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Attenuated Plaque Detected by Intravascular UltrasoundClinical, Angiographic, and Morphologic Features and Post-Percutaneous Coronary Intervention Complications in Patients With Acute Coronary Syndromes
Author + information
- Received August 22, 2008
- Accepted August 30, 2008
- Published online January 1, 2009.
Author Information
- Sung Yun Lee, MD⁎,
- Gary S. Mintz, MD†,
- Seok-Yeon Kim, MD⁎,
- Young Joon Hong, MD⁎,
- Sang Wook Kim, MD⁎,
- Teruo Okabe, MD⁎,
- Augusto D. Pichard, MD⁎,
- Lowell F. Satler, MD⁎,
- Kenneth M. Kent, MD, PhD⁎,
- William O. Suddath, MD⁎,
- Ron Waksman, MD⁎ and
- Neil J. Weissman, MD⁎,⁎ (neil.j.weissman{at}medstar.net)
- ↵⁎Reprint requests and correspondence:
Dr. Neil J. Weissman, 100 Irving Street, NW, EB # 5123, Washington, DC 20010
Objectives We evaluated the clinical significance of attenuated plaque (hypoechoic plaque with deep ultrasound attenuation).
Background Attenuated plaques are unusual intravascular ultrasound (IVUS) findings in patients with acute coronary syndrome (ACS).
Methods We reviewed clinical presentations and angiographic and pre-intervention IVUS findings in 293 ACS patients undergoing percutaneous coronary intervention (PCI) without a distal protection device: 187 with non–ST-segment elevation myocardial infarction (NSTEMI) and 106 with ST-segment elevation myocardial infarction (STEMI).
Results Attenuated plaque was observed in 75 patients (25.6%): 39.6% of STEMI versus 17.6% of NSTEMI (p < 0.001). (We also reviewed 100 randomly selected patients with stable angina and pre-intervention IVUS; none had attenuated plaque.) Overall, in ACS patients with attenuated plaques: 1) the level of C-reactive protein was higher; 2) angiographic thrombus and initial coronary flow Thrombolysis In Myocardial Infarction flow grade <2 were more common; and 3) IVUS lesion site plaque burden and remodeling index were significantly greater, lesion site luminal dimensions significantly smaller, and thrombus, positive remodeling, and plaque rupture were more common. No-reflow (26.7% vs. 4.6%, p < 0.001) and deteriorated post-PCI coronary blood flow (8.0% vs. 2.8%, p = 0.001) were higher. In ACS patients with normal coronary blood flow at baseline, deterioration in the coronary blood flow post-PCI was more common in lesions with attenuated plaque.
Conclusions Attenuated plaque was more common in ACS patients with STEMI than NSTEMI. Attenuated plaque in ACS patients was associated with a higher C-reactive protein level, more severe and complex lesion morphology, reduced coronary blood flow before PCI, and especially no-reflow after PCI.
Intravascular ultrasound (IVUS) can be used to identify high-risk or unstable lesion morphologies. For example, IVUS data have indicated that acute coronary syndrome (ACS) lesions more often have positive remodeling (1–3), plaque rupture (4,5), and hypoechoic (soft) plaque (1,6–8) compared with non-ACS lesions. IVUS characteristics that can predict no-reflow and/or increased creatine kinase-MB after percutaneous coronary intervention (PCI) (9–12) include a larger plaque burden (13,14), intracoronary mobile mass (15), lipid pool-like plaque characteristics (16,17), and, most recently, attenuated plaque (defined as deep ultrasound attenuation without calcification) (18). However, attenuated plaques have not been studied in detail in patients with ACS. Therefore, we report the frequency; clinical, angiographic, and morphologic features; and post-PCI complications of IVUS-detected attenuated plaques in patients with ACS.
Patient population
We identified 293 patients with ACS (187 patients with non–ST-segment elevation myocardial infarction [NSTEMI] and 106 patients with ST-segment elevation myocardial infarction [STEMI]) treated with PCI who had undergone pre-intervention IVUS imaging between January 2006 and March 2007 at the Washington Hospital Center. During this time period, PCI was performed in 1,306 ACS patients of whom 39.1% had IVUS guidance. We excluded 217 patients with target lesions that were restenotic, graft vessel disease, lesions located at the side branch, lesions that were pre-dilated before IVUS, lesions treated with any distal protection or thrombectomy device, and IVUS image acquisition using below 40 MHz transducers. The clinical, angiographic, and IVUS feature of these 293 patients are the basis of this report. The study protocol was approved by the internal review board at MedStar Research Institute at Washington Hospital Center.
An experienced research nurse obtained clinical demographics at the time of the procedure. Demographic information included gender, age, presence of hypercholesterolemia (treated or >240 mg/dl), diabetes mellitus (dietary glycemic control or oral agent or insulin-treated), hypertension (medication-treated), family history of coronary artery disease, and current or experienced smoking.
Angiographic analysis
Angiograms were analyzed by an independent operator (S.W.K.) using standard methodology and blinded to the clinical and IVUS findings (19). Angiographic coronary blood flow was assessed at baseline and after PCI based on Thrombolysis In Myocardial Infarction (TIMI) flow grade (20) and corrected Thrombolysis In Myocardial Infarction frame count (CTFC) (21). Angiographic no-reflow was defined as a post-PCI decrease from baseline in final TIMI flow grade <2 after PCI without identified mechanical obstruction. Presence or absence of intracoronary thrombus (discrete intraluminal filling defect), intimal flap (discrete intraluminal filling defect), and calcification were also evaluated.
IVUS analysis
All IVUS studies were performed before any intervention and after intracoronary administration of 200 μg of nitroglycerin using a commercial scanner (Boston Scientific Corporation, Maple Grove, Minnesota) that consisted of a 40-MHz transducer mounted on the tip of a flexible shaft rotated at 1,800 rpm within a 2.6 to 3.2-F monorail sheath. The IVUS catheter was advanced beyond the lesion followed by automatic transducer pull back (at 0.5 mm/s) to the aorto-ostial junction. IVUS images were recorded onto 0.5-inch high-resolution s-VHS videotape or digitally onto a CD or DVD for offline analysis.
Qualitative analysis was performed blind to clinical data according to criteria of the American College of Cardiology clinical expert consensus document on IVUS (22). Lesion site was at the minimum lumen cross-sectional area (CSA). Distal and proximal references segments were the most normal looking cross sections within 10 mm distal and proximal to the lesion site, respectively. Using planimetry software (TapeMeasure, INDEC Systems, Mountain View, California), we measured external elastic membrane (EEM) and lumen CSA (mm2) at the lesion site and at the proximal and distal reference segments. If EEM circumference could not be identified because of attenuation, we interpolated the EEM area. Plaque and media (P&M) CSA was calculated as EEM minus lumen CSA. Plaque burden was calculated as P&M divided by EEM CSA. Plaque eccentricity was calculated as maximum P&M thickness minus minimum P&M thickness divided by maximum plaque plus media thickness. Remodeling index was defined as the lesion site EEM CSA divided by mean reference-segment EEM CSA. Positive remodeling was defined as a remodeling index >1.0, intermediate/negative remodeling as a remodeling index <1.0 (22).
Lesion plaque composition at the culprit lesion was assessed visually (22). IVUS plaque rupture was defined as the presence of a cavity that communicated with the lumen with an overlying residual fibrous cap fragment (23). Thrombus was an intraluminal lobulated mass with evidence of blood flow (microchannels) within the mass, mobility, and sparkling or scintillation appearance (24). Attenuated plaque was defined as hypoechoic plaque with deep ultrasound attenuation without calcification or very dense fibrous plaque (Figs. 1 and 2).⇓⇓ Attenuated plaque required the agreement of 2 independent, experienced observers (S.Y.L. and N.J.W.); lesions in which these 2 observers disagreed were excluded. With motorized transducer pullback, we measured the distance from each attenuated plaque back to the respective coronary ostium (pullback speed multiplied by number of seconds). Calcification was identified as very bright echoes (brighter than the adventitia) with acoustic shadowing of deeper tissue zones (25). Fibrotic plaques can also produce shadowing or attenuation; however, their echoreflectivity distinguishes them from attenuated plaques.
Statistical analysis was performed with StatView 5.0 (SAS Institute, Cary, North Carolina). Continuous variables were expressed as mean ± SD and compared with Student unpaired t test. Categorical variables were expressed as frequencies and compared with chi-square statistics. A p value <0.05 was considered statistically significant.
Attenuated plaque was observed in 75 of 293 (25.6%) ACS patients; 42 of 106 (39.6%) STEMI patients, and 33 of 187 (17.6%) NSTEMI patients (p < 0.001). Three lesions were excluded because of disagreement between observers; these 3 lesions were located adjacent to calcium. For the purposes of comparison, we also reviewed a random sample of 100 patients with stable angina undergoing pre-PCI IVUS between January 2006 and March 2007 selected from our database; none of them had attenuated plaques.
Patient baseline characteristics are shown in Table 1. There were no significant differences in cardiac risk factors in ACS patients with attenuated plaques except that attenuated plaques were observed more often in male patients (p = 0.002) and in patients with a high C-reactive protein level (p = 0.03). There were no significant differences in use of thrombolytics in STEMI patients or use of direct thrombin inhibitors or glycoprotein IIb/IIIa inhibitors comparing the 2 groups.
Baseline angiographic and IVUS data
Angiographic data are shown in Table 2. Most lesions with attenuated plaque were detected in the left anterior descending coronary artery (LAD) and right coronary artery (RCA); 80% were located in proximal and midcoronary artery segments of the LAD and RCA. One patient with NSTEMI had 2 attenuated plaques: 1 was located in the mid-RCA and the other in the proximal RCA (Fig. 3). Angiographic thrombus was more frequently found in target lesions with attenuated plaque, and angiographic calcification was less common. Baseline TIMI flow grade was reduced, and CTFC was higher in ACS patients with attenuated plaque compared with that in patients without attenuated plaque.
IVUS data are summarized in Table 3. Lesion site plaque burden, plaque eccentricity, and remodeling index were significantly greater, and lesion site lumen area and minimal lumen diameter was significantly smaller in lesions with attenuated plaque. IVUS target lesion thrombus, positive remodeling, and plaque rupture were more common in lesions with attenuated plaque. By IVUS analysis, attenuated plaques were predominately located at the proximal portions of a coronary artery—specifically, within 40 mm from the ostium in 62 (82.7%) patients (Fig. 4). Echo attenuation was located at the minimal lumen CSA site in 65 of 75 patients (86.7%) and proximal to it in 6 (8.0%) patients. Attenuated plaques were more frequently found in lesions with plaque ruptures compared with those seen in lesions without plaque ruptures (42.4% vs. 18.8%, p = 0.001).
A total of 311 stents were implanted; but there were no significant differences in stent number (1.14 ± 0.42 vs. 1.05 ± 0.34 per lesion, p = 0.08), stent size (3.23 ± 0.47 vs. 3.19 ± 0.43 mm, p = 0.4), or stent length (21.5 ± 7.8 vs. 20.3 ± 7.4 mm, p = 0.2) comparing the 2 groups (with vs. without attenuated plaques).
Post-PCI coronary flow was restored to normal in 89.7% of ACS patients, but it deteriorated compared with that seen in baseline in 4.1% of ACS patients. No-reflow (26.7% vs. 4.6%, p < 0.001) and deteriorated post-PCI coronary blood flow (8.0% vs. 2.8 %, p = 0.001) were more common, and CTFC (Table 2) was higher in ACS patients with attenuated plaque compared with that in patients without attenuated plaque. In patients with TIMI flow grade <2 at baseline, improvement of coronary blood flow post-PCI (75.7% vs. 89.3%, p = 0.3) was not different between the 2 groups; but in lesions with normal coronary blood flow (TIMI flow grade 3) at baseline, deterioration in the coronary blood flow post-PCI (13.2% vs. 3.2%, p = 0.021) was more common in lesions with attenuated plaque. There were no significant differences in peak levels of creatine kinase-MB after PCI, and the duration of hospital stay was similar comparing the 2 groups (Table 1).
In this analysis of 293 ACS patients who underwent pre-PCI IVUS examination, we found attenuated plaque in 25.6%, more commonly in STEMI than in NSTEMI patients. This study suggests that attenuated plaque is not unusual in patients with ACS and may be part of the unstable lesion morphometric spectrum.
In a recent angiographic study, Wang et al. (26) analyzed 208 patients with STEMI to determine the location of epicardial coronary artery thrombosis. Occlusions tended to cluster in the proximal one-third of the major epicardial coronary arteries. In a 3-vessel IVUS study, Hong et al. (27) evaluated the axial location of plaque rupture in 392 patients. Plaque ruptures occurred mainly in proximal segments of the LAD, the proximal and distal segments of the RCA, and the proximal left circumflex artery. The location of attenuated plaques in the current study is similar to the location of acute occlusions or plaque ruptures in these previous 2 studies, especially with regard to proximal distribution in the LAD and RCA. Thus, "hot-spots" for thrombotic occlusion, plaque rupture, and attenuated plaque are in similar locations. Proximally located "hot-spots" may lead to more myocardial damage, but also (potentially) early detection and localized directed preventive strategies.
Recent pathological reports have studied the mechanisms of ultrasound attenuation in plaques that were not densely fibrotic (28–30). In human cadaver coronary arteries, Hara et al. (28) reported ultrasound attenuation was associated with Von Kossa-positive granules within the fibrous plaque, interpreted to indicate microcalcification. In another report also from human cadaver coronary arteries (29), dense fibrofatty tissue and necrotic core were more common in plaques with ultrasound attenuation. Directional coronary atherectomy specimens from attenuated plaques showed very advanced atherosclerosis consisting predominantly of hyalinization with scattered, small areas of calcification (30). Calcium is a reflector of ultrasound; the extent of image attenuations might be related to the distribution and volume of calcification. However, the sensitivity of IVUS (using 30-MHz transducers) for microcalcification is only 64% for calcium particle size <0.05 mm (31). The current study also showed that attenuated plaque was associated with target-lesion thrombus assessed using either angiography or IVUS. An animal experiment (32) suggested that white thrombi may produce an attenuated ultrasound pattern compared with a nonattenuated pattern for red thrombi; white thrombi contain more densely homogenous cellular elements. These findings support the hypothesis that microcalcification and thrombus with underlying advanced atherosclerosis maybe the mechanism of echo attenuation in unstable plaques.
Previous IVUS studies have shown that culprit lesions in ACS patients typically contain, at most, spotty calcium. Similarly, recent plaque imaging with multislice computed tomography (33,34) has also described plaques with minimal calcification in unstable lesions. However, it is not clear whether multislice computed tomography studies can separate the ultrasound-attenuated plaques reported in the current study from merely noncalcified plaques.
In the present study, only 1 patient had multiple attenuated plaques. However, this was not a 3-vessel IVUS study; therefore, the exact frequency of multiple-attenuated plaques cannot be determined. Although the exact frequency of multiple ruptured plaques is the subject of debate, in several IVUS studies secondary ruptured plaques have been found at sites remote from the culprit lesion, evidence of the systemic nature of plaque vulnerability (35,36).
A recent IVUS study by Okura et al. (18) in 110 ACS patients with 73 lesions showed that attenuated plaque was related to a transient deterioration in coronary blood flow and poor outcome such as larger infarct size and higher incidence of fatal arrhythmia after PCI. The current study showed an incidence of 26.7% of no-reflow after PCI in ACS patients with attenuated plaque. In addition, even in the presence of normal baseline coronary blood flow, there was a high incidence of deterioration in the coronary blood flow post-PCI if lesions had attenuated plaque. In the current study, attenuated plaque was also associated with more severe and complex lesion morphology, IVUS predictors for no-reflow (13–17). Distal protection device use—especially routine use—in patients with ACS is still controversial (37–39); our results and those of others suggest a more selective use of these devices during primary PCI in patients with ACS according to plaque morphology and morphometry.
Study limitations
This was a retrospective study of patients from a single center. It identified the relationship between attenuated plaque PCI complications, but additional prospective studies will need to be conducted to determine its relative value versus other parameters that may cause complications. Almost 90% of patients had TIMI flow grade >1; therefore, ACS patients presenting with totally occluded vessels and angiographic thrombus-containing lesions were typically not imaged, and the current results cannot be extrapolated to such patients. We excluded ambiguous plaque with ultrasound attenuation (i.e., attenuation located adjacent to significant calcium or at a side branch). The presence of acoustic shadowing of the EEM at the site of attenuated plaques may interfere with calculation of remodeling and plaque burden. The lag between symptom onset and IVUS imaging and PCI may have influenced attenuation if attenuated plaque changes dynamically. IVUS examinations using low-frequency IVUS transducers (below 40 MHz) were excluded; we did not find any attenuated plaques in the 43 patients studied using such instruments presumably because of greater degrees of penetration with 20- versus 40-MHz transducers. Similarly, Yamada et al. (29) exclusively used 40-MHz transducers to detect attenuated plaques.
Attenuated plaque was detected in 25.6% of patients with ACS. Attenuated plaque was more common in ACS patients with STEMI than in those with NSTEMI. Attenuated plaque was associated with a higher C-reactive protein level, more severe and complex lesion morphology (thrombus and plaque rupture), reduced coronary blood flow before PCI, and especially no-reflow after PCI.
Dr. Lee was supported by a scholarship from Inje University IlsanPaik Hospital, South Korea.
- Abbreviations and Acronyms
- acute coronary syndrome(s)
- cross-sectional area
- corrected Thrombolysis In Myocardial Infarction frame count
- external elastic membrane
- intravascular ultrasound
- left anterior descending coronary artery
- non–ST-segment elevation myocardial infarction
- percutaneous coronary intervention
- plaque and media
- right coronary artery
- ST-segment elevation myocardial infarction
- Thrombolysis In Myocardial Infarction
- Received August 22, 2008.
- Accepted August 30, 2008.
- American College of Cardiology Foundation
- ↵
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DAJV-Fachgruppentag / Specialized Group Conference
03/04/2016 (13:00)Institute for Law and Finance, Frankfurt am Main
Please join the German American Lawyer`s Association (DAJV) in Frankfurt on Friday, 4 March 2016 for a meeting of German, American and international attorneys and interested parties at the
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subset: commoncrawl


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HCO Day Camp
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When Neil Pasricha started his WordPress.com blog, 1,000 Awesome Things, he decided to highlight one awesome thing each weekday to help him keep a positive outlook.
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via An Awesome WordPress.com Success Story — Blog — WordPress.com.


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I like a good story as well as the next person. I majored in English because I honestly couldn't imagine anything simpler than reading books and writing papers. However, paper writing and storytelling are two different things, and I've always been extremely uncomfortable with story-telling. I have no aspirations to be a professional writer, my blogging is more of a journal and advice column for me, rather than a creative outlet.
So imagine my horror when I discovered that this week's shared topic at Blog Azeroth asks "What sort of boss would you be?" My first thought was to skip it. I'm not obligated to participate in the BA topics. That argument would usually allow me to gracefully eek out of this social obligation except…. I've been ignoring BA for almost a month! And there have been really good topics in there too. I just know if I procrastinate on this one, it will spiral into a never-ending maw of oblivion which leaves me permanently adrift from BA…. and honey, I need BA.
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The Battle
Phase One: Windsoar will drop totems beginning at fight initiation and every cool-down thereafter. She will not cycle totems. At the 30 second mark, Windsoar will summon elementals. She will continue to do so at every available cooldown.
Phase Two: Phase two begins when Windsoar reaches the 40% mark. She will begin randomly hexing members of the raid, as well as casting Thundershock on cool-down. Elemental and totem drops will continue.
Loot Table
I'll let the devs figure this one out!
So… would you wanna kill me?


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Spy Fighters: Spyware battle that took six tools to win
One SearchWindowsSecurity.com reader shared this story about a major spyware battle he fought and finally won -- using six different antispyware tools.
Letter to the Editor: A spyware battle that took six tools to win
by Bruce Hevner
Six months ago one of my company's business machines started getting pop-up ads. Although this machine was scheduled to be replaced with a new one, it was given a clean Windows XP install. Pop-ups should not have been a big problem.
Some time later I was using Spybot-Search & Destroy to scan the machine. This is a good tool except for the fact that it relies on user input to keep up with the latest adware definitions. Sure enough, I Spybot had not been updated on this particular machine since the previous month. I ran the update, did a sweep and found a few applications that it promptly removed. However, the user continued to get pop-up ads even when he was offline. Spybot said the system was clean, but problems were still apparent.
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Finally I ran Lavasoft's Ad-Aware SE. It turns out the adware had been removed, but a registry entry was triggering a warning to say it was still trying to install. Ad-Aware found the registry entry that was triggering the warning. (This was one of the few good experiences I had with Ad-Aware.)
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For more about Bruce's story, click for his letter to the editor.


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An animated Holiday video for Proprint - an established print services company.
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Richard Krakower and his team know a thing or two about what makes their clients "tick".
They guided this creative right down to the right voice over selection (Louise Phillipe).
They guided this creative right down to the right voice over selection (Louise Phillipe).
The results can only be measured in the strong business relationships that continue into the new year.
This video was sent out to a long list of established customers thanking them for their business and wishing them well over the Holidays.
Holiday Email Campaign
This targeted campaign established positive results on all fronts.
Video Stills:


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Hundreds of school children today took a pledge in the presence of Delhi Chief Minister Arvind Kejriwal to fight pollution and convince their parents, relatives and friends to adhere to the odd-even scheme to be rolled out in two days.
"Convince your parents, relatives and friends to follow the odd-even scheme. We are to do this not out of any imposition, but because it is important for our health and life.
"If you see anyone violating the odd-even scheme, just roll down your car window and ask that person to go back home. If the same person receives 10 such remarks in a day, it would stir his conscience and persuade him to keep his car off the road," Kejriwal said, addressing the students at Rajkiya Pratibha Vikas Vidyalaya in north Delhi's Civil Lines.
Before the students took the oath, the Chief Minister also encouraged them to convince their parents and relatives to go for carpooling, as public transport vehicles such as buses and Delhi Metro are likely to be quite crowded for 15 days during which the scheme is to be implemented, starting January 1.
"I, myself, shall carpool with Transport Minister Gopal Rai, who lives not very far away from my residence," Kejriwal said.
During the programme 'Pollution Free Delhi', a student asked the Chief Minister about the exemption on medical emergencies provided in the scheme and how is it to be implemented on the ground, to which Kejriwal replied by saying that the scheme is largely based on trust.
On being asked about the probability of people buying two cars to evade the scheme, the Chief Minister called it a "baseless claim" being propagated for the past few days.
"The media is exaggerating about people buying two cars to evade the scheme. Not too many people are that rich, and the affluent ones already have more than one car. These are baseless claims being propagated over the past few days. And above all, it is not a permanent scheme anywhere," said Kejriwal.
Deputy Chief Minister Manish Sisodia and Rai were also present on the occasion.


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I was at a Scout Jamboree in Southern Alberta two summer ago, in the foothills of the Canadian Rocky Mountains. Beautiful country with lots of wildlife.
Including bears.
Being Scouts we were prepared. Everybody received instruction on food storage, garbage disposal, and cooking protocols. Young men and women were on stand-by with ATVs and walkie-talkies to respond to any bears that might wander into camp. Rally points and head-counts were established. Think of a fire drill except with bears.
About the fifth day just before supper we go those bears. Right in the heart of 1500 campers. On the siren's signal we rallied at the sub-camps (large groups of people being a deterrent to bears), and after they proved difficult to dislodge we more at various larger collection points in the facility. Away from our supper and closer to the few hard-sided buildings in camp. Everything was going according to plan.
Scaring Off The Bears
Except for one thing. These kids were tired after a long day of running around in the woods and playing on the water. They were hungry. They could hear the ATVs driving up and down the trails chasing the bears and not having much success. Some of them were starting to get scared. It was time for some leadership!
I leapt on the nearest rock and started singing the silliest, most juvenile "action" song I could think of called "I Found a Bug". I don't want to spoil the ending for you, but let's just say that bugs get eaten. At first people thought I was crazy. This happens a bit so I've learned to ignore it. It didn't take long for the 200 kids at our rally point to start singing along. When I was done two of the Scouts wanted to lead a song themselves. My plan was working. The kids were taking over.
One after the other Scouts got up on the rock and led a song, story, or skit to keep themselves entertained while the bears were chased through the woods. I think my singing have even helped scare them off! Half an hour later the all clear was sounded, and we returned to our campsites prepared our supper, lighter of step and smiles on our faces.
Values are Culture, Culture is Brand
I believe that the stories we tell ourselves, the songs we sing, and the ritual we indulge in is what makes us human. Other animals can use tools, some animals may even use language. We don't know. But as far as we can tell we're the only ones that pass knowledge on from generation to generation verbally.
This is a powerful force in our lives, one that we sometimes hesitate to indulge in. We're suspicious of being manipulated, and rightly so. We don't have to reach too far back into history to find examples of these forces being used for evil or personal gain.
Yet this is the essence of leadership, good or bad: to nurture and leverage the group consciousness to execute a goal or task that one person cannot accomplish alone. Many business leaders force success by dint of personality, intellect, or sheer stick-to-it-ivness. Yet in the end how effective are they really? How long do their accomplishments last after they're gone?
If all you want or need is to make money, then there are many ways to do that. If you want to have a real effect on the world you're going to have to work through others. The others that believe the same things you do, value the same things you do, and will continue having an effect long after your presence has faded.
What is Your Company's Culture?
Values are culture, culture is brand. What stories does your company tell about itself? What is the real brand that emerges in times of stress?


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Ironman Cozumel Race Report >> New Beginnings
As I got caught and pushed off the Professional Female Podium at Mile 25, I knew that was it. This was going to be my Last Mile as a Professional Triathlete and I let myself pull back a little bit in an attempt to enjoy it.
For 6-monthes, I did everything right. I put everything in my preparation for Ironman Cozumel. As with any Ironman Build, it wasn't perfect. I had to overcome a Run Injury early in the Build that forced me to be patient with my Run Progression. I cleaned up my Act >> Diet, (No) Alcohol, Sleep, Recovery, etc. I put in the Long, Slow, FUN Miles at the beginning of the process on the Bike and really enjoyed the Training. There wasn't doubt with my Preparation. I was swimming well, I was hitting the Bike Numbers and I nailing Run Sessions.
I nailed the swim in COZ. I lined up and immediately hopped on the feet of the girls I knew would be first out of the water. I was able to hang for 500-800m and then they gapped a bit. I was super winded and working HARD and outside of my comfort zone and more like Olympic/70.3 Pace to keep up. As I fell back Rachel came around me on the side I prefer to draft off (the side I breathe to) and I picked up my Effort and forced myself to hang with her. I knew getting out of the water that my swim execution was on point. I (mentally) high-fived myself and quickly moved on as Rachel TORE through Transition and I hustled in an attempt to keep up.
Getting on the Bike, I felt good. My Power Meter was immediately WAY off so I knew it would be a Heart Rate & Perceived Effort Day which was fine. My Coaches Race Day Instructions were to worry about myself but to try to be strategic with the windy side of the Island and have a legal draft when possible. I kept Rachel in sight for quite some time, but I wasn't catching up. I wasn't comfortable pushing too much harder so early in the race. In my past few Ironman, I think I've been so worried about getting into the race that I've ignored how I've felt, what or when I was eating, my pacing, etc. and I've crumbled about half-way through the bike subsequently. I think it served me to ride the Race mostly solo with a few packs of AG Men coming around me on the second and third Loops. Although as a Result of my Solo Effort, I probably lost 10′-15′ on the Front of the Race.
Regardless, I got off the Bike in 5th place and I had confidence in my Run Legs. Starting the Run, my Legs felt like crap, but I stayed positive and told myself I'd run into my Legs… and I kept waiting for them to show up… And waiting… I stayed reasonably positive despite running about a 1′ per mile slower than I expected. It wasn't a total implosion but it was close. I had no desire to run out the entire marathon about the 13.1 mark but I was still well in the money and I pretty determined to stay there. It was pure delusion driving me forward. When I made the final turn around and I saw the new girl 4' back and FLYING, I said 'Bitch.' and I dug as deep as I have ever dug to hold onto 10th and $750. I dropped my pace those final 4-miles by :30-seconds per mile which was a miracle given the fatigue build up at the point.
It wasn't the Run I expected to have. It wasn't the Run I wanted to have but it was the Race Experience I needed to move on. It's time. THAT WAS EVERYTHING. I can look at my Race and my Build into Ironman and take Pride in my Effort. That was everything I had. I have no doubt. It is time to move on… I've always told myself when it didn't make sense personally, professionally and I was no longer making progression in my Career, I would know to walk away. This wasn't the Transition I expected to make in Central Florida this Spring, but I look forward to this next stage in my Career, I'm excited! I'm excited to put continued focus on my Athletes, AG Multisport Consulting, and supporting those around me in reaching their Goals. I'm excited to put my Time & Energy into new Projects and Adventures.
I would be amiss if I didn't take a moment to THANK those that have supported me throughout this Journey. Thank you Matthew Rose and The Dynamo Multisport Family, Thank you Cannon Cyclery, Thank you Coeur Sports, Thank you Patty Gellatly, Anne Chrzanowski & Tom Ramthun, Thank you Jerry & Cheryl Grissom, Thank you Tony & Michelle Dalton, Thank you to all past and present AG Multisport Coaching Athletes, Thank you to the Tri-PTC Community, Thank you to Home-Stays around the World especially Tom Price and Jenny & Andrew Calder, Thank you to CNN FitNation & Roni Selig. There is an emotional debt that I can never repay for your personal buy-in on my Professional Career. One of the most beautiful gifts you can give is to believe in the dream of another. I am grateful beyond words for all of the gifts I have been given over the years.
Cheers, THANK YOU, Here's to 2017 & NEW BEGINNINGS!!!


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We demonstrate electro-optic ultrafast control of the optical quality factor of an on-chip silicon microcavity. The micrometer-sized cavity is formed by light confinement between two microring resonators acting as frequency selective mirrors. The ring resonators are integrated into p-i-n junctions enabling ultrafast injection and extraction of carriers. We show tuning of the cavity quality factor from 20,000 to 6,000 in under . We demonstrate both high-Q to low-Q and low-Q to high-Q transitions.
© 2008 Optical Society of AmericaFull Article | PDF Article
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Opt. Express 20(19) 21341-21345 (2012)
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Obtains information about which SNS topics receive status messages from the specified directory.
If no input parameters are provided, such as DirectoryId or TopicName, this request describes all of the associations in the account.
Request Syntax
{ "DirectoryId": "
string", "TopicNames": [ "
string" ] }
Request Parameters
The request accepts the following data in JSON format.
- DirectoryId
The Directory ID for which to get the list of associated SNS topics. If this member is null, associations for all Directory IDs are returned.
Type: String
Required: No
- TopicNames
A list of SNS topic names for which to obtain the information. If this member is null, all associations for the specified Directory ID are returned.
An empty list results in an
InvalidParameterExceptionbeing thrown.
Type: Array of strings
Length Constraints: Minimum length of 1. Maximum length of 256.
Required: No
Response Syntax
{ "EventTopics": [ { "CreatedDateTime": number, "DirectoryId": "string", "Status": "string", "TopicArn": "string", "TopicName": "string" } ] }
Response Elements
If the action is successful, the service sends back an HTTP 200 response.
The following data is returned in JSON format by the service.
- EventTopics
A list of SNS topic names that receive status messages from the specified Directory ID.
Type: Array of EventTopic objects
For information about the errors that are common to all actions, see Common Errors.
- ClientException
A client exception has occurred.
HTTP Status Code: 400
- EntityDoesNotExistException
The specified entity could not be found.
HTTP Status Code: 400
- InvalidParameterException
One or more parameters are not valid.
HTTP Status Code: 400
- ServiceException
An exception has occurred in AWS Directory Service.
HTTP Status Code: 500
The following examples are formatted for legibility.
Example Request
POST / HTTP/1.1 Host: ds.us-west-2.amazonaws.com Accept-Encoding: identity Content-Length: 66 X-Amz-Target: DirectoryService_20150416.DescribeEventTopics X-Amz-Date: 20161214T025225Z User-Agent: aws-cli/1.11.24 Python/2.7.9 Windows/7 botocore/1.4.81 Content-Type: application/x-amz-json-1.1 Authorization: AWS4-HMAC-SHA256 Credential=AKIAI7E3BYXS3example/20161214/us-west-2/ds/aws4_request, SignedHeaders=content-type;host;x-amz-date;x-amz-target, Signature=d04fcf5cf8439dd8d0503933cab61c2bad6d6b29b9e1e5dca25f6d6de1704e17 { "DirectoryId": "d-926example", "TopicNames": "snstopicexample" }
Example Response
HTTP/1.1 200 OK x-amzn-RequestId: a68a1e79-c19b-11e6-870b-c3330207df37 Content-Type: application/x-amz-json-1.1 Content-Length: 29 Date: Wed, 14 Dec 2016 02:52:27 GMT { "EventTopics": ["eventtopicexample"] }
See Also
For more information about using this API in one of the language-specific AWS SDKs, see the following:


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Brenda McClearen is a delight to work with. She makes magic with her keen sense of trends, style and her trusty camera. I normally dread photo shoots but Brenda makes it easy and fun.
McClearen Design is as good as it gets. They've designed, typeset and prepared for press two books I've been part of, and they designed and oversee my website. I couldn't be happier with their work or with Brenda, Terri and Amanda as people. There is no part of the creative process they can't handle wonderfully for any size project. I recommend McClearen Design to friends and I'm proud to recommend them here.
Back in 1996 I had a dream of launching a small record label that specialized in old-time instrumental music. I was directed to Brenda McClearen at McClearen Design Studios and we began a creative relationship that is still going strong... 15 years later. My business would never have been as successful without the talents of Brenda McClearen and Terri Morris at McClearen Design Studios. Together we created artistically unique CD covers, catalogs, postcard mailers and point of purchase display headers that helped make my business a frontrunner in the gift market music industry. Thanks McClearen!...it's been fantastic working with you all these years!
I have worked with McClearen Design on two projects, both with extremely successful outcomes. This is a firm that knows how to meet a deadline. I so admire that quality. I've found them accessible, responsive, and delightfully creative.
I just cannot say enough about the profesionals at McClearen Design! These gals are the best!
For the last 10 years, McClearen Design has done all of my art and I am always astounded at the level of quality that is accomplished. They catch my vision and take it to a fresh, beautifully, stunning level. Their designs not only look fantastic, but they find a way to make statements with their art. They stay knowledgeable of the current styles and trends, and I appreciate that. There is no better design firm than McClearen Design Studios.
Brenda McClearen and her group of extremely talented and creative people are simply the best there is. Being in the business of entertainment and related product creation it is of supreme importance to my company that we be connected to a source of graphic artistry that can take a project and move it from an idea to a reality, be it a CD cover, a total book art design, an online marketing promotion site, DVD design or promotional photography. McClearen does it all, and I know of no one that does it better. For many years McClearen has been my first and only graphic design destination in any creative adventure that arises. Bravo, McClearen.
My friends at McClearen Design have always created unique, eye-catching art for any occasion, accompanied with a timely and loving attitude.
For over twenty years, McClearen Design has been the artistic directors for the Burchfield Brothers. Along with producing beautiful art that is eye catching and relevant, they also have greatly enhanced our career with constructive council in web design, social networking and marketing. These are the things that will keep us going another twenty years!
Thank you from the Burchfield Brothers!
When I found myself in need of a graphic designer, I had the good fortune of being directed to McClearen Design. Needing a lot of understanding and direction with three books now completed, Brenda McClearen provided that and more. Her expert guidance, along with an incredibly talented support staff, delivered for me quality results in the most professional manner. If you're looking for something special, unique and refreshing, McClearen Design is the place for expert graphics and design in the most creative fashion.
I wholeheartedly recommend McClearen Design to anyone for expert photography and graphic design. I have known and worked with Brenda McClearen for over twenty years and have always found her and her staff to be professional in every way with prompt, creative service at a reasonable price. I have used McClearen Design for event photos, advertising banners, CD production and even the publication of books. It is without reservation that I recommend McClearen Design.
I found McClearen Design Studios through the recommendation of a major printing house in Nashville. I paid them a visit and explained the creative vision for my brand of Revolutionary War and Colonial period historical novels. Brenda and her team fully understood my vision and delivered award winning results. I always get compliments on the design work of my books and I proudly tell my customers that it was all produced by Tennessee folks. From covers to illustrations, to text pages, they design high quality output, ready for print at the big printing houses or print on demand with Lightning Source. They even allowed me access to the studio for the editing sessions, putting up with my perfectionism! That's why I know, from personal direct observation, that they are good people to have as business partners on your production team. McClearen Design has designed two novels for me, "Bonny Kate's Honeymoon" (2009) and "Song of the Shenandoah" (2011). I highly recommend their work and reasonable rates for all kinds of publishing and visual marketing needs.


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Phone: 866-663-2725
In NH: 603-352-0600
In VT: 802-257-0900
Fax: 603-352-4802
Office Address (NH)
41 School Street
Keene, NH 03431
Office Address (VT)
We now have a VERMONT satellite office conveniently located at:
145 S. Main Street
Chester VT 05143
– by appointment only.
P.O. Box 332
Chester, VT 05143
Awesome experience in a stressful time
April 2015
Workman Comp Injury
October 2015
The best around
December 2014
Slip and fall /broke wrist
Thank you!
An attorney that really cares about you as a friend!
Excellent job on my accident / injury case
In my work I deal regularly with many attorneys, and I have not worked with any better.
A lawyer dignified and trustworthy
He was fully present and focused when engaging me to discuss my case.
I always felt respected and that Matt was putting my best interests first. I believe I received a fair and just settlement based on my injury and the circumstances surrounding it. His support team (legal secretary) was also very professional and kind.
My final comment is that I consider Matt Newborn a friend. I highly recommend his service as a lawyer.
Charles & Monette


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10 Frickin' Amazing Facts about the ITER Fusion Reactor
The sun lies at the heart of our solar system and is one of the largest and most influential objects in space. Unlike the light we see that comes from a light bulb, the sun produces its energy and light. It creates this energy through a process called nuclear fusion, where two atoms of hydrogen combine to form one, larger atom of helium. When this happens, energy is produced as both light and heat. That's why when the sun is shining, we can see its bright light and feel its heat from a million miles away. What if we were able to employ the energy from the sun to provide thousands of cities throughout the world with a cleaner and more sustainable form of energy? Although it sounds far-fetched, it is something that 35 different countries are currently trying to do in Southern France.
The ITER Fusion Reactor, or International Thermonuclear Experimental Reactor, is a multi-billion-dollar project that is looking to tap into the sun's power on a greater level than ever before. Compared to some of the most common energy sources that we use around the world today, nuclear energy is much cleaner than oil, coal, or natural gas. While nuclear fission reactors produce toxic residue, nuclear fusion generates waste that is non-radioactive and that can be recycled seamlessly in less than a century. In addition, compared to traditional reactors, nuclear fusion doesn't pose the same risk with regards to nuclear meltdown and dysfunction. Since nuclear fusion reactors can run off of water from the sea, they offer a clean and renewable source of energy unlike any that the world has seen up until this point in time. Here are ten amazing facts about the ITER Fusion Reactor that will transform your thoughts on how we power our world.
10ITER Tops Fusion Power Production
The ITER Energy Project is one of the biggest and best of its kind. Known as one of the most ambitious and astonishing energy projects in the world, it aims to build the largest and strongest tokamak, which is a confined magnetic device that is used as the basis of modern-day fusion reactors. It is an advanced system that aims to pave the way for fusion reactors of the future. It will be the first device ever created that will produce net energy. Net energy is when the amount of energy that is generated from the system is greater than the energy that is used to power the system itself. The ITER tokamak has been strategically designed to surpass the current world record for fusion power. The current record is held by a European tokamak called 'Jet.' This tokamak produced 16MW of power from a 24MW input in 1997. The ITER energy project aims to shatter this record, providing an incredible return on energy. With just 50MW of power put in, it is expected to produce 500MW of fusion power! Although ITER will not capture and retain the power it is anticipated to produce, it will provide the platform for developing a machine of the future that can.
9ITER is the First of Its Kind to Maintain Energy for Long Periods of Time
Not only is ITER expected to shatter the record for energy output and net gain, but it is projected to maintain power for much longer periods of time. In the research world, we are just beginning to fully comprehend the mechanics behind burning plasma. In order for nuclear fusion to occur, atoms need to be heated to incredibly high temperatures before joining together. On the surface of the sun, for instance, temperatures reach more than 10-15 million degrees Celsius! In order to replicate those extreme temperatures on earth, scientists have experimented with different devices to create a state of matter that is very similar to plasma. It is not considered a liquid, gas, or a solid, so scientists refer to it as plasma. In order to create sustainable fusion, the plasma has to be burning. Those who are helping to develop ITER believe that the plasma that is produced in ITER will not only create more energy, but will last for much longer periods of time as compared to traditional reactor methods. This could be an incredible breakthrough for the future of energy creation!
8ITER is Being Developed by More than 35 Different Countries
Impressively, this massive project is being completed by more than 35 different countries. The idea was first planted in 1985, when thousands of scientists and engineers came together to discuss the possibility of designing something with such integrity and wonder. The ITER agreement came together in 2006 when the United States, China, the European Union, India, Japan, Russia, and Korea signed the contract to participate in such a large undertaking. Together, they would explore one of the greatest areas of science and aim to replicate the energy of the sun here on earth.
Each ITER member shares in the cost of the construction. They will also chip in for operational costs and help to oversee commissioning once the project is completed. Each member will also share in the results and have full access to lessons learned along the way. The European Union is primarily responsible for the construction costs. China, India, Japan, Russia, Korea, and the United States share in a small percentage of those fees. Interestingly enough, the countries that are participating in the project are donating little money. Rather, contributions are being made in the form of buildings and other construction components. Altogether, the ITER project is supported by more than half of the world's population and more than 85% of the gross domestic product around the globe. The power of 35 countries coming together to support the creation of sustainable energy is truly amazing.
7ITER Will Demonstrate How Feasible it is Produce Tritium
Tritium is a form of hydrogen that is radioactive. Its properties are very useful when it comes to generating energy in nuclear fusion reactors. When you mix Tritium with a phosphor, it emits light. Hence, it serves as a robust and sustainable light source. So, why is Tritium so important when it comes to the ITER project? While Tritium is one of the two primary fuels that generates a nuclear fusion reactor, it is virtually non-existent in nature. That means that in order to make a nuclear fusion reactor, Tritium must first be created. Fusion reactors are able to produce Tritium through a process known as 'Tritium breeding'. This refers to the reaction that takes place when a neutron produced from the fusion reactor is mixed with lithium. When combined, this mixture forms one Tritium and one Helium nucleus. Since there is not enough Tritium in the world to supply future reactors, the ITER project will provide scientists with the opportunity to organically produce it on their own. They will be able to make their own Tritium in a well-organized and efficient manner, while utilizing specially designed systems that will help to adequately manage Tritium levels and prevent any unnecessary exposure. This process will undoubtedly serve as a useful tool for the future of nuclear energy production.
6ITER was Licensed as a Nuclear Operator in France in 2012
For ITER members, safety is of the utmost concern. If not tended to appropriately, the generation of nuclear power can bring about grave concerns. This is why the signing of a decree authorizing ITER as a nuclear operator in 2012 was such a huge success in the world of nuclear fusion. After years of rigorous review by officials specializing in nuclear safety, the French government gave the project its final blessing. This is the first time in our history that a nuclear fusion device has ever been successfully licensed as a nuclear operator. What an incredible feat! For years, officials had to pine away at more than 5,000 pages of detailed safety outlines. They considered the inventory of several radioactive materials in a fusion device, as well as the potential for toxic radiation exposure. After reviewing the principal hazards, they analyzed the built-in safety functions and quality of the design as a whole. Overall, they deemed the nuclear reactor a safe and viable project that complies with rather stringent French regulations. While there will certainly be ongoing auditing and inspection by French nuclear agents, this is truly an incredible milestone for the collaboration this early in the game.
5The ITER Project is an Architectural Masterpiece
ITER is truly an architectural masterpiece. Per their contribution to the project, the European Union is helping to build most of the foundation and site buildings on more than 180 hectares of land. To put this into perspective, one hectare is equal to approximately 100 acres of land! The site, which is located in Southern France, is quite extensive, to say the least. At the end of construction, there will be more than 39 buildings that will house the primary tokamak and all of its plants. The Tokamak, itself, will be accommodated in a building that is more than seven stories high. This building is due to be reinforced with concrete that will be thirteen meters below the ground level platform. On the lot, as a whole, there will be designated areas for offices, storage, active workshops, and other project zones. Huge buildings will be placed within the lot with plenty of space to create, develop, and produce nuclear magic. In addition, civil engineers are working hard to build a fully integrated system of drainage, as well as parking areas and roads for easy access to the ITER site. When all is said and done, the ITER site will truly be an architectural wonder.
4ITER Transportation is Impressive
Can you imagine how much precision and coordination it must take to transport thousands of little pieces and several large objects around the world without compromising the integrity of such parts? The ITER project is a collaborative effort between 35 different countries. While the European Union is responsible for a large part of the construction, there are pieces that are being shipped overseas and transported long distances from countries across the world. While the final construction is sure to amaze millions, the actual process is perhaps more of a wonder. In addition to meticulous coordination and precision, transporting such items requires the right infrastructure, as well.
Once the items are shipped to the shores of South France, they shall be carried to Cadarache where they will be put together. The bridges, back roads, and highways have been scrutinized carefully to ensure that they can support such heavy loads for such long distances. The heaviest of all the loads is projected to weigh roughly 800 tons! After all, the existing infrastructure wasn't built with the notion that the world's largest and most powerful nuclear fusion reactor would be built there! Those who assisted in the preparation also needed to make sure that nearby villages would not be disturbed once convoys started passing through with such bulky materials. Many roads were enlarged and bridges were reinforced to support the commencement of such a large-scale project. The transportation and configuration of such materials for this project is truly amazing.
3The ITER Machine will Require 1.5 Million Hours of Man-Power to Assemble
Another surprising fact about the ITER project is that it is expected to take more than 1.5 million hours of manpower to transport, assemble, and finalize the construction of this massive undertaking. To put this into perspective, one million hours is equal to roughly 114 years. This means that the entire project is going to take close to two centuries of sheer manpower to finish! To put this into perspective even further, the Eiffel Tower, which is one of the most popular travel destinations in the world, took just over two years to build. While this was indeed considered 'fast' for the construction of such a large tower back in the late 1800's, it is nothing compared to how long it is expected to take to finalize ITER. The ITER organization has several people who are currently working on putting together what they refer to as a user's manual for the construction. What is most challenging, perhaps, is that there is no outline or blueprint for a project of this magnitude in existence. The individuals who are working on the backside of this project must figure out exactly how all of the pieces will fit together and how the existing resources will best be allocated. There is an insane amount of work that is going to have to come together to ensure that all of the pieces are transported safely, inspected to ensure they are in proper working condition, and put together to make sure that they will operate as intended once the final construction is up and running.
2The ITER will Contain More than One Million Components
If the ITER machine is going to require more than 1.5 million hours of manpower, you know that the construction of this machine is no small feat. In fact, in order to construct the 30 buildings that are going to be used to operate ITER, as well as the ITER machine itself, more than 10 million pieces need to come together in harmony to create the largest and most efficient nuclear fusion reactor known to man. Over 30,000 components are going to be manufactured and assembled and more than 10 million bits are going to be pieced together to ensure a smooth operation. This is altogether one of the most complex, unique, and intricate machines ever designed in the history of man.
Again, to put this into perspective, it is helpful to consider the Eiffel Tower. The Eiffel Tower is certainly an architectural wonder in and amongst itself. Built at the tail end of the nineteenth century, the Eiffel Tower was designed and constructed as the main attraction for the World Fair, which was held in Paris in 1889. More than 18,000 pieces were designed, built, and assembled to complete the tower in just over two years. While the Eiffel Tower was considered a remarkable project at the time and remains one of the top attractions in the world today, it is nothing compared to the sheer magnitude of the ITER project.
1Visits to ITER Can Be Arranged Year Round
The most exciting and amazing fact about ITER is that you can visit the site and explore this nuclear wonder! If you have a group of anywhere from nine to 50 people, you can coordinate a site visit on any given day throughout the year. Of course, what you will be able to see will depend on weather conditions once you arrive. Regardless, this will provide you with the opportunity to see one of the most amazing and extensive projects known to man being built! You will witness all of the action up close and personal. When you coordinate a site visit, you will first stop at the visitor's center. Here, you will view a presentation of the project, as a whole, and learn more about how the project was started, how the site is being constructed, and what ITER means for the future of nuclear energy. Once you have watched the main presentation, you will be given a guided tour of the platform where the scientific facility is currently being built.
ITER does accommodate guided tours for smaller groups and schools, as well. It is recommended that tours are arranged at least four weeks in advance. Proper identification must be furnished at the time of visit. In addition to being able to schedule an individual tour, you can take advantage of ITER's open door days. This is when ITER is open to the public, free of charge. You can access the schedule of open events on the ITER website. On these days, you can take advantage of a wide range of presentations, guided tours, slideshows, videos, and conferences to learn more about this incredible project. Presentations are given in both English and French. Considering that this is such an intense and challenging undertaking, it is amazing that you are provided with ample opportunity to immerse yourself in the construction of such an architectural wonder.
Globally, we know we are at the point where we need to do something different. We need to tap into alternative sources of energy that are not as detrimental to our environment as some of our traditional means. Scientists and researchers are turning away from traditional energy sources like crude oil and natural gas to explore cleaner and more sustainable forms of energy. While crude oil and natural gas help to heat homes, fuel automobiles, and produce a wide range of items that we use every day, sourcing and extracting such energy from the environment produces some serious side effects. So, scientists are looking at whether we can harness energy from the sun, as well as from the wind, water, and many other things.
The International Thermonuclear Experimental Reactor, or ITER as it is commonly referred to, is a multi-billion-dollar project that is looking to tap into the sun's power on a greater level than ever before. ITER, meaning 'the way' in Latin, is one of the largest, most ambitious, and most complex energy projects in the world. The project is a collaborative effort of more than 35 different countries that are looking to build the world's largest magnetic fusion device. This device will help us to prove that fusion, the process in which the sun produces light and heat, is feasible here on earth. This project, which is going to take many years to complete, is expected to pave the way for future fusion research and transform how we look at nuclear energy. While it is certainly going to take a lot of time, effort, and manpower to complete, the ITER project is expected to be bigger and better than ever before. It is truly a unique undertaking that, when completed, will pave the way for a brighter, cleaner, and safer future for our world.


text: Choosing the Right Humidifier for Your Lawrence Home Posted February 4, 2016 The winter is always changing, but no matter how gentle or intense the season is, chances are that you've had quite enough by the end of it. And just when you think spring is almost here, another cold front comes through. It's important to stay in front of your furnace service, even during the end of the winter, because you honestly never know when you are going to have to use it next. Through this time of shifting weather, the air and moisture are also in continuous flux, which might provide the perfect opportunity to capitalize on a humidifier for your home. Humidifiers provide important humidity to your house during the chilly, dry air of the winter and can help keep you healthy in the wintertime. Here are a few things to keep in mind when choosing which humidifier to purchase for your home: Cost – of course you want to consider the price, but don't forget to consider the operating and maintenance costs that come with a new humidifier, too. There are various levels of efficiency that each humidifier runs on, just like other heating and cool equipment. You will want to think about the needs of your home's humidity as well as your budget to make sure that your investing in the ideal choice. Size – each humidifier is different, but all will commonly have a number that shows the gallons per day that it can hold. This number can generally be calculated by multiplying your home's total square footage by the height of your ceiling. Finding this number and making sure that it corresponds to the needs of your home will help establish what size humidifier is right for you. Our technicians can also help you take into account the insulation in your home, which can occasionally impact the ideal product to choose. If you're still stumped about which humidifier to buy for your home, our pros at Scott Temperature typically endorse a whole-home humidifier. They produce the most dependable results throughout your full home and provides you the most bang for your buck. The coolest part is that it gets entirely integrated into your present system, making the installation and maintenance easy for long-term use. Every home is different, obviously, and there are a range of factors that one can contemplate before making a final decision on the perfect humidifier. They aren't talked about as much as furnaces are, even though they are really just as important, so we understand if you have more questions or worries that you might want to run by our pros before deciding. Give us a call at our Lawrence at 785-269-0465. Back To Blog


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Is This Normal Relay Functioning?
Brrwobig replied to Brrwobig's topic in Equipment Use and RepairThanks for the reply. I am so used to a manual kiln I am not sure what is normal and what isn't with a digital kiln.
Is This Normal Relay Functioning?
Brrwobig posted a topic in Equipment Use and RepairI have a Skutt KM822 I have been firing since I bought it new in March 2013. I fire to cone 6 in it. Lately I have noticed a change in when the relays "click." Let me preface by saying the firing I did last week I got error code 1. Kiln stalled out at 2177. I fire to 2210 with a 10 min hold. It was a very hot day when I did this firing, was mid afternoon when the error code 1 came on. I have multiple fans going to move air around in my kiln shed. I did diagnostic test and for amp, voltage. All OK. I also did a test fire of the kiln to 1100 with a 30 min hold and checked every peephole to see if elements all on. They were and I heard relays clicking the entire firing. OK..here is the issue. I just completed another cone 6 firing. I do ramp/hold program. Modified from one I saw online here in this forum. All are degrees Fahrenheit 150 to 250 degrees no hold 400 to 1900 no hold 130 to 2210 Hold 10-13 min. This firing I heard the relays clicking at the beginning. When I checked at 1700 degress no clicking but the temp rising. Checked again at 1923 and I hear clicking relays. Checked again at 2127 no relays sounds but the temp rising. I didn't hear the relays click again until I was in the hold at the end. The temp during the hold rose to 2217 and then the relays began clicking and the temp dropped to 2210. I have fired a manual Skutt for decades, so digital is foreign to me still. I will probably call Skutt this week, but curious if this sounds normal or not to those of you who have more digital firing experience than I do. Appreciate any insight!
Could Someone Help A Mama?
Brrwobig replied to roselle's topic in Educational Approaches and ResourcesDo you get to travel much? Kentucky Mudworks is in Lexington KY. They sell wheels, kilns etc. Ordered some glaze from them awhile back.
I can't envision NOT working in clay in some way, shape or form. It is part of who I am.
Pets in the studio
Brrwobig replied to buckeye's topic in Studio Operations and Making WorkI live on an acreage, my studio consists of three small outbuildings (one throwing shed and two kiln studios.) I leave the door open during spring/summer/fall and my dogs come and go as they please. I have 4 dogs-a yellow Lab mix, Australian Blue Heeler, and two Rat Terriers. The only concern I have at times is the rat terriers getting in the way when I trim. I use the old kick wheel my dad made me when I trim. It has a big cement flywheel. I don't want them to get their paws caught so I try to shoo them away when trimming.
Brrwobig replied to buckeye's topic in Studio Operations and Making WorkHi Buckeye, I'm Bev from Nebraska. From your user name, I can tell you probably aren't a fan of my state right now. (Congrats on the win over Illinois though) I'm 56 and pottery is how I keep myself sane. I carry the mail as a rural letter carrier to make a living. Hope to leave the USPS in a year or so and concentrate more on my pottery. I've had my hands in clay since high school. My dad made me a kick wheel back then, one I still use to trim with. At present I show/sell my wares at regional Renaissance Faires for the most part. Stumbled onto the Renaissance Faire scene back in 1985. Seems to be a nice fit for the work I do. I do both functional and whimsical ware (dragons, gargoyles etc.)
Pottery 099.jpg
Brrwobig commented on Brrwobig's gallery image in Browse Member Galleries
Paragon Vs Skutt Kiln Purchase
Brrwobig replied to Isculpt's topic in Studio Operations and Making WorkI have both a Skutt and a Paragon. The Skutt has been firing since 1974, have never changed elements in it. I only go up to cone 5 in it. I've had the Paragon about 25 years now, I suppose. I do need to change out some elements in it as they are sagging pretty bad in places. I used to fire to cone 9 in it, now I am firing at cone 6. They both have manual kiln sitters. The Paragon's doesn't drop anymore. In fact it started "sticking" not long after I purchased it. I replaced it a couple years ago and it worked for a couple firings and then it began to stick again. So I just use large witness cones viewable via the peep hole to fire.


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- Minneapolis
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Wendy Berklich is a paralegal in the firm of Briggs and Morgan, Professional Association. She is based in our Minneapolis office and works with the Business Law Section.
Wendy assists attorneys primarily in the areas of general commercial and corporate law, and mergers and acquisitions. Her primary duties include assisting in the creation and organization of legal entities, as well as assisting with general business operations and record maintenance for businesses, including corporations, limited liability companies and partnerships. In addition, Wendy assists with stock and asset acquisitions by organizing due diligence, assisting attorneys in the preparation of ancillary documents, organizing transactions for closings and coordinating transaction closing meetings.
Wendy graduated cum laude from Winona State University where she received her B.S. in the university's paralegal program.


text: When city and state officials, other dignitaries and well-wishers gathered to cut the ribbon on the newly renovated Bell Diamond Manor in the Berkley section of Norfolk, a special focus was on Mr. George Banks. It was Mr. Banks whose vision and effort with the Beacon Light Civic League originally launched Bell Diamond Manor in the early 1970s. A few years ago, Beacon Light looked to Woda Cooper to take Bell Diamond Manor to the next chapter with a $14 million top-to-bottom renovation. Mr. Banks is shown front wearing a hat.


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Yet another great audiobook, I actually finished it yesterday morning, but a looming art history exam kept me from being able to sit down at the computer and devote a few minutes to typing out my review. Either way, here it is.
This audiobook is actually intertwined with the last one I listened to, it shows the plight of this fascinating alien race that is introduced in the first one.
With this one, you'll learn about this alien race and its plight primarily trough the eyes of a young doctor on her first assignment. It also pops into a few other points of view for a limited time to complete the picture of what happens. Overall, I must say well done! It kept my attention and I didn't get lost while listening to it. Not only that, but I found it hard to put away.
So, check it out on Amazon!


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Ms Triguna B Rao, Manager, Bangalore, India
V. Rajasekar, Businessman, Bangalore, INDIA
N. Rajashree Rao, Project Manager, Bangalore, INDIA
Kundan Srivastava, Mechanical Engineer, Gujarat, INDIA
Naresh is an highly effective, skillful and proficient NLP Master Practitioner & Trainer who has his basic fundamentals very well sorted out and clear. It is particularly his this capability that reflects in his coaching sessions. His style is simple and straight forward and his approach is very results oriented. He has the promise and potential to be amongst the best in the business. I wish him all the best. ~Anil Saighal, Mumbai
What I gained in my experience as a student of NLP Wellness Training with Naresh was beyond anything I expected. I was pleasantly surprised by how I was able to learn and uncover about myself through the Wellness coaching process. I was exceptionally impressed with the individualized and customized experience with Naresh. The training helped rekindle, realign and re-cement my inspiration to help others by elevating their Wellness. ~Deep Kamal Arora, Bangalore
I have personally experienced the change in state of my mind from the framing exercise where from a state of negativity, I immediately moved to a state of positivity as this exercise brought a lot of clarity to my mind. The NLP techniques I learnt in the two-day workshop are immensely beneficial in all walks of life. Subconscious mind dictates our life. I was knowing this as a fact. After the workshop , I have learnt to program my mind, and various other techniques which will help me in dealing with various people from all walks of life & in achieving my goals. Naresh is very calm and patient which are pre-requisites for a NLP Practitioner. He listens to you with empathy & compassion, and helps you by challenging & by supporting your goals. ~Sanjay Sindhia, Bangalore
The NLP workshop which I have done on Feb 13 & 14 by Mr. Naresh was excellent. His way of approach was good, on-time, well-behaved, good knowledged, enthusiastic, and very good narrator. We wish him all the success, and want to join your next course in future. A very good program for mind transformation. ~Ramesh BK, Real Estate Business Owner, Bangalore


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Hi Everyone!
This week's PaperCrafter's Corner Magazine Monday inspiration is this image:
I had a hard time with this one until I remembered what Stephanie said about it...a grey-blue background....a single word title. I created a monochromatic card with a single word sentiment. But, I didn't stop there. I also challenged myself to make a trio of cards with the same supplies but different looks. And here's my cards:
They were all made with paper scraps, Unity stamps, and Colorbox ink.
Have a GREAT week!
A grey-blue backgro


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- FPIES stands for Food Protein-Induced Enterocolitis Syndrome.
- FPIES is a delayed type of allergic reaction that happens after eating a certain food. Trigger foods cause parts of the intestines to swell and get irritated.
- Common FPIES symptoms include throwing up, diarrhea, stomach pain, becoming pale and very tired (lethargic).
- Reactions can range from mild to life-threatening. Children with FPIES can dehydrate quickly and may go into shock.
- Most reactions start 2 to 3 hours after eating a trigger food. A child can react up to 8 hours after eating the food.
- Most times children have only one trigger food. However, it's not uncommon to react to more than one trigger food with FPIES.
- Milk, soy, and rice are common triggers. Some less common triggers are oats, barley, beef, chicken, turkey, sweet potato, squash, peas, and lentils. Any food can be a trigger.
- Avoid eating trigger foods. Some infants might need special formula.
- Breastfeeding mothers should not avoid an infants trigger foods unless the infant has had a past reaction to the food in breast milk.
- There are no blood or skin tests for FPIES. A food challenge helps find out if your child has FPIES to a food. It can also help find out if he or she has outgrown FPIES.
- Food challenges happen in a clinic or hospital while an allergist or nurse is with you.
- Most children outgrow FPIES around age 2-3 years old. FPIES in adults is very rare.
- A written plan for your child's FPIES can be helpful for people treating your child in an emergency.
- FPIES can be mistaken for severe infections (sepsis), food poisoning, anaphylaxis, or stomach problems needing surgery.
- In FPIES, the body loses fluids and may become very dehydrated. This can lead to shock. Shock is a life-threatening medical emergency.
- Shock happens when the body cannot get enough blood and oxygen to its brain and other organs.
- Symptoms of shock include:
- Cool, pale, clammy skin
- Getting weak, dizzy, or confused
- Being fearful or restless
- Fast, weak pulse
- Quick, shallow breathing
- Fainting
- Less urine or darker urine
- Low blood pressure
- If your child has eaten a trigger food consider getting emergency help even before a reaction starts.
- Children can get very sick very quickly and need emergency help.
- If you think your child is in shock, call 911 or get emergency help right away.
FPIES or ANAPHYLAXIS
FPIES and anaphylaxis are different kinds of allergies. Anaphylaxis is a severe allergic reaction that can cause death within minutes unless treated right away.
FPIES is more delayed but can be just as life-threatening.
Rarely children with FPIES may also have symptoms of anaphylaxis, or may start having anaphylaxis to trigger foods. Allergists often do tests to check for anaphylaxis to trigger foods before a child tries them again.


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Coast Guard continues to build on its past success in the Mid Atlantic Rifle Conference while it faces tough outside competition against DI schools such as West Virginia, Nebraska, Texas Christian, and sister academies Air Force, Army, and Navy.
Last season, the Bears swept the MAC in both team and individual categories, broke the team four person team smallbore record twice, tied the air rifle record, set a new five person team record, established a new aggregate record, and tied school individual records in both prone and standing.
The heart of that team returns with sights set on moving team and individual records higher. Captain and senior Marshall Grant and sophomores Hunter Blankenship, Anthony Contreras, Seth Strayer, Aiden Uvanni, and Grayson Wheeler will be joined by recruited athletes Bryce Sturtz and Dalton Stoves. Filling out the roster will be walk-ons who have expressed an interest during the Swab Summer are Turran 'TJ" Johnson, Matthew Kim, and Cody Myers will be joined by sophomore Zara Burns.
Most of the first part of the season will be on the road as the South Range will be undergoing a ventilation upgrade during October and November. While this will put a crimp on hosting home events and training, the range will be available for air gun and it is expected that the interruption will not hamper progress.


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Waging "War" Against the Cyber Threat
Dr. James Norrie, Dean of Business and Justice Studies, was recently published in Frontline Security Magazine. His article entitled "Waging "War" Against the Cyber Threat" discusses how labels have been used to help the general population understand the nuances of the cyber industry and define the growing cyber threat. These labels fall into three categories: Geophysical, as in a "place" or "space", Biomedical, as in a "virus" or conducting a "system health check", and "War", as in "cyber weapons", "digital warfare" and "bad actors". Dr. Norrie demonstrates how each metaphor has been detrimental to understanding the complex social and legal issues related to cyber conflict and insider threats, and concludes that "Cyber Terrorism" might be a more accurate term.
Pros: The familiar terms "cyberspace" and "the web" already invoke a physical location. We refer to the "domain" we're in and talk about "barriers to entry" and not wanting to "open the floodgates". We are focused on protecting "cyberspace" from unauthorized access. This served to simplify the complex virtual network we were tasked with protecting and made it understandable.
Cons: Using these phrases may have over-simplified the task at hand and perhaps made the total effort seem too simple. The complex technical architecture and increasingly global nature of cyber threats made the geophysical metaphor incomplete.
Pros: Helped us voice the need to protect our systems from "contagions" as "things were going viral". We "cleansed" our systems using "anti-virus" software to remain "infection-free". Tools such as "penetration tests" were used to detect "weakness" and "points of entry". This brought the seriousness and complexity of cyber threats back to the forefront and allowed the greater public to draw the analogy that the systems-related protection tasks we undertook were as important as protecting their own health. As such, the significant investments in time, energy and costs by organizations were worth it.
Cons: The biomedical metaphors lacked the ability to capture intent, and did not adequately explain a deliberately aggressive act, not associated with nature itself, but derived from a threatening posture and actions of a perceived enemy.
Pros: Used in our work world, we made a case for "digital warfare" with "nation states". There was "threat escalation" to contend with and corporate "war rooms" in which to devise strategy to fight "coordinated attacks" and new "cyber weapons" being born in top secret labs. Many important public constituencies believe we are now engaged in a cyber war.
Cons: May be too inflammatory. No doubt we can all agree that a "clear and present" online danger exists; but it is debatable if that translates to being "at war". It is true that cyber weapons do exist and have been used offensively, e.g. Stuxnet attack in July 2010. However, could this be more properly categorized as cyber espionage, subversion or sabotage instead?
Cyber Terrorism
Pros: Helps us to understand that much of the attacks today are very unconventional and do not follow "rules of engagement". The motives of the actors involved have changed. While the original intent was mainly for financial gain through theft of intellectual property or online digital assets, this has evolved to be more politically, religiously, or other activist motivated. We are clearly not at war in cyberspace in any traditional sense.
Cons: None as yet.
Society's increasing dependence on cyber connectivity has made it an appealing target for disruption. It is important for the broader public to understand that the bigger and growing threat we face now extends to an internal "trusted insider" threat. The question arises "What practical, legal, and ethical boundaries should govern the actions of cyber professionals in the face of these cyber threats?" In conclusion, the author indicates that Cyber Terrorism is a better description for these acts than any of the other metaphors to date.
Want to Learn More?
Read the full article by visiting the Frontline Security site. To learn more about how you can shape the future of Cybersecurity and Cyber Policy, Request More Information or call us today at (315) 732-2640 or toll-free at (866) 295-3106.


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Tea Guy Speaks
life's short. drink good tea.
Monday, December 14, 2009
Tea Tunes: Tea - Sam Brown
She doesn't get any points for her lip-syncing abilities, but as the song strongly suggests, she's rather fond of tea.
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RedUmbrella Tea, Canada's Loose Leaf Tea Co.
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