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Home > Wellness > Health Library > Pruritus (PDQ®): Supportive care - Patient Information [NCI]
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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Pruritus is an itchy feeling that makes you want to scratch your skin. It may occur without a rash or skin lesions. It's a symptom of a condition or disease. Pruritus can be caused by cancer, cancer treatments, and conditions related to cancer. It also may be caused by an infection, dry skin, reaction to a drug, or a disease or condition that is not cancer.
The skin is the largest organ of the body. The most important job of skin is to protect against heat, sunlight, injury, and infection. The skin is also important to self-image and your ability to touch and be touched.
Pruritus can be very uncomfortable and scratching may cause breaks in the skin, bleeding, and infection. If your skin feels itchy, let your doctor know so it can be treated and relieved.
Certain cancers and blood disorders are likely to cause pruritus.
These include the following:
Certain cancer treatments may cause pruritus.
Cancer treatments that may cause pruritus include the following:
When chemotherapy causes pruritus, it may be a sign that you are sensitive to the drugs being used. Anticancer drugs that commonly cause itching include the following:
The way you react depends on the drug, the dose, and whether you are allergic to it. Itching caused when drugs are given by infusion usually occurs only near the place where the needle was inserted and often stops on its own 30 to 90 minutes after the infusion ends. It's important to report itching caused by chemotherapy to your doctor because your reactions can get worse each time the same drug is used.
Radiation therapy
Radiation can kill skin cells and cause dryness, burning, and itching as the skin peels off. Broken skin may become infected by scratching. If your skin is severely damaged, radiation treatments may have to be stopped for a while to give your skin time to heal. This can affect how well your cancer treatment works. Your doctor will try to keep your skin healthy so you can continue treatment. Some types of radiation cause fewer side effects than others.
Radiation therapy and chemotherapy together
The side effects of radiation therapy and chemotherapy given together can be more severe than the side effects when each is given alone.
Biologic therapy
Several biologic therapy drugs may cause itching. This is most common with drugs called interferons.
Bone marrow transplant
Graft-versus-host disease (GVHD) can occur after a bone marrow transplant. In some patients, GVHD may cause dry skin and an itchy rash. In severe cases, it can progress to scleroderma, which is a hardening and thickening of the skin. Muscles and tendons can also harden and make joints stiff. This complication of scleroderma is called contracture.
Drugs for supportive care
Some of the drugs used to prevent or treat cancer symptoms may cause pruritus, including the following:
Pruritus can be a symptom of infection.
Itching around the anus or vulva might be caused by infections with Trichomonas or fungi, nearby tumors, hemorrhoids, tears in the anus, or fluids draining from wounds.
Finding the cause of the itching is the first step in relieving pruritus.
Since pruritus is a symptom of a disease or condition, finding and treating the cause is the first step in bringing you relief.
A physical exam and a blood test are done to assess pruritus.
The following tests and procedures may be done to find the problem that is causing the itching:
A history of your health habits and past illnesses and treatments will also be taken, including the following information:
Treatment of pruritus in cancer patients involves learning what the triggers are and taking steps to avoid them.
It is important for you and for caregivers to know what triggers itching, such as dry skin or hot baths, so you can take steps to prevent it. You may need more than one type of treatment to relieve or prevent pruritus, protect your skin, and keep you comfortable.
Self-care, drugs, and comfort measures may all be used to treat pruritus.
Self-care includes avoiding pruritus triggers and taking good care of your skin:
Your doctor may prescribe an antibiotic if your pruritus is caused by an infection. You may also be given an oral antihistamine to relieve itching, with a larger dose at bedtime to help you sleep. For pruritus that is not related to radiation, you may use a mild corticosteroid on your skin, to relieve itching. Corticosteroids should not be used if the cause of pruritus is unknown.
Other drugs that may be used if other treatments do not work to control pruritus include sedatives and antidepressants. Antidepressants can have strong antihistamine and antipruritic effects.
Talk with your doctor about medicines you take that may be causing pruritus, such as opioids, morphine, or antibiotics. Changing to a different drug may stop the itching.
Comfort measures and acupuncture
The following may help relieve itching:
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
This summary was completely reformatted and some content was added.
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the causes and treatment of pruritus. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
National Cancer Institute: PDQ® Pruritus. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's E-mail Us.
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site's E-mail Us. We can respond only to email messages written in English.
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2014-02-05
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
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YORKTOWN — The 89th Annual Yorktown Grange Fair kicked off with a karaoke contest Thursday evening. The winners were determined by the applause of the audience and were awarded trophies.
The winners were: 1st Place: Kayla Lonergan and Becca Thompson; 2nd Place: Taylor Headrick and Kristyn Hatley; 3rd Place: Thomas Dalceredo.
The fair continues through Sunday at the fair grounds off Moseman Avenue in Yorktown Heights; visit http://www.yorktowngrangefair.org/default.html for a complete schedule.
Right to left: Thomas Dalceredo, Taylor Headrick, Kristyn Hatley, Kayla Lonergan, and Becca Thompson.

subset: commoncrawl


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Early detection.
Accurate diagnosis.
Proper treatment.
Refreshments will be served. To register, call 1.855.HHC.HERE.
8/29/2017WomenHeart of Greater Lehigh Valley
9/9/2017PHA on the Road: Patient and Family Forum
9/10/20173rd Annual Swing With Heart Golf Tournament
9/11/2017WomenHeart of El Camino
9/11/2017WomenHeart of Overland Park
6/28/2017Senate Health Care Bill Will Put Women with Heart Disease at Greater Risk
5/17/2017WomenHeart Announces Grant Applications Now Being Accepted For National Hospital Alliance Membership
5/2/2017WomenHeart Issues Policy Recommendations To Improve Access To Health Care For Women With Heart Disea
4/26/2017WomenHeart Announces 2017 Wenger Award Winners
4/17/2017Applications Now Being Accepted for Fall 2017 WomenHeart Science & Leadership Symposium


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Diane von Furstenberg Spring 2014
You have only to step into Lincoln Center this week to feel how far the once-exclusive fashion industry has merged with inclusive entertainment. The city's biggest thoroughfare for shows—inside, outside, on the surrounding streets—is thronged with people, dressed to the nines, parading, posing, out for fun. That suits Diane von Furstenberg, the city's empress of good-time fashion, absolutely down to the ground. She turned her packed show into a live New York affirmation of everything her clothes have always been about—summery seventies disco-dressing, a lifestyle vibe she's triumphally transitioned into popular twenty-first-century brand relevance without missing a beat.
The fact that she played Daft Punk's "Get Lucky"—a current hit, but featuring Nile Rogers, god of New York seventies disco—as her spring 2014 signature tune set it all in good-natured foot-tapping context. What's not to love about any number of DVF wrap dresses flirting along in fit-and-flare shape, or slinky long ones, maybe lashed about with rope, showing plenty of skin in seventies halter mode? She had the waterfronts covered—in mini-tunics to zebra-prints to maxi-skirts to sundresses—for every summer holiday eventuality from Miami to Ibiza and all destinations in between. It was classic DVF in all senses, ending in an all-out performance by the lady herself, who took her finale victory lap to exuberant showstopping level, tossing her hair and almost breaking into dance as she toured the front row.


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Sheet Music Plus - 150 of the Most Beautiful Songs Ever (3rd Edition)
For voice, piano and guitar (chords only). Traditional Pop, Broadway and Vocal Standards. Contains vocal melody, piano accompaniment, lyrics, chord names and guitar chord diagrams. This 3rd edition has been updated to feature 150 of the best ballads of all time! Over 500 pages of slow and sentimental ballads, including Fields of Gold, I'll Be Seeing You, Unchained Melody and many more.


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Shoemaker Steve Madden has picked a fight with Ebay, suing the e-commerce site for allowing the sale of counterfeit watches. This is becoming a well-trodden path for retailers feeling burned by illicit activity on Ebay — Tiffany, LVMH and L'Oreal have all filed similar suits.
But if history is a guide, Steve Madden will have a hard time recouping any alleged losses. Courts have tended to rule in Ebay's favour, arguing that the e-commerce site is not responsible for ensuring the authenticity of goods sold by outside sellers. Only LVMH won compensation, to the tune of $63m. Read more


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On Campus
Win A Prize for Outstanding Research! Enter A Paper/Project in the Annual AU Library Research Competition
AU Library is offering two prizes for outstanding Undergraduate Research papers or projects prepared during 2012: one for the Best College Writing Research Paper or Project and one for the Best Undergraduate Research Paper or Project. A prize of $1,000 will be awarded in each category. Papers and projects prepared for spring, summer, or fall 2012 AU courses will be accepted for consideration.
Submission Dates and Prizes
In January the University Library will begin accepting application for two prizes for high quality undergraduate research papers or projects:
- University Library Prize for Best College Writing Research Paper or Project
- University Library Prize for Best Undergraduate Research Paper or Project
One prize of $1,000 will be awarded in each category. The deadline for submission is 5:00 pm, March 21, 2013.
The purpose of the prize is to recognize and award American University undergraduate students who make extensive use of the University Library's collections and show evidence of critical analysis in their research skills, including locating, selecting, evaluating and synthesizing information.
Students must be currently enrolled as undergraduates at American University. Groups and teams are not eligible.
- Undergraduate papers or research projects that have been completed for a registered American University course, including study abroad courses, are eligible for consideration for the Best Undergraduate prize. Papers or projects prepared for a College Writing class are eligible for the Best College Writing prize.
- Papers submitted in Spring, 2012, Summer 2012, and Fall 2012 courses are eligible.
Evaluation criteria:
Successful projects will demonstrate:
- Substantial use of library resources and collections in any format, including but not limited to printed resources, databases, primary resources, and materials in all media;
- Ability to locate, select, evaluate, and synthesize library resources and to use them in the creation of a project that shows originality and/or has the potential to lead to original research in the future;
- Evidence of significant personal learning and the development of a habit of research and inquiry that shows the likelihood of persisting in the future;
- Originality of thought, mastery of content appropriate to class level, clear writing, and a high quality of presentation.
Application Procedure:
Applications may be received beginning January 14, 2013.
To apply, students must submit the following in electronic form (Word or Rich text format) to email@example.com no later than March 21, 2013.
- Completed application cover sheet with student name, title of project, title of course, name of professor, date of submission to competition.
- Letter of recommendation from the faculty member who taught the course for which the paper or project was prepared. (Refer faculty to the list of evaluation criteria.)
- A brief 500 to 700 word reflective essay describing research strategies, application of library tools and resources in completion of the project.
- A bibliography or other listing of sources consulted, if not already included in the paper.
- A final version of the project. Written papers should be double spaced and may be of any length. Digital projects should be submitted on a DVD or CD. For other formats, contact firstname.lastname@example.com
Students may submit more than one paper, but only one award will be granted per individual. If you have questions about the award, the nomination or application process, contact librarian Mary Mintz or email@example.com.
Evaluation Committee:
A committee composed of American University faculty from the library, the College Writing program, and other academic units will evaluate submissions.
Awardees will be announced in late spring semester and will be honored at a special event.
Awardees will receive a certificate and a monetary prize of $1000.
Awardees may be acknowledged in library publications and may be recognized at other appropriate university venues such as the Undergraduate Research Fair.
Copies of the research papers may be held in the AU's digital repository, American University Research Commons.


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Good thing too, who else would know more about malware hire a Microsoft employee lol Jk but not really
Congrats Lou Ferrigno.
Looks like the real life version of angry pigs
She makes up for in brains
I think she wood need a IQ of a 1000
To compensate
wholes =/= holes
It's a Man, Man... Famed Hacker Chris Paget check it out!
Chris Paget talks about long-range RFID tag reading - YouTube


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Dodgers fall to Marlins despite promising start
Adrian's early homer goes for naught as LA drops eighth straight
LOS ANGELES -- Friday night started well for the Dodgers, but the result was still the same as their losing streak increased to eight games.
The Dodgers combined for 10 hits, including Adrian Gonzalez's three-run homer in the first inning, but they couldn't get the big one when they needed it down the stretch and fell to the Marlins, 5-4, in the opener of a three-game series at Dodger Stadium.
Ronald Belisario lost his fourth game in relief, allowing two runs on three hits in the seventh to break a 3-3 tie. It was the third straight game a Dodgers reliever took the loss.
"That formula, like everything else right now, doesn't seem to be working," manager Don Mattingly said of the back end of his bullpen, which includes Belisario, setup man Kenley Jansen and closer Brandon League.
The Dodgers rallied in the eighth but came up just short. Matt Kemp began the charge with a single to extend his hitting streak to nine games, and he scored on a single up the middle by A.J. Ellis. But with two out and Ellis on third, Dee Gordon grounded out to second.
Gonzalez gave the Dodgers a 3-0 lead before they recorded an out. Carl Crawford led off with a single and Nick Punto walked to set up Gonzalez's fourth homer of the year.
Playing with a mild neck strain, Gonzalez did not take batting practice on the field, but his first swing of the game had things looking good.
Marlins 20-year-old rookie Jose Fernandez, however, retired 17 of the next 20 batters he faced until Ellis singled in the sixth. Skip Schumaker followed with a double down the left-field line. Fernandez intentionally walked Gordon to face pinch-hitter Tim Federowicz with two outs and the bases loaded, but Federowicz flied out to center.
"I was trying to make great pitches," said Fernandez, who struck out seven over six innings. "Their lineup is incredible. They made adjustments and I had to make adjustments just as fast."
The Dodgers had another chance to score in the fifth. With runners on first and second and none out, Punto was unable to lay down a bunt and Juan Uribe was picked off at second. Punto and Gonzalez each struck out to end the inning.
"That was definitely a momentum-changer," Mattingly said. "If Nick gets the bunt down, we're going to get to Adrian, Matt and Andre [Ethier]. We kind of shoot ourselves in the foot there."
It was just another example of things not going in the Dodgers' favor during the club's longest losing streak since 2008.
"I think negative breeds negative, that's for sure," Mattingly said. "When things aren't going good, it seems like we talk about momentum in this game and us trying to get it turned around. You got to get that turned somehow. We have to fight."
In his third Major League start, Matt Magill went five innings for the Dodgers and allowed three hits, including a three-run homer that was the only damage against him. He struck out two and walked four.
Magill cruised through the first three innings while allowing just one hit, but the Marlins got to the rookie in the fourth as Magill struggled to find the strike zone. The right-hander walked Placido Polanco and Marcell Ozuna before Derek Dietrich launched his first big league home run.
"I wasn't hitting my spots like I needed to and I take full responsibility for this loss," Magill said. "My team shouldn't have been in that situation. I just need to get better."
It was quite possibly Magill's final start with the Dodgers for a while, as right-hander Zack Greinke made a rehab start with Class A Rancho Cucamonga on Friday and showed no ill-effects from the left collarbone he broke on April 11 in a benches-clearing incident against the Padres. Greinke said he's ready to start Wednesday against the Nationals.
J.P. Howell relieved Magill and tossed a 1-2-3 sixth.
Paco Rodriguez fired two scoreless innings in relief of Belisario. The left-hander has allowed just one hit in his last five outings. He has 10 strikeouts in his last 6 2/3 innings and is making a case to earn a high-leverage role in the bullpen.
"He's a guy that we're really having to take a look at," Mattingly said. "It's hard to stay status quo. You want to kind of stick with your plan and you'd like to stick to your guns because you plan along time to get somewhere and get yourself into positions and get the ball to the people you want. So you hate to just jump ship on that and give up on guys. He's working his way more and more towards that role."
Austin Laymance is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Cervical spondylosis is a term used to describe the changes
to the bones (vertebrae),
joints and
discs of the neck (cervical spine) as a
result of aging (disc degeneration). The vertebrae and discs wear down,
possibly resulting in pain. Cervical spondylosis is commonly seen in people starting in middle age. It is related to osteoarthritis of the neck.
See pictures of
the neck and the
vertebrae and discs.
As you age, the discs gradually break down and
become stiffer. The body reacts to this by developing bony growths
(bone spurs or osteophytes). These growths often cause problems. The osteophytes can put
pressure on the
spinal nerve roots or
spinal cord, resulting in pain.
There are often no symptoms. When
there are, neck pain and stiffness are the main symptoms. It is usually worse
in the morning and gets better throughout the day. You may also have a
headache. If the bony growths are pushing against a nerve root or the spinal
cord, you may have numbness, tingling, weakness, or an aching, shooting pain in
an arm or a leg.
Initial treatment consists of pain relievers,
physical therapy, and strengthening and range-of-motion exercises. If this does
not work, surgery may be considered to relieve the pressure on the nerve root
or spinal cord.
Other Works ConsultedBarbano RL (2012). Mechanical and other lesions of the
spine, nerve roots, and spinal cord. In L Goldman, A Shafer, eds.,
Goldman's Cecil Medicine, 24th ed., pp. 2258–2269. Philadelphia:
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July 30, 2012
Healthwise Staff
Medical Review:
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Robert B. Keller, MD - Orthopedics
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© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.


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Serves 41.
Melt Candy Melts following package instructions.
Marbleize white and cocoa Candy Melts by adding a small amount of melted candy in another color or variety; mix slightly (Do not overmix; you want to see streaks of color.) Fill seashells mold with melted candy. Gently tap mold on counter. Refrigerate until firm. Unmold. Dust with Pearl Dust.
Pipe color details in molds using melted candy in parchment bag or disposable decorating bag with a small hole cut in tip, or paint melted candy into areas. Refrigerate until firm. Fill remainder of mold with melted candy. Refrigerate until firm; unmold.
Fill Candy Bar Mold with melted dark cocoa Candy Melts. Refrigerate until firm. Fill cordial cup mold with melted peanut butter Candy Melts. Refrigerate until firm. Unmold candy.
Pour a layer of nonpareils in pie pan. Melt white candy in parchment bag; cut bag and pipe outlines in coral shapes on top of nonpareils. Immediately pour additional nonpareils over coral, covering completely. Refrigerate until firm.
Bake your favorite 2-layer 10 in. round, 3-layer 6 in. square and mini wonder mold cakes; cool completely. Place round cake on cake drum; spatula ice with blue buttercream icing. To support square cake, insert dowel rods towards back of round cake. Place square and mini wonder mold cakes on cake circle cut to size. Spatula ice square cake with tan icing; immediately press granulated brown sugar onto iced cake. Stack on round cake. Spatula ice wonder mold cake with tan icing; press brown sugar onto iced cake. Stack on square cake; if desired, insert wooden skewer to secure.
Tint piping gel blue; spatula ice top of round cake at edges. Sprinkle granulated brown sugar in area around square cake. Attach candy bar door, seashell candy windows and house corners; cordial cup and seashell candy turrets. Attach coral candy on round layer sides; add tip 352 green buttercream sea plants. Arrange seashell candy around bottom of round layer; sprinkle drum with granulated brown sugar. Attach sea creatures and other candies on cake sides.


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KidKraft Step N Store Footstool
Little people need a big boost to get what they need! This KidKraft Step N Store keeps some essentials at ground level so they have easy access to them and doubles to allow them to reach for all those toys and goodies we keep neatly out of the way in their proper place! Great for children with a lot of shelves in their room but not exactly tall enough to use what's arranged!


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LG's handset division has posted a loss of £64 Million for the second quarter ending 30th June 2010, despite selling 30.6 million units in the quarter. It is our view that this is because the handset manufacturer has a relatively weak "total Portfolio" this is most apparent in the smartphone segment which is a segment that is on the rise for other mobile manufacturers. The weakness in this key area has allowed Apple and BlackBerry to increase their sales in this segment.
LG can recover from this but we think that they need to look at the breadth of their range in order to ensure that they can optimise their market share. They do have a number of handset models available but they do not cover all sectors adequately.
LG do have a large range of mobile phone accessories available for their range of phones, LG batteries, LG Bluetooth kits and LG mains chargers are all available to purchase. So if you are an LG fan maybe take a look at the range.


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The U.S. Energy Information Administration's (EIA) recent report exploring the potential impacts of reductions in refinery activity in the Northeast on petroleum product markets in that region pointed out that, if Sunoco's Philadelphia refinery shuts down, waterborne movements from the Gulf Coast could be an important route for alternative supplies to help replace lost volumes in the short term, particularly for ultra-low sulfur diesel (ULSD). Because this route would involve vessel movements between U.S. ports, Jones Act vessels must be used. The Jones Act requires goods or passengers moved in U.S. coastal waters between U.S. ports to be carried on U.S. flagged ships that are constructed in the United States, and owned and crewed by U.S. citizens.
EIA's report mentioned 56 Jones Act tankers handling petroleum, including tankers being decommissioned. But the table did not show the many barges that are also used to transport petroleum in coastal waters. Updated information suggests that less than 40 tankers and perhaps as many as 270 coastal barges[1] are in operation. However, as discussed below, delivery of a large volume of petroleum products on a sustained basis from the Gulf Coast to the Northeast still appears to represent a significant challenge in the short run.
Some years ago, short vessel runs were the province of tug tank barges, while tankers handled the longer routes. But today long ocean-going routes are also covered by articulated tug barges (ATBs) and large barges. The ATB design provides stability, speed (up to 12 or 13 knots), and increased maneuverability over the traditional barge units, and they are large, at least 10,000 dead weight tons (DWT), which is the equivalent of about 75,000 barrels of diesel. These vessels have provided an alternative to tankers.
Of the approximately 300 vessels now in use, not all are capable of moving from the Gulf Coast to the Northeast due to size, and others would not likely be available in the short term due to other factors. While 50,000 barrel capacity would appear to be a minimum vessel size to serve this route, historically vessels moving product from the Gulf Coast to the Northeast range in size from about 80,000 to 145,000 barrels.[2] Many of the smaller Jones Act vessels are used in New York Harbor to move product among different ports in the area and to transport product from the harbor to New England.
About ten Jones Act tankers are crude oil tankers used to haul Alaskan crude oil to the West Coast; other tankers and barges are involved in West Coast product movement. It is not clear that any of the product vessels normally used on the West Coast would be diverted temporarily or even permanently to serve a new East Coast need.
About 30 percent of the petroleum-carrying Jones Act vessels move crude oil or dirty products (e.g., asphalt, residual fuel oil). In general, ship owners would not spend the time and money to convert vessels carrying crude oil or dirty products to transport clean products in the short run; however, such vessels can be cleaned to carry products in the long term if sufficient incentives exist. For example, while an 80,000-barrel barge carrying crude condensate could be cleaned and ready to carry clean products in about three days for a cost of approximately $45,000, the cost to clean a vessel carrying a heavier grade of crude or comparable residual fuel could be $600,000 or more and would take additional time.[3]
In order for Jones Act vessels to transport additional products to the Northeast and leave other areas unaffected, sufficient capacity is required. The operating vessels mentioned above are not currently idled, and, while improved scheduling might free up some vessels, others would have to be diverted from their current routes to respond to an increased need to move product into the Northeast. For example, a number of vessels are involved in spot transactions, and could be almost immediately available. However, Northeast petroleum product demand might require a sustained need for product flow to the Northeast; not a one-time diversion. A diversion for 3 weeks has different implications on existing service than a diversion for 3 or 6 months. The size and duration of the need, and the amount of time available to schedule product moves in advance, affects the availability and cost of vessels.
To provide some perspective, our report on the Northeast closures indicated 180,000 barrels per day (bbl/d) of ultra-low-sulfur diesel fuel must be made up by increased imports, pipeline flows, and domestic waterborne movements. (We assumed increased utilizations for existing Northeast refineries before estimating the 180,000 bbl/d additional supply needs.) Although pipelines are near capacity in the short run, they can add some additional volume. This could result in the need to move 100,000 bbl/d by water. Using vessels sized at 100,000 barrels capacity, that demand would require offloading one vessel per day in the Northeast.
If the entire waterborne product came from the Gulf Coast, we would need to know the duration of the journey in order to estimate the number of vessels needed. A trip from the Gulf Coast to the Northeast is about 2,000 nautical miles. An ATB traveling at 10 nautical miles per hour (knots) could make the trip in 8 days. There is time needed to offload the cargo and then return. The round trip might be about 20 days, depending on weather and time to load and offload the vessels.
If we assume that vessels sized at 100,000 barrels were used to move the increased USLD volume, approximately 20 vessels would be required to load, travel to the Northeast, unload, and travel back to maintain 100,000 bbl/d. If larger vessels are available, fewer would be needed. For example if 170,000-barrel vessels were used, then about 12 vessels would be required, and if large tankers could be devoted to this route, even fewer vessels would be needed. While a sizeable share of existing vessels may be needed, the industry has indicated the capability to respond would be there.[4]
Cost is one of the issues that will vary with how much product needs to be moved and how quickly. Consider a trip from Houston to Philadelphia. A 325,000-barrel tanker has economies of scale that make it more economic than the smaller barge movements that typically move on this route. While terms may vary with specific circumstances, such a tanker might cost around 7 cents per gallon for a round trip. ATB's would be less efficient than tankers, but more efficient than a towed barge. A barge cost for this route might run around 15 cents per gallon, perhaps a little less for the ATBs and a little more for towed barges. Tankers are in high demand and are usually booked well ahead of time. ATBs and large barges would likely be used for some of the movements to the Northeast, at least initially.
With transportation rates around 15 cents per gallon reportedly for Gulf Coast-Northeast barge movements, imports may be more economic for some of the needed volumes of ULSD. Foreign tankers are available, and a tanker moving product from Europe to New York Harbor (3,400 nautical miles) cost around 5-9 cents per gallon this past year, similar to the tanker costs from the Gulf Coast to New York Harbor.
As indicated in our report, the largest costs would likely be incurred during the initial transition period following a shutdown of the Sunoco Philadelphia refinery as the market resolves initial supply dislocations. While the maritime industry is flexible and confident of its ability to supply needed volumes, short-term flexibility is more limited than long-term flexibility. If the initial volume need is high, rerouting vessels from existing service may come at a higher cost than usual rates. Imports would play an important balancing role, potentially reducing the need for domestic shipping. While we acknowledge the U.S. maritime industry's confidence, it remains unclear exactly how and at what cost the Northeast would be supplied, and what, if any, additional costs might be incurred outside of the Northeast if significant domestic shipping is diverted from other uses in the short run.


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Size matters for geckos' and flies' glue pads, as described in New Scientist, 6 September 2003, p22. Geckos, flies and some spiders are able to walk upside down by using tiny flat pads on their feet called spatulae. The spatulae form temporary atomic bonds with what ever surface they are walking on. Biologists were puzzled that the size of the spatulae was larger in small light creatures such as flies compared with larger, heavier creatures such as geckos. Eduard Arzt from the Max Planck Institute has solved the problem by examining the spatulae of insects, spiders and geckos with an electron microscope and found that by making them smaller they could pack them more densely which increased the bonding power of the geckos toes and enabled them to carry a much larger weight.
Editorial Comment: This is a good example of how all aspects of a system have to work before the system can work. It is not enough just to have the right material in the stick-on pads. They must be the right size and density. Also, the animal has to be able to place them in the stick-on position and be able to release them when it wants to move on. We also wonder what could have made any half evolved geckos and flies try walking upside down on ceilings, branches, cave roofs, when there was every chance they would fall off. It is far more logical to believe that the God who designed flies and geckos knew how much stick-on power they would need and gave them the right size, number and density of spatulae for it. (Ref. gecko, insect, spatulae)


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Session of 1999
HOUSE BILL No. 2275
By Committee on Business, Commerce and Labor
9 AN ACT concerning accountancy; prohibiting certain acts in the practice
10 thereof; amending K.S.A. 1998 Supp. 1-316 and repealing the existing
11 section.
Be it enacted by the Legislature of the State of Kansas:
14 Section 1. K.S.A. 1998 Supp. 1-316 is hereby amended to read as
15 follows: 1-316. (a) It is unlawful for any person, except the holder of a
16 valid permit issued under K.S.A. 1-310 and amendments thereto, or any
17 firm, unless it is registered under the provisions of K.S.A. 1-308, and
18 amendments thereto, to affix or cause to be affixed the signature of any
19 such person or firm to any accounting or financial statement, to any opin-
20 ion on, report on or certificate to any accounting or financial statement
21 with any word indicating that such person or firm, or its members, officers
22 or employees, are certified public accountants.
23 (b) It is unlawful for any person, except the holder of a valid Kansas
24 certificate, to use or assume the title "certified public accountant" or to
25 use the abbreviation "C.P.A." or any other title, designation, words, let-
26 ters, abbreviation, sign, card, or device likely to be confused with "certi-
27 fied public accountant."
(c) No person holding a permit or firm holding a registration under
this act shall use a professional or firm name or designation that is mis-
leading about the legal form of the firm, or about the persons who are
partners, officers, members, managers or shareholders of the firm, or
about any other matter except that: (1) Names of one or more former
partners, members or shareholders may be included in the name of a firm
or its successor; (2) the use of a fictitious name by a firm is permissible if
the fictitious name is registered with the board and is not otherwise mis-
leading; (3) the name of a firm may not include the name of an individual
who is neither a present nor a past partner, member or shareholder of
the firm or its predecessor; and (4) the name of a firm may not include
the name of an individual who is not a certified public accountant if the
title "CPAs" is included in the firm name.
Any person who violates any provision of this section shall be
42 guilty of a misdemeanor, and upon conviction thereof, shall be subject to
43 a fine of not more than $500, or to imprisonment for not more than one
1 year, or by both such fine and imprisonment.
2 Sec. 2. K.S.A. 1998 Supp. 1-316 is hereby repealed.
3 Sec. 3. This act shall take effect and be in force from and after its
4 publication in the statute book.


text:
Topic: Watching a friend die of cancer...when you have cancer
Has got to be one of the hardest things I have been through.
Liza is only 24. She has Fibrolamellar Hepatocellular Carcinoma. She learned of her cancer 8 months before me. We were friends before cancer, and worked for the same local bank.
She is hanging in there, but it looks like she doesn't have much longer at all. My heart hurts. And it makes me sad for my family too. Because I see how much her family is hurting, and I know mine will feel the same.
I'm looking for any advice or words of wisdom on how to get through this, and keep my spirits up.
Wife to Brian; Mommy to Carter (11) and Madison (8)
Liver transplant 7-9-2013


text:
Complete Medical Billing Services
Medical Billing Services And Profits
Reliable medical billing companies that can increase revenue and collection rates are difficult to find. We guaranteed increased collection rates and have a proven track record of success. We believe timely medical billing and account reimbursements are two important factors that determine the financial health of your practice. WorkSmart MD Billing will provide your practice with a complete Medical Billing Service that includes claims denial management and full accounts receivable monitoring. We provide our clients' with prompt, professional medical billing while treating their patients with courtesy and compassion. When you partner with WorkSmart MD you will experience quicker payments, reduced claim denials, and expert insurance negotiations. Typical WorkSmart MD clients experience a 10%-15% increase in revenue and a collection rate that exceeds 97% within 45 days.
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When it comes to providing physicians with medical billing services and practice management we are the industry leader. Whether you have a family practice or you're a cardiovascular specialist we have the tools to meet your medical billing needs. The direct experience of our expert billing staff allows us to understand the terminology for your chosen medical specialty and we understand the importance of the medical care you provide to your patients. We offer a variety of medical billing services to streamline operations and reduce overhead while increasing profitability.
The WorkSmart MD practice management and physician medical billing services will eliminate payment posting and follow-up, all charge entry, claim submission and much more.
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In today's economy practice overhead continues to rise and collecting ALL the money you've earned is essential to the survival of your practice. If you would like fewer denials, quicker payments, less stress and a stronger bottom line you owe it to yourself to contact us today for a no-obligation analysis.
Contact Us Today - 877.242.8475


text:
Search Adobe TV
2 results found on
"DITA Open Toolkit"
FRAMEMAKER 11: Easy PDF output from DITAMap
FrameMaker 11 publishes sample files from DITA Open Toolkit "out-of-the-box." Using other DITA editors, it can required a lot of work to design style sheets that will publish OTK to rich PDF. FrameMaker 11 allows you to save DitaMaps to a FrameMaker book "with components." This means that a cover page, generated TOC, Index, List of Tables and List of Figures is automatically inserted in the correct locations. From that point you can swiftly publish to PDF with stunning results. Watch this video to see how you can achieve this with just a few mouse clicks.


text:
Note: This item is more than 11 years old. Please take the publication date into consideration for any date references.
Print – Plain Text – Permalink
News Release
Media Contact: TPWD News, firstname.lastname@example.com, 512-389-8030
Sept. 22, 2005
State Parks Host Rita Evacuees, Game Wardens Prep For Rescue Work
AUSTIN, Texas — As Hurricane Rita bears down on the Texas coast, coastal state parks are temporarily closing, while others open their doors at no cost to hurricane evacuees. Meanwhile, Texas Parks and Wildlife Department game wardens, many of them fresh from Katrina duty in New Orleans, are staging for a possible new round of rescues in their home state. (The Governor's Emergency Management Council is coordinating Rita response for all state agencies, including TPWD game wardens.)
The entire field force of 495 Texas game wardens with approximately 500 boats is on standby for search and rescue operations as needed. Boats, fuel, manpower and all available resources are ready, with staging locations along the coast identified. The Rockport district office, La Marque district office, Victoria district office, Freeport field office and Houston Communications Center of TPWD's Law Enforcement Division are closing to comply with mandatory evacuation orders.
All coastal wildlife management areas are closing temporarily due to Rita, a move that is shutting down several public hunts scheduled by the Wildlife Division for this weekend at various sites. This includes cancellation of public waterfowl hunts through Sept. 25 at closed coastal state parks and at Peach Point, Mad Island, Matagorda Island, J.D. Murphree, Guadalupe Delta WMAs. Likewise, TPWD Coastal Fisheries Division offices have been evacuated and closed. Boats and fuel supplies managed by both divisions are being moved to safe areas, ready for use by enforcement and rescue authorities as needed.
Yesterday, all Texas state parks were notified that Hurricane Rita evacuees will be allowed to use state parks as evacuation centers for the duration of the storm. Campsite and entrance fees will be waived during that time. Evacuee use pertains to inland sites, since coastal state parks are closing, as listed below. Additional state parks not shown below may also close as conditions change.
- Brazos Bend — CLOSING 9/21–9/25
- Choke Canyon — CLOSING 9/22–9/25
- Fairfield — CLOSING 9/22–9/25
- Falcon — OPEN for now — Accepting evacuees
- Fulton Mansion — CLOSING 9/21–9/28
- Galveston — CLOSING 9/21–9/25
- Goliad — CLOSING 9/22–9/25
- Goose Island — CLOSING 9/22–9/25
- Huntsville — CLOSING 9/22–9/25
- Inks Lake — CLOSING 9/22–9/25
- Martin Dies — CLOSING 9/22–9/25
- Matagorda Island — CLOSING 9/22–9/25
- Mustang Island — CLOSING 9/22–9/25
- Lake Casa Blanca — OPEN for now — Accepting evacuees
- Lake Corpus Christi CLOSING 9/22–9/25
- Lake Houston — CLOSING 9/21–9/25
- Lake Texana — CLOSING 9/22–9/25
- Lake Livingston — Possible CLOSING — Evacuees are able to stay in the park for now
- Sabine Pass Battlegrounds — CLOSED 9/21–9/25
- San Jacinto — CLOSING 9/21–9/25
- Sea Rim — CLOSING 9/21–9/25
- Sheldon Lake — CLOSING 9/21–9/25
- Stephen F. Austin — CLOSING 9/22–9/25
- Varner Hogg — CLOSING 9/21–9/25
For the latest information on state park temporary closures and state parks able to host hurricane evacuees, phone the TPWD state park Customer Service Center reservations line at (512) 389-8900. A complete list of state parks, including a statewide map and regional maps showing park locations, is on the TPWD Web site.
On the Net:
Publication — Permission is granted to publish, in whole or in part, any news releases on this page.
Print — A print-friendly version of the news release shows only the release with font sizes set to the browser default.
Plain Text — Plain text versions of TPWD news releases are provided for copying and pasting into editing software.
To copy text into an editing software:
- Click a Plain Text link to display the plain text page in your browser.
- Select all.
- Copy.
- Paste in a document in your editing program.
Permalink — This is a direct link to the news release, omitting the navigation context from the URI.
English/Spanish — News releases posted in both English and Spanish have one of these links.
If you have any suggestions for improving these pages, send an e-mail to firstname.lastname@example.com and mention Plain Text Pages.
(5.4.16 i)


text:
Tagged: 'Chris Forcier'
Jacksonville Jaguars Make Even More Roster Changes as Rookie Mini-Camp Ends.
May 7th, 2012 at 2:23 PM
The Jacksonville Jaguars have reshaped their 90-man roster after this weekend's mini camp by releasing and signing a bunch of veteran and rookie players. ***PHOTO1*** Released: WR Jarett Dillard, QB Dan LeFevour, S Akwasi Owusu-Ansah, WR Nelson Rosario, WR Jarrett Boykin, DE Frank Trotter Signed: QB Jordan Palmer, FB Naufahu Tahi, DT Odrick Ray,...


text:
Never Get Me BackRiddles are little poems or phrases that pose a question that needs answering. Riddles frequently rhyme, but this is not a requirement.
I can run swiftly and silently when you want me to stay still,
I can move slowly and cautiously and am yours to fill.
You look at me often and yet you always forget me,
I am the most feared killer, yet you can't live without me.
Sometimes you have me for all to spare,
Yet when you need me, I am not there.
You can waste me, or cherish me, you choose the track,
But once you're done you can never get me back.
What Next?
See another brain teaser just like this one...
Or, just get a random brain teaser
If you become a registered user you can vote on this riddle, keep track of
which ones you have seen, and even make your own.
Back to Top


text:
In many D&D campaign settings Maanzecorian is the illithid deity of knowledge and philosophy.
Maanzecorian was killed by Tenebrous while the latter was trying to return to his former existence as the Demon Prince Orcus.
Maanzecorian's realm of Rictus was located on the plane of Gehenna.
- Cook, Monte. Dead Gods (TSR, 1997).
- Sargent, Carl. Monster Mythology (TSR, 1992).
|This page uses Creative Commons Licensed content from Wikipedia (view authors).


text:
Youth Activity Sheets
The following Activity Sheets have been designed to make Alabama's history fun as well as educational. Explore through these themes about Alabama History to pick an activity sheet of interest. Activity sheets include crossword puzzles, word searches, matching games, and more!
Please print these activity sheets for your child, classroom, or yourself! Many of these Activity Sheets can also be found in hard copy in the Hands-On Gallery. Enjoy and have fun!


text:
President Barack Obama delivers a speech at M. Luis Construction, a local small business in Rockville, Maryland, near Washington. Mr Obama travelled to the company to highlight the impact that a US government shutdown and default would have on the economy. The shutdown entered its third day on Thursday with little sign of compromise between Republicans and Democrats.
© The Financial Times Ltd 2016 FT and 'Financial Times' are trademarks of The Financial Times Ltd.


text:
Did you know?
The Echo Caves were "discovered" by a farmer in search of water, who realised that his cattle had already found their way into the caves to quench their thirsts.
The Echo Caves, Limpopo, lie 26km from Ohrigstad, a small town tucked away on the Tzaneen/Lydenburg Road in Limpopo.
Only by visiting will you be able to appreciate why these caves, some of the oldest limestone caves in the world, are today a national monument and a tourist attraction.
The caves were first discovered on the farm Klipfonteinhoek back in 1923 by the local farmer who stumbled upon them while searching for his cattle. Although the caves may stretch for over 40km, nobody knows their full extent.
There are two tours of 45 minutes and 75 minutes respectively which will give you a glimpse of this underground wonderland.
On the longer tour you will explore the some 2km cave network open to the public from well-lit walkways showcasing the beautiful dripstone formations. You will also visit the beautiful Crystal Palace and Madonna Room and find out how the caves came by their name as there is a large stalactite that, when struck, makes a sound that resonates even beyond the cave walls.
The caves have further historical significance in that prehistoric items and artefacts dating back to the Stone Age that have been found here. These are now housed inside the nearby Museum of Man which is also worth a visit.
If you stay in one of the rustic rondavels on the farm you can also hike in the surrounding mountains which are part of the northern Drakensberg range and home to rare birds like the elusive blue swallow.
Travel tips & Planning info
Who to contact
Echo Caves
Tel: +27 (0)13 238 0015/72
Ohrigstad Tourism Association
Tel: +27 (0)13 238 8100
How to get here
The Echo Caves are 26km north of Ohrigstad, which is off the R36 on route to Hoedspruit. The caves are also close to the turnoff to the scenic R532 also known as the Panorama Route.
Best time to visit
The caves are open from 8.30am to 4.30pm every day of the week (on Sundays they close at 4pm)
Around the area
Ohrigstad Dam Nature Reserve, Blyde River Canyon, Drakensberg Mountains, Panorama Route, Gustav Klingbiel Nature Reserve.
Get around
There are numerous hiking trails in the area as this is part of the northern Drakensberg.
What will it cost
A guided tour will cost you R60 per adult and R25 per child under 12. The price is the same regardless of which length of tour you choose to follow.
Where to stay
Accommodation for up to 140 people is available at the caves, including dormitory-style rooms and 11 chalets. (R500 for two, self-catering).
What to eat
There are restaurants at nearby Ohrigstad or else bring a picnic basket. The accommodation is self-catering.
Best buys
Local arts and crafts at Ohrigstad town


text:
Twilight of the Dreamboats #4
Welcome to Show Business! #22
Original Captions:
New Orleans -- Car in which actress Jayne Mansfield crashed to her death June 29 is nothing but twisted metal. The 34-year-old sex symbol, her chauffeur Bonnie Harrison, and lawyer Sam Brody, were all killed when the car smashed into a truck on a winding road outside New Orleans. Three of Miss Mansfield's children, ranging in age from three to eight, were treated for cuts and shock at a New Orleans hospital. (1967)
This was posted by Tom Sutpen
|your thoughts:
The series is: Twilight of the Dreamboats, Welcome to Show Business
7 comments:
- Maureen said...
- March 30, 2009 11:37 AM
- Mike said...
More shots of the vehicle (plus other stuff) here: http://www.youtube.com/watch?v=LCw8o05uApk&eurl=http%3A%2F%2Fwww%2Efindadeath%2Ecom%2FDeceased%2Fm%2FMansfield%2Fjayne%5Fmansfield%2Ehtm&feature=player_embedded
- March 30, 2009 8:31 PM
- Tommy O'C said...
- March 30, 2009 8:43 PM
- estiv said...
Weird to think that Mariska Hargitay was one of the children in that car.
- March 30, 2009 10:02 PM
- Tommy O'C said...
Mariska survived that crash? My God...
- April 01, 2009 9:18 PM
- kevracer said...
Mariska survived with just a cut on her cheek
- July 10, 2009 6:46 PM
- Christopher Brame said...
Driver's name was Ronnie Harrison, not Bonnie.
- June 04, 2013 5:28 PM
Subscribe to: Post Comments (Atom)


text:
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Model UN team wins three awards at Yale
Contributed by Juan Arroyo on 10/08/12
The Ithaca College Model United Nations team won three awards this past weekend at the Security Council Simulation at Yale.
This event is centered on a simulation of the UN Security Council, but it has also added committees that re-enact or imagine groups of 10-20 people involved in intense dilemmas or crises that may demand responses from different types of actors with different resources. Some of the committees are historically based, and some are fictional.
Each committee gave certificates of honorable mention, and one each to recognize an outstanding delegate and the best delegate. The three IC students who were recognized for their work are listed below, along with a brief summary of their committees and roles.
Kayla Reopelle ('14, Documentary Studies), Best Delegate
Kayla represented two different Supreme Court justices dealing with some of the most important cases of the 20th century. As Justice Hugo Black she deliberated on Brown v. Board of Education, and as Justice Samuel Alito she helped rule on the constitutionality of the Affordable Care Act. In a third role, she played an advocate testifying on Roe v. Wade.
Avi Rosen ('13, Politics), Outstanding Delegate
Avi was sent to the mines as Renán Ávalos, a victim of the Chilean Mine collapse of 2010. As one of 33 trapped miners trapped for 69 days, Avi had to work with the others how to organize their supplies and their resources in order to survive.
Ryan Bince ('14, Speech Communication), Honorable Mention
As Nellie Bly, Ryan took part in a committee called, "Steel City Empire." This group of Gilded Age millionaires and industrial barons discussed and negotiated mergers and monopolies, their links to the political and economic system and obligations to society.
Great work, delegates!
© Copyright Ithaca College. All rights reserved; unauthorized use prohibited. All material on this server is produced by our community but, except for designated pages, is neither approved nor verified by Ithaca College.


text:
LANDesk Management Suite for ThinkVantage Technologies, an exclusive, innovative value-added version of LANDesk Management Suite, and you completely integrate ThinkVantage Technologies and LANDesk Management Suite into a single console to access best-in-class Lenovo PC life cycle management capabilities.
LANDesk Management Suite for ThinkVantage Technologies includes exclusive features that let you do more than with either LANDesk Management Suite or ThinkVantage Technologies alone. And once you're managing your Lenovo systems with LANDesk Management Suite for ThinkVantage Technologies, you can add other LANDesk management solutions to extend your systems and security management capabilities even further.


text:
SME is unleashing its breadth and depth of manufacturing content into a powerful, user-friendly, 24-7 online resource. Everything you want to know about manufacturing is available when you want it, where you want it.
NOW AVAILABLE! The former Tool & Manufacturing Engineer's Handbook (TMEH) has been digitized and is now available in a new peer-reviewed and validated WIKI environment.
Show that you have the knowledge to make a difference in manufacturing! Earning your Certified Manufacturing Technologist (CMfgT) requires an investment of time and energy that will reap dividends throughout your career.
The CMfgT is an entry-level certification that benefits both new manufacturing engineers and experienced manufacturing engineers without other credentials. Pursuing a CMfgT certification requires a minimum of four years combined manufacturing-related education and/or work experience.
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Start your preparation by reviewing the Body of Knowledge (PDF), Competency Model (PDF), and recommended reading materials. Visit sme.org/prepare and read the Exam Preparation Tips for additional information and resources.
These programs can help you assess and evaluate your knowledge before you take the exam:
The CMfgT exam is offered in online and paper/pencil formats. You have one year in which to take the exam from the date of purchase.
The CMfgT exam is a three hour, open book and open notes exam. It consists of 130 multiple-choice questions mapped to the Body of Knowledge (PDF). You must submit your Proctor Form and Agreement (PDF) to SME at least two weeks before your scheduled exam date.
To pass the exam, you need to score 60% or higher. After your exam is scored, you will receive official results by mail, which includes an Examination Analysis Report (PDF) that provides a breakdown of your results by knowledge area. Use this analysis to make decisions about your future professional development.
If you passed your exam, congratulations, you are now certified as a CMfgT! Your certification is valid for three years. During this three-year period you must document a minimum of 36 recertification credits to recertify. You may also want to consider pursuing your Certified Manufacturing Engineer (CMfgE) certification. For more information on the recertification process visit sme.org/recertification.
If you did not pass the exam, you can apply to retake the exam 30 days after you receive your exam results. Use the Examination Analysis Report (PDF) to focus on weaker knowledge areas to help prepare you for retaking the exam. A reduced exam fee is offered for retaking the exam.
If you have questions or need additional information email us, complete an online inquiry form, or call SME Customer Care at 800.733.4763 or 313.425.3000.


text:
Walt Disney Records single LP vinyl release of the songs to Disney's 2013 animated musical hit Frozen. Release Date: September 30, 2014. This is a 180 gram, heavyweight vinyl release. Frozen is the highest grossing animated film of all...
Kristen Bell
Latest News
- Music From PENNY DREADFUL by Abel Korzeniowski Coming to Vinyl January 2017
- CRUISING Soundtrack Now Available for Pre-Order on Vinyl
- Waxwork Records Release of Douglas Pipes' score to TRICK 'R TREAT
- Limited Edition UTOPIA TV Series Yellow Vinyl Soundtrack
- More LOOPER Vinyl Soundtrack Release Details
- Marco Beltrami's THE GIVER Coming to Vinyl
- CANDYMAN Score by Philip Glass Coming to Vinyl
Latest Film Soundtracks
- BATMAN BEGINS Vinyl Soundtrack by Hans Zimmer and James Newton Howard
- Limited Edition THE FLY Vinyl Soundtrack by Howard Shore (Teleporter Fog Green)
- Limited Edition FANTASTIC BEASTS AND WHERE TO FIND THEM 12″ Vinyl Picture Disc by James Newton Howard
- Limited Edition STAR WARS EPISODE III: REVENGE OF THE SITH Vinyl Soundtrack (General Grievous) by John Williams
- COCKTAIL 180 Gram Limited Anniversary Edition Vinyl Soundtrack (2014)
- HALLOWEEN III Season of the Witch Vinyl Soundtrack by John Carpenter
- SUPERBAD Vinyl Soundtrack by Lyle Workman
Latest TV Soundtracks
- DOCTOR WHO 'Ghost Light' Vinyl Soundtrack by Mark Ayres
- BATMAN Original Television Series Vinyl Soundtrack
- GAME OF THRONES Season 4 Vinyl Soundtrack by Ramin Djawadi
- VIKINGS Season 2 Vinyl Soundtrack by Trevor Morris
- NATURE WALKABOUT 180 Gram Vinyl Soundtrack by Sven Libaek
- THE ULTRA SONIC PERCEPTION 180 Gram Vinyl Soundtrack by Eric Siday
- COLD WORLDS 180 Gram Vinyl Soundtrack by Don Harper
Latest Video Game Soundtracks
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The purpose of this program is to provide funding to states/territories/tribes to improve treatment for adolescents and transitional aged youth through the development of a learning laboratory with collaborating local community-based treatment provider sites. Through the shared experience between the state/territory/tribe and the local community-based treatment provider sites, an evidence-based practice (EBP) will be implemented, adolescents, transitional aged youth, and their families/primary caregivers will be provided services, and a feedback loop will be developed to enable the state/territory/tribe and the sites to identify barriers and test solutions through a services component operating in real time.
Learn more.
© 2016 National Sexual Violence Resource Center – Founded by the Pennsylvania Coalition Against Rape
This site is supported by Grant/ Cooperative Agreement No. 1UF2CE002359-04 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.


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I am doing my final project for my python programming class. I need some help just with the first part of this flowchart. The rest of the flowchart is cake but I am stuck at the beginning.
I'm not asking for the solution just the first step, please.
Full flowchart: https://docs.google.com/file/d/0B7ECg6b ... sp=sharing


text: HomeTabletsSamsungGalaxy Tab 7 Samsung Galaxy Tab 7.0 Cases The Samsung Galaxy Tab 7 is a mini Android tablet to be proud of, so make sure you treat it right by protecting it against scratches and other damage. Samsung Galaxy Tab 7 cases from The Snugg offer the best protection for your tablet without breaking the bank. Browse our wide range of styles and find the perfect Galaxy Tab 7.0 case to express your character. At The Snugg, you can find Samsung Galaxy Tab 7 cases made of durable materials. Not surprisingly, most people want a case that will protect their valuable electronic device from the nicks and scratches that can occur throughout the day. Customers can have peace of mind when they purchase a well-made Samsung Galaxy Tab 7.0 case from The Snugg. Take a look at just a few of the other advantages customers enjoy when they purchase from our online selection. Practical Style When you order a Samsung Galaxy Tab 7 case from us, you're not just getting a practical item. You're getting an attractive case that is a pleasure to take out of your pocket or purse. Our black leather Samsung Galaxy Tab 7.0 case with white stitching detail is sure to win many compliments from your friends. A Unique Design The design of our Galaxy Tab 7.0 case includes cut-outs that allow you to use the device without taking it out of its protective housing. The buttons and ports of the device are fully accessible, so you can capture that photo or look up an address on your device without having to fumble with a cover. In addition, you can connect your charger to the device without removing it from its case. In short, you can use your device with confidence knowing that it's protected at all times! Helpful Features Our affordable Samsung Galaxy Tab 7 case has a flip-stand with two positions, making it easy to conduct research online, watch videos, or check out a friend's photos. You can even set up your device on a table or desk in front of you and enjoy a favourite movie! Our Samsung Galaxy Tab 7 cases are compatible with the dimensions of this unique tablet, so your device will fit securely inside its case without any sliding or movement. And at The Snugg, we are glad to accept bulk orders from organizations and businesses. We are proud to offer the best possible protection for your Samsung Galaxy 7 tablet. Sort By: Popularity Newest $ Low - High $ High - Low Filter Device Galaxy Note 10Galaxy Note 10 1Galaxy Note 10 2014Galaxy Note 8Galaxy NotePRO 12 2Galaxy Tab 10Galaxy Tab 2 10Galaxy Tab 2 7Galaxy Tab 3 10Galaxy Tab 3 7Galaxy Tab 3 8Galaxy Tab 4 10 1Galaxy Tab 4 7Galaxy Tab 4 8Galaxy Tab 7Galaxy Tab 8 9Galaxy Tab S 10 5Galaxy Tab S 8 4Galaxy TabPRO 10 1Galaxy TabPRO 8 4 Style Leather clear selected Colour clear selected Price Under $15.00$15.00 - $25.00$25.00 - $35.00over $35.00 clear selected No results found for that selection, please try again


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It has been 10 years since Kingstonfirst was established as the UK's first ever Business Improvement District (Bid).
And now the company is aiming for another five-year term after launching its third business proposal for Kingston at the Rose Theatre last week.
More than 900 businesses will be asked to vote in a secret postal ballot on Kingstonfirst's proposals between May 29 and June 26.
But for Kingstonfirst chief executive Ros Morgan, the most important thing is that businesses vote in the first place.
She said: "It's really important people vote, whether it's yes or no. If loads of people vote and vote no, then the Bid shouldn't exist anyway, and we'll all get new jobs."
The Kingstonfirst team
Kingstonfirst's third business proposal focuses on three key aims – marketing, managing and shaping Kingston.
Some new ideas are already in place – such as the regenerated ancient market place, which has been given its own brand, website and magazine even before it is finished.
Others, such as the Rangers clean up team and the ambassadors – who help tourists and visitors get around Kingston - are a familiar sight in the town already.
Mrs Morgan said: "There is a lot of the same stuff because it works, and there's no point changing it."
"But other things do change, and this time we're really going to push the independent shops.
"The reality is now with online shopping, even if you've got big brands, you have to have added attractions – and that for us is the river, the markets and the independents."
Click below to see Kingstonfirst's video celebrating 10 years as town centre manager
Kingstonfirst will also take a different approach to this year's Ride London cycling festival, which last year saw thousands of visitors come to town, but virtually nobody shop.
Mrs Morgan said: "Some of the businesses lost 60 per cent of their trade on that day, and that's where we come in.
"So this time we'll be promoting Kingston as a weekend destination.
"We'll be saying to families why not come down on Friday or Saturday and get to know Kingston."
She added: "I meet with businesses and they tell me there are still issues and there are still problems, and I agree with them.
"But that for me is why you need a Bid to sort out those issues.
"The question is - can you afford not to have Kingstonfirst?
"My answer is no."
For more information about the proposal, visit the website.
What do you think? Do Kingstonfirst deserve a third term? Leave your comments below or email firstname.lastname@example.com


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Kodak introduced the Gallery Awards in 1985 as a way to honor and promote the importance and value of excellence in professional photography.
Kodak has always represented quality imaging through its many products and services and will continue to work to elevate the importance of professional, quality imaging within the industry, as well as with customers. It's a connection we're pleased to make.
Therefore, we are delighted, once again, to salute and support outstanding professional photography and photographers by presenting the annual KODAK Gallery and KODAK Gallery Elite Awards. The Gallery Awards are judged on a state or regional basis, with winners going on to compete at the national level for the Gallery Elite Award.
Gallery Awards will be presented, throughout the year, at annual Professional Photographers of America (PPA) regional and state conventions — in addition to those events' customary awards.
For entry questions, please contact Lori Guarino at 585-310-5574.
KODAK Gallery Award Trophy
An elegant engraved crystal trophy will be presented to the winning photographers regionally, along with a specially designed lapel pin.
The Best of the Best
If you are chosen as a KODAK Gallery Award winner, you may be eligible to compete for the prestigious Gallery Elite Award, provided the image was captured and/or printed using KODAK PROFESSIONAL Imaging Solution (Film, Papers and Chemistry).
KODAK Gallery Elite Award
► Gallery Elite: Winners Showcase — 2014 winners


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Discussion of the nature of Ultimate Reality and the path to Enlightenment
Tomas wrote:The murder of Kurt Cobain
When I heard mutterings of this long ago I thought, "Oh Please. Murder? Kurt Cobain? But didn't he already try suicide? So... this time he did it. Bummer".
Dead Men Don't Pull Triggers
1456200423 wrote:Tomas wrote:The murder of Kurt Cobain
When I heard mutterings of this long ago I thought, "Oh Please. Murder? Kurt Cobain? But didn't he already try suicide? So... this time he did it. Bummer".
Dead Men Don't Pull Triggers
Interesting. I suspected her, but I never got around to look in to it. Good find Tomas.
Tomas wrote:She always reminded me of a scumbag, and that's putting it mildly. Never quite a fan of Nirvana (probably due to that I'm so much older and set in my musical ways) but one of my adult children thought they were fab.
Tomas wrote:That website http://www.anomalies-unlimited.com has other stuff that may interest you, knowing some of your posting habits over the years :-)
Tomas wrote:Naturyl otherwise known as James Quirk (who's married to Elizabeth Isabelle) and "Unidan" on Genius Forums...
The Faith Based Monetary and Employment Religion:
Why We Occupy
-one of 26 youtube videos-
Jamesh wrote:He seems to have gotten the idea from the Australian movie Danny Deckchair
"This was Couch's third balloon flight. He realised it would be possible after watching a TV show about the 1982 lawn chair flight over Los Angeles of truck driver Larry Walters, who gained folk hero fame but was fined $US1500 ($1563) for violating air traffic rules."
Bachelorhood And Its Discontents
...only to Mencken it was the bachelor's great intellect and creativity that kept him single, not the other way round. "The bachelor's very capacity to avoid marriage is no more than a proof of his relative freedom from the ordinary sentimentalism of his sex, in other words, of his greater approximation to the clearheadedness of the enemy sex. He is able to defeat the enterprise of women because he brings to the business an equipment almost comparable to their own." Who can argue that a brief catalog of famous bachelors reads like a roll call of the architects of Western Civilization?:
Pierre Bayle
Robert Boyle
Johannes Brahms
Samuel Butler
Robert Burton
Ludwig van Beethoven
Johannes Brahms
Giacomo Casanova
Frederic Chopin
Nicolaus Copernicus
Eugène Delacroix
Rene Descartes
Gustave Flaubert
Galileo Galilei
Edward Gibbon
Vincent van Gogh
Oliver Goldsmith
Thomas Hobbes
David Hume
Washington Irving
Henry James
Franz Kafka
Immanuel Kant
Soren Kierkegaard
Charles Lamb
T. E. Lawrence
Meriwether Lewis
Philip Larkin
Gottfried Leibniz
John Locke
Friedrich Nietzsche
Sir Isaac Newton
Blaise Pascal
Alexander Pope
Marcel Proust
Maurice Ravel
George Santayana
Jean Paul Sartre
Franz Schubert
Benedict de Spinoza
Arthur Schopenhauer
Herbert Spencer
Adam Smith
Jonathon Swift
Nikola Tesla
Henry David Thoreau
Henri De Toulouse-Lautrec
Leonardo da Vinci
Ludwig Wittgenstein
Not a bad list, hey! My favs are bolded
Cahoot wrote:Tomas wrote:Naturyl otherwise known as James Quirk (who's married to Elizabeth Isabelle) and "Unidan" on Genius Forums...
The Faith Based Monetary and Employment Religion:
Why We Occupy
-one of 26 youtube videos-
Lack of experience doesn't preclude the logic of cause and effect.
The martyr with a voice will be heard.
The martyrs without a voice, will not be heard.
A précis explaining intent, with numbers indicating the web traffic that views writings, could be evidence of grant eligibility. Focus on foundations sympathetic to the views in the writings. Be a paid voice for the ideas the foundation wants voiced. Become popular, bigger voice, appropriate digs and wheels.
The quality. Writing as intellectual entertainment rather than as cant is the appropriate standard for defining quality.
Tomas wrote:Be Afraid: Russia and China Seek To Put In Place Top-Down Regulation Of The Internet
It's a bunch of countries who are seeking to use the International Telecommunication Union (ITU) to create a top-down regulatory scheme for the internet.
This issue is going to pick up steam pretty quickly in the next few months, so educate yourselves now...
McDowell highlights a few of the key points in the plan:
http://www.techdirt.com/articles/201202 ... lace-top-d
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text:
D-Link Enters Home Automation Market with Wi-Fi Smart Plugby Ganesh T S on 5/6/2014 10:01 AM EST
- Posted in
- D-Link
- Home Automation
- Wi-Fi
12 Comments
Back to Article
jonsmirl - Tuesday, May 06, 2014 - linkWhat chip is the QFN package on the power supply board? Reply
extide - Wednesday, May 07, 2014 - linkThat is the chip that actually measures the power being used by whatever you plug into this thing. Reply
willis936 - Tuesday, May 06, 2014 - linkI feel like a control system of this sort would be much more elegant by using the same idea as power line adapters with a diagnostic and control protocol rather than WiFi. Reply
Fallen Kell - Tuesday, May 06, 2014 - linkExcept that many people do not have power line network capability configured, and in some cases (like apartments and condos) might not even be able to even use it. Wi-Fi on the other hand is pretty much universally used in homes that have home networking configured so things like laptops, tablets, smart-phones, and game consoles can connect. Reply
willis936 - Tuesday, May 06, 2014 - linkI think the big thing is that WiFi is cheaper to implement than power line adapters right now. Having a smart plug protocol talk over power cables doesn't mean you already have a power line network already in place. I don't see why apartments couldn't use it either. Reply
Fallen Kell - Wednesday, May 07, 2014 - linkMany apartment buildings share power infrastructure which means crosstalk between all apartments within the building, essentially opening up your network to anyone in the building. Reply
SuperSpy00bob - Wednesday, May 07, 2014 - linkI can't seem to find anywhere it's amperage rating. They imply you can use high-power appliances with it, but nowhere in the spec sheets does it give any rating besides 125V. Reply
Fallen Kell - Wednesday, May 07, 2014 - linkYeah, it would be nice to know the amperage... Reply
will2 - Wednesday, May 07, 2014 - linkAbout 9 years ago I bought a cheap mains adapter for £9 from a high street store that displayed, Volts, Amps, Power-Factor, True-Watts on its LCD display. It had enough resolution to monitor appliances sipping little power, eg laptop on standby. Since then I have been looking for a similarly priced version that can store that same data in a small buffer memory, for readout over Bluetooth to a Smartphone or laptop, without success.. I suspect the reason D-Link are charging almost 4 times the price is partly due to use of WiFi, whereas Bluetooth is a far cheaper, and more appropriate network for a 'IoT' node. With absolutely zero spec as to its Power Monitoring capability, my guess is, along with some other recent launches, it only measures current, merely 'assuming' a fixed voltage in calculating power; without measuring actual voltage, and most importantly, 'Power Factor', the 'power' figure will be near worthless, i.e. not a SmartPlug ! It is also not encouraging to see its spec sheet states it consumes upto 5W - which is more than the idle power of my Haswell ULV miniPC !
Use of BT LE can help cure that, and its high price. Reply
Murloc - Wednesday, May 07, 2014 - linkI still don't see the point. I'd still rather enter the room and click the button than to have to whip out my phone and open the app or browser just to turn on the light. Reply
will2 - Wednesday, May 07, 2014 - linkIf you follow the link and read the spec page, you can read it does at least have a on/off button, but as I wrote above, there is nothing in the spec sheet to commend it as a useful energy monitor, especially as it consumes upto 5W for itself. Reply
alextall - Wednesday, May 07, 2014 - linkI'll be interested when it can activate the light/fan/etc. by proximity. Might be a decent use of wearable devices once they mature. Reply


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Auburn, Ala. – German-based Borbet Group, a leading European manufacturer of light metal alloy wheels for the automobile industry, recently announced the appointment of Ulf M. Kranz as its new President and CEO. Borbet will also hire a new Chief Operating Officer, Dieter Schmidt.
"We're proud to get Mr. Ulf M. Kranz in our Auburn operation. Both Mr. Kranz and Mr. Schmidt have the experience to continue to grow the business and to improve the operation capabilities of Borbet in the USA," said Borbet owner Peter Wilhelm Borbet.
Borbet took over the aluminum wheels plant in Auburn Technology Park North in spring of 2008. Since then, the company has steadily increased production, with a total volume of 1.3 million wheels in 2012. With demand still above capacity, production plans call for at least 1.4 million wheels in 2013.
Founded in 1881 in Germany, the family-run business has been producing light-alloy wheels since 1997. Borbet is recognized throughout the world as a specialist in design excellence and high quality in aluminum wheels.
"With employment of approximately 375, up from around 200 in 2008, Borbet has become one of Auburn's top manufacturing employers," said Auburn Mayor Bill Ham, Jr. "They're a valuable asset to Auburn and I look forward to their continued growth."
For more information, contact Economic Development at 501-7270.


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ooohhhh.....for f**k sake No!!!God I was really looking forward to it..please tell me this is some hoax...my mates just sent off for tickets too!!!
Looks like it'll be headcharge if thats the case....C'mon it's just a hoax yeah??
MegaTeaBag lineup 6march Manchester Academy 8pm-6am
Discuss 808 State Radio Shows, DJ sets, Podcasts etc.
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'Fraid not - according to this link here - http://www.ticketline.co.uk/event_details.asp?CPFlag=0&EventId=24843, it's cancelled...
Is it going to be rescheduled, Mr Egg?
Is it going to be rescheduled, Mr Egg?
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Spook-tacular Fun in Balboa Park
The third annual Halloween Family Day takes place tomorrow (Saturday, October 29) in Balboa Park! Stop by MOPA for some photography and fun, preferably in costume and experience Halloween in the Park.
Among the highlights of this year's park-wide Halloween Family Day is a doggie costume contest at the Spanish Village Art Center, a Great Pumpkin parachute drop at the San Diego Air & Space Museum, a creepy nocturnal Critter Cavern at the Natural History Museum, a dance performance by Ballet Folklorico Xochitl at the Mingei Museum, and activities that explore local cemeteries and gravestones at the San Diego History Center.
Over a dozen museums, including MOPA, will be offering children 12 and under free admission with a paid adult, with spooky crafts and activites through the Park from 11:00 am - 3:00 pm. Learn more about the full lineup of activites.


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Only voters receive the private messages a model sends to her fans.
Voting is how you show love and appreciation to your favorite models & photographers.
Zivity pays them a cash royalty for each vote they receive.
love your bold poses...!!photoman027
Love you guys <33Rant
Love your animal postureStoneNYC
So beautiful and sexy <3TheHowling67
The moves of a cat!wd40xxx
Just luscious...absolutely luscious;)piratenate
Buy votes to support this artist on Zivity. Votes are $1 each, and when you vote on a set you like, 55% goes to the model and 30% to the photographer. You can vote in the next step after registering and purchasing votes.


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OFFICERS from British Transport Police (BTP) are reminding commuters who cycle to and from railway stations to ensure their cycles and locks are as secure as possible as efforts continue to deter thieves who target bikes locked at stations.
Unfortunately, cyclists who leave their bikes at stations for long periods of time can find themselves the victims of theft - but Chris Basey of the BTP said: "I cannot highlight strongly enough the importance of using a good quality D-lock to secure your cycle and also to lock both wheels as well as your frame.
"It will act as a deterrent to thieves and reduce your chances of becoming a victim of crime.
"Don't use poor quality wire locks which are easy to snap."
In the meantime, BTP is stepping up the number of plain clothes patrols around the UK and working with train operators to conduct security patrols and improve CCTV at locations where cycle racks are in place.


text:
Study About Safety and Efficacy of Coenzyme Q10 in Progressive Supranuclear Palsy
- Full Text View
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- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Study hypothesis:
A 6-week p.o treatment with 5 mg/Kg Coenzyme Q10 is safe and tolerable,increases the brain's metabolism and ameliorates clinical symptoms in patients with PSP.
|Progressive Supranuclear Palsy
|Drug: Coenzyme Q10
|Phase 2
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:
|Mono-Center, Prospective, Double-Blind, Placebo-Controlled, Randomized Clinical Phase IIa Trial to Assess the Safety, Tolerability, and Immediate Biological Effects of Coenzyme Q10 - nanoQuinon® in Progressive Supranuclear Palsy
- Brain Energy Metabolites measured by Magnetic Resonance Spectroscopy
- Slowdown of clinical progression after 6 weeks, rated with UPDRS III, PSP rating scale, PSP staging system, modified Hoehn and Yahr, FAB, MMSE, Montgomery- Asberg Depression scale, Schwab and England Score and UPDRS II
- Safety and tolerability:Vital signs physical examination and safety laboratory with Blood tests and urine status.
- Evaluation of occuring adverse events(AE), severe adverse events(SAE) up to 6 Weeks after the beginning of the treatment.
|Study Start Date:
|May 2006
|Study Completion Date:
|February 2007
Background and Rationale:
1. Progressive Supranuclear Palsy (PSP, Steele-Richardson-Olszewski Syndrome) is a sporadic neurodegenerative disorder resulting clinically in a Parkinson syndrome (i.e. akinetic-rigid movement disorder) with prominent postural instability, oculomotor deficits, and cognitive decline (for review: Albers and Augood, 2001; Burn and Lees, 2002). With an average annual incidence of 5.3 per 100000 and an age-adjusted prevalence of 6.4 per 100000, PSP is as common as motor-neuron disease (Burn and Lees, 2002). There is no symptomatic treatment, because PSP patients do not respond to any known therapy (Albers and Augood, 2001; Burn and Lees, 2002). The progression of PSP is rapid and the median survival after onset of symptoms is 5-10 years (Albers and Augood, 2001). Presently, there is no known effective symptomatic or neuroprotective therapy for PSP.
2. Evidence suggests an impairment of mitochondrial energy metabolism in PSP (Albers and Beal, 2002):
- Reduced cerebral glucose and ATP metabolism have been shown in functional imaging studies in PSP patients (Forster et al., 1988; Martinelli et al., 2000).
- Cybrid cells harboring mitochondrial genes from PSP patients have decreased ATP-levels and complex I activity (Swerdlow et al., 2000; Albers et al., 2001; Chirichigno et al., 2002).
- A tropical PSP-like tauopathy has been linked clinically and experimentally to the consumption of the fruit and teas of leaves of the tropical plant annona muricata rich in lipophilic complex I inhibitors (Caparros-Lefebvre et al., 1999; 2001). These clinical observations suggest a role for mitochondrial dysfunction in the etiology of PSP.
3.Coenzyme Q10 (CoQ10) is the physiological electron recipient of complex I. Exogenous CoQ10 (1.) enhances the electron transport by complex I and (2.) powerfully scavenges free radicals. Thus, CoQ10 has been shown to reduce the toxicity of complex I inhibitors in vitro (Menke et al., 2003) and in vivo (Beal et al., 1998
|Ages Eligible for Study:
|40 Years to 85 Years (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Diagnosis of clinically probable PSP (Litvan et al., 1996).
- Early stage PSP [PSP staging system ≤ III (Golbe, 1997)].
- Capability and willingness to give written informed consent to participate in the study.
Exclusion Criteria:
- Age > 85 years.
- Parkinson syndromes other than PSP (e.g. idiopathic Parkinson's disease, multiple system atrophy, diffuse Lewy body disease, FTDP17, symptomatic parkinsonism)
- Dementia [Mini Mental State Examination (MMSE) ≤ 24]
- History of epilepsy, structural brain disease, brain surgery, or electroconvulsive therapy
- History of stroke related to the onset or progression of PSP symptoms
- Arterial hypertension (systolic >180 or diastolic >110mm Hg)
- Thyroid dysfunction requiring thyroxin supplementation (CoQ10 may change its metabolism)
- Presence of other serious illnesses
- Insufficient contraception in male and pre-menopausal female participants. Accepted means of contraception are hormonal contraception, intrauterine devices, vaginal rings, preservatives, and abstinence.
- Pregnancy or lactation period
- Participation in other drug studies within 60 days before baseline visit.
- Use of CoQ10 within 60 days before baseline visit
- Use of any antioxidants (e.g. vitamin E, C) within 60 days before baseline visit
- Use of any drugs modifying mitochondrial activity within 60 days before baseline visit
- Use of statins within 60 days before baseline visit (inhibit endogenous CoQ10 production)
- Use of drugs interfering with catecholamine metabolism (e.g. reserpine, amphetamines, or monaomine oxidase-A inhibitors, methylphenidate, cinnarizine) within 30 days before baseline visit.
- Use of Levodopa within 30 days before baseline visit (CoQ10 may change its metabolism).
- An unstable dosage of CNS-active drugs (e.g. anxiolytics, hypnotics, tranquillizer, and antidepressants) within 30 days before baseline visit or throughout the study.
- An unstable dosage of other antiparkinsonian drugs within 30 days before baseline visit or throughout the study.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00328874
|Neurologische Klinik der Philipps-Universität Marburg
|Marburg, Hessen, Germany, 35033
|Principal Investigator:
|Wolfgang Oertel, Professor
|Neurologische Klinik der Philipps Universität Marburg
Additional Information:
|ClinicalTrials.gov Identifier:
|NCT00328874 History of Changes
|Other Study ID Numbers:
EudraCT: 2005-000574-40
|Study First Received:
|May 21, 2006
|Last Updated:
|March 25, 2008
Keywords provided by German Parkinson Study Group (GPS):
Progressive Supranuclear Palsy
Coenzyme Q10
Additional relevant MeSH terms:
Supranuclear Palsy, Progressive
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Movement Disorders
Ocular Motility Disorders
Cranial Nerve Diseases
Neurodegenerative Diseases
Eye Diseases
Coenzyme Q10
Growth Substances
Physiological Effects of Drugs
ClinicalTrials.gov processed this record on August 22, 2017