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Incidence and Mortality
Estimated new cases and deaths from thyroid cancer in the United States in 2012:[1]
Carcinoma of the thyroid gland is an uncommon cancer but is the most common malignancy of the endocrine system.[2] Differentiated tumors (papillary or follicular) are highly treatable and usually curable. Poorly differentiated tumors (medullary or anaplastic) are much less common, are aggressive, metastasize early, and have a much poorer prognosis. Thyroid cancer affects women more often than men and usually occurs in people between the ages of 25 and 65 years. The incidence of this malignancy has been increasing over the last decade. Thyroid cancer commonly presents as a cold nodule. The overall incidence of cancer in a cold nodule is 12% to 15%, but it is higher in people younger than 40 years and in people with calcifications present on preoperative ultrasonography.[3,4]
Risk Factors
Patients with a history of radiation administered in infancy and childhood for benign conditions of the head and neck, such as enlarged thymus, acne, or tonsillar or adenoidal enlargement, have an increased risk of cancer as well as other abnormalities of the thyroid gland. In this group of patients, malignancies of the thyroid gland first appear beginning as early as 5 years following radiation and may appear 20 or more years later.[5] Radiation exposure as a consequence of nuclear fallout has also been associated with a high risk of thyroid cancer, especially in children.[6,7,8] Other risk factors for the development of thyroid cancer include the following:[9]
Prognostic Factors
The prognosis for differentiated carcinoma is better for patients younger than 40 years without extracapsular extension or vascular invasion.[10,11,12,13,14] Age appears to be the single most important prognostic factor.[12] The prognostic significance of lymph node status is controversial. One retrospective surgical series of 931 previously untreated patients with differentiated thyroid cancer found that female gender, multifocality, and regional node involvement are favorable prognostic factors.[15] Adverse factors included age older than 45 years, follicular histology, primary tumor larger than 4 cm (T2–T3), extrathyroid extension (T4), and distant metastases.[15,16] Other studies, however, have shown that regional lymph node involvement had no effect [17,18] or even an adverse effect on survival.[13,14,19] Use of sentinel lymph node biopsy may aid in identifying patients with occult metastases who might benefit from central neck dissection.[20]
Diffuse, intense immunostaining for vascular endothelial growth factor in patients with papillary cancer has been associated with a high rate of local recurrence and distant metastases.[21] An elevated serum thyroglobulin level correlates strongly with recurrent tumor when found in patients with differentiated thyroid cancer during postoperative evaluations.[22,23] Serum thyroglobulin levels are most sensitive when patients are hypothyroid and have elevated serum thyroid-stimulating hormone levels.[24] Expression of the tumor suppressor gene p53 has also been associated with an adverse prognosis for patients with thyroid cancer.[25]
Patients considered at low risk by the age, metastases, extent, and size (AMES) risk criteria include women younger than 50 years and men younger than 40 years without evidence of distant metastases. Also included in the low-risk group are older patients with primary tumors smaller than 5 cm and papillary cancer without evidence of gross extrathyroid invasion or follicular cancer without either major capsular invasion or blood vessel invasion.[11] Using these criteria, a retrospective study of 1,019 patients showed that the 20-year survival rate is 98% for low-risk patients and 50% for high-risk patients.[11] The 10-year overall relative survival rates for patients in the United States are 93% for papillary cancer, 85% for follicular cancer, 75% for medullary cancer, and 14% for undifferentiated/anaplastic cancer.[2]
The thyroid gland may occasionally be the site of other primary tumors, including sarcomas, lymphomas, epidermoid carcinomas, and teratomas and may be the site of metastasis from other cancers, particularly of the lung, breast, and kidney.
Related Summaries
Other PDQ summaries containing information related to thyroid cancer include the following:
Cell type is an important determinant of prognosis in thyroid cancer. There are four main varieties of thyroid cancer (although, for clinical management of the patient, thyroid cancer is generally divided into two categories: well differentiated or poorly differentiated):[1]
A definition for each major type can be found under stage information.
Definitions of TNM
The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define thyroid cancer.[1]
Papillary and Follicular Thyroid Cancer
Stage I papillary thyroid cancer
Stage I papillary carcinoma is localized to the thyroid gland. In as many as 50% of cases, there are multifocal sites of papillary adenocarcinomas throughout the gland. Most papillary cancers have some follicular elements, and these may sometimes be more numerous than the papillary formations, but this does not change the prognosis. The 10-year survival rate is slightly better for patients younger than 45 years than for patients older than 45 years.
Stage II papillary thyroid cancer
Stage II papillary carcinoma is defined as either: (1) tumor that has spread distantly in patients younger than 45 years, or (2) tumor that is larger than 2 cm but 4 cm or smaller and is limited to the thyroid gland in patients older than 45 years. In as many as 50% to 80% of cases, there are multifocal sites of papillary adenocarcinomas throughout the gland. Most papillary cancers have some follicular elements, and these may sometimes be more numerous than the papillary formations, but this does not appear to change the prognosis.
Stage III papillary thyroid cancer
Stage III is papillary carcinoma in patients older than 45 years that is larger than 4 cm and is limited to the thyroid or with minimal extrathyroid extension, or positive lymph nodes limited to the pretracheal, paratracheal, or prelaryngeal/Delphian nodes. Papillary carcinoma that has invaded adjacent cervical tissue has a worse prognosis than tumors confined to the thyroid.
Stage IV papillary thyroid cancer
Stage IV is papillary carcinoma in patients older than 45 years with extension beyond the thyroid capsule to the soft tissues of the neck, cervical lymph node metastases, or distant metastases. The lungs and bone are the most frequent distant sites of spread, though such distant spread is rare in this type of thyroid cancer. Papillary carcinoma more frequently metastasizes to regional lymph nodes than to distant sites. The prognosis for patients with distant metastases is poor.
Stage I follicular thyroid cancer
Stage I follicular carcinoma is localized to the thyroid gland. Follicular thyroid carcinoma must be distinguished from follicular adenomas, which are characterized by their lack of invasion through the capsule into the surrounding thyroid tissue. While follicular cancer has a good prognosis, it is less favorable than that of papillary carcinoma. The 10-year survival is better for patients with follicular carcinoma without vascular invasion than it is for patients with vascular invasion.
Stage II follicular thyroid cancer
Stage II follicular carcinoma is defined as either tumor that has spread distantly in patients younger than 45 years, or tumor that is larger than 2 cm but 4 cm or smaller and is limited to the thyroid gland in patients older than 45 years. The presence of lymph node metastases does not worsen the prognosis among patients younger than 45 years. Follicular thyroid carcinoma must be distinguished from follicular adenomas, which are characterized by their lack of invasion through the capsule into the surrounding thyroid tissue. While follicular cancer has a good prognosis, it is less favorable than that of papillary carcinoma; the 10-year survival is better for patients with follicular carcinoma without vascular invasion than for patients with vascular invasion.
Stage III follicular thyroid cancer
Stage III is follicular carcinoma in patients older than 45 years, larger than 4 cm and limited to the thyroid or with minimal extrathyroid extension, or positive lymph nodes limited to the pretracheal, paratracheal, or prelaryngeal/Delphian nodes. Follicular carcinoma invading cervical tissue has a worse prognosis than tumors confined to the thyroid gland. The presence of vascular invasion is an additional poor prognostic factor. Metastases to lymph nodes do not worsen the prognosis in patients younger than 45 years.
Stage IV follicular thyroid cancer
Stage IV is follicular carcinoma in patients older than 45 years with extension beyond the thyroid capsule to the soft tissues of the neck, cervical lymph node metastases, or distant metastases. The lungs and bone are the most frequent sites of spread. Follicular carcinomas more commonly have blood vessel invasion and tend to metastasize hematogenously to the lungs and to the bone rather than through the lymphatic system. The prognosis for patients with distant metastases is poor.
Hürthle cell carcinoma
Hürthle cell carcinoma is a variant of follicular carcinoma with a similar prognosis and should be treated in the same way as equivalent stage non-Hürthle cell follicular carcinoma.[2]
Medullary Thyroid Cancer
Several staging systems have been employed to correlate extent of disease with long-term survival in medullary thyroid cancer. The clinical staging system of the AJCC correlates survival to size of the primary tumor, presence or absence of lymph node metastases, and presence or absence of distance metastasis. Patients with the best prognosis are those who are diagnosed by provocative screening, prior to the appearance of palpable disease.[3]
Stage 0 medullary thyroid cancer
Clinically occult disease detected by provocative biochemical screening.
Stage I medullary thyroid cancer
Tumor smaller than 2 cm.
Stage II medullary thyroid cancer
Tumor larger than 2 cm but 4 cm or smaller with no metastases or larger than 4 cm with minimal extrathyroid extension.
Stage III medullary thyroid cancer
Tumor of any size with metastases limited to the pretracheal, paratracheal, or prelaryngeal/Delphian lymph nodes.
Stage IV medullary thyroid cancer
Stage IV medullary thyroid cancer is divided into the following categories:
Medullary carcinoma usually presents as a hard mass and is often accompanied by blood vessel invasion. Medullary thyroid cancer occurs in two forms, sporadic and familial. In the sporadic form, the tumor is usually unilateral. In the familial form, the tumor is almost always bilateral. In addition, the familial form may be associated with benign or malignant tumors of other endocrine organs, commonly referred to as the multiple endocrine neoplasia syndromes (MEN 2A or MEN 2B).
In these syndromes, there is an association with pheochromocytoma of the adrenal gland and parathyroid hyperplasia. Medullary carcinoma usually secretes calcitonin, a hormonal marker for the tumor, and may be detectable in blood even when the tumor is clinically occult. Metastases to regional lymph nodes are found in about 50% of cases. Prognosis depends on extent of disease at presentation, presence or absence of regional lymph node metastases, and completeness of the surgical resection.[4]
Family members should be screened for calcitonin elevation to identify individuals who are at risk of developing familial medullary thyroid cancer. MEN 2A gene carrier status can be more accurately determined by analysis of mutations in the RET gene. Whereas modest elevation of calcitonin may lead to a false-positive diagnosis of medullary carcinoma, DNA testing for the RET mutation is the optimal approach in evaluating MEN 2A. All patients with medullary carcinoma of the thyroid (whether familial or sporadic) should be tested for RET mutations, and, if they are positive, family members should also be tested. Family members who are gene carriers should undergo prophylactic thyroidectomy at an early age.[5,6,7]
Anaplastic Thyroid Cancer
No generally accepted staging system is available for anaplastic thyroid cancer. All patients are considered to have stage IV disease.
Undifferentiated (anaplastic) carcinomas are highly malignant cancers of the thyroid. They may be subclassified as small cell or large cell carcinomas. Both grow rapidly and extend to structures beyond the thyroid. Both small cell and large cell carcinomas present as hard, ill-defined masses, often with extension into the structures surrounding the thyroid. Small cell anaplastic thyroid carcinoma must be carefully distinguished from lymphoma. This tumor usually occurs in an older age group and is characterized by extensive local invasion and rapid progression. Five-year survival with this tumor is poor. Death is usually from uncontrolled local cancer in the neck, usually within months of diagnosis.[8]
Surgery is the therapy of choice for all primary lesions. Surgical options include total thyroidectomy or lobectomy. The choice of procedure is influenced mainly by the age of the patient and the size of the nodule. Survival results may be similar; the difference between them lies in the rates of surgical complications and local recurrences.[1,2,3,4,5,6,7]
Standard treatment options:
Total Thyroidectomy
This procedure is advocated because of the high incidence of multicentric involvement of both lobes of the gland and the possibility of dedifferentiation of any residual tumor to the anaplastic cell type.
From the National Cancer Center Data Base (NCDB) registry of 52,173 patients, 43,227 (82.9%) underwent total thyroidectomy, and 8,946 (17.1%) underwent lobectomy. For a papillary thyroid cancer measuring less than 1 cm, the extent of surgery did not impact recurrence or survival (P = .24 and P = .83, respectively).[8] For tumors measuring 1 cm or larger, lobectomy resulted in higher risk of recurrence and death (P = .04 and P = .009, respectively). To minimize the influence of larger tumors, 1-cm to 2-cm lesions were examined separately; lobectomy again resulted in a higher risk of recurrence and death (P = .04 and P = .04, respectively). In this study, total thyroidectomy resulted in lower recurrence rates and improved survival for patients with papillary thyroid cancer measuring 1 cm or larger compared with lobectomy.[8][Level of evidence: 3iiA]
Furthermore, in a pattern of care study, using the NCDB registry from 1985 to 2003, 57,243 papillary thyroid cancer patients with tumors measuring 1 cm or larger underwent total thyroidectomy or lobectomy. Trends in the extent of surgery were examined for patients wtih papillary thyroid cancer over 2 decades. Logistic regression was used to identify factors that predict the use of total thyroidectomy compared with lobectomy. Use of total thyroidectomy increased from 70.8% in 1985 to 90.4% in 2003 (P < .0001). Patients treated at high-volume medical facilities or academic centers were more likely to undergo total thyroidectomy than were patients examined at low-volume medical facilities or community hospitals (P < .0001).[9][Level of evidence: 3i]
The objective of surgery is to completely remove the primary tumor, while minimizing treatment-related morbidity, and to guide postoperative treatment with radioactive iodine (RAI). The goal of RAI is to ablate the remnant thyroid tissue to improve the specificity of thyroglobulin assays, which allows the detection of persistent disease by follow-up whole-body scanning. For patients undergoing RAI, removal of all normal thyroid tissue is an important surgical objective. Additionally, for accurate long-term surveillance, RAI whole-body scanning and measurement of serum thyroglobulin are affected by residual, normal thyroid tissue, and in these situations, near total or total thyroidectomy is required. This approach facilitates follow-up thyroid scanning.
I131: Studies have shown that a postoperative course of therapeutic (ablative) doses of I131 results in a decreased recurrence rate among high-risk patients with papillary and follicular carcinomas.[4] It may be given in addition to exogenous thyroid hormone but is not considered routine.[10] Patients presenting with papillary thyroid microcarcinomas (tumors <10 mm) have an excellent prognosis when treated surgically, and additional therapy with I131 would not be expected to improve the prognosis.[11]
Thyroid lobectomy alone may be sufficient treatment for small (<1 cm), low-risk, unifocal, intrathyroidal papillary carcinomas in the absence of prior head and neck irradiation or radiologically or clinically involved cervical nodal metastases. This procedure is associated with a lower incidence of complications, but approximately 5% to 10% of patients will have a recurrence in the thyroid following lobectomy.[12] Patients younger than 45 years will have the longest follow-up period and the greatest opportunity for recurrence. Follicular thyroid cancer commonly metastasizes to lungs and bone; with a remnant lobe in place, use of I131 as ablative therapy is compromised. Abnormal regional lymph nodes should be biopsied at the time of surgery. Recognized nodal involvement should be removed at initial surgery, but selective node removal can be performed, and radical neck dissection is usually not required. This results in a decreased recurrence rate but has not been shown to improve survival.
Following the surgical procedure, patients should receive postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress thyroid-stimulating hormone (TSH); studies have shown a decreased incidence of recurrence when TSH is suppressed.
I131: Studies have shown that a postoperative course of therapeutic (ablative) doses of I131 results in a decreased recurrence rate among high-risk patients with papillary and follicular carcinomas.[4] For optimal treatment with RAI, total thyroidectomy is recommended with minimal thyroid remnant remaining. With a large thyroid remnant, a low thyroglobulin level cannot be achieved, which increases the chance of requiring multiple doses of RAI.
Consideration of RAI for remnant ablation is based on pathological risk features including:
RAI may be given with one of two methods of thyrotropin stimulation: withdrawal of thyroid hormone or recombinant human thyrotropin (rhTSH). Administered rhTSH maintains quality of life and reduces the radiation dose delivered to the body compared with thyroid hormone withdrawal.[13] Patients presenting with papillary thyroid microcarcinomas (tumors <10 mm), which are considered to be very low risk, have an excellent prognosis when treated surgically, and additional therapy with I131 would not be expected to improve the prognosis.[11]
The role of RAI in low-risk patients is not clear because disease-free survival (DFS) or overall survival (OS) benefits have not been demonstrated. One study reviewed 1,298 patients from the French Thyroid Cancer Registry.[14] Patients were identified as having low-risk papillary or follicular cancer as they are defined by the American Thyroid Association and the European Thyroid Association criteria:
Of the 1,298 patients, 911 patients received RAI after surgery, and 387 patients did not receive RAI after surgery. Follow-up period was 10.3 years; in multivariate analyses, there were no differences in OS (P = .243) or DFS (P = .2659), according to RAI use.[14]
Long-term complications of RAI using I131 include second malignancies, sialadenitis, and lacrimal and salivary gland dysfunction. Options for reducing the amount of radiation exposure by reducing the amount of RAI in each dose and also to give RAI in combination with rhTSH injections have been explored for low-risk thyroid cancer patients.
Two phase III, randomized, noninferiority studies of patients with low-risk thyroid cancer using a comparison of two thyrotropin-stimulation methods (thyroid hormone withdrawal or use of rhTSH) and two doses of radioiodine I131 1.1GBq [30mCi] and 3.7GBq [100mCi] using a 2 × 2 factorial design showed equivalent thyroid ablation rates between high and low dose I131 at 6 to 10 months after administration of I131.[15,16][Levels of evidence: 3iA and3iDii] However, differences in the inclusion criteria in one study [15] consisted of a low-risk, homogeneous cohort in which all of the patients underwent total thyroidectomy, and had pathological TNM stage pT1 ( ≤1 cm) and N1 or Nx, pT1 (>1–2cm) and any N stage, or pT2N0 without thyroid capsule extension/distant metastases. Complete thyroid ablation rate in this study was 92%. Patients undergoing thyroid hormone withdrawal had greater symptoms of hypothyroidism associated with deterioration in quality of life compared with the rhTSH group.
In the other study,[16] patients with more advanced T stage (T1–T3, N0–1) and with less than a total thyroidectomy were included with a lower overall ablation rate of 85%. Neither study assessed the effect of low-dose RAI on long-term recurrences or survival. The studies also did not address whether RAI could be safely omitted in specific low-risk groups.
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I papillary thyroid cancer, stage I follicular thyroid cancer, stage II papillary thyroid cancer and stage II follicular thyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III papillary thyroid cancer and stage III follicular thyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
The most common sites of metastases are lymph nodes, lung, and bone. Treatment of lymph node metastases alone is often curative. Treatment of distant metastases is usually not curative but may produce significant palliation.
Patients unresponsive to I131 should also be considered candidates for clinical trials testing new approaches to this disease.
Treatment options under clinical evaluation:
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV papillary thyroid cancer and stage IV follicular thyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Medullary thyroid cancer (MTC) comprises 3% to 4% of all thyroid cancers. These tumors usually present as a mass in the neck or thyroid, often associated with lymphadenopathy,[1] or they may be diagnosed through screening family members. MTC can also be diagnosed by fine-needle aspiration biopsy. Cytology typically reveals hypercellular tumors with spindle-shaped cells and poor adhesion.[2]
The overall survival of patients with MTC is 86% at 5 years and 65% at 10 years. Poor prognostic factors include advanced age, advanced stage, prior neck surgery, and associated multiple endocrine neoplasia (MEN) 2B.[2,3,4]
Approximately 25% of reported cases of MTC are familial. Familial MTC syndromes include MEN 2A, which is the most common; MEN 2B; and familial non-MEN syndromes. (Refer to the PDQ summary on Genetics of Endocrine and Neuroendocrine Neoplasias for more information.) Any patient with a familial variant should be screened for other associated endocrine tumors, particularly parathyroid hyperplasia and pheochromocytoma. MTC can secrete calcitonin and other peptide substances. Determining the level of calcitonin is useful for diagnostic purposes and for following the results of treatment.
Family members should be screened for calcitonin elevation and/or for the RET proto-oncogene mutation to identify other individuals at risk for developing familial MTC. All patients with MTC (whether familial or sporadic) should be tested for RET mutations, and if they are positive, family members should also be tested. Whereas modest elevation of calcitonin may lead to a false-positive diagnosis of medullary carcinoma, DNA testing for the RET mutation is the optimal approach. Family members who are gene carriers should undergo prophylactic thyroidectomy at an early age.[5,6]
Treatment options for localized disease:
Patients with MTC should be treated with a total thyroidectomy, unless there is evidence of distant metastasis. In patients with clinically palpable MTC, the incidence of microscopically positive nodes is more than 75%; routine central and bilateral modified neck dissections have been recommended.[7] When cancer is confined to the thyroid gland, the prognosis is excellent.
External Radiation Therapy
External radiation therapy has been used for palliation of locally recurrent tumors; however, no evidence exists that it provides any survival advantage.[8] Radioactive iodine has no place in the treatment of patients with MTC.
Treatment options for locally advanced and metastatic disease:
Palliative Chemotherapy
Vandetanib is an oral inhibitor of RET kinase, vascular endothelial growth-factor receptor, and epidermal growth-factor receptor signaling. It was tested in a placebo-controlled, prospective trial (NCT00410761) in 331 patients with locally advanced and metastatic disease with a 2:1 ratio in assignment to the study drug.[9] With a median follow-up of 24 months, progression-free survival (PFS) favored vandetanib (hazard ratio = 0.46; 95% confidence interval, 0.31–0.69; P < .001) with a median PFS estimated at 30.5 months for vandetanib versus 19.3 months for placebo.[9][Level of evidence: 1iiDiii]
Overall survival (OS) was not different at 24 months; longer follow-up will be required since only 47 patients had died at the time of analysis, and there was a crossover to the study drug on progression from placebo, making analysis of OS problematic. Vandetanib has significant side effects, including diarrhea, rash, hypertension, and QT prolongation. Quality of life was not formally assessed in this trial.[9]
Palliative chemotherapy has been reported to produce occasional responses in patients with metastatic disease.[10,11,12,13] No single drug regimen can be considered standard. Some patients with distant metastases will experience prolonged survival and can be managed expectantly until they become symptomatic.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with thyroid gland medullary carcinoma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Standard treatment options:
Tracheostomy is frequently necessary. If the disease is confined to the local area, which is rare, total thyroidectomy is warranted to reduce symptoms caused by the tumor mass.[1,2]
Radiation Therapy
External-beam radiation therapy may be used in patients who are not surgical candidates or whose tumor cannot be surgically excised.
Anaplastic thyroid cancer is not responsive to I131 therapy; treatment with individual anticancer drugs has been reported to produce partial remissions in some patients. Approximately 30% of patients achieve a partial remission with doxorubicin.[3] The combination of doxorubicin plus cisplatin appears to be more active than doxorubicin alone and has been reported to produce more complete responses.[4]
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with anaplastic thyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Patients treated for differentiated thyroid cancer should be followed carefully with physical examinations, serum quantitative thyroglobulin levels, and radiologic studies based on individual risk for recurrent disease.[1] Approximately 10% to 30% of patients thought to be disease free after initial treatment will develop recurrence and/or metastases. Of these patients, approximately 80% develop recurrence with disease in the neck alone, and 20% develop recurrence with distant metastases. The most common site of distant metastasis is the lung. In a single series of 289 patients who developed recurrences after initial surgery, 16% died of cancer at a median time of 5 years following recurrence.[2]
The prognosis for patients with clinically detectable recurrences is generally poor, regardless of cell type.[3] Those patients who recur with local or regional tumor detected only by I131 scan, however, have a better prognosis.[4] The selection of further treatment depends on many factors, including cell type, uptake of I131, prior treatment, site of recurrence, and individual patient considerations. Surgery with or without I131 ablation can be useful in controlling local recurrences, regional node metastases, or, occasionally, metastases at other localized sites.[5] Approximately 50% of the patients operated on for recurrent tumors can be rendered free of disease with a second operation.[3] Local and regional recurrences detected by I131 scan and not clinically apparent can be treated with I131 ablation and have an excellent prognosis.[6]
Up to 25% of recurrences and metastases from well-differentiated thyroid cancer may not show I131 uptake. For these patients, other imaging techniques shown to be of value include imaging with thallium-201, magnetic resonance imaging, and pentavalent dimercaptosuccinic acid.[7] When recurrent disease does not concentrate I131, external-beam or intraoperative radiation therapy can be useful in controlling symptoms related to local tumor recurrences.[8] Systemic chemotherapy can be considered. Chemotherapy has been reported to produce occasional objective responses, usually of short duration.[4,9]
A phase II study (NCT00654238) looked at the activity of sorafenib, an orally active, multityrosine kinase inhibitor that affects tumor cell proliferation and angiogenesis, administered to 30 patients with advanced iodine-refractory thyroid cancer.[10] Among 25 assessable patients, there were 7 patients with partial responses and 16 patients with stable disease. The progression-free survival for differentiated thyroid cancer patients was 84 weeks.[10][Level of evidence: 3iiDiii] Further investigation of this approach is warranted.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent thyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
General Information About Thyroid Cancer
Added text to state that the use of sentinel lymph node biopsy may aid in identifying patients with occult metastases who might benefit from central neck dissection (cited Cunningham et al. as reference 20).
Stage I and II Papillary and Follicular Thyroid Cancer
This section was extensively revised.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of thyroid cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Thyroid Cancer Treatment are:
Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Adult Treatment Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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The preferred citation for this PDQ summary is:
National Cancer Institute: PDQ® Thyroid Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Accessed <MM/DD/YYYY>.
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text:
While backing up his pickup truck, Charlie Abruscato from Astoria, N.Y., damaged this outdoor lighting fixture located along a driveway at a hotel property in Indianapolis, Ind. Recognizing this as a possible hazard because of the lost illumination and exposed wires, he reported the damage to the hotel security guard.
When Charlie left the hotel around five the next morning, the luminaire was repaired, and shined brightly once again. But Charlie said it looked like someone used about "three rolls of plastic tape" to make the repair. After a few hours on the road, he thought about the possibility that the fixture was not properly grounded. Was it? Probably not.
Editor's Note. Article 410, Part V, covers grounding. Section 410.17 indicates that luminaries (fixtures), and lighting equipment must be grounded as required by Article 250. See Sections 410.20 and 410.22 for equipment grounding conductor attachment, connection and size required in accordance with Section 250.122.
Note: This article includes the author's "personal opinions" and should not be considered as a formal interpretation on the NEC.
Attention CEE News readers. Do you have a photo of a glaring Code violation? Mail your color photos and descriptions to Joe Tedesco at 350 North St., Boston, MA 02113 or e-mail them to [email protected]. Your photo may be published in our upcoming photo gallery of America's worst NEC violations.

subset: commoncrawl


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Dec. 31, 2007
SANTA CLARA, Calif. - Chandice Cronk and Elizabeth Doran dropped 19 points each to help the Broncos ring in 2008 with a 50-point victory margin, 88-38, over CS Fullerton Monday evening at the Leavey Center. With the win, Santa Clara improved its overall record to 10-3 and pushed its current winning streak to six games, while Fullerton dropped to 1-10 on the season.
"We really challenged the team after Saturday's game and we couldn't have been happier with the way they responded to that challenge," said head coach Michelle Bento-Jackson. "They game out and played with intensity for all 40 minutes and our bench players did a great job of not letting up the momentum and intensity of the game."
The scoring margin ranks second on the list of largest victory margins at the Leavey Center, while checking in at No. 6 on the all-time largest victory margin list. Freshman Nicole Gall added a season-high 16 points to the Broncos win, while junior Claire Goins chipped in with a career-high 12 points. Freshman Kathy Willinsky also made her collegiate debut Monday night with two points and one rebound.
Although the Titans opened the game with a quick jumper from Alison Bennett, Cronk responded with a three-pointer to give Broncos control of the scoreboard, 3-2. Doran then added five points to Santa Clara's lead, 12-4, with a nailed jumper and a trey with 15:06 on the clock. SCU then went on a 10-0 rally on back-to-back three-pointers from Cronk and layups from Jen Gottschalk and Maggie Goldenberger to improve their lead to 29-10. Goins joined in on the action with a pair of layups to make the score 33-12.
Fullerton fought hard to start a rally on successful baskets from Ashley Richie, who led the team with 15 points. Yet, SCU claimed its largest lead of the first half, 32-points, on two occasions. The first was on a three-point goal from Doran with 3:07 remaining in the first half and the second was on a layup from Goins with 1:04 left. Bennett scored a deuce for the Titans with 36 seconds left to end the first half, 50-20. At halftime, the Broncos were shooting 72 percent from the field and were 7-for-8 from beyond the arc, with 21 of their points coming off the bench.
Richie started things off for Fullerton in the first half, but Sara Majors responded with a traditional three-point play to make the score, 53-22. The Broncos compiled a 17-3 run on points from Cronk, Doran, Gall and Majors to give Santa Clara a 47-point advantage, 80-33, with 9:07 remaining. SCU claimed its largest margin of the game, 55-points, with 3:45 left in the second half on a jumper from Willinsky, 88-33. However, Fullerton produced a five-point run, its longest of the contest, on a jumper from Montoya Fontenot and free throws from Fontenot and Richie.
The Broncos return to action on Friday, Jan. 4 against the Roadrunners of CS Bakersfield. Tip off is scheduled for 7 p.m. at the Leavey Center.


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*Based on a survey of Connections Academy families conducted in February 2017 by Shapiro+Raj.
Complete the online registration form to start enrollment in our online education system, Connexus®.
Then complete the required forms and upload required documents for enrollment (such as your child's birth certificate, proof of residency, etc.).
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Once your student is enrolled, your free course materials will be sent to you and your student's teachers will be assigned!
"This school is perfect for my son. He has improved dramatically not only in his studies but in his overall health as well. He is more outgoing, likes to do his class work, and is more motivated to do his class work. This school is the best of the best."
"The support of the teachers has been outstanding. They are willing to try new things and help my child grow and learn at her own pace. They also value and respect my input as a parent."
"The curriculum challenges my students without being so hard that they can't figure it out. In the end, they are prouder and have better esteem because their hard work has paid off."
"I think using the technology on a daily basis is giving my child an advantage educationally. When she leaves school and enters the workforce, she will have stronger computer skills."
"The curriculum challenges my students without being so hard that they can't figure it out. In the end, they are prouder and have better esteem because their hard work has paid off."


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Community Notes: 4-26-13
Summit Youth Baseball & Softball (SYBS) registration ends on Sunday. Register now at http://www.summitbaseball.com. SYBS is for boys and girls ages 4-14. New this year is an Indoor facility with several batting cages that all players will be able to use. Register now and come join the fun. Questions, call 262-5778
The Peak School, Summit County's independent nonprofit school for middle and high school students, will hold an open house today from 9-11 a.m. at 103 S. Harris in Breckenridge. All interested families and students are encouraged to attend anytime between 9 and 11 a.m. to learn more about The Peak School's unique academic program and see Peak in action! This open house will give visitors a chance to meet teachers and students, and view classes. The open house will be held at the current Peak School building at 103 S. Harris in Breckenridge. Beginning in August, 2013, The Peak School will be located on Main Street in Frisco. This will be the final open house for this school year. The Peak School provides academic rigor, an engaged student community, energetic teachers, Chinese, Spanish, STEM and Outdoor Education along with all core classes and small class sizes of 8-16 students and a student teacher ratio of 7:1. In 2013-14, The Peak School will offer Grades 6-9, adding a grade annually through 12th at its new location on Main Street in Frisco. For more information visit ThePeakSchool.org.
Summit Advocates for Gifted Education (SAGE) will be hosting Julia Watson, PhD, our Gifted Education Regional Consultant (GERC) on Wednesday, May 1, 6-8 p.m. at the SMS Cafeteria. She will speak about the "Latest and Greatest" on the current legislature, budget, and programming to include initiatives, projects, and tools developed for gifted students in Colorado and our Region, i.e., learn where we have been and the direction gifted education is going. This free event will provide free childcare including educational activities, free SSD CDE credit for teachers (2 contact hours) and light refreshments. Please RSVP no later than Tuesday to email@example.com to ensure we meet seating and refreshment requirements.
The Summit County Wildfire Council invites Summit County property owners to learn more about the 2013 Hazardous Fuels Reduction Grant Program. This grant program provides assistance to eligible homeowner groups, allowing residents to conduct hazardous-fuels reduction (for example, tree-removal projects) in their neighborhoods. Effective fuels-reduction projects help protect Summit County communities and watersheds from the threat of wildfire. Interested community members can download a grant application from Summit County's Colorado State University Extension page, http://www.co.summit.co.us/extension. Grant applications will be accepted through today. Please call Dan Schroder at (970) 668-4140 for more information.
Open Arms Childcare and Preschool has a limited number of openings in both the infant and preschool rooms. Parents are welcome to visit our center, located at Christ Lutheran Church, 16072 Hwy. 9, Farmers Korner. For more information please call (970) 237-3229, visit our website at http://www.OpenArmsChildcareAndPreschool.com, or follow us on Facebook.
Whether you like it or not, they're still there. Where? Afghanistan. Who are they? People, the sons and relatives of Summit County residents, who are serving our nation in our all volunteer military. They live under poor conditions, especially if they are serving in FOBs, Forward Operating Bases. They love receiving our packages filled with goodies and necessities, which although addressed to one soldier, are shared with their buddies. We need your support in brightening the days of these brave, young people. Please get out your check book and send a donation to the Summit County Rotary Charitable Fund, PO Box 4401, Frisco, CO 80443. Put for "Troop Support" on the check, please. Please note that contributions are tax deductible as the SCRCF is a 501(c)3 non profit organization. Thank you so much. For further information, contact (970) 453-4778.
Carol Turrin, an associate professor at Colorado Mountain College in Breckenridge, is being promoted to full professor. Turrin has four decades of experience in clinical and administrative nursing. She has taught nursing courses as a full-time faculty member at the college since 2007. She has a bachelor's degree in nursing from the University of South Florida, an MBA from the University of Phoenix and a master's in nursing from Walden University. Besides Turrin, Colorado Mountain College is promoting seven associate professors and four assistant professors throughout the college's nine-county service area. Being promoted to full professor are Tal Hardman, Derek Johnston, Bruce Kime and Becky Loth Luetke at Spring Valley (near Glenwood Springs); Susanna Spaulding at the Leadville campus; and Lindsey Royce at the Steamboat Springs campus. Being promoted to associate professor are Kelli McCall and Jeffrey Runyon at Leadville and Connie Selzer and Rod Taylor at Spring Valley.
On Tuesday, May 7, the Caregiver Memory Loss Support Group will sponsor a discussion on "Life After Caregiving."Four members of the group that have lost their loved ones in the last year will speak and answer questions on life after caregiving. They will openly share their reflections on being a caregiver including things they know they did right and things they would do differently. This is an open meeting. No registration required. The discussion is Tuesday May 7, at 1 p.m., at the Senior Center in Frisco. For questions please contact facilitator Sandy Bainbridge at (970) 584-0311.
Start a dialogue, stay on topic and be civil.
If you don't follow the rules, your comment may be deleted.


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A journey from crystallographer to marketing entrepreneur.
I am incredibly lucky to have found a career in marketing that I love, but realizing my true career required a series of "aha" moments that unfolded over many years. Marketing is not about the phone calls you receive at dinnertime; it's about developing products that meet user needs. That restriction enzyme that helped you with your cloning and that centrifuge you rely on, along with many other things you regularly use in the lab, were designed for you with a lot of help from marketers.
My career boils down to three moments that I remember clearly. As an undergrad, I started school not knowing what I wanted to do. I bounced from law to physical therapy to bioengineering. However, in biology class sophomore year, I remember hearing about proteins and DNA. Wow, the building blocks of life. That was my first aha moment, and I became a biochemistry major.
In grad school at Duke University and later the University of California, Riverside, I knew I wanted to study protein function, and X-ray crystallography was the thing for me. Determine how the building blocks of life combine in 3-D to carry out biological processes? Bingo – aha number two! I also was lucky to work with some crystallography pioneers – David and Jane Richardson showed me how to take precession photographs on film and to visualize proteins. Alex McPherson, my fantastic PhD advisor, taught me how to crystallize proteins and solve structures (along with a great mentor, Steve Larson), and I even sent experiments on a space shuttle. I also started realizing that crystal structures were a great way to make nice visualizations, and I created one that was featured on the cover of the San Diego Supercomputer Center newsletter.
Aha number three was a long time coming, but I had fun along the way. In my postdoctoral fellowship, I actually moved away from X-ray crystallography because I had a fantastic project involving the conformational change of a virus. It was cool not only because I got to do a lot of different types of experiments (yes, I love working at the bench) but also because it challenged me to learn how to communicate the results. I also designed my lab's website and found that I enjoyed it a lot. At the end of my postdoc, I realized staying in San Diego was important to me and that getting a job outside of academia would allow me to stay.
My first job was during the genomics boom working at a startup called GeneFormatics, which used protein structure prediction models to determine functions of genes. I dabbled in bioinformatics, and when the company eventually folded, it gave me the opportunity get a job at Life Technologies (then Invitrogen) as an informatics product manager in the marketing department. My aha moment came when I was learning about different concepts in marketing, such as positioning and branding. These concepts, when understood as a whole, are the basis for developing and improving products that people—in our case, scientists—need. Here was a chance for me to make a difference in life scientists' progress.
In 2008 I took my show on the road, so to speak, and started a marketing consulting company, Comprendia. I bootstrapped the company, and my web and creative skills helped me get started. I also work with talented developers and designers who help me with projects that are more involved. We provide everything from product-development consulting to printed brochures to websites and applications. We do most things virtually and have partners and clients all around the world.
Life science marketers usually split their time between strategic and tactical marketing activities. Strategic marketing is the work required to develop products that customers need and involves market and scientific research, competitive analyses, forecasting and working closely with a research and development group. It doesn't end after the product is launched, as there is continuous competition as well as scientific advances. Life science companies stay tuned to all of these changes through their marketing department, resulting in products that always are improving.
Tactical marketing is the part of the job that you probably are more familiar with: it's the advertising and sales portion. We need to communicate the value of the products we've worked so hard to make for you. Now, some people say that a good product will sell itself. That's true to some extent, but in this crowded marketplace, scientists like to know about and understand the value of the product before they buy it.
As you can see from my history, marketing was in the cards for me long before I even knew it. I enjoy all aspects of marketing but have the most fun with the tactical part. I love, for example, creating a web application and seeing how many scientists use it and taking the feedback we get to improve the product. To me, it's the equivalent of standing over a protein gel waiting for it to destain. However, the activities of a marketer can be quite varied, and even if you don't see yourself having as much fun with this aspect, there are many marketing positions that involve a lot more strategic than tactical work. Having a strong science background is of course very helpful for these positions, and the analytical skills you use to interpret your data can help you understand forecasting and planning. Marketers interface with almost every department in a company – R&D, tech service, sales and management – and it really is a very interesting job with great travel and growth opportunities.
You're lucky because there is so much information available about careers outside of R&D now. There even are classes offered by the American Marketing Association in many areas of the country. Take your destiny into your own hands and find ways to talk to people who could help or hire you. As early as possible, look at companies that are hiring marketers (or product managers) and finding the areas in which they're hiring. Remember, I got my break in marketing by being in the informatics field – could you steer your work into a hot area? I've met many ambitious young scientists who are proactively creating a niche for themselves while in academia. I'm also a big proponent of face-to-face networking – find (or even start!) networking groups in your area. We founded the San Diego Biotechnology Network, which now has 6,000 members and helps life scientists to connect and learn.
In summary, make those aha moments come more quickly by opening yourself up to careers outside of R&D now. I'm happy about my career path, as I was able to learn and make many great contacts along the way. Make sure you're getting the most out of every situation you're in and don't be afraid to branch into other areas, as they can be very rewarding on both the individual and community level.
More from the current issue


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Do you really love cake?
Do you love cake so much that whenever you're in the same room, you find yourself unable to resist its siren call?
Then certainly Leslie F. Miller's new book, Let Me Eat Cake, is for you. Now, let's get it straight--though the book has a few recipes, that's not what it's about--it's more about the culture of cake, its lure and the lore behind it, baked up full of personal anecdotes and cake stories galore. And--as we were surprised and delighted to discover--there's even a mention of CakeSpy.com!
And you, dear friend, could be the winner of a signed copy of the book. Oh, you want this!
To put your name in the running, simply answer this question in the comments. You can be as literal or as figurative as you like, just be sure to leave your thoughts on this important subject:
What is the best thing about cake?
The poll will be closed on Monday at 12 p.m. PST, and the winner will be announced shortly thereafter. If you're interested in purchasing the book, click here. Oh, and in case you were interested, the cupcake shown is a Chai Cardamom cupcake from Seattle's Trophy Cupcakes!


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RECALLS FOR 1998 ACURA 2.3CL VIN 19uya325xwl006925
Recall #1Date: 05/16/2002
Component:ELECTRICAL SYSTEM:IGNITION:SWITCH
Summary:ON CERTAIN SEDANS, COUPES, HATCHBACKS, AND SPORT UTILITY VEHICLES, ELECTRICAL CONTACTS IN THE IGNITION SWITCH CAN DEGRADE DUE TO THE HIGH ELECTRICAL CURRENT PASSING THROUGH THE SWITCH WHEN THE VEHICLE IS STARTED.
Conequence:WORN CONTACTS COULD CAUSE THE ENGINE TO STALL WITHOUT WARNING, INCREASING THE RISK OF A CRASH.
Notes:DEALERS WILL REPLACE THE IGNITION SWITCH. OWNER NOTIFICATION BEGAN JUNE 14, 2002. OWNERS WHO TAKE THEIR VEHICLES TO AN AUTHORIZED DEALER ON AN AGREED UPON SERVICE DATE AND DO NOT RECEIVE THE FREE REMEDY WITHIN A REASONABLE TIME SHOULD CONTACT HONDA AT 1-800-999-1009 OR ACURA AT 1-800-382-2238.
Recall #2Date: 10/27/2003
Component:ELECTRICAL SYSTEM:IGNITION:SWITCH
Summary:ON CERTAIN PASSENGER VEHICLES AND MINI VANS, THE IGNITION SWITCH MAY WEAR EXCESSIVELY AND PREVENT PROPER INTERLOCK OPERATION, MAKING IT POSSIBLE TO TURN THE IGNITION KEY TO THE "OFF" POSITION AND REMOVE THE KEY WITHOUT SHIFTING THE TRANSMISSION TO "PARK."
Conequence:IF THE VEHICLE OPERATOR DOES NOT SHIFT TO "PARK" BEFORE REMOVING THE KEY AND FAILS TO ENGAGE THE PARKING BRAKE, THE VEHICLE COULD ROLL AND A CRASH COULD OCCUR.
Notes:DEALERS WILL PERFORM AN INSPECTION PROCEDURE THAT DETERMINES THE AMOUNT OF CYLINDER BODY WEAR. IF SIGNIFICANT WEAR IS INDICATED, THE DEALER WILL REPLACE THE CYLINDER BODY, COLLAR, AND LATCH PLATE. IF NO SIGNS OF WEAR ARE INDICATED, DEALERS WILL REPLACE THE LATCH PLATE WITH A REDESIGNED PART. OWNER NOTIFICATION BEGAN DECEMBER 8, 2003. OWNERS SHOULD CONTACT HONDA AT 1-800-999-1009 OR ACURA AT 1-800-382-2238.
Recall #3Date: 02/10/1998
Component:POWER TRAIN:AUTOMATIC TRANSMISSION:PARK/NEUTRAL START SWITCH
Summary:VEHICLE DESCRIPTION: PASSENGER VEHICLES (HONDA ACCORD SEDANS MANUFACTURED FROM SEPTEMBER 18, 1997 TO JANUARY 10, 1998; COUPES MANUFACTURED DECEMBER 11, DECEMBER 15, 1997, AND JANUARY 5, 1998; ACURA 2.3CL MANUFACTURED OCTOBER 22, 1997 THROUGH JANUARY 7, 1998). DURING MANUFACTURING, THE CASTING DIE CAUSED AN IRREGULARITY IN THE RIGHT-SIDE TRANSMISSION COVER. THIS IRREGULARITY CAN LIMIT THE MOVEMENT OF THE PARKING PAWL ACTUATION LEVEL AND PREVENT ADEQUATE ENGAGEMENT OF THE PARKING GEAR PAWL. THIS DOES NOT COMPLY WITH FMVS NO. 114, "THEFT PROTECTION."
Conequence:THIS CONDITION CAN CAUSE THE VEHICLE TO ROLL DOWN AN INCLINE WHEN THE TRANSMISSION IS LOCKED IN "PARK," INCREASING THE RISK OF PERSONAL INJURY AND/OR PROPERTY DAMAGE.
Notes:DEALERS WILL INSTALL A COLLAR ON THE TRANSMISSION PARKING PAWL TO ENSURE PROPER MOVEMENT OF THE ACTUATION LEVER.
Recall #4Date: 05/10/1999
Component:SUSPENSION:FRONT:CONTROL ARM:LOWER BALL JOINT
Summary:VEHICLE DESCRIPTION: PASSENGER VEHICLES. CERTAIN VEHICLES WERE MANUFACTURED WITH BALL JOINTS THAT CAN PREMATURELY WEAR OUT AND, IN THE WORSE CASE, THE BALL JOINT WOULD SEPARATE CAUSING THE FRONT SUSPENSION TO COLLAPSE.
Conequence:THIS CONDITION WOULD RESULT IN VEHICLE DECELERATION AND A SUDDEN LOSS OF POWER. ALSO STEERING CONTROLLABILITY WOULD BE REDUCED.
Notes:DEALERS WILL REPLACE THE FRONT SUSPENSION LOWER BALL JOINTS.
Get FULL Vehicle history report only for $8.99!


text:
Need help identifying what you've seen? Upload a photo to iSpot and make sure you add the tag #gbb17. Go to iSpot
Add the hashtag #gbb17 to your tweets, or tweet your photos to @GardenBioblitz, and we'll try to help you with identifications
Once you've identified your garden wildlife, add it to iRecord, and have your garden wildlife added to the national database! Go to iRecord
What's happening during the Garden Bioblitz? Check out what's being found, who's finding what and where, and totals at the Info Centre
Why not check out the other BioBlitzes going on throughout the UK in 2017 on the Bristol Natural History Consortium website.
To keep up to date with news & tips as we lead up to the 2017 Garden BioBlitz, subscribe below
Tweets by @GardenBioblitz


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This installment of the Paperclipping Roundtable featured Angie Lucas joining us to talk about titles (and as usual a whole lot more!)
Oh – want to know what Nancy's big announcement is? Check out the latest class at Big Picture Classes!![audio:http://traffic.libsyn.com/roundtable/prt042_uum.mp3]
To listen to this week's episode, you can use the player embedded above, right-click on this link to download the file to your computer, visit the Paperclipping Roundtable web page or to make things easy, you can use this link:
Subscribe for free to Paperclipping Roundtable on iTunes
That link will open in iTunes and take you to the subscribe page, and then you can click on the "subscribe" button.
Subscribing in iTunes is one of the best ways to support Paperclipping Roundtable. Using iTunes is free, and subscribing is free. (If you don't know how to use iTunes to subscribe, you can watch a video here that shows you how.)
The Panel
Art Journaling Bundle with Dina Wakely from GetItScrapped.com: Click here for the course information, and make sure you use coupon code dwajbundle4prt at checkout.
Big Picture Classes! Big Picture Scrapbooking has a new name! Click here for a promo code for Paperclipping Roundtable listeners to use to save 10% on any one class at Big Picture Classes! (Don't forget that you can still use the link to support Roundtable even if you've already used the one-time discount code.)
Picks of the Week
- StickyBellies and Watch Me Grow
- Sizzix Big Shot Machine
- Ticket Collage Rubber Stamp from Magenta
- Noell's recommendation for quick journaling.
More Links
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Garlicky-feta goodness. Plus olives.
1 batch pizza dough (I used Mark Bittman's recipe with a little spelt flour mixed in, but plan to try this one in the future)
flour as needed
1 head broccoli, washed, stems removed, and finely chopped
2-3 cloves garlic, minced
red pepper flakes
2 teaspoons olive oil, plus more for brushing
6 ounces feta cheese, crumbled
1/2 cup pitted kalamata olives, chopped
Preheat the oven to 500F.
Lightly brush a baking sheet with olive oil.
Roll out pizza dough on a lightly floured surface, and transfer to the baking sheet. Brush the dough with olive oil.
In a large bowl, combine chopped broccoli, red pepper flakes, garlic, and two teaspoons olive oil, and toss to combine.
Carefully pour the broccoli mixture onto the pizza. Top with the feta crumbles and chopped kalamata olives.
Bake at 500F for 6-12 minutes, monitoring carefully after the 6 minute mark.
Sunday, March 7, 2010
8 comments:
- Cooking Rookie said...
Beautiful pizza, beautiful pic!
- March 7, 2010 at 1:19 PM
- Dana Treat said...
Wow, looks gorgeous! I love all of those things and I'm sure they are crazy good on pizza.
- March 7, 2010 at 4:10 PM
- sweetlife said...
wow this looks so tasty...great pic!!
- March 8, 2010 at 2:12 PM
- Table Talk said...
No guilt with this kind of pizza---yum!
- March 9, 2010 at 7:08 PM
- mangocheeks said...
That is a beautiful looking pizza, I'd sure eat that and give the others a miss.
- March 11, 2010 at 12:13 PM
- Carnivore Girl said...
Hi Beatrice,
I love your blog! I too have a food blog devoted to vegetarian cuisine. I'll definitely be trying some of your dishes soon!
- March 11, 2010 at 5:21 PM
- Foodycat said...
How delicious! It looks wonderful!
- March 14, 2010 at 9:28 AM
Oh yum. Talk about all my favourite flavours in one dish :)
- April 23, 2010 at 8:56 PM
Subscribe to: Post Comments (Atom)


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As a rescue partner of the San Jose Animal Care Center, Silicon Valley Pet Project strives to support the shelter in new ways to promote adoption. Every Monday, our volunteers take select dogs from the shelter who need a break from their stressful environment in our Shelter Dog Day Out Program. We will be giving these dogs a much needed change of scenery and giving them the opportunity to relax outside the shelter for a day. During their time away, they will hang out with our volunteers, go for walks, maybe even a puppachino at Starbucks. Come visit us on Mondays from 11am to 3pm at Pup Plaza and hang out with the pups!
Back to All Events
Earlier Event: December 2Doga at Pup Plaza
Later Event: December 4Community Hours


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Wedding Cars In Corsica
Take a look below at our selection of the best wedding cars and transport in Corsica. No harm in checking out what's available in the surrounding counties too. By their very nature, they're willing to travel!
Sorry, there were no results for your search criteria. Either remove some filters and search again or you can see all Wedding Cars in Corsica below.
Wedding Cars In Corsica
Often overlooked, you really do need to think about transportation sooner rather than later. Getting around Corsica can require more logistical planning than you might necessarily think so it's really worth considering transport for you, your family and your guests. Also put some consideration into transport at the end of the wedding.


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Associate Sales Representative (UAE Nationals Only)Full time Cisco Systems posted 9 months ago
Job Description
Program start date: July 2019/20
Training hub during 1st Year: Amsterdam, Netherlands
Job location after the training: Dubai, United Arab Emirates
What You'll Do:
You'll be part of our Cisco Sales Associates Program (CSAP), an award-winning graduate training program for young talent aspiring to move into sales or engineering roles. For the first part of the program, you'll learn about the latest technology advancements and how to effectively sell them. During the second part of your CSAP year, you'll further develop your skills through an On-the-Job Experience in the Global Virtual Sales and Customer Success (GVS&CS) organization.
The program, while challenging, will push you to become the best version of yourself. You'll be encouraged to pursue industry-standard certifications, be assessed and coached through customer simulations and on-the-job activities. We'll offer you a safe and fun environment to practice what you've learnt, all the while providing you with feedback to develop your potential. Thanks to this rigourous training plan, we've earned a strong reputation within our internal sales organization.
Upon graduating from CSAP, you'll transition into a Virtual Account Manager role in GVS&CS where you'll ultimately accelerate your career into more senior sales roles. You'll build strong relationships with existing accounts, working closely with them to understand their business strategy and uncover new business opportunities. You'll partner with Sales Engineers and together you'll position the benefits of our Cisco solutions to your customer, using our market-leading collaboration tools.
Who You'll Work With:
You'll train alongside incredibly talented individuals, like yourself, from different countries and diverse backgrounds. Early on, you'll make longlasting friendships and belong to a rich human network that will support you throughout your career. As a successful Associate Sales Representative (ASR), you'll learn to discover, build and drive new opportunities with our Cisco partners while collaborating with Cisco engineers to provide technical solutions that drive business outcomes for our customers. You'll learn from top experts and coaches in a unique classroom setting where we use our own 'state-of-the-art' collaboration technology. You'll have your own mentor, a CSAP alumn who's been in your shoes and will guide you in your first year. With a strong Cisco team committed to your success, you'll gain hands-on education and experience, while receiving an attractive salary and pursuing your career aspirations.
Who You Are:
- Technology enthusiast, who enjoys talking about innovation and always keeps up with the latest technology news.
- A strong communicator with the confidence to engage and talk to a wide range of people.
- Willing and able present your ideas in front of an audience.
- View team collaboration as instrumental to achieving success.
- Enjoy looking at practical real life challenges and thinking creatively to solve them.
- Approach situations with an open and curious mind, taking on challenges with an eye for opportunity.
What You Need To Be Eligible:
- Graduate by the start date of the program, July 2019/20
- Preferably hold a degree in Business and Management, Finance, Marketing and other related degrees. You will graduate from a bachelor's degree (or higher) with no less than a 2:1 result or equivalent in your country.
- Fluent in English and the official language(s) of the country you are applying for, (Arabic)
- Hold the right to live and work in the country that you are applying for, without future company sponsorship required. Student visas and temporary permits obtained on your own will not be acceptable.
- Willing to relocate for 12 months to a designated CSAP training hub if required. Visa assistance and relocation package to trainings hubs will be provided as required.
- Willing to return to your country you applied for, unless otherwise required due to business needs.
Cisco are always looking to identify talented people. If you are reading this posting then we may not have an open job right now, however it is highly likely we will in the future. If you are interested in working for Cisco in this capacity then please submit your details and CV or resume against this requisition so that when a suitable vacancy arises a Cisco representative can contact you directl
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Overview of Diabetic Kidney Disease (videos)
Q&A | Robert Stanton, M.D., Chief of Nephrology (Kidney Medicine)
Up to 40 percent of people with type 1 diabetes and 20 to 30 percent of those with type 2 diabetes have some form of kidney disease. But much can be done to prevent it or keep it from progressing, says Joslin's Robert Stanton, M.D., whose Renal Section is devoted to patients with diabetic kidney disease. Here, he answers questions about preventing and treating the disease.
When should someone with diabetes come to the Nephrology Clinic?
You should come if you have diabetes and have signs of kidney disease as discussed below. You may also meet with us to discuss the best approaches to preventing the development of diabetic kidney disease.
There are two tests we recommend be done at least yearly to recognize the presence of the kidney disease as early as possible. It is very important to measure both tests, as abnormal results in either test may indicate kidney disease.
The first is a urine test that reveals an increase of a protein called albumin. An increase in urine albumin (if the increase is relatively low it is called microalbuminuria) is often the first sign of damage to the kidney. This test is best done in a single urine collection where the albumin/creatinine ratio is measured. You should see a kidney doctor if your albumin levels are above 30 mg/g measured on two occasions.
Second is a blood test to measure the level of a chemical called creatinine that is a reflection of kidney filtering. The serum creatinine level is used in a formula to estimate your GFR (glomerular filtration rate). The GFR is the level of filtering at which your kidney is functioning. At birth GFR is about 120 ml/min and declines at about 1% per year as we age. Men and women have different GFR levels.
Thus we use a formula (the MDRD equation) to estimate the kidney's filtering capacity (GFR) as the MDRD equation accounts for various factors that affect GFR such as age, gender and ethnicity. You should see a kidney doctor if your GFR is less than 60 ml/min. This formula is readily available on-line by using the search term "MDRD Equation" and then entering the requested data.
Why is it so important to catch kidney disease early?
Worsening of kidney disease may be slowed, stopped or even reversed if caught very early. It is very important to slow worsening of kidney as the advanced stage of the disease is kidney failure, when the kidney can't do its job of filtering harmful wastes from the blood. You can't live without at least one functioning kidney. When the kidneys have failed, dialysis or a kidney transplant is necessary to stay alive. Kidney disease can progress more quickly to kidney failure in those with diabetes. The best chance to stop kidney disease from progressing is to recognize it early, when we can start aggressive treatments that can slow or stop the decline in kidney function.
What do you do to help people preserve their kidney health?
We establish an individualized plan for each patient to achieve optimal blood glucose control, optimal blood pressure control, and institute treatments aimed at lowering urine albumin levels. Achieving these three goals has a dramatic effect in slowing progress of the disease. Smoking cessation, nutrition and exercise are also very important parts of maintaining kidney health.
What special expertise does the Joslin Nephrology Clinic offer?
We see and manage people with diabetic kidney disease primarily but we have expertise in all types of kidney diseases. We also do research in all areas of diabetic kidney disease, from basic studies aimed at finding the causes and treatments for diabetic kidney disease to clinical trials with promising new treatments. Thus we are ideally suited to diagnose, treat and do the research needed to give our patients the very best care available.
We have five nephrologists (kidney doctors) and one nurse practitioner all of whom also understand diabetes. We're all aware of the latest cutting-edge ideas and approaches to diabetic kidney disease because that's what we think about and read about. We write the chapters on diabetic kidney disease in textbooks, publish journal articles on advances in treatment, and speak and consult around the world. We have been invited to speak all over the United States as well as China, India, Europe, United Arab Emirates, Mexico and South America.
How common is kidney failure and what can be done then?
In general kidney failure occurs in about 10 percent of cases, but it really depends on where someone's GFR starts at the time of diagnosis. GFR decreases as the disease progresses. If we diagnose and start treating early, when the GFR is in the range of 40 to 60 percent of normal, the chance of the disease progressing is much less than if aggressive management of kidney disease doesn't start until the GFR is at 25 percent of normal.
Should kidney failure occur, however, we are also on the staff at the Beth Israel Deaconess Medical Center, where dialysis and kidney transplantations are done through our Joslin-BIDMC Transplant Program.
How does someone get a referral to the Nephrology Clinic?
Talk to your doctor for a referral or call directly at 617-309-2477.
- Click here for information on the Renal (Kidney Health) Clinic at Joslin Diabetes Center
Diabetic Kidney Disease
- Know Your GFR To Stop Kidney Disease
- Diabetic Kidney Disease
- How to Prevent Kidney Disease
- Your GFR Can Help Stop Kidney Disease (video)
- High Blood Pressure and Diabetic Kidney Disease
- Blood Pressure Medications for Diabetic Kidney Disease
- Nutrition for Advanced Kidney Disease
- Kidneys and Bone Disease
- Anemia and Kidney Disease
- Kidney Transplants
Page last updated: November 07, 2019


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Teledyne DALSA raises the performance bar once again with the Piranha4. Powered by our latest high performance CMOS line scan imagers, the Piranha4 offers resolutions from 2k to 8k pixels in a variety of pixel sizes to let you inspect and detect with unrivalled precision, speed, and responsivity.
Built for Maximum Throughput with CMOS Line Scan
Teledyne DALSA delivers the highest line rates in the industry, with 4k models reaching 100/200 kHz. Our unique CMOS line scan architectures include dual line scan monochrome to deliver a 2x increase in responsivity, as well as bilinear, trilinear, and quadlinear color designs to maximize color performance. Large full-well capacity maximizes signal coverage for bright light, while low read noise ensures superior signal-to-noise at low light. Our CMOS image sensors' high dynamic range, combined with on-chip ADC for high speed, gives the Piranha4 cameras unprecedented performance.
High Performance Color, Advanced Features, and Programmability
The Piranha4 cameras offer advanced features such as sub-pixel spatial correction, areas of interest (up to 4 at a time) to reduce data processing and simplify cabling, as well as dual-line area mode to double line rate, HDR mode, shading and lens correction. The Piranha4 is built for the real world with features to ease system integration. The advanced GenICam compliant user interface makes it easy to set up and control camera parameters such as exposure control, FFC, white balance, gain, test patterns, diagnostics and more.


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Fans of "Lost" opened up their checkbooks this weekend to take home a piece of television history.
Some estimates put the total haul around $1.8 million, with the top item, the classic VW Dharma Van, selling for $47,500.
Other big-ticket items include Faraday's journal ($27,500), the Frozen Donkey Wheel ($25,000), an autographed pilot script ($15,000) and Desmond's fail-safe key ($11,000).
One of our favorite items, the Swan station computer, went for $16,000. Small price to pay for being able to save the world at home every 108 minutes.
Not every item reached five digits. Hurley's lottery ticket (4-8-15-16-23-42) sold for $5,500, while his flash-sideways ticket (10-28-44-53-77-80) went for $1,300.
The beverage-themed items were a bit more attainable for modest bidders, with the DHARMA-branded cola selling for $1,500, DHARMA wine at $1,200 and DHARMA water at $950.
The two-day auction was hosted by Profiles in History and was held at the Barker Hangar in Santa Monica.
All final bids are posted on liveauctioneers.com, with more highlights on the Washington Post's website and the ODI.


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Christmas Parade - Pell City
- Pell City High School 1300 Cogswell Ave Pell City, AL 35125 (map)
Use the form on the right to contact us.
You can edit the text in this area, and change where the contact form on the right submits to, by entering edit mode using the modes on the bottom right.
3521 Ratliff Road
Irondale, AL, 35210
United States
The Zamora Shriners are Birmingham Alabama's Temple of the Shriners International. Shriners are a Masonic fraternity based on fun, fellowship and the Masonic principles of brotherly love, relief and truth. With nearly 200 temples (chapters) in several countries and thousands of clubs around the world. Our fraternity is open to men of integrity from all walks of life.
Click on events for more information if available.


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South Pass City WY
Andy-Carrie added South Pass City WYSouth Pass City, approximately 90 miles north of Rock Springs, is a historic site administered by the state of Wyoming. It consists of over 30 log, frame, and stone buildings, along with the Carissa Mine and Stamp Mill.
South Pass City Historic Site
- 11 images
Surprise Canyon, California
David A. Wright posted a topic in General Discussion,Recently, I've been going through my old VHS video tapes and digitizing them to DVDs. These tapes contain my travels and explorations between 1995 and 2009. I thought I'd start releasing some video shorts of my early travels on this forum.
The back story for this particular video is as follows. On March 30, 1996, I made a short hike of about a mile and a third up the lower third of Surprise Canyon, on the western slopes of the Panamint Range, Inyo County, California. This canyon is just outside of Death Valley National Park. This canyon has running water running year round through the stretch shown, fed by substantial Limekiln Springs, and the canyon is a water wonderland. For those not familiar with the area, refer to the two maps. The first one shows the canyon in relation to the region, the other a close up of the canyon and the ghost town of Panamint City. The blue line in the close up image shows the route that was taken.
- 20 replies
Exploration Field Trips - March 31-April 2, 2000 - Into the Nevada Triangle with Lew Shorb
David A. Wright posted a topic in General Discussion,My next series of videos will be based on a trip in 2000 that I took with Lew Shorb. Lew is a board member here, as well as owner of the popular website http://www.ghosttownexplorers.org/ghost.htm
In breaking with my past habit of culling out historical sites and ghost towns and creating short videos dealing with these, I decided to keep the exploring part of Explore Forums in and create videos of each day of my travel and exploration, including our camps. Scenery, travel, camping ghost towns and wide open spaces.
Part one of this series, as well as subsequent videos, will all appear here within this same thread. Part I will start in my garage, where I was finishing up with the packing my truck. The following day, after work, I begin my travels to meet Lew Shorb at Rhyolite, Nevada ghost town.
Our three day, two night travels prowled about the "Nevada Triangle" section of northeastern Death Valley National Park; and will include such sites as:
1. The Las Vegas & Tonopah Railroad
2. Gold Bar
3. Phinney Mine
4. Strozzi Ranch
5. Currie Well (LV&T RR)
6. Mud Springs Summit (LV&T RR)
7. Happy Hooligan Mine
This video, that of March 30th and 31st, will start off this series; and is brief, only being 3:28 long. Nevada-Triangle_Shorb-2000_Part-1.wmv
So, below is my narrative of part one of this series to give full context of what is seen in the video. It will probably take longer to read than the video is long.
- 6 replies
Exploration Field Trips: May 1-3, 2000 - Trip with Alan Patera and Alan Hensher into Death Valley
David A. Wright posted a topic in General Discussion,Exploration Field Trips:
May 1-3, 2000
Trip with Alan Patera and Alan Hensher into Death Valley
What do you do with three authors, two 4x4's, two two-way radios, three cameras, and camping supplies? Send them to Death Valley, of course. For three days in the first week of May, 2000, fellow authors and historical researchers Alan Patera, Alan Hensher and myself explored Death Valley north and south.
Alan Patera writes and publishes the WESTERN PLACES series of monograph books. Alan Hensher has been published in several periodicals as well as authoring several books, centering primarily on the history of Mojave Desert sites.
Alan Patera, who hails from Oregon, came south to California and picked up Alan Hensher; then the two came my way. At the time I was living in Ridgecrest, California. After overnighting with my wife and I, the three of us took off for Death Valley. Alan was busy researching and photographing for a future edition of WESTERN PLACES, this time centering on the camps of the Funeral Range, which forms the eastern border of east central Death Valley. Circumstances and changes of our journey lead Alan to plant the seeds of two more future books, this time centering just outside the northernmost section of Death Valley.
- 3 replies
Trip 2001 - Northeastern Nevada, Southwestern Idaho
David A. Wright posted a topic in General Discussion,Reconnoitering Trips
Northern Nevada, Southwestern Idaho
(and a Blip of Southeastern Oregon Thrown in for Good Measure)
June 19 - 28, 2001
This is the trip that I consider to be my favorite trip I have ever undertaken. It had been in the planning stages since the previous December. Originally, quite a number of people were invited and had semi-committed themselves to come along. Over time, however, eventually the number of people whose semi-commitments became firm commitments to this trip narrowed to four. And I was one of them.
Below, a list of historic locations we visited – in the order that we visited them:
1. Bodie & Benton Railway, California.
2. Stillwater, Nevada.
3. White Cloud City (Coppereid), Nevada.
4. Unionville, Nevada.
5. Midas, Nevada.
6. Spring City, Nevada.
7. Paradise Valley, Nevada.
8. Buckskin, Nevada.
9. National, Nevada.
10. Delamar, Idaho.
11. Silver City, Idaho.
12. Rio Tinto, Nevada.
13. Pattsville, Nevada.
14. Aura, Nevada.
15. Cornucopia, Nevada.
16. Edgemont, Nevada (from a distance – on private property)
17. White Rock, Nevada (from a distance – on private property)
18. Tuscaurora, Nevada.
19. Dinner Station, Nevada.
20. Metropolis, Nevada.
21. Charleston, Nevada.
22. Jarbidge, Nevada.
- 16 replies


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Browsing Drake Theses and Dissertations by Author "Waters, Kathleen"
Now showing items 1-1 of 1
Contemporary American Authors' Questioning of Religion Waters, Kathleen (Drake University, 1976-08)The problem. In contemporary American fiction it was noted that religion frequently appeared as a topic of debate. In some novels a major theme was a debate over whether to accept, change, or reject organized religion. ...


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Everything we do is daring, ingenious and fun. Our awards acknowledge and prove that our ground-breaking SKYACTIV Technology is an unbeatable combination of efficiency and driving performance. Take a look at our most recent award wins below.
The all-new Mazda MX-5 Retractable Fastback has followed its convertible siblings success after winning the "Red Dot: Best of the best" title at the 2017 Red Dot product design award. Awarded to products meeting the highest design standards in their given category, the jury of 39 designers, professors and journalists picked the Mazda MX-5 RF as a winner from a criteria including innovation, functionality, ergonomics, symbolic and emotional content, self-explanatory quality and ecological compatibility.
"Despite facing new competition this year, the Mazda MX-5 has triumphed again. We love its rev-happy and punchy 2.0-litre engine, its simple mechanical roof and its temptingly low price. Even better, the MX-5's ride and handling proves beyond any shadow of a doubt that less is more. Its lightweight chassis construction makes for a driving experience that's guaranteed to brighten your day, and with surprisingly good fuel economy, this is a fun car that's both cheap to buy and run." –WhatCar?, 2017.
"Mazda's SKYACTIV Technology has given the CX-5 some of the lowest CO2 emissions and highest fuel economy figures in the class, beating those of rivals such as the Honda CR-V and Toyota RAV4. However, the Mazda CX-5 also has the space to rival them, because its interior is large and the boot a generous size. It handles exceptionally well for a large SUV
, too, while the amount of standard equipment you get is plentiful considering the car's relatively low price."–WhatCar?, 2017.
Curtis Hutchinson, Editor, Motor Trader, said "The overriding criteria was to identify which companies are delivering the highest quality products, and services. Motor Trader awarded Mazda for their impressive approved used programme and Mazda's National Used Car Locator".


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WASHINGTON (MarketWatch) — Among the stocks that could see active trade in Tuesday's session are Books-A-Million Inc., Ulta Beauty ULTA, +1.41% and Rackspace Hosting Inc.
Companies on tap to report financial results Tuesday include blue chip Walt Disney Co. DIS, -1.69% as well as DirecTV Group Inc. DTV, -0.16%, Gaylord Entertainment Co. GET, -0.24%, Perrigo Co. PRGO, +2.79%, Henry Schein Inc. HSIC, +0.41%, Hecla Mining Co. HL, -0.42%, Kinross Gold Corp. KGC, -1.41%, Rosetta Stone Inc. RST, -3.80%, OfficeMax Inc. OMXS30, -0.03%, Fossil Inc. FOSL, +0.90%, Medifast Inc. MED, +0.84%, Chiquita Brands International Inc. CQB, +0.88%, Wendy's Co. WEN, -1.48%, Molson Coors Brewing Co. TAP, +2.38%, International Flavors & Fragrances Inc. IFF, +0.01% and Scotts Miracle-Gro Inc. SMG, -0.14%, among others.
A special committee of Books-A-Million directors will hire financial advisers as it considers a recent $3.05-a-share buyout offer and makes a recommendation regarding it, the Birmingham, Ala.-based retailer BAMM, +0.00% said late Monday. The bid surfaced late last month as Clyde Anderson, executive chairman of Books-A-Million, and members of his family offered to buy out the company's publicly held shares for cash.
Ulta Beauty ULTA, +1.41% said it would make a secondary public offering of 7 million common shares but would receive no proceeds since the stock up for sale is being sold by certain entities associated with Mousse Partners. Underwriters will have a 30-day option to buy up to an additional 15% of shares from one of the selling stockholders, if investor demand warrants. Separately, Bolingbrook, Ill.-based Ulta Beauty said preliminary results for the first quarter ended April 28 indicate that profit, revenue and comparable-store sales will all come in higher than management previously had forecast. The company opened 18 new stores in the latest quarter, which Ulta Beauty said would subtract a penny from bottom-line results. First-quarter financial results are to be formally reported June 5, the company said.
Along with reporting results for the fourth quarter ended March 31, Electronic Arts Inc. EA, +0.00% issued a forecast for the first quarter of fiscal 2013 and for the full year. The Redwood City, Calif.-based company projected a first-quarter a loss of 40 cents to 45 cents a share on revenue of $500 million, both on an adjusted basis. Consensus estimates as compiled by FactSet Research had been for a loss of 33 cents a share on revenue of $581 million. And for the year, Electronic Arts said adjusted earnings would range from $1.04 to $1.20 a share, on revenue of nearly $4.08 billion; analysts' consensus stood at $1.14 a share and $4.52 billion, respectively.
Clayton Dubilier & Rice LLC continues to sell down its equity stake in Sally Beauty Holdings Inc. SBH, -0.21%, the Denton, Texas-based specialty retailer and distributor. The company said the private-equity house will sell 15 million common shares, or roughly one-third of the 24.4% investment interest it holds in Sally Beauty. The company won't receive any proceeds from the offering. In addition, Sally Beauty said it's agreed to buy back about $200 million in common stock directly from Clayton Dubilier & Rice, concurrently with the closing of the offering of the 15 million shares.
Penn National Gaming Inc. PENN, +1.06% said it agreed to acquire Harrah's St. Louis from Caesars Entertainment CZR, +0.82% at a price of about $610 million. The transaction's expected to close in the second half of 2012, the parties said. The property, some 20 miles from downtown St. Louis and near Penn National's Argosy Casino Alton property, encompasses 109,000 square feet of gambling space as well as a 500-room hotel and nine dining and entertainment venues, and has parking space for 4,644 vehicles. It will be rebranded as one of Penn National's Hollywood-themed properties, the Wyomissing, Pa.-based company said.
Louisiana-Pacific Corp. LPX, -1.24% will take a charge against second-quarter results associated with a cash tender offer and consent solicitation commenced to retire outstanding high-yield senior secured notes due 2017. The charge will amount to $53.2 million, for writing off the notes' unamortized original discount and deferred debt-issuance costs, the Nashville-based company said. Louisiana-Pacific pegged the aggregate principal amount of the 13% notes outstanding at maturity at nearly $244 million. In conjunction with retiring the notes, the company said it commenced a $300 million offering of senior notes due 2020 and would apply proceeds primarily toward the tender offer.
The board of Chatham Lodging Trust CLDT, +0.39% approved a 14% increase in the quarterly dividend paid on common stock, to 20 cents a share. It's payable July 27 to stockholders of record as of June 29. The increase was announced as the Palm Beach-based real estate investment trust reported first-quarter results late Monday.
Monday earnings recap
Rackspace Hosting RAX, -4.07% reported first-quarter earnings of $23.2 million, or 17 cents a share, up from $13.8 million, or 10 cents, earned in the comparable period during 2011. Quarterly revenue generated by the San Antonio-based company reached $301.4 million, up from the prior year's $230 million. Rackspace's profit came in a penny a share shy of the consensus forecast among analysts polled by Thomson Reuters.