text:
- Research article
- Open Access
- Open Peer Review
The GPIIIA PlA2 polymorphism is associated with an increased risk of cardiovascular adverse events
© Galasso et al; licensee BioMed Central Ltd. 2010
- Received: 26 February 2010
- Accepted: 16 September 2010
- Published: 16 September 2010
The clinical impact of PlA2 polymorphism has been investigated in several diseases, but the definition of its specific role on thrombotic cardiovascular complications has been challenging. We aimed to explore the effect of PlA2 polymorphism on outcome in patients with atherosclerosis.
We studied 400 consecutive patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention. A replication study was conducted in 74 hypertensive patients with cerebrovascular events while a group of 100 healthy subjects was included as control population. PlA genotype was determined by PCR-RFLP on genomic DNA from peripheral blood cells. Major adverse cardiac events (MACE), were considered as end points, and recorded at a mean follow up of 24 ± 4.3 months.
The frequencies of PlA2 polymorphism was similar between groups and genotype distribution was in Hardy-Weinberg equilibrium. In patients with CAD, the presence of PlA2 allele was associated with higher incidence of cardiac death (13.1% vs. 1.5%, p = 0.0001), myocardial infarction (10.7% vs. 2.6%, p = 0.004) and needs of new revascularization (34.8% vs. 17.7%, p = 0.010). Accordingly, the Kaplan-Meier analysis for event free survival in patients harboring the PlA2 allele showed worse long-term outcome for these patients (p = 0.015). Cox regression analysis identified the presence of PlA2 as an independent predictor of cardiac death (OR: 9.594, 95% CI: 2.6 to 35.3, p = 0.002) and overall MACE (OR: 1.829, 95% CI: 1.054 to 3.176, p = 0.032). In the replication study, the PlA2 polymorphism increased the risk of stroke (OR: 4.1, 95% CI: 1.63-12.4, p = 0.02) over TIA and was identified as an independent risk factor for stroke (B:-1.39; Wald: 7.15; p = 0.001).
Our study demonstrates that in patients with severe atherosclerosis the presence of PlA2 allele is associated with thrombotic cardiovascular complications.
- Percutaneous Coronary Intervention
- Acute Myocardial Infarction
- Transient Ischemic Attack
- Peripheral Artery Disease
- Major Adverse Cardiac Event
Atherosclerosis manifesting as myocardial infarction, angina pectoris, cerebral ischemia and peripheral artery disease is a multifactorial disease with the environment and genetics contributing to its pathogenesis. During the last decade several genes involved in the atherosclerotic process and their polymorphisms have been suspected to increase the thrombotic predisposition and to influence the risk for acute coronary syndromes. Among these genes, polymorphisms of those involved in platelet function have been extensively studied. Indeed, platelets play a pivotal role in atherothrombosis [1] and their function is strongly related to the interactions of the glycoprotein IIb/IIIa receptor (GP IIb/IIIa) and the von Willebrand factor, as well as fibrinogen, leading to platelets aggregation[2–4]. GP IIIa is a high polymorphic protein with platelet antigen 1 (PlA1) and 2 (PlA2) as the most common allelic isoforms [5]. In the PlA2 allele, cytosine is substituted for thymidine in exon 2, which is phenotypically translated in the substitution of proline for leucine at position 33 of the mature GP IIIa [6]. A previous in vitro study demonstrates that the PlA2 variant enhances the binding of the GPIIb/IIIa receptor to fibrinogen and therefore increases the platelet aggregation induced by agonists [7]. The clinical impact of PlA2 polymorphism has been investigated in several diseases, in which thrombus formation is a key pathogenetic factor, but the definition of the specific role of such polymorphisms on thrombotic coronary and cerebrovascular complications has been challenging. Weiss et al. [8] observed a strong association between the PlA2 polymorphism of the GP IIIa gene and acute coronary thrombosis, and this association was strongest in patients who had had coronary events before the age of 60 years, suggesting this polymorphism as an inherited risk factor for coronary thrombosis. These findings were further expanded on peripheral artery disease by Mikkelson [9] who reported an association between PlA2 variant and the progression of atherosclerosis in the abdominal aorta. Similarly, in the Copenhagen City Heart Study, a prospective study with 9,149 subjects, there was a three-fold and four-fold risk of ischemic cardiovascular disease and MI in men <40 years homozygous for PlA2 polymorphism [10]. On the other hand, several studies failed to confirm this association; indeed a metanalysis of 23 of such negative studies, showed the lack of association between the PlA2 allele and the risk of myocardial infarction and this negative result persisted even after subgroup analyses [11]. Therefore, up to date, available data are hugely uncertain and still debated. Several issues common to epidemiologic risk factor studies can be accountable for the difficulty encountered in reproducing the results of genetic association studies. Among these limitations there is inaccurate phenotyping [12]. In particular, atherosclerotic disease may present with different clinical manifestations. It is therefore pivotal to accurately select the clinical phenotype that can be affected by the genetic variability. To address this issue, and therefore gain more inside on the role of PlA2 polymorphism on atherothrombotic disease, we performed a prospective study in a cohort of patients selected for angiography documented severe coronary artery disease (CAD), which needed percutaneous coronary intervention (PCI). Moreover, to assess the role of this polymorphism on cerebrovascular disease, a replication study was performed in an independent population of hypertensive subjects, screened for large vessel atherosclerotic disease, and previous ischemic cerebrovascular events, namely stroke or transient ischemic attack (TIA). Finally, a group of 100 healthy subjects was included as control population of our study.
To assess the role of PlA2 polymorphism on cardiovascular disease we analyzed the incidence of this gene variant in a total of 574 unrelated individuals. A first group was constituted by 400 consecutive patients (mean age 60.5 ± 10, 83% male) undergoing elective or urgent PCI for CAD documented by a positive stress test or by Tl single photon emission computed tomography. To perform a replication analysis we selected an independent population of patients with cerebrovascular disease. Therefore, a population of 74 unrelated patients (mean age 61.58 ± 2, 63% male) with cerebrovascular events was examinated, recruited from those admitted to the Hypertension Diagnosis and Care Outpatient Clinic of "Federico II" University of Naples and participating in the 'Campania Salute Project'[13]. Finally, to identify normal distribution of the PlA genotype, we enrolled a control population of 100 gender- and age-matched healthy unrelated individuals (60 ± 10 years, 83% male), recruited from blood donors of our blood bank. Controls were free from heart disease, medication use, and cardiovascular risk factors, except for smoking habits. To help to diminish the likelihood of bias and reduce population stratification case and controls individuals were drawn from the same geographic region (Campania, Southern Italy) and matched for age, sex and race. All clinical data and biochemical features of enrolled patients were stored in a computerized database. A written informed consent was obtained from all patients according to the Ethics Committee of the "Federico II" University of Naples School of Medicine. The Ethic Committee regulations of our Institution approved the study protocol.
Percutaneous coronary intervention
PCI was performed according to the American Heart Association/American College of Cardiology guidelines [14]. Antegrade perfusion was graded by Thrombolysis In Myocardial Infarction (TIMI) criteria [15]. Angiographic lesion morphology was classified according to American Heart Association/American College of Cardiology classification [16]. Stenoses >50% were considered significant. Bare-metal stents (BMS) were used in the 80% of patients, while drug-eluting stent (DES) in the remaining 20%. Glycoprotein IIb/IIIa inhibitors were used in 30% of patients. After the procedures, all patients were on dual antiplatelet therapy with aspirin and clopidogrel for at least 30 days after BMS implantation and for 12 months after DES. Other cardioactive drugs for long-term medical treatment were left to the discretion of the attending cardiologists.
Outcome evaluation
In the evaluation of long-term clinical outcome, major adverse cardiac events (MACE) were considered as end points, including cardiac death, acute myocardial infarction (AMI), and needs of any new myocardial revascularization (considering re-PCI or coronary artery by-pass graft). All deaths were considered as cardiac, unless it was unequivocally proven non-cardiac. AMI was defined as recurrent chest pain with ST-segment or T-wave changes and recurrent elevation of cardiac enzyme levels. The follow-up was based on a direct systematic review of all patients' clinical files for a mean study period of 24 ± 4.3 months, contacting relatives or a patient's physician when necessary. Follow-up was completed in all patients and data stored in a computerized database. A second population was identified among the hypertensive cohort of patients afferent to the 'Campania Salute Project' [13]. We selected 74 patients affected by cerebrovascular events, either TIA or stroke. In particular, the diagnosis of TIA or stroke was confirmed by neurological evaluation according to current standards for care [17]. This included patient personal and family history, physical examination, computed tomography or magnetic resonance imaging, and laboratory testing. The diagnosis of stroke was based on WHO criteria, confirmed by TC or MR, when needed. The cause of stroke was identified in large-vessel disease, according to the clinical features and results of the diagnostic workup, based on TOAST pathophysiological classification [18]. TIA was defined as an episode of focal neurological symptoms with abrupt onset and rapid resolution lasting <24 hours that is due to altered circulation to a localized portion of the brain [19].
GpIIIa genotyping
Using a commercially available kit (Midiprep DNA, Qiagen, Valencia, California), genomic deoxyribonucleic acid (DNA) was isolated from 2 ml of the peripheral blood samples. PlA2 polymorphism was studied using combined polymerase chain reaction (PCR) and restriction fragment length polymorphism technique (RFLP) on PCR amplified products using PCR conditions and primers on a Thermocycler (MJ Research, St. Bruno, Canada) and DNA polymerase (TAQ, Qiagen) as previously reported [20, 21].
Statistical Analysis
Continuous variables are presented as mean ± SD and categorical variables as absolute number and percentage value. Differences between groups were assessed using univariate analysis of variance for continuous variables, with a Bonferroni post-hoc test for evaluation of multiple comparisons. Categorical variables were analyzed by chi-square test, and odds ratio (OR) with 95% confidence intervals (CIs) or by the Fisher exact test when the expected values in any of the cells of the test, given the frequencies and the overall sample size, was below 10; p value <0.05 was considered significant. Difference in event-free survival between groups were evaluated by the Kaplan-Meier method, comparisons were made using log-rank test. A Cox regression analysis was conducted for the PlA2 polymorphism considering age, cardiovascular risk factors, medication use, left ventricular ejection fraction, angiographic characteristics, and interaction of the PlA2 polymorphism in both the study populations. The software used was SPSS 16 (SPSS Inc., Chicago, Illinois).
Frequencies of PlA2 polymorphism in study population
Genotype distribution of PlA2 polymorphism in study populations
CAD patients
Hypertensive patients
Control population
Clinical and angiographic characteristics in patients with coronary artery disease
Clinical characteristics of CAD patients
PlA1 (n = 300)
PlA2 (n = 100)
p Value
60 ± 10
62.1 ± 8.6
Male sex (%)
Hypertension (%)
Diabetes (%)
Smoking (%)
Dyslipidemia (%)
Obesity (%)
Family history of CAD (%)
Previous AMI (%)
Previous PCI (%)
Previous CABG (%)
LVEF prior to PCI, mean ± SD
47 ± 10
51 ± 8
Angiographic characteristics of CAD patients
PlA1 (n = 300)
PlA2 (n = 100)
p Value
Coronary artery disease (%)
Multivessel Disease (%)
Lesion type, B2/C (%)
TIMI 3 post PCI (%)
cTFC post (mean ± SD)
15.10 ± 6
14.25 ± 8
Lesion length (mm)
15.54 ± 6.59
16.48 ± 8.74
Preprocedural stenosis (%)
86.55 ± 10.19
85.05 ± 11.48
Stent/patient (n)
1.08 ± 0.32
1.07 ± 0.26
Medication use
There were no differences between groups regarding medication use at the time of PCI and during follow-up time. In particular, at follow-up time both groups were similarly treated, using dual antiplatelet therapy (99% vs. 98% group 2, p = NS), calcium antagonist (19% vs. 18% group 2, p = NS), beta-blockers (45% vs. 47% group 2, p = NS), angiotensin-converting enzyme inhibitors (36% vs. 34% group 2, p = NS), and statins (42% vs. 40% group 2, p = NS).
Long-term follow-up
Effect of PlA2 polymorphism on cerebrovascular events in hypertensive patients
Characteristics of hypertensive patients
Hypertensives with TIA (n = 46)
Hypertensives with stroke (n = 28)
P value
Age (years)
62.06 ± 1.63
61.1 ± 2.60
Male sex (%)
Diabetes (%)
Smoking (%)
Dyslipidemia (%)
SBP (mmHg)
150.08 ± 3.23
147.5 ± 2.88
DBP (mmHg)
87.94 ± 1.78
88.83 ± 2.16
LVMI (g/m 2 )
127.09 ± 3.64
127.82 ± 2.68
The main finding of this study is the relationship between the PlA2 gene variant and the incidence of major adverse cardiovascular events in patients harbouring the PlA2 gene polymorphism. Indeed, in patients with CAD undergoing PCI we found that the presence of PlA2 allele associated with a significantly worse prognosis with a higher incidence of cardiac death, AMI, and new myocardial revascularization. Moreover, in an independent population of hypertensive patients with large vessel atherosclerosis and previous cerebrovascular events, patients harbouring the PlA2 gene polymorphism presented with a significantly higher incidence of stroke over TIA. Taken together these data suggest an effect for the PlA2 gene polymorphism in the development of more severe thrombotic complications in high risk patients.
Since the original report from Weiss et al.[8] indicating PlA2 polymorphism as a risk factor for myocardial infarction or unstable angina, several studies have investigated this polymorphism in the effort to discover a novel thrombogenic risk factor but to date results have been inconclusive and often controversial [8, 11, 22]. The inconsistence of findings in literature can be mostly attributed to differences in the design as well as to the choice of the control group and the endpoint of the studies. Moreover, studies differ in the variation of environmental factors and ethnicity, present biases in the selection of patients and controls and often aim to different clinical endpoints. Since atherosclerosis is a multifactorial disease, it would be too simplistic to explain interindividual variations based on genetic inheritance alone. Indeed several challenges exist in identifying the genetic determinants of such a complex disease including genetic heterogeneity, gene-gene and gene-environment interactions[12]. Furthermore, interaction of multiple genes that are in linkage disequilibrium and simultaneous studies of several genes may reveal associations that at present seem to be weak. Nevertheless, such approaches are costly, and impose the use of large populations and heavy statistic modeling in order to carefully peruse small impact of single gene variants on multifactorial disease [12]. There is still room for candidate gene association study that can be performed in relatively small populations, that are carefully characterized and selected for homogeneity[12]. We also have recently underlined the need for accurately selection of patients in association studies in order to identify the populations in which single gene polymorphisms may be more determinant in complex phenotypes such as atherosclerosis [20, 21]. Therefore, since platelets play a major role in the development of atherosclerotic thrombosis and acute ischemic events, we investigated the role of the PlA2 gene polymorphism in higher risk populations such as patients with severe CAD requiring mechanical revascularization and hypertensive patients with previous cerebrovascular events. Interestingly, in the CAD population, we observed that the presence of PlA2 patients was associated with a 3 times higher risk of death or 2.8 increased risk of AMI. Noteworthy, patients harbouring the PlA2 allele presented an higher risk of needing new revascularization at follow up with 50% of patients undergoing new PCI for the occurrence of a new myocardial infarction. This is consistent with data by Kastrati et al[23] reporting a higher risk of restenosis after coronary stent placement in these patients. Moreover, in an independent population of hypertensive patients with cerebrovascular events, the presence of the PlA2 allele was associated with a 4.1 higher risk to develop stroke rather than TIA. Thus, these data suggest that, in a high risk clinical scenario represented by patients with a greater prevalence of atherothrombotic risk factors, the presence of PlA2 is associated with a more aggressive disease leading to an higher incidence of major ischemic events and to an unfavourable outcome. Our results only apparently differ from the finding observed in a subgroup analysis of the Physicians' health study (PHS) [24] by Ridker et al.[25] which prospectively studied the risk associated with the PlA2 polymorphism for myocardial infarction, stroke or venous thromboses and reported no associations between PlA2 polymorphism and the relative risk to develop any cardiac or cerebro-vascular event. Indeed, as already remarked by previous studies [26, 27], the PHS was conducted in a very healthy population, with an event rate 4 times less than general population, and therefore with a very low risk of cardiovascular events. Also, our analysis focused on the outcome and the incidence of MACE in patients that already had a clinical manifestation of the disease, while the PHS aimed to the occurrence of the first event.
Limitations of our study include those inherent to any prospective but observational study. Moreover, since this is an association study, we cannot rule out the presence of a possible linkage disequilibrium with other neighboring genes that might explain the significant association with atherosclerotic phenotype or adverse prognosis.
The study was conducted in patients with severe CAD undergoing PCI while the replication study was performed in hypertensive patients with previous cerebrovascular events; therefore, our findings need to be confirmed in further larger patient populations. Nevertheless, recent studies[20, 21] underlines the need for selection of patients in association studies in order to identify the populations in which single gene polymorphisms may be more determinant in complex phenotypes such as CAD.
Conclusions and clinical implications
Our study suggests that the PlA2 polymorphism is associated with a more aggressive atherothrombotic disease and adversely affects the prognosis in these high risk patients. Indeed, in patients with severe CAD undergoing PCI the presence of PlA2 allele is associated with increased risk of death, myocardial infarction and new myocardial revascularization. Moreover, high risk hypertension patients harbouring the PlA2 allele show an increased risk to develop severe cerebral damage. Therefore considering the atherothrombotic disease, the PlA2 genotype could be useful to physicians in targeting antithrombotic strategies and therapeutic options. Since atherosclerosis is a multifactorial disease, future studies on interactions between environmental factors, common cardiovascular risk factors and platelet associated genetic determinants are warranted.
All Authors substantially contributed to the production of the manuscript.
FP and GG identified the hypothesis of the study. GG, GS and GI drafted the manuscript. Furthermore, FP was in charge of the percutaneous revascularization procedures, together with GG in patients with coronary artery disease. RDR, RP, SC and VT carried out the molecular genetic studies, performed the statistical analysis, patients' data collection and follow up. MC and BT are respectively, the heads of the Division of Cardiology and Division of Internal Medicine, at our Institution, and they finally approved the submission of the manuscript.
All authors read and approved the final manuscript.
Authors' Affiliations
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- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2261/10/41/prepub
Pre-publication history
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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subset: commoncrawl


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Marsh & Daughter set out on yet another exploration of past misdeeds.
A visit to a pub on the Kentish North Downs is the start of a new project for Georgia and Peter Marsh, a daughter-father team well known for solving and than writing up true crimes. A large gathering at the Three Peacocks pub turns out to be the Chillingham Drama Group, who are about to re-create a pilgrimage to publicize their upcoming play Becket. The same pilgrimage, 40 years before, led to the unsolved murder of Hugh Wayncroft. Now his son Julian and Julian's half brother Valentine Harper and their families are re-creating the original with the hopes of putting the village of Chillingham on the tourist map. Long associated with Saint Thomas, the Wayncrofts are an old Catholic family whose estate is rumored to be the resting place of Thomas' bones. Georgia and Peter's research and interviews unveil a massive split in the community between those who want the area developed and those who don't. When the vicar who is on the anti side is murdered, even more bad feelings and many a motive for murder are revealed. Now it only remains to pick the right one.
This is not the most exciting of Myers' Marsh & Daughter mysteries (Murder Takes the Stage, 2009, etc.), but the tried-and-true formula of mystery plus history makes for a pleasant read.


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I made this hand print t-shirt for my father-in-law's birthday. I wanted to do something with the girls' hand prints but didn't want to use paint. I've been using Wonder Under A LOT these days, I figured I could use it for this too!
Plain white t-shirt, washed
Wonder Under
Fabric of choice
Straight pins
1) Trace your kiddo's hands onto paper and cut out to use as a pattern
2) Pin your hand print pattern onto the fabric and cut out
3) Following the directions of the Wonder Under, iron the hand prints onto the t-shirt
4/5) Using the zigzag stitch on your sewing machine, stitch around each hand print
The t-shirt can be machine washed, just be sure it is turned inside out.
I have entered the world of blogging! My purpose? To stay connected to friends and family and invite you into my world. A world filled with fun, tears, laughter, excitement, elation, disappointment and all the blessings of being a mother and wife.
Sunday, February 26, 2012
A Simple Grandparent Gift
Labels: grandparent gift, handprints, sewing
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These are 8 scriptures to consider when discussing a pastor's salary. There scriptures are helpful for both the pastor and for those leaders in the church who set it.
Scriptures that the senior pastor should bear in mind:
- I am not doing this for gain (2 Cor. 2:17; 1 Tim. 3:8; 1 Tim. 6:5; Titus 1:7).
- I am free from love of money, and am content trusting God (Heb. 11:5-6).
- I am above reproach, and at pains to do what is right in the eyes of God and man (1 Tim. 3:2; 2 Cor 8:21).
- My followers owe me nothing—I will gladly spend myself for them (2 Cor. 12:14).
- I consider devotion to me as if to God; I will pour it out to the Lord (1 Chron. 11:18).
- My leaders are worthy of double honor (1 Tim. 5:17).
- My aim is to make their lives a joy (Heb. 13:17).
- I can be attentive to their needs, and quick to try to help, and alert to give them support and encouragement (1 Chron. 11:18).


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Jess Brigug — Babe of the Day
Meet Jess Brigug, a tall, blonde 22-year-old dream come true from Saint Louis, Missouri.
The city of Saint Louis has given us many great things – 7-Up, The Busch Clydesdales, the sweet yacht rock smoothness of Michal McDonald – and Jess, a model and college student, is continuing that tradition.
Much of her work has been on the runway, but we think this girl is ready for a cover shoot. What do you think?
Height: 5'7 | Weight: 115 | Measurements: 32B-24-36


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Will a Brocade 5100 SAN switch perform an overtemp shutdown if it reaches a certain threshold? I can't find any documented information about when warnings are issued when high temperatures are detected and at what temperature the SAN switch will eventually shutdown. Are any of these values documented and if so where can I find them? Is there a command which will display these? I can use tempshow to view the current internal temperature, but at what temperature do warnings get issued etc?
I have a switch that shows the following temperature values. Which are currently ok, but I think they are quite high.
Sensor State Centigrade Fahrenheit
1 Ok 38 100
2 Ok 41 105
3 Ok 35 95


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Erik S Barry is a freelance theatrical, dance and event lighting designer based in Chicago. Erik's designs have been seen at The John F. Kennedy Center for the Performing arts, The Harris Theatre Porchlight Music Theatre, and The Museum of Contemporary Art. He is the resident Lighting Designer for Underscore Theatre Company, and The Chicago Gay Men's Chorus. He received his Masters of Fine Arts degree at the University of Wisconsin -Madison campus. He has designed over 80 productions in his career. He has also designed for Chicago Shakespeare Theatre, Porchlight Music Theatre, Underscore Theatre Company, Tetro Vista, terraNOVA Collective, Chicago Folk Operetta, 16th Street Theatre, Bailiwick Chicago and The Museum of Contemporary Art. He received his Masters of Fine Arts degree at the University of Wisconsin -Madison campus. For further information, please use this site as a resource and feel free to use the Contact section.
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Can you think of a caption for this photo?
You can then check out some more fab entries for Saturday is Caption Day over at Mammasaurus blog by clicking the badge below. Happy Saturday!
Can I make one last plea before you shut me in the bin with this nasty pink bear??
Lol! Love it :)
To be or not to be, that is the question
"Mummy I'm telling you your chocolate bar is not in here!"
How many times do i have to tell you lot! No cold callers!
Haha! Fantastic :)
Lol! :)
Ha! :)
You see Officer, it's like this...first Mummy told me to hide in here. Then it took an awfully long time for her to find me...then I had a bit of a nap. No, I don't know where my mummy's got to!
Brilliant - that made me laugh!
Is is still raining out there?
Haha it does look like that :)


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If you pay estimated taxes, you may find yourself facing a tax debt when you come to fill in your tax return. As estimated tax payments are predominantly based on your income for the previous tax year, you can easily be crippled with a tax bill that is more than you anticipated if your income rises. If this happens to you, how can you cope with an unexpected tax bill that you probably won't have budgeted for?
It's tempting to hold off on sending your completed tax return so that you have more time to scrape together the cash to pay your tax debt. In reality, this is a bad move as it signals to the IRS that you are looking to evade paying your taxes. While this may be completely untrue, it's best not to give the wrong impression as the IRS can choose to prosecute you if they feel that you are purposefully dodging tax payments.
Getting in touch with the IRS might seem like a scary prospect, but it's a necessary step if you're having problems paying your tax debt. Once they are aware of your situation, they can offer advice on the repayment options that are available to you. After all, their main priority is receiving the money that you owe them! That said, it can be difficult to enter into negotiations if you don't fully understand tax matters and this can result in you agreeing to repay more than you can afford to. To reduce the risk of this happening, you may want to think about hiring a tax professional who will offer a free consultation on how best to set about negotiating with the IRS.
A tax debt should be considered a bigger priority than any other debts that you may have. If you usually throw more than the minimum payment at credit cards or loans, try stepping down to the minimum payments until you've paid off your tax debt. It may not put you in the best position, but the IRS will expect you to pay back your debts to them before you pay back your debts to other creditors.
Unless you don't have any alternative options, avoid taking out a loan to pay off tax debts. Most loans are coupled with extortionate interest rates that will result in you paying back a good deal more than you owe to the IRS. Using a credit card to pay off the tax debt in one go can be a better option, but make sure that you have the means to pay this off at a later date or you can quickly become saddled with high interest fees there too. If your tax debt isn't too high (for example, if it's less than $1,000), you may want to consider borrowing money from friends or family. In most cases, you won't be charged ridiculously high interest charges on top of the original loan and the repayment terms can be much less stringent.
This option allows you to spread your tax debt across five years (plus interest) as long as your overall tax debt does not surpass $25,000. If you think that this applies to you, you can submit an Installment Agreement Request Form (Form 9465), which the IRS will use to determine whether you are eligible. Alternatively, you can apply online via the "I Need To…" section of the IRS website and selecting the "Set Up a Payment Plan" option.
If you are approved for a streamlined installment plan, it won't come free. Successful applications are subject to a fee of $102 if you intend to pay by check, money order or credit card, but this falls to $52 if you opt for the convenience of monthly direct debit payments. This option does not automatically exempt you from late charges and interest, so this is worth bearing in mind if you anticipate struggling to cover these.
Generally speaking, the IRS are likely to approve your application if you meet the following requirements:
If you are experiencing severe financial difficulties and have no real means of paying your tax debt, you can fill in an Offer in Compromise Form (Form 656). Not everyone will be eligible, as you have to be able to prove that you are in financial difficulty to be approved. The 'compromise' aspect of the agreement involves offering either a lump sum or a series of fixed payments based on how much you can afford to offer. It's not uncommon for successful applicants to take a loan from friends or family members so that they can put forward a lump sum to reduce future interest payments.
Whichever payment offer you request, there are certain conditions attached. For example, offering a fixed lump sum means that the rest of the tax debt must be paid in a maximum of five further installments, with the lump sum being sent with the form. Requesting the short term periodic payment option requires the full amount to be paid within 24 months of your offer being received by the IRS, and your first payment must be sent with the form. Typically, each payment should be made on the same day each month. Requesting the deferred periodic payment option does not set a deadline for your due tax to be repaid, but it does require regular monthly payments to be made. As with the previous option, your first payment must be sent with the form.
Based on the circumstances, a taxpayer could qualify for an agreement to full pay within 60 or 120 days. The IRS is willing to offer these short term agreements to full pay in order to assist in tax debt repayment. Most of A taxpayer can request an agreement length depending on the specific situation.
Any one in this position essentially failed to adequately plan during the tax year. The best way to avoid tax problems and owing the IRS, is to work with your CPA or tax professional on a regular basis to ensure that your estimated payments are sufficient to meet your tax obligation at the end of the year.
I have to laugh because my friend is having this same issue with his latest tax return. He made a huge lump sum between estimated tax payments and he thought for sure he had put enough money aside.
As with any debt I think "Keeping your head out of the sand" is the most critical aspect here. Make more money should be beneficial not a pain in the ass.
another reason that people postpone sending their tax returns it to look for more tax deductions and tax credits due to them. This is normally very hard to scrape together alone so the option is normally a tax professional to go this for you because in the long run you save a lot of cash
Excellent tips. Even Nicholas Cage can take something useful from this post.


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Last night I attended the 2010 Scream awards show. TrueBlood hottie Anna Paquin arrived and decided to come over to sign autographs for dozens of fans on hand. Well all I can say is it turned into a frenzy. Things we so crazy u had to be there to understand. I was shooting video and at one point when she was in front of me I nearly ended up on top of her but I managed to hold onto the guardrail. However, the autograph guy next to me was not so lucky as he got knocked through the rail and onto the ground. The railing hit Anna in the foot and she left right away. Luckily the sexy TrueBlood star was not seriously injured. The video I shot is the first clip below
Here is another video shot by a friend


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I'm still knitting Lizard Ridge squares so for variety I came across this meme which is a little bit more quirky than usual – if you join in please leave a comment so that I can read yours
Things you've already done: bold
Things you want to do: italicize
Things you haven't done and don't want to – leave in plain font
1. Started your own blog. res ipsa loquitur.
2. Slept under the stars. Field weekend, 1998 – we didn't have enough tents so I was in the bivvy bag – it was great.
3. Played in a band. It was proper big band music and I loved it!
4. Visited Hawaii.
5. Watched a meteor shower.
6. Given more than you can afford to charity. I give what I can afford.
7. Been to Disneyland/world. And we all know how that worked out for me!
8. Climbed a mountain. I had to look them up to check that they count as mountains but I've been up a few in the Lake District including the Old Man of Coniston – affectionately known as Kanchenjunga
9. Held a praying mantis. No intention whatsoever.
10. Sang a solo. For real as well as in the bath!
11. Bungee jumped. No way.
12. Visited Paris. loved it.
13. Watched a lightning storm at sea.
14. Taught yourself an art from scratch. Does photography count? I tried to teach myself watercolours when I was younger but I was never very good at it – H is the artist in this house.
15. Adopted a child.
16. Had food poisoning.
17. Walked to the top of the Statue of Liberty. I've been to Liberty Island on 4 July but the tickets for the top were all sold out.
18. Grown your own vegetables.
19. Seen the Mona Lisa in France. smaller than you expect and not that impressive.
20. Slept on an overnight train. I've certainly slept on a train a few times but I don't think it counts – I harbour a secret wish to go on the Orient Express though.
21. Had a pillow fight.
22. Hitch hiked.
23. Taken a sick day when you're not ill.
24. Built a snow fort. Sadly we don't get that kind of snow – Dad once built us a mini igloo when we were very tiny though.
25. Held a lamb.
26. Gone skinny dipping.
27. Run a marathon. Edinburgh 2005. It has hills. Ouch
28. Ridden a gondola in Venice. Maybe I could tie that in with the Orient Express?
29. Seen a total eclipse. I'm counting this as a yes even though to be strictly accurate I have experienced a total eclipse but as it was in England it was cloudy and we had to watch the actual eclipse pictures on the telly. Very beautiful and awe inspiring none the less. We watched from my parents garden which looks out over the bay and saw hundreds of camera flashes and all the ships lights come on as it got dark. Because of the viewpoint we could see out of the total darkness to the south where it stayed light the whole time.
30. Watched a sunrise or sunset.
31. Hit a home run.
32. Been on a cruise. Not in the sense of cruise ship – I've done a lot of sailing but I don't think that's what it means.
33. Seen Niagara Falls in person. It rained. I was 10 I think. I want to go again with H as it's one of the few places that he's never been.
34. Visited the birthplace of your ancestors.
35. Seen an Amish community
36. Taught yourself a new language.
37.Had enough money to be truly satisfied.
38. Seen the Leaning Tower of Pisa in person
39. Gone rock climbing. Heights and I do not mix. I like land.
40. Seen Michelangelo's David in person.
41. Sung Karaoke.
42. Seen Old Faithful geyser erupt.
43. Bought a stranger a meal in a restaurant.
44. Visited Africa.
45. Walked on a beach by moonlight.
46. Been transported in an ambulance. In Florida, with appendicitis, on my honeymoon. enough said!
47. Had your portrait painted.
48. Gone deep sea fishing.
49. Seen the Sistine chapel in person.
50. Been to the top of the Eiffel Tower in Paris. Remember no 39 – I was fighting fear on the open air platform at the top. I'm still glad I did it.
51. Gone scuba diving or snorkeling.
52. Kissed in the rain.
53. Played in the mud.
54. Gone to a drive-in theatre.
55. Been in a movie.
56. Visited the Great Wall of China
57. Started a business
58. Taken a martial arts class. Judo – I was 10, it was a disaster!!
59. Visited Russia
60. Served at a soup kitchen
61. Sold Girl Scout cookies. No girl scouts, no cookies – I was in the Brownies though
62. Gone whale watching.
63. Been given flowers for no reason.
64. Donated blood. (blood bank not keen on my blood)
65. Gone sky diving.
66. Visited a Nazi Concentration Camp.
67. Bounced a cheque.
68. Flown in a helicopter.
69. Saved a favorite childhood toy. And it's not just my childhood toy – my teddy was also my father's before me.
70. Visited the Lincoln Memorial
71. Eaten Caviar
72. Pieced a quilt. And one of these days I'll actually quilt it and finish it!
73. Stood in Times Square. On 4 July – the electronic signs all said Happy 4th July
74. Toured the Everglades.
75. Been fired from a job.
76. Seen the Changing of the Guard in London.
77. Broken a bone. apparently you break your little toe lots of times without really noticing – nothing major though
78. Been on a speeding motorcycle
79. Seen the Grand Canyon in person.
80. Published a book.
81. Visited the Vatican.
82. Bought a brand new car.
83. Walked in Jerusalem.
84. Had your picture in the newspaper.
85. Read the entire Bible. I've read lots of it more than once but I don't think I've got cover to cover yet
86. Visited the White House.
87. Killed and prepared an animal for eating.
88. Had chickenpox.
89. Saved someone's life.
90. Sat on a jury. It was only very recently that they allowed lawyers to sit on juries – I'd love to see court proceedings from the other side.
91. Met someone famous. Bill Clinton and the Queen. Not on the same day. Clinton was at my old college and the Queen came to help celebrate a special college anniversary – I was in the choir and we were introduced to her. She said she enjoyed our singing.
92. Joined a book club.
93. Lost a loved one.
94. Had a baby.
95. Seen the Alamo in person.
96. Swum in the Great Salt Lake.
97. Been involved in a law suit. It's my day job!
98. Owned a mobile phone.
99. Been stung by a bee. On the bottom of my foot. It hurt. A lot.


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Teachers Enriching The Lives of the Girls
Teachers at Joan of Arc Academy are instrumental in helping the girls achieve their highest academic performance by creating learning environments that bring out the best in each student. Our teachers are qualified educators who are passionate about their careers, and have a positive impact upon the lives of young girls.
Our teachers are known for using a combination of learning methods to deliver the school curriculum. They enrich the academic experience through activities, outings, events and kinesthetic learning experiences. When girls are having fun, they want to learn even more!
Teachers encourage polite and respectful behaviour from the students, teaching them how to care for their peers and manage social issues. Learning to respect others, also encourages the girls to respect and care for themselves.
A student who completes the full Joan of Arc Academy program moves on to high school with exceptional French and English language skills, an in-depth understanding of math and science, well-established study habits and confidence in both her leadership skills and academic ability. The teachers at Joan of Arc help create a supportive environment for the girls to succeed academically, challenge themselves and develop life-long skills.


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South Florida Community Land Trust is a non-profit corporation that protects land to keep housing affordable forever. With a mission "to provide and preserve quality, sustainable, affordable housing for underserved populations in South Florida," the group is committed to ensuring that individuals and families – particularly low-income households – can afford housing without comprising on quality or location. It is the only established organization in Broward and Miami-Dade Counties currently committed to the long-term affordability of housing.
Mandy Bartle | Executive Director
Mandy is a visionary with the proven ability to shift community outcomes. She has published over 30 reports identifying strategies for distressed areas, resulting in over $15M in investment to South Florida's underserved communities. Ten years ago, she organized South Florida's first regional housing conference, first countywide housing needs assessment, and first coalition of businesses, community groups and government to address affordable housing. The efforts resulted in the formation of South Florida Community Land Trust, in which she has served as the Executive Director since 2010.
Mandy holds a Bachelor's from Carnegie Mellon University in Architecture and Urban Studies, where she also completed graduate coursework in Public Policy and Management. She has been a leader on local issues, serving on numerous boards and committees, including most recently as Chair of the Fort Lauderdale Affordable Housing Advisory Committee and on the Board of the Community Reinvestment Alliance of South Florida.
Anna McMaster | Program Manager
Anna McMaster is passionate about building equitable, sustainable, and engaged communities. She has been instrumental in various affordable housing developments, establishing regional and local plans, as well as leading community engagement projects throughout South Florida. In addition to her experience in Urban Planning and Real Estate, Anna has a background in photography and graphic design work.
Anna holds a Master's in Urban and Regional Planning from Florida Atlantic University where she completed her master's thesis on linking historic preservation and affordable housing in East Little Havana by utilizing the CLT model. She also holds a certificate of Urban Planning and Design from Harvard University and a BS in Sociocultural Anthropology from the University of California. Anna currently serves on the Advisory Board of the Broward New Leader's Council and was a fellow of its inaugural class.
Charles Dabney | DIRECTOR OF REAL ESTATE DEVELOPMENT
Charles T. Dabney, Jr. serves as South Florida CLT's Miami Market Manager. Charles recently arrived from Jacksonville where he most recently served as Senior Program Officer for Real Estate and Lending with the Jacksonville Program Office of Local Initiatives Support Corporation. However, Charles is no stranger to South Florida, having served with both the Greater Miami LISC office and Miami-Dade County.
Charles was raised on a farm in Tidewater Virginia and hails from a family of public school teachers. He is a graduate of Hampton University, where he received his B.S. degree in Business Management, and Carnegie-Mellon University's H. John Heinz III School of Public Policy and Management, where he was awarded the M.S. degree in Public Policy and Management with a major in Environmental Planning. Charles has also completed additional studies at the University of Maryland – College Park, where he earned a Graduate Certificate in Housing Finance.
Claudia Alaimo | Office Manager
Claudia P. Alaimo serves as South Florida CLT's office manager. She was born in Bogota, Colombia, and as a teenager moved to Queens, New York. After graduating with a degree in Business Administration, Claudia worked in the import/export industry in New York. Claudia also worked in the investment banking industry in New York City. After relocating to South Florida, she became very involved in the Broward County Public and Charter School Systems volunteering in her children's elementary school where she was awarded volunteer of the year from Broward schools. She also held many leadership positions within the Parents Teacher Association. Claudia helped her husband start up a successful audio and video integration business and was the office manager for a decade.
Claudia's passion to help people led her to graduated Magna Cum Laude from Liberty University with a Psychology and Counseling degree. She is a member of the Psi Chi International Honor Society in Psychology and volunteers in faith-based organizations and nonprofit counseling centers.
Giovanni Moss, President (since 2010)
Housing & Community Development Director, Town of Davie
Giovanni Moss has worked in housing, community development and neighborhood revitalization at the Town of Davie since 2005. As Director, he has secured and managed over $8MM of federal and state grants. Giovanni brings a vast amount of leadership to the South Florida CLT Board, particularly on government, programs and partnerships.
Jerry Heniser, Treasurer (since 2012)
Senior Vice President, BBVA Compass
Jerry Heniser has over thirty years of professional business experience, spending the last two decades in the banking industry specializing in public, institutional and nonprofit finance. Mr. Heniser rejoined the South Florida CLT Board of Directors, having previously served as the founding Chair.
Sandra Einhorn, Secretary (since 2010)
Executive Director, Nonprofit Executive Alliance of Broward
Sandra Einhorn is a strategic marketing professional working with nonprofits for the past decade. She currently serves as the Executive Director of the Nonprofit Executive Alliance of Broward. She has taken leadership roles on several local boards and committees. South Florida CLT is fortunate to also have her on our Board.
Marcia Barry-Smith (since 2007)
President, MBS Consulting Services
Marcia Barry-Smith's career spans over thirty years in the banking and finance industry. She currently is President of MBS Consulting Services, Inc. having previously served as the Senior Vice President, CRA Officer and Foundation Director for BankAtlantic. She has received numerous awards for service and leadership in the community. Her years of service on the South Florida CLT Board have been critical in developing relationships with local partners.
Steve Werthman (since 2010)
Vice president of operations, HOPE South Florida
Steve Werthman has dedicated his career to helping serve the homeless, working with faith- based and community-based organization as well as County government. At HOPE South Florida he oversees $18 million in federal, state and local contracts. Steve lends the South Florida CLT his expertise on local and federal programs as well as ongoing homeless needs.


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Cooking is an art form and like many others, it can always be improved. With new information, or just a few reminders, you can up your game significantly. If you are looking to improve those skills you picked up ages ago in college, or just want to try out something different, these tips will help you to do just that.
When cooking any recipe, use the best ingredients that you can afford. Splurge a little on imported cheeses or better quality meats when you can, so that you can experience a restaurant, quality-tasting meal at home. To enhance the experience even further, try to creatively plate up the meal with a little thought, for something different every now and then.
You should not boil pasta in water that has oil in it. When you add oil to the water that you are boiling your pasta in it keeps the sauce from sticking to the pasta. By leaving the oil out you can toss your pasta in the sauce and it will cling to it.
Save time by cooking large quantities, and freezing the extra. When you are planning an elaborate or time consuming meal, prepare extra servings. Making more won't increase your cooking time much, and these extra meals can be frozen, providing a fast and healthy alternative to the typical frozen TV dinner.
Improper storage techniques won't ensure they will last from harvest through the winter months, which is when they are most often desired for inclusion in recipes. Apples rot in dry warm air, so store them in loosely tied plastic bags in the refrigerator or a cool basement. Quickly remove any apples that are rotting, because they will cause the other apples to spoil quicker.
Eventually if you practice enough you will get good at it. By following these tips you will have the knowledge that other people have had to acquire the hard way. Following good advice and tips is a must in cooking and thanks to these you will be well on your way. Just remember to enjoy it!


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Technical Service Assistants
» Graduate of Electronics or any IT-related course
» Excellent communication and interpersonal skills
» Assertive & has initiative, performs with a sense of urgency
» Willing to be trained, honest and can work without supervision
City/Town: Cebu
Location: Cebu
Wage/Salary: Negotiable
Start: Immediately
Duration: Permanent
Type: Full Time
How to apply: Send resume by email. Walk-in applicants are also welcome!
Company: Toplis Solutions, Inc.
Contact: Recruitment Officer
Email: email@example.com


text: Launch Angiopoietin-2 (ang-2) an angiogenic peptide released by endothelial cell Weibel-Palade bodies (WPBs) increases endothelial activation and vascular permeability. in 83 patients ABCG2 with early sepsis and 41 hospital controls and related to reactive hyperaemia-peripheral arterial tonometry RH-PAT a measure of endothelial NO bioavailability. Results Plasma Ang-2 was elevated in sepsis (median [interquartile range (IQR)] ng/ml: severe sepsis 12.4 [8.5-33.4] sepsis without organ failure 6.1 [5.0-10.4] controls 2.7 [2.2-3.6] P < 0.0001). It correlated inversely with RH-PAT (r = -0.38 P < 0.0001) and positively with IL-6 (r = RAF265 0.57 P < 0.0001) and degree of organ failure (sequential organ function assessment score) (r = 0.58 P < 0.0001). The correlation of ang-2 with RH-PAT persisted after controlling for sepsis severity. In a longitudinal mixed-effects model recovery of RH-PAT over time was associated with decline in ang-2. Conclusions Ang-2 is usually elevated in proportion to sepsis severity and inversely correlated with NO-dependent microvascular reactivity. Impaired endothelial NO bioavailability may contribute to increased endothelial cell release of ang-2 endothelial activation and capillary leak. Brokers that increase endothelial NO bioavailability or inhibit WPB exocytosis and/or Ang-2 activity may have therapeutic potential in sepsis. Introduction Microvascular and endothelial dysfunction are central to the pathophysiology of sepsis contributing to organ dysfunction even in the setting RAF265 of normal post-resuscitation haemodynamics [1]. Angiopoietin-2 (ang-2) an angiogenic peptide activates endothelial cells and increases vascular inflammation. It functions as an autocrine mediator of the endothelium and is stored predominantly in endothelial cells [2]. Ang-2 is usually a ligand of the tyrosine kinase receptor Tie-2 and antagonises the angiopoietin 1-induced Tie-2 receptor autophosphorylation responsible for the maintenance of endothelial cell quiescence [3]. This results in endothelial cells being sensitized to the effects of pro-inflammatory cytokines and vascular endothelial growth factor (VEGF) resulting in a lack of endothelial cell quiescence and a rise in vascular activation and irritation. Degrees of circulating ang-2 have already been been shown to be elevated in individual sepsis [4-6] RAF265 and recently to correlate with mortality [7-9] and pulmonary vascular drip [10 11 Despite an evergrowing fascination with ang-2 in sepsis the systems underlying raised ang-2 amounts in sufferers with sepsis are unclear. Ang-2 is certainly co-packaged with von Willebrand Aspect (vWF) within endothelial cell Weibel-Palade physiques (WPBs) and it RAF265 is instantly released upon endothelial cell excitement and WPB exocytosis [12]. In-vitro research demonstrate that exocytosis of WPBs could be brought about by multiple secretagogues including thrombin histamine epinephrine VEGF and hypoxia [13]. Nevertheless there are just two known inhibitors of WPB discharge: nitric oxide (NO) and hydrogen peroxide (H2O2) which NO is certainly regarded as the main [14]. We've recently confirmed impaired microvascular reactivity in sufferers with sepsis by reactive hyperaemia peripheral arterial tonometry (RH-PAT) [15] which reaches least 50% NO-dependent and therefore provides an estimation of endothelial NO bioavailability [16]. As opposed to previously hypotheses suggesting main overproduction of Simply no in sufferers with sepsis [17] there is currently increasing proof that systemic Simply no production is certainly normal or reduced in human beings with sepsis [18 19 Impaired endothelial Simply no bioavailability may underlie elevated WPB exocytosis in sepsis and therefore the discharge of ang-2 from endothelial cells. Nevertheless the relation between endothelial Simply no measures and bioavailability of WPB release in sepsis is not determined. We hypothesized that plasma ang-2 amounts in sufferers with sepsis will be elevated compared to disease intensity and will be inversely linked to endothelial NO bioavailability as approximated by RH-PAT. Components and methods Research design and setting We performed a prospective observational study at a 350-bed teaching hospital in tropical Australia with an 18-bed mixed ICU. Prior approval was obtained from the Human Research Ethics.


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Every day, so many people are excited to try vegan diet! Unprocessed vegan diet is good for health and environment. In 2017, it is really cool to be a VEGAN across the world!
Today, I read an interesting blog - 22 Days Nutrition. Word renowned excercise physiologist Marco Borges inspire people to try nutritious and tasty plant-based diet. 22 Days Nutrition is awash with nutritious recipes , motivating articles and tips to maintain healthy lifestyle.
Here is the link to the amazing blog, http://www.22daysnutrition.com/blog/
Here are some interesting articles about Marco Borges
Thursday, January 26, 2017
Vegan Blog - 22 Days Nutrition
Labels: 22 days nutrition, Marco Borges
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2012 Ford Focus Reviews
2012 Focus Owner Reviews (10)
Kevin 2018-10-02 14:26:46
We bought our 2012 Focus se in 2015 with 22,000 miles on it for my sig other. She and i are over 55 and she had to stoop to get in. The door swings way out and ypu have to lean out to get it. The stereo developed a short so we installed a 7" all in 1 android dvd specific fpr rhis car. Just like the remote start (fortin) plug and play pretty much. 30.2 mpg 60 miles a day. The seats were long enough to come to her knees sitting. Not awd a bummer on our street. I tried talking her into a Fusion awd... nope At 52,000 miles the transmission was overheating backing up my 30degree driveway 50feet. Recall on trans module. We had to wait 2 weeks for the part. A deer (500lb+) ran into our fender, looked at us (10pt)and ran off... $2500 indamage. Fixed. 89,000 code for missfire on 1. Started ising gumout P.E.A.... SEAFOAM IS FOR OUTBOARD 2 CYL ENGINES. Ok til 22,000 po031 or 131 cyl 1 misfire, new coils, new plugs. 25,000 miles intetmittant cyl 1 misfire, traded in on Trax awd. I love my 2005 mercury Montego AWD.
Great small sedan for every day use
2015-12-28 08:48:57
Excelent equipment, love the audio and all the standar features.Great fuel consumption, I just rent on for my trip to Orlando and I just had to buy one. 35+mpg for a 160hp car, nice sporty suspension. And all the Safety features with the next gen Airbags.Nothing like a Honda Civic or a Toyota Corolla, way over this vehicles. Something weird with the Transmission feeling ******* a matter of knowing the car to get use to, I just love it.
2012 Ford Focus SE w/Sport Package - 5-speed Manual
2015-11-03 18:26:44
I had a long line of Subaru WRXs before I bought this car, but needed something for a 50+ mile (one-way) commute. I bought this Focus brand new with 7 miles on the odometer. It's been the best, most reliable vehicle I have ever owned. I went with the manual gearbox due to the reported issues with the automatic (and that extra 1 hp!) It is sporty and fun to drive, loves to be thrown into corners and driven hard - but it handles a boring freeway commute with ease (and great fuel economy!) This car performs admirably in all driving conditions.But the biggest praise is the build quality and safety. I was driving home on the freeway and was sandwiched between two semi trucks - a driver wasn't paying attention and pinned my car against the other semi. Not only was I able to walk away from the accident, but the car only sustained body damage - despite being in a 40+ mph crash with two semi trucks!! This little car saved my life. Thank you Ford Motor Company!!
Unsafe at any speed,,,,,stay away
mcl8t1 2013-08-17 20:07:36
I bought my Ford Focus with excitement figuring that I was going to buy American this time. Within 5000 Miles I lost my power steering 2x while driving, the second time I ended up in the way of oncoming traffic, Ford replaced the rack and pinion steering system 2x. It hitches and jerks as you acelerate from a stop, The car recently went dead and was brought in at 36,000 miles. it spent 2 weeks in the shop and they left the ticket open on it when I finally did get it back......, they can't even figure out their own cars. It had a transmission module replaced as well as a bad ground wire to the starter, Fords may be assembled in America but their parts can't be.......no doubt about it, At 5000 miles and 2 new front ends I asked them to take the car back.......they basically told me to go scratch..........never again will I buy a Ford
disappointed in the car
fairgolfer 2012-08-18 17:37:52
The Focus hatchback looks great from the outside and is fairly comfortable on the inside (providing you're in a front seat). We got a 5-door hatchback Titanium model. The hatch is nearly impossible to close and it takes more upper body strength than either my wife or a neighbor can garner. I also own a Nissan Murano without automatic tailgate and it is way easier to close than the one on the much smaller Focus. Ford Sync is a real joke - it can't find you on an interstate highway and the "commands" are not very reliable. Have to shut off the canned message all the time after it can't figure ******* own command prompts. We've just about giving up using it and certainly won't renew it when the 3 year free period is over, absent major improvements. Shifting is very noticeable and it hesitates when travelling uphill. It gets good gas mileage, though. If I were looking again (only had it 3 months) I would look at a Prius V and bypass the Ford dealer.
My First Ford And My LAST Ford!
AOL user 2012-07-12 22:59:20
The Focus is comfortable and gets great gas mileage. But that's it! The auto trans shudders at acceleration, the idle is rough, it has a miss and the suspension makes strange noises. And guess what, the car has less than 7,000 miles. And if all of that isn't enough, the trunk lid is way, way out of alignment. Basically the Ford Focus is over rated and over priced!!!!!! And don't expect Ford to get real excited when comes to helping their customers!!!!
Bought this vehicle for commuting to work
AOL user 2012-07-04 18:25:27
Car is really beautiful considering the 2003 focus I traded in. The SYNC that comes with the car is almost impossible to figure out. The car has a lot of room on the inside. It seems to take a little while to switch gears but I was told that is because of the mileage you get per gallon which is about 31-33. My biggest complaint is the dealership that told me when I was just looking that the focus comes with zero percent financing, however after sitting at the table I was told the focus would be 2.9% even with great credit. I should have walked at that moment but call me a fool.
2012 Focus SE sedan
rcbutler62 2012-02-23 23:55:24
SE__4dr_Sedan~*************************~Phoenix~Arizona~City~Average~Daily Commuting~Fun or Weekend Car~Stock from the factory with sport package~Ford Fusion & Fiesta~I love this car! I bought it back in August 2011 to replace my gas guzzling 1997 Explorer XLT. Living in Phoenix it gets a lot of surface street time, stop & go type driving with about 20-25% freeway driving. The Explorer was getting about 12-13 mpg in town, this is averaging 33.6 mpg overall! Took a day trip to Benson & Tucson, AZ and averages 42 mpg! Plenty of leg room, lots of get up & go and handles great. Mine was brought in from a Las Vegas dealership with the sport suspension, moon/sun roof, tinted windows and was on the lot 4 1/2 hours before I drove it home. If you are looking for economy, sporty packaging and a fun ride, look no further - this is it!~false
try it you will like it
AOL user 2011-11-11 22:03:32
I replaced a 2003 focus hatch which was flooded during hurricane Irene. the improvements in styling, interior and features are quite significant. i thought the 2003 handled like a go-kart, but the 2012 is much better. what makes me miss the 2003 are the transmission ( auto ) which has an annoying stutter in first gear when warm in local travel, a spare tire well that barely fits the compact spare and a real tacky dashboard cover that looks and feels like a cheap rubber welcome mat. overall this is a major improvement over the 2003 which I really liked. The car is roomier and has better handling and acceleration. Fuel mileage so far is decent for short trips locally, but I have not had it on a trip at highways speeds yet. Overall, it is better than I expected having had an older model. i like it.
The Titanium Ford Focus is your luxury sedan in a small package.
cpogordon 2011-06-19 13:55:43
The upscale interior and available options on the Ford Focus Titanium makes it possible to move from a low mpg luxury sedan to a smaller sedan, or hatch, with all the comforts of a larger luxury vehicle along with the additional benefit of higher mpgs. Great looking car in both the Sedan and Hatch version and I especially love the 5-door Hatch which I own. The 10 speaker Sony sounds system is great, the 6-speed automatic manual transmission has been smooth and flawless, upscale soft-tough materials along with the comfortable leather seats are best in class, and the My Ford Touch (MFT) is great. Many of the initial problems with MFT have been fixed and some of the problems reported about MFT or lower than expected gas mileage are the result of people not following proper directions with using MFT or not properly setting Trip 1 & Trip 2 settings when trying to determine mpg. The ride is very quit for a small car and it has excellent handling.


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PHOTO FRIDAY: Scenes From Kirsten Geyer's 'Film Friday' Series
'Photo Friday' is an occasional photographic series we post on The B-Town Blog, and this week's edition is 'Film Friday' by area resident Kirsten Geyer, who says:
"Film Friday" is a photography project I started in order to re-discover my love of film.
The project itself is simple – take and show a full roll of film every week.
As a professional portrait photographer, I was curious to see what kinds of images I could come up with if I spent a few minutes each week taking "portraits" of (mostly) non-human subjects.
For the first week I decided to venture out of my own neighborhood of White Center and head South to B-town.
If you would like to learn more about the project or get an urge to pull out your old film camera and play along, visit my blog!
Kirsten lives in the White Center area, and her gear for this shoot included:
- Nikon F100
- Fuji 400h
- 50mm 1.8
- Walgreens 1 hour photo
- Photos are uncut and unedited…welcome to my first roll!
She also said this on her blog about the photos below:
- All of these photos were taken … in the pouring rain I might add…since the lab I sent my other roll too gave me a 2 week (?!) estimate! All I can say is that those photos better be GOOD! So, thanks, Walgreens 1 hour photo, for saving my butt (plus you can't beat $5 for a 1 hour develop/scan!).
- If you ever need an open pass to photograph anything you want without making people nervous, bring your charming 4-year old with you, they make a pretty fine entrance ticket.
- This was the first roll of film I've seen from my f100! I'm in love.
- I over-exposed the film 1 stop or so…ala Jonathon Canlas (see his link below).
- 35 exposures is ALOT…I was stretching it towards the end trying to find things I wanted to photograph, but as always I think my best shots come at the end of a photo-session…once my brain has had a chance to warm up a bit.
To see larger versions of each photo, just click an image:
"To me, the most beautiful moments don't happen in a perfectly-styled Photography Studio," she said on her website. "…they happen while you kiss your baby's feet on the changing table or when you roll around the living room floor with your four year old. These are the moments that, as a Mother, make me want to shut my eyes tight and remember forever. And, as a Photographer, those are the moments that I want to capture for you."
Kirsten's work can be found here:
- Project Blog: www.filmfriday2011.wordpress.com
- Personal Blog: www.somethingcheeky.wordpress.com
- Portrait Site: www.kirstengeyer.com
[EDITOR'S NOTE: Are you a local Photographer? Have some pics shot in Burien you think we should showcase? Or just some amazing photos worth sharing with our Readers? Please email us a link and explanation (including technical details) and we'll consider posting yours!]


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On November 14, 2017, the Court of Appeals (Division 1), in Offerman v. Granada, LLC, 2017 WL 5352664, reversed a trial court order directing specific performance of an alleged option to purchase real property, holding that the alleged option was too indefinite to be specifically performed because the parties did not agree to all of the material terms of the option.
Tenant-Purchaser Offerman executed a two-year lease with Landlord-Seller Granada, which granted Offerman "the option to purchase [the] property…for a sales price to be determined at that time by an independent appraiser acceptable to both Tenant and Landlord. (Terms and Conditions to be stipulated by both parties at such time)." (emphasis added). Offerman timely advised Granada he intended to exercise the option, asked Granada to name an appraiser, and, when Granada did not respond, Offerman tendered a $240,000 appraisal to exercise the option. Granada did not retain an appraiser but instead simply demanded $350,000 to close the sale. After a bench trial, the Court determined that Offerman was entitled to specific performance, and, as the parties had not agreed to certain terms, held a second evidentiary hearing to resolve the form of judgment, therein naming a title agency to handle the escrow, setting a closing date, allocating the transaction fees between the parties, and ordering Granada to pay for the property inspection.


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There's no debating that the past 12 months stand as the high-water mark of DeMar DeRozan's career.
There's no debating that the past 12 months stand as the high-water mark of DeMar DeRozan's career: he posted career-highs in scoring, PER, and Win Shares, he advanced in the playoffs for the first time, he earned his second All-Star trip, he was a central piece on a top-five offense for the second straight season, he raked in a fat $139 million contract, and he won gold at the Rio Olympics. Even DeRozan's harshest critics—the ones who rightfully point to his poor shot distribution, rough efficiency numbers, shaky three-point stroke and forgettable defense—must acknowledge that DeRozan (23.5 PPG, 4.5 RPG, 4 APG) took his non-shooting approach to the shooting guard position about as far as it can go last season. How long will it take for the other shoe to drop? DeRozan, 27, has logged massive minutes for six straight seasons, he hasn't made much progress extending his range, and he's had the benefit of playing in the glow created by Kyle Lowry. DeRozan's defensive work has really gone in the tank too: last year, Synergy Sports ranked him in the 21st percentile overall as a defender, Defensive Real Plus Minus ranked him No. 78 among shooting guards, and Toronto's defensive rating improved by nearly six points when he was off the court. For now, DeRozan's elite ability to get to the foul line and his strong fit with Lowry should keep this honeymoon going. Unfortunately for DeRozan, the margin between "Best season ever!" and "Big step backwards" looks pretty thin. (Last year: No. 61)
+ He set new career-highs with 23.5 PPG, a 21.5 PER and 9.9 Win Shares
+ Fourth in the 2016 playoffs with 123 FT attempts, trailing only KD, Westbrook and LeBron
– His 46.3 eFG% was worst among players with at least 1,200 field goal attempts last season
– Led the NBA with 558 field goal attempts from 10-to-19 feet, but connected on just 40.3%


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|Biosequences .. Software .. Molbio soft .. Network News .. FTP
I have funding secure until August 1998 for a postdoctoral position in my lab to study the regulation of muscle fiber phenotype by hormones. Opportunities to learn state-of-the-art anatomical and imaging methods as well electrophysiolgical approaches to neuromuscular function are available in an attractive research environment. More details can be found at http://www.emory.edu/ANATOMY/Postdoc.html.


text: >..........but please keep in mind >that I have watched for several years as budgets have been cut, my tuition >and living expenses goes up, and my income and financial-aid remain the >same. It is like a broken record (yes I know what records are) to hear >people complain about a short term inconvenience and offer a solution that >threatens long term progress. >Anthony Odenthal >KE7OSN >President Amateur Radio Club at OSU -------------------------------------------------- Hi Anthony, Very well said. I find it astonishing the tone deafness of some of the postings that appear here from time to time. Thanks for your post. 73, Armando N8IGJ


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Name: Honky Tonk Angels
Year: 1988
Language: English
Duration: 77 min
Country: United States
Director: Richard Mailer
Women and the mean they love that's the theme of this new story based on a collection of Richard Mailer's greatest scenes from intropics. Here they all are: Blondi, Nina Hartley, Jeanette Littledove, the one and only Angel, and many, many more of the industry's hottest stars. They're honky tonk angels, and they'll bring out the devil in you!
Actress: Annette Haven,Nina Hartley,Angel,Trinity Loren,Blondie Bee,Bionca,Sheena Horne,Renee Morgan,Tammy Hart
Categories: 80s porn stars, 1988, United States, English, Richard Mailer, Annette Haven, Nina Hartley, Angel, Trinity Loren, Blondie Bee, Bionca, Sheena Horne, Renee Morgan, Tammy Hart, Tom Byron, Paul Thomas, Randy West, Billy Dee, Harry Reems, Francois, Tony Montana, Richard Pacheco, Facial, Interracial, Black, Latin, Asian
Actors: Tom Byron,Paul Thomas,Randy West,Billy Dee,Harry Reems,Francois,Tony Montana,Richard Pacheco80s porn stars in "Honky Tonk Angels"
Tuesday, November 10, 2015
Keywords:80s porn stars1988United StatesEnglishRichard MailerAnnette HavenNina HartleyAngelTrinity LorenBlondie BeeBioncaSheena HorneRenee MorganTammy HartTom ByronPaul ThomasRandy WestBilly DeeHarry ReemsFrancoisTony MontanaRichard PachecoFacialInterracialBlackLatinAsian
© 2019 TUBEPORNCLASSIC.MOBI :: The latest Classic porn movies and photos on VINTAGE Tube. Daily-updated Retro porn videos.


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Two Months!
Maisy is two months old today! And my has she grown in the last two months! We haven't had her check up yet, but I know what we'll find out... that she is a little gainer! She is already over 13 pounds and deliciously chubby. I love snuggling her and nibbling on her chubby arms and legs. Oh, and those cabbage patch doll cheeks! She is soooo kissable. We have just LOVED these last two months with our little girl. I can honestly say that although learning how to be a mom has been the hardest thing I've ever experienced, it is the greatest blessing. Thank goodness for my man Stu, who has eased into parenthood like a pro... We lean on each other a lot and I am so excited to keep learning and growing together as parents!
At 2 months, Maisy:
-is a great sleeper! She takes 3 great naps a day (most days) and sleeps about 6-7 hrs solid at night!
-is such a happy baby! About 4 weeks ago, we were concerned because she was so sad all the time :( we later found out that she had a pretty intense outbreak of eczema all over her body (we thought it was just baby acne for a long time) turns out, it is extremely itchy and uncomfortable, which is why she was always fussing. I felt terrible. But now that it's under control, she is so happy and smiley! I'm SO glad she's feeling better.
-needs to be swaddled tight, otherwise she will not fall asleep... If she breaks free of her swaddle, she will not fall back asleep for anything! She is VERY particular about her swaddles too. It just makes me nervous because I worry she'll get too hot, but she loves it...
-has discovered her little tongue! She loves sticking it out and making faces. Sooo cute.
-has the BEST hair! People stop me in the store to comment on it, some even asking if they can touch it (yeah, I'm gonna say no...) Her little faux hawk is so cute and can't be tamed! We try to brush it down after her baths, but it just ends up sticking straight up anyway...
-is our little water baby! She loooves bathtime and swimming with mommy and daddy in the pool. Plus, she is dang cute in her little swim suit :)
-still has deep blue eyes. The left one has a little bit of orange-ish color around the pupil, making me think that she may have her daddy's "sunflower eyes" after all. I'm not getting my hopes up though...
-loves her swing!
-sits up tall and proud in her bumbo! She loves sitting in it! She is so strong and loves to just sit and look around.
-seriously loves her daddy. She recognizes his voice when I'm talking to him on the phone and she perks up like crazy! She loves when he comes home and just stares at his face. So sweet.
-eats like a champ! Not too many know about my hard experience with nursing... I almost gave up soo many times, but she eventually got the hang of it and now she eats so great! I'm so proud of my little MJ. It's probably one of my most favorite things to nurse her and hold her close :)
-has her parents hearts, completely. We can't imagine life without our little joy.
This weekend we are flying up with my family to Oregon to be with my Gramma Billie. I am nervous/excited to take our baby girl on her first plane ride! I'm sure we'll have lots of pictures and stories from our trip!
11 comments:
- Paige said...
so adorable Angela! I'm so happy for you guys :)
- August 15, 2011 at 3:33 PM
- kelsey bang said...
oh my goodness, cutest daughter ever! Love the cute pictures in the pool to! So fun! its great to hear you have a good sleeper to! What a great family! So happy for you guys!
- August 15, 2011 at 3:49 PM
- emily said...
love those chubby cheeks! So cute
- August 15, 2011 at 4:09 PM
- Kelcie&Taylor said...
she is darling! gorgeous girl! :)
- August 15, 2011 at 6:52 PM
- Bobby Bottoms said...
She is gorgeous all over, but my goodness she has such perfect lips. They are so cute.
- August 15, 2011 at 7:22 PM
- The Merrills said...
Her hair is the best!! I love that she has lots of it :) Little girls should. I secretly wish Briggy would start growing some hair too. We're happy for you guys! So cute!
- August 15, 2011 at 8:57 PM
- Brea said...
so precious!
- August 16, 2011 at 1:06 AM
- j&j said...
.. oh my gosh. maisy is adorable. i can't believe i haven't met her yet.. makes me so sad!! i just oo and ahhh at the pics:)
- August 16, 2011 at 9:42 AM
- Grafton and Laurisa Milne said...
okay i can't stop Drooling over her!! ahh. I need to see her soon, she's growing so fast. SOO glad she is doing so well, you deserve it. you're such a good little mommy. love you sister :)
- August 16, 2011 at 9:29 PM
- Monica said...
Congratulations! She is so beautiful. I am so happy for you! What an exciting time! I'll have to keep looking on your blog to see all the amazing pictures you take of her. You are a great photographer!
- August 23, 2011 at 10:17 AM
- Ashley Kay said...
SO SO SO Cute ang! i miss you! and i want to miss this little cute chunky baby! hope you're doing great! LOVE YOU
- August 30, 2011 at 6:06 PM


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I'm always on the lookout for a good parm sandwich to feed my friends! And the city is full of charming hidden gems – including the amazing Parmigiana Sandwiches, tucked in an industrial area of Woodbridge, near Weston Rd. and Hwy. 7.
It's home to an incredible assortment of homemade sandwiches and sides including a melt-in-your-mouth cutlet smothered in all the fave toppings (peppers, onions, mushrooms, rapini – it's all there!).
I recently visited and found the place jammed with customers, even though it was a late-lunch crowd. People were either at the counter, or eating at a table. I noticed sandwiches were mighty substantial, served by no-nonsense but friendly staff.
At the helm of this family-run operation is a real Italian nonna – family matriarch Rosa Francavilla, who came to Canada when she was only 13 and has been in the food biz with her family, first back home in Italy and later in Toronto.
"We do everything from scratch here," said the petite grandmother, who is at the helm of the busy kitchen out back while her daughter, Patricia, works the front. "We've been using family recipes from back home, in Calabria – we keep the traditions alive through the foods we offer."
Sandwiches include the aforementioned veal and chicken cutlets plus grilled steak, "Mamma's Meatballs," sausage plus veggie sandwiches and eggplant cutlet sandwiches. There are spicy olives made with fresh jalapeno peppers to order on the side as well.
The place was busy but wait times were minimal. What I loved was how everyone seemed to know everyone – a best-kept secret I am now sharing with you. Company offers catering, too.
– PARMIGIANA SANDWICHES, 180 Winges Rd. Unit 8, Woodbridge, 905-265-0964; Parmigiana.ca.


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Internationalizing the black college: an investigation of the stage of readiness of private black colleges as it relates to select benchmarks for comprehensive internationalization
Date of Award
Degree Type
University or Center
Clark Atlanta University(CAU)
School of Education
Degree Name
Educational Leadership
First Advisor
Dr. Sheila Gregory
Second Advisor
Dr. Moses Norman
Third Advisor
Dr. Trevor Turner
The purpose of this study was to investigate the state of internationalization at the private Historically Black Colleges/Universities (HBCUs), and to identify select factors that drive or restrain the internationalization process at these particular institutions. The problem of practice explored by this study was that despite the research in U. S. higher education on internationalization, unique conditions exists, which impact comprehensive internationalization at private HBCUs. The problem of research addressed by this study was that although the literature indicates a wide array of approaches to internationalization in higher education, it does not include a study that specifically examines the unique challenges internationalization present to private HBCUs, or the applicable internationalization strategies given their unique institutional missions, cultures, histories, and priorities.
This mixed methods multi case study employed philosophical assumptions, the combined use of quantitative and qualitative methodologies, and a sequential explanatory research strategy to examine the state of internationalization at private HBCUs. As a result of the quantitative phase, an Internationalization Index was created to select two private HBCUs (one Highly Active and one Less Active) institutions engaged in internationalization. Data were collected by on-line surveys, interviews, document analysis and qualitative observations and analyzed through within-case and cross-case examinations.
The findings indicate that four of the eight dimensions of internationalization introduced in this study were the least utilized strategies for achieving comprehensive internationalization at private HBCUs. The study revealed that the absence of assessment of global learning outcomes, foreign students, an internationalization review and an internationalized curriculum as strategies severely restrained the ability of the private HBCUs of this study to successfully achieve comprehensive internationalization. The conclusion drawn from the findings suggest that it is critical for private HBCUs to integrate the goals of all eight dimensions (internationalization strategies) into one comprehensive strategic plan to achieve sustainable internationalization, and subsequently, aligned with other institutional priorities.
Recommended Citation
Pinder, Anthony Louis, "Internationalizing the black college: an investigation of the stage of readiness of private black colleges as it relates to select benchmarks for comprehensive internationalization" (2012). ETD Collection for AUC Robert W. Woodruff Library. 272.
Notice to Users, Transmittal and Statement of Understanding


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Photo credit: Fiona Peters
Sitting destroys healthy hips.
Your body's primary objective is to conserve energy for survival and reproduction. It's therefore constantly adapting so that you can do the things you do most often, as efficiently as possible.
Unfortunately, if you spend a lot of time sitting, you sacrifice a significant amount of joint mobility, especially in the hips.
How to get strong and supple hips
In the previous two articles, I demonstrated yoga poses that stretch and strengthen the musculature of the hips. Here are the links if you'd like to go back and take a look at those:
3 Types Of Hip Openers To Stretch Tight Hips
Strengthen Your Hips For Speed, Power And Agility
In the following exercises, we're going to go deeper into the hips and focus on freeing up the joint capsules themselves.
How do flexibility and mobility training differ?
"The joint capsule is a ligamentous sac that surrounds the joint. This sac creates an internal environment for freedom of movement. It also helps create stability, keeping the joint from overstretching." Dr. Kelly Starrett, Becoming A Supple Leopard
Similar to muscles, the ligaments that support your joints also adapt and get tight when they are kept in the same position for prolonged periods ie. when you sit. You therefore need to consistently move your joints through full range of motion to maintain optimal mobility, loosen up restrictions and ensure that your joints are set in the correct position.
7 Ways to mobilise the hips
Here are 7 exercises to create space in the hip joints. They incorporate all planes of motion: rotation, lateral and extension/flexion.
- Practice each exercise for the prescribed number of reps and then hold the stretch for 10-15 seconds.
- Focus on controlled movements, exploring your end ranges of motion.
- Try to get into all the nooks and crannies.
- Breathe in and out through your nose.
You can do these exercises in the morning, during the day and especially before exercise.
Taking your hips through full range of motion pre-workout has some interesting additional benefits: circulating blood flow to your muscles and joints, demonstrating to your central nervous system where it is safe for your muscles and joints to go and challenging and strengthening your increased range of motion.
1. Seated Hip Circles
- 5-8 reps each way
2. Tabletop Hip Circles
- 5-8 reps each way
3. Half Monkeys
- 5-8 sets each side
4. Spider Planks
- 3-5 sets each side
5. Lying Leg Circles
- 3-5 each way
6. Bridges
- 5-8 reps
7. Windscreen Wipers
- 5-8 reps
Take care
If you're hypermobile, these exercises may not be suitable for you. Concentrate on strengthening the muscles surrounding the joints and avoid taking them to their end ranges of motion.
If you find that you are incredibly tight, please consider working with a physiotherapist who can perform more rigorous mobilisation techniques with you.
For the best results, combine these exercises with soft tissue work, stretching and strength training.
I've just released a new series of 15 x 15-minute videos designed to loosen up tight hips, increase hip mobility and build stability and strength in the hip joints. Here is the link: yogafortighthips
There are 5 different types of sequence in this series:
- The MOBILITY sequences are relatively fast-paced and are designed to loosen up the hips. They are best practiced in the morning or early on in the day.
- The BALANCE and STRENGTH sequences are the most challenging physically and are designed to build strength and stability in and around the hip joints. They are also best practiced in the morning or early on in the day.
- The FLEXIBILITY sequences are slow and steady and are designed to strategically increase flexibility in the hip muscles. They are best practiced in the early evening when your muscles are warm and pliable and you're winding down.
- The RELAXATION sequences are gentle and restorative and are best practiced in the evening to prepare your body for sleep.
Let me know if you have any questions and share your favourite hip opening poses in the COMMENTS below .


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An accomplished physician with several decades of experience, Dr. Richard Epstein most recently served as a staff anesthesiologist at American Anesthesia in Towson, Maryland. Previously, Dr. Richard Epstein spent 25 years with Physicians Anesthesia Associates PC, where he cared for patients and directed the practices billing and administrative office and outpatient anesthesia sites.
Dr. Epstein earned a cum laude undergraduate degree from the University of Maryland, before graduating from medical school in the top-15 percent of his class. Subsequently, he completed an internship and additional residency training in internal medicine at Emory University Medical System prior to his residency in anesthesiology and fellowship in cardiac anesthesia at the University of PA. He began his career as a cardiac anesthesiologist and staff physician with Associated Anesthesia Services in Washington Dc. In addition to his role as an anesthesiologist, Dr. Richard Epstein has been providing expert medical testimony in medical malpractice cases since 2004. In his free time, he stays active through outdoor activities such as hiking, swimming, and playing tennis. He is a student of economics and world history.