text: Home / Walking Length Automatic Umbrella with Maple Wood backward forward prev next Walking Length Automatic Umbrella with Maple Wood Black €210.00 Colour: Black Luxury Gift Wrap Add 2 left in stock Add to bag Order by 1pm for next day delivery Description Details Delivery Item code: 038-1696 Whether you're teaming it with shoes or wellingtons, our luxurious black Stand Up Automatic Umbrella is ready for duty at any moment, expanding at a touch of a button with the automatic spring loaded opening mechanism. Handmade in Italy, this luxurious walking length automatic umbrella is crafted from an ultra-lightweight and durable black tight-weave fabric with a matching cover and features a striking traditional maple wood crooked handle. The sturdy steel tube shaft has eight spokes and a silver plated tip cup which is engraved with Aspinal signature branding. Striking and an instant classic, it will prove indispensible in both a light shower and a fierce storm! Read more Shaft Length: 36 inches / Canopy Span: 42 inches / No. of Spokes: 8 Handmade in Italy Walking length long design Waterproof Italian woven fabric Automatic spring-loaded opening Telescopic metal shaft Eight spokes Maple wood crooked handle Silver plated handle collar Laser engraved signature branding Insurance & Handling Fee €21.00 will be added to your total purchase price at checkout. This will subsidise tax, duty, credit card fees, insurance in transit and handling. UK DELIVERY UK Standard Delivery (2-3 days) £4.95 UK Express Delivery (Next Day) * £9.95 *Orders placed before 2pm are delivered next working days. All delivery times are based on working days. INTERNATIONAL DELIVERY European Delivery £13.00 €16.00 US/Canada Standard Delivery (2-3 days) £15.00 $15.00 US/Canada Priority Delivery (1-2 days) £18.00 $28.00 Worldwide Delivery £20.00 Insurance and Handling will be charged at a rate of 2.5% (EU) / 5% (USA & Canada) / 10% (Rest of World) on your total purchase price at checkout. This will subsidise tax, duty, credit card fees, insurance in transit and handling. In the unlikely event that any extra charges are requested from you at the time of import by customs or by courier at the time of delivery, please contact our Customer Services Team for advice with this matter.


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Gold Dust Park Fitness Room
646 Industrial Boulevard
Villa Rica, GA 30180
Instructor: Sue Hopkins
Registration is held at Gold Dust Park is located at 646 Industrial Blvd. For class information, please call 770-459-7011.
Class schedule: Tuesday & Thursday
Ages: Adults 18 years & Over
Time: 6:00 p.m. – 7:00 p.m.
Cost: $45 per month or $15 drop-in fee per class
Requirements: Participants must bring their own yoga mat. Water bottle and towel recommended.

subset: commoncrawl


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WASHINGTON, March 1 (UPI) -- Residents of Hawaii are the happiest in the United Sates for the fourth year in a row while those in West Virginia are the least happy, a Gallup poll indicates.
West Virginia has held its distinction of having the lowest well-being in the nation for the fourth consecutive year, a Gallup-Healthways Well-Being poll conducted between Jan. 1 and Dec. 31, 2012, said.
Rounding out the top five happiest states are Colorado, Minnesota, Utah and Vermont, and the five least happy states include Kentucky, Mississippi, Tennessee and Arkansas.
The rankings were determined based on interviews with more than 350,000 Americans asking questions about physical and emotional health, income, satisfaction with work environment and eating habits.
The information for each state was given scores with 100 indicating the highest level of well-being and 0 indicating the worst. Hawaii had a score of 71.1, West Virginia had a 61.3 and the United States had an overall score of 66.7.
Frank Newport, editor in chief of Gallup, said happy residents are more likely to contribute positively to their community, the Los Angeles Times reported Thursday.
"If your citizens have high well-being, they're more likely to be better citizens and engage in better behaviors and make things better all-around," he said.
The survey had a 1 percent to 2 percent overall margin of error. The margin of error was as high as 4 percent in states with smaller populations like Alaska.


text: We take the health of our dogs very seriously, and pay close attention to physical fitness, to avoid the problems caused by canine obesity. Our dogs receive regular immunizations and parasite prevention. In addition they are not housed in kennels when we are at home. They have freedom to run and play in our fenced yard, spend time inside with us (though rarely all at once!), and accompany us on hiking, swimming, fishing, camping, and hunting excursions.


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The City Tech Library, in partnership with the Faculty Commons, is pleased to invite all faculty and staff to a workshop. Do you know how copyright and fair use applies to web-based teaching? Are you interested in making material available to students online? Learn about the tools and guidelines available for your use.
Our workshop will be held on Wednesday February 19, 1-2pm in Rm. A441 in the Library, Atrium 4th Fl. RSVP to Prof. Bronwen Densmore at email@example.com.


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Africa underwent tremendous change in the early parts of the 20th Century. Access to air travel and increased motor vehicle availability led to increased travel led to increased development and modernization. This beautiful map, produced by the National Geographic cartographic section in June of 1935, tells the story of a continent amidst the old and new. Thorough research and spectacular detail are hallmarks of this beautiful map, one that should be part of any map collection.
Coverage Area: Africa, Cape Verde Islands, Italy, Spain, Turkey, Saudi Arabia


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The illustration shows Jobs at home in 1982. The empty room of Apple's then already wealthy master productizer might tell us something about his way. The former white house photographer Diana Walker attributes the following quote by Jobs to the picture in her book The Bigger Picture:
"This was a very typical time. I was single. All you needed was a cup of tea, a light, and your stereo, you know, and that's what I had."
The question now is whether Apple will run out of Apple within a couple of years and become some kind of Sony.
[via:Mika Isomaa]


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A module containing broadcast channels (one-to-many). Whereas a one-to-any channel features one writer sending a single value to one (of many) readers, a one-to-many channel features one writer sending the same value to many readers. So a one-to-any channel involves claiming the channel-end to ensure exclusivity, but a one-to-many channel involves enrolling on the channel-end (subscribing) before it can engage in communication.
A communication on a one-to-many channel only takes place when the writer and all readers currently enrolled agree to communicate. What happens when the writer wants to communicate and no readers are enrolled is undefined (the writer may block, or may communicate happily to no-one).
This module also contains reduce channels (added in version 1.1.1). Because in CHP channels must have the same type at both ends, we use the Monoid type-class. It is important to be aware that the order of mappends will be non-deterministic, and thus you should either use an mappend that is commutative or code around this restruction.
For example, a common thing to do would be to use lists as the type for reduce channels, make each writer write a single item list (but more is possible), then use the list afterwards, but be aware that it is unordered. If it is important to have an ordered list, make each writer write a pair containing a (unique) index value and the real data, then sort by the index value and discard it.
Since reduce channels were added after the initial library design, there is a slight complication: it is not possible to use newChannel (and all similar functions) with reduce channels because it is impossible to express the Monoid constraint for the Channel instance. Instead, you must use manyToOneChannel and manyToAnyChannel.
|Added in version 1.2.0.
|Added in version 1.2.0.
|Produced by Haddock version 2.4.2


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What I care about more than anything is results.
These packages are the guidelines and standard things we will do, however if we see that something works better for your campaign than something in the standard list we may switch the things we are doing for you. We only do that in the aim of giving you more results.


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In my dissertation I proved a certain theorem(s) concerning the representation theory of a direct product G x H of algebraic groups over a field, given those of G and H. But I would wager 100:1 that this theorem is well known, and as such I am looking for a primary reference for it. I have combed (my personal) literature for it, e.g. Jantzen, Humphreys, etc., but cannot find it.
The theorem(s) can be found in section 2 of the following pdf file:
Please ignore the other sections of the file as they pertain to questions having little relevance here.
Thanks in advance for any help.
$\underline{\text{Question, version 2.0}}$
Sorry again for the confusion, my notation appears to have been sloppy. And sorry that I haven't posted the entire thing on this page, but I really think it's more efficient (for everyone) that I post it here:
This theorem I believe is much more basic than the gracious people who bothered to try to answer it (in my garbled terminology) have made it out to be. I am talking about arbitrary representations (not irreducible, etc.) over arbitrary fields (not algebraically closed, etc.) for arbitrary algebraic groups (not reductive, etc.). It is simply the statement that any $G \times H$-module structure on a $k$-vector space $V$ can be factored (as a product of matrices, or linear maps if you like) uniquely into a product of commuting representations for $G$ and $H$ on that same vector space. In section 2 there are no tensor products or direct sums of vector spaces taking place; the vector space $V$ is fixed throughout, and all three of the groups $G$, $H$, and $G \times H$ are acting on it.
The corollaries that follow in section 3 merely re-affirm the suspicion that, for fixed $G \times H$-representations on the fixed vector spaces $V$ and $W$, things like "tensor product", "direct sum", and "morphism" of $G \times H$-modules should behave as expected with respect to their respective $G$ and $H$ modules.
Thank you once again for any help.


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radiant energy
"follow" me on Twitter at @newtownpentacle
– photo by Mitch Waxman
Once more doth the angels sing, and the devil weepeth, for the holiday season springs forth upon us. Since most of y'all are either traveling somewhere or busy with final preparations for the annual gorging, lets take it a bit easy this Maritime Sunday, and admire the estimable Captain D tug hauling a dredge down the Kill Van Kull.
Tonight is Festivus, by the way, and I'm accepting donations for the Human Fund. Make the checks out to me, I'll see that your donations go where they will do the most good.
One Response
"I'm calling Bellevue because you're nuts." – Ralph Kramden.
9 more days 'till the Honeymooners Marathon. The excitment is getting unbearable.


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Blaithwaite Tariff 2011
A warm welcome awaits you from the people at Christ Church Felling. Please explore the site to find out what, where and when things are happening. If you have a question or would just like to say hello then please drop us a line or pop along to any of our programmed activities.


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Shopping Cart:
Mon-Fri: 9am-6pm, Sat: 9am-3pm
My Cart: $0.00
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Search from thousands of products
Check out our inventory of classic truck and suburban parts, like interior hard parts. We have inside vent window handles, consoles, dome lamps, mouldings, kick plates, seat belts and more.
Shipping around the world. Additional charges will apply.
Safe & secure for your orders. PCI DSS 3.1, Level 1 certified.
We work hard to get you the right product at the right price.
Family owned business with over 50 years experience.


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Several Syrian military officers, including two generals, have reportedly fled their civil war-torn country for Turkey
Today's Zaman reported that Friday's defections mean 49 Syrian generals have left the Assad regime for Turkey.
The latest generals to defect were reported to have been regional commanders in the Syrian air force. The other officers included five colonels, two majors, two captains, four lieutenants, three major sergeants and their families.
They entered Turkey at the border village of Bukulmez, Today's Zaman said, and were taken to the Apaydin camp where Syrian army members are being housed.


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If you have forgotten your password, please see How to reset a forgotten master account password instead and if you have a sub account please see How to change a sub account password.
If you do not have your Sign-in ID please contact us for help and if you do not have your password reset it using the instructions provided here.
You are not allowed to have a master account. You need to ask your parent or guardian to contact us for help.


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Cocoon — a utopia in the sky.
Its inhabitants believed their world a paradise.
Under the Sanctum's rule, Cocoon had long known peace and prosperity.
Mankind was blessed by its protectors, the benevolent fal'Cie, and believed that tranquil days would continue forever.
Their tranquility was shattered with the discovery of one hostile fal'Cie.
The moment that fal'Cie from Pulse — the feared and detested lower world — awoke from its slumber, peace on Cocoon came to an end.
Fal'Cie curse humans, turning them into magic-wielding servants.
They become l'Cie — chosen of the fal'Cie.
Those branded with the mark of a l'Cie carry the burden of either fulfilling their Focus or facing a fate harsher than death itself.
A prayer for redemption.
A wish to protect the world.
A promise to challenge destiny.
After thirteen days of fates intertwined, the battle begins.


text: Beginning stitching jeans at the age of 15, little did Renzo Rosso realise he was about to fulfil his dreams. Located in the luscious Italian province of Vicenza, Diesel broke boundaries in fashion by producing a rebellious range of jeans. The wearing, ripping and designs of the garment harboured worldwide acclaim. Diesel, now universally recognised, went on to start a sunglasses range with optical specialist Marcolin in the 2000's, not looking back since. Diesel sunglasses are available for men and women, promoting daring design and confidence. Frames, like the brands jeans are crafted with precision and flamboyancy; signified by wonderful cat-eyed, wayfarer and thick-framed looks. Some models – such as the men's DL0111 model – hark back to the company's denim origins by producing a denim pattern within the frame. Lenses are again opulent, mirrored to protect your eyesight and to let passers by realise what they're missing… At Glasses Station we have a vast collection of Diesel prescription sunglasses to help you dazzle in front of any audience. Check out Diesel for the pair of glasses which personifies you; such as the unisex DL0111/S – decorated in denim inspired patterned frame and featuring smoked lenses embellished with the prestigious Diesel logo.Mens Diesel Sunglasses


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The myWebsite website system is not merely "space on a server", but is a collection of programs, databases and services to make it possible for non-technical people to maintain their own website. The aims of the system are to:
All of these aims have been achieved by creating a database to hold the information and installing a system that allows "content" and "navigation" to be added to the system without the use of specialist website maintenance software.
The myWebsite website system is not like a normal web hosting arrangement where you get space on a machine but have to provide all of the input and formatting of pages yourself. The system consists of software, graphic designs, and databases with the dual aim of maximising information to users, while reducing the amount of maintenance effort required to keep the system up to date.
All of us are familiar with websites that are enthusiastically setup by willing volunteers, only to run out of steam as the initial creators move on or lose interest. To reduce the possibility of this happening, the system is designed to make it possible for people with even moderate skills to maintain the system, thereby greatly increasing the number of people that are capable of maintaining the site. For experienced website developers, it should relieve them the burden of being the only person in the club that is technically capable of putting new material onto the system.
Any organisation that has many many member organisations, all of whom wish to run their own websites, whether they be a National Sporting body, or any other organisation.. The main reasons to run many 'sitelettes' off the same site are:
Typically, a single PC with a website editor (similar to a word processor) is used to maintain the website. Pages are constructed on the PC and then copied up to the webserver.
All the software to maintain the system resides on the web server. Therefore to update the system, you can update from any PC connected to the internet without the need for specialist software on your machine.
The following explains how some of the more common features work to provide an indication of how the system works, and what is required to maintain a website.
News items are entered into the database from a web browser with a "First Date to Publish" and a "Last Date to Publish". These items will show on the front page during this time and will age off on the due date – there is no need to remove the items after their "Use By" date.. The News Archive (under the News main menu) shows all News Pages by month, on the date that they were first published. Once a news item has been added to the system, there should be no reason to ever change the article or links to the article – it will automatically age off the front page and appear in the Archive section.
The Calendar is a series of "Events" whether they be a sporting event, training session, committee meeting, social function, etc. The calendar is a searchable database to allow searches by type of event, date range, level of event, etc. There is one calendar for all of Australia, but the display is typically filtered to only show events for an individual state or club. So for a Club, all events at the club are displayed.
The Content Management system manages the "normal" web pages in the system. It manages the following:
All Web Pages, Menu entries, Image records and Events reside in the database and are updated via a normal web browser.
Typically the National and State Authorities maintain a National Register of all of these organisations and the officers of these organisations. This register is available to anyone using the system and a standard set of searches and reports are available. For example, it is possible to search for a club in your own area. The maintenance of this information is available to the level most appropriate, e.g. a club can update it's list of office bearers, but only the National Authority can update the list of qualified National Coaches.
Each organisation using the system site can maintain their own "look" to their website using a series of template files that specifies the colours, logos, fonts and overall layout of the site. For example, the National, State and Club websites all run off the same series of programs, but each have a different template to make them look quite unique. As well as a set of standard templates, the colours of some templates are modifiable to suit the colours of your club, or if you have an experienced web designer, they can create a unique template for your club.
The security system uses a User ID and password to restrict access to the required areas of the website. There are three levels of access – Writer, Publisher, Administrator. A Writer can create new pages, but they will not become public until reviewed by someone with Publisher access. A Publisher can update all areas of the site. An Administrator has the additional ability to create new User IDs.
Initially one User ID is created and sent to the Administrator of the website. It is then the responsibility of this Administrator to create additional User IDs for each person who will be maintaining areas of the site.
myWebsite also has other components that are available such as:
If your organisation has the services of a person familiar with website development, you are not restricted by the system. While FTP access is not provided, a browser based file uploader is available to load user created HTML files to the system.


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Hampton Inn & Suites
Clarion Inn & Suites
When planning any large event, you are bound to need a meeting space! Check out our list of vendors that will provide the perfect meeting room to plan your special day, in a location near you! Search here for Meeting Rooms in Bastrop TX.


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Sign up to get interesting news, updates, and coupons delivered to your inbox. We only send 1-2 emails per month...so don't worry about us taking over your inbox!
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By submitting this form, you are granting: Ray Wakley's Car Care & RV Center, 10261 W. Main Road, North East, Pennsylvania, 16428, United States, http://wakleyrv.com permission to email you. You may unsubscribe via the link found at the bottom of every email. (See our Email Privacy Policy for details.) Emails are serviced by Constant Contact.
Our vision is to supply our customers with the best valued products in the industry and to smother them with unbeatable service after the sale. The day you take delivery of your New RV or Used RV it's not the end of our relationship, it is the beginning.
Summer Hours
May 1 - Sept. 30
M - F 8 am - 5 pm
Sat 9 am - 2 pm
Sunday: Closed
Fall/Winter Hours
Oct. 1 - April 31
M - F 9:00 am - 5:00 pm
Sat 9:00 am - noon
Sunday: Closed


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Ancient City of Ephesus & Pamukkale
Fethiye Cruise Port
Private Tour
from 148 AUD to 736 AUD
Per person based on your group size
Fethiye Cruise Port
Share a Private Tour
177 AUD per person
Max. 8 people group size
Visiting: Ancient city Ephesus, Pamukkale.
Duration: 23 hours
Do not miss your opportunity to visit Ephesus and UNESCO world heritage Pamukkale once you visit Turkey by cruising. Utilizing your time at the port by taking a cruise shore excursion that introduces you to all the depth and beauty this city has to offer. And with our well-trained guide, you can be sure to have a quality time full of both knowledge and entertainment with this two days tour.
You will meet your professional guide at Fethiye Harbour and start the first-day tour with a scenic drive to Ancient City Ephesus through flourishing countryside in an air conditioned vehicle.
Ephesus was the second biggest city in the ancient world with estimated population more than 250.000 which made it a mega city at the time. Our guide will start explaining you the history of the place where Alexander the Great has visited this magnificent city. The Temple of Artemis, one of the world's seven wonders will be waiting for you along with the famous Library of Celsus, the giantic and most preserved building of Ephusus. Walk around and you will see the marble of avenue and the ancient theatre which has a capacity of 25,000 people. There are also so may ruins of monuments and other impressive buildings such as the Terrace House, which is a rich people mansion, for you to explore. You need to pay the entrance fee at the Terrace House, but those who have been in there would tell you that it is probably one of the most impressive sights to visit in Ephesus for it is still very well preserved. You can see the art and architecture and the affluent lifestyle of the people in that period.
After Ephesus, you will check in at a hotel in Selcuk, another beautiful town of Turkey where you can enjoy your own free time in the evening. Have a wander around it and you will understand why people have been falling in love with the place. You can see the Roman ruins everywhere blending in with cute local cafes and restaurants. Look up and you will see families of stork birds building their nest atop of Roman poles around the city, giving Selcuk another unique flavor.
The second day, we will head to Pamukkale (UNESCO world heritage site). This is ultimately one of the most important highlights in Turkey. Not only spectacular sight of Pamukkale, a spectacularly unique natural wonder with dazzling white petrified lime cascades, you will also visit the ancient city of Hierapolis and explore its theater, Necropolis and the largest ancient cemetery in Anatolia. Pamukkale and Hierapolis rank among one of the oldest thermal cities of the world. The thermal water of Pamukkale has been known to be rejuvenating to people since ancient times.
You will begin your walking tour after getting dropped off at Hierapolis where the thermally heated Antique Pool located and you can swim among the remains of ancient Roman columns, toppled into the water by various earthquakes. This antique pool is also known as Cleopatra's bath. You have to pay extra fee to get in it. Among the Roman ruins at Hierapolis are many significant site, including, the remains of the Temple of Apollo, the Gate of Domitian, the tomb of Flavius Zeuxis, Necropolis, the Plutonium, and the well- preserved theater constructed around 200BC.
After Hierapolis, we continue to Pamukkale or "Cotton Castle" in Turkey, located above the theatre of Hierapolis. Pamukkale is the result of limestone formations built over thousands of years. The marvelous landscape of Pamukkale has been created by this gradual formation, leaving a cotton-like image. Hot water raising from underground four springs start the temperature of 35 Celsius and is saturated with calcium salt and carbon dioxide. As the water cools, these salts precipitate and form the white travertine layers. The water is famous for its benefits to the skin and it is believed to cure the ills of asthma and rheumatism as well. The sight of this place so beautiful that you will think it is what heaven might look like. So do not forget to bring your swimming suit and try the dip yourself in one of the fabulous thermal pools there.
After the tour, we will drive back to Fethiye and drop you off at the port in our luxurious vehicle.
Lunch is not included in the cost of the tour. We will suggest options for local Turkish restaurants and provide ample time for you to have a sit-down lunch.
- Port pick-up and drop-off
- Entrance fees as per itinerary
- Luxury air-con coach
- Licensed tour guide
- Drinking water in vehicle
- Lunch and beverages
- Entrance fees to the Terrace Houses $15 extra (optional)
- Gratuities (optional)
This tour requires a bit of walking and we suggest you wear comfortable tennis shoes or sandals. As it can be very hot in summer months, please bring sunscreen, sunglasses, hats and any other necessary sun gear with you.
For optional mosque visits you need to bring a sarong to cover legs and a head scarf for women.
Alternative cruise ship port
Private Tour Exclusive, Flexible, Guaranteed
- Fethiye Cruise Port
Share a Private TourShare the cost of a private excursion
- Fethiye Cruise Port


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VANCOUVER -- If Vancouver's cold temperatures continue through next week, the city could be on track to its coldest April on record.
The mean temperature was only 6.9 C for the first 18 days of the month, whereas normal for the month of April is 9.2 C, said David Jones, meteorologist for Environment Canada.
"If that kept up at that pace we would set a record for the coldest April in 74 years at Vancouver International Airport," Jones said. "It has been extremely cold, but so far we haven't broken any records."
A brief respite is in store for the upcoming Easter weekend, but the weather will turn cold and wet again by Sunday, Jones said.
"We've got 18 degrees forecast for Saturday if you're away from the water and we haven't seen too many days like that yet," Jones, meteorologist for Environment Canada. "I'm sure the mean temperature will be above 6.9 after the sunshine on Saturday. On Sunday the rain comes back."
Jones said it's far too early to predict if this April will set a record, but computer models show the freezing levels staying low.
"If the models are still performing well, it looks like we've got a little rise this weekend in the freezing level, but then it drops off again until the 28th," Jones said. "On the second of May it bumps up again, so you might see upper teens again in the beginning of May, but then the freezing level drops down again.
"The freezing level has been lower through March and April and now the beginning of May then it was during the entire Olympics last year."
Although a cold spring is one ingredient that can lead to flooding, Jones said this year's snowpack in the Interior is not very big. A sudden warm spell with heavy rains, however, could increase flooding dangers.
The mean temperature for the day is the high and low divided by two, while the mean temperature for the month is the sum of the daily means divided by the number of days in the month, Jones said.


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CBS' Two and a Half Men, with 14,073,000 viewers last week, crushed Heroes (which reeled in only 8,198,000 viewers). Plus Heroes' lead-in, the dorkcom The Big Bang Theory, also destroyed the 112-character Tim Kring serial. When television ratings decline, the incentive to invest in hour-long series with multiple locations generally goes with it. That's why it's time to make our dream of a SF sitcom in high definition come true. We've got all the details, plus a bonus Alf retrospective.It was predicted that the multi-camera show would make the once stale setups of situation comedies, but attractive people in high definition never really gets old.
The dramatic form in television has become itself a known commodity, fulfilling an audience's sometimes meager expectations. Most of these longer dramas are framed as an unfolding series of revealed information. Sure, there are distinct takes on that format, whether it be the J.J. Abrams iteration or the familiar CSI layout, but you can no longer expect any more surprises from a well-produced drama than a situation comedy. The field has tilted back. As long as we can acknowledge that a sitcom has its strengths, why not take advantage of what that successful form can do for science fiction? Fact: the alien comedy Alf rated more viewers than The Wonder Years when it debuted in 1987. I try to view this greatest hits YouTube of Alf once every decade:
NBC's John Lithgow-Jane Curtain vehicle Third Rock from the Sun was similarly hot when it came out. And while the friendly neighborhood alien concept has surely been beaten into the ground, the advantages of the short form remain inviolate: Sitcoms can replicate some of the magic of live theater, and scale back the high costs of producing science fiction television. From the audience participation in what's happening onstage to the limited number of sets, theater has elements specific to its format that make it both compelling and cheap. Such restrictions might reasonably be expected to dim the excitement when you're dealing with elements of the fantastic, but a few limitations can in fact be fun. It's like a writing prompt: make a certain number of things happen without the pressure of having to fully realize every idea you think of on greenscreen. Sitcoms help their cause in their formative years by being easier to sell in syndication. This kind of rope could help the right show gather a devoted audience. Plus there's more licensing opportunities when you're 20 minutes long: Two and a Half Men landed everywhere including the web, and Lost is buried on G4. That's a difference of quite a few dubloons. Effects work can actually get attention. We were blown away by the amount of CGI on Sanctuary — the show looks fabulous. How great would be to use those elements to that seemed something completely familiar as a sitcom, and yet have a world of the fantastic underneath? Think Frank Oz's Little Shop of Horrors - I mean, Rick Moranis is obviously the next logical former 80s star to be reinvented on the small screen. Is he really having more fun releasing country albums? Let's find a way to make this happen. As the early returns on No Heroics prove, a single room can hold as much magic as an entire universe of delights.


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Effect of Concentrating Endogenous Stromal Cells in the Fat Graft
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
|ClinicalTrials.gov Identifier: NCT01564524
Recruitment Status : Terminated (Funding ended)
First Posted : March 27, 2012
Last Update Posted : October 25, 2016
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
Traumatic facial injuries, especially those sustained in military combat, are characterized by destruction of bone and soft tissue. While the bony structures of the face can be reconstructed, it is difficult to return the soft tissue back to its original form. Many times, fat grafting, a common cosmetic and reconstructive procedure, is used in hopes of improving the soft tissue deformity. Fat grafting is a procedure in which a person's own fat is taken from areas throughout the body, usually the thighs or abdomen, with a small liposuction tube. The fat is then transferred into the area that has lost volume or fullness. The fullness of the soft tissue area may decrease over time because the transferred fat can be reabsorbed by the body. Altering the current fat grafting procedure, slightly, could lead to less reabsorption and a lasting fullness of the soft tissue area outcome of the fat graft procedure.
We are conducting this research study to help us improve the surgical treatment of people who have suffered facial soft tissue loss as a result of trauma. The goal of this research study is to see how each person's fat grafts will maintain the fat over time and to measure the quality of life during a 9 month post-surgical follow-up period. The total duration of participation is approximately 11 months.
In this study, we will concentrate the fat in the fat grafting procedure to determine whether this process will maintain the fat over time. The areas treated with enhanced fat grafts will be compared with areas treated with standard of care fat grafts. At least two areas of your face will be treated with fat grafts, (standard of care fat grafts and concentrated fat grafts).
|Condition or disease
|Facial Injuries Adipose Tissue
|Procedure: Fat graft surgical procedure
Craniofacial injuries have serious psychosocial sequele and affect quality of life. Many individuals who suffer significant facial disfigurement from injury experience psychological distress and impairment in functioning not limited to the acute phase of injury, but over a longer term period of treatment, recovery, and adjustment. Until recently, treatment of disfiguring craniofacial injuries has been mostly limited to surgical flap procedures, microsurgical tissue transfer, and implantable prostheses. However, these methods can leave conspicuous scars on the face and the donor site, and in the case of implants can lead to complications associated with foreign materials. Autologous fat grafting with minimally invasive cannulas is a procedure that has been used for decades in common plastic surgery practice for facial aesthetic procedures. This technique is also a promising treatment for soft tissue reconstruction after craniofacial trauma because the graft harvest and injection are minimally invasive. The treatment is performed by using a small liposuction cannula to aspirate fat tissue from the donor site, and then re-injecting the fat into the recipient site with specialized injection cannulas. After harvest, and prior to injection, the fat graft is subjected to a mechanical processing step to separate the aqueous layer and concentrate the adipocytes. This often takes the form of centrifugation or filtering.
The main problem with autologous fat grafting is a variable resorption of the graft volume over time. As much as 30-60% of the graft volume can diminish over time. Many variables may influence the behavior of clinical fat grafts, including harvest site, harvest technique, graft preparation, and injection technique. In our current IRB approved study on fat grafting (IRB # PRO09060101), we are seeking to accurately quantify the fat graft resorption over time following a highly standardized surgical technique. Evaluation methods include a 3D surface imaging, high resolution CT scanning, and quality of life measures. This study has enrolled and treated patients without adverse event, and the evaluation methods have been performed successfully.
In this proposed study, we plan to use essentially the same surgical procedure and evaluation methods, but with modified preparation of the fat graft. This modified preparation involves concentrating the endogenous stromal cells in the graft material in an effort to increase graft retention over time. The aspirated fat material used for fat grafting consists of mature adipocytes, a small amount of fibrous tissue, and immature adipose stromal cells. These adipose stromal cells (ASCs) are a mixed population of non-lipid laden cells that serve to turn over mature adipocytes and vascular elements. "Preadipocytes," as well as endothelial precursor cells and multilineage progenitor cells, are found. Of note, ASCs have been shown to stimulate angiogenesis when stressed under hypoxic conditions and these cells may be instrumental in healing and volume retention of fat grafts. Yoshimura, et. al. (1) found that fat aspirated with a liposuction cannula (i.e. the method of fat harvest for fat grafting) is deficient in ASCs compared to whole fat. This is due to the fact that a major portion of ASCs are located around larger blood vessels that are left intact in the donor site after liposuction with a blunt cannula.
|Study Type :
|Actual Enrollment :
|3 participants
|Observational Model:
|Time Perspective:
|Official Title:
|Structural Fat Grafting for Craniofacial Trauma: Effect of Concentrating Endogenous Stromal Cells in the Fat Graft
|Study Start Date :
|April 2011
|Actual Primary Completion Date :
|August 2013
|Actual Study Completion Date :
|August 2013
- Procedure: Fat graft surgical procedure
The fat graft surgical procedure will concentrate the adipose stromal cells (ASCs) in the fat graft material. A blunt tip hollow cannula is used to aspirate approximately 200-400cc of fat tissue. The aspirated fat is divided into two portions: one portion will be processed as standard graft material, the other portion will be used in a processing step that concentrates the ASCs. The aspirated fat processed as standard graft material will be divided into small alioquots and centrifuged to separate the aqueous and oil layers, and transferred into 1ml syringes. Standard fat graft material will serve as a control treatment and will be injected into one area of the face. The ASC concentrated graft material will be processed so it first separates the ASCs in a brief collagenase digestion and then resuspends the ASCs in the native fat tissue from which the stromal cells were derived. The ASC concentrated fat will be injected into another region of the face.
- Fat grafting for facial trauma, facilitated by enhancing graft quality with a higher concentration of endogenous autologous adipose stromal cells in the grafted tissue, will enable successful restoration of tissue volume and craniofacial form. [ Time Frame: Will take at months 9 after the fat grafting procedure ]Facial appearance and persistence of graft volume will be assessed using aesthetic grading scales, state of the art 3D photography, and high resolution CT scanning with 3D reconstruction. Subjects will be followed for 9 months after graft procedure to define long term outcomes.
- Measure quality of life in subjects after grafting using validated psychosocial measures. [ Time Frame: 9 months ]A comprehensive battery of tests for evaluation of quality of life has been assembled for this study. It is important to properly determine the impact of the surgical changes and the investigators have selected Psychosocial assessment instruments to evaluate four domains: a) Satisfaction with appearance/surgical outcomes; b) Satisfaction with Medical/Health Services; c) Social Functioning, Distress, Avoidance; d) Quality of Life and General Functioning Outcomes.
- Cell assessment will include adipose ASC yield, cell proliferation and characterization, capacity for adipogenic differentiation, interactions with biomaterial scaffolds that may be used in future therapies, and analysis by flow cytometry. [ Time Frame: At the end of the 4 week observation period after entry into the study, at which time the intervention will occur and the cells will be analyzed. ]Cell assessment will include adipose ASC yield, cell proliferation and characterization, capacity for adipogenic differentiation, interactions with biomaterial scaffolds that may be used in future therapies, and analysis by flow cytometry.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:
|18 Years to 110 Years (Adult, Older Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
|Sampling Method:
|Non-Probability Sample
Inclusion Criteria:
- Aged 18 years or older and able to provide informed consent
- Have suffered injury resulting in craniofacial volume defects which could be treated with a graft volume of between 3 and 100 cc of lipoaspirate
- Be at least 3 months post-injury or post-surgery (from trauma procedures) so that acute edema is resolved
- Volume defects are covered by intact skin and do not communicate with oral cavity or sinuses
- The three dimensional geometry of the volume defects would allow for treatment with lipoaspirate injection so that at least two distinct treated areas could be discerned on gross examination and radiographically (e.g. treated regions are on opposite sides of the face, on lower face versus upper face, or separated by a bony landmark such as zygoma. This would include the ability to treat an uninjured regions with fat grafts in order to obtain symmetry or balance.
- Willing and able to comply with follow up examinations, including radiographic studies
Exclusion Criteria:
- Age less than 18 years
- Inability to provide informed consent
- Craniofacial defects intended for treatment have open wounds or communicate with oral cavity or sinus (note: presence of such a defect in the setting of another defect(s) that meets treatment criteria will not exclude the patient from participating).
- Active infection anywhere in the body
- Diagnosed with cancer within the last 12 months and /or presently receiving chemotherapy or radiation treatment
- Known coagulopathy
- Systemic disease that would render the fat harvest and injection procedure, along with associated anesthesia, unsafe to the patient.
- Pregnancy
- Diagnosis of Schizophrenia or Bipolar Disorder
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01564524
|United States, Pennsylvania
|University of Pittsburgh
|Pittsburgh, Pennsylvania, United States, 15213
|Principal Investigator:
|J. Peter Rubin, MD
|University of Pittsburgh
|Responsible Party:
|J. Peter Rubin, MD, Principal Investigator, University of Pittsburgh
|ClinicalTrials.gov Identifier:
|Other Study ID Numbers:
|First Posted:
|March 27, 2012 Key Record Dates
|Last Update Posted:
|October 25, 2016
|Last Verified:
|October 2016
Craniomaxillofacial (CMF) Battle-injured (BI)
Facial Trauma
Fat Grafts
Autogenous Fat Transfers (AFT)
Wounded warriors
Facial Injuries
Craniocerebral Trauma
Trauma, Nervous System
Nervous System Diseases
Wounds and Injuries


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Arbor Snowboards was first launched in 1995 and guided by a desire to create high-quality boards with sustainable sourced materials. They sought to inspire individuals with their commitment to premium designs and cutting edge materials like Eco-friendly sourced woods, bamboo, and other sustainable materials. Today, they continue this philosophy and have not wavered in their effort to provide the highest quality product made consciously and in order to protect the planet. They do so with their "Returning Roots" program where they donate proceeds to deserving groups that protect and restore rain forests. Zumiez is a proud carrier of Arbor Snowboards and has a multitude of styles, camber profiles, technology, and sustainably sourced materials for you to get shredding in Eco-Friendly style. Check out the Arbor Formula Snowboard for a fun and responsive ride or the park beast Thunder Stick. No matter your riding style Arbor and Zumiez have a board to accent your riding abilities.


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Complete Test Bank for Basic Business Statistics 11th Edition Berenson
You will Purchase Downloadable Test Bank for for Basic Business Statistics 11th Edition Berenson, [Comprehensive Test Bank – Instant Download]
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The unique "social e-textbook" pioneered by Hope College faculty member Dr. Christian Spielvogel as a way of more fully realizing the Internet's teaching potential is one of only 20 innovative concepts nationwide - out of 1,000 hopefuls - to receive major support through the Ewing Marion Kauffman Foundation.
The unique "social e-textbook" pioneered by Hope College faculty member Dr. Christian Spielvogel as a way of more fully realizing the Internet's teaching potential is one of only 20 innovative concepts nationwide - out of 1,000 hopefuls - to receive major support through the Ewing Marion Kauffman Foundation.
Spielvogel's approach blends textbook content, social media and role-playing to move students from the sidelines to the center of the action in living out the material they're studying to deepen their understanding of it. It's a model that he has been using at Hope since 2009 in his "Communication and Conflict" course, during which students take on the identity of real-life Civil War-era residents of the Shenandoah Valley and interact with each other in responding to the events of the time from their counterpart's perspective.
"Our goal is to transform the textbook from a passive, solitary, read-only product to a collaborative, interactive and immersive experience," said Spielvogel, who is an associate professor of communication. "The idea is that reading is still critically important, but students by playing the simulation will have a better chance to apply, extend and critique traditional textbook content."
Spielvogel has received a fellowship through the foundation's Kauffman Education Ventures Program designed to help promising educational innovations find their way to market. From February through June, Ventures Lab fellows will spend two months at the foundation's headquarters in Kansas City, Mo., immersed in a training, mentoring and coaching program, and then another two months shadowing the heads of educational companies to see the principles they've learned in action. The fellowship also includes housing and covers all related expenses for the duration of the program.
Spielvogel's collaborators include his wife, Dr. Laura Spielvogel, an associate professor of cultural anthropology at Western Michigan University; Dr. Khusro Kidwai, a research associate and instructional designer at Penn State University; University of Virginia historian Dr. Gary Gallagher; and UCLA historian Dr. Joan Waugh. The chief outcome of the fellowship will be a social e-textbook on the Civil War and Reconstruction co-authored by Gallagher, Waugh and Spielvogel.
Spielvogel, a member of the Hope faculty since 2000, began developing collaborative online learning environments during a 2007-08 sabbatical at the University of Virginia, supported by grants from the National Endowment for the Humanities and the Virginia Endowment for the Humanities. He was seeking to more fully use the Internet as not only a source of information, but as a way of producing information and interacting with others about it - a progression that he dubs "Web 2.0," as opposed to the earlier "Web 1.0" days of read-only.
The result was the "Valley Sim," in which students take on the identity of one of 25 real-life citizens of two communities that were on opposite sides of the Civil War. The students then interact, in character, via Internet chat as they learn about and respond to the events of the war through information featured in an online database
The Kauffman Foundation fellowship is the second round of support that Spielvogel has received this year as a way of helping him and his collaborators develop business acumen to accompany their concept and technical understanding. This summer, Spielvogel's "social e-textbook" was one of only four concepts chosen from a statewide competition to participate in the 12-week entrepreneurial "boot camp" program sponsored by Momentum in Grand Rapids.
Spielvogel intends to apply the lessons from both experiences to his teaching at Hope as well. He sees potential in the contacts that he is developing with other education-focused firms in creating internships around the country for Hope students. He has gained valuable perspective for his new role as a faculty advisor to the college's Hope Entrepreneurship Initiative for students. He is also picking up more ideas for innovating in the classroom - a potential new summer course, for example, might involve students working in teams on projects that draw on the expertise of multiple faculty mentors and use multiple classrooms and computer laboratories rather than follow the more traditional model of a single instructor and single room.


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Red Lobster Spinoff Is Wrong Recipe for Darden
The proposal by Barington Capital Group to split Darden Restaurants' Red Lobster is the sort of financial alchemy that makes little sense. Spencer Jakab joins MoneyBeat. Photo: AP.
This transcript has been automatically generated and may not be 100% accurate.
... Darden Restaurants under some pressure today ... announced that it will spin off its Red Lobster seafood chain ... Spencer Jacob our heard of the Tape columnist wrote about this month before the news actually came out ... and Spencer joins us now on you said that that would be the wrong thing to do ... now that the news is actually out to ... be filled up ... the five percent it's down because of the guidance of media that they gave ... us he had his hedge fund were ... representing a group that owns just about two percent and now almost at the right yet was down sharply ... um ... they even pushing to spin off Olive Garden ... and Red Lobster Olive Garden is larger than Red Lobster those are two of the chain's ... than they have a bunch of other ones that LongHorn Steakhouse which is also one of the more mass market a little bit ... but it is doing better ... no frills another one The Capital grille which is very upscale they have ideas to the fees they have a few other ones in the Balkans love that they just crawl Baltic of your house ... so they have some ... some chains that are doing better but yet to put this in context of what's happening with them in the last few years of tech ... firms ... this can of casual dining has been doing poorly at the lower and head of the and that that that ... Olive Garden and Red Lobster ... targets ... and ... what's benefited from ... is that the more operatic because get this yet Income Strategy kiasu him ... for people to inform rich people getting richer the middle of the bean ... being all about a knock on Olive Garden much mocked was all but as much for the event was possible that the debate you have ... aam is fast casual tripled its nothing is really doing very very well ... the third thing you have is the valuations of some small than dependent fast growing ... up restaurant chains to a small loss more than dark which is the biggest ... doing very very well God getting much larger multiples and so we ... we owe if you have not had this morning that the you know it but say you know alls people ... the marker reaction may have been quite good ... but he wouldn't it made sense to mean if you take something you split it up you know you have efficiencies of scale and the right to have a lot of efficiencies of scale and they were ... arguing gets us all a sudden they're they're making a U turn in saying on over to spend this on ... and then scratch in the new spinoff Red Lobster out on its own ... the chances that change ... I mean it's and I guess I get them and they care about such an extent ... chart builder today they're talking the targeted attacks Reese write off or selling the business right ... now I mean you know what's it going be worth ... the one thing that this has going for it is that ... he noted that for reasons that are very complicated to explain spinoffs tend to do well so you get a spinoff of this not discover spinoff necessarily but you gotta ... give a large company ... and it spins off ... of a division ... that the something else is going to be a smaller company all the sudden people are like all the stock is out of the Essen P five hundred or whatever and Exxon follow ... this is not the type of business I was in ... Minnesota I wanted ... all but you have a management that the company and all the sudden is free to do all kinds of innovative things and take risks in and they have stock options and things like that and they know they have a big incentive to to make things happen ... it's all the sudden you have the sort of thing that sold them that were given to you for free in a depressed valuation and kicked out of people's portfolios ... that does well and that's ... that's the the the beauty of of of the spinoff and that's I guess


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Spinal Cord Compression
Incidence and Epidemiology
Estimates suggest that 2-5% of cancer patients have at least one episode of spinal cord compression (SCC) during the last 2 years of life. Rates vary drastically depending on the primary tumor type; the more likely a tumor is to metastasize to the bone, the higher the risk of SCC. One Canadian study found rates to be a mere 0.22% in pancreatic cancer, versus 7.91% in myeloma, a tumor known to cause bone destruction. Prostate, breast, and lung cancers account for the majority of SCC cases (about 15-20% each), with myeloma, non-Hodgkin's lymphoma, and renal cell cancers accounting for 5-10% each. Colorectal cancer, sarcoma, and cancer of unknown primary account for most of the remaining cases. Incidence decreases with age, peaking between 40-60 years of age. An estimated 7-14% of patients will experience a second episode of SCC. Although most SCC occurs in patients with a known cancer diagnosis, it is the initial manifestation of cancer in 8-20% of cases. Four to 5.5% of pediatric cancer patients will be diagnosed with SCC during the course of their illness. In children, the causes differ from adults, with neuroblastoma, Ewing 's sarcoma, Wilm's tumor, lymphoma, and other bone and soft tissue sarcomas causing the majority of cases.
Eighty-five to 95% of patients with SCC report new or worsening back pain, often accompanied by tenderness in the affected area. This pain is often aggravated by lying down, weight-bearing, coughing, sneezing or the Valsalva maneuver, and may be relieved by sitting. The location of the pain was found to correlate with the location of compression in only 16% of patients. Table 1 lists the common side effects experienced with SCC. The presence of any of these symptoms should be considered an emergency and be promptly evaluated. Early diagnosis and treatment is critical. Once paraplegia occurs, there is little chance of regaining function.
Table 1 – Signs/symptoms of cord compression
- New or worsening back pain
- Weakness
- Loss of sensation in affected limbs
- Decreased proprioception
- Numbness / tingling / coldness
- Urinary retention / constipation
- Ataxia / spasticity Bowel / bladder incontinence
Spinal cord compression due to malignancy is defined as a compression of the thecal sac by tumor in the epidural space. This can occur by a few circumstances; vertebral metastases can directly invade the epidural space or cause bone destruction, with bone fragments leading to compression. Retroperitoneal tumors can grow through the intervertebral foramen, compressing the cord. In addition, cord injury can result from edema and ischemia caused by compression of blood flow to the cord. In children, masses are typically located between the vertebrae, impinging on the cord, rather than bone metastasis in the vertebrae.
Patients with compression in the cauda equina area present differently. The cauda equina is a bundle of nerves located at the bottom of the spinal cord, with nerves spreading out like a horse tail. Compression in this area results in loss of bowel and/or bladder function, loss of sensation in the buttocks, thighs and groin (saddle distribution).
Picture 1
Picture depicts a tumor in the vertebrae, extending into the spinal canal, resulting in severe spinal cord compression.
Photo © 2004 Elsevier Inc.
Patient education is critical to the early diagnosis and intervention of SCC. Patients with known bony metastases and those with high risk tumor types should be educated on the importance of reporting worsening or new back pain promptly, allowing the oncology team to evaluate further. One study found that patients who thought that their back pain could be related to their cancer experienced far shorter delays in treatment than those who thought the pain was unrelated to their cancer (5.5 days to treatment vs. 17 days).
Prevention can include bisphosphonates, despite a clear advantage in the prevention of SCC in clinical trials of those agents. In patients with bone metastases, radiation to known vertebral lesions can prevent the onset of SCC. Unfortunately, cancer patients who present to a community medical center or general practitioner with back pain may be treated according to a back pain algorithm used for non cancer patients, leading to delays in treatment. It is important for the oncology team to follow high risk patients closely and educate them on SCC symptoms to watch for and report.
Magnetic resonance imaging (MRI) is the gold standard for diagnosing SCC, with an overall accuracy of 95%. X-ray films have a high false-negative rate (17%), and vertebral metastases are only visible when 50% of bone is lost. An estimated 25% of patients with SCC have no bone destruction, making x-rays and bone scans unhelpful. Prior to the widespread use of MRI, CT scan with myelography was standard, and may be used in patients where MRI is contraindicated. MRI should include a scan of the entire thoracic and lumbosacral spine, since it is not uncommon to detect more than one area of compression. It is not necessary to scan the cervical spine unless symptoms are present in this area. Imaging can also assist in making decisions about the value of surgery, radiation therapy and other treatment options.
Seventy five to 100% of patients who are ambulatory before diagnosis of SCC remain ambulatory after therapy. Of patients who develop partial or full paralysis, only 15-30% are likely to regain useful function. In addition, the duration of symptoms prior to diagnosis are a sign of outcomes, with a slower development or longer duration of symptoms leading to better outcomes. Survival is dependent upon tumor type, number of metastases and functional status. Patients with radiosensitive tumors or treatments that respond well to therapy tend to have longer survival.
Despite these predictors, most patients have limited prognoses and would benefit from hospice or palliative care referrals. Nurses can play a key role in initiating hospice and social work referrals, working with patients to develop closure of personal relationships, financial affairs and making decisions related to resuscitation status.
High-dose corticosteroids are typically the first line therapy and in cases with a reasonable suspicion of SCC, corticosteroids (generally dexamethasone) are started prior to a radiologic diagnosis. Steroids can reduce peritumoral swelling, reduce pain and improve neurologic function. There is some controversy related to the dose required, with some institutions utilizing a bolus of 100mg followed by 6mg four times a day and others using 10mg every 6 hours. Several studies have shown no difference between the regimens in regards to response. Nurses should be aware of the possible dangerous side effects of high dose steroid use and watch for them (diabetes, adrenal insufficiency, susceptibility to infection, ulcer and psychosis).
Radiation oncology and neurosurgery should be consulted immediately to plan further treatment. The decision between surgery followed by radiation versus radiation alone is based on several factors, including radiosensitivity of the tumor, the expertise of surgical decompression available, prior radiation to the area, level of the compression and the rate of growth of the compression or decline in neurologic status.
Radiation therapy
Radiation is started emergently and typically includes 1 or 2 vertebrae above and below the site of compression. The most commonly used regimen is given over 10 fractions, although this period varies based on patient factors. A review of the literature found no difference in the various regimens typically used with regard to post-therapy ambulatory status or pain relief. Patients may experience myelosuppression, particularly if multiple ports are treated. Radiosurgery is being investigated as an option for treatment of SCC, but has yet to become a standard practice.
The longer a patient survives after SCC, the more likely they are to have another episode. Fifty percent of patients who survived 2 years had a second episode, while almost all patients who survived 3 years had a second episode. Radiation oncology should be consulted for a second episode because repeat radiation may be an option. In the case of widely metastatic disease, radiotherapy to SCC lesions is considered palliative, but allows for great improvements in quality of life for patients and their caregivers. In limited systemic disease, these interventions may be curative.
Patients who should be considered for surgery are those who can tolerate the surgery, have an unstable spine or bony fragments in the spine, a radioresistant tumor, solitary metastases (as in plasmacytoma) or an inability to receive more radiation therapy. Surgery is usually followed by radiation therapy.
Traditionally, laminectomy with a posterior approach was used, but this can lead to spinal instability and incomplete removal of the tumor in the majority of patients, whose tumors are located anteriorly. Anterior decompression allows for complete removal of the tumor and reconstruction of the damaged vertebrae. This is a more complex and technically challenging surgery, but leads to better results. Patients with tumors at L3 or more distal are still treated with the posterior approach. Radiation therapy can then be started 7 days after the surgery. Studies have found complications from surgery to be more common in patients over 65, those who had previously had radiation, and those who were paraplegic prior to surgery. Complications can include poor wound healing, infection, hemorrhage, stabilization failure, respiratory failure and intraabdominal complications.
Surgery plus radiation vs. radiation alone
Although several studies did not show a benefit to surgery followed by radiation, these had been done with the older, posterior laminectomy procedure. The report of a randomized trial in 2005 has finally proven the case for surgery (using the anterior approach) with radiotherapy in appropriate patients. The study, conducted at 7 institutions within the U.S., included 101 patients and was closed during an interim analysis due to the positive results in the combination arm. The following comparisons were made between the groups; retained the ability to walk: 84% Surgery + Radiation (S+R) vs. 57% Radiation alone (R) (p<0.001), median time able to walk: 122 days S+R vs. 13 days R (p<0.003), median time they maintained continence: 156 days S+R vs. 17 days R (p<0.016). Of the 32 patients unable to walk at randomization, 62% (10/16) in the surgery group versus 19% (3/16) in the radiation alone group regained the ability to walk (p<0.012). The surgery group survived longer, with a median of 126 days versus 100 days for the radiation alone group (p<0.033). The surgery group used less morphine and corticosteroids, did not remain in the hospital any longer, and the 30 day morbidity was actually greater in the radiation alone arm (mainly due to paralysis and immobility issues). These results clearly demonstrate greater quality of life and survival for patients receiving surgery followed by radiation. It is important to remember; patients eligible for this study had only single sites of compression, were considered candidates for surgery, and were not paraplegic for more than 48 hours prior to surgery. This surgery is performed emergently to achieve the best results, which can put a strain operating room function and staff, particularly in a smaller institution. Despite the limitations of population selection, surgery now plays a bigger role in the management of SCC.
Nursing Interventions
The key to treating or preventing spinal cord compression and retaining quality of life is early intervention. Nurses, both inpatient and outpatient based, play an important role in early recognition of symptoms, patient and family education and coordination of appropriate referrals. Knowing who is at highest risk and educating these patients of the importance of what may seem like minor symptoms is a major step in early intervention. In the outpatient setting, nurses may need to triage symptoms over the phone, requiring knowledge of symptoms, risk factors and what questions to ask. Many nurses take responsibility for coordinating referrals for imaging studies and coordinate consultation with radiation oncologists and neurosurgeons. Time is critical to positive outcomes and nurses can often expedite this process, helping patients and families understand what is going on along the way. As we tirelessly advocate for our patients, know that astute nursing care can help these patients maintain dignity and quality of life.
Abeloff, M., Armitage, J., Niederhuber, J., Kastan, M. & McKenna, G. (Eds.): Clinical Oncology (2004). Elsevier, Philadelphia, PA.
Abrahm, J. L. (2004). "Assessment and treatment of patients with malignant spinal cord compression." Journal of Supportive Oncology 2 (5): 377-88, 391; discussion 391-3, 398, 401.
Lenhard, R. E., Osteen, R. T., & Gansler, T. (Eds.): The American Cancer Society's Clinical Oncology (2001) . The American Cancer Society, Atlanta, Georgia.
Loblaw, D. A., J. Perry, et al. (2005). "Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the Cancer Care Ontario Practice Guidelines Initiative's Neuro-Oncology Disease Site Group." Journal of Clinical Oncology 23 (9): 2028-37.
Patchell, R. A. (2005). "New developments in the surgical management of spinal cord compression caused by metastatic tumor." Clinical Neurosurgery 52 : 65-7.
Patchell, R. A., P. A. Tibbs, et al. (2005). "Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial." Lancet 366 (9486): 643-8.
Prasad, D. and D. Schiff (2005). "Malignant spinal-cord compression." Lancet Oncology 6 (1): 15-24.


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Unless you've been living under a rock, you probably know that there's an historic fight happening this Saturday.
Heck, you don't even have to be an MMA fan to know about it. In the world of pop culture and 24/7 media, the UFC 157 main event between Ronda Rousey (6-0 MMA, 0-0 UFC) and Liz Carmouche (7-2 MMA, 0-0 UFC) is what's known as a "talker."
Yes, the first women's fight in UFC history has been hyped up for more than three months now. And yes, it's getting a full-on massive promotional push. But UFC President Dana White, who has been one of Rousey's biggest cheerleaders – even after saying for years he didn't see a day that women would fight in the UFC – believes he knows the reason the pay-per-view at Honda Center in Anaheim, Calif., is a big deal when it comes to his women's bantamweight champion.
"The media is following her because she's legit – she's the real deal," White said this past Saturday following the post-event news conference for UFC on FUEL TV 7 in London. "She's a world-class athlete who won an Olympic medal. How do you not respect that? How do you not respect someone who's been training since they were 6 years old and medaled in the Olympics, and has worked as hard as she has to round out her game as a martial artist, too?"
Rousey, a Olympic bronze medal winner in judo at the 2008 games, has one weapon that opponents and fans should see coming a mile away, and that's her armbar. It's how she famously has finished every opponent, all in the first round, both as an amateur and through six wins as a pro. If Carmouche sees the second round on Saturday, she'll already be making history of her own, at least when it comes to Rousey.
But White said he believes Rousey is rounding out her game to include a lot more than just a textbook judo throw and textbook armbar.
"Everybody was talking about her hands two years ago," White said. "Look at her f—ing hands now. I know things you guys don't know about her and what she's doing as far as her hands go. I'd love to see guys go spar with her. She'd knock someone's f—ing head right off, and would love doing it. She is tough, she is mean, and she is f—ing nasty. She's f—iing mean, man. She's a tough chick."
White said that goes for Carmouche, too, not just Rousey – who is a 12-to-1 favorite in the fight. Carmouche is coming off back-to-back stoppage wins under the Invicta banner and knows what it's like to fight for a title, as well.
She lost a title fight to Marloes Coenen nearly two years ago, finally tapping in the fourth round to a triangle choke.
"I've heard some flak about the girls," White said. "But their mitt work is better than half the f—king guys. Their hands are great, they're well-rounded, they represent the sport well, they represent themselves well. I couldn't be happier that I made the decision and I couldn't be happier with this fight."
The women may be headlining, but the rest of the main card features a fairly solid lineup that has the UFC boss stoked, too. A key light heavyweight fight between Dan Henderson (29-8 MMA, 6-2 UFC) and Lyoto Machida (18-3 MMA, 10-3 UFC) serves as the co-main event, while former featherweight champion Urijah Faber (26-6 MMA, 2-2 UFC) returns to fight Ivan Menjivar (25-9 MMA, 4-1 UFC). Plus, Robbie Lawler (19-9 MMA, 4-3 UFC) returns to the promotion to meet Josh Koscheck (17-6 MMA, 15-6 UFC) to open the pay-per-view.
"I'm obviously excited for that (Rousey-Carmouche) fight, but I'm excited for the whole card," White said. "The whole card is a great card."
For more on UFC 157, stay tuned to the UFC Rumors section of the site.
(Pictured: Dana White)


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Following a gluten-free diet does show some advantages:
1. With gluten removed, the body's immune system can rest and absorption can be restored. The body can then function at optimal levels and repair muscles more efficiently.
2. The hypoglycemic effect that results from intense exercise is minimized.
3. A gluten-free diet helps to maintain a stable blood sugar level during exercise, which is optimal for an increase in muscle strength and stamina.
Tips to Live Gluten-Free
1. Emphasize the foods which are naturally gluten-free, such as vegetables, fruits, starchy vegetables, legumes, and certain whole grains.
2. Choose fresh vegetables or frozen without sauce, fresh, dried or frozen fruits, all varieties of fresh corn, potatoes, and squash, dried beans and lentils, whole grains such as certified gluten-free, breads, cereals, pastas, granola, oats, millet, quinoa, amaranth, sorghum, teff, corn tortilla, tapioca, all varieties of rice, eggs, organic tofu, all natural nut butters, cold pressed oils, and vinegars.
3. Read food labels. The Food Allergen Labeling and Consumer Protection Act states that 'wheat' must be on the food label if wheat is used in the food. This is not true for barley and rye; food manufacturers do not have to label foods that contain barley or rye. If you are unsure about a products' ingredients avoid it. Labels must be read every time that you purchase food. Manufacturers can change ingredients at any time.
Follow these steps to ensure that every packaged food that you buy is gluten-free:
Look for 'GLUTEN FREE" clearly labeled on the packaging. If it is labeled certified gluten-free, then it is safe.
Read the allergen statement. If the product contains wheat, put the food down and look for another option. If the product does not contain wheat, then...
Look for a statement regarding the facility in which the food was processed. If the food was processed in a factory that also processes wheat, put the food down and look for another option.
Avoid Cross-Contamination
Tiny amounts of gluten hidden in foods will cause damage to the intestinal lining. Avoid cross contamination in your home and when eating outside of your home.
If you live alone, throw out or give away anything that contains gluten or could have been contaminated with gluten, such as peanut butter or mayonnaise. If you live with others, place vividly colored stickers on gluten-free foods.
Discard wooden cooking utensils, cutting boards and non-stick pans that may be contaminated with gluten.
Use soap and water liberally. Clean dishes and utensils very well to remove gluten. Keep your sponge clean.
At the market avoid bulk bins with shared scoops.
Flour sifters and mesh colanders should not be shared with gluten-containing flours.
Deep fried foods cooked in oil shared with breaded products should not be consumed.
Living with Allergy/Intolerance
It is natural to mourn old food habits for a period of time after being diagnosed with celiac disease or gluten intolerance. Stay focused on all of the foods that you can eat. Appreciate how your diet, health and sport may improve.
Canyon Ranch pioneered the evolution of wellness lifestyle and has been an industry leader for 30 years. Lead by a team of expert physicians and other health and wellness specialists, Canyon Ranch operates the world's most celebrated collection of life-enhancement properties with the goal to inspire people to make a commitment to healthy living.
Chrissy Wellington is co-author of Navigating the Supermarket: A Nutritious Guide to Shopping Well. To pick up a copy of her book, please visit willpowermatrix.com/public/120.cfm.
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While the saturated UK festival market continues to hold its own in spite of the recession, it's always reassuring to know that there are some out there whose individuality in terms of location, setting and line-up make them stand out from the crowd.
One such event is Indietracks, now entering its fifth year. Set in the picturesque grounds of the old Midland Railway site in Butterley, Derbyshire, its homely feel and host of unique selling points have made it one of the most attractive festivals on the circuit since its conception back in 2007.
Past line-ups have witnessed the likes of Los Campesinos!, The Pains Of Being Pure At Heart and Art Brut play memorable sets to an ever increasing legion of punters. This year's bill - due to take place from Friday 29th to Sunday 31st July - is already taking shape, having confirmed Edwyn Collins, The Hidden Cameras, Jeffrey Lewis, Ringo Deathstarr, Butcher Boy and Jonny among others with many more set to be announced over the coming weeks.
With the 2011 festival season fast approaching, we here at DiS thought it an appropriate time to question Indietracks founder Stuart Mackay about its continuous growth, the difficulties and pitfalls in organising such an event, and put forward his all time dream Indietracks line-up.
DiS: When you started the festival in 2007, did you expect it to have grown to the level it has five years later?
Stuart: Yes. When we set out we predicted that an audience figure of a thousand would be achievable, it just took a few goes to get there!
DiS: What prompted the idea to start such a genre specific event, particularly as the likes of ATP, Truck, End Of The Road and to a lesser extent Green Man festivals already provide a large proportion of the musical element associated with Indietracks?
Stuart: I was only interested in indiepop at the time so it had to be genre specific. After our first little three band show on the railway in April 2007 we wanted to do something a little bigger to make it more worthwhile to all the people that travelled from around the country for that show and we never really set out to start a festival. At first it was being planned as an all-dayer but as we're not a regular venue all the setting up meant it was more cost effective to hold it over two days.
DiS: Obviously the most unique factor about Indietracks is the location itself. How difficult was it persuading the Midland Railway Trust to hold a music festival on their site?
Stuart: I worked there at the time and knew the management very well. They were very impressed with the three band show we started with - in particular their bar takings and how nice the audience were - so were happy to try something bigger.
DiS: Were there any reservations on their part from the outset and did they impose any conditions or targets that had to be met to justify the event?
Stuart: Just the obvious one that it had to at least break even, which it didn't the first year, but thankfully they saw the potential and allowed us another go. They also recognised that their volunteers loved it. It was something different from the normal railway themed events, and it brought many of the individual volunteer groups together, and they thought it was wonderful seeing so many people using and appreciating the railway.
DiS: With the number of punters increasing and more widely recognised artists appearing on the bill every year, has there ever been a temptation on your part to move the festival to a bigger site, or extend the capacity by way of speaking to adjoining landowners to make the site bigger?
Stuart: Not really. We're happy as we are. It's manageable to organise as a hobby, and I think it's smallness is part of its charm.
DiS: Because of the nature of the stages (a cowshed, a church and an articulated lorry), how difficult is it to organise and facilitate in terms of getting the stages and sound quality absolutely right?
Stuart: The engine shed still needs some tinkering to get it right. We need to drape the walls but we haven't been able to afford that yet. Our only problem is really the capacity of the church which sees longer and longer queues each year, but it's such a popular stage we couldn't stop using it.
DiS: Which of the four Indietracks festivals you've held so far stands out as your favourite and why?
Stuart: Probably 2010. Much more of my work had been delegated to Team Indietracks so for once I actually had a chance to relax, see some bands, mingle with the audience and appreciate what goes on.
DiS: Similarly, given the power of hindsight, have you ever looked back and wished you had done something differently, whether that be in terms of booking certain bands or allocating artists to other stages for example?
Stuart: Yes, there's certainly some bands that shouldn't have been booked. If anything I would have picked a different weekend to hold it on, as it's a very expensive time for foreign bands and audiences to travel.
DiS: In terms of 2011's bill, you've already booked Edwyn Collins, Jeffrey Lewis and The Hidden Cameras so far. What can you tell us about the type of acts you'll be announcing in the coming weeks?
Stuart: I'm not involved in choosing bands anymore - some of the bands I don't recognise. I don't keep up with the scene as I used to, so I leave it to others who are more in touch with what's going on!
DiS: Past events have seen pop quizzes and knitting classes among various non-musical sources of entertainment at the festival. Will there be any new additions this year and aside from the bands themselves, what are you most looking forward to about Indietracks 2011?
Stuart: The workshops will continue no doubt bringing other interesting topics to fill interludes between people's favourite bands, but I doubt there'll be any side show additions. Like many people I'm looking forward to catching up with people I rarely get to see now. Socialising with like minded people seems to be one of the great attractions at Indietracks.
DiS: Finally, if you could create the ultimate Indietracks festival line-up choosing any artists past or present, who would it be and why?
Stuart: It'd probably be full of bands from the past that I'd never got to see or would love to see again. The Chesterf!elds, Language of Flowers, Shop Assistants, that kind of thing.
For more information on Indietracks visit their official website.


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IN the week the late George Harrison would have celebrated his 67th birthday this never-before seen photo shows him at the age of six.
The photo is one of a rare collection showing him during his years at Dovedale School, Mossley Hill, thought to have been taken in 1949/50.
George is sat on the back row, second from the left.
It is taken from David Bedford's book "Liddypool: The Birthplace of the Beatles" which includes other rare photos and official records.
Mr Bedford – who moved to Dingle from Guildford with his family aged four and attended Ringo's old primary school St Silas – spent more than 10 years compiling the book.
It concentrates solely on The Beatles and their hometown of Liverpool, covering their rise from birth and childhood in the 1940s and obscurity, to their triumphant civic reception at in Liverpool in July 1964.
He managed to find the rare photos after digging in the old school archives, as his daughters attend the school.
The book also includes records showing George joining Dovedale on April 19 1948 and that his parents excluded him from daily religious assembly.
Fans of Harrison marked his birthday around the world yesterday with members of Liverpool Beatles Appreciation Society laying flowers at the Beatles statue in Cavern Walks.


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Put the dumbest injury you've ever gotten in the tagsWednesday, September 28th, 2016
Reposted from http://ift.tt/2cMMHAs.
Reposted from http://ift.tt/2cMMHAs.
Tags: it's a tie, both from when I was a teen, once I was burning the freshly cut end, of a piece of 1/4-inch dacron line, which is a thing you do on a boat, to prevent the end fraying and unraveling, when you're too lazy to do a proper whipping, and I did this sitting in the cabin, in shorts, and watched as a big drop of molten dacron, dropped onto my bare thigh, I still have that scar, also still have the scar near my right knee, that one day at track practice, when we were goofing around, and decided to try to do a standing high jump, b/c I'd read it was an event, in the first modern olympics, and I spiked myself with my track shoes. Posted in Tumblr by jbc | Permalink | No Comments »
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"Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study" by James H Fowler, associate professor, Nicholas A Christakis, professor had as objectives "To evaluate whether happiness can spread from person to person and whether niches of happiness form within social networks". The abstract also says "Clusters of happy and unhappy people are visible in the network, and the relationship between people's happiness extends up to three degrees of separation (for example, to the friends of one's friends' friends). People whoare surrounded by many happy people and thosewho are central in the network are more likely to become happy in the future. Longitudinal statistical models suggest that clusters of happiness result from the spread of happiness and not just a tendency for people to associate with similar individuals. A friend who lives within a mile (about 1.6 km)andwhobecomeshappy increases the probability that a person is happy by 25% (95% confidence interval 1% to 57%). Similar effects are seen in coresident spouses (8%, 0.2% to 16%), siblings who live within a mile (14%, 1% to 28%), and next door neighbours (34%, 7% to 70%). Effects are not seen between coworkers. The effect decays with time and with geographical separation. Conclusions People's happiness depends on the happiness of others with whom they are connected. This provides further justification for seeing happiness, like health, as a collective phenomenon".
Full paper is available on http://christakis.med.harvard.edu/pdf/publications/articles/095.pdf More information about their book "Connected" is available on http://connectedthebook.com


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Me writing anything is wishful thinking. One has to have the skill to do so and be creative s well as interesting. My paintings are both, know that sounds way too egotistical for my own good. Now, if I had the skill of Mr. Kunstler, to to paintings on the topic of the Civil War, battles, heroes, scenes of beauty, romance, violence, and dearth. If I could be as talented in writing as he is in painting, just fantasy on my part but I do love buying and collecting his works of art.
Do what I did and just write down each experience you've had so at least there is a record of what you have seen.
you never know, it might be enough with a little bit of editing to actually make up a book.
at least set some time aside and write up your experiences.


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Before we start off, reports are coming in from across the nation — my new book, Sit Down & Shut Up! is available in the shops. Some people who ordered it on-line already have their copies. So what are you waiting for? Go out and get yours today!
I spent some time this afternoon at the UCLA Book Fair signing copies. But my first official book signing is scheduled for May 17th at the Bodhi Tree Book Store in West Hollywood. On Saturday June 2nd I'll be at the Phoenix Zen Center with a couple other locations in Phoenix on the following 2 days. Then it's up to San Francisco the week after that. I'll post a full schedule soon.
Today's offering is a kind of "bonus track" to my latest piece for Suicide Girls (see the link to your left). In there I mentioned some crates of records I found while cleaning out my dad's closets. I also found a bunch of my old comics that my parents had saved. When I started college I was an art student. My ambition at the time was to be a professional cartoonist. But I wasn't quite ambitious enough. My teachers never really got anything I did. It was far too low-brow for them to comprehend. I mean, my lord, The Three Stooges?!?!?!
This here was the first piece of Buddhist inspired writing I ever did. Click on the picture to enlarge it to readable size. The Rinzai Stooges was the first and the second was Bedlam in Nirvana, which I'm saving for next week's Suicide Girls page. The date on that one is December 1984, so this one must be a month or so earlier. Tim McCarthy, my Zen teacher at the time, loved this and encouraged me to do more. But I only ever did those two.
The katakana in the final frame is completely wrong, by the way. All I knew of Japanese came from a book I got out of the library. It's supposed to say "Curly Roshi."


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There is a risk that U.S. stocks could drop in the second half of the year "like in 1987" without further quantitative easing, according to the investment guru Marc Faber, who spoke to Bloomberg TV on Thursday.
"I think the market will have difficulties to move up strongly unless we have a massive QE3," said Faber, who manages $300 million at Marc Faber Ltd. "If it moves and makes a high above 1,422, the second half of the year could witness a crash, like in 1987."
He says that the overall technical condition of the U.S. markets "is deteriorating rapidly." The European markets have already turned bearish, he notes.
The S&P 500 moved up about 0.25% to trade at 1,361 midday on Friday. The Dow Jones was up 0.20% at 12,880.
Despite JP Morgan's (JPM) report of a $2 billion loss, investors reacted to the news that consumer sentiment edged higher in May to its best reading since January 2008.
The preliminary report of the University of Michigan-Thomson Reuters index was 77.8 in May, up from 76.4 in April. Plus, the current economic conditions index jumped to 87.3, another best since January 2008, and up from 82.9 in April.
The Dow plunged 23% on Oct. 19, 1987, in the biggest crash since 1914. On the same day, S&P 500 dropped 20%. That year, the Dow ended up 23% higher, and the S&P improved 2%.
"If the market makes a new high, it will be a new high with very few stocks pushing up and the majority of stocks having already rolled over," Faber said. "The earnings outlook is not particularly good because most economies in the world are slowing down."
Faber said that the S&P rallied in 2009, made an orthodox top on May 2, 2011, at 1,370, and then a new high of 1,419 on April 2. "The new high was not confirmed by the majority shares … and every day there are some shares that are breaking down …," said Faber, whose prediction of a February selloff in global equities never occurred.
"I think we may have seen the high of the year unless you get a huge—a huge—QE3, and that may not be forthcoming," said the investment expert, noting slower growth at many U.S. firms, especially those tied to sales and earnings in Europe.


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Bit delayed by now, but my work weeks keep getting craaazier! I got a north jetty report & a cute harbor seal story to go along with it… But that'll have to wait!
So I went out to the Pacifica Pier to hang out with my dear of dad, and check up on how crabbing was out there. First sign of life was around halfway down the pier:
Didn't see any other fish pulled up. Decent amount of people casting out hi-los and even one throwing a large kastmaster! No luck with it while I was there.
Around 3/4 of the way down we ran into the first person with crab. Continue reading Pacifica Pier – Crab & Perch Report


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It's beginning to look a lot like the holidays and my favorite thing to do at Christmas, besides watch Christmas movies or bake cookies is read Christmas romances. There is nothing like a good Christmas romance anthology. Over the years I've read many, and each season a new one becomes available for the masses.
There's the historicals, which are always marvelous because who doesn't love seeing how in a time when couples had difficulty falling in love in the first place, let alone being alone together, a pair of romantically matched people find themselves declaring love for one another in less than forty thousand words.
Here's a few of my favorites:
Christmas in the Duke's Arms by Grace Burrowes, Carolyn Jewel, Miranda Neville, and Shana Galen ~ All the tales occur around an inn, in a small town. My favorite is a friends to lovers tale.
The Heart of Christmas by Mary Balogh, Nicola Cornick, and Courtney Milan ~ Delicious romance with rakes, benefactors, and unlikely heroes
All I Want for Christmas Is a Duke by Valerie Bowman, Vivienne Lorret, Tiffany Clare, and Ashlyn Macnamara ~ Dukes. Need I say more?
I'm mighty proud of the fact I've offered you stories by 11 different Historical romance authors, and they are all fabulous. This is just the tip of the romance iceberg because several other historical authors offer up full-length Christmas tales, including an entire series from Theresa Romain, which right now they are all together as a Holiday Pleasures Bundle in an ebook steal deal.
Then I have that 'but wait; there's more' moment. Because I haven't discussed contemporary romance. There is plenty of holiday joy to be shared around there. The ones I fell in love were the typically full length and the run the gauntlet from sweet to steamy. Regardless, they are all romances and feature Christmas in some capacity.
A few more favs:
Simply Irresistible by Jill Shalvis ~ first in the Lucky Harbor series.
Last Chance Christmas by Hope Ramsey ~ part of the Last Chance series.
Maybe This Christmas by Sarah Morgan ~ a friends to lovers tale and part of her Snow Crystal series.
And, if you haven't heard a fellow HSG blogger/author, Jennifer Shirk has her latest release in the Christmas contemporary romance category. Check out Wrong Brother, Right Match. A shameless plug, but I've already got it pre-order and on my list of holiday romances to indulge in.
Of course, as with all things, these are just a handful of Christmas romance books available. I'm leaving out Maisey Yates and her cowboys, and Jessica Lemmon with her Bad Boy for Christmas book. I could go on and on, but I do believe that will cut into my reading time.
Do you have a favorite Christmas romance book? If so, tell me, I'd love to add it to my list.
About Landra Graf
Landra Graf consumes at least one book a day and has always been a sucker for stories where true love conquers all. She believes in the power of the written word, and the joy such words can bring. In between spending time with her family and having book adventures, she writes romance with the goal of giving everyone, fictional or not, their own happily ever after.