and delivers it to me through a canula, which I wear at night. No oxygen bottles are involved. It's a bit uncomfortable sleeping with the canula, but I want to resolve the insulin resistance and the cancer risks related to it. Insurance covers all the costs for the machine except for $17/month, which I pay.


text:
In this three-minute STC Atlanta podcast, Judy Glick Smith says she's tired of trying to convince sales people of the value of documentation. She says she's "tired of fighting the good fight."
No doubt as a technical writer you've heard the phrase, "No one reads the help anyway." They let out a small chuckle to indicate that they're only kidding, although deep down they're being totally serious. Many people believe help files are almost insignificant except to a small percentage of people.
But the next time you hear someone say, "No one reads the help anyway," say, "Yah, no one uses Google either."
This will lead to a puzzling follow-up question -- What do you mean? I use Google all the time.
Then you say, What do you use Google for? To search for answers, solutions, and information when you have questions?
Google is one large help file.
Update Jan 2008: I updated my thoughts on this post with some new reflections.
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How long should I wait?!(26 Posts)
In a nutshell:
Called developer on Thursday morning to make very cheeky offer on partially completed property.
Developer did not laugh and hang up Will crunch some numbers and get back to me.
hhh firmly crosses fingers and waits.
Still waiting over weekend.
Now drumming crossed fingers and feeling impatient.
I've put the ball firmly in his court and don't want to seem desperate/overly keen so am reluctant to call him again. But how long should I wait? How long does it take to re-calculate the cost of completing a build and selling etc? The property's been on the market for a long time, and AFAIK this is his only offer. So perhaps he's not feeling in a hurry to deal with it. But I am!! Should I give him a nudge? And if so, how to do it without compromising my 'poker face'?!
Our estate agent reassured us when we were wondering whether to put our house on the market by saying we could always see what interest there was then say that we would accept an offer subject to our purchase, ie subject to us finding something to buy. That way we would be upfront about the fact that we might not move as quickly as some people would like. That helped me feel brave enough to put ours on the market but as it turned out, in between getting the EA round and actually getting our house on the market we had an offer accepted on a lovely house so it never came to that.
Sooo, for anyone who might be still watching this thread...
I've just spoken with the developer. He says:
He's also talking to another couple in a similar position to us - also not sold but offering a higher figure. (fictional or not? I don't know - he did tell me previously that he'd shown a couple of other folks round the property)
He's cracking on a bit with the house and doing a bit more work to it in the meantime.
My figures are on the low side (I knew this - I'm chancing my arm, of course)
He still sounded keen to keep negotiating - suggested comparative figures for other properties he's got and an equity share idea which someone else discussed with him last year.
So basically, we'll have to decide whether or not to take the plunge and go on the market. Best case: we sell quickly, for a good price and can come up to his level on price. Worst case: we don't sell quickly enough and are beaten to the punch by this 'other couple' OR we sell, but still can't meet the figure he's looking for. I don't know if we should be brave and just go for it, or if this is really too much of a long-shot?! Eek. This property stuff is a real head-masher
Seems to me to be very similar to the very early stages of a relationship. You wouldn't phone a guy twice when you knew that he had your number but hasn't called you back the first time, would you?
Basically I fear the developer is not really interested in your offer, either because it's too low or because you're not procedable.
Sorry to be brutally honest.
Good luck!
I would phone back. And I would say I'm just calling since I seem to have missed you calling me back. If it is all going to be business like then you don't want to be messed around and he can't just leave you hanging.
And I just want to add - thanks for your replies folks, good or bad! I need the reality check, and also to get the thoughts out of my head and share them with someone else, otherwise I'm going round in circles!
Financialwizard we had our house valued a few months ago to give us an idea of our budget so we know roughly what to expect.
Jammy I did mention our position to him when we viewed the property so if he remembers that, then he knows.
We've got estate agents coming early next week to get us ready for market if need be, so we are certainly preparing to sell if it looks like this deal could be going somewhere. I know this is not technically the 'correct' way of doing things, but we're cautious about venturing onto the market without some idea of having another home to move to.
Does he know your position hopeful? I'm inclined to agree with happy if so.
Our offer was accepted over 2 weeks after it was made. They got the agent to call back to see if there was any more we could offer. In the meantime we sat tight and held our nerve. They then called back to accept. It is plausible he is still considering it.
Serious question. How do you know how much you can afford to offer without even having yours valued yet?
Latest: still no call back.
But I have discovered he's having boards put down for flooring
Perhaps, happy, and if that's the case then I'm willing to accept that. But irrespective of our current property status, I made an enquiry and he said he would get back to me. Surely it's common courtesy - and good business - to do so?
I suspect he's one of those
men people who need a good deal of nudging and reminding to get things done. And this property is probably much more in my thoughts than his...
Maybe he's just completing the house to sell it as planned?
Sorry, but perhaps he isn't taking your offer seriously since your home isn't even on the market much less sold..
Oh and it might be worth knowing that there has been some activity at the property - a friend who lives opposite has reported back to me that she's spied workmen there, moving things about/measuring up etc.
So it appears I've prompted him into some kind of action, and I can only assume he's taking the idea seriously or he wouldn't be wasting time re-estimating the build.
Still waiting here! It's now almost 2 weeks since I made the follow up call, when he told me he hoped to get back to me by the end of the week
flatbread, you may be right - perhaps he's now holding off, waiting to see if I'll call him back again. If so, I hate games like this. Tbh even if I did phone him back, I'll be sticking to my limit and holding out for big discounts, so he can think I'm desperate all he wants, but I'm not going to be paying big bucks for his half-finished house!
However, I'm using the time to get some good mortgage advice, do the sums and get our own house ship-shape so we're ready to get on the market quick (yes, that's right, we're looking before we're on the market. I know, but we have a small search area and no desire to sell before we at least have a rough idea what we hope to buy.)
However, time is indeed ticking and I'm impatient to know - one way or another. Can he have forgotten? That we may be willing to pay him several thousands for a plot he's looking to offload?? Would a person be likely to let this slip their mind??
Any advice how long I should let this run before chasing?
Hmm, you shouldn't have called. He knows now that you are keen.
When he calls back with a counter offer don't accept it on the spot. Wait a week before calling back.
It is a game of poker in a slow market and you have just revealed your hand, I am afraid (so says the person who made a too-high offer within minutes of seeing her 'dream' house).
Hopeful Any news?
Keeping my fingers crossed for you.
Thanks jammy, that's reassuring. I at least feel a bit less on edge, waiting for him to call back. I'll play it cool from now on and keep crossing my fingers!
That can only be a good thing if he said he'll call back. Although if its been on the market for a while you'd think he'd be biting your arm off at a decent offer. I still think its largely a buyers market unless you're in London and vendors can't be overly picky.
I would wait and hear back from him. If you do have to chase again don't call till at least Monday. Then you have two options, you've seen something else that you'd like to move on so you need to know one way or another. Or if you really want it, sound him out on what price he's trying to achieve and meet in the middle.
Eek, I gave in and phoned just now -brief conversation, he's planning to call me back by the end of the week.
Somebody reassure me I haven't just blown it with my impatience?!
I really hope I came across business-like and keen to move things along - not desperate and inexperienced!?
Good grief, I've never tormented myself this much over a relationship, never mind a property
bumping for the post-school run crowd...any other words of wisdom, people?!
Thanks jammy - I may have to bluff a bit then on the 'other properties' as there are aren't many coming up in our (quite limited) search area at the moment, which is one of the reasons I'm quite keen to pursue this one.
And I am indeed prepared to walk away - I have a clear idea of what deal we would need to do here and if it's not going to happen, then I think I'll know this one isn't for us. It's a bit of a long-shot as if we were to get the property for the price I've suggested we'd have an amazing bargain. Possibly too good to be true...
Call me back Mr Developer, I need to know how/if this is going to go down?!
He's hoping you're going to come back with a counter offer. I agree on making them aware there are other properties you're interested in. And of course be prepared to walk away.
I made an offer on Monday on a barn that has been on the market for over a year. I've been watching as the developer has knocked 175 off the initial asking. They recently have started remarketing at 550. Offered 500. Which is reasonable they however are holding out for more. The developer will get back to us in 2 weeks if they don't get a better offer. In the meantime holding out the poker face whilst feeling a bit sick. Arghhhh!
Haha, it's not terrible - just overpriced I think! Got lots of info on the place from a friend who's built a house in the plot opposite, so we've got a good inside track from her.
LOL is it really that bad??? why are you so interested then? Are you thinking of doing it up? Have you wondered why no one else made him an offer since it's gone on the market? perhaps the area is not a good one? it's always good to be aware of the history of a place before buying. We nearly put an offer on a house we liked which was in a lovely spot right across a huge field. Luckily we enquired and found out the council had plans to build new housing developments on that field.
Honestly, I'd be shocked and VERY miffed if there was another offer on the go just now - as I say it's been on the market for AGES and there has been very little activity on it. That's one of the main reasons I'm hoping he might accept a cheeky offer.
I like your idea about saying I have other options though, perhaps I could use that as an excuse to call.
Thanks Adeona!
He might have had a second offer in parallel and is probably weighing out the options. I would give him a call today, I don't thinky you will sound desperate, housing is a fast moving business and you don't want to miss a good opportunityl. You could say you have 1 or 2 other interesting options and you need to know fairly quickly if he's interested so you can move on. Good luck
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text:
A feed aggregator for open source desktops
WWW: http://www.gnome.org/projects/straw/
No installation instructions: this port has been deleted.
The package name of this deleted port was: straw
PKGNAME: straw
distinfo: There is no distinfo for this port.
NOTE: FreshPorts displays only information on required and default dependencies. Optional dependencies are not covered.
No options to configure
Number of commits found: 39
Garbage collect expired ports
2011-04-01 accessibility/linux-f8-atk: End of Life since Jan 7, 2009
2011-04-01 archivers/linux-f8-ucl: End of Life since Jan 7, 2009
2011-04-01 archivers/linux-f8-upx: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-alsa-lib: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-arts: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-esound: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-freealut: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-libaudiofile: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-libogg: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-libvorbis: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-mikmod: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-nas-libs: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-openal: End of Life since Jan 7, 2009
2011-04-01 audio/linux-f8-sdl_mixer: End of Life since Jan 7, 2009
- Move over to py25 or above
- While here get rid FreeBSD 6.X and md5 support
- Fix a typo
Thanks to: email@example.com
- Mark it DEPRECATED because abandoned upstream and does not work with python
- Remove MD5
PR: ports/153457
Submitted by: Ruslan Mahmatkhanov <email@example.com> (maintainer)
- update to 1.4.1
Reviewed by: exp8 run on pointyhat
Supported by: miwi
- update to jpeg-8
- bump all port that indirectly depends on libjpeg and have not yet been bumped
or updated
Requested by: edwin
Reset maintainer (not seen since Dec 2007, email bounces)
Approved by: portmgr (linimon@)
- Use GNOME macro instead of ${MASTER_SITE_GNOME}, remove
MASTER_SITE_SUBDIR when possible.
PR: ports/125243
Submitted by: pgollucci
Reworked by: myself
Tested on: pointyhat exp-run (pav)
Bump portrevision due to upgrade of devel/gettext.
The affected ports are the ones with gettext as a run-dependency
according to ports/INDEX-7 (5007 of them) and the ones with USE_GETTEXT
in Makefile (29 of them).
PR: ports/124340
Submitted by: edwin@
Approved by: portmgr (pav)
- Remove USE_XLIB/USE_X_PREFIX/USE_XPM in favor of USE_XORG
- Bump PORTREVISION
Approved by: portmgr (xorg cleanup)
Presenting GNOME 2.20.1 and all related works for FreeBSD. The official
GNOME 2.20 release notes can be found at
http://www.gnome.org/start/2.20/notes/en/ . Beyond that, this update
includes the new GIMP 2.4 (courtesy of ahze).
The GNOME 2.20 update also includes a huge change in the FreeBSD GNOME
hierarchy. We are now using the more standard DATADIR of ${PREFIX}/share
rather than ${PREFIX}/share/gnome. The result is that fewer patches and
hacks are needed to port GNOME components to FreeBSD. This will mean some
user changes may be required, so be sure to read /usr/ports/UPDATING for
more details.
This release and the things we accomplished in it would not have been
possible without mezz's crazy idea to collapse DATADIR, and his persistence
to make it happen successfully. Ahze and pav also deserve thanks for
- Make Python 2.5.1 the default Python version
- Add significantly better support in bsd.python.mk for working with
Python Eggs and the easy_install system
Tested by: pointyhat runs
Approved by: pav (portmgr)
Most work by: perky
Thanks to: pav
- Update to 0.27
- Update MASTER_SITES
- Switch to BZIP2 distribution
- Resurrect LookupManager.py patch, deleted accidentally
(straw won't work if py24-adns is installed)
Submitted by: R.Mahmatkhanov <email@example.com> (maintainer)
- Welcome X.org 7.2 \o/.
- Set X11BASE to ${LOCALBASE} for recent ${OSVERSION}.
- Bump PORTREVISION for ports intalling files in ${X11BASE}.
- Update to 0.26
- Update MASTER_SITES
- Remove BROKEN and DEPRECATED
- Remove python < 2.4 stuff, cause straw is now requires 2.4
- Change port description
- Fix pkg-list
- Pass maintainership to submitter
Submitted by: R.Mahmatkhanov <firstname.lastname@example.com>
Schedule these broken ports for removal on 2007-04-10 if they are still
broken at that time and no fix has been submitted.
Chase the GNOME X11BASE to LOCALBASE move, and fix the build with the
new freetype2 where needed.
Submitted by: mezz, ahze, pav, and many others
Approved by: portmgr (implicit, kris)
Remove USE_REINPLACE from all categories starting with N
- Add SHA256
Bump PORTREVISION to chase the glib20 shared library update.
Add missing runtime-dependency on py-gtkhtml-binding from pygnomeextras
(bump PORTREV for package-cluster).
PR: ports/81109
Submitted by: Yann Golanski
Bump PORTREVISION to chase the glib20 shared lib version change.
Properly install GConf schema files.
Reported by: pointyhat via kris
Bump PORTREVISIONS for all ports that depend on atk or pango to ease in the
big upgrade.
Update to 0.25.1.
PR: ports/70807
Submitted by: Tom McLaughlin <firstname.lastname@example.com>
Drop maintainership to ports.
Add a call to ``env'' for the gconf install and uninstall rules just to be
Chase the new gconf key policy, which will make handling gconf schemas much
easier for GNOME 2.8.
-Update to 0.23
-Change my email to firstname.lastname@example.com
Approved by: adamw (mentor)
Update to 0.22.1. The code is no longer optimized upon install, as it was
causing the install to bork out on -CURRENT. Hopefully this can be
fixed later on.
PR: ports/63156
Submitted by: mezz (maintainer)
Make RUN_DEPENDS BUILD_DEPENDS as well.
Submitted by: maintainer
Update to 0.22.
Submitted by: maintainer
Bump PORTREVISION on all ports that depend on gettext to aid with upgrading.
(Part 1)
- SIZEify
PR: ports/62128
Submitted by: maintainer
Host distfile in my MASTER_SITE_LOCAL space while savannah is AWOL.
Fix a problem where straw wouldn't show any articles if the locale was set
to anything other than C. Also, make sure we persist articles across reboots.
Approved by: maintainer
Add a missing dependency on py-xml.
Submitted by: maintainer
Reported by: Hendrik Scholz <firstname.lastname@example.com>
Add straw, a GNOME/Python based RSS/RDF news feed aggregator.
Submitted by: Jeremy Messenger <firstname.lastname@example.com>
Servers and bandwidth provided byNew York Internet, SuperNews, and RootBSD
1 vulnerabilities affecting 7 ports have been reported in the past 14 days
* - modified, not new
All vulnerabilities


text:
Results 1 to 1 of 1
May 4th, 2015, 10:15 PM #1Where Global Travelers Want to go this Season
Skift just shared a report analyzing preferred destinations and durations for this summer, plus a list of some of the best airfare decreases. Good info if you have a travel site, or even any kind of travel info on your site!
Where Global Travelers Want to go this Season
Similar Threads
Great Infographic on Millenial Travelers and New Info TechnologyBy JCrooks - AffiliateWindow in forum TravelReplies: 2Last Post: November 19th, 2014, 10:53 PM
Hello fellow travelersBy young_affiliate in forum Introduce YourselfReplies: 4Last Post: November 17th, 2014, 04:59 AM


text:
The Strider Knives SnG is one of the most recognizable in the Strider line-up. Considered their medium sized folder, the SnG is most at home in a medium to large sized hand or being used with thick gloves. Carry friendly for day to day while also being heavy duty enough for in field use. Brand new directly from Strider Knives, Inc.
The Blade: With a thick tool steel alloy blade, there's not much the SnG can't handle. This model comes with a Stonewash finished 3/4 ground Tanto blade to hide the daily wear and tear. These mean pointers feature a deep jimping on the top of the blade ensuring a secure grip during use. Each knife comes with a hair popping edge and deploys easily via the ambidextrous thumb hole cutout.
The Handle: Like most of their folders, the SnG has a combination G10 and Titanium frame. What makes it slightly different from everyone else is that the backspacer, traditionally a separate piece on most production knives, is instead integral to the front scale. Keeping with the hard use concept, Strider used bronze washers and a chain ring bolt construction to secure the blade. Also incorporated is the Hinderer lock bar stabilizer, which prevents the user from overextending the frame. This version comes with an Orange G10 scale in the flat lego configuration, with black oxide hardware and a Stonewashed lock side. A heavy duty titanium clip is affixed for every day carry.
About PSF-27 Steel: Tool steel alloy uses the Spray Forming Process resulting in improved wear resistance, toughness, crack resistance and higher hardness.The result is D2 with better edge holding and toughness than cast D2.
About the Strider Knives SnG Folder: The Strider Knives SnG Tactical Folder is a legendary member of the Strider Lineup. Quite possibly the most popular due to its near-perfect size for the average hand (gloved or otherwise). The SnG has an ingenious design built to handle the toughest of jobs all from American made stock. The SnG comes in a variety of flavors and finishes making them all near-unique to its owner. Quality and dependability describe the Strider SnG whether you're heading to battle or heading to work.
|Overall Length
|Blade Length
|Sharpened Length
|Blade Thickness
|Blade Material
|Steel Type
|Frame Lock
|Closed Length
|Handle Material
|G10 & Titanium
|4.75 oz.
|Country of Manufacture
|United States


text:
The technology you spoke of was actually RFID. And according to your own source, the information on it is already on the paper passport.
But RFID is not a "tracking chip." The idea was to make the passport harder to forge, not to pinpoint my location. RFID does not do that inherently; the only reason you can use it to track anything is because of the reader. The location is inferred from where an RFID tag is scanned The RFID chip would not contain my current residence or be able to tell anyone where my travel destination is, nor my hotel reservations or favorite places to eat. All convenient places to kill me, but it doesn't work quite like that. Now if you go on to read this article, you find that there was a legitimate concern about the security (the information could be picked up by strangers using a remote scanner, an invasion of my privacy), but put down the kool-aid.Starting in early 2006, the U.S. Department of State will begin issuing passports with 64-kilobyte RFID (radio frequency identification) chips that will contain the name, nationality, gender, date of birth, and place of birth of the passport holder, as well as a digitized photograph of that person.


text:
ACParadise Network: American Cosplay Paradise American Cosplay Experience American Cosplay Snapshots
Cosplayer rhaps0die > Costume of Utena Tenjou (Revolutionary Girl Utena)
- Most Recent Photo
- Series
- Revolutionary Girl Utena
- Character
- Utena Tenjou
- Special Variation:
- child's mourning dress
- Year Completed:
- Construction Difficulty:
- Easy
This Costume has been retired
About this Costume
- Construction Details:
This was more or less a homemade closplay, made because I wanted something semi-gothic lolita. The dress was my first time patterning something out purely from scratch, and I love the end result! The wig was my first attempt at sharpie-dyeing. I wanted a more vibrant pink that wasn't neon, and I think I got that. It's also colorfast and still relatively soft, so...success!
Add a Comment


text:
South Tyrol Museum of Mining - Prettau Mine Museum
Hörmanngasse 38a, Prettau
1th Apr–5 Nov
Interactive map
We could not calculate directions.
In 1996 the St. Ignaz Gallery, the lowest gallery in the former copper mine at Prettau in the Ahrntal Valley, was opened to visitors as an adventure mine: equipped with helmet and waterproof jacket, they take the train one kilometre into the mine, where a 350-metre tour begins with lifelike replicas of miners demonstrating the different techniques once used in the narrow tunnels and deep shafts. The cement copper plant shows an alternative copper extraction method still in use today. A climate gallery, located some 1,100 metres inside the mine, is intended as a place of quiet, relaxation and recovery.


text:
Are there traffic concerns in your neighbourhood? Do you have ideas and suggestions to address the issues? We want to hear from you!
Residents of Wildwood are invited to attend a public meeting to identify and discuss local traffic issues in the neighbourhood. The meeting will be hosted by the City of Saskatoon, Transportation Division.
The Transportation Division will examine the issues identified at this meeting, gather additional information through traffic counts, and prepare a comprehensive plan to address traffic concerns across the entire Wildwood neighbourhood. The plan will be presented at a follow-up meeting in fall 2017/early 2018.
All local stakeholders are welcome and encouraged to attend. Please join us as we discuss the traffic issues that affect your neighbourhood.
Can't make the meeting? Join the discussion below by clicking the blue 'View Topic' box.
For more information, please contact:
Lanre Akindipe, P.Eng., Transportation Engineer


text:
Srirangapatana Island, Mandya District
The final resting place of Hyder Ali, his Queen and their son, Tipu Sultan.
St Philomena's Church, Mysore
Have you noticed pictures of children during prayers in a mosque? There's always a child standing and looking in the opposite direction, his mind in a world of its own. It's the same in churches too, like this little fellow dressed in his Sunday best, who followed his eyes filled with wonder and ended up examining a door. His father caught up with him soon enough and pulled him in.
Srirangapatana, Mandya District
A boatman rests. The circular object to the right is his boat.
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text:
Oxford Dictionary of National Biography
Barry Till, Watson, Thomas (d. 1686), first published 2004, 1244 words
> View Thomas Watson complete biography [Oxford DNB subscription required; no subscription?]
The Oxford Biography Index is an accurate index of notable people from throughout history – their names, dates, and fields of activity. References to full text articles are also provided, and many are available to public library members simply by inputting their library card number.
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Oxford Biography Index entry
Thomas Watson
Watson, Thomas (d. 1686), ejected minister
Oxford Biography Index Number 101028867 [what is this?]
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text:
Feature: Albums We Hope Change the Game in 2013 – Slayer
Mon, 14 Jan 2013 06:57:31
Slayer Photos
Slayer Videos
There are a few records on the horizon in 2013 that we're sure are going to completely change the game.
New music is always exciting prospect, and we bring you the records we think will totally blow you away in 2013.
Next up is…
Slayer — TBA
Slayer practically razed the entire globe touring in support of World Painted Blood since its 2009 release.
Whether it was on The Big 4 or the Rockstar Energy Drink Mayhem Festival, thrash's tightest and toughest unit assaulted every crowd with an unforgettable barrage of heavy metal. Somehow, they get better and more brutal with every subsequent release, and their forthcoming twelfth studio album will undoubtedly uphold that trend cast in blood and fire.
"Chasing Death" and "Implode" are among what we can expect from this next effort. With their track record and the bevy of brilliantly battering shows they've logged under their belts even in these past few years, this is set to once again inspire an entire generation to pick up guitars and hail Satan.
—Rick Florino
Go Back or Forward
What's your favorite Slayer song?


text:
BHF-Bank accelerates access management approvals by 40 percent
Be the security "Risk Mitigator" your organization needs. Control user and privileged access. Govern identities. Secure data. Get more done with less. Now, identity and access management (IAM) can be driven by business needs, not IT capabilities. With Identity Manager and its modular and scalability capabilities, you can unify security policies, meet compliance needs and achieve governance while improving business agility — today and long into the future.
Make better security decisions by combining security information and policies from multiple sources to reduce exposure and eliminate information silos
Provide auditors with detailed, real-time governance reports that includes information about what resources are in your environment, who has access to them and when, and why that access was granted and terminated. Experience a stress-free audit with our customizable reporting engine that gives you and the auditors what you need.
Eliminate manual mistakes by automating provisioning to any system, platform or application.
Enhance security by providing employees, contractors, partners, customers, students, alumni, constituents and patients with only the access they absolutely need - nothing more and nothing less.
Saves time and reduces IT effort via a customizable online intuitive "shopping cart". This enables users to request access to network resources, physical assets, groups and distribution lists, and control access rights and permissions for their entire identity lifecycle while leveraging predefined approval processes and workflows.
There's no need to start over. Build on the investments and infrastructure you already have and grow from there. Move from your current platform by integrating a modular and integrated solution into your "traditional" IAM frameworks as you progress to a single, consistent IAM strategy.
External regulations? No problem. Internal policies? No problem. Get the complete visibility you need while meeting the demands of all the other groups.
Enables you to schedule on-demand or routine attestation and display the status of group or distribution list in a clear, concise dashboard view; and enables you to produce detailed reports for discovery, as well as to substantiate compliance.
Achieve a unified governance approach for all employees, regardless of their role and level of access. By integrating Privileged Password Manager with Identity Manager, users can request, provision and attest to privileged and general user access within the same console.
System requirements
Ensure that your system meets the following minimum hardware and system requirements before installing One Identity Manager.
One Identity Manager supports the following database systems:
For more detailed information about system prerequisites, see the One Identity Manager Installation Guide.
Windows® operating system
Following versions are supported:
UNIX® and Linux® operating systems
SQL Server®
Oracle® Database
The patch level varies depending on the system platform.
It is strongly recommended to apply the patch 19504744 for the Oracle bug 18097476 (Doc ID 1683819.1).
Windows® operating system
Following versions are supported:
Linux® operating systems
Windows® operating system
Linux® operating system
Windows® operating system
Windows® operating system
Linux® operating system
Windows® operating system
Linux® operating system
Windows® operating system
Windows® operating system
Access control at major universities is complex. They have to manage the digital identities of thousands of students and staff. What's more, individuals will be assigned to bundles of applications relevant to their course or job role.
The Identity Manager family of solutions enables you to choose the one that best meets your organization's specific access management
Gartner Inc. has named One Identity a Challenger in its 2017 Magic Quadrant for Identity Governance and Administration. Download the full report.
In this paper, you'll learn about IT security compliance for the Health Insurance Portability and Accountability Act (HIPAA) from an auditor's perspective.
Understanding the fundamentals for Digital Transformation and knowing how to protect data – especially identity-related data – will help organizations succeed in this new age. When executed correctly, organizations can move from a high-risk/low-agility st
In this paper, you'll learn about IT security compliance for the Payment Card Industry Data Security Standard (PCI DSS) from an auditor's perspective.
Read key findings from One Identity's survey of federal IT professionals.The study reveals that the security stance at most agencies has improved but they have not fully realized the objectives of regulatory and legislative guidelines.
A cloud based, managed-service offering, Connect for Cloud extends the governance capabilities
Provide security and access rights to the appropriate users
Industry analysts have weighed in on today's IAM solutions and one thing is clear: One Identity Solutions are an industry-leading, simplified approach to IAM.
Self-service tools will help you to install, configure and troubleshoot your product.
Find the right level of support to accommodate the unique needs of your organization.
Search from a wide range of available service offerings delivered onsite or remote to best suit your needs.
Training courses delivered through online web-based, on-site or virtual instructor-led.


text:
Can a light bulb be as cool as the iPhone?
Sengled wants to make bulbs as functional as the smartphone. "By embedding consumer tech into LED lighting, we are able to reduce the cost of buying incremental devices in the home, so we help to reduce the cost of [home] ownership," Ruan said.