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The name of the association shall be the Association of Physician Assistants in Cardiology herein referred to as APAC.
ARTICLE II: Purpose
This Association shall be representative of graduate and student physician assistants within the United States of America. The purpose of the APAC shall be to promote enhanced patient care by providing appropriate educational and informational services to physician assistants working in cardiology.
Section 1:
The specific purposes of this corporation shall be to establish and maintain a representative organization for physician assistants (PAs) who are employed in or have an interest in the practice of cardiovascular medicine, provide focused quality CME specifically designed for cardiology PAs, gather and disseminate information related to the issues affecting our practice, ie., clinical privileges, risk management, quality assurance, reimbursement, and benefits, collect demographic data to share with the PA profession and other interested agencies or representative organizations, act as a national repository of relevant information and disseminate data when requested to assist both established and new cardiology practices devise a more standardized credentialing mechanism and scope of practice for cardiology PAs, advise cardiology PAs of impending regulatory or statutory changes which have potential to impact their professional specialty practice, advise cardiology PAs of impending development of credentialing mechanisms to establish competency of individual practitioners in our specialty, stand ready to assist the American College of Cardiology (ACC) in the generation, maintenance, and periodic updating of guidelines on PA utilization in inpatient and outpatient cardiovascular settings, advise the AAPA Education Council or similar organizations or agencies regarding the development and maintenance of an alternate pathway for PA recertification and establish liaisons with and between the American Academy of Physician Assistants (AAPA) and the American College of Cardiology (ACC).
ARTICLE III: Membership
Section 1: Categories
The membership shall consist of: 1. Fellow members, 2. Associate members, 3. Student members, 4. Honorary members, and such other members as may be recognized by the Board of Directors.
Section 2: Eligibility
Members of this Association shall be men and women who are cognizant of their obligation to serve the public and who meet the requirements for membership as herein defined.
Section 3: Applications
Application for membership shall be made in writing on forms as prescribed by the Board of Directors. Applications shall be reviewed and approved or rejected by the Board of Directors or its designee. Each member shall be issued a certificate of membership as may be determined by the Board of Directors, title to such certificate remaining at all times with the Association.
Section 4: Definition of Physician Assistant
The term "physician assistant" as used herein shall include any person who has graduated from an educational program for physician assistants accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), or an ARC-PA predecessor or approved successor agencies, and who has passed or is eligible to sit for the certification examination administered by the National Commission on Certification of Physician Assistants.
Section 5: Fellow Members
Fellow members shall be physician assistants. Fellows shall have full voting privileges, shall be entitled to privileges of the floor and may hold office.
Section 6: Associate Member
Associate members shall be any non-physician assistant individual who desires to associate with the Association. Associate members shall be entitled to privileges of the floor, but shall not be entitled to vote or hold office.
Section 7: Student Members
Student members shall be students enrolled in an ARC-PA accredited physician assistant program with an interest in cardiovascular medicine. Student members shall be entitled to privileges of the floor, but shall not be entitled to vote or hold office.
Section 8:Honorary Members
Honorary members shall be persons designated by the Board of Directors for their contributions to the field of health care, the physician assistant profession and/or cardiovascular medicine. Honorary members shall be entitled to privileges of the floor, but shall not be entitled to vote or hold office. They shall be exempt from payment of dues.
Section 9: Dues and Assessments
The amount of annual dues and assessments and the manner of payment shall be determined by the Board of Directors.
Section 10: Nonliability of Members
A member of this corporation is not, as such, personally liable for the debts, liabilities, or obligations of the corporation.
Section 11: Termination of Membership
The membership of a member shall terminate upon the occurrence of any of the following events: (1) Upon his or her notice of such termination delivered to the President or Secretary of the corporation personally or by mail, such membership to terminate upon the date of delivery of the notice or date of deposit in the mail. (2) If this corporation has provided for the payment of dues by members, upon a failure to renew his or her membership by paying dues on or before their due date.
Section 12: Rights upon Termination of Membership
All rights of a member in the corporation shall cease on termination of membership as herein provided.
Section 13: Non-discrimination Membership
In the Association Membership shall not be denied or abridged because of sex, color, creed, race, religion, disability, or ethnic origin.
ARTICLE IV: Discipline
Section 1: Judicial Body The Board of Directors shall serve as the judicial body of the Association.
Section 2: Procedure To protect against misconduct by members of the Association, any member may, in good faith, prefer charges against another member who is believed to have violated the principles of medical ethics or the rules and regulations of this Association, or who is believed to be otherwise guilty of conduct justifying censure, suspension, or expulsion from the Association. Such charges shall be in writing and signed by the accuser or the accusers and state the acts or conduct complained of. Such charges must be filed with the Secretary of the Association who shall send a copy to the President and each member of the Board, and to the accused member. A date shall be set thereafter within a reasonable time for a meeting of the Board for purposes of considering such charges. Said meeting shall be held not later than one hundred eighty (180) days after the date such charges are filed with the secretary. At such meeting, the Board shall give both the accused and accuser every opportunity to be heard on the charges presented. No technical rules of evidence shall apply, and all parties to the charges shall be given a full opportunity to present all arguments both written and oral. Within fifteen (15) days following the conclusion of the hearing, the Board of Directors shall render a decision. The affirmative vote of a majority of the members present during said hearing and otherwise constituting a quorum shall constitute the decision of the Board, which shall either exonerate, censure, suspend, or expel the accused from the Association. The Board's decision shall be in writing and shall state its decision without statement or opinion about the case. The decision shall be signed by the President and Vice-President.
Section 3: Appeal Any member censured, suspended, or expelled by the Board of Directors may appeal such action within six (6) months after notice is provided in writing of the decision of the Board. The Board of Directors shall designate a time and place for the hearing of such appeal and shall give the appealing member and his/her representative reasonable opportunity to be heard. The majority vote of a quorum of the Board shall either sustain or reverse such censure, suspension, or expulsion. Such decision of the Board shall be final.
Section 4: Suspeneded and Expelled Members Any member who is under sentence of suspension or expulsion of membership shall not be entitled to any of the rights or benefits of the organization, or be permitted to take part in any of the proceedings until he or she has been reinstated.
Section 5: Violation of Professional Practice Statutes If any member has their physician assistant license, certificate, registration, or temporary permit currently revoked as the result of a final adjudicated disciplinary action for violation of their professional practice statutes or regulations, then their APAC membership shall be automatically revoked. Any individual who has their physician assistant license, certificate, registration, or temporary permit currently revoked as the result of a final adjudicated disciplinary action for violation of their professional practice statutes or regulations shall be ineligible to apply for APAC membership during the period of that revocation. Revocation of membership under this section may not be appealed.
ARTICLE V: Meetings of Members
Section 1: Member Meetings The members shall hold meetings at such time and at such places as shall be designated by the Board of Directors, but in no event shall there be less than one such meeting in any calendar year, for the purpose of transacting such business as may come before said meeting.
Section 2: Notice of Meetings Notice of meetings shall be in writing. A copy of the notice shall be given to each member no less than 60 days before the date of the meeting. Special meetings of APAC may be called by President and/or by a majority of the Board of Directors.
Section 3: Voting on Motions Each fellow member is entitled to one vote on meeting motions.
Section 4: Majority Action as Membership Action Every act or decision done or made by a plurality of voting members present at a duly held meeting is the act of the members, unless the law, the Articles of Incorporation of APAC, or these Bylaws require a greater number.
Section 5: Conduct of Meetings Meetings of members shall be presided over by the President of the corporation or, in his or her absence, by the Vice President of the corporation or, in his or her absence, in the absence of all of these persons, by a Chairperson chosen by a majority of the voting members, present in person or by proxy. The Secretary and Treasurer of the corporation shall act as Secretary and Treasurer of all meetings of members, provided that, in absence of either, the presiding officer shall appoint another person to act as Secretary or Treasurer of the Meeting. Meetings shall be governed by Sturgis: Standard Code of Parliamentary Procedure, as such rules may be revised from time to time, insofar as such rules are not inconsistent with or in conflict with these Bylaws, with the Articles of Incorporation of APAC, or with any provision of law.
Section 6: Action by written ballot without a Meeting Any action which may be taken at any regular or special meeting of members may be taken without a meeting if the corporation distributes a written ballot to each member entitled to vote on the matter. The ballot shall set forth the proposed action, provide an opportunity to specify approval or disapproval of each proposal, provide that where the person solicited specifies a choice with respect to any such proposal the vote shall be cast in accordance therewith, and provide a reasonable time within which to return the ballot to the corporation. Ballots shall be mailed or delivered in the manner required for giving notice of meetings specified in Section 2 of this Article. The ballots must specify the time by which they must be received by the corporation in order to be counted. Directors may be elected by written ballot. Such ballots for the election of Directors shall list the persons nominated at the time the ballots are mailed or delivered. If any such ballots are marked "withhold" or otherwise marked in a manner indicating that the authority to vote for the election of Directors is withheld, they shall not be counted as votes either for or against the election of a director. A written ballot may not be revoked after its receipt by the corporation or its deposit in the mail, whichever occurs first.
ARTICLE VI: Board of Directors
Section 1: Number of Directors There shall be thirteen (13) Directors of APAC, consisting of: the president, immediate past president, vice president, secretary, treasurer, five (5) regional Directors, and three (3) Directors at large. The number may be changed by amendment of this Bylaw, or by repeal of this Bylaw and adoption of a new Bylaw, as provided in these Bylaws.
Section 2: Authority In addition to the powers and authorities by these bylaws expressly conferred upon them, the Board of Directors may exercise all such powers of APAC and do all such lawful acts and things as are not by statute or by the Articles of Incorporation or by these bylaws directed or required to be exercised or done by the members.
Section 3: Specific Powers and Duties It shall be the duty of the Directors to: (a) Perform any and all duties imposed on them collectively or individually by law, by the Articles of Incorporation of this corporation, or by these Bylaws; (b) Appoint and remove, employ and discharge, and, except as otherwise provided in these Bylaws, prescribe the duties and fix the compensation, if any, of all agents and employees of the corporation; (c) Supervise all officers, agents and employees of the corporation to assure that their duties are performed properly; (d) Meet at such times and places as required by these Bylaws; (e) Register their addresses with the Secretary of the corporation and notices of meetings physically or electronically mailed or telegraphed to them at such addresses shall be valid notices hereof.
Section 4: Annual Election of Directors The annual election of the Board of Directors shall be held by written ballot in June. To be eligible to hold office on the Board of Directors, the candidate must be Fellow member of the association and also be a member of AAPA in good standing.
Section 5: Term of Office The President after serving one year as president will become the Immediate Past President. The office of Vice President shall after one year of service as Vice President assume the office of President. The term of office for Vice President, President and Immediate Past President is one year. The following Board members shall serve two year terms and be elected in even numbered years: North Central Regional Director, West Regional Director, Treasurer and two At-Large Director. The following Board members shall serve two year terms and be elected in odd numbered years: North East Regional Director, South Central Regional Director, South East Regional Director, Secretary and one At-Large Director. The delegate for the AAPA House of Delegates shall be chosen from among the APAC Board of Directors by the APAC Board of Directors on or before July 15. The term of office shall be from July 1of the election year to June 30 of the following year or two year intervals of the same.
Section 6: Election of Board APAC shall make available to members reasonable nomination and election procedures with respect to the election of Directors by members. Such procedures shall be reasonable given the nature, size and operations of APAC, and shall include: (a) A reasonable means of nominating persons for election as Directors. (b) A reasonable opportunity for a nominee to communicate to the members the nominee's qualifications and the reasons for the nominee's candidacy. (c) A reasonable opportunity for all nominees to solicit votes. (d) A reasonable opportunity for all members to choose among the nominees. Upon the written request by any nominee for election to the Board and the payment with such request of the reasonable costs of mailing (including postage), the APAC shall, within ten (10) business days after such request (provided payment has been made) mail to all members or such portion of them that the nominee may reasonably specify, any material which the nominee shall furnish and which is reasonably related to the election, unless the APAC within five (5) business days after the request allows the nominee, at the APAC's option, the right to do either of the following: 1. inspect and copy the record of all members' names, addresses and voting rights, at reasonable times, upon five (5) business days' prior written demand upon the APAC, which demand shall state the purpose for which the inspection rights are requested; or 2. obtain from the Secretary, upon written demand and payment of a reasonable charge, a list of the names, addresses and voting rights of those members entitled to vote for the election of Directors, as of the most recent record date for which it has been compiled or as of any date specified by the nominee subsequent to the date of demand. The demand shall state the purpose for which the list is requested and the membership list shall be made available on or before the later of ten (10) business days after the demand is received or after the date specified therein as the date as of which the list is to be compiled. If the APAC distributes any written election material soliciting votes for any nominee for director at the APAC's expense, it shall make available, at the APAC's expense, to each other nominee, in or with the same material, the same amount of space that is provided any other nominee, with equal prominence, to be used by the nominee for a purpose reasonably related to the election. Election of the Board of Directors will be held in June. Ballots will be mailed no later than April 1rst and must be returned (not postmarked) by May 15th. Declaration of candidacy for elected office on the Board of Directors will be open from January 1rst to March 15th. Ballots may be cast at the annual AAPA conference and a final count of mailed written ballots and written ballots received at the AAPA annual conference will then be made. Candidates may self-declare or may be nominated by any fellow member. Declaration is considered official when a self declaration or an acceptance of nomination is received in writing by the secretary. All candidates shall be fellow members. All candidates for regional director may only run in the region wherin they reside as of the record date.
Section 7: Voting A majority of valid ballots otherwise shall elect the vice president, secretary, and treasurer. In the event that there is no majority, a run-off election between the two candidates receiving the most votes for the affected office shall be held. A majority of valid ballots shall elect in a runoff election. Cumulative voting for the election of Directors shall not be permitted.
Section 8: Directors-At-Large The candidates for director-at-large receiving the highest number of votes cast shall be elected to office, up to the number of available positions.
Section 9: Regional Directors Only those members eligible to vote and residing in one specific region at the time of the record date may vote for that region's candidates. A majority of valid ballots shall elect the regional director. In the event that there is no majority, a run-off election between the two candidates receiving the most votes for the affected office shall be held. The candidate receiving the highest number of votes shall be elected in a runoff election. There shall be five (5) regions for purposes of electing regional Directors. Region 1, Northeast, shall consist of the states of Connecticut, Maine, Vermont, New Hampshire, Massachusetts, New York, Pennsylvania, New Jersey, and Rhode Island. Region 2, Southeast, shall consist of the states of Delaware, Maryland, Virginia, West Virginia, Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Alabama, Florida, and the District of Colombia. Region 3, North Central, shall consist of the states of Ohio, Indiana, Michigan, Wisconsin, Illinois, Missouri, Iowa, Minnesota, North Dakota, South Dakota, and Nebraska. Region 4, South Central, shall consist of the states of Mississippi, Arkansas, Louisiana, Texas, Oklahoma, Kansas, Colorado, and New Mexico. Region 5, West, shall consist of the states of Montana, Wyoming, Idaho, Utah, Arizona, Nevada, Oregon, Washington, California, Alaska, and Hawaii.
Section 10: Compensation of Directors Directors shall serve without compensation. They shall be allowed reasonable advancement or reimbursement of expenses incurred in the performance of their regular duties as specified in Section 3 of this Article. Directors may not be compensated for rendering services to the corporation in any capacity other than director unless such other compensation is reasonable and is allowable under the provisions of Section 6 of this Article.
Section 11: Restriction Regarding Interested Directors Notwithstanding any other provision of these Bylaws, not more than forty-nine percent (49%) of the persons serving on the Board may be interested persons. For purposes of this Section, "interested persons" means either: (a) Any person currently being compensated by the APAC for services rendered it within the previous twelve (12) months, whether as a full- or part-time officer or other employee, independent contractor, or otherwise, excluding any reasonable compensation paid to a director as director; or (b) Any brother, sister, ancestor, descendant, spouse, brother-in-law, sister-in-law, son-in-law, daughter-in-law, mother-in-law, or father-in-law of any such person.
Section 12: Place and Time of Meetings The Board of Directors shall hold meetings at such time and at such places as shall be designated by the president, but in no event shall there be less than one such meeting in any calendar year.
Section 13: Special Meetings Special meetings of the Board of Directors may be called by the President, the Vice President, the Secretary, the Treasurer, or by any two Directors, and such meetings shall be held at the place, within or without the State of Pennsylvania, designated by the person or persons calling the meeting, and in the absence of such designation, at the principal office of the APAC. The object of any special meeting shall be stated in the call and no other business shall be transacted.
Section 14: Notice of Meetings Regular meetings of the Board may be held without notice. Special meetings of the Board shall be held upon four (4) days' notice by first-class mail or forty-eight (48) hours' notice delivered personally, by telephone, telegraph, or electronic mail. If sent by mail or telegraph, the notice shall be deemed to be delivered on its deposit in the mails or on its delivery to the telegraph company. Such notices shall be addressed to each director at his or her address as shown on the books of the APAC.
Section 15: Quorum for Meetings A quorum shall consist of seven (7) Directors. Except as otherwise provided in these Bylaws or in the Articles of Incorporation of this corporation, or by law, no business shall be considered by the Board at any meeting at which a quorum, as hereinafter defined, is not present, and the only motion which the Chair shall entertain at such meeting is a motion to adjourn.
Section 16: Majority Action as Board Action Every act or decision done or made by a majority of the Directors present at a meeting duly held at which a quorum is present is the act of the Board of Directors.
Section 17: Action by Unanimous Written Consent Without Meeting Any action required or permitted to be taken by the Board of Directors under any provision of law may be taken without a meeting, if all members of the Board shall individually or collectively consent in writing to such action. Such written consent or consents shall be filed with the minutes of the proceedings of the Board. Such action by written consent shall have the same force and effect as the unanimous vote of the Directors. Any certificate or other document filed under any provision of law which relates to action so taken shall state that the action was taken by unanimous written consent of the Board of Directors without a meeting and that the Bylaws of this corporation authorize the Directors to so act, and such statement shall be prima facie evidence of such authority.
Section 18: Board Vacancies In the event of vacancy the Board of Directors, at any meeting thereof, may appoint such additional officers with such title, authority, and duties as it may deem advisable until the following elections. The Board will set the amount of any compensation for additional officers or office personnel and will have the right to remove or replace any appointees at the Board's discretion.
Section 19: Removal from the Board Any officer may be removed from office, for cause, at any time by the affirmative vote of a majority of the Board provided that the affected officer shall have been given written notice of the charges and offered an opportunity to appear and be heard on the matter before the Board of Directors takes final action.
Section 20: Appeal The officer may appeal such action, in writing, within six months after notice of removal is given and the Board has taken action to remove the officer. The Board of Directors shall designate a time and place for the hearing of the appeal. After giving the officer and representatives reasonable opportunity to be heard, the Board of Directors shall, by a majority vote either sustain or reverse the removal of the officer. The decision of the Board of Directors shall be final.
Section 21: Director Liability A director shall not be personally liable for monetary damages, for any action taken, or any failure to take action unless the director has breached or failed to perform the duties of office set forth in section 8363 of Pennsylvania Act 145 of 1986, known as the Directors liability act, and the breach or failure to perform constitutes self dealing, willful misconduct, or recklessness.
ARTICLE VII: Officers
Section 1: President The President shall preside at all business meetings of the organization and of the Board of Directors. He or she shall make a full report of the year's activities at the annual meeting of the organization. He or she shall coordinate agendas for future meetings, preside at meetings and maintain order, and set up forums for discussion. He or she shall appoint all standing committees and designate their chairs, subject to approval of the Board of Directors.
Section 2: Vice President The Vice President shall assume the duties of the President during meetings in his absence. The Vice President will organize and conduct, with the assistance of the Secretary, all annual elections and be chair of the Elections Committee.
Section 3: Immediate Past-President The Immediate Past President shall perform such duties as may be delegated by the President. The Immediate Past President will serve as chair of the Membership Committee.
Section 4: Secretary The Secretary shall keep minutes of all meetings of the organization, be responsible for all organization communications, assist the Vice President on elections, notify all members of all meetings, record and file all membership applications. The Secretary shall serve on the Elections Committee. He or she shall also perform such duties as may be assigned by the President.
Section 5: Treasurer The Treasurer shall maintain accurate record of the financial status of the organization and is responsible for the collection of yearly dues from all members, depositing in the organization's account all money received by the organization and with the President's or Vice-President's approval and co-signature paying all bills approved by the organization, and recording all receipts of those payments. The Treasurer's records shall be audited every year upon leaving office. The method of audit will be determined by the Board of Directors. The Treasurer shall serve on the Sponsorship Committee.
There shall be such committees as may be specified by the Board of Directors with such authority and responsibility as may be delegated by the Board of Directors or specified in the bylaws. There shall be the following Standing Committees: a) Membership, b) Elections, c) Sponsorship, and d) CME.
Section 1: Membership Committee
The Membership Committee shall encourage and promote the increase of APAC membership by coordinating the recruitment, retention, and development of the organization's members. The members shall serve for a term of one year starting July 1 and ending June 30 of the following year.
Section 2: Elections Committee
The Elections Committee shall prepare a slate of candidates to fill positions on the Board of Directors and AAPA House of Delegates. The committee shall establish rules and regulations governing the elections. The committee shall conduct the elections in the manner discussed in Article VI sections 4 and 6. The members shall serve for a term of one year starting July 1 and ending June 30 of the following year.
Section 3: Sponsorship Committee
The Sponsorship Committee shall encourage and promote the increase of APAC sponsorship by coordinating the recruitment, retention, and development of the organizations sponsors. The members shall serve for a term of one year starting July 1 and ending June 30 of the following year.
Section 4: CME Committee
The CME Committee shall be in charge of coordinating the notification of the membership of upcoming events. The committee shall be responsible for planning and executing any CME activities sponsored by APAC. The members shall serve for a term of one year starting July 1 and ending June 30 of the following year.
Section 5: Special Committees
Special (ad hoc) committees may be appointed by the President with the concurrence of the Board of Directors for such special tasks as circumstances warrant.
Section 6: Appointment and General Duties of Committees
All committee members shall be appointed by the President with the majority approval of the Board of Directors, and shall be subject to removal by the President. Committees shall be responsible to the President and Board of Directors. Committees shall hold regular meetings and shall make quarterly reports to the Board of Directors through the President.
Section 1: Execution of Instruments
The Board of Directors, except as otherwise provided in these Bylaws, may by resolution authorize any officer or agent of the corporation to enter into any contract or execute and deliver any instrument in the name of and on behalf of the corporation, and such authority may be general or confined to specific instances. Unless so authorized, no officer, agent, or employee shall have any power or authority to bind the corporation by any contract or engagement or to pledge its credit or to render it liable monetarily for any purpose or in any amount.
Section 2: Checks and Notes Except
As otherwise specifically determined by resolution of the Board of Directors, or as otherwise required by law, checks, drafts, promissory notes, orders for the payment of money, and other evidence of indebtedness of the corporation shall be signed by the Treasurer and countersigned by the President or Vice President of the corporation.
Section 3: Gifts
The Board of Directors may accept on behalf of the corporation any contribution, gift, bequest, or devise for the specific purposes of this corporation.
Section 1: Fiscal year of the Corporation The fiscal year of the corporation shall begin on the first day of June and end on the last day of May in each year.
Section 1: Generally The bylaws and articles shall be amended by resolution of the Board of Directors and by the vote of the membership.
Section 2: Voting An affirmative vote of two thirds (2/3) of both a quorum of the Board and of the ballots cast by the membership shall amend the articles and/or bylaws.
Section 3: Notice Notice of the proposed amendments shall be mailed to the members at least sixty (60) days prior to the vote. Ballots shall be distributed by the secretary/treasurer to the voting membership at least thirty (30) days prior to the vote. For purposes of this section the record date for determining members allowed to vote shall be ninety (90) days prior to the vote.
Section 1: Prohibition against sharing Corporate Profits No member, director, officer, employee, or other person connected with this corporation, or any private individual, shall receive at any time any of the net earnings or pecuniary profits from the operations of the corporation, provided however, that this provision shall not prevent payment to any person of reasonable compensation for services performed for the corporation in effecting any of its purposes, provided that such compensation is otherwise permitted by these Bylaws and is fixed by resolution of the Board of Directors. Notwithstanding the above, the assets of the corporation will be distributed upon dissolution to a non-profit physician assistant organization as specified by the current Board of Directors. Written Consent of Incorporators Adopting Bylaws
We, the undersigned, are all of the persons named as the incorporators in the Articles of Incorporation of ASSOCIATION OF PHYSICIAN ASSISTANTS IN CARDIOLOGY, INC., a Pennsylvania nonprofit corporation, and, pursuant to the authority granted to the incorporators by the Pennsylvania Legal Code, Title 19, Chapter 41, subchapter A, section 41.1 to take action by unanimous written consent without a meeting, consent to, and hereby do, adopt the foregoing Bylaws, consisting of fifteen pages, as the Bylaws of this corporation.
Dated: December 15, 2003
John Flesher, Incorporator
Jonathan Skillings, Incorporator
Our Mission
To enhance the personal and professional growth of its constituent members and all Physician Assistants practicing in the Cardiology specialty through educational opportunities, community involvement, and political representation and advocacy.
Get In Touch With Us!


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subset: commoncrawl


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responder para KisdobosComentário de #1Hi Peter,
I have had some problems to upload my Video Quiz on my Portuguese Language section. I have tried to download my video activities in the French section, and it worked!! However, I have a hard problem to do it in the Portuguese section.
I start by creating the activities, suddenly a message of error appears saying it's not possible to register your activity.
Could you help me, please?
Best regards.


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Take part
You are here
This is an open project. As such, there are many ways you can help Musafir. Everyone can be part of the journey, even without being physically on board.
The exchange of information and knowledge is one of the highest potential possibilities of the times we are living in.
If you have experience or skills in any of the work that we are doing, share your advice and information with us. Anything you can offer is appreciated.


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When you've got a Viking warrior and a fucking polar bear throwing down on your album cover, then you'd damned well better be ready to throw down the gauntlet yourselves and get into the fight. While I can't claim that Death or Glory is a much heavier evolution of this Swedish band's sound than the Metal Conquest EP, it brings back a lot of the dramatic dynamics that defined their 1978 debut album and fuses them into some of the band's best songwriting. In fact, if I had to choose a single Heavy Load record to recommend that best represented their sound, this would be my first selection, a strong balance of pure 80s thunder and epic arrangements that might have competed in the same arena as Battle Hymns or Metal on Metal, if not for the limited accessibility the Swedes suffered from having to release the music themselves. Even today this is quite a rarity, and one is almost as likely to find the Japanese licensed copies as an original vinyl.
Death or Glory actually dials down a fraction of the single minded masculinity of the Metal Conquest EP in terms of its sheer sound, and as a result the guitar tones here have more of a fragility to them which really helps sell the blustering leads and the dual melodies (as you hear through a track like "Might for Right"). In general, though, the musicianship here is simply a more interesting experience than anything the band had brought out to date. The vocals shift back to a bit of the crazier charisma found on Full Speed at High Level, only with a lot more restraint and refinement which manages never to seem as sloppy or disjointed. The drums and bass on this record still sound great today, and for the first time in Heavy Load's careers, the leads really soar through cuts like "Might for Right", "Bleeding Streets" or the flashier segments in the bridge "Still There is Time", which have this raw classical formality to them which explodes into a sequence in which the noodling winds down into this pure, exotic chugging and flexing.
The Swedes retained a bit of their theatrical edge with the use of melodic, layered backing vocals and song structures that play out almost like tributes to the Sagas. In particular, "Daybreak Ecstasy" is a notable piece for its 9 minutes of escalation, from wintry acoustics and choirs to Styrbjörn's brief war drum thumping into some of the most glorious, imagination carving dual melodies on any Heavy Load release. This thing is simply PACKED with excellent riffing and pacing, and the vocals really howl out across the wintry background created through the reverb and atmosphere of the guitars. Hot damn, when they hit that tremolo riff around the 3:00 mark you just wanna find your own ursus maritimus and spill its savage blood across the snows. The track "Trespasser" is another unsung classic here, with more of those choppy, mean melodic guitar chugs that would have been huge if they were on Kill 'Em All (though the chorus here is admittedly a fraction too loud), and a few psychotic effects that give it almost this Hawkwind meets Diamond Head sci-fi feel that jives well with the apocalyptic lyrics.
Seriously, if Heavy Load had released an album full of tracks like that, with a little more control to the vocal lines, they likely would have blown up across Europe. But then, the variation present on Death or Glory is far from a weakness, and at least 6-7 of its songs rank among the best of their entire canon. Even the lyrics here are in general quite thoughtful, if not complex (like how they manage to create a jubilant transcendence out of what is essentially a metal groupie tribute in "Heavy Metal Angels"). The production of the record isn't perfect, with the voices clearly too voluminous in spots, but the tight rhythm section and the airy atmosphere of the guitars still sounds fresh to my ears 30 years later. I might be a little biased in its favor, as this was the first Heavy Load record I was ever exposed to (several years after it came out), but all of its many facets combine into what is very much mandatory for fans of this era. It was no Restless and Wild or Screaming for Vengeance in terms of 'hit potential', but holds up favorably along the output of acts the world over like Anvil, Loudness and Riot.
Verdict: Win [8.75/10] (can't stand for less)


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Cannonball Path Phase 6
Last Updated: 11/20/2017
This project is a shared-use (bicycle and pedestrian) path that extends the existing Cannonball Path at Fish Hatchery Road to the Wingra Creek Path.
It includes over a half-mile of new asphalt path and a bridge over Wingra Creek. It generally follows the WSOR (formerly Union Pacific Railroad) corridor heading Northeast and turns North to follow along the driveway for Bowman Park and Wright Middle School.
This is the final piece of the overall 4+ mile Cannonball Path linking areas of Fitchburg and Arbor Hills neighborhood with downtown Madison. The overall Cannonball Path project is a joint effort between Madison and Fitchburg, with land acquisition partially funded by Wisconsin Department of Natural Resources. Madison is the lead agency for the project from the west line of the Arbor Hills neighborhood to its northern terminus.
The Cannonball Path connects neighborhoods with parks, schools, major conservancy areas as well as retail, commercial and employment centers. It also connects to the Capital City Trail, Southwest Path, Military Ridge Trail and Badger State Trail, making it a key component of the regional network of paths for recreation as well as transportation.
The construction contract includes substantial length of sanitary sewer, not directly related to the path but intended to increase reliability for this portion of the City.
Total length of path is 3500 feet from the north end of the Cannonball Path Phase 5 connection at Fish Hatchery Road to the Wingra Creek Path. This project includes installing a new bridge west of the existing pedestrian bridge over Wingra Creek near South Street. The existing bridge will remain to provide a pedestrian connection opposite South Street while the new bridge will be wider and improved for bicycle and pedestrian traffic using the Cannonball Path.
Project construction is currently scheduled for 2020.
Preliminary cost estimate for construction is approximately $1 Million


text: XPLORA can receive, but not send ordinary texts (SMS). This is mainly because of the small screen size, which makes it hard to write messages. It is however possible to send position updates manually from the clock, via the "Send location". The child can use this function for example to notify his/her parents about leaving school or arriving at a friend's place.


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CCDE Practical Exam Demonstration:
The following is a sample of the CCDE Practical Exam. This demonstration was built with the same tools used to create the actual CCDE Practical Exam. However, the demo is much shorter; it includes just enough questions to illustrate the environment and tools available to the candidate. The scenario presented in the demo is not a real exam scenario and the score is not representative of the score a candidate will receive on the exam.
In the sample scenario, a theme-park operator needs to add network connectivity for vendors located within the concession venues of the park. The demo provides a general statement of initial functionality requirements. Additional requirements are delivered via written documentation, email, network diagrams, and other tools as the scenario progresses. The candidate will need to identify the network requirements, gather the needed information, perform a design analysis, and make design recommendations in the form of diagrams, ordered lists, implementation checklists, and other response types. All information needed to complete the sample scenario is provided within the demo.
Note: You may need to adjust your monitor resolution. The demo is available in the three resolutions listed below. In addition, the demo is best viewed in full-screen mode on your browser with menu and status bars hidden. The demo works best in IE version 5 or above and you may also need to disable your pop-up blocker.
This content is only accessible by Registered Users. If you have not yet registered, you will be prompted to Register, before proceeding to access this content.
Select the demo that best fits your screen resolution:


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Before When I first installed Potplayer, I had it all on my 3 monitors running on stretched, and a couple days later, now it doesn't do all 3, it only stretches to two now, I tried to look around but I can't see anything to find it, I need help!!! I want to watch movies on all 3 screens
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I-CAR Gold Class and ASE Certified For Collision Repair Service Excellence.
Modern Auto Body is owned and operated by Francis Fistori who started his collision repair service in 1985 in a rented one bay garage. After a few years of hard work striving for excellence in auto body repair, Fran was successful enough to purchase the land at 561 N. Montello Street, Brockton, and build the current facility.
Modern Auto Body finished an expansion in 2010 adding a 2nd building beside 561 N. Montello Street which houses our paint department with two high end paint booths and a new office.
Visit our Modern Auto Body shop and meet our highly knowledgeable and friendly staff. You'll also find that all our equipment is the latest in auto collision repair technology.
I-CAR Gold Class Shop #3137 since 1995
ASE Master Technicians Certified Collision Specialists
Liberty Mutual Superior Service Shop
Plymouth Rock Door to Door Program
Hanover Express Claims Commerce Cares Program
Metropolitan PAS Program Awarded Small Business of the year 2003 by Metro South Chamber of Commerce
Massachusetts Registered Repair Shop # 722
I-CAR: an inter-industry conference on auto collision repair.
I-CAR Vision: that every person in the collision repair industry has the relevant technical knowledge and skills to achieve a complete and safe repair.
We work hard to maintain our I-CAR Gold Class status: our technicians are extensively educated and all hold I-CAR certificates. We just recently finished an I-CAR Welding Qualification Series, which is an in-depth training on welding. We are keeping up on training and certification which we feel one day will be mandatory in the industry.
The National Institute for Automotive Service Excellence awards ASE Certification. Our technicians are continually trained and take the tests required to regularly update their ASE Certificates.
Over the years Modern Auto Body has hired many students from the area trade schools. Modern Auto Body has 15 employees and currently 3 Massachusetts Licensed Appraisers on staff.
Fran has been in the automotive industry for 30 years. He is an ASE Certified Master Auto Tech and is extensively trained in the latest collision technology put forth by I-CAR the Inter-Industry Conference on Auto Collision Repair. As the owner of Modern Auto body for over 25 years he has learned that every car that he works on is that persons show car. Fran makes sure the collision repair quality is his major concern. Fran lives in Norton with his wife and three children. His favorite hobby is spending time with his children. He coaches his local football team and is a member of The Blue Hills Regional School Committee. He also sits on the auto body advisory board of the Southeastern Regional School Committee.
561 N Montello St,
Brockton, MA 02301
Phone. 508-580-6422
Fax. 508-587-7954


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Debugging PHP and JavaScript code at the same time
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Just-In-Time debugging and PHP Exception Breakpoints with PhpStorm and Xdebug
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Installing and Configuring XAMPP / MAMP with PhpStorm
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Debugger Configuration Validation with PhpStorm
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Debug command line scripts with PhpStorm 2.1
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As part of its growth plans, Ratnakar Bank wanted to completely transform its business right from expanding its offerings, enhancing its service efficiency to meet its internal and external customer demands and improving customer satisfaction.
Here is the story of the bank –the problems they faced, the solutions they deployed and the results of the implementation.
The Problem
The bank realized that investing in a robust, scalable and highly available technology infrastructure was crucial to usher in a transformation for their business. With legacy systems and need for employee training to embrace new technology, this seemed an uphill task. Hence, Ratnakar Bank decided to partner with a managed IT hosting service provider who would not only help them bring in this transformation but also enable its employees to focus on more strategic initiatives.
The Solution
Core banking infrastructure is hosted on the AIX platform with multiple LPARs as per application requirements in high availability environment
IDC & Managed Hosting – PetaVault (Electronic Backup), Leased Line, Dedicated Servers, Firewalls, Load Balancing, Ethernet, Dedicated NOC, Switches, Routers
IMS – Infra Manage, Infra Monitor
Mail & Messaging – Mail Security, Microsoft SPLA
Managed Security Service – Comprehensive Network Attack Monitoring
Ratnakar Bank's entire Internet banking services infrastructure including hardware, patching and database management is hosted and managed by Netmagic. Despite numerous hurdles, Netmagic was able to migrate the bank's Internet banking services infrastructure seamlessly to its datacenter within a short span of 4 days. Netmagic's team worked in close coordination with the bank and the Internet banking application provider to understand the workflow, future growth plans, and setting up the necessary backup mechanism before migrating the application to its facility.
"We evaluated Netmagic Solutions in all aspects and realized that they were competitive from a capability as well as cost perspective. In fact, in certain areas they were way ahead of the so-called global IT companies both domestic and international." says Anup Purohit, Head – IT, Ratnakar Bank.
Additionally, Netmagic helped Ratnakar Bank in building the infrastructure for its core banking application (on AIX platform with multiple LPARs) from scratch. This also includes setting up of mailing & back office infrastructure. Netmagic also set up a DR facility for Ratnakar Bank. Besides this, the bank also contracted to avail complete managed hosting for its website and infrastructure & service delivery management. In future, Ratnakar Bank plans to migrate their treasury and other business applications to be hosted at Netmagic's datacenter.
Currently Netmagic supports and manages firewalls, network links from multiple service providers connecting all branches of the bank across the country, and servers (OS and DB) spread across its datacenters for Ratnakar Bank. Netmagic has also provided DR services to the bank on both Windows & Linux platforms in physical as well as virtual environment
The Result
Ratnakar Bank realized the following business benefits:
High availability of IT infrastructure supported by 99.9% uptime SLA for their Internet banking service ensuring a consistent customer experience
Round the clock support, maintenance and technical expertise assuring faster turnaround times (TAT) and improved performance levels
A robust and a scalable IT infrastructure helped support Ratnakar Bank's expansion and growth plans
Enhanced security for their internet banking services to assure safety of their sensitive customer information
As Ratnakar Bank builds its IT infrastructure from scratch; it also wanted to control costs. Netmagic worked out a cost structure where the Bank spends on IT on an OpEx model that does not affect its cash flows.
Ratnakar Bank has realized significant business benefits out of the present engagement with Netmagic solutions. The bank does not have to worry about the availability and management of its Internet banking infrastructure. Netmagic's round the clock support, maintenance and technical expertise ensures faster turnaround times (TAT) and improved performance levels for Ratnakar Bank.
A dedicated 19-member Network Operations Center (NOC) team manages and monitors the bank's critical IT infrastructure and provides technical support to the bank with respect to incident management and change management. Netmagic has also provided the bank with L1/L2/L3 technical support across domains viz. Windows, Network, Linux & AIX.


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Long before Grand Theft Auto leapt into the third dimension, and the same year that Driver tentatively sketched out a mould for free-roaming automotive violence as a basis for a console game, Crazy Taxi caused trailing queues with an arcade cabinet experience that allowed gob-smacked players to burn rubber and guzzle gas in a frantic, fully realised 3D city
A year later at the turn of the millennium it moved to the Dreamcast, becoming a benchmark game for Sega's brilliant but doomed console, and since then the series has enjoyed success on a number of formats.
As of yet, other than a terrible Game Boy version, there have been no handheld versions of the fondly remembered series, meaning the latest cab-driving offering from Sega should bring some welcome nostalgia to the back pockets of any twenty-something gamers the length and breadth of the country. Sadly though, despite the fact that Fare Wars ably squeezes both the original Dreamcast Crazy Taxi and its sequel onto one UMD, with a sprinkling of new features, this classic duo of games have not aged well.


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Official Website | Facebook | @Tanner4Delegate
A retired U.S. Air Force captain and government contractor, Donte Tanner says he is running for the Virginia House of Delegates to serve his community and hold Richmond accountable to make government more efficient.
Donte lives in Centreville with his wife Dana, a dance teacher. They are expecting their first child this summer. He is challenging Tim Hugo, who has held the seat since 2002, and won by 70% the last election.
District 40 Voter Research
Courtesy of Donald Braden TheFullSlate.com
Further Reading
VPap.org Campaign finances
Donte Tanner Competes for District 40 Virginia House of Delegates Seat – Data Snapshot – http://www.dailykos.com/story/2017/3/9/1641673/-Donte-Tanner-Competes-for-District-40-Virginia-House-of-Delegates-Seat-Data-Snapshot


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Good to know....
Is It Okay To Crack Your Knuckles?
How many times did you crack your knuckles while watching this? Check out more awesome BuzzFeedBlue videos! http://bit.ly/YTbuzzfeedblue1 MUSIC "Pizza Take" ...
Tuesday, August 25, 2015
Is It Okay To Crack Your Knuckles?
Good to know....
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Height: 5'9
Hometown: Vancouver, BC
Languages: English, Tagalog
Occupation: Model
Justine Felizarta is a proud Canadian from Vancouver, British Columbia. She moved to Canada from the Philippines at the young age of six. As the eldest daughter of four children, Justine assumed responsibilities early on and learned to help take of her siblings. Her parents always encouraged her to study hard and to pursue her passions in life, whatever they may be. Now, 23-year-old Justine is a licensed medical aesthetician, a signed model, and devout humanitarian.
As a recent graduate of Medical Aesthetics, Justine is committed to building awareness to health issues pertaining to the skin and the importance of proper maintenance. This is important to her as she experienced being teased all throughout high school due to severe acne. With the help from dermatologists and medical aestheticians, her skin cleared, thus becoming more confident in herself. She then pursued a modeling career shortly after – appearing in Vancouver Fashion Week and walking the runway for Calvin Klein and Forever 21 in Asia. She most recently shot an ad campaign for a luxury hotel that is to open in Vancouver sometime this year. Through it all, she now wants to help treat skin concerns such as acne and eczema, to help others put their best face forward. She wants to inspire others who are facing self-esteem issues to harness their unique beauty and to use their insecurities as fuel to become better.
Philanthropy is also very important to Justine. She is part of several charitable organizations such and Helping Hands Foundations, ANCOP, and Operation Smile. However, she hopes to one day amplify her contribution to society by having her own non-profit organization. Her main mission and goal would be to speak out on behalf of people who deal with body image problems in their everyday lives and to take action through different support outlets of wellness, skills development workshops, and makeover treatments.
Aside from all her work and volunteer endeavours, she likes being outdoors exploring the city in search for new local hot spots to spend quality time with her family and friends. No matter what she does, Justine is set out to enjoy what life has to offer and takes every opportunity to make herself and the people around her better. She is excited to be a delegate in the Miss Universe Canada pageant and is ready for the road ahead!
Dr. Raymund Torres Dentistry, Max's Restaurant, Family & Friends
What are your interests and what do you enjoy doing the most?
My interests include singing, travelling, and modeling. Modeling has always been my creative outlet, it allows me to transform and create different stories with the clothes and vision of the designers. I also enjoy being outdoors; I love cozying up to a good book by the beach on a warm summer day in Vancouver.
List any special training you have had (music, art, drama, dance, etc.)
- Vocal training
- Dance training
- Makeup training
- Runway training
In what sports, if any, have you participated?
In high school, I was always asked to try out for numerous sports teams because of my height. I was skeptical at first, but then I started getting involved in volleyball, basketball, and track and field. Looking back now, I am glad I did it. It taught me endurance, commitment, teamwork, and good sportsmanship.
Name one person, other than your parents, who has had the most influence on your life. Why?
One person other than my parents that has had the most influence on my life is my older brother David. Being the eldest son of the family, he always set a good example and made sure that we were living our lives to the fullest. I always turned to him for advice on everything and he never fails to uplift and motivate me. From him, I've learned the essence of hard work and going after what you want no matter the circumstance. He is definitely my biggest supporter and pushes me to be the best person I can be.
What is your proudest personal accomplishment (other than participating in this pageant)?
My proudest accomplishment to date would have to be graduating from school and becoming a licensed medical aesthetician, while modeling at the same time. My years of being a student and a model have taught me to be patient, to have empathy, and to work hard to get what you want. During this time, I was also able to participate in another national pageant where I placed in the Top 15, giving me the opportunity to experience working with charities to help poverty-stricken areas and low-income communities.
What is the most interesting or unique thing that has ever happened to you and/or what is the most interesting thing about you?
I love taking risks and the adrenaline that comes with it. That being said, I like to step out of my comfort zone every now and then to conquer some of my biggest fears. For instance, I am terrified of heights and deep bodies of water. But on a recent excursion out in Cancun, Mexico, I spontaneously did a 9-part zip line and cliff-jumped into a deep river. It felt great, now I plan on skydiving and swimming with the dolphins in the near future.
What is your career ambition and what are you doing or plan to do to accomplish that goal?
As a graduate of Medical Aesthetics, I am very passionate about skin care and promoting inner beauty. I plan on having my own skin clinic one day, where I can treat skin disorders and give people that extra boost of confidence. I plan on starting small, continuing to learn new procedures and doing treatments from home until I build a good clientele base. Then eventually, have a place of my own after some experience and exposure to the industry.
What would be your "dream job" in life?
My dream job would be to host my own talk show – combining my passion for music, beauty and fashion with good jokes and good conversations. To be the next Ellen DeGeneres and making other people happy, that would definitely be living the dream.
Describe where you were raised and what your childhood was like.
I was born in the Philippines, but raised in Canada. I come from a big family of six – two loving parents and three other siblings. My childhood involved a lot of family gatherings, which meant endless performances. Our parents would make us practice different songs and dances to perform for our relatives. I remember singing with my sister while my brothers choreographed the steps. We also enjoyed the great outdoors all year round, from snow tubing down Mt. Seymour to camping out in Tofino to having picnics at Stanley Park. To this day, I cherish all these memories and reminisce the moments we had together.
List any interesting or unusual jobs you may have had.
As a model, I am expected to transform and make the designers vision come to life. One of the more interesting jobs I had was for a salon product where the client envisioned a look for me that entailed an afro with purple streaks all over. I was in hair and makeup for six hours and by the end of it, my hair probably added another seven inches to my height. All in all, I loved the outcome of the shoot and it was probably one of the more outrageous shoots I have ever done – when am I ever going to get an opportunity to rock a purple afro.
List any volunteering you have done.
- Helping Hands Foundations
- Habitats for Humanity
- Operation Smile PH
- Various orphanages and children's hospitals
What is your most unusual talent?
I learned to play the drums and the cymbals in high school when I decided to take band as an elective. I wanted to play in the percussion side because I wanted to prove that girls could play the drums just as well as the boys.
Where is the most interesting place you have been to?
The most interesting place I have been to would be Chichen Itza in Yucatan, Mexico. Not only is it a favorite amongst the tourist but it is also one of the eight Wonders of the World. I have always been intrigued by historical landmarks and seeing how people used to live back in the day. Just being able to stand in front of an old Mayan pyramid was exhilarating. My favorite part of the trip was swimming in the Sacred Cenote, a cave with fresh water and a small natural waterfall.
What do you hope to be doing in ten years?
In ten years, I envision myself running a skin clinic where I am happily treating and changing the lives of others through wellness appointments, development workshops and makeover treatments. I also hope to be travelling the world while doing philanthropy work to further my contribution to society and future generations. Last but not least, I hope to have my own happy family to share all the excitement and enjoy my life with.
Is there anything you would like to add that we haven't asked?
I am thrilled and honored to be one of the candidates of Miss Universe Canada 2017. This once in a lifetime experience will give me the opportunity to contribute to society through philanthropy and by becoming an ambassador of change. I hope I can make an impact in someone's life, big or small, and give him or her hope for a better future. I am excited for the road ahead and I cannot wait to show the universe what Canada has in store!


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As well as writing this blog, did you know I also write for other websites, e-zines and blogs?
You will find my writing on the Leading Minds Academy, Dot Com Women, Planner Lounge and HR Daily Community websites, with different and relevant articles.
Here are links to recent articles on those sites:
Are you an expert yet? on leadingmindsacademy.com
Are you a creature of habit? on dotcomwomen.com.au
Ideal traits of paraplanners and financial advisers on plannerlounge.com.au
Top 5 critical skills in shortfall on community.hrdaily.com.au
It's possible your clients, managers or members could also use this information.
Please get in touch if you'd like to add this sort of content to your own publications, online or in print.


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Chest X-Rays No Help in Cutting Lung Cancer DeathsNew research shows lung cancer screening with x-rays doesn't reduce mortality rate.
WEDNESDAY, Oct. 25, 2011 (Medpage Today) — Through up to 13 years of follow-up, the rate of lung cancer mortality was similar in the screening and control groups (14 per 10,000 person-years versus 14.2), Paul Kvale, MD, of the Henry Ford Health System in Detroit, reported at the American College of Chest Physicians meeting.
The findings, which were reported simultaneously online in the Journal of the American Medical Association, are consistent with studies conducted in the 1970s and '80s that also showed no benefit for screening with chest x-rays.
They also complement the findings of the National Lung Screening Trial (NLST), which showed a 20 percent reduction in lung cancer mortality with low-dose spiral CT screening relative to chest x-rays, Kvale said in an interview with MedPage Today.
"What we've been able to show is that screening with the plain chest x-ray isn't an improvement in terms of reduced mortality from lung cancer as compared with no screening at all, but when you move to a low-dose CT scan you do get a reduction in lung cancer mortality by virtue of finding those cases at a time when treatment can save lives," he said.
Limitations of the studies done in the 1970s and '80s — small size, use of chest x-rays in the control groups, inclusion of men only, and exclusion of nonsmokers — resulted in uncertainty about the possible benefits of screening with chest x-rays. That led to the design of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The lung screening arm of the trial — reported on here — randomized 154,901 men and women ages 55 to 74 to undergo four annual screens with chest x-rays or to receive usual care from 1993 to 2001.
Roughly half of the participants were women. Nonsmokers were included — 45 percent had never smoked, 42 percent had quit, and 10 percent were still smoking. Through a median follow-up of 11.9 years, the incidence of lung cancer was similar in the screening and control groups (20.1 versus 19.2 per 10,000 person-years), and the lung cancer mortality rate was similar, regardless of smoking history or gender.
Disease stage, histology, and treatment rates were similar in the two groups. In the subset of patients who would have been eligible for the NLST, there was still no significant benefit from screening with chest x-rays.
"As such, the 20 percent mortality benefit of low-dose spiral CT versus chest radiograph observed in NLST is likely a good approximation of the mortality benefit that must have been observed of low-dose spiral CT versus usual care if this latter group had been added to NLST," Kvale and colleagues wrote in their paper.
That 20 percent mortality benefit is much lower than the benefit of CT screening claimed in a 2006 study led by Claudia Henschke, MD, then of Weill Medical College in New York City. In that study, which has since been called into question, she and her colleagues claimed that 80 percent of lung cancer deaths could be prevented with CT screening.
"Henschke in a poorly designed study says screening [decreases the] risk of death by 80 percent," wrote Otis Brawley, MD, chief medical officer of the American Cancer Society (ACS), in an email to ABC News and MedPage Today. "She has explained the fact that NLST found a 20 percent mortality reduction because it compared CT to chest x-rays, not CT to nothing."
The PLCO findings suggest the NLST "really did compare CT to nothing and the 20 percent reduction is real," Brawley wrote. "This PLCO finding really does put the 80 percent figure of Henschke to question." The ACS currently recommends against screening for lung cancer, but Kvale said that he thinks that could change soon, pending a review of the NLST findings.
"They're almost certain to come out with a revision in the very near future advocating in favor of low-dose CT screening for people who have an appropriate risk category to be screened," he said.


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LUCKY TRENDY Bomb Curl Brush
One of a Kind Brush!
Create volumes, curls, and easily de-tangle your hair all with just one versatile brush!
The Lucky 3D Trendy Bomb Curl Brush is a spherical comb that will catch hair from any angle, 360 degrees around.
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text: For The Sake Of My Sanity (My Sons First Two Weeks Of Daycare) 11/05/2016 So tomorrow will mark the two weeks that my son has attended day care. My son is seven months old and it took me that ENTIRE time to let go and finally accept that he would in fact survive without being attached to my hip. In fact, it got to the point where I was in desperate need for a little detachment. Like most first time moms the idea of daycare terrified me. I refused to trust anyone with the one little person I love most in this world. Then something happened… I got desperate! My


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Nanaimo Justice Access Centre
Monday 8:00 a.m. – 5:30 p.m.
Tuesday 8:00 a.m. – 5:30 p.m.
Wednesday 8:00 a.m. – 7:00 p.m. (5:30 to 7:00 p.m. by appointment only)
Thursday 8:00 a.m. – 5:30 p.m.
Friday 8:00 a.m. – 5:30 p.m.
Service Area
The centre serves Nanaimo and the surrounding mid-Island communities. If you can't travel to the centre, call for information.
(Family Justice Centres are located in other communities around the province. The centres provide services to British Columbians going through separation or divorce. Visit Family Justice Counsellors in Family Justice Centres to learn more.)


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Push for LNG pipeline from Oregon's Coos Bay
Coos Bay snakes from the Pacific into the hilly Oregon coast, its waters sheltered from the ocean by a long, sandy spit.
Resident Jody McCaffree sees it as a place of sand dunes and shore birds, where the slumping local economy hasn't destroyed a high quality of life. But a group of energy companies, including PG&E Corp., sees Coos Bay as a potential source of fossil fuel.
The companies plan to build on the bay's northern shore a terminal for importing liquefied natural gas, deeply chilled fuel that, when warmed up, can run power plants, furnaces and stoves.
A proposed pipeline from the terminal would cut through 234 miles of rural land, mostly forest, before stopping at the town of Malin on the California border. There, an existing pipeline would move the gas north to the Pacific Northwest and south to California.
"You're tearing up half of Oregon for a pipeline to import foreign energy," said McCaffree, who has helped spearhead opposition to the project with her group Citizens Against LNG.
McCaffree fears that if an LNG tanker suffered an accident in the narrow bay, it would form a vapor cloud capable of igniting into a fast-moving fireball. About 17,000 people live within a 3-mile radius of the proposed terminal, called Jordan Cove.
"Maybe there's a reason California doesn't want these things on its shore," McCaffree said.
Radical market change
Five years ago, energy companies were racing each other to build LNG terminals on the West Coast. Natural gas production in the United States was falling, and prices were rising, pushing up home heating bills in the process. Despite fierce opposition from people like McCaffree, many state and federal officials saw importing liquefied natural gas as the answer.
But the natural gas market has changed radically since then. Improved technology helped energy companies tap gas that had been locked in shale rock in places like Arkansas, Louisiana and Texas. Domestic production boomed. Prices fell. And interest in LNG - at least in America - fizzled.
Diversify for future
So why are PG&E and its partners pushing ahead in Coos Bay?
Jonathan Marshall, a spokesman for the San Francisco company, said PG&E is trying to plan ahead. The company is part of a consortium that would build the $1.1 billion pipeline, called the Pacific Connector, while another consortium would build the $1.2 billion terminal.
"None of us has a crystal ball," Marshall said. "It goes back to supply diversity. As we've seen before, prices can shift very quickly. Right now they're shifting down. But small changes in demand, in supply, can trigger big changes in price."
The projects have applied for approval from the Federal Energy Regulatory Commission, and a vote could come as early as the commission's next meeting, later this month. The projects would still need permits from several other federal and state agencies.
Demand fuels project
But Bob Braddock, project manager for the terminal, said neither the terminal nor the pipeline will be built if there isn't demand for the gas. If LNG exporters overseas don't think they can get a good price in America, they won't sign contracts to use either facility.
"This will never be built unless the capacity for the terminal and the pipeline are contracted," he said. "Right or wrong, (the exporters) are making decisions based on what they see the prices will be in America 25 years from now."
Big energy infrastructure projects - from coal-fired power plants to wind farms - often provoke opposition. But not like LNG. Fierce resistance already helped block proposals to build LNG import terminals in Eureka and Long Beach, on Vallejo's Mare Island and off the coast of Ventura County.
Opponents tend to focus on safety.
Ignition danger
LNG is natural gas cooled to minus 260 degrees Fahrenheit, at which point it turns into a clear liquid. Ships carry it in insulated tanks. If those tanks are punctured and the liquid escapes, it will turn back into gas and hover on the surface of the ocean until it disperses in the wind, rather than forming a slick like spilled petroleum.
But before it disperses, spilled LNG can ignite. In 1944, a Cleveland facility that produced and stored liquefied natural gas leaked, creating a vapor cloud that seeped into a nearby residential neighborhood. The vapor ignited, and 130 people died. In 2004, an explosion at an Algerian LNG plant killed 27 people.
Proponents of the fuel say that despite those rare incidents, the LNG industry has a good safety record. And some parts of the world welcome LNG. San Ramon's Chevron Corp., for example, announced recently that it would build a $37 billion project off Australia's northwest coast to pump natural gas from undersea reservoirs, chill it and ship it to customers in China, Korea and Japan. Chevron has already signed contracts for much of the gas.
Purpose questioned
The fact that other countries are eager to buy LNG while America isn't makes McCaffree and other Jordan Cove opponents wonder if it isn't an export terminal in disguise.
The Pacific Connector pipeline, they note, could easily link to another proposed pipeline, called Ruby, that would enter Oregon from the east, supplying the West Coast with natural gas from the Rocky Mountains. If Jordan Cove is really designed for export, then any private property condemned to build the Pacific Connector pipeline would be condemned solely for corporate profit, McCaffree said, not to fill a community need the way an import facility arguably would.
"I just don't understand why PG&E's still pursuing it, unless it's going to be an export terminal," she said. "There's no way we need all that gas." She considers any LNG project - import or export - a waste of money and effort when the country needs to be building more renewable power facilities and weaning itself off fossil fuels.
Export too costly
Braddock said that turning Jordan Cove into an export terminal would require completely redesigning the project and reapplying for government permits. And the proposed site on Coos Bay isn't big enough to accommodate the equipment needed for cooling the natural gas into a liquid, he said. An export terminal would also cost far more to build - closer to $5 billion.
"I couldn't make the economics of that work no matter how hard I'd try," Braddock said. "It's not like someone can just flip a switch. The technical issues are huge."


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S Korea's Total March Crude Imports from Iran Rise YOY
TEHRAN (Tasnim) – South Korea's oil imports from Iran fell 12 percent in March from a year earlier, customs data showed on Monday, but the monthly intake was still the highest since the country resumed buying Iranian oil in January.
South Korea, one of Iran's biggest Asian customers, imported 1.2 million tons of crude oil from Iran in March, or 284,639 barrels per day (bpd), versus 1.37 million tons a year earlier, the data showed, Reuters reported.
That was up 23 percent from February and more than a five-fold increase from January as buying has ramped up.
For the first three months, South Korea's imports of Iranian crude were down 29.8 percent at 2.4 million tons, or 196,303 bpd, compared with 3.45 million tons over the same period last year, according to the data.
South Korea is one of the eight countries that received six-month waivers from the United States in November and can buy up to 200,000 bpd of oil from Iran, mostly condensate, or an ultra-light form of crude oil.
Across the five months from November through March, South Korea imported about 117,000 bpd on average of Iranian oil, according to the report.
The sanctions waiver is due to expire in early May and South Korea has been in talks with the United States to extend its waiver to continue to source oil from Iran.
In total, South Korea's March crude oil imports were 11.5 million tons, or 2.72 million bpd, up 5.8 percent from 10.9 million tons a year earlier.
Oil shipments from the United States were more than seven times higher in March at 1 million tons, from 134,911 tons a year earlier, according to the data.
Imports from Saudi Arabia, the country's top crude oil supplier, fell 9.5 percent to 2.7 million tons, from a year earlier, the data showed.
For the first quarter of the year, crude oil imports increased 1.2 percent to about 37.2 million tons year-on-year.


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Dumbest Pick Up Lines.
We hope this evaluation helps you decide about which electrical guitar is right for you primarily based on features, quality, prices, and intangibles. Although their may be some tweaks to transmission gear ratios or shift settings to bring more low finish torque, these trucks stay largely the identical. If you are knitting BANDS, a good higher trick (imho) is to sufficiently change the GAUGE of the knitting you'll add on the newly-picked-up stitches, so that this new knitting is at the pure pickup gauge of 1:1. For around two minutes, we see the driver of a baby blue pickup truck that had been involved in one too many accidents judging from the situation of the physique panels, spinning the automotive on a public street.
This can have an effect on traction on the front tires, steering, as well as the seems of the truck. While different charity providers require you to drop off your donations or schedule pickups weeks prematurely, Pick Up Please can pick up your donation within 24 hours in most locations. Our pickup periods have develop into a giant half our lives, many good friendships have started due to pickup soccer. To get the very best full sized pickup fuel mileage be sure to aren't hauling round further weight. Truck bed mats hold your truck trying new and undisturbed by everyday work hundreds.
As quickly as I get the possibility, I'll be including some cute pictures of this year's calves, faithfully checked by and probably hauled in this old yellow truck. The course of the Nineteen Eighties also noticed the rise of EMG pickups, which took a third method – that of manipulating the output of the normal pickup association utilizing lively electronics. Shortly after their arrival, the previous mates return to the best summer season of their lives – practical jokes, midnight kitchen raids, boat races, campfire stories – and even secret romances pick up right where they left off. Don't let it run out, or your truck will default into limp mode, fit solely to get you to service.
They are shops where you'll be able to pick up the gadgets you've gotten ordered on-line from at your personal convenient time, Within the stipulated supply interval(1-5 working days). What you have got described is what my truck does when I'm nearly out of fuel (lower than a gallon in the tank maybe). In different words, for those who choose up at a price of 1:1 (one loop per row) you're going to get 7 loops where you actually need only 5.
Pickup cannot accumulate an merchandise if the Pokémon that consumed the item is not on the sector at the end of the flip, or if the merchandise has already been recovered (reminiscent of with Recycle , one other Pokémon's Pickup, or Harvest). Comanche: Similar design to the Fender Stratocaster however makes use of MFD Z-coil pickups, a Dual Fulcrum vibrato bridge and extra pickup swap choices (super-change).…


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Objective #4:
To make people aware that resisting our needs limits our experience of God
Our next objective finds us at a very familiar place. We frequently visit the subject of need as a supply pipeline, a gateway to mercy and a means of connection. Each of these elements, we have said, is an avenue to experience God; but have we truly paused to consider what we mean by "experiencing God?"
This gets tricky very quickly. Each individual person experiences God as an individual, as much as all individuals experience all things individually. The same vanilla ice cream will be experienced differently by as many people who sample it. There will surely be people who have similar, or nearly identical experiences – because, after all, we are all made up of the same "stuff" that makes people what we are – but each experience will ultimately be uniquely and infinitely definable, down to the tiniest nuance, unto each separate individual.
So it goes with God. What really complicates things is that God is invisible; discernible, but intangible; singular in concept, but infinite in existence. Ice cream, by comparison, is measurable and finite. Infinite variables experienced infinitely by individuals is just too infinite to try and condense into a pamphlet called "What to Expect When Experiencing God." To further complicate things, we are all at different places in our spiritual lives, some at great heights, some rejecting spirituality altogether, and most of us scattered somewhere in between. How can a group of Missionaries claim anything about helping or hindering our experience God?
Let this be very clear: We are not selling any absolutes, any guarantees or any formulas. We are following a string of "ifs" which seems (to us) to logically hang together.
IF we all have human needs to be recognized and understood;
IF God has that same need, for us to recognize and understand Him;
IF "need" is a channel through which human connection flows;
IF God Himself is our Origin and Source, found at the very first link in our chain of connectedness;
We would expect that, the more we actively practice embracing our needs, the more likely we are to experience connection with others;
The more likely we are to experience connection to God through our connections with others.
This is a vital and defining element of our Missionary philosophy. We are out to help people connect with God, but rather than preaching a way to do that directly, one on one, we are suggesting a different route: connecting with God, eventually, by first connecting well with others.
Why take an indirect approach, when our core philosophy demands sincerity? Let us assure you, we ARE being quite sincere. We sincerely think that, in many cases, the indirect approach is more effective than flying straight toward something we are not prepared to handle.
Consider these points:
And so, here we are. We offer this as an alternative route, as a proposal to see if the Way of Saint Thorlak is a way that takes us to God slowly, gently, with plenty of support and practice and small steps along the way. Those of us familiar with autism spectrum disorders know what it looks and feels like to be in a state of sensory overload and anxiety hijack. These are very real experiences, and certainly not exclusive to those affected by autism. Imagine, then, being curious about God but feeling overwhelmed, intimidated, disempowered, excluded, overlooked or too different to fit in. Imagine saying things like, "I'd like to know God better, but God would not like me. I do things, I think things, I like things that are way out there." Maybe so. Maybe, too, we have heard that such "things" are explicitly opposed to God or the church we heard them discussed in.
It would not be the first time that has ever happened.
Nor does it mean that our comforts and preferences should be automatically approved by God "if" God loves us.
It does mean that, no matter what we think, or like, or want to do, God thirsts to be known and understood.
If we presumed to put words in God's mouth, they might be, "Before you write Me off, please, see first where I am coming from. For my part, I will never write you off. I may not approve one bit of your desires, but that is because I can see further and wider than any big picture you can see. Can you at least learn about My intended design before making up your mind?"
Furthermore, the standards by which we define civil behavior apply no less to the way we approach our concept of God. "Our needs" include the need to not be mocked, ridiculed, belittled or disabled by the words or actions of others. It is just as wrong to make those gestures toward God. In this way, resisting our need – our need to be human toward one another – does indeed limit our potential experience of God.
This week's Missionary Thought is likely to stir up questions and strong feelings. We conclude here with two very important closing items:
We repeat once more that our purpose is to foster understanding and connection. If our Catholic loyalty is a stumbling block for some, we respect that. We also hope, sincerely, that readers will extend to us the same purpose, to foster understanding and connection… for, we believe, it is through connecting with one another that we will all mutually begin to experience God in new and enlightening ways.
Pray: God, Father: Help me to see You in the connections I have, and the connections I form.
Contemplate: Is it the case that I need God, or that God needs me, in order to experience Him? Is there a distinction?
Relate: How does connecting with people around me help me to better approach God?
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May the power of Divine Love shine in and through my weakness, so that He might be glorified in and through me, and that in my weakness, His power may reach perfection. Through Christ Our Lord, AMEN.
Fr. Mark P. Nolette - Spiritual Director for the Mission of Saint Thorlak
December 2019