text:
Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV
The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.
Considerations for Antiretroviral Use in Special Patient Populations
Older Patients with HIV
Last Updated: January 28, 2016; Last Reviewed: January 28, 2016
|Key Considerations When Caring for Older Patients With HIV
|Rating of Recommendations: A = Strong; B = Moderate; C = Optional
Rating of Evidence: I = Data from randomized controlled trials; II = Data from well-designed nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion
Effective antiretroviral therapy (ART) has increased survival in individuals with HIV, resulting in an increasing number of older individuals living with HIV. In the United States, among persons living with HIV at year-end 2013, 42% were age 50 years or older, 6% were age 65 or older, and trends suggest that these proportions will increase steadily.1 Care of patients with HIV increasingly will involve adults 60 to 80 years of age, a population for which data from clinical trials or pharmacokinetic (PK) studies are very limited.
There are several distinct areas of concern regarding the association between age and HIV disease.2 First, older patients with HIV may suffer from aging-related comorbid illnesses that can complicate the management of HIV infection. Second, HIV disease may affect the biology of aging, possibly resulting in early manifestations of clinical syndromes generally associated with advanced age. Third, reduced mucosal and immunologic defenses (such as postmenopausal atrophic vaginitis) and changes in risk related-behaviors (e.g., decrease in condom use because of less concern about pregnancy or more high-risk sexual activity with increased use of erectile dysfunction drugs) in older adults could lead to increased risk of acquisition and transmission of HIV.3,4 Finally, because older adults are generally perceived to be at low risk of acquiring HIV, screening for this population remains low.
HIV Diagnosis and Prevention in the Older Adult
In older adults, failure to consider a diagnosis of HIV likely contributes to later initiation of ART.5 The Centers for Disease Control and Prevention (CDC) estimates that in 2013, 37% of adults aged 55 years or older at the time of HIV diagnosis met the case definition for AIDS. The comparable CDC estimates are 18% for adults aged 25 to 34 years and 30% for adults aged 35 to 44 years.6 In one observational cohort, older patients (defined as those ≥35 years of age) appeared to have lower CD4 T lymphocyte (CD4) cell counts at seroconversion, steeper CD4 count decline over time,7 and tended to present to care with significantly lower CD4 counts.8 When individuals >50 years of age present with severe illnesses, AIDS-related opportunistic infections (OIs) need to be considered in the differential diagnosis of the illness.
Although many older individuals engage in risk behaviors associated with acquisition of HIV, they may see themselves or be perceived by providers as at low risk of infection and, as a result, they are less likely to be tested for HIV infection than younger persons.9,10 Despite CDC guidelines recommending HIV testing at least once in individuals aged 13 to 64, and more frequently for those at risk,11 HIV testing prevalence remains low (<5%) among adults aged 50 to 64, and decreased with increasing age.12 Clinicians must be attuned to the possibility of HIV infection in older adults, including those older than 64 years of age and especially in those who may engage in high-risk behaviors. Sexual history taking is therefore an important component of general health care for older adults who do not have HIV, together with risk-reduction counseling, and screening for HIV and sexually transmitted infections (STIs), if indicated.
Impact of Age on HIV Disease Progression
HIV infection presents unique challenges in aging adults and these challenges may be compounded by ART:
- HIV infection itself is thought to induce immune-phenotypic changes akin to accelerated aging,13 but recent laboratory and clinical data provide a more nuanced view of these changes. Some studies have shown that patients with HIV may exhibit chromosomal and immunologic features similar to those induced by aging.14,15 However, other studies show the immunologic changes to be distinct from age-related changes.16 In addition, although data on the increased incidence and prevalence of age-associated comorbidities in patients with HIV are accumulating,17,18 the age of diagnosis for myocardial infection and non-AIDS cancers in patients who have HIV and those who do not is the same.18,19
- Older patients with HIV have a greater incidence of complications and comorbidities than adults of a similar age who do not have HIV, and may exhibit a frailty phenotype—defined clinically as a decrease in muscle mass, weight, physical strength, energy, and physical activity,20 although the phenotype is still incompletely characterized in people with HIV.
Initiating Antiretroviral Therapy in the Older Patient with HIV
ART is recommended for all individuals with HIV (AI; see Initiation of Antiretroviral Therapy section). Early treatment may be particularly important in older adults in part because of decreased immune recovery and increased risk of serious non-AIDS events in this population. In a modeling study based on data from an observational cohort, the beneficial effects of early ART were projected to be greatest in the oldest age group (patients between ages 45 and 65 years).21 No data support a preference for any one of the Panel's recommended initial ART regimens (see What to Start) on the basis of patient age. The choice of regimen should instead be informed by a comprehensive review of the patient's other medical conditions and medications. The What to Start section (Table 7) of these guidelines provides guidance on selecting an antiretroviral regimen based on an older patient's characteristics and specific clinical conditions (e.g., kidney disease, elevated risk for cardiovascular disease, osteoporosis). In older patients with reduced renal function, dosage adjustment of nucleoside reverse transcriptase inhibitors (NRTIs) may be necessary (see Appendix B, Table 10). In addition, ARV regimen selection may be influenced by potential interaction of antiretroviral medications with drugs used concomitantly to manage comorbidities (see Tables 21a-22b). Adults age >50 years should be monitored for ART effectiveness and safety similarly to other populations with HIV (see Table 3); however, in older patients, special attention should be paid to the greater potential for adverse effects of ART on renal, liver, cardiovascular, metabolic, and bone health (see Table 17).
HIV, Aging, and Antiretroviral Therapy
The efficacy, PKs, adverse effects, and drug interaction potentials of ART in the older adult have not been studied systematically. There is no evidence that the virologic response to ART differs in older and younger patients. In a recent observational study, a higher rate of viral suppression was seen in patients >55 years old than in younger patients.22 However, ART-associated CD4 cell recovery in older patients is generally slower and lower in magnitude than in younger patients.8,23-25 This observation suggests that starting ART at a younger age may result in better immunologic response and possibly clinical outcomes.
Hepatic metabolism and renal elimination are the major routes of drug clearance, including the clearance of ARV drugs. Both liver and kidney functions decrease with age and may result in impaired drug elimination and increased drug exposure.26 Most clinical trials have included only a small proportion of participants over 50 years of age, and current ARV dosing recommendations are based on PK and pharmacodynamic data derived from participants with normal organ function. Whether drug accumulation in the older patient may lead to greater incidence and severity of adverse effects than seen in younger patients is unknown.
Patients with HIV and aging-associated comorbidities may require additional pharmacologic interventions that can complicate therapeutic management. In addition to taking medications to manage HIV infection and comorbid conditions, many older patients with HIV also are taking medications to relieve discomfort (e.g., pain medications, sedatives) or to manage adverse effects of medications (e.g., anti-emetics). They also may self-medicate with over-the-counter medicines or supplements. In older patients who do not have HIV, polypharmacy is a major cause of iatrogenic complications.27 Some of these complications may be caused by medication errors (by prescribers or patients), medication nonadherence, additive drug toxicities, and drug-drug interactions. Older patients with HIV are probably at an even greater risk of polypharmacy-related adverse consequences than younger or similarly aged patients with HIV. When evaluating any new clinical complaint or laboratory abnormality in patients with HIV, especially in older patients, clinicians should always consider the possible role of adverse drug reactions from both ARV drugs and other concomitantly administered medications.
Drug-drug interactions are common with ART and can be easily overlooked by prescribers.28 The available drug interaction information on ARV agents is derived primarily from PK studies performed in small numbers of relatively young participants with normal organ function who do not have HIV (see Tables 21a-22b). Data from these studies provide clinicians with a basis to assess whether a significant interaction may exist. However, the magnitude of the interaction may be greater in older patients with HIV than in younger patients with HIV.
Nonadherence is the most common cause of treatment failure. Complex dosing requirements, high pill burden, inability to access medications because of cost or availability, limited health literacy including misunderstanding of instructions, depression, and neurocognitive impairment are among the key reasons for nonadherence.32 Although many of these factors associated with nonadherence may be more prevalent in older patients, some studies have shown that older patients with HIV may actually be more adherent to ART than younger patients.29-31 Clinicians should regularly assess older patients to identify any factors, such as neurocognitive deficits, that may decrease adherence. To facilitate medication adherence, it may be useful to discontinue unnecessary medications, simplify regimens, and recommend evidence-based behavioral approaches including the use of adherence aids such as pillboxes or daily calendars, and support from family members (see Adherence to the Continuum of Care).
Non-AIDS HIV-Related Complications and Other Comorbidities
Among persons treated effectively with ART, as AIDS-related morbidity and mortality have decreased, non-AIDS conditions constitute an increasing proportion of serious illnesses.33-35 Neurocognitive impairment, already a major health problem in aging adults, may be exacerbated by the effect of HIV infection on the brain.36 In a prospective observational study, neurocognitive impairment was predictive of lower retention in care among older persons.37 Neurocognitive impairment probably also affects adherence to therapy. Social isolation and depression are also particularly common among older adults with HIV and, in addition to their direct effects on morbidity and mortality, may contribute to poor medication adherence and retention in care.38,39 Heart disease and cancer are the leading causes of death in older Americans.40 Similarly, non-AIDS events such as heart disease, liver disease, and cancer have emerged as major causes of morbidity and mortality in patients with HIV receiving effective ART. The presence of multiple non-AIDS comorbidities coupled with the immunologic effects of HIV infection may add to the disease burden of aging adults with HIV.41-43 HIV-specific primary care guidelines have been updated with recommendations for lipid and glucose monitoring, evaluation and management of bone health, and management of kidney disease, and are available for clinicians caring for older patients with HIV.44-48
Switching, Interrupting, and Discontinuing Antiretroviral Therapy in Older Patients
Given the greater incidence of comorbidities, non-AIDS complications and frailty among older patients with HIV, switching one or more ARVs in an HIV regimen may be necessary to minimize toxicities and drug-drug interactions. For example, expert guidance now recommends bone density monitoring in men aged ≥50 years and postmenopausal women, and suggests switching from tenofovir disoproxil fumarate or boosted protease inhibitors to other ARVs in older patients at high risk for fragility fractures.45
Few data exist on the use of ART in severely debilitated patients with chronic, severe, or non-AIDS terminal conditions.49,50 Withdrawal of ART usually results in rebound viremia and a decline in CD4 cell count. Acute retroviral syndrome after abrupt discontinuation of ART has been reported. In severely debilitated patients, if there are no significant adverse reactions to ART, most clinicians would continue therapy. In cases where ART negatively affects quality of life, the decision to continue therapy should be made together with the patient and/or family members after a discussion on the risks and benefits of continuing or withdrawing ART.
Healthcare Utilization, Cost Sharing, and End-of-Life Issues
Important issues to discuss with aging patients with HIV are living wills, advance directives, and long-term care planning, including related financial concerns. Out-of-pocket health care expenses (e.g., copayments, deductibles), loss of employment, and other financial-related factors can cause temporary interruptions in treatment, including ART, which should be avoided whenever possible. The increased life expectancy and the higher prevalence of chronic complications in aging populations with HIV can place greater demands upon HIV services.51 Facilitating a patient's continued access to insurance can minimize treatment interruptions and reduce the need for other services to manage concomitant chronic disorders.
HIV disease can be overlooked in aging adults who tend to present with more advanced disease and experience accelerated CD4 loss. HIV induces immune-phenotypic changes that have been compared to accelerated aging. Effective ART has prolonged the life expectancy of patients with HIV, increasing the number of patients >50 years of age living with HIV. However, unique challenges in this population include greater incidence of complications and comorbidities, and some of these complications may be exacerbated or accelerated by long term use of some ARV drugs. Providing comprehensive multidisciplinary medical and psychosocial support to patients and their families (the "Medical Home" concept) is of paramount importance in the aging population. Continued involvement of HIV experts, geriatricians, and other specialists in the care of older patients with HIV is warranted.
- Centers for Disease Control and Prevention. HIV Surveillance Report, 2014; vol. 26. 2015. Available at http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed December 10, 2015.
- Deeks SG, Phillips AN. HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity. BMJ. 2009;338:a3172. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19171560.
- Levy JA, Ory MG, Crystal S. HIV/AIDS interventions for midlife and older adults: current status and challenges. J Acquir Immune Defic Syndr. Jun 1 2003;33 Suppl 2:S59-67. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12853854.
- Levy BR, Ding L, Lakra D, Kosteas J, Niccolai L. Older persons' exclusion from sexually transmitted disease risk-reduction clinical trials. Sex Transm Dis. Aug 2007;34(8):541-544. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17297381.
- Althoff KN, Gebo KA, Gange SJ, et al. CD4 count at presentation for HIV care in the United States and Canada: are those over 50 years more likely to have a delayed presentation? AIDS Res Ther. 2010;7:45. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21159161.
- Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2013. HIV Surveillance Supplemental Report 2015;20 (No. 2). 2015. Available at: http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed August 21, 2015.
- Lodi S, Phillips A, Touloumi G, et al. Time from human immunodeficiency virus seroconversion to reaching CD4+ cell count thresholds <200, <350, and <500 Cells/mm3: assessment of need following changes in treatment guidelines. Clin Infect Dis. Oct 2011;53(8):817-825. Available at http://www.ncbi.nlm.nih.gov/pubmed/21921225.
- Sabin CA, Smith CJ, d'Arminio Monforte A, et al. Response to combination antiretroviral therapy: variation by age. AIDS. Jul 31 2008;22(12):1463-1473. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18614870.
- Stone VE, Bounds BC, Muse VV, Ferry JA. Case records of the Massachusetts General Hospital. Case 29-2009. An 81-year-old man with weight loss, odynophagia, and failure to thrive. N Engl J Med. Sep 17 2009;361(12):1189-1198. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19759382.
- Ward EG, Disch WB, Schensul JJ, Levy JA. Understanding low-income, minority older adult self-perceptions of HIV risk. J Assoc Nurses AIDS Care. Jan-Feb 2011;22(1):26-37. Available at http://www.ncbi.nlm.nih.gov/pubmed/20580270.
- Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. Sep 22 2006;55(RR-14):1-17. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16988643.
- Ford CL, Godette DC, Mulatu MS, Gaines TL. Recent HIV testing prevalence, determinants, and disparities among U.S. older adult respondents to the behavioral risk factor surveillance system. Sex Transm Dis. Aug 2015;42(8):405-410. Available at http://www.ncbi.nlm.nih.gov/pubmed/26165428.
- Martin J, Volberding P. HIV and premature aging: A field still in its infancy. Ann Intern Med. Oct 5 2010;153(7):477-479. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20921548.
- Liu JC, Leung JM, Ngan DA, et al. Absolute leukocyte telomere length in HIV-infected and uninfected individuals: evidence of accelerated cell senescence in HIV-associated chronic obstructive pulmonary disease. PLoS One. 2015;10(4):e0124426. Available at http://www.ncbi.nlm.nih.gov/pubmed/25885433.
- Zanet DL, Thorne A, Singer J, et al. Association between short leukocyte telomere length and HIV infection in a cohort study: No evidence of a relationship with antiretroviral therapy. Clin Infect Dis. May 2014;58(9):1322-1332. Available at http://www.ncbi.nlm.nih.gov/pubmed/24457340.
- Lee FJ, Amin J, Carr A. Efficacy of initial antiretroviral therapy for HIV-1 infection in adults: a systematic review and meta-analysis of 114 studies with up to 144 weeks' follow-up. PLoS One. 2014;9(5):e97482. Available at http://www.ncbi.nlm.nih.gov/pubmed/24830290.
- Schouten J, Wit FW, Stolte IG, et al. Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals: the AGEhIV cohort study. Clin Infect Dis. Dec 15 2014;59(12):1787-1797. Available at http://www.ncbi.nlm.nih.gov/pubmed/25182245.
- Althoff KN, McGinnis KA, Wyatt CM, et al. Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults. Clin Infect Dis. Feb 15 2015;60(4):627-638. Available at http://www.ncbi.nlm.nih.gov/pubmed/25362204.
- Rasmussen LD, May MT, Kronborg G, et al. Time trends for risk of severe age-related diseases in individuals with and without HIV infection in Denmark: a nationwide population-based cohort study. Lancet HIV. Jul 2015;2(7):e288-298. Available at http://www.ncbi.nlm.nih.gov/pubmed/26423253.
- Althoff KN, Jacobson LP, Cranston RD, et al. Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men. J Gerontol A Biol Sci Med Sci. Feb 2014;69(2):189-198. Available at http://www.ncbi.nlm.nih.gov/pubmed/24127428.
- Edwards JK, Cole SR, Westreich D, et al. Age at Entry Into Care, Timing of Antiretroviral Therapy Initiation, and 10-Year Mortality Among HIV-Seropositive Adults in the United States. Clin Infect Dis. Oct 1 2015;61(7):1189-1195. Available at http://www.ncbi.nlm.nih.gov/pubmed/26082505.
- Horberg MA, Hurley LB, Klein DB, et al. The HIV Care Cascade Measured Over Time and by Age, Sex, and Race in a Large National Integrated Care System. AIDS Patient Care STDS. Nov 2015;29(11):582-590. Available at http://www.ncbi.nlm.nih.gov/pubmed/26505968.
- Althoff KN, Justice AC, Gange SJ, et al. Virologic and immunologic response to HAART, by age and regimen class. AIDS. Oct 23 2010;24(16):2469-2479. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20829678.
- Bosch RJ, Bennett K, Collier AC, Zackin R, Benson CA. Pretreatment factors associated with 3-year (144-week) virologic and immunologic responses to potent antiretroviral therapy. J Acquir Immune Defic Syndr. Mar 1 2007;44(3):268-277. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17146370.
- Nogueras M, Navarro G, Anton E, et al. Epidemiological and clinical features, response to HAART, and survival in HIV-infected patients diagnosed at the age of 50 or more. BMC Infect Dis. 2006;6:159. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17087819.
- Sitar DS. Aging issues in drug disposition and efficacy. Proc West Pharmacol Soc. 2007;50:16-20. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18605223.
- Steinman MA, Hanlon JT. Managing medications in clinically complex elders: "There's got to be a happy medium." JAMA. Oct 13 2010;304(14):1592-1601. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20940385.
- Marzolini C, Back D, Weber R, et al. Ageing with HIV: medication use and risk for potential drug-drug interactions. J Antimicrob Chemother. Sep 2011;66(9):2107-2111. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21680580.
- Wellons MF, Sanders L, Edwards LJ, Bartlett JA, Heald AE, Schmader KE. HIV infection: treatment outcomes in older and younger adults. J Am Geriatr Soc. Apr 2002;50(4):603-607. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11982658.
- Wutoh AK, Elekwachi O, Clarke-Tasker V, Daftary M, Powell NJ, Campusano G. Assessment and predictors of antiretroviral adherence in older HIV-infected patients. J Acquir Immune Defic Syndr. Jun 1 2003;33 Suppl 2:S106-114. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12853859.
- Silverberg MJ, Leyden W, Horberg MA, DeLorenze GN, Klein D, Quesenberry CP, Jr. Older age and the response to and tolerability of antiretroviral therapy. Arch Intern Med. Apr 9 2007;167(7):684-691. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17420427.
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- Palella FJ, Jr., Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. Sep 2006;43(1):27-34. Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16878047.
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Tuesday, January 13, 2009
And on the Seventh Day He Shall Rest...Posted by Indentured Pleb at 11:06 AM
Well it's almost game time... now, being a Philadelphia resident you might think I'm talking about next week when the Philadelphia Eagles take on the Arizona Cardinals for the NFC championship - which they will, in what also I think will ultimately turn out to be an all Pennsylvania Super Bowl 43. However, as much as I am looking forward to the Steelers being taken down due to other personal vendettas, I am of course talking about another game all together... The Presidency of the United States.
On January 20th, 2009 the clock officially starts ticking and everything from thereon is officially on Obama's watch. For those of you paying any attention there are a few minor things the current president elect has vowed to tackle... Will he be able to? What bridges will he be forced to burn? How will the media whom remain in a state of utter euphoria handle the inevitable failures many of us are expecting? Regardless, we shall all be witness.
Below is a tiny list of things Obama has promised to take care of, I may have missed a thing or to so please don't be shy and feel free to remind me.
End poverty domestically
End poverty worldwide
Give housing to homeless vets
Give people more days off from work
Help people save more money
Increase the average family's income
Cut taxes for 95% of families
Clean coal technology and other alternative fuel types
Build new roads
Provide a "royal class" education to every child
End independence of Middle East oil in 10 years
Make nuclear power safer
Retool the domestic auto industry
Make fuel-efficient cars cheaper
Get better teachers and pay them more
Send every American to college
Lower health care costs
Get women better pay
Increase sick leave policies
Expand personal bankruptcy protection
Capture Osama Bin Laden
End the war in Iraq
Protect Israel and Georgia
Defeat Al-Qaeda
Increase military spending
End nuclear proliferation
End genocide
End the spread of disease
Make the rest of the world love America
End political partisanship
Unite the country
Reduce unwanted pregnancies
Take guns away from criminals while giving them to hunters
End discrimination against gays
End the hiring of illegal immigrants
Change the culture of Washington
Put an end to the housing crisis
Reestablish order in the financial markets
Create millions of new jobs


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Flags to fly at half-staff Sept. 13
Posted by Velvet Hasner
By order of Gov. Mike Parson, all U.S. and Missouri flags at state and government offices will be flown at half-staff from sunrise until sunset Thursday, Sept. 13, in memory of Deputy Sheriff Aaron P. Roberts of Springfield, Missouri. He died in the line of duty Sept. 7.


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Snake Survival Guide For Dogs
Ford Wilson and his wife Wendy lived in Mexico, at least five months a year, for 30 years. He now lives in Washington state and raises chickens. Here is his snake story,
We have quite a snake history since we lived near Los Barracas, out in the tulies between Cabo Pulmo and La Ribera for so many years. We had a few near misses, one of them when we returned home and turned on the lights. Lying in the middle of the living room was a 4 ft long rattler! I grabbed a shovel and dispatched it.
This was the first rattler we killed and we decided that if the snake was on our property and around an area that our dog walked thru, well, sorry but the death penalty would have to be applied. If we encountered a rattlesnake on the road or anywhere else like a hike, we avoided the snake and in some cases would protect it from being run over on the road.
We would never walk in the dark without a good flashlight to illuminate where we
would step. When hiking we would always watch where we were going and especially where we put our hands. You just can't relax when you are in snake country.
In 2010 we got a new puppy. On our migration to Baja in October, we stopped in Bermuda Dunes, California to meet up with a guy who trained dogs to avoid rattlesnakes.
The trainer and an assistant had an ice chest with snakes in it. The snakes had surgical tape around their mouths to render them harmless. Raven was fitted with an electric shock collar, with the strength set for her size and hooked up to a long leash.
First the trainer put a snake in the middle of the clearing and walked Raven around and towards the snake. As Raven noticed the snake and started to investigate it, she got a mild zapping which caused her to back away. This continued in other scenarios, like putting a snake
under a bucket and letting Raven sniff the bucket and, again, getting zapped. Another snake was put in the open area and was agitated enough for it to rattle, again letting Raven get close enough to get a zapping.
The theory is that when seeing a snake, smelling it, and by hearing the rattle and getting zapped for getting close, a dog would avoid snakes in the future. (I wonder if that works for quitting cigarettes? Wear a shock collar for a couple weeks, maybe?)
The final exam was to put a snake in the clearing, have us stand on one side and the trainer and Raven on the other side. He let Raven off the leash as we called her. If she ran straight toward us and close to the snake, well, that was a fail. If she took a great circle route to avoid the snake on the way to us, that was a pass. She passed.
One year later we did another session to re-enforce the avoidance training. The cost of this training was around $100 per session. There is also the option of anti-venom injections for protecting dogs, although this is more controversial and something we decided not to do.
For the five winters that Raven spent in Las Barracas there was never an encounter with a rattlesnake that we were aware of. Additionally we never saw a rattlesnake on the beach but seeing them on the roads was common.
We consider rattle snakes a manageable risk if you follow some common sense rules.


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Famous Ithaca College Alumni
List Rules People on this list must have gone to Ithaca College and be of some renown.
List of famous alumni from Ithaca College, with photos when available. Prominent graduates from Ithaca College include celebrities, politicians, business people, athletes and more. This list of distinguished Ithaca College alumni is loosely ordered by relevance, so the most recognizable celebrities who attended Ithaca College are at the top of the list. This directory is not just composed of graduates of this school, as some of the famous people on this list didn't necessarily earn a degree from Ithaca College.
The list you're viewing is made up of graduates like David Boreanaz and Ricki Lake.
This list answers the questions "Which famous people went to Ithaca College?" and "Which celebrities are Ithaca College alumni?"Use this list of Ithaca alumni as your own personal Ithaca College directory and take a look at these famous Ithaca alums!


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we've dedicated ourselves to procuring and providing educational opportunities that transform the lives of those they touch.
Cascajal Foundation is a non-profit - 501c(3) organization dedicated to procuring, funding, and promoting educational opportunities
for young Hispanics from high school to graduate school.
We are funded by members and people like you. We are independent of any political ideology, economic interest or religion.
We organize a wide variety of social activities for fund-raising with the aim to provide financial support, such as scholarships,
to a large range of students with lower-incomes. Since 2009, Cascajal Foundation has awarded
students scholarships which cover partial tuition in different colleges and universities around
the United States.
Make a donation today and help us expand and enhance our program. Cascajal Foundation relies on support of generous people such as YOU.
Cascajal Foundation is committed to inspire, prepare, and empower our future leaders with lifelong learning and advanced knowledge to produce positive change within our community and the country.
Our hope is that by 2020, Cascajal Foundation will be a leading institution in the United States in charge of creating and implementing programs to promote and support higher education for young hispanic with our emphasis in Colombian Descents. as well as having a group of professionals responsible for the socioeconomic development of their community and country.
We value and support leadership and creativity. That's why we are committed to mentor youth before and during their academia as well as promoting community and institutional involvement to encourage success.
we've dedicated ourselves to procuring and providing educational opportunities that transform the lives of those they touch.
Cascajal Foundation organizes forums/talks to raise awareness about a variety of health issues within Hispanic community.
Counseling is provided free of charge for high school students, current college students, and international students.
Researcher at UT Health Center and current president and co-founder of Cascajal Foundation.
Teacher at HISD and current Vice President and co-founder of Cascajal Foundation since 2009.
Mss. Ibarguen is a College Adviser and current Program Manager of Cascajal Foundation.
Teacher at HISD for more than 15 yrs & current treasurer and co-founder of Cascajal Foundation since 2009.
Our vital work is only possible because of people like you.JOIN WITH US
Estoy muy agradecida estimado Dr., y demás miembros del equipo de la Fundación Cascajal por tenerme en cuenta, haberme seleccionado, y por confiar en mí.
Manuel y yo asistimos con mucho gusto y amor a los eventos de Cascajal . Cuente con nuestro apoyo para esta importante labor que está haciendo a beneficio de la comunidad.
Con mucho gusto es mi deseo continuar colaborando con la fundacion Cascajal.
There are lots of valueable information around the world,We help you to know the unknown.


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Frankfurt Dresses up for the World Cup
That reddish rectangular structure in the middle of the River is a giant Phillips television display, with a series of bleachers being set up on the north side for viewing.
And all along the banks you will find various vendors, most certainly for beer and wursts.
And yes, as noted here a few weeks ago, they finally unveiled the Dom. Still not the best angle here, but getting there.


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Judy Wills
Frequently, when I'm trying to find something to write about, I will go back through my pictures and find something that teases my interest. I did that recently, and discovered that I have some really delightful pictures of myself and my brother as we were growing up. Therefore, I would like to share those wonderful memories with you all. Here's the first installment.
Billy and I were both born in Dallas, Texas.
And by-the-way – we called him "Billy" until he was about 14 years old when he decided he wanted to be called "Bill." But for this purpose, he will be Billy. He is about 3½ years older than I am, and while we had our ups and downs that most siblings have, we are overjoyed to be living within an hour of each other now. We really like each other much more now that we are adults!
Since we have Google and other browsers at our fingertips now, I looked up our old house in Dallas, and was pleased to see that the latest owners have really kept up the house – including adding an in-ground swimming pool in the back yard! So I guess the neighborhood has not gone downhill as I feared it might! Here's a picture of our Mother with Billy and me in front of our house. Billy is 4½ years old, and I am one year old.
You can see by this picture of the neighborhood that Billy, by the age of about six months or so, was already into trucks and such.
Those of you who enjoy really old cars, will get a kick out of the cars in this photo and others to follow. These pictures were taken in the late 1930's-to-early 1940's. Enjoy! Here are a few other pictures of him….with a model airplane – see, he really DID start at an early age loving airplanes.
Remember his post about having that toy parachute (August 27, 2014)? Here is a picture of him with it.
And do you remember my post about the furniture that our grandfather made out of empty spools of thread (October 26, 2012)? Here is a good picture of Billy with the child's chair Grandpa made.
We don't have those chairs anymore, but we do have other furniture he made for the family. Our mother had some, and her sister, our Aunt Jessie, had some, and now Bill and I each have some of that furniture, to remember a man who was so creative.
Here's a picture of Billy and a second cousin, Jimmy Mac. Billy was only two years old.
And here's another picture of the two of them – with me in the mix – when they were three years older.
And here's a good picture of our Mother and Father, with Billy, when he was two years old.
And this one is of the four generations – Billy, our Mother, her Mother (our Granny), and Granny's father.
Neat, neat, neat. I just LOVE these old pictures!
~~~~~~~~~~To Be Continued~~~~~~~~~~


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The Human Rights Law and Policy Forum (HRLF) facilitates international internship opportunities for LLB and JD students of the CityU School of Law. Such internships not only allow students to earn credits but also gain valuable global perspectives as to how different organisations function.
Students have been able to do internship with the UN Office of the High Commissioner for Human Rights (OHCHR) in Geneva as well as at human rights law firms and non-governmental organisations (NGO) in Seoul, South Korea. Some students have also assisted UN agencies (like UNDP) or the UN human rights experts in their projects as part of the United Nations Volunteers Programme.
In August 2018, 10 LLB and JD students participated in the MUPR Competition held in Seoul, South Korea. HRLF collaborated with Human Asia, a South Korean human rights NGO, to create this unique opportunity for CityU law students. The aims of the MUPR are to encourage participating students to understand human rights challenges and explore sustainable solutions to such challenges in a given country that they represented. By simulating the UN Human Rights Council's universal periodic review system, the MUPR also allows students to learn how the UPR works at the UN level. Moreover, Human Asia organised an all-day human rights tour of Seoul for participating students.
My summer at the OHCHR was an amazing and eye-opening experience. Over the ten weeks at the UN Headquarters for Human Rights in Geneva, I had the opportunity to attend various events, conferences, and training offered by the United Nations.
Besides working with my team, I also had the opportunity to participate in a Global Consultation of OHCHR, an open discussion conference that happens every four years to discuss and address current issues and priorities. Participating in different small group discussions and listening to the views of OHCHR and government representatives on controversial issues, including business and human rights, was a rewarding and fascinating experience. This unique internship allowed me to understand the impact of international law on a global scale and has further fuelled my passion for law.
Lo Mandia Yat Man (JD student)
Thanks to the support I received from CityU, I was able to spend 3 months in Geneva, Switzerland as an intern at the OHCHR. During my time at the OHCHR, I was given the opportunity to work in a variety of different areas, such as "Illicit Financial Flows" which studies the impact of tax evasion and tax avoidance on the rights of citizens. My time at the UN was a learning rollercoaster which I thoroughly enjoyed. It has given me a new perspective on international human rights, and I believe it will have a lasting impact on my career path going forward.
Jacobus Du Plessis (LLB student)
In July 2018, I did internship with pNan, a Korean NGO which aims to protect and assist international refugees seeking asylum in Korea and abroad. I was there to research the UN resettlement programs of taking refugees carried out in the UK. I also looked for the social integration policies in the EU countries from a comparative approach, particularly how to prevent refugees from the poverty trap. Our research group made a presentation about how countries such as UK, USA, Canada and Germany review the applications of asylum seekers. Based on our research, pNan would make recommendations to the Korean government to improve their procedure to review applications of asylum seekers. During the research, we learned both international and Korean domestic laws concerning the refugees. Furthermore, we got to know the implementations of those laws in various countries, and the roles of UNHCR and NGOs in refugees' protection around the world. In a nutshell, the internship with nPan not only enriched my knowledge of international human right laws, it also exposed me about the global plight of refugees.ZhengXin, Katie (JD student)


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JEFF LOOMIS: New Song 'Speak Of Nothing' Available For Streaming
"Speak Of Nothing", a brand new song from former NEVERMORE guitarist Jeff Loomis, can be streamed using the SoundCloud player below (courtesy of GuitarWorld.com). Featuring vocals from Joe Nurre, the track will be included on the special tour edition of Loomis' latest album, "Plains Of Oblivion", which will be released on April 16 via Century Media Records.
In support of Jeff's upcoming dates with SOILWORK, the "Plains Of Oblivion – Tour Edition" features three bonus tracks, in addition to the original "Plains Of Oblivion" disc that was released earlier this year.
Another one of the bonus tracks on the disc, "A Liar's Chain", can be streamed below.
Loomis's second solo album, "Plains Of Oblivion", sold 2,900 copies in the United States in its first week of release to debut at position No. 179 on The Billboard 200 chart. The effort landed at No. 2 on the Top New Artist Albums (Heatseekers) chart, which lists the best-selling albums by new and developing artists, defined as those who have never appeared in the Top 100 of The Billboard 200.
"Plains Of Oblivion" was released on April 10, 2012 in North America (one day earlier in Europe) via Century Media Records. The CD was produced by Aaron Smith (7 HORNS 7 EYES) and features cover artwork by Colin Marks of Rain Song Design, who has previously worked with ALL SHALL PERISH, THE END and XERATH.


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Our park has a AAA Tourism 3 ½ star rating and offers patrons pleasant surroundings with lots of trees, grassy grounds and full amenities.
Our Facilities:
- Caravan and Camping Sites
- Air-conditioned Cabins and Single En-suited Rooms
- Laundry
- Amenities
- Dump Point
- Camp kitchen
- 2 large barbecues – free for patrons' use
- Fridge and microwave
- Boiling water on tap
- Plenty of bench space
- Undercover seating
- Digital TV
- Fire pit
- Vehicle wash-down bay
- Coach companies welcome
- Pets are welcomed if you are camping or Caravanning
- Strictly no pets in Accommodation
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|Praveen Mothkuri <Praveen.Mothk...@kpit.com>
|RE: No Reducer scenarios
|Fri, 03 Feb 2017 11:43:34 GMT
In this case the output of the map-tasks directly go to distributed file-system, to the path set by FileOutputFormat.setOutputPath(JobConf, Path)<https://hadoop.apache.org/docs/r2.7.3/api/org/apache/hadoop/mapred/FileOutputFormat.html#setOutputPath(org.apache.hadoop.mapred.JobConf,%20org.apache.hadoop.fs.Path)>. Also, the framework doesn't sort the map-outputs before writing it out to HDFS. From: 萝卜丝炒饭 [mailto:firstname.lastname@example.com] Sent: Friday, February 03, 2017 12:05 PM To: ☼ R Nair (रविशंकर नायर); dev; user; user Subject: Re: No Reducer scenarios HI Nair, have you know the class please? I tried to find but failed. I know NewDirectOutputCollector is used to write tmp files. ---Original--- From: "☼ R Nair (रविशंकर नायर)"<email@example.com<mailto:email@example.com>> Date: 2017/1/30 13:32:04 To: "dev"<firstname.lastname@example.com<mailto:email@example.com>>;"user"<email@example.com<mailto:email@example.com>>;"user"<email@example.com<mailto:email@example.com>>; Subject: No Reducer scenarios Dear all, 1) When we don't set the reducer class in driver program, IdentityReducer is invoked. 2) When we set setNumReduceTasks(0), no reducer, even IdentityReducer is invoked. Now, in the second scenario, we observed that the output is part-m-xx format(instead of part-r-xx format) , which shows the map output. But we know that the output of Map is always written to intermediate local file system. So who/which class is responsible for taking these intermediate Map outputs from local file system and writes to HDFS ? Does this particular class performs this write operation only when setNumReduceTasks is set to zero? Best, Ravion This message contains information that may be privileged or confidential and is the property of the KPIT Technologies Ltd. It is intended only for the person to whom it is addressed. If you are not the intended recipient, you are not authorized to read, print, retain copy, disseminate, distribute, or use this message or any part thereof. If you receive this message in error, please notify the sender immediately and delete all copies of this message. KPIT Technologies Ltd. does not accept any liability for virus infected mails.
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The necessity for frequent underwater cable/pipe inspection is becoming more apparent with increased construction of subsea piping networks for the oil and gas industry and heavy international telecommunication traffic. Current methods for the surveillance, inspection and repair of undersea cables/pipes utilize remotely operated vehicles (ROV) controlled from the surface. This work can prove to be very tedious and time consuming while also being prone to human error due to loss of concentration and fatigue. Cables can be covered along sections of their length thus making it difficult to recover cable trajectory after losing track. A reliable image processing based cable tracking system would prove much less expensive and less prone to error than current solutions, as the need for constant operator supervision is removed. The development of the vision based cable tracking system for use on autonomous vehicles would also be beneficial because of the reduced cost as a mother ship is no longer necessary and such systems are beginning to appear in commercial use (Hydro-International 2008). Vision systems also possess advantages over magnetometer and sonar based solutions for cable tracking (Ito et al. 1994). Vision systems prove less expensive, have the ability to identify faults and require a smaller less powerful vehicle for operation (Ortiz et al. 2002).
An early attempt at a cable tracking system using machine vision was developed by Matsumoto and Ito (Matsumoto & Ito 1995). The method, like most underwater cable tracking techniques, takes advantage of the lack of straight line edges found in the
Fig. 2. Camera and lights setup (red box illustrates image frame)
underwater environment. An edge image of the sea floor is acquired using a Laplacian of Gaussian filter. The Hough transform is then applied to the edge pixel image in order to find the most likely pipe edge candidates. A method of candidate evaluation is implemented by examining the length and width of each edge pixel line candidate. The direction of the cable in the present image and the previous image are used to predict the angle of the Hough transform to be applied to the subsequent image to reduce computation time. This cable following algorithm also attempts to address the problems of sediment covered pipes and non-uniform illumination. While achieving reasonable results in a controlled environment, factors such as spurious edge detection from other pipes or elements, abrupt pipe direction changes and a search algorithm (when cable is undetected) have not been accounted for and result in reduced performance.
Balisuriya et al. developed on previous work (Balasuriya et al. 1997) by adding an a priori map of the cable location to his technique (Balasuriya & Ura 2002). The main features of the method are the ability to follow the cable when it is not visible to the vision system and selection of the correct cable in the image (in the case of multiple cable presence). These objectives are addressed by assuming that an a priori map of the cable is available. The a priori map serves three purposes; to predict the region of interest (ROI), to avoid misinterpretations with other cables in the image and to be used as a navigation map in the case where the cable disappears from view. A similar method to Matsumoto and Ito is implemented to locate the cable in the image by utilizing the Hough transform. The technique described fuses inputs other than optical information to track the cable and has attempted to overcome the issues of tracking a cable when it becomes partially or fully obscured to the vision system (due to sediment or algae coverage). It also addresses the difficulty associated with correct cable selection. The method demonstrates that the extra information, in the form of a map, fused with optical sensing can greatly improve performance. Unfortunately, having an a priori map of the cable location is not always a realistic assumption especially in the case of older installations.
Ortiz et al. developed a method for real-time cable tracking using only visual information that again takes advantage of the cables shape to locate strong alignment features along its side (Ortiz et al. 2002). After the initial image segmentation step the contour pixels are examined to locate pixel alignments that display strong pipe characteristics (long pixel alignments, parallel alignments and alignments in a y direction on the image). Once the cable has been located in the image a Kalman filter is implemented to reduce the ROI for the subsequent image to reduce computation time. When anomalies occur in the prediction phase actions are taken in order to correct the algorithm; either the frame causing the anomaly is discarded or, if a number of consecutive frames are incorrect, the Kalman filter is reset. This method achieved a 90 percent success rate for trials at 25 frames/sec performed on old cable installations. The technique dealt reasonably well with partially covered cables however, a minimal presence of the cable is required in the image at all times. No backup system in the scenario where the cable becomes undetectable by the system is described. The performance of the method discussed by Ortiz et al. (Ortiz et al. 2002) was later improved upon while also reducing the complexity of the system (Antich & Ortiz 2005). This new technique also includes a first approximation to the vehicle control architecture for locating and tracking the cable autonomously using the vision system and a method is proposed for unsupervised tuning of the control system. Both the control system and the tuning strategy were validated using 3D object-oriented simulator implemented in C++ using the OpenGL
graphics library. Only simulation results have been published to date but results for the implemented control architecture are promising.
Recently Wirth et al. developed a method for cable tracking by implementing a particle filter in an attempt to predict the location of the cable when it is partially obscured and thus the number of extracted image features is reduced (Wirth et al. 2008). A motion model is calculated to describe the cable parameters' changes over time using previously captured cable inspection footage. An observation model is also described to detect cable edges in the image. These models are then combined in a particle filter which sequentially estimates the likelihood of the cable position in subsequent frames. Experimental results concluded that the system was capable of working online in real time and showed good performance even in situations where the cable was scarcely visible. A method for dealing with multiple cable presence has yet to be developed for the system.
Different methods for cable tracking systems exist each with their own advantages and disadvantages. The work reviewed uses similar techniques for cable detection (looking for straight line edges) but differ in their approaches to cable direction prediction to save on computational expense and improve detection robustness. The need for a robust system for tracking a cable that is partially obscured for a short segment remains a priority. Sensor fusion has been proved to be a good approach to robust cable following when the cable is in view. The future will focus on refining tracking methods and working towards the development of vision systems for inspection, fault identification and localisation with the hope of fully automating the process of cable tracking and inspection and reducing human input. There remains a lot of room for improvement in these systems but despite this there is a surprising lack of publications in the field over recent years.
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Are You Frustrated Because Your Graphics Are Not Looking Professional? Have You Been Slaving Over Your Projects, But Find Yourself Not Getting What You Want From Your Generic Graphic Software? Well, youre about to learn some of the secrets and tips to enhance your images, photos and other projects that you are trying to create and make look professional.


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Among other things, I'm an author. If you are mostly interested in reading about my reading, writing and self-publishing life, you can find me at www.prosperocious.wordpress.com.
This blog is for the other things: designing, knitting, sewing, gardening, cooking, painting and living the simple life in an urban setting without sacrificing creativity. Occasionally, I write, direct, set design or act for the theatre.


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Me and "The Cajun" - Riverboat Gamblers
Wayne (AKA "The Cajun") and me at Olde Time Photo in Rehoboth Beach
After having slept most of this rainy Sunday, I decided late in the afternoon to take a ride into Rehoboth.
Normally I would not do this on a Sunday night in season but since it rained today I figured the vehicle and people traffic wouldn't be too bad. I was right.
As I was making my left turn off of Rt. 1 onto Rehoboth Avenue (Rt. 1A) I thought to myself, "Why not stop by Dos Locos and see if Wayne is still there?" Wayne is a host at Dos Locos. He usually gets off around 5 pm. I thought on a lark, drop by, pick up Wayne, treat him to dinner at the Purple Parrot and then go to Olde Time Photo and have a crazy picture taken.
I was in luck. Wayne was just getting off work. He was surprised to see me but he was up for the adventure. He said he had already eaten but would join me for a drink at the Purple Parrot while I chowed down a Wimpy hamburger (with cheese and crispy bacon - no raw bacon for me thank you.)
About a year and a half ago (was it that long ago), a group of us used to meet at the Feathered One (AKA the Purple Parrot restaurant) on Sunday nights for a weekly get together of old friends. Really OLD FRIENDS.
However, somehow that tradition has fallen by the wayside for several reasons of which I won't go into at this time.
It was good to get our table by the window again where we could view the parade of people strolling down Rehoboth Avenue while we chatted and waited for our order. Wayne ordered a margarita. He was sampling the competition. Dos Locas has the best margaritas this side of Rt. 1. The margarita he got at the Parrot missed the mark. Obviously from a mix, it was bitter and not pleasant. Somewhat awkwardly he asked the waiter to take it back. But that was the only sour note on the night. My Wimpy hamburger and fries were perfecto. Just as I remembered them from a year and a half ago, the last time I was at the Parrot.
While stuffing my face with my Wimpy, who do I think I see walking by outside than none other than one of my blog fans. I do believe it was Mark with his partner Fred. Was that you Mark? I think we made eye contact but you swiftly averted your eyes. You came into the Parrot and went to the bar with Fred but you left shortly thereafter. I was tempted to go up and say "Hi!" to you but Wayne advised me against it. I didn't want to cause any problems in your marriage. Ah, the drama that unfolds when one ventures out into the night.
It was a beautiful night. After dining at the Parrot, Wayne and I crossed the street to the old time photo place. This Sunday Rehoboth Avenue was busy but not crazy busy like it is in the height of summer. A cool breeze surrounded us, the soft lights of the avenue was kind to our old visages, and we were in an adventurism mood. Almost like two young kids even though I'm 68 and Wayne is 64. God, we're old.
As luck would have it, they were empty. I didn't want to have our pictures taken with a bunch of screaming, irritable, restless kids around. I did that when I had my Christmas card pictures at J.C. Penney Dover last year. I didn't want to go through that experience again.
The two young ladies from some eastern European country (one from Russia) who were working at the old time photo place were delightful. We decided to have our pictures taken as two old time western gamblers. Oh and did we ever look like the gamblers. I'll post those pictures tomorrow (I have to scan them and it's too late now for all that activity.)
After our pictures were taken and we were choosing what pictures we wanted to keep, Wayne's two bosses stopped by to say "Hi!" The picture posted on this blog is the one they took of us. I know, I know, my blue plaid shirt does not match my gambler outfit (Wayne already told me.) However, the smiles are genuine.
All and all, a good night in the town. One is never too old for a little spontaneous action.
We're not dead yet.
The night didn't end well - our usual relationship - contentious


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History of test/fts3c.test
|Start reworking fts3 code to match the rest of SQLite (code conventions, malloc-failure handling etc.). file: [fc723a9c] check-in: [30a92f11] user: dan branch: fts3-refactor, size: 9221
|fts3 functions for testing scripts. These are a first step towards being able to write test script which verify that fts3 is internally building indices in the expected way. Both new functions are only defined if fts3.c is compiled with SQLITE_TEST defined, as when building testfixture. These functions are not intended to be part of the exposed fts3 API. dump_terms() generates a TEXT result of all the terms in the index (or a specified segment), sorted and joined with spaces. dump_doclist() generates a TEXT representation of the doclist associated with a given term in the index (or a specified segment). (CVS 5340) file: [4c7ef29b] check-in: [a48e3d95] user: shess branch: trunk, size: 11655 Added


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With Snow Leopard's low upgrade price and performance boost, many Mac OS X users are expected to upgrade if not already done so. The upgrade to most users so far has been smooth, most are inconvenient by certain third party apps that are not running well with the new OS. The following are 32 things that are new or changed in Snow Leopard, helpful info before your upgrade.
1. Snow Leopard is for Intel processor based Mac only. Applications load faster in Snow Leopard. And the OS is smaller which frees up an average of 7 gigabytes of hard drive from Leopard.
2. The $29 upgrade price is for Mac OS X 10.5 Leopard owner. If you are running Mac OS X older than 10.5 Leopard, you have to buy the $169 Mac Box Set which includes iLife 09 and iWorks 09. Technically though you can use the Snow Leopard DVD from the $29 purchase to upgrade Mac OS X prior to 10.5 Leopard. The Mac Box Set is an option for Leopard owners looking to upgrade iLife and iWorks together.
3. Snow Leopard has a new 64-bit architecture with improved 64-bit support. Key system applications are now 64-bit apps and Mac OS is now capable of accessing significantly more memory. Snow Leopard is a 64-bit system with support to run 32-bit applications. System applications that are still 32-bit include DVD Player, Front Row, Grapher, and iTunes.
4. Not all third-party software is guaranteed to work. As with all OS upgrades, there are going to be some third-party developers who are late on testing their software to ensure compatibility with Snow Leopard. Most applications working on Mac OS X 10.5 Leopard will most likely run fine in Snow Leopard.
5. Snow Leopard by default will boot into a 32-bit kernel for smooth upgrade for most users. To boot up to 64-bit kernel, press the number '6' and '4' together during boot time. However only newer Macs with a 64-bit EFI chipset is able to load the 64-bit kernel. From user's point of view, Snow Leopard is 64-bit for its system and GUI.
6. Snow Leopard has build-in support for Microsoft Exchange Server. This makes Mac OS X more enterprise-ready. The rest of changes in Snow Leopard are mainly behind the hood, and system refinements and optimization.
7. Grand Central Dispatch is a new system feature of Snow Leopard build to maximize multi-core processors. OpenCL is another system feature that allows Snow Leopard to designate some processes to the ever increasing powerful GPU graphical processor. Together, these features speed up Snow Leopard system and apps to a certain degree.
8. Expose has a new look. Windows are now line up in grids instead of all over the place.
9. Dock Expose is new in Snow leopard and should be favorite among many. Just click and hold the app icon on the dock, and windows for the app will appear in Expose grid. This makes it easy to locate the app window.
10. Menu bar can now show the full date, not just the day of the week. Previously you need a hack to achieve such.
11. When you boot into Windows using Boot Camp, you can now read Mac's HFS+ partition. This makes it easy to share data between Mac and Windows. This is read-only access from Windows session.
12. Safari is now safe from plug-ins crashes. The whole browser does not go down together with a plug-in crash.
13. Restore deleted item from Recycle Bin will now automatically restore back to its original location.
14. Spotlight search results is now sortable for more efficient searching. You can sort search data by name, date created, date modified, size, type of file, or label.
15. Preview app in Snow Leopard allows you to annotate and markup PDF files. The annotation tools include comments, links, highlighting, strikethrough text, shapes, text, and arrows.
16. AirPort now displays signal strength for all available wireless networks on the menu. This make it easy to choose the strongest possible connection.
17. When printing, Snow Leopard displays nearby printers as well. Allowing you to identify and select the best available device for printing your document.
18. Printer drivers are now downloaded from Internet. Snow Leopard checks and automatically updates the latest printer driver.
19. Users can now create a service via Automator and add it to the Services menu.
20. Snow Leopard has build-in support for Cisco VPN connectivity which will make many enterprise users happy.
21. Snow Leopard has a brand new QuickTime system and libraries. And sports a brand new QuickTime Player X with interface makeover. With QuickTime Player X, you can record your desktop screen and audio input into video for screencasting. You can upload directly to YouTube and MobileMe from QuickTime Player X. Most QuickTime third party plugins such as Flip4Mac have yet to work with the new QuickTime engine. QuickTime 7 is still available as an optional install on Snow Leopard DVD.
22. When capturing screenshots, the images are assigned file name containing a time stamp. This makes it easy to locate screenshots.
23. Snow Leopard has a built-in text expansion/substitution utility. This includes auto-correct as you type and a universal user-defined text substitution tool.
24. Newer Mac running Snow Leopard can now be Wake On Demand over a network.
25. For those who use the Terminal app alot, the default font used is Menlo instead of Monaco. Monaco however is still available for you to select as the font for your Terminal session.
26. Snow Leopard has build-in support for malware protection. System will alert you when you try to open a malware.
27. When you try to eject an external harddisk or thumbdrive which is still in use, Snow Leopard will alert and inform you which application is locking the use of the external device. You can then switch to the program, quit the program and eject the device again.
28. Snow Leopard adds four finger gestures to the trackpad. Swipe four fingers up or down the trackpad to enter and exit Exposé. By swiping all four fingers left or right, you bring up OS X's application switcher.
29. Snow Leopard has a new Core Location library that can detect the location you are at. The Time Zone tab under "Date & Time" makes use of this to stick a red-pin onto the map showing your current location. You can also select to set the system time based on your location.
30. You can now enter Chinese character using the multi-touch trackpad in your Mac notebook. This is similar to the Chinese text input on the iPhone.
31. The virtual keyboard on Snow Leopard is much larger than the one in Leopard. Some has speculated that Snow Leopard is build for future tablet Mac.
32. Rosetta, which is system software that allows you to run PowerPC app, is now disabled by default. When you first start up a PowerPC app, Snow Leopard will prompt you if you want to install Rosetta or not. And if you choose yes, Snow Leopard will download Rosetta from the net and install the software.


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text: LONDON (MarketWatch) -- European shares opened slightly lower on Monday, as oil prices headed back towards $59 a barrel, adding board-based pressure to stocks. In deal news, the London Stock Exchange LSE, +0.74% gained 3.5% in early trade amid press reports that Goldman Sachs is preparing to back Macquarie Bank in a bid to take over the exchange, U.K. home builders Persimmon PSN, +0.40% and Westbury jumped after agreeing a takeover deal, and Dutch food group Numico dropped 3.1% after saying it would pay 1.2 billion euros for Asian baby food company EAC Nutrition and issue 550 million euros in shares. The U.K. FTSE 100 index edged 0.1% lower at 5,457, the German DAX dropped 0.2% at 5,080 and the French CAC-40 index eased 0.3% at 4,524.


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Cryptocurrencies, in general, have received plenty of media attention in recent months. They have started a revolution in global finance, and have turned investors into billionaires overnight. Many people don't realize, however, that cryptocurrencies are also disrupting the venture capital industry as well. Through a process known as an ICO, fledgling businesses are raising billions of dollars in startup capital and operating funds almost overnight.
If you've never heard the term, an ICO, or Initial Coin Offering, is the process by which a startup creates and then distributes a new cryptocurrency as a means of funding their company. ICOs are rapidly becoming an attractive and viable alternative to the traditional venture capital process for many tech-based companies. For the uninitiated, here's a guide that will fully explain the process, and answer the all-important question – what is ICO?
In the past, when a startup sought to find investors to buy into their vision and back it up with cold, hard, cash, they'd usually turn to large banks and venture capital firms. Those institutions offer to fund to startups that have already demonstrated growth in exchange for an equity stake in the business. The problem that technology startups often face is that they need access to significant funding to develop their products – and won't begin to grow until they get it. For them, an ICO fits the bill perfectly.
To begin an ICO, a startup typically creates a plan or whitepaper that spells out exactly what technology they are trying to create, what purpose it serves, and how much money they need to make it a reality. Then, they create a cryptocurrency and announce how many tokens will be made available to the public, and how many will be retained by the company. The earliest buyers during the sale period are often rewarded with a discount on the cost of each token, making a better return on investment more likely.
An ICO is a great way for innovative new businesses to secure financing for their ideas, but they are not without risks, both the to company organizing the ICO and to investors. For the startup, the ICO must reach its initial sale goals, or all of the collected funds are returned to the token purchasers. If that happens, it means that the startup will have spent all of the money necessary to organize and promote the sale, but with no results to show for it. A startup facing that kind of loss is doomed to fail.
For investors, though, the risks of an ICO are far, far, greater. First, the ICO market as it exists today is largely unregulated, leaving investors at higher risk of fraud and other malfeasance. To illustrate the danger, the U.S. Securities and Exchange Commission went as far as setting up their own fraudulent ICO website to educate neophyte investors. They've also stepped up prosecutions of anyone caught trying to steal investor funds through an ICO.
For investors, an ICO can be an excellent chance to get in on the ground floor of a technology company with a bright future. As previously mentioned, though, they can also be a way for scammers to lure victims into a trap. To avoid an ICO scam, investors should look for these telltale signs of trouble:
Despite the risks, the ICO market has had a number of success stories that have spawned successful companies and happy investors. The most visible example is Ethereum, which is now the second-largest cryptocurrency by market capitalization in the world. During Ethereum's ICO, Ether tokens sold for a mere $0.31. At the time of this writing, they're worth about $518. That represents a 167,000% return on investment. That kind of appreciation in value is unheard of for almost any other type of investment, which is why the ICO market has remained robust, despite the challenges of fraud and looming regulation.
ICOs, like cryptocurrencies themselves, aren't going away any time soon. As long as innovative entrepreneurs keep dreaming up new technologies and turning to an ICO to fund their enterprises, investors will continue to flock to the market. As previously noted though, the world of ICOs presents a high-risk high-reward proposition for investors, who have to use their own best judgment to avoid major losses. Those that do still can realize returns that outpace any other kind of investment. As global regulatory bodies continue to work to police the ICO marketplace, it should mature into a stable, safe, and mainstream financing vehicle for the global industry. For ICOs, the sky is the limit.


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Apartment Spotlight: The Ambassador at 175 North Street
Apartments at The Ambassador offer all the benefits of city living at a very affordable price. The building itself used to be an old hotel that was converted into apartment living spaces, which were renovated in 2012.
About The Ambassador
The recently renovated apartments feature modern amenities and several different floor-plans to choose from. The building also offers a laundry room with free wifi and wired cable and internet already set up in each apartment. Gated off-street parking, additional storage and pet-friendly options are also available at an additional price. And if you want a great vantage point to see the city of Buffalo, you have to check out the rooftop patio.
Life at 175 North
This location is ideally located close to downtown and within walking distance of nightlife attractions in the Allentown and Elmwood neighborhoods. It's also surrounded by so many great restaurants and food stops that you'll never get sick of going to the same places over and over again. These apartments are centered in the heart of some of Buffalo's most unique cultural areas where there's always something going on, so finding something to do will never be a problem at 175 North.
If the exciting lifestyle at The Ambassador sounds interesting to you, check out our rental page and get in touch with us for more information.


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Category: Live
Visiting Greece for the first time? Here's what you need to know.
Traveling is good for your health
The Creative Adult is The Child who Survived
About a month ago my friend Sheema-Throughmylens, the inspired blogger of sheemazaman a thoughtful life style blog, nominated me with the "Creative Blogger Award". I immediately decided to answer because nominations are truly a gesture of encouragement and appreciation and a creative way for new bloggers to meet each-other. Sheema I can't thank you enough… Continue reading The Creative Adult is The Child who Survived
The perfect way to celebrate Mother's Day
Looking for fun ways to celebrate Mother's day with your family this year? I've got some ideas that will make this special day one to remember. A Day Together Set aside all other plans and treat the mother as a queen for the day. Turn the day into a one day adventure to someplace special.… Continue reading The perfect way to celebrate Mother's Day
Here's to New Beginnings
Festive SundayMeal – the Mediterranean way
Today is Easter Sunday for the Greek Orthodox church and it's one of the best time to be in Greece. Spring has sprang, the weather is ideal for long walks in the country and for site seeing. Though Greece is a popular summer destination, visiting during spring might be the best choice. While Mediterranean nature… Continue reading Festive SundayMeal – the Mediterranean way


text: NEW YORK (MarketWatch) -- U.S. stocks finished mixed Wednesday, with the Dow Jones Industrial Average breaching record territory after upbeat earnings from JP Morgan Chase & Co. and Intel Corp., while weakness in the technology sector persisted after lower-than-expected earnings at Yahoo Inc. and a downgrade of IBM. The Dow Jones Industrial Average was up 30 points at 12,803 at the unofficial 4 p.m. close. The Dow broke through both its previous intraday record high and its closing record high, lifted by gains in only 11 of its 30 components. Among those, JP Morgan JPM, -0.88% jumped 3.8% after its earnings topped expectations. The S&P 500 [s; $spx] gained 1 point to 1,472, while the Nasdaq Composite COMP, +0.20% fell 6.4 points to 2,510. Techs were impacted by weaker than expected earnings at internet portal Yahoo yhoo, whose shares slumped 11.8%.


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A few weeks ago, I started reading the book Bridging the Class Divide, by Quaker author Linda Stout. In the first few pages I came across something (in the introduction?) that has stuck with me ever since:
- As people who are concerned about social justice and equality, we often direct our efforts to impact the field of social services when what we need to do is focus our energy and attention on the concept of social change.
[CORRECTION: It isn't in the introduction, though this concept is in the part of the book that I had first started reading, the chapter called "Principles for a New Organizing Model": "Providing services does not result in social change." (p.106; emphasis mine)]
In the monthly meeting, we do fairly well to help feed and shelter people who are homeless--at least when it's "our turn" to do so as a meeting. We go to peace vigils and march along one of the bridges that span the Mississippi to protest the ongoing wars in Iraq and Afghanistan. We often gather a group of us to go to the state capital to participate in the annual Lobby Day on behalf of GLBTQ rights, and we turned out in force to rally against the Republican National Convention when it came to town in the fall of 2008.
It's been years, though, and little has changed, other than--most notably--the administration in Washington D.C. The wars are still going on; same-sex couples are still without equal federal protections under the law, and poor people, including more and more of the "working poor," are lining up at food shelves.
Recipients of social services no doubt appreciate the help, care, and support. Their individual lives are made better, if only for a short time before the oppression, financial destitution, or illness come knocking at their door once again.
But change in the way that social systems work, in the way that our attitudes and perceptions impact those systems: now, THAT would be real change.
The question is how to go about making those sorts of system-wide, integrated, and internalized changes.
It's been happening in Iran, of course, since their elections in June earlier this year. Something new has been struggling to break through, and it's changing the political, social, judicial, religious, international, and technological fabric that had existed there.
And it happened because Iranians began putting themselves in the way.
They put themselves in front of the military. They put themselves in front of television, cell phones, and Twitter. They put themselves in front of their oppressors and the world began to pay attention.
The world began to pay attention, not just the individuals who shout from rooftops each night or the relatives and friends of people who are in Tehran.
And so it was that during the last few minutes of Meeting for Worship, two days before I was to head to FGC's Gathering, that the pieces came together for me: Linda Stout's remark; the revolution in Iran; and the meeting's apparent laissez-faire approach to opportunities that await us:
- We must be willing to put ourselves in the way if we want to affect change.
- We must be willing to put ourselves in the Way if we want to affect change.
I remember watching the film Iron Jawed Angels and being impressed, not by the Quaker women portrayed in the film but how they put themselves in the Way of Truth, and they put themselves in the Way of Justice.
So many other examples exist in our history as Americans: Martin Luther King, Jr. Harvey Milk. Harriet Tubman.
During worship that morning, I began to wonder just where it is that we are to stand in order to find ourselves in the Way.
And yet...
In the very last few minutes of my afternoon worship, I began to understand that first, for me, I must pray to be changed inwardly and intrinsically. I must be changed at the core so that I might open myself "to be willing to be willing" to stand in the Way.
- Lord, make us an instrument of Thy peace.
Where there is hatred,
where there is injury,
where there is doubt,
where there is despair,
where there is darkness,
and where there is sadness--
Give us the courage and the faith to be willing to put ourselves in the Way.
P.S. There'll be more to read about "social change" and "social services" both here and at my partner's blog, Quakers & Social Class. Both of us were in George Lakey's workshop at Gathering about, well... Quakers and social class. And we both have something to say about our experience there.
UPDATE: Jeanne has published a post on her thoughts about the "rules" that play into this sort of social service vs. social change paradigm, just moments after I posted this!


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The incident starts with Indya stomping on a "Re-elect Trump" sign in NYC. Then tried to walk away with it, but the owner of the sign, Dion Cini, stepped in to grab his property. Both struggled over the sign for a bit and then Dion started shoving Indya and another guy.
The scrap lasted a few moments until another man got in between them to calm things down ... or at least he tried, lol. Indya reached back in to knock off Dion's 'MAGA' visor.
Police eventually stepped in and lectured Indya.
TMZ reached out to Dion, who tells them, he's filed a police report for larceny. He says the sign's custom-made and ran him about $250. Indya, who plays Angel Evangelista on the FX show, took to Twitter to thank fans for the support afterwards.
Trump, of course, kicked off Pride Month by saying Americans should celebrate and "recognize the outstanding contributions LGBT people have made to our great Nation" ... while his administration announced a proposal that would essentially allow health care providers to discriminate based on gender identity.
The Trump administration's also essentially re-instituted a "don't ask, don't tell" policy for trans service members.
All of that is obviously not sitting well with Indya.


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GLORY 64 will feature a super bantamweight championship rematch between champ Anissa Meksen and number one ranked contender Tiffany Van Soest.
France's own Meksen (97-4, 31 KO) was last seen at GLORY 61 in New York– stopping Jady Menezes with strikes to retain the title she won from Van Soest at GLORY 48.
Van Soest (19-3-1, 6 KO) went 4-0 in GLORY as the division's first champion before dropping it to Meksen in 2017. She earned a rematch versus Meksen with a win at GLORY 55 over Sofia Olofsson.
GLORY 64 takes place in Strasbourg, France on Saturday, March 9. The card airs on UFC Fight Pass.
Source: GLORY Kickboxing


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Traditional Struga Wedding in Chicago
Albanian heritage, generation after generation cultivated and preserved a rich history in tradition. Each province, each Albanian territory, have the character and charm of tradition in which they pridefully characterize.
· 6,164 views ·