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What's New at Target Health Inc.?
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Congratulations to Dr. Tibor Sipos as FDA Approves Pertzye!
FDA Approves Pertzye (pancrelipase) Delayed-Release Capsules for the Treatment of Pancreatic Insufficiency Due to Cystic Fibrosis or Other Conditions
Target Health congratulates our good friend and colleague for receiving FDA approval of Pertzye (pancrelipase) Delayed-Release Capsules. Pertzye is indicated for the treatment of exocrine pancreatic insufficiency due to cystic fibrosis or other conditions. Dr. Sipos had championed Pancrease development while at JnJ and subsequently developed this unique delayed release formulation while at Digestive Care Inc. (DCI).
Target Health has been working with DCI on this and other programs since 1999. In addition, Dr. Jules Mitchel and Dr. Tibor Sipos have been colleagues and friends for over 20 years, so this is a very special event both professionally and personally. We both want to thank Dr. Glen Park and his terrific regulatory team at Target Health for guiding this program through FDA.
Target Health is at BioMed Israel this coming week of May 20 – 17, 2012
Tel Aviv Sunset Over the Mediterranean
For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 104). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website at www.targethealth.com
Quiz Questions (fill in the blanks)
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Neuroscience and the Electronic Pavlov Dog
(Credit: ©TheSupe87 / Fotolia)
Hungry dogs naturally salivate at the sight of food. Pavlov rang a bell before feeding the dog. After repeated bell-food pairings, the bell also caused the dogs to salivate. Nanotechnology scientists and memory researchers at the Kiel University redesigned a mental learning process using electronic circuits. The bell rings and the dog starts 1) ___. Such a reaction was part of studies performed by Ivan Pavlov, a famous Russian psychologist and physiologist and winner of the Nobel Prize for Physiology and Medicine in 1904. His experiment, nowadays known as "Pavlov's Dog," is ever since considered as a milestone for implicit learning processes. By using specific electronic components scientists form the Technical Faculty and the Memory Research at the Kiel University together with the Forschungszentrum Julich were now able to mimic the behavior of Pavlov`s 2) ____.
The study is published in the current issue of Advanced Functional Materials.
Digital and biological information processing are based on fundamentally different principles. Modern computers are able to work on mathematical-logical problems at an extremely high pace. In fact, procedures in the computer's central processing unit and in the storage media run serially. While digital computers have shown immense success throughout the years in certain fields, they reveal weaknesses when it comes to pattern 3) ___ and cognitive tasks. However, to imitate biological information processing systems recognition and cognitive tasks are essential. Mammal brains — and therefore also the brains of humans — decode information in complex neuronal networks of synapses with up to 1014 (100 Trillion) connections. However, the connectivity between neurons is not fixed. "Learning means that new connections between 4) ___ are created, or existing connections are reinforced or weakened," says PD Dr. Thorsten Bartsch of the Clinic for Neurology. This is called neuronal plasticity.
Is it possible to design neural circuits with electronic devices to mimic learning? At this crossroad between neurobiology, material science and nanoelectronics, scientists from the University of Kiel are collaborating with their colleagues from the Research Center Julich. Now, they have succeeded in electronically recreating the classical "5) ___ Dog" experiment. "We used memristive devices in order to mimic the associative behavior of Pavlov's dog in form of an electronic circuit," explains Professor Hermann Kohlstedt, head of the working group Nanoelectronics at the University of Kiel.
Memristors are a class of electronic circuit elements which have only been available to scientists in an adequate quality for a few years. They exhibit a memory characteristic in form of hysteretic current-voltage curves consisting of high and low resistance branches. In dependence on the prior charge flow through the device these resistances can vary. Scientists try to use this memory effect in order to create networks that are similar to neuronal connections between 6) ___. "In the long term, our goal is to copy the synaptic plasticity onto electronic circuits. We might even be able to recreate cognitive skills electronically," says Kohlstedt. The collaborating scientific working groups in Kiel and Jülich have taken a small step toward this goal.
The project set-up consisted of the following: two electrical impulses were linked via a memristive device to a comparator. The two pulses represent the food and the 7) ___ in Pavlov's experiment. A comparator is a device that compares two voltages or currents and generates an output when a given level has been reached. In this case, it produces the output signal (representing saliva) when the threshold value is reached. In addition, the memristive element also has a threshold voltage that is defined by physical and chemical mechanisms in the nano-electronic device. Below this threshold value the memristive device behaves like any ordinary linear resistor. However, when the threshold value is exceeded, a hysteretic (changed) current-voltage characteristic will appear.
"During the experimental investigation, the food for the dog (electrical impulse One) resulted in an output signal of the comparator, which could be defined as salivation. Unlike impulse One, the ring of the bell (electrical impulse Two) was set in such a way that the compartor's output stayed unaffected — meaning no salivation," describes Dr. Martin Ziegler, scientist at the Kiel University and the first-author of the publication. After applying both impulses simultaneously to the memristive device, the threshold value was exceeded. The working group had activated the memristive memory function. Multiple repetitions led to an associative learning process within the circuit — similar to Pavlov's dogs. "From this moment on, we had only to apply electrical impulse Two (bell) and the comparator generated an output signal, equivalent to salivation," says Ziegler and is very pleased with these results. Electrical impulse One (feed) triggers the same reaction as it did before the learning. Hence, the electric circuit shows a behavior that is termed classical conditioning in the field of behavioral 8) ___. Beyond that, the scientists were able to prove that the electrical circuit is able to unlearn a particular behavior if both impulses were no longer applied simultaneously.
ANSWERS: 1) drooling (or salivating); 2) dog; 3) recognition; 4) neurons; 5) Pavlov's; 6) synapses; 7) bell; 8) psychology
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Lenin's Stroke: Doctor Has a Theory (and a Suspect) (1870 – 1924)
The Soviet leader Vladimir Ilyich Lenin on his death bed, in an undated photo
Photo Credit: Associated Press
The patient founded a totalitarian state known for its "merciless terror," Dr. Victoria Giffi told a rapt audience of doctors and medical students. He died suddenly at 6:50 p.m. on Jan. 21, 1924, a few months before his 54th birthday. The cause of death: a massive stroke.
The man's cerebral arteries, Dr. Giffi added, were "so calcified that when tapped with tweezers they sounded like stone."
The occasion was a Clinicopathological Conference, at the University of Maryland, where clinicopathological conferences focus on historical figures and have been an annual event for the past 19 years.
At these conferences, a mysterious medical case is presented to an audience of doctors and medical students. Attending doctors have reviewed the case records. In the end, a pathologist solves the mystery with a diagnosis.
This May 2012, was a conference with a twist. The patient was long dead — he was, in fact, Vladimir Ilyich Lenin. The questions posed to the conference speakers: Why did he have a fatal stroke at such a young age? Was there something more to his death than history has acknowledged?
On Friday, two experts were called upon to solve the mystery of Lenin's death: Dr. Harry Vinters, professor of neurology and neuropathology at the University of California, Los Angeles, and Lev Lurie, a Russian historian in St. Petersburg.
Dr. Vinters began by telling the audience some details of Lenin's medical and family history.
As a baby, Lenin had a head so large that he often fell over. He used to bang his head on the floor, making his mother worry that he might be mentally disabled.
As an adult, Lenin suffered diseases that were common at the time: typhoid, toothaches, influenza and a painful skin infection called erysipelas. He was under intense stress, of course, which led to insomnia, migraines and abdominal pain.
At 38, he was shot twice in an assassination attempt. One bullet lodged in his collarbone after puncturing his lung. Another got caught in the base of his neck. Both bullets remained in place for the rest of his life.
Lenin's father died early, too, at 54. The cause of death was said to be cerebral hemorrhage, but Lenin's father had an illness at the time of his death that may have been typhoid fever.
Most of Lenin's seven brothers and sisters died young, two in infancy. A brother was executed at age 21 for plotting to assassinate Emperor Alexander III, and another brother died of typhoid at 19. Of the three who survived past young adulthood, a sister died of a stroke at age 71, another sister died of a heart attack at 59, and a brother died at age 69 of "stenocardia," an archaic medical term whose meaning is no longer clear.
In the two years before he died, Lenin had three debilitating strokes. Prominent European doctors were consulted and proposed a variety of diagnoses: nervous exhaustion, chronic lead intoxication from the two bullets lodged in his body, cerebral arteriosclerosis and "endarteritis luetica."
Dr. Vinters speculates that the last term referred to meningovascular syphilis, inflammation of the walls of blood vessels mainly around the brain, resulting in a thickening of the interior of the vessel. But there was no evidence of this on autopsy, and Lenin's syphilis test was said to have been negative. He had been treated anyway with injections of a solution containing arsenic, the prevailing syphilis remedy.
Then, in his last hours and days of his life, Lenin experienced severe seizures.
An autopsy revealed a near total obstruction of the arteries leading to the brain, some of which were narrowed to tiny slits. But Lenin did not have some of the traditional risk factors for strokes.
He did not have untreated high blood pressure — had that been his problem, the left side of his heart would have been enlarged. He did not smoke and would not tolerate smoking in his presence. He drank only occasionally and exercised regularly. He did not have symptoms of a brain infection, nor did he have a brain tumor.
So what brought on the stroke that killed Lenin?
The clues lie in Lenin's family history, Dr. Vinters said. The three siblings who survived beyond their 20s had evidence of cardiovascular disease, and Lenin's father died of a disease that was described as being very much like Lenin's. Dr. Vinters said Lenin might have inherited a tendency to develop extremely high cholesterol, causing the severe blockage of his blood vessels that led to his stroke.
Compounding that was the stress Lenin experienced, which can precipitate a stroke in someone whose blood vessels are already blocked.
But Lenin's seizures in the hours and days before he died are a puzzle and perhaps historically significant. Severe seizures, Dr. Vinters said in an interview before the conference, are "quite unusual in a stroke patient."
But, he added, "almost any poison can cause seizures."
Dr. Lurie concurred on Friday, telling the conference that poison was in his opinion the most likely immediate cause of Lenin's death. The most likely perpetrator? Stalin, who saw Lenin as his main obstacle to taking over the Soviet Union and wanted to get rid of him.
Communist Russia in the early 1920s, Dr. Lurie told the conference, was a place of "Mafia-like intrigue."
In 1921 Lenin started complaining that he was ill. From then until his death in 1924, Lenin "began to feel worse and worse," Dr. Lurie said.
"He complained that he couldn't sleep and that he had terrible headaches. He could not write, he did not want to work," Dr. Lurie said. He wrote to Alexei Maximovich Gorky, "I am so tired, I do not want to do anything at all."
But he nonetheless was planning a political attack on Stalin, Dr. Lurie said. And Stalin, well aware of Lenin's intentions, sent a top-secret note to the Politburo in 1923 claiming that Lenin himself asked to be put out of his misery.
The note said: "On Saturday, March 17th in the strictest secrecy Comrade Krupskaya told me of 'Vladimir Ilyich's request to Stalin,' namely that I, Stalin, should take the responsibility for finding and administering to Lenin a dose of potassium cyanide. I felt it impossible to refuse him, and declared: 'I would like Vladimir Ilyich to be reassured and to believe that when it is necessary I will fulfill his demand without hesitation.'"
Stalin added that he just could not do it: "I do not have the strength to carry out Ilyich's request and I have to decline this mission, however humane and necessary it might be, and I therefore report this to the members of the Politburo."
Dr. Lurie said Stalin might have poisoned Lenin despite this assurance, as Stalin was "absolutely ruthless."
Dr. Vinters believes that sky-high cholesterol leading to a stroke was the main cause of Lenin's death. But he said there is one other puzzling aspect of the story. Although toxicology studies were done on others in Russia, there was an order that no toxicology be done on Lenin's tissues.
So the mystery remains.
But if Lenin had lived today, or if today's cholesterol-lowering drugs had been available 100 years ago, might he have been spared those strokes?
"Yes," Dr. Vinters said. "Lenin could have gone on for another 20 or 25 years, assuming he wasn't assassinated. History would have been totally different."
Lev Lurie, Ph.D., is a teacher, journalist, and broadcaster based in St. Petersburg, Russia. His Ph.D., dissertation, earned at Leningrad State University in 1987, was entitled "Social- Demographic Characteristics of the Revolutionary Movement in Russia 1810-1880," and he has been recognized as one of the leading scholars on the life of Vladimir Lenin. From 1978 to 1991, Lurie was a senior researcher at the State Museum of History of Leningrad, and in 1989 was a founder of the first classical gymnasium in Russia where he serves as vice director for academic affairs and teacher of history. He is author of more than one hundred scientific articles on Russian history and has been a columnist for several magazines and newspapers. In 2011, Lurie founded and continues to serve as creative director of the independent education and cultural center Lev Lurie's Dom Kultury.
Harry Vinters, M.D., is professor of pathology and laboratory medicine in the department of neurology at the David Geffen School of Medicine at UCLA. He received his medical degree from the University of Toronto Faculty of Medicine in 1976, interned at the University of Alberta Hospital, and received residency training in neuropathology at the University of Western Ontario. Vinters followed with a fellowship in pediatric neuropathology at Vancouver General Hospital and became board certified in neuropathology by the American Board of Pathology in 1981. He pursued an additional fellowship in neuropathology at the University of Iowa Hospitals and Clinics in 1982. Vinters' practice is located at the Ronald Reagan UCLA Medical Center, and he serves as chief of neuropathology and as a member of its Brain Research Institute.
Experts differ on the likely causes of the stroke that killed Lenin at 53.
Photo Credit: The New York Times
The body of Vladimir Lenin , the Soviet state founder lies in the Mausoleum of Lenin on Red Square. Doctors say , the founder of Russian communism, may have died because of stress, family medical history or of poison given to him by his political successor Joseph Stalin, opposing a popular theory that he died of sexually-transmitted disease syphilis.
Photo: Peter Andrews/Reuters
Source: The New York Times, May 2012, by Gina Kolata
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Coffee Drinkers Have Lower Risk of Death
According to an article published in the New England Journal of Medicine (2012; 366:1891-1904), older adults who drank coffee – caffeinated or decaffeinated – had a lower risk of death overall than others who did not drink coffee. The coffee drinkers were also less likely to die from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, although the association was not seen for cancer. These results from a large study of older adults were observed after adjustment for the effects of other risk factors on mortality, such as smoking and alcohol consumption. The authors caution, however, that they can't be sure whether these associations mean that drinking coffee actually makes people live longer.
The study examined the association between coffee drinking and risk of death in 400,000 U.S. men and women ages 50 to 71 who participated in the NIH-AARP Diet and Health Study. Information about coffee intake was collected once by questionnaire at study entry in 1995-1996. The participants were followed until the date they died or Dec. 31, 2008, whichever came first. Results showed that the association between coffee and reduction in risk of death increased with the amount of coffee consumed. Relative to men and women who did not drink coffee, those who consumed three or more cups of coffee per day had approximately a 10% lower risk of death. Coffee drinking was not associated with cancer mortality among women, but there was a slight and only marginally statistically significant association of heavier coffee intake with increased risk of cancer death among men.
The investigators caution that coffee intake was assessed by self-report at a single time point and therefore might not reflect long-term patterns of intake. Also, information was not available on how the coffee was prepared (espresso, boiled, filtered, etc.). The authors considered it possible that preparation methods may affect the levels of any protective components in coffee.
According to the authors the mechanism by which coffee protects against risk of death – if indeed the finding reflects a causal relationship – is not clear, because coffee contains more than 1,000 compounds that might potentially affect health.
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Paralyzed Individuals Use Thought-Controlled Robotic Arm to Reach and Grasp
In an ongoing clinical trial, a paralyzed woman was able to reach for and sip from a drink on her own – for the first time in nearly 15 years – by using her thoughts to direct a robotic arm. The trial, funded in part by the National Institutes of Health, is evaluating the safety and feasibility of an investigational device called the BrainGate neural interface system. This is a type of brain-computer interface (BCI) intended to put robotics and other assistive technology under the brain's control. NIH has supported basic and applied research in this area for more than 30 years. In 2009 and 2010, an additional $3.8 million in NIH funding was made possible through the Recovery Act.
The report published in Nature (2012;485:372-375), describes how two individuals – both paralyzed by stroke – learned to use the BrainGate system to make reach-and-grasp movements with a robotic arm, as part of the BrainGate2 clinical trial. The report highlights the potential for long-term use and durability of the BrainGate system, part of which is implanted in the brain to capture the signals underlying intentional movement. It also describes the most complex functions to date that anyone has been able to perform using a BCI.
For the woman, it was the first time since her stroke that she was able to sip a drink without help from a caregiver.
The BrainGate neural interface system consists of a sensor to monitor brain signals and computer software and hardware that turns these signals into digital commands for external devices. The sensor is a baby aspirin-sized square of silicon containing 100 hair-thin electrodes, which can record the activity of small groups of brain cells. It is implanted into the motor cortex, a part of the brain that directs movement.
The latest analysis from the BrainGate2 trial focused on two participants – a 58-year-old woman and a 66-year-old man. Both individuals are unable to speak or move their limbs because of brainstem strokes they had years ago – the woman's in 1996 and the man's in 2006. In the trial, both participants learned to perform complex tasks with a robotic arm by imagining the movements of their own arms and hands. In one task, several foam targets were mounted on levers on a tabletop and programmed to pop up one at a time, at different positions and heights. The participants had less than 30 seconds to grasp each target using the DEKA Arm System (Generation 2), which is designed to work as a prosthetic limb for people with arm amputations. One participant was able to grasp the targets 62% of the time, and the other had a 46% success rate. In some sessions, the woman controlled a DLR Light-Weight Robot III arm, which is heavier than the DEKA arm and designed to be used as an external assistive device. She used this arm prior to the DEKA arm in the foam target task, and had a success rate of 21%. In other sessions with the DLR arm, her task was to reach for a bottled drink, bring it to her mouth and sip from a straw. She was able to complete four out of six attempts.
The authors noted the woman's ability to use the BrainGate was especially encouraging because her stroke occurred nearly 15 years ago and her sensor was implanted more than five years ago. Some researchers have wondered whether neurons in the motor cortex might die or stop generating meaningful signals after years of disuse. Researchers in the field have also worried that years after implantation, the sensor might break down and become less effective at enabling complex motor functions.
As the trial continues, the BrainGate research team needs to test the technology in more individuals. They envision a system that would be stable for decades, wireless and fully automated. For now, the sensor – and therefore the user – must be connected via cables to the rest of the system. Prior to each session with the robotic arms, a technician had to perform a calibration procedure that lasted 31 minutes on average. Improvements are also needed to enhance the precision and speed of control. In the foam target task, for example, a successful reach-and-grasp motion typically took almost 10 seconds.
The ultimate goal for helping people with paralysis is to reconnect the brain directly to paralyzed limbs rather than robotic ones. In the future, the BrainGate system might be used to control a functional electrical stimulation (FES) device, which delivers electrical stimulation to paralyzed muscles. Such technology has shown promise in monkeys. The Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD) has long supported the clinical trial research for BrainGate, with the goal of enabling mental control of an FES system for limb movement. In previous reports from the BrainGate2 trial, a participant was able to use the BrainGate system to direct the movements of a virtual, computer-animated arm designed to simulate FES control of a real arm.
To support this research, NIH has worked closely with the Department of Veterans Affairs (VA) and the Defense Advanced Research Projects Agency (DARPA), the research arm of the Department of Defense. DARPA supports development of the DEKA arm. Development of the DLR arm is funded by the German aerospace agency DLR. NIH has supported the fundamental neuroscience and BCI development, and the clinical research in collaboration with the VA.
The BrainGate trial began in 2004 and was run by Cyberkinetics Inc., in collaboration with Brown University and MGH. NICHD began funding the trial in 2005. After Cyberkinetics withdrew from the research for financial reasons, funding continued through this NICHD contract, MGH became the clinical trial and administrative lead, and the trial was renamed BrainGate2. The trial is currently recruiting.
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New Clues on How ApoE4 Affects Alzheimer's Risk
Alzheimer's disease is the most common cause of dementia in older adults, and affects more than 5 million Americans. A hallmark of the disease is a toxic protein fragment called beta-amyloid that accumulates in clumps, or plaques, within the brain. Gene variations that cause higher levels of beta-amyloid are associated with a rare type of Alzheimer's that appears early in life, between age 30 and 60. However, it is the ApoE4 gene variant that is most strongly tied to the more common, late-onset type of Alzheimer's disease. Inheriting a single copy of ApoE4 from a parent increases the risk of Alzheimer's disease by about three-fold. Inheriting two copies, one from each parent, increases the risk by about 12-fold.
While common variants of the ApoE gene are strongly associated with the risk of developing late-onset Alzheimer's disease, the gene's role in the disease has been unclear. Now, according to an article published online in Nature (16 May 2012), it was discovered that mice having the most risky variant of ApoE damages the blood vessels that feed the brain. The study found that the high-risk variant, ApoE4, triggers an inflammatory reaction that weakens the blood-brain barrier, a network of cells and other components that lines brain's brain vessels. Normally, this barrier allows nutrients into the brain and keeps harmful substances out.
The ApoE gene encodes a protein that helps regulate the levels and distribution of cholesterol and other lipids in the body. The gene exists in three varieties. ApoE2 is thought to play a protective role against both Alzheimer's and heart disease, ApoE3 is believed to be neutral, and ApoE4 confers a higher risk for both conditions. Outside the brain, the ApoE4 protein appears to be less effective than other versions at clearing away cholesterol; however, inside the brain, exactly how ApoE4 contributes to Alzheimer's disease has been a mystery.
The study evaluated several lines of genetically engineered mice, including one that lacks the ApoE gene and three other lines that produce only human ApoE2, ApoE3 or ApoE4. Mice normally have only a single version of ApoE. The authors found that mice whose bodies made only ApoE4, or made no ApoE at all, had a leaky blood-brain barrier. With the barrier compromised, harmful proteins in the blood made their way into the mice's brains, and after several weeks, authors were able to detect loss of small blood vessels, changes in brain function, and a loss of connections between brain cells.
The study also found that ApoE2 and ApoE3 help control the levels of an inflammatory molecule called cyclophilin A (CypA), but ApoE4 does not. Levels of CypA were raised about five-fold in blood vessels of mice that produce only ApoE4. The excess CypA then activated an enzyme, called MMP-9, which destroys protein components of the blood-brain barrier. Treatment with the immunosuppressant drug cyclosporine A, which inhibits CypA, preserved the integrity of the blood-brain barrier and lessened damage to the brain. An inhibitor of the MMP-9 enzyme had similar beneficial effects. In prior studies, inhibitors of this enzyme have been shown to reduce brain damage after stroke in animal models.
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TARGET HEALTH excels in Regulatory Affairs. Each week we highlight new information in this challenging area.
FDA Approves Generic Versions of Blood Thinner Plavix
The FDA last week approved generic versions of the blood thinning drug Plavix (clopidogrel bisulfate), which helps reduce the risk of heart attack and stroke by making it less likely that platelets in the blood will clump and form clots in the arteries. Clopidogrel is FDA-approved to treat patients who have had a recent heart attack or a recent stroke, or have partial or total blockage of an artery (peripheral artery disease).
According to Keith Webber, Ph.D., deputy director of the Office of Pharmaceutical Science in the FDA's Center for Drug Evaluation and Research, "for people who must manage chronic health conditions, having effective and affordable treatment options is important," and that "the generic products approved today will expand those options for patients."
Clopidogrel has a boxed warning to alert health care professionals and patients that the drug may not work well for those with certain genetic factors that affect how the body metabolizes the drug. Patients can be tested for these genetic factors to ensure that clopidogrel is the right choice for them. Also, certain medicines, such as proton pump inhibitors Prilosec (omeprazole) and Nexium (esomeprazole), reduce the effect of clopidogrel, leaving a person at greater risk for heart attack and stroke.
Clopidogrel may cause bleeding, which can be serious and sometimes lead to death. While taking the drug, people may bruise and bleed more easily, be more likely to have nose bleeds, and it may take longer for all bleeding to stop. Clopidogrel is dispensed with a patient Medication Guide that provides important instructions on its use and drug safety information.
Dr. Reddy's Laboratories, Gate Pharmaceuticals, Mylan Pharmaceuticals, and Teva Pharmaceuticals have gained FDA approval for 300 milligram (mg) clopidogrel. Apotex Corporation, Aurobindo Pharma, Mylan Pharmaceuticals, Roxane Laboratories, Sun Pharma, Teva Pharmaceuticals, and Torrent Pharmaceuticals have received approval for 75 mg clopidogrel.
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Defining Primary Care
By Mark L. Horn, MD, MPH, Chief Medical Officer, Target Health Inc.
Virtually all models for reforming or reinventing the health care system incorporate a major role for primary care. Key problems in assessing various options are that the presumptive providers and the relationships among them vary, and the practice of primary care is itself evolving in response to (among other influences) changing economic pressures, emerging information technology and the consequent requirements for data collection, reporting, and analysis. These realities make analyses and comparisons of different approaches to primary care problematic. While these complex realities and their implications for providers and policymakers are well described, they are sometimes not explicitly acknowledged, so it was reassuring to see these problems highlighted in a recent article by Susan Okie, MD, in the New England Journal of Medicine, entitled "The Evolving Primary Care Physician" (2012; 366:1849-1853).
Dr.Okie clearly describes key uncertainties in the state of play of primary care, and notes specifically, that depending on how one views the potential for expanded practice by nurse practitioners and physician assistants, we may, or may not, confront a shortage of primary care physicians. The potential of expanded roles for ancillary care providers coupled with rapidly advancing information technology offers impactful opportunities to redefine the role of primary care physicians.
The potential for change is fundamental and broad, with some models for team-based care apparently envisioning physicians primarily as leaders of teams rather than as providers of care. The changes in expectations and training required to operationalize this degree of transition are significant, and evidently current trainees are concerned that their hospital intensive training model may inadequately prepare them for their (presumptive) emerging roles in community based primary care.
There are lots of moving parts in this dynamic, who (actually what level of provider) will provide care, what will the structural models be, who will 'lead' the evolving teams of providers, and how will primary care fit into the overall system of care, integrating with both outpatient specialties and a growing hospitalist cohort? Essentially, how will the nature and scope of primary care practice be defined, and how will these vary in different settings?
Absent consensus on these and other fundamental questions, it is really not possible to develop definitive answers; instead, we shall likely continue with a particularly American approach of experimenting with multiple models and sharing experiences of success and failure, a sort of health care "federalism".
One thing is certain, assuming that the Affordable Care Act is upheld and large numbers of new patients enter the system, it is important that these questions be thoughtfully considered and addressed. Significant new demands make it critical that limited resources be wisely allocated. Dr. Okie has performed a valuable service by focusing our attention on these vitally important questions.


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You Need More Than a Tarp to Keep Your Boat Covered
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In tough economic times some boaters are tempted to let their insurance coverages lapse. Should you ever need to use your watercraft insurance, however, it is one of the best investments you could make. Here are some things to consider:
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Your watercraft needs protection on the water, and on land, with coverage for you, your guests, and your boat. Thinking of buying a boat in California? Check with us at M3 Monagan Miller McCreary Insurance to see what it will cost to insure it.
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M3 Monagan Miller McCreary Insurance: Come for the Savings...Stay for the Service.
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The dance hall was quite the experience! I danced with some gentlemen my Papaw's age, and over the course of three hours, they only played about three songs that I recognized. (I loveee country - new and old - so they were playing some really obscure songs!) I didn't get home until after midnight, slept a few hours, and then went to the flea market with my family the next day.
Happy Memorial Day!
P.S. - My Facebook page could really use some love! I'd love to like your page, as well, so when you stop by to like, leave me a comment with your link, and I'll like your page back :)


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Beautifully decorated shop with traditional and unique items of the highest quality. Great attention to detail.
Pros: fresh and carefully made products
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RV Park Regulations
The following regulations are intended to provide all guests of the Magnolia RV Park with an enjoyable and safe experience.
Check-in Time: 1:00 p.m.
All guests must register upon arrival. Rates are based upon
the current rate schedule posted in the office. DMV registration may be requested at
Check-out Time: 12:00 p.m. Campers staying over must re-register before checkout. Prior reservations take preference over change of plans.
Pets: Pets are welcome. Dogs must be leashed while on park property. No dog pens of any type are allowed on park property. If pets are tied outside on the owner's site, they must be attended. Do not tie pets to any of the park trees or fixtures. Cleanup is required and enforced and is the responsibility of the pet owner. Aggressive or disruptive pets will be banned from the park. Pets are not allowed inside any of the park buildings.
Limit: Please obey the 5
mph speed limit.
Quiet hours: Please be considerate of other residents. Quiet hours are 9:00 p.m. to 7:00 a.m. Please be reasonable with your TV and radio volumes. No generators shall be run. (Exceptions may be made in the event of power outages.)
Fires / BBQ: Fire rings that are off the ground and have screen covers are allowed at your site. Please be aware of flying ash from your equipment so as not to interfere with other campers. All fires are to be put out by 12:00 midnight and debris cleaned up. Let coals in BBQ extinguish themselves. Please do not dump ashes on ground.
Smoking: Smoking is not allowed in any of the park buildings. Dispose of your butts in a trash/smoke receptacle, not on the park grounds.
Showers: Showers are for overnight paying guests only.
Laundry: Effective use of the laundry room is made possible by your cooperation. Please clean washers & dryers after each use and obey all posted signs in the laundry area. NO outside clothes lines please.
Trash: Deposit trash in tied bags inside of the dumpster.
Trees: No trees are to be cut, damaged, or harmed in any way. No rope, string, or wire may be attached to trees, vegetation, poles or County property at any time.
Vehicles: Only two cars are permitted per site.
Motorbikes: Unlicensed motorbikes and/or motorized scooters are prohibited. Posted speed limits must be observed.
Sites: Sites are to be kept clean at all times. Don't park on grass area or put anything on the grass without permission.
Sub-rental: Recreational vehicles at Magnolia RV Park are to be used solely by owner. No rental of units is permitted.
Repairs: No vehicle repairs, maintenance activities, fluid changes, washing/rinsing of vehicles / RV's are permitted in the park.
Pond/Fishing Rules: No swimming or wading is not allowed in pond. Children under 12 must be accompanied by an adult when around the pond. No boats are allowed. Catch and release only!
Children: Parents are responsible for their children at all times. Management assumes no responsibility for injury, accidents or losses from any cause. Management is not responsible for loss of personal property or for accidents of any nature. Management reserves the right to limit the stay and number of persons per site.
Thank you for obeying these rules. We hope your stay will be enjoyable and you will visit us again soon!


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"Perpetual Light" e.p.
(Rusted Rail)
  1. Gulliver
Rusted Rail is proud to announce the release of "Perpetual Light" a ten-track 3inch extended player by folk voyagers Cubs.
Recorded in Ireland, Northern Ireland, England and Sweden, "Perpetual Light" emerges as a loose sequel to their
"Willowfield" EP from 2012. Traversing territories and sonic space, inhabited by ghosts, birds and bells, this 3"
EP is housed in a hand-assembled and hand-stamped card sleeve featuring a cover photo of a Super8 still from a
film by Cecilia Danell.
Click here to read the liner notes
(Rusted Rail)
  1. Willowfield
Rusted Rail is proud to announce the release of "Willowfield" a
ten-track 3inch extended player by outsider-folk outfit Cubs. Recorded
in Belfast, Cork, Galway and Sheffield, these bijou pieces form an
intriguing mosaic of 21st century psychedelic-folk. For this
recording, Cubs comprise six collaborators: Aaron Hurley (Phantom Dog
Beneath The Moon), Cecilia Danell, Eddie Keenan (The Driftwood Manor),
Paul O'Reilly, James Rider (United Bible Studies) and Keith Wallace
(Loner Deluxe) who craft a fine patchwork of lysergic late night
lullabies, spooked campfire ballads and space age folk transmissions.
This 3" EP is housed in a hand-assembled and hand-stamped card sleeve
featuring a cover photo by Cecilia Danell of an acoustic guitar that
perished during the recording of the EP.
Click here for some reminiscences on the recording of the Willowfield e.p.
"The Whispering Woods"
(Rusted Rail/Deadslackstring)
  1. Stonewater
Also Available - Rusted Rail and Deadslackstring are proud they announced the release of "The Whispering Woods" by Cubs -
a recording project featuring members of Phantom Dog Beneath The Moon, United Bible Studies, C Joynes,
Plinth, Agitated Radio Pilot, Yawning Chasm and other travellers on the folky-margins.
Featuring eleven musicians and thirteen songs, the album was recorded in Ireland, England and Africa.
Born out of improvisation, Cubs have delivered an album album of 21st century psych-folk stylings comprised of late night lysergic lullabies, occasionally electrocuted acoustica and cosmic composition, while also finding time to take in spectral strings, backwoods progressions and tripped-out trad. The album is housed in a beautiful hand-assembled sleeve.
"Stonewater" E.P.
(Rusted Rail)
Also Available - "Stonewater" ep (2007). Formed under the influence of long winter nights and the avoidance of
musical hibernation Cubs have delivered an ep of intimate, improvised instrumentals and night time melodies. These
recordings emerged from late night sessions beneath the stars and rain in a glasshouse in Galway on the west coast
of Ireland, and veer from oblique takes on folk to rustic evocations with a hint of the space-age through to bijou
interludes. Weaving mandolin, guitar, accordion, tin whistle, banjolin and occasional wordless singing, Cubs forge a
completely improvised yet coherently intimate set of songs.
Video for "Lunar Electrification Program" by Cubs.
Made by tinyEpics.
Video for "Blackberry Lane" by Cubs.
Video for "Willowfield" by Cubs.
Video for "Gulliver" by Cubs.
Video for "Lowering of Ropes" by Cubs.


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My friend & I were talking about why kids didn't take to the new line. He used to be a fan of He-Man when he was a kid, but he always thought the name "He-Man" didn't make sense because "He" and "Man" are the same. I started thinking, what if Mattel decided to tell the story of He-Ro instead of He-Man? I think "He-Ro" probably would have sound better to the kids than "He-Man". I really think the Powers of Grayskull might have been a hit with the kids in the 80's, but also in 2001. It's a shame it never came to be.
What are your thoughts on this subject?


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Thank you so much you have to spend some time visiting here! Many complain occur in everyone, but you have to overcome them. Looking up, down, forward, backward and into the mind is a choice.
Sometimes life is hard, but there is always a way that you can go through. All the things that you have encountered has meaning, you may be confused at this time. In many places, many people have had is quickly frustrated and always run to negative actions. Are you used to talk a lot to other people? Keep your secret, all information must be analyzed.
Do you still need a quote for encouragement or inspiration? I hope the above quotation helpful for you, make sure you do not miss the more interesting quotes. Thanks for visiting shortquotepics, This image posted by Donald Joel.


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In Her Own Words: The HCD 10's Jennie Evans
Wanderlust has led Jennie Evans to many different parts of the world. At a young age, she would look through travel books and pick out spots she wanted to visit. "I was always thinking beyond my current geography," she says.
She's traveled to several continents, including Asia, South America, and Europe, and a few years ago fulfilled a life-long dream backpacking along the Salkantay Trail to the Incas in Peru.
That quest for new landscapes has also influenced her career. Fresh out of nursing school, she took a job as a travel nurse, where she received short-term contracts to work in a number of locations across the U.S.
The realization to work in healthcare design came later in life, and of course, it was during a trip—this time aboard a ferry boat back from Alaska—where she learned she could use her nursing background to influence the design and architecture of healthcare spaces.
Nineteen years ago, she packed her bags and moved to Dallas to work at Children's Medical Center in Dallas, where she served as a clinical liaison on a major ICU expansion and bed tower renovation. She eventually made the leap to the architecture firm side, where she now works as associate principal and senior vice president at HKS.
This year, Evans, who is also a past president of the Nursing Institute for Healthcare Design, was named the HCD 10 association/foundation executive for her work.
In this HCD 10 podcast, she talks about how her career path has given her have a more empathetic viewpoint for healthcare design, the biggest concern she hears from nursing staff and physicians, and why she'd like to see the industry find a solution to improve clinical integration and communication within the healthcare team.
For more HCD 10 podcasts, read "Getting Up Close And Personal With The HCD 10."


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Healthy Mixed Herbal Drink
Click Image for Gallery
1 Carton: 24 bottles x 325 ml
Shelf Life: 24 months
Ingredients: Sugar 8.0% Chrysanthemum Flower Water 3.4% Grass Jelly Leave Water 1.4% Liquorice Root Extract 0.14%
About the Product:
Made from herb and natural ingredients, this delicious mixed herbal drink is healthy and super refreshing drink. It can also prevent ulcers and dehydration.
Product Highlights:
- Made from quality herbs.
- Healthy and refreshing drink
Standards: Thai FDA, GMP, HACCP, Halal,ISO9001:2008


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Renault Duster 4WD Coming Soon
While Renault Duster already became one of the successful Vehicle, Renault releasing Duster 4WD (4 Wheel Driving) very soon date is not yet announced. India is the 4th largest market for Duster sales. This upgrade is made mainly to overtake XUV500 and other vehicles in the market.
Recent Posts


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Adderall is the drug indicated to treat ADHD as it controls hyperactivity. This medication found to be highly effective in treating people affected with ADHD. It is a combination of amphetamine and dextroamphetamine and these stimulants affect the chemicals in the brain responsible for impulse and hyperactivity. It is an oral medication that mustn't be taken beyond the dosage prescribed by the doctor as it is a habit-forming medication.
The dose strength and the dosage vary from person to person and the doctor would be the best person to judge as to who must consume how much. Depending on factors like age, the extent of the condition and the way the patient reacts to the medication, the dose strength will vary and also the frequency of administration. However, almost every person is given a lower dose strength initially and then gradually increased based on their response.
People with allergic reactions to stimulants, heart-related problems, overactive thyroid, glaucoma and a history of drug addiction must report their problems to the doctor before taking the medication. A patient's complete medical history also has to be discussed with the medical practitioner so that interactions between the various medicines taken by the patient can be avoided.
Side Effects
The medication does come with some side effects and the ones experiencing one or many of these effects must report to the doctor immediately. Increased heart rate, dizziness, dry mouth, loss of weight, loss of appetite, abdominal pain and mood changes are some common side effects. If a person experiences convulsions, hallucinations, breathing problems, vision problems or chest pain, an emergency room visit is a must.
Where to buy Adderall without a prescription?
Online Pharmacies are considered to be the best place to purchase your Adderall without prescription in a hassle free manner. Internet drugstores have also positioned themselves as the portal to purchase the best quality Adderall medication at a discounted price without compromising on the quality of the medications.


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Take the one pot pledge!
If you've never grown anything to eat before, then I have just the challenge for you!
Garden Organic, the leading gardening charity, aim to get 30,000 people who have never grown anything before to give growing a go with their "One Pot Pledge"
As you know, one of my sayings is that you don't need a garden to grow food and the One Pot Pledge is all about supporting people with limited space. You can grow on your windowsill, in window boxes, patio pots, hanging baskets or a stack of tyres. Whatever your space you are only limited by your imagination.
Last year, the National Trust ran their 'Grow veg on your ledge" initiative, encouraging UK householders to turn their 600 acres of window ledges into veggie patches. Their suggestions for the top five leg veggies were lettuce, radish, beetroot, rainbow chard and creeping rosemary.
Garden Organic recommend summer salad leaves, rocket, coriander, dwarf beans or basil as crops that are easy to grow, so there is plenty to choose from!
When you sign up to take the "One Pot Pledge" you will be entitled to discounts and offers through Garden Organic. If you have some experience to share you can still join in the fun; why not share your knowledge by signing up to be a 'Gardening Guru'?
Growing food; even just a small amount in just a pot, gives you the opportunity to connect with the food you eat and it's a wonderful activity to do with children. As well as saving you money and encouraging healthier eating, growing your own food helps you live more sustainably.
Despite the huge increase and interest in 'grow your own' many people still don't know where to start when it comes to food growing. Many are put off because they think they don't have enough space, time or knowledge. By encouraging people to start small with just one pot, the One Pot Pledge campaign aims to make growing easy and successful.
What about you – are you a complete novice; could you join in with the challenge, or are you an experienced "Garden Guru" with some knowledge to share?
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Tags:If you enjoyed this post, click tags below to show posts on similar topics, or why not add a comment?
2 Comments »
sarah rodriguez says:
What a great idea! Our garden last year produced an enormous amount of food! Almost more than we could eat! From one little patch of yard.
Mrs Green says:
@sarah rodriguez: Hi Sarah; it's amazing what you can grow in a tiny plot isn't it! Hope you have a good growing season this year too 🙂


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Ireland can certainly hold it's own when it comes to distinct artisan cheeses, and this selection will not fail to impress those who already knew that, and those who have yet to find out.
Irish cheeses we like to include:
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Drupal 7 Development
Drupal open source application platform has evolved to greater offerings with its Drupal7 version for greater benefits to corporations, commercial and industrial environments. Greater expectations of dynamic web business sites are heightened with the emergence of Drupal7.
Our website designers and developers are ready to take on any Drupal7 design and development projects with our foresight of the dynamism of this new technological development tool. Our team of website designers and developers are trained and well versed with the available Drupal7 features to be manipulated for the best effect on our client's web business site.
We are equipped with the right technical skills and knowledge to exploit the powerful and advanced features of Drupal7 in setting up the most dynamic and versatile content management platform for any site desired by any company or individual.
Advanced Features of Drupal 7
Drupal7 offers more advanced features in the design and development of the preferred website that ensure a smoother flow of transactions to bring on higher outcomes for the user.
Some of the advanced Drupal7 features include:
- Greater User Friendliness
- Users of Drupal7 platforms enjoy the ease of completing daily tasks without being a routine with an enhanced administrative interface.
- Significant improvements on the functionality of content editors and site builders
- Greater Flexibility
- Users on Drupal7 would feel comfortable with the simple content structure that allows personal flexibility and creativity.
- Custom fields can be easily added to any part of the site with over 800 modules in Drupal7 for creativity, innovation and website extension or expansion at any time.
- Greater Scalability
- Drupal 7 website users are going to enjoy faster speed and quicker system response that should promote the system better than before.
- Web business would enjoy a significant improvement in CSS optimization feature along with JavaScript and cache functions.
THE ONES to Call…
We are well equipped with the best of resources to handle any blog sites, micro sites, social community sites and corporate sites using Drupal7 solutions. Our highly competent Drupal7 team is always kept abreast with the new and advanced features to be one step ahead of our competitors.
We pride ourselves to be a committed and diligent CMS service provider, designer and developer with a stellar track record in projects under Drupal or Drupal7 platforms as well as other environments.
Our unblemished reputation puts us at the front of the pack as technology industry experts with a wide multinational clientele that spans the globe.


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Most people are sad to see summer go. I can admit I hate summer. I LOVE Fall and hope we have a nice, long fall. My summer started with a visit to the hospital..my first time ever (as a patient). I was dragging most of the year and when I went to the doctor in early June, I had a 103.8 temp and pneumonia and was immediately admitted. It was an awful experience and I hope to never have to go back to a hospital. Once I was released, I followed their orders and took some much needed time off. Then, the summer concert series started at the Today Show and Good Morning America and I was back out, camera in full force! Here are a few of the concerts I covered this summer:
Afro Jack with special guest Sting Dee Snider of Twisted Sister performed to a packed crowd at Fox and Friends. I shoot A LOT of concerts and they BLEW ME AWAY. Just fantastic and Dee's voice is so powerful. Demi Lovato Ed Sheeran Jennifer Lopez John Legend Keith Urban Maroon 5 (Adam Levine) Mick Jagger at the "Get On Up" premiere at the Apollo Theater Jennifer Hudson. She is SPECTACULAR! Her stage presence, smile AND that voice...just amazing! I have been hired to shoot scenics and touristy type photos of NYC for a brochure...here is just one. I will post more about this wonderful job at a later date. Brad Paisley I went to the Book Expo at the Javitts Center....my next book, "You Don't Have to be Purrrrfect" will be released next month. I had a blad, and a copy of my "Bruce Springsteen In Focus 1980-2012" book and ran into Billy Idol. We smiled at one another and I said "My book is bigger" and he gave me this great look. Billy was one of the first musicians I ever photographed back in 1980 (after I shot Springsteen and Southside Johnny) while a college student at RIT. Lady Antebellum Heidi Klum. Always gracious. Simone and Lab get married in Central Park. What a great couple. My FAVORITE assignment of the summer...if not the year. I have loved actor Chris Pratt since seeing him years ago in "The 5 Year Engagement." This assignment was to follow him around as he surprised some lucky kids who were seeing a special screening of his hit movie "Guardians of the Galaxy." Not only is he gorgeous, he is super friendly, charming, down to earth and just a wonderful man. When the movie was over and ALL the kids wanted selfies with him, he did not disappoint. He stayed LONG after he was scheduled to leave to make sure not one kid was left out.
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All Films.All Above Board.NOW INCLUDES TV SHOWS & TV LISTINGS
Mike Leigh's violent and disturbing look at the milieu inhabited by London's homeless. David Thewlis is the motor-mouthed protagonist; bitter, cynical and on the run from Manchester after raping a woman. He arrives in London, shacking up with his ex-girlfriend and her gothic flatmate, before drifting onto the streets - undergoing a series of encounters which convince him of the spiritual emptiness of modern life. As with many of Leigh's films, the dialogue was often improvised by the cast.


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The University of Kentucky's Sanders-Brown Center on Aging has been awarded an $8.25 million, five-year grant to continue its work on Alzheimer's disease.
The grant will continue Sanders-Brown's designation as an Alzheimer's Disease Center, one of only 30 in the country. UK's center was among the first 10 centers designated in 1985, and it has been continuously funded since then.
"We're honored that the NIH continues to recognize the caliber and scope of our work with this grant," Sanders-Brown director Linda Van Eldik said.
Sanders-Brown specializes in detecting early changes in the brain associated with Alzheimer's and other age-related dementias, Van Eldik said. The work is made possible in part by a large cohort of more than 800 volunteers — both healthy and cognitively impaired — in the Sanders-Brown Longitudinal Study. The study generates significant amounts of data about how healthy brain aging occurs, and when and why some people develop Alzheimer's.
But, she said, Sanders-Brown tries to help entire families.
"We often say Alzheimer's is a family disease," Eldick said. "It affects the patient primarily, but it is a devastating financial and emotional burden for family and caregivers as well. Sanders-Brown offers outreach, education and support to help patients and their families get the help they need to lead active and engaged lives."
Sanders-Brown opened in 1963. A grant from the Eleanor and John Y. Brown Jr. Foundation in 1972 started the construction of the current Sanders-Brown Research Building on South Limestone. The center was named for the Browns, and John Y. Brown's business partner at the time, Col. Harland Sanders, the creator of Kentucky Fried Chicken.
UK President Eli Capilouto said UK is one of 21 universities in the United States to house a National Cancer Institute research center in Markey Cancer Center, a NIH-funded Center for Clinical and Translational Science and an Alzheimer's research center.
"The Sanders-Brown Center on Aging is one of UK's outstanding centers, and continued federal funding from the National Institutes of Health is yet another acknowledgment of its excellence," Capilouto said. "The University of Kentucky is proud to play a leading role in the international effort to discover solutions for what is arguably one of society's greatest medical mysteries and challenges."
Linda Blackford: 859-231-1359, @lbblackford


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Tony Popovic can take Andreu out of Spain but he'll never take Spain out of Andreu, the new Western Sydney Wanderers signing says.
The 32-year-old Barcelona youth product has vowed to stick to the style he knows and loves when he makes his likely A-League debut against Brisbane Roar at Pirtek Stadium on Thursday night, in front of impassioned home fans.
After more than a decade with the Catalan giants including time playing for the Barca B side before moving on to Malaga, Spanish football is well and truly in Andreu's blood.
"My style is keep the ball, play for a while, and try to keep the balance between defence and attack," said the midfielder, whose fellow childhood students included the likes of Lionel Messi and Andres Iniesta.
"I enjoy keeping the ball, and trying to give good ball for the forwards.
"This is my style, I cannot change."
Popovic's off-season recruitment would indicate he is fine with that.
As part of his enormous roster transformation - the squad is almost unrecognisable - the coach also signed other Spaniards in midfielder Dimas, defender Alberto and assistant coach Andres Carrasco.
It's undoubtedly part of a wider trend that has led to Spanish players finding their way onto the books of five clubs this season, though Popovic has previously said the signings were more a by-product of the Eurozone's financial problems.
Nevertheless, it provides enticing opportunity for a new awakening following last season's lowly ninth place, in a campaign blighted by a gruelling workload that also took in the Asian Champions League, FIFA Club World Cup and FFA Cup.
Andreu is looking forward to working with an eclectic mix with teammates, including returned Socceroo Dario Vidosic who is back in the A-League after an unhappy two seasons in Switzerland with FC Sion.
"(So) it's not the Spanish style - it's Popovic's style," Andreu said.
"He wanted to play like that from the first day.
"I think everybody's very happy with the training. It's sometimes very hard, but they are very happy with this style."
Andreu said the perception in Spain is that the A-League's level is improving as the league continues "growing up".
"I've played maybe just three games against teams from here but in the first minute the level is very high, very intense and physical.
"The players have very good quality and technique, and the A-League we can compare with the second division of Spain for sure."


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Pipeline2, Issue #31: Breaking Into Comics
I first "met" Derek Fridolfs on-line in September of 1996. We were both members of the FAO – Fin Addicts On-Line – a mailing list for fans of Erik Larsen's SAVAGE DRAGON comic. He's been the most serious of all the comic artist wannabe's I've ever known in my time in comics fandom. As of this week, he's a "wannabe" no longer. His inking can be found gracing 11 of the pages of the current issue of WOLVERINE (#147). That's just the beginning, though, of a promising career.
Like many, he first started reading comics as a result of G.I. Joe and Transformers, almost 15 years ago. His artistic leanings have been evident since way before then, though. He grew up as that kid in school who could draw stuff. It didn't get serious until his last year in high school when he realized that drawing stuff wasn't just something he liked to do on the side, but something that he actually loved to do. And although he went to college as an English major on a full music scholarship, art became an even bigger interest for him, thanks in large part to another animated series, BATMAN. Soon, he joined up with a group of fellow artistic souls and began to push his creativity. It was there he first started learning how to be an inker, and for a pretty pragmatic reason.
"I was one of the last ones that joined the group," Derek says. "Most already were pencillers, but they needed someone to ink them. It was only by that chance that I was introduced to starting out as an inker. And I've loved it ever since. I think my own pencils and inks favor my own tastes and were more for my own enjoyment. But I feel that I can bring more as an inker to those I get the chance to work over. Plus, it's a joy getting the chance to work over so many different talents and trying to make a total package."
After receiving his Bachelors in English, Derek went to animation school near Los Angeles. In today's comic market, this isn't a bad backup plan. More and more comics artists are finding work outside of comics, particularly in animation.
So how does an English degree and an animation school background get one the job inking on Wolverine? It's a curious mix of skill, good timing, and networking. Like so many young hopefuls, it begins at the annual International Comic-Con: San Diego, a/k/a San Diego Comic Con.
"After the San Diego Comic Con this past August, I had high hopes that I would finally, after a few years of trying, land something," Derek explained to me in an e-mail conversation. "I showed my samples around to various editors and companies, and had a few places interested in what I could do. And keeping my options open, I hit up both comics and animation.
"After the San Diego Comic Con this past August, I had high hopes that I would finally, after a few years of trying, land something."
– Derek Fridolfs
"On the animation side of things, I met with Sony and WB, both of whom I received storyboard tests to work on (for STARSHIP TROOPERS and BATMAN BEYOND respectively). I worked on those first, since those were the places I heard from right away. But animation, like comics, is very tough to get in… not only due to the need to have great talent and ability (which I still have much to learn), but also due to how the companies hire. They're very seasonal, hiring enough to work on a show for a given amount of months and then laying them off until production begins either on another season or on a new show. In any case, I was pretty much out of luck on both, but was happy to have gotten the opportunity to at least get tested."
In San Diego this year, Derek ran across the DC Booth, where a signing was being held with STEAMPUNK co-creator Chris Bachalo, whom Derek had previously talked to and inked samples from. Bachalo was interested enough to ask Derek to do some samples for him for his then upcoming STEAMPUNK series. Derek didn't get the job, and Richard Friend eventually filled the position.
Shortly thereafter, in stepped CrossGen Comics. Derek had met with art director Brandon Peterson at the convention and submitted samples there. After being one of some 900 inking submissions, Derek made the cut to the last 6 inkers for the position. Derek described the process to me:
"They took all the submissions and judged them off of the talent itself and not off of the names… be they long-standing pros or first time amateurs. I made it to the final phase, which [meant] they'd be sending me 3 sample pages to ink over and send back."
In the end, Derek didn't make the cut.
"Needless to say, by this point of time," he continues, "I was pretty much in a state of depression. It's one thing to spend a few years working on samples and mailing them off to companies only to not get a response back or to get a form letter saying they didn't have a position available. But it's another thing to actually have a few very high profile chances, one right after the other, just not get close enough to land them…
"Needless to say, by this point of time, I was pretty much in a state of depression."
– Derek Fridolfs
"Well, eventually I decided to send a few emails out to some pros for some advice on what I should do next. One person that I talked to was Tim Townsend. I was pretty much surprised to hear back from him, that he had just talked with Chris whom mentioned my inks on the STEAMPUNK samples…how close I was to inking STEAMPUNK…but that they understandably wanted to go with a more proven talent on such a high profile creator-owned book. It lightened up my day to hear that. And I think just out of sheer pity from hearing my long sob story, Tim made me an offer that if I sent him a few enclosed samples, that he would get it into the right editors' hands at Marvel. It wasn't a guarantee for a job, but it was going to get through the door to the right people. It was a great opportunity and I jumped at it.
"It was only a week after I sent [the samples] to him that I actually got a call from Marvel. Editor Mark Powers received my samples that Tim passed to him, and he liked my samples over Joe Madureira that I sent, and thought I'd work well inking over Roger on Wolverine. Never would I have dreamed that a call, much less a high profile title like Wolvie, would come my way…and quickly. So how's that for inspiration? Sometimes, things actually do work out alright in the end. Keep pluggin' away on samples, and attending conventions, and anything is possible."
Don'tcha just love a happy ending? Come back here next week for part two of the interview, with plenty of tech talk about the art of inking.
In the meantime, pick up WOLVERINE #147. Derek inked pages 1, 4, 6, 10-16, and 22. Then let him know what you think.
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love this very nice 3d effects and the colour you have chosen works great. what program do you use to get the 3d effects?
Artist Comment
Hey i haven't done any work latly(due to lack of inspiration) so here we go the first one in a bout a week
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twistedfreak Sep 07, 2005
SimonPro Feb 23, 2006
wow, nice job on the breaking of the dimensions ^^
btw, can u plz show me how to do a similar wallpaper like this?
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text: ShopABot Review Archive 0 ShopABot Review – Start A Campaign That Will Make You Money FOREVER Written on March 10, 2018 by admin in Software & Program ShopABot Review – is a revolutionary way to profit as an Amazon affiliate. It's the only Amazon store that is truly automated AND comes with inbuilt traffic technology that is guaranteed and proven to generate sales. ShopABot Review "See it how amazing in action right now" . 1. Overview Vendor: Cindy Donovan Product: Shopabot Launch Date: 2018-Mar-15 Launch Time: 11:00 Read More


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gig alert
Give the singer hidden in you a chance at the Cray Cray Karaoke event. KJ Abe will make sure you forget all your inhibitions, and sing your heart out! Get your friends along, grab some beer and a mic, and belt out your favourite tunes. June 23. Entry free. At 153 Biere Street, Whitefield. 8.30 pm. Details: 9845887454
Night watchman
Here's your chance to watch movies under the open sky. SteppingOut, a lifestyle membership programme, will organise an outdoor movie screening, of The Lion King, at the beautiful lawns of JW Marriott. Grab a chilled drink from the bar, and enjoy the film. June 19. At Vittal Mallya Road. 4-10 pm. Tickets (`330) on bookmyshow.com
Move and groove
The Humming Tree and DesiHipHop.com launched 'Hum Hip-Hop Project' recently. A monthly showcase, it will highlight hip-hop talent from across the country. This Saturday, the artiste line-up includes Third Degree, Bijju and Su.1, and the evening will be hosted by rapper, Smokey the Ghost. June 18. At Indiranagar 9 pm. Tickets (`500) on insider.in


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FDA approves expanded label of Abilify Maintena
Otsuka America Pharmaceutical Inc. and Lundbeck said the FDA has approved the expanded label of Abilify Maintena® (aripiprazole) for extended-release injectable suspension. The new deltoid injection site is for caregivers administering Abilify Maintena to patients with schizophrenia.
The medication is the only once-monthly injection of a dopamine D2 partial agonist for patients with schizophrenia. Previously the only allowed injection site as in the gluteal area.
"Having more choices and flexibility in the administration of Abilify Maintena for the treatment of schizophrenia may help strengthen the patient-physician alliance for the long-term management of the disease," said study investigator David Walling, Ph.D., chief executive officer and principal investigator, CNS Network. "It is important to offer an administration option for the deltoid muscle, in addition to the gluteal muscle, because some patients and physicians prefer the deltoid muscle site for injection."
This new deltoid administration offering for Abilify Maintena is scheduled to be available in the fall.


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Trading Bitcoin is really amazing, and provides a large range of advantages over something like foreign exchange trading. The inspiration behind why Bitcoin addresses just be made use of once because is to hide the character of the Bitcoin customer mining among a buy or in different scenarios. Fifth, Bitcoin provide minute purchase gazing in few second of sending and also confirmation in 10 minutes. For larger quantities like USD 1000, it is makes sense to wait for 6 verifications or additional information. Final as today there are no nation recognize Bitcoin as an authority currency, nonetheless, in any kind of particular scenario it is call for to pay, offers, pay-roll as well as capital additional charges.
Is an info website that gives you just what you need to get going with our brand-new digital money, Bitcoin. Its detail exactly what is Bitcoin, how to acquire a Bitcoin account, the best ways to extracting a Bitcoin, software and hardware needed to mining a Bitcoin, and so on
Cloud Mining permits you to buy a particular variety of hashes, to make sure that you receive a portion of whatever the company mines. The company was founded in February 2013, probably among the earliest well-known occasions Cloud Mining. Given that its production, it has actually possessed mining over 27,500 Bitcoins for 5,000 approximately customers. An additional modification from the standard is that they also provide Cloud Mining for various other cyrptocurrencies as well as not simply Bitcoin.
Fortunately is that there are no other fees for you to pay, including upkeep as well as electricity. The newcomers to the Cloud Mining market, Hashie might not be experienced however they are without a question a force to be reckoned with. This was even confirmed on the BTC Guild, the top source for stats for all points Bitcoin. Something to bear in mind with Cloud Mining is that it can be difficult to turn a profit, either over a long or short period of time. There are several aspects to bear in mind, such as the problem for mining Bitcoin, upkeep costs, period of your contract, estimated result of your miner, etc.
. Prior to buying any Cloud Mining contract, I 'd extremely recommend using a productivity calculator, to establish whether or not its worth your money and time. Being web based, you need a place where you can keep your Bitcoins while playing, wagering, trading or extracting them.
It is suggested for a beginner which has an interest in mining to download and install the client for their operating systems. You should ensure you have your purse address since you will certainly sue the address in mining Bitcoins. Bitcoin Casino poker has actually enhanced its popularity specifically on-line as a result of such an application of Bitcoin Pocketbook. The following factor for beginners to keep in mind is that you should make sure that your Bitcoin Wallet is secure. As soon as you have a wallet and a client you are almost prepared to mine Bitcoins online.
For novices, it is important to note that if you actually want to make serious Bitcoins online for say Bitcoin Betting then you need to join a swimming pool. Being in a pool raises your possibility of gaining Bitcoins which you could use to play Bitcoin Online poker.
The truth is that mining bitcoin is merely also difficult today for individuals without access to one of the most powerful specialized chips. Remember that with extracting different crypto moneys, it is your relative, as opposed to downright, calculating power that is very important.
Somehow the LTC bandwagon is currently well underway, the excellent time to get into mining was a year earlier. Actually the surge in rate of LTC in November was bigger than that of BTC; as well as the drop on Dec. . In addition it is likely that the problem will certainly not rise as quick, so "pastime" mining will remain to be feasible. You need to definitely backup as well as encrypt your pocketbook (and also make certain you have the password cunningly hid someplace quite risk-free). There you will certainly locate your wallet address, a lengthy number starting with L (view photo listed below).
You can naturally enter litecoin merely by acquiring or offering it, without ever obtaining associated with mining your own. Mining with a CPU will be really sluggish, as well as you will possibly invest a lot more on electrical power compared to you will make from the little amount of coins you get. Mining in a pool protects you from the inconsistencies of good luck, over a month you will get near to just what you are statistically forecasted to mine given your hardware. When you have actually chosen your mining pool, you will certainly have to sign up, with a username as well as a password. It is therefore extremely important that you make the effort to choose the most effective Bitcoin pocketbook for you.
If you are mining with only one computer, create one employee, if you are making use of several setups, it is best to create a worker for each and every equipment. In this manner your mining efforts will certainly be included in the swimming pool and also you will certainly be paid your share of coins obtained. The (slightly) problem concerning CUDAMiner is that there is no version with a graphic interface, there are no pretty buttons to press, areas to load, and also drop down listings.
Hi, tirelesstraveler well I do have a center about bitcoin: but I'm uncertain it will certainly answer your concern. The secret key resembles an inner password which is used to authenticate any type of purchases made by your pocketbook.
This post will consider some of the best Bitcoin purses for newbies, giving a brief evaluation and also web link for each one. Each of these Bitcoin wallets should be simple and also fast for newbies to find out the best ways to utilize, as well as should offer you with a great volume of safety and security. Before I jump on to recommending particular items, I think that it is well worth while taking a moment to examine the various different kinds of wallet that are available. Each of these different types of wallet has its very own benefits and also drawbacks, so you selection will depend on exactly what your very own individual top priorities are.
Typically it is considereded as more suitable to use a finances which provides you control of your secret trick. Individuals with a great deal of coins might have a cold budget – something like a savings account or safety deposit box – as well as a 'warm finances' for day-to-day usage. Paper Budgets: A paper purse is simply a print out of all the information you should spend as well as recieve Bitcoin Because it is not saved on a computer, a paper budget could not be swiped by hackers, but you still keep full control over your money as you would certainly with a desktop computer pocketbook.


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At the end of April, my boyfriend and I headed up to Washington DC for the Nike Women's Half Marathon. In case you missed my other posts, check out my recap of our first day, my recap of the race expo and how we spent the second day of our trip.
On Sunday morning, the alarm went off at an obscene hour. Seriously, waking up at 4:15 is not healthy for anyone. I did take some comfort knowing that it wasn't as early as my runDisney races though. I quickly got ready and ate a few of the mini Luna bars that I got at the Expotique. The metro was supposed to open at 5 AM and I wanted to be on the first train.
When I was finished getting ready, I kissed my boyfriend, grabbed my gear check bag and headed to the metro station. Thankfully, I didn't have to worry about changing trains because there was a slight delay that had my nerves on edge. I made it to the starting area around 5:45 and found a spot to hang out. Since I wasn't very familiar with the area, it took a little effort to find my bag check tent.
While I waited, I thought about my goals for the race. Ultimately, I wanted this to be my goal race for the season but I knew that wasn't going to be possible. My training wasn't even close to where I wanted it to be. I settled for finishing the race in under 3 hours because I knew that I could do that. I also wanted to enjoy the scenery. I was so excited to be running through the streets of Washington DC. The course was designed so that we would be running past a bunch of national monuments.
At 6:30, I checked my bag and headed to my corral. In the other races I have participated in, the corrals have always been based on the anticipated finish time. This race was a little different. When I picked up my race bib, I was given a wristband with the pace I expected to maintain and that is what determined my corral.
Miles 1 – 3:
- Mile 1 – 9:28 min/mile* –> Running through a tunnel.
- Mile 2 – 11:58 min/mile
- Mile 3 – 12:48 min/mile
Just after 7AM, the race started. Despite being in corrals, there was a lot of congestion at the start. I think it was because the corrals didn't have separate starts. The course started on Pennsylvania Avenue with the Capitol Building in front of us. It turned right at 9th Street and went through the tunnel. Once I got past the tunnel, the course made a right turn onto the interstate. I knew that I was running faster than I wanted to but when I reached the Mile 1 Marker I was a little shocked. Of course, the bands playing inside the tunnel were fantastic and really got the crowds going. I don't run that fast ever! {*I think the tunnel messed with the GPS on my watch.}
The second and third miles were really good for me. My pace slowed down when I started incorporating my walk breaks but it was the right thing for my body. The course made a right turn on 15th Street. As I ran past the Bureau of Engraving and Printing, I passed the first water stop. I knew that the day was going to warm up so I grabbed a cup of water and a cup of Nuun. The course made a left turn on Independence Avenue when I reached the Washington Monument. I ran past the Lincoln Memorial before making a few quick turns and ending up on the Arlington Memorial Bridge.
Miles 4 – 6:
- Mile 4 – 12:36 min/mile
- Mile 5 – 12:48 min/mile
- Mile 6 – 11:23 min/mile
Halfway across the Arlington Bridge, I crossed a timing mat for the 5k point. Based on the timing clock, I was maintaining a pace that put me across the finish line well before the 5 hour mark. Unfortunately, the temperature was already starting to climb and that would force me to slow down even more. I kept on running though and tried to maintain the best pace possible. I reached the end of the bridge, ran around the loop and then headed back over the bridge. The course made a left turn and continued along the Rock Creek Parkway.
Near the Mile 4 marker, there was the second water stop, which also had Clif Shot Bloks. I was pleasantly surprised to find that the packages were already cut open. I grabbed my Shot Bloks, a cup of water and a cup of Nuun. The course continued along past the Kennedy Center before making U-turn. When I reached the Lincoln Memorial, the course continued straight Ohio Drive towards the East Potomac Park.
Miles 7 – 9:
- Mile 7 – 12:44 min/mile
- Mile 8 – 12:57 min/mile
- Mile 9 – 13:56 min/mile
The East Potomac River Park was a very beautiful park of the course but for me it was where I really started to struggle. It wasn't the miles that were getting to me but the heat. I may live in Florida but I really don't enjoy running in the direct sunlight when it is hot outside. Those are the times when I am on the treadmill. This part of the course didn't had very few spectators so I didn't have their enthusiasm to keep me going.
Nike posted motivational signs throughout the park to keep people moving forward. When I reached the turn around point, there was another water stop with more Nuun and mini Luna bars. I grabbed some fuel and continued on my way. The last mile through the park was definitely the most difficult for me. There was hardly any shade and my body was not really happy with me. My walk breaks were a little longer than I wanted them to be.
Miles 10 – 13.1:
- Mile 10 – 12:52 min/mile
- Mile 11 – 13:01 min/mile
- Mile 12 – 8:06 min/mile* –> Running through the tunnel again.
- Mile 13 – 12:51 min/mile
- Mile 14 – 13:54 min/mile** –-> My GPS totally got messed by the tunnel!
Once I was out of the park, the course made a few turns and headed back onto the interstate. The ramp that I had to run up to get back on the interstate was a lot steeper than I was expecting. My quads were screaming at me the entire time and I wasn't the only one. The course took a left turn and before I knew it I was running back through the 9th Street tunnel. As I looked at my watch, I could tell that my total distance was not matching the course.
On the other side of the tunnel, I knew I was getting close to the finish line but I still had some running to do. The course made a right turn and headed towards the Capitol Building. Thankfully, there plenty of spectators along this final stretch to keep me motivated. I was hot and my legs were tired. I made a large circle around the Capitol Reflecting Pool before heading down the home stretch.
When I finally reached the finish chute, I saw my boyfriend waiting under a tree. I waved and then sprinted across the finish line. Despite how my body was feeling, I was thrilled to run down that red carpet. I had just finished my 10th half marathon!
As I made my way through the finisher's chute, I was handed my Tiffany blue box by a tuxedo-clad gentleman. I also grabbed my water bottle and post-race food. Then I went through the tent for my official finisher's shirt before going search of my boyfriend.
The finisher's area was so crowded that we decided to avoid the lines and just go back to the hotel room. I retrieved my bag from the bag check tent and we walked over to the metro station. Of course, I really needed my post race coffee so we stopped into the Starbucks just outside of the metro station. By the way, I think this Tiffany necklace is one of my absolute favorite pieces of race bling.
Overall Thoughts:
I thought the course was absolutely gorgeous and very well laid out. I wasn't used to the subtle hills throughout the course but they weren't horrible.
The aid stations were only on one side of the course. With as many runners as there were, I really think they should have been on both sides.
I would highly recommend going to the Expotique as early as possible! From what I have heard, the lines were crazy on Saturday afternoon.
Oh and I would definitely do this race again!


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Apple censors Lawrence Lessig over warranty information; iOS 7 mess grows
Make sure you read Lessig's post as well:
Wow, or from the When-Apple-Became-the-Borg Department
Here's another story about an Apple iOS user taking legal action:
Apple taken to court over unwanted iOS 7 install download | Apple - CNET News
I originally though this might be a nuisance suit, but iOS automatically downloads iOS 7 and wastes a whole gig of storage on a user that wants to stay with iOS 6 on their phone. (He's only asking for $50 in small claims court, that seems fair to me.)
It's hard to imagine a worse person they could have picked to censor!
Note that the post was over a new problem caused by iOS 7.0.3.
iOS 7.0.3 isn't all bad [assuming you don't need wifi :-)]:
Apple Releases iOS 7.0.3, Kills Nauseating Animations – ReadWrite
Apple was able to fix the iPhone 5Ss faulty sensor with a software patch:
Apple iPhone 5S sensor bug fixed with iOS 7.0.3 | Expert Reviews
However, there's a new issue:
Robotic testing finds touchscreen inaccuracies at edge of iPhone display | AppleInsider
iOS 7's Lengthy List of Faults is Finally Getting Appropriate Mainstream Press Coverage
An aesthete's take on iOS 7: Ive's Webified interface jumble | ZDNet
Apple Strikes Out with Troubled iOS7 | Sci-Tech Today
Consumers sound off on iOS 7 issues | USA Today
Review: Apple's New iOS Software Plagued by Problems | CIO Today
iOS 7 is a perfect example of why automatic updates shouldn't always happen | PhoneDog
Apple iOS 7: 85 Percent Of People Haven't Used Siri, 46 Percent Think Apple Oversold Its Release
Disable Blur Effects in iOS 7 for Easier Reading, Better Performance
Another daylight saving time bug strikes Apple's iOS 7, affects calendar display
Apparently it is possible to downgrade iPhone 4s, but not iPhone 4Ss using some backdoor (i.e. not Apple-sanctioned) technique:
How to Uninstall iOS 7 and Downgrade Your iPhone 4 to iOS 6 | Digital Trends
AppleInsider still isn't seeing the big picture:
USA Today prints contemptuous trashing of Apple's latest iOS 7 release | AppleInsider
Apple had a Product Launch
It was boring.
Innovation Isn't Dead At Apple—But Excitement Is – ReadWrite
Apple stays in its lane, announces no 'new product categories' | ZDNet
Woz is not buying the new iPad - Woz not Woz | TechEye
Why I don't care about today's Apple announcement | Washington Post
It is good to see the press finally catching on to the fact that Apple is overpriced:
iPad Mini Price Analysis: Why are Apple's iPads so expensive? | BGR
Both the previous article and this next one point out that Apple has already lost the tablet marketshare race:
Google Android takes tablet lead from Apple iPad - CBS News
I'm not the only one laughing about Apple's ridiculous $399 pricing of the iPad-mini-with-retina-display (really Apple, that's the best you could do for the product name?):
Why Apple Inc's iPad Mini price hike is a strange, high-risk move | Financial Post
Apple released the next version of MacOS X "Maveriks", according to this article, its top feature is iBooks, which should tell you just how little is happening there:
Top 10 New Features in Mac OS X 10.9 Mavericks | PCMag.com
One good thing, they finally fixed the VNC bug that kept people from logging in from non-Apple systems. (The bug was in both Lion and Mountain Lion.)
Finally, Apple did something right, they made iWorks free! No, wait! They screwed this up too:
Apple faces backlash over missing, changed functions in iWork revamp | AppleInsider
Free iWork upgrade angers Mac users - Computerworld
Apple's iWork upgrade screwup has Microsoft laughing all the way to the bank | Computerworld Blogs
Apple's free software gives you what you pay for - iWork and iLife fails to deliver either | TechEye
Apple Released Earnings
Generally they met expectations, but then expectations were bad.
Overall Apple's profit dropped by 9%.
Apple reports earnings of $7.5B on sales of 33.8M iPhones, 14.1M iPads & 4.6M Macs | AppleInsider
Many are underwhelmed:
Apple Inc. (AAPL): Apple Is In Deep Trouble: A Reformed Bull Speaks Out - Seeking Alpha
Apple Inc. (AAPL): Apple: Unfortunately It Was A Disappointing Earnings Report - Seeking Alpha
Apple Earnings: iPhone Sales Leap Forward, But Company Stuck Standing Still - Forbes
Apple Inc. (AAPL): Apple - Time To Take Profits As It Cedes Computing Market To Google - Seeking Alpha
Apple Inc. (AAPL): Apple Is Slowly Rotting: Rosy Financials Mask Competitive Disadvantage And Souring Future - Seeking Alpha
More importantly Apple's long term prospects are bad. Apple is forecasting 0.9% to 6.4% growth for the holiday quarter:
Apple Inc forecasting slowest holiday sales in 5 years amid Samsung gains | Financial Post
Apple hints it may not have enough Retina iPad minis to meet holiday demand | AppleInsider
Note that last article is by AppleInsider. Less "optimistic" sources would listen to Tim Cook's comment and say: "Apple likely to not to have enough iPad minis to meet holiday demand".
A side note coming out of the earnings call:
While I find it hard to believe that school districts would waste their precious resources on hideously expensive Apple iPads:
Los Angeles school district's iPad program running grossly over budget
They clearly do:
Apple's education sales breached $1B for first time ever in Q3, iPad share at 94%
Again, this reminds me of the '90s. School districts then continued to waste money on Macs, long after it was clear they were very overpriced.


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Online Muslim Vashikaran
Holy Quran is a perfect supply which teaches the mankind that how to business lead life and it offers the reasons that why a person faces different types of difficulties and problems in his life. Besides this it also give best resolutions for each and every type associated with issue related to any field of life. Muslim Vashikaran is one of the particular methods among them which can remove a number of problems in a very short time period. This technique is applied by making use of specific verses and phrases which usually are taken from Holy Quran; these are recited with special techniques. The particular methods are in make use of from the older occasions and therefore are recommended by the Prophets.
Muslim Vashikaran for love problems:
Muslim Vashikaran for love problems is usually the best resolution for all types of issues which come in love relationships, adore marriage and married life. If your partner will be annoyed with you and he or she is not talking to you then you can use this technique to get him back again to you. If you are deeply in love with someone and you want to get that individual in your existence but you do not have courage to show your feelings then this process will help you in getting the love of that person. If you feel that love and bonding is vanished through your married life then you can certainly apply this method to fill your married lifestyle with affections and adore.
Advantages of Muslim Vashikaran:
-To get your lost love back to a person.
-To get Visa and to travel abroad.
-To win a court case.
-To get promotion and development at work.
Leave a Reply.


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Share the roads
When people who normally ride get behind the wheel to drive a car, they tend to watch for motorcyclists. However, not everybody rides and often drivers don't see motorcyclists. Motorcycles are harder to see than other vehicles. They are small, blend easily into the background, can accelerate faster than other vehicles and it can be difficult to judge their approaching speed.
Check twice
Motorists need to be aware that with basic observation, many dangerous situations can be avoided. Tips for drivers to share the road with motorcyclists include:
- Remember to scan the road environment and watch for motorcycles, especially when you approach intersections.
- Cars have blind spots that can be large enough to obscure your view. Look over your shoulder before you make a move of any kind.
- Check your mirrors and blind spots often, and give motorcycles room in traffic.
- When you're getting out of a parked car, check for motorcycles before you open the door.
- When you're pulling out from the kerb, look especially for motorcycles. They have a narrower profile than cars and can quickly appear.
- Do the same during any manoeuvre. Motorcycles can turn up in the most unexpected places.
- Give motorcycles space. They may have to avoid an obstacle that might not matter to drivers, but could be a serious problem for them.
Check blind spots. Look out for motorcyclists. Give motorcyclists space.