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Created in the 1860s for the Baron de Rothschild family of Europe and considered by many connoisseurs to be the paragon of hand painting on porcelain. Painted in twelve different motifs, each representing a 19th century Hungarian legend about Baroness Rothschild, who lost her pearl necklace in the garden of her Vienna residence. Several days later it was found by her gardener, who saw birds playing with it in a tree.
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Six Sigma Greenbelt: Breakthrough Improvements to the Supply Chain
Six Sigma is a set of principles and tools used in a disciplined approach to define, measure, analyze, improve and control a significant problem or issue affecting the supply chain. Participants will learn and apply this disciplined approach using an actual performance problem from their organization. This is not about small incremental improvements over time; it is about making breakthrough improvements to the value stream.
The Business & Community Institute
West Campus
Phone: (517) 483-1857
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The Lincoln County Court is accepting applications for the position of Bailiff/Courtroom Clerk. This position is responsible and varied clerical work in liaison with the judges, the court clerk's office and courtroom sessions. Work involves performing courtroom clerical duties including operating the digital recorder and relieving judges of routine administrative duties. A bailiff oversees and assists in the preparation of records and documents for each court session; acts as liaison for the judge with attorneys, court personnel and the public, escorts defendants and transports documents to the clerk's office; and performs a variety of confidential, technical and general clerical tasks for the judges. Requirements include education or experience sufficient to enable an individual to perform the duties and meet the knowledge, skills and abilities required including knowledge of legal terminology; knowledge of court procedure; knowledge of business English, spelling and punctuation; knowledge of office practices, equipment, and computer usage; and the ability to understand and carry out moderately complex oral and written instructions. Successful completion of on the job training in the use of JUSTICE (the statewide court computer system) will be required. The ability to speak Spanish is desired but not required. Starting salary is $11.76 based on experience with excellent benefits. Please visit http://www.statejobs.nebraska.gov/ to fill out the State application. Applications must be received no later than July 23, 2013.
Notify the Administrative Office, 402-471-2921, if an accommodation is needed in the selection process. For persons with hearing impairments, please call the Nebraska Relay System, 7-1-1. AA/EOE.


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The week has been going pretty well. I've written quite a bit of our new business plan this week and will hopefully be finishing it up in the next few days. We are considering moving to a renovated warehouse place in downtown Minneapolis.
We are still looking for a contract, but haven't done so very actively yet. We will start doing this in the next week or so.
My belief in people was a bit shattered to hell this week and strengthened at the same time. A girl I was seeing did some pretty cruel, stupid, and slut-like things. Someone else did remarkably admirable things. In any case, an overall hard and stressful week.
I tell you, having gout sucks ass. I have medicine now that is supposed to prevent it, and I've actually been taking it for like 3 weeks almost now. Well, it happens that when you start taking it actually gives you gout. Suck. Suck. Suck.
The rats are growing.


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When do you lock your dog box? Immediately after loading the dog(s) and unlock when you reach your destination? Only when you are parking your vehicle and leaving the dogs inside and unattended for a period of time? Something else?
I lock my box only when my truck will be parked and unattended for a period of time. I NEVER lock the box when I load the dogs, I'm afraid that if involved in an accident I wouldn't be able to get the dogs out in an extreme emergency.
What do you guys/gals do?
Lonnie Spann


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Find out which games will ensure PlayStation Vita hits the ground running in 2012.
Following on from our look at the PS Vita launch line-up from Sony Computer Entertainment Europe, here's the pick of the titles coming your way from games makers including Ubisoft, Electronic Arts and Sega.
EA SPORTS FIFA Football
When's it out? 22 February 2012
What is it? The ultimate recreation of the beautiful game in the palm of your hand. Take your custom created player from youth starlet to world class pro in the in-depth Career Mode, and play against friends via PlayStation Network in the online Head-to-Head Mode.
Play it if you like: Intuitive passing and shooting controls courtesy of the touchscreen and rear touch pad, respectively.
Ninja Gaiden Sigma Plus
When's it out? 22 February 2012
What is it? Formidable fighting action set in feudal Japan. Carve a clinical path through crowds of enemies, play mini-games and enter first person mode to survey your surroundings thanks to touchscreen controls.
Play it if you like: Uncompromising ninjutsu combat you can really get a grip on.
When's it out? 22 February 2012
What is it? Jowl-rippling racing wherever you go. Lay down rubber in Grand Prix and Time Trial modes using the cars and stars that rocketed around the globe in 2011.
Play it if you like: Hitting the road as much as the real-life Formula One bandwagon, and racing just as hard and fast.
Rayman Origins
When's it out? 22 February 2012
What is it? The colourful, free-flowing adventure featuring everyone's favourite armless hero, Rayman.
Play it if you like: Exploring an endlessly enchanting world and learning new skills with a hero who never fails to raise a smile. This is classic platforming delivered in real style.
Virtua Tennis 4: World Tour
When's it out? 22 February 2012
What is it? A globetrotting journey that'll leave tennis fans wowed as you dominate tennis courts. Start out as a nobody and finish as a legend in an innovative Career mode that combines fun mini-games with epic clashes.
Play it if you like: Smashing cross-court winners and deft volleys using touchscreen controls, and serving up two-player tennis with a difference in Touch Versus Mode on one system.
Ultimate Marvel vs Capcom 3
When's it out? 22 February 2012
What is it? Spectacular beat 'em up action you can unleash wherever you are.
Play it if you like: Watching the likes of Spider-Man and Iron Man collide with Resident Evil's Wesker, Street Fighter's Ryu and many other famous names.
LEGO Harry Potter: Years 5-7
When's it out? March 2012
What is it? The story of the illustrious boy wizard's long journey to face his greatest nemesis: the truly evil Voldemort. However, this being a LEGO adaptation, there's considerable humour at play, too.
Play it if you like: Adventure, magic and touchscreen controls that enable you to cast spells with a swish of your fingers.
Doctor Who: The Eternity Clock
When's it out? March 2012
What is it? A breathless Doctor Who tale in which you must guide the Tardis through time and space, and save Earth using your incredible powers of logic.
Play it if you like: The thought of stepping into the time-worn brogues of the eleventh Doctor, Matt Smith, who lends his voice to this latest time trek.
Gravity Rush
When's it out? 2012
What is it? A meeting of mesmeric art and mystical powers that makes full use of the PS Vita system's touchscreen and rear touch pad controls. Break the bonds of gravity in an epic adventure that knows no limits.
Play it if you like: Defying physics against a stunning backdrop inspired by the best of Japanese and European comic book art.
Sound Shapes
When's it out? 2012
What is it? Side-scrolling platform action with a musical twist, where what you do impacts directly on what you hear.
Play it if you like: Seeing your musical vision brought to life. Thanks to the PS Vita system's touchscreen, you can compose music and create levels with intuitive ease, and then share your masterpieces with your friends via PlayStation Network.
Resistance: Burning Skies
When's it out? 2012
What is it? A powerful depiction of alien invasion on PS Vita that lets you fight back as New York fireman Tom Riley, putting the front line in your pocket.
Play it if you like: Putting your finger directly on the trigger of some of the most devastating firepower ever conceived, thanks to touchscreen and rear touch pad controls.
When's it out? 2012
What is it? A brand new, instantly charming adventure powered by your own creativity. Guide Sackboy through innovative touch-based challenges and then use clever tools to bring your vision to life.
Play it if you like: Letting Sackboy off the leash and into your life, everywhere you go. If you have an idea for a level, there's no need to wait until you get home – simply whip out your PS Vita system and go to work.
Keep an eye on PlayStation.Blog at blog.eu.playstation.com and eu.playstation.com for the latest information on PS Vita.
|Publish date:
|Tue Feb 28 12:00:00 GMT 2012


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LiverKick.com Podcast Episode 23 - Joe Schilling Talks GLORY 12
- Written by Dave Walsh
Man, GLORY 12 New York came FAST, didn't it? GLORY 12 is this weekend live on Spike TV from the Theater at Madison Square Garden. We decided that it sounded like a good idea to have another sitdown with Joe Schilling as you all seem to love them so much, this time around we were talking about Joe's life post-GLORY 10 money, the quick turnaround between camps and his preparation going into the fight with Wayne Barrett.
As always, I have a lot of fun talking to Joe about Kickboxing and everything in between.
Don't forget to check Joe out on Facebook, Twitter and to keep tabs on Can't Stop Crazy.
{enclose lk_ep23.mp3}
Also, for those who have phones, etc. that don't support flash, here it is on SoundCloud.


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Last Modified: Friday, October 12, 2012 3:29 PM
BATON ROUGE (AP) — In a new effort to brand Louisiana seafood, the state has started a new certification program.
State officials say the Louisiana Certified Seafood Program is meant to make consumers think of Louisiana seafood in a "geographically-based" way, similar to the way consumers now think of Maine's lobsters and Idaho's potatoes.
The program seeks to certify that seafood is caught, landed and processed in Louisiana.
State officials say licensed commercial fishermen automatically qualify under the program and that dock owners, processors, grocers, dealers, restaurants and others selling seafood can participate in the program and get a certified permit.
"People are demanding transparency in the seafood industry, so we're giving it to them," Randy Pausina, of the Louisiana Department of Wildlife and Fisheries, said Thursday.


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ACHICA > Wee Gallery & Smiling Planet > Smiling Planet Plate - Small Elephant
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Smiling Planet Plate - Small Elephant
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|Sale closed
UK Delivery: Estimated 21st - 25th May - we'll email you once your items have been dispatched.
Returns: Click Delivery & Returns or check your delivery confirmation.
If you are ordering multiple items, ACHICA aim to send as few deliveries as possible for your convenience – you will only pay one delivery charge.
|Product Information
Smiling Planet founder Olivia Haviland combines her 150-year family history of making fine porcelain with her husband and founder Freddy Deane's whimsical art and stories. Together, their products and designs respect the environment, and their designs make the earth safe and make people smile - because smiles are good for the planet, too.
Dimension: 21cm dia.
Product Code PL007
|Delivery & Returns
We hope you will be thrilled with your purchases but in the unlikely event that you want to return something, you can find full return instructions on the back of your delivery note or click here


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- 100% acrylic, low VOC formula
- Resists moisture, fading and stains
- Easy to apply and provides uniform color
- Model
- 805001
- Internet/Catalog:
- 204902316
BEHR Premium Plus Interior/Exterior Hi-Gloss Enamel is 100% acrylic, provides a mildew resistant finish and is great for high-use surfaces. This tough, stain resistant sheen withstands moisture and wear; provides ultimate durability and exceptional hide. The finish displays a brilliant, shiny appearance.
Info & Guides
- Ideal for kitchens, bathrooms, cabinets, shutters, doors, furniture, garage doors, windows and trim
- 100% acrylic finish for easy cleaning
- Dependable and tough finish that displays a brilliant shiny appearance
- Exceptional hide, 1 can covers up to 400 sq. ft. depending on color selected and surface porosity
- Easy soap and water clean-up
- Exceptional latex formula provides a mildew resistant finish
- Self priming finish that seals the surface
- Actual paint colors may vary from on-screen and printer representations
- GREENGUARD Certified products are certified to GREENGUARD standards for low chemical emissions into indoor air during product usage. For more information, visit ul.com/gg.
- Online Price includes a Paint Care fee in the following states: CA, CO, CT, DC, ME, MN, OR, RI and VT
- Color Family :
- Grays
- Color/Finish :
- PPF-29 Traditional Gray Hi-Gloss
- Container Size :
- 1 GA-Gallon
- Coverage Area (sq. ft.) :
- 400
- Dry to touch (min.) :
- 60
- Interior/ Exterior Paint :
- Interior Paint
- Paint & Primer in One :
- No
- Paint/Stain Clean Up :
- Soap & Water
- Paint/Stain Key Features :
- Mildew Resistant,Primer Required
- RGB Value :
- 202:198:195
- Returnable :
- Non-Returnable
- Sheen :
- High-Gloss
- Time before recoating (hours) :
- 2
- Tint Base :
- Base 1
- Transparency :
- Solid
Ratings & Reviews87% of customers recommend this product
- Great Trim Paint
January 21, 2014
- Verified Purchase & Recommended Product
We used this paint on all door, window, and baseboard trim in the house, new and old wood. Also used it on a new french door, after first painting on some bare wood primer. This stuff goes on smooth, dries quickly - even a second coat, and looks awesome. It's just what I wanted, a nice clean white paint with a bit of shine.Pros Even Application, Easy to Apply, Good Coverage, Easy to Clean, Looks Great, Looks High End, Dries Quickly
Video & Photo
MelFTennessee, USA
35 to 44, Female18 out of 18 people found this helpful
Shipping & Delivery OptionsShipping options for [zipcode] (change)
Arrival dates and shipping costs shown above are estimates.See exact dates and costs and select your preferred shipping option during checkout.
Express Delivery from Store is available for items currently in stock at a The Home Depot store within a delivery ZIP code. A driver from a local store will deliver the item(s).
Outside Delivery: Service includes delivery to area outside the house which is accessible by delivery equipment.
Threshold Delivery: Service includes delivery across your first doorway or threshold (ie. garage, backyard, deck, first room of the home).
This item cannot be shipped to the following state(s): AK,CA,GU,HI,PR,VI


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Applications for 2017-2018 are now available through the MyHousing portal!
1. Mission
The Pre-Med LLC Program is designed to assist UNF students in establishing a support network within the university and the community in order to improve student success in and out of the classroom, while simultaneously developing competitive candidates for admission to professional schools in the medical field.
2. Program Goals
3. Applicable Majors include:
4. Community initiatives:
5. Participation Expectation:
LLC students
must enroll in General Biology 1 (BSC 1010C) for Fall 2016.
There are two options:
1. BSC 1010C (CRN 80304 or 80305) choose from one of two lab
and Students must also enroll in BSC 2992 (CRN 81849). This is 1 credit hour pass/fail course which takes place weekly
with other Pre-Med LLC members on Thursday evenings starting at 6:00 PM, and is required both the fall and spring semester.
Location for 2016-2017 – Osprey Crossings RCapacity – up to 25 studentsThis program is in collaboration with the Department of Biology and Housing and Residence Life.
Those interested in the Pre-Med LLC may also be interested in participating in the BIO-FLITE program which is an intensive orientation for biology majors. This 6-day workshop takes place prior to the LLC retreat and provides participants with an experience into what it takes to be a biology major at UNF. Click the image below for more information on the BIO-FLITE program
Copyright © 2016 University of North Florida1 UNF Drive | Jacksonville, FL 32224 | Phone: (904) 620-1000
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By Ben Levisohn
Of the 70 cities followed by China's National Bureau of Statistics, 67 experienced an increase in property values in April from March. The Shanghai Stock Exchange Composite Index rose 0.8% today.
Some 80% of Indians consider China a threat, according to a new study. The S&P BSE India Sensex Index dropped 0.3%.
North Korea has been firing missiles into the sea, in what may be a test of a new launcher, South Korea said. The Korea Stock Exchange KOSPI Index fell 0.2%.
The Philippines will limit the use of special deposit accounts for investments as it seeks to rein in its surging peso. The Philippines Stock Exchange PSEi Index dropped 0.1%.
Thailand's economy shrank by 2.2% during the first quarter of 2013 from the last three months of 2012, worse than forecasts for a 0.8% drop. The Stock Exchange of Thailand SET Index climbed 1%.
Indonesia named Chatib Basri, the head of its investment agency, its new finance minister. The Jakarta Stock Exchange Composite Index rose 1.4%.
A South African union that represents skilled workers is seeking a 10% boost in its members' wages. The FTSE/JSE Africa Top40 Tradeable Index has fallen 1.1% so far today.
Emerging Market Stocks in the News
Qihoo 360 Technology (QIHU) has gained 13% to $46.39 in pre-open trading after reporting better-than-forecast earnings and revenue and guiding higher.
JA Solar (JASO) has jumped 13% to $6.34 before the open after it said revenues increased after six quarters of declines.
Morgan Stanley upgraded E-Commerce China Dangdang (DANG) to Overweight from Equal Weight, according to Briefing.com. Dangdang's stock is up 5.1% to $6.00 before the open.
Citigroup upgraded Netease.com (NTES) to Buy from Neutral.
Baidu (BIDU) is considering an IPO for its video site, Bloomberg reported. Baidu's shares have dropped 0.8% to $94.


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CK-12 Chemistry - Second Edition
- 1.
Introduction to Chemistry
This chapter details the scientific method and provides a brief history of chemistry.
- 2.
Measurement in Chemistry
This chapter covers measurement and the mathematics of measurement and formulas.
- 3.
Matter and Energy
This chapter details the concepts of matter and energy.
- 4.
The Atomic Theory
The various models of the atom are developed from Dalton through Rutherford. This chapter also covers basic atomic structure and sub-atomic particles.
- 5.
The Bohr Model of the Atom
This chapter introduces electromagnetic radiation, atomic spectra, and their roles in the development of the Bohr model of the atom.
- 6.
The Quantum Mechanical Model of the Atom
This chapter covers the quantum mechanical model of the atom, energy waves, standing waves, Heisenberg's uncertainty principle, and Schrödinger's equation. Quantum numbers, energy levels, energy sub-levels, and orbital shapes are introduced.
- 7.
The Electron Configuration of Atoms
This chapter covers the Aufbau principle, and several methods for indicating electron configuration.
- 8.
Electron Configuration and the Periodic Table
This chapter develops the relationship between the electron configuration of atoms and their positions on the periodic table.
- 9.
Chemical Periodicity
This chapter explains the periodic change in atomic size and its relationship to the periodic trends for ionization energy and electron affinity.
- 10.
Ionic Bonds and Formulas
This chapter explains the reasons for ionization, ionic bonding, and the properties of ionic compounds. This chapter develops the skills involved in predicting ionic charge, writing ionic formulas, and naming ionic compounds.
- 11.
Covalent Bonds and Formulas
This chapter covers the nature and theories of covalent bonds – atoms forming covalent bonds, nomenclature rules, electronic and molecular geometries, and the octet rule. Polar molecules are also discussed.
- 12.
The Mole Concept
This chapter develops the skills involved in formula stoichiometry.
- 13.
Chemical Reactions
This chapter develops the skills involved balancing equations and the determination of reaction types.
- 14.
This chapter develops the skills involved in equation stoichiometry including limiting reactant equations, yields, and introduces heat of reaction.
- 15.
The Behavior of Gases
This chapter describes the molecular structure and properties of gases and develops both the combined gas law and the universal gas law. The stoichiometry of reactions involving gases is also covered.
- 16.
Condensed Phases: Solids and Liquids
This chapter covers the causes of the liquid and solid condensed phases and the properties of liquids and solids. It covers the different types of intermolecular forces of attraction and includes a section on the energy involved in phase changes and phase diagrams.
- 17.
Solutions and Their Behavior
This chapter covers properties of solutions including solvation, concentration calculations, solubility, colligative properties, dissociation, electrolytes and non-electrolytes, reactions between ions in solution, and ionic and net-ionic equations.
- 18.
Chemical Kinetics
This chapter covers reaction rates and the factors that affect reaction rates.
- 19.
Chemical Equilibrium
This chapter covers relationships between forward and reverse reaction rates, the concept of chemical equilibrium, the mathematics of the equilibrium constant, Le Chatelier's principle, and solubility product constant calculations.
- 20.
Acids and Bases
This chapter includes the definitions of acids and bases, the causes of strong and weak acids and bases, the hydrolysis of salts, and an introduction to pH.
- 21.
This chapter covers the mathematics of the dissociation of water, acid-base indicators, acid-base titration, and buffers.
- 22.
This chapter covers the energy involved in bond breaking and bond formation, the heat of reaction, the heat of formation, Hess' law, entropy, and Gibb's free energy.
- 23.
This chapter covers oxidation-reduction and electrochemical cells.
- 24.
Nuclear Chemistry
This chapter is an introduction to radioactivity, nuclear equations, and nuclear energy.
- 25.
Organic Chemistry
This chapter introduces the structure and nomenclature of straight chain hydrocarbons, aromatic hydrocarbons, and the functional groups of hydrocarbons.
- 26.
Chemistry Glossary
This chapter provides a glossary of all of the Chemistry vocabulary terms.


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When it comes to digital imaging, a number of well-respected brands specialize in either cameras or printers. Rarely does a company excel in more than one area. But Canon stands out as a reputable brand that crosses over several categories, including point-and-shoot cameras and printers.
- » Digital Camera Buying Guide
» What's the Best Kind of Camera for You?
For example, if you're looking for a digital camera, the low rate of repairs for Canon cameras reported in our most recent brand-reliability survey should be reassuring. Our survey indicates that Canon (along with Panasonic and Sony) is a best bet on brand performance for superzooms (which include lenses with 15x optical zoom or more), subcompacts, and compact cameras. Such Canon point-and-shoots include the compact PowerShot S110 ($450).
Another category that Canon has done well in, according to our test, is all-in-one printers. Our testers rated Canon (along with HP) as a best bet for these best-selling inkjets. We don't have reliability info on them, but Canon has done well based on our performance ratings. Some recently tested recommended Canon models include Canon Pixma MG8220, $300 and Canon Pixma MG3220, $60.
For more on point-and-shoots, check out our digital camera buying guide and ratings. For more on all-in-one models, check out our printer buying guide and ratings.
Copyright © 2006-2013 Consumers Union of U.S., Inc. No reproduction, in whole or in part, without written permission.
- Technology & Electronics
- Cameras & Photography


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Confused on what you want to do? There are lots of career options and below you can explore many of them. Find 16 career clusters — 16 groupings of educational paths that will lead you to a rewarding career. It's time to focus on your future!
Start with Career Pathways. Explore career options that'll help you decide on a career that fits with your interests.
You'll find clear direction — from high school through college — to complete the education you need to succeed.
Whether you're seeking a certificate or degree, you'll find the courses you need in the order you need to take them. Just follow the path!
Below you will find sixteen different career clusters. Select any of the topics below to learn more about that field and the MCC programs that can help prepare you for a particular job or career. Both certificate programs and degrees are offered in most subject areas.
mesacc.edu | 480-461-7000 | © 2017 Mesa Community College | A Maricopa Community College
The Maricopa County Community College District (MCCCD) is an EEO/AA institution and an equal opportunity employer of protected veterans, and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.


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Web Stories
Halper to discuss U.S. foreign policy, Feb. 7
Posted February 2, 2007; 12:57 p.m.
Stefan Halper, a former adviser to four U.S. presidents, will discuss "American Exceptionalism, Institutional Failure and U.S. Foreign Policy" at 4:30 p.m. Wednesday, Feb. 7, in 16 Robertson Hall.
Halper served in the White House and Department of State during the Nixon, Ford, Reagan and the first Bush administrations, advising on matters concerning U.S. foreign policy, national security and the United Nations. He is now a senior fellow at Cambridge University's Centre of International Studies, where he directs the Atlantic Studies Programme and lectures on late-20th-century U.S. foreign policy, Anglo-American relations and contemporary international security issues.
Halper's recent work has focused on the nature of political discourse, the rise of extremist views and their prevalence in the national political discussion, the rise of anti-Americanism among European elites and the implications for U.S. policy in the decades ahead. His books include "America Alone: The Neo-conservatives and the Global Order" and "Silence of the Rational Center: Why American Foreign Policy Is Failing."
The lecture is sponsored by the Woodrow Wilson School of Public and International Affairs.


text: I didn't look at the list but Tim Couch deserves to be extremely high. The highest profile busts like Ryan Leaf and Jamarcus Russell at least had the physical talent to be a great player. Tim Couch had nothing, other than -- eventually -- a Playmate of the Year wife. Weak arm and awful mechanics. No athletic ability. I was on Las Vegas radio that spring and said I wouldn't take him in the 5th round. He was a franchise killer if anyone ever fit the description. If you take a guy like that in the 6th or 7th round, where his talent warranted he should be picked, then you experiment with him at starter eventually, but once that fails it's no big deal and you demote him back to a reserve, where he belongs. But when you're dense enough to take him high, let alone #1 overall -- it's still difficult for me to type that -- you are forced to waste season after season. In Cleveland's case it came at just the wrong time, the rebirth of the franchise. And it destroyed Butch Davis' NFL coaching career, once he was moronic enough to sign with a team quarterbacked by Tim Couch. I sent him a warning letter. Darn fool didn't write back, unlike Barry Switzer. He's the greatest, Barry Switzer. Always answered my letters in handwritten form and at length, with great enthusiasm and humor.


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- Home /
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- Schumann Songs
Song literature, and particularly the romantic song literature, has been my delight and inspiration from a very early age, when I began my singing career as a boy soprano. Later on during my studies, when I worked on the song cycles of Robert Schumann, this fascination became stronger. His songs, with their longing, their deep and sincere emotions, their strong sense of nature, and their burning passion -- the purest form of Romantic music-- drew me irresistibly. For me, the art song, and particularly that of Schumann, is the musical form which allows the singer and his personality the greatest opportunities of expression. If, in the opera, we are confronted with a designated, concrete role, which we are intended to realize on stage with the help of costumes and makeup, the song is inherently a more intimate form, which puts more value on of the individuality and spontaneous ideas of the singer.
Additional Information
|Main artist
Songs of Schumann
Jochen Kupfer, born 1969 in Grimma (Germany) started his vocal training already at the age of 10. As from 1989, he studied with Professor Helga Forner at the Musikhochschule Leipzig. He followed masterclasses with amongst others Aldo Baldin, Theo Adam and Elio Battaglia. He completed his studies with Dietrich Fischer-Dieskau and Elisabeth Schwarzkopf. The artistic development of Jochen Kupfer resulted in several prizes and awards: winner of the 1991 Mozart-Fest-Wettbewerb in Wrzburg, special award of the Academia Vocalis Tirolensis 1991, prize-winner at the International J.S. Bach Competition in Leipzig 1992, first price at the VDML Bundeswettbewerb in Berlin 1992, first prize at the Mendelssohn Bartholdy Competition in Berlin 1993, scholarship of the Studienstiftung des Deutschen Volkes, award of the Richard Wagner stipend 1994, 2nd prize at the Meistersnger competition Nrnberg 1995. In the concert-field Jochen Kupfer sings works from Bach and Handel through Mendelssohn to Britten. He is regularly heard with the Thomanerchor Leipzig, the Berliner Singakademie and with the Bachchor Salzburg, conducted by Howard Arman. He especially likes to sing Lieder.
() Kupfers intelligente gestaltung gleitet niemals in Manierriertheit ab. () () die hollndische Pianistin Reinild Mees ermglicht durch ihr differenziertes spiel eine homogene Balance mit dem Interpreten. Blitz
|Normal PCM CD
|Running time
|Year of release
|Number of cd's
() Kupfers intelligente gestaltung gleitet niemals in Manierriertheit ab. () () die hollndische Pianistin Reinild Mees ermglicht durch ihr differenziertes spiel eine homogene Balance mit dem Interpreten. Blitz
() a Lieder singer of uncommon gifts. American Record Guide A highly gifted and intelligent singer () one of the most satisfying, finely executed discs of Schumann interpretation ever to come my way. Gramophone
() kernachtig van toon, arm aan vibrato, rijk aan aandrukking, en vooral dienstbaar aan het gezongene () Volkskrant () bijzonder fraaie, edele en vloeiend klinkende bariton. () Luister
() Reinild Mees leidt de bariton met zachte hand door de verschillende passies en emoties heen. () () Een kleinood. Haarlems Dagblad
() Kupfer instantly commands attention as a performer of assurance and individual expression () () He never loses sight of the forest for the trees; the general sense of a song is always well projected () Fanfare
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I'm not trying to be facetious.
But why would the Prez say that the key to balancing the budget is to get a health care reform package passed?
How are the two related? How can adding a (at last count) a $900 million dollar program to the federal budget get the budget balanced?
I cannot follow his logic. Geez, I try and give this guy the benefit of the doubt but then he comes up with a statement like this.
I just don't get it.
Anybody got an analysis?


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If the studies and number-crunching are correct, Mississippi has lost more than $600 million in uncollected online sales taxes.
So, those great buys off Amazon and eBay may be great for your pocketbook, but not so great for the coffers of local and state governments.
And, of course, local retailers also missed out on critical sales.
Proponents of the Marketplace Fairness Act say it levels the playing field for brick-and-mortar retailers and their online counterparts.
Under the bill, states could require out-of-state retailers to collect sales taxes when they sell products over the Internet, in catalogs, and through radio and TV ads. The sales taxes would be sent to the states where a shopper lives.
If businesses with physical locations have to collect a sales tax on purchases, why are online retailers exempt, the argument goes.
It's a competitive disadvantage, a loophole the MFA hopes to close.
The U.S. Senate passed the bill last week. It awaits a vote by the House of Representatives. If it's approved there, it's up to the individual states to implement an online sales tax plan.
However, opponents say it's too burdensome to work through a swath of differing state tax codes. While the larger online businesses can handle it, the smaller ones don't have the resources, they say.
Perhaps that's why the legislation exempts businesses with less than $1 million in annual revenue. Perhaps the threshold may be pushed higher – to $10 million, as some have recommended.
Another argument opponents make is that it's a tax increase. For the bill's supporters, it's about collecting a tax that hasn't been paid. But the counter-argument is that people who haven't been paying taxes on online purchases before will be hit with a "new" tax.
And there's also this component of the online tax debate: The taxes will be collected by the state, not the individual municipalities.
So, cities may be wondering how those diversions will reach them.
The legislation requires states to provide Internet businesses with free software to calculate what taxes are owed and to designate a single agency to collect the taxes.
That would be the Department of Revenue in Mississippi, and it has said it could get complicated to implement a streamlined online tax program.
Still, if it takes a little work to cash in on some of the $600 million the state has missed, we should make every effort to do so.
For a cash-strapped state like Mississippi, imagine how far more than half a billion dollars can go.
Prolific online shoppers may protest, but the Marketplace Fairness Act is worth fighting for.
Contact Dennis Seid at (662) 678-1578 or firstname.lastname@example.com.
Dennis Seid/NEMS Daily Journal


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Web Stories
Funeral services for Alan Ebersole held this week in Vicksburg, Miss.
Posted October 30, 2004; 04:01 p.m.
Events honoring the life of Princeton sophomore Alan Ebersole will be held this week in Vicksburg, Miss. Visitation will be between 3 and 7 p.m. Tuesday, Nov. 2, at Riles Funeral Home, 5000 Indiana Ave. The funeral Mass will be at 2 p.m. Wednesday, Nov. 3, at St. Paul Catholic Church, 713 Crawford St.
In lieu of flowers, the Ebersole family requests that donations be made in Alan's name to the United Way of Central Mississippi, Teen Help, 920 South St., Vicksburg, MS 39180; Vicksburg Catholic Schools, 1900 Grove St., Vicksburg, MS 39183; or Vicksburg Swim Association, c/o Craig Fischemich, 1100 Newitt-Vick Drive, Vicksburg, MS 39183.
Ebersole, a member of the University's men's swimming and diving team, died this weekend in an accident while swimming in the Atlantic Ocean off the Florida coast. He was 20 years old.
Broward County Sheriff's officials said preliminary reports indicate that this was an accidental death by drowning. No foul play, alcohol or drugs were involved in the incident, officials said.
Ebersole was training with the men's and women's swimming and diving teams in Deerfield Beach, Fla., during the fall semester recess. Ebersole and two teammates left their hotel room around 10:30 p.m. Friday for a late night swim in the ocean, sheriff's officials said. The other students, who emerged from the water approximately a half hour later, were unable to locate Ebersole. Public safety officials in Broward County located his body around 1 a.m. Saturday three-quarters of a mile away from where the group was swimming, officials said.
Ebersole, who lived in Butler College, competed in the 200- and 100-meter breaststroke. He was studying Spanish and politics, among other academic pursuits. In Vicksburg, Ebersole graduated in 2003 from St. Aloysius High School and was salutatorian of his class. He was a member of the high school's swim team coached by his father, Bruce.
President Shirley M. Tilghman, who was traveling in Asia at the time, was notified and expressed her sincere condolences to Ebersole's family, friends and teammates. Provost Christopher L. Eisgruber spoke with Ebersole's parents and also notified the campus community of the loss.
"This is another tragic and untimely loss for our community," said Janet Smith Dickerson, vice president for campus life. "We deeply regret this tragedy and extend our sympathy to Alan's family, friends and teammates."
Survivors include his parents, Bruce Alan and Story Stamm Ebersole, and younger brothers, John Bernard and James Stamm, all of Vicksburg.
Students from the swim teams, who received grief counseling in Florida, gathered on the beach Saturday morning to place flowers in the water and pay their respects to Ebersole. The teams returned to Princeton on Sunday.
"Our heart goes out to the family, to the members of the swim team and the coaches," said Gary Walters, Princeton director of athletics. "This makes one ponder these kinds of events but, more importantly, it makes us value the friendships we have."
An informal gathering in Ebersole's honor was held at Wu Lounge in Butler College on Saturday. A vigil for students and other community members was held Sunday in the Chancellor Green rotunda. Counselors from University Health Services and religious life deans continue to be available for students, faculty and staff. University Health Services is open 24 hours and students may also call the Counseling and Psychological Services team at 258-3139 or 258-3285.
A University memorial service will be held at a later date.
Contact: Lauren Robinson-Brown (609) 258-3601


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The International Year of Water Cooperation is about what you will do in 2013 and beyond to promote cooperation in the water domain. The key messages provided below are to be used as a basis to help you frame and design your own activities and messages. You can adapt the messages to your local conditions or to your specific audience to make them more targeted and efficient.
Water cooperation builds peace
Access to water can be a source of conflict, but it is also a catalyst for cooperation and peace building. Cooperation on such a practical and vital issue as water management and drinking water supply and sanitation services can help overcome cultural, political and social tensions, and can also build trust and social peace between different groups, genders, communities, regions or states.
Water cooperation is key to socioeconomic development, poverty eradication, social equity, gender equality and environmental sustainability
Universal access to efficient drinking water supply and sanitation services is the foundation for the fulfillment of basic human needs and contributes to the achievement of all the Millennium Development Goals. Inclusive, participatory and gender sensitive governance of water and cooperation between different stakeholders can help to overcome inequity and prevent conflicts in access to water and thus contribute to poverty eradication, socioeconomic development and improve the living conditions and educational chances, especially of women and children.
Water cooperation creates tangible economic benefits
All economic activities depend on water. Cooperation can lead to a more efficient and sustainable use of water resources, e.g. through joint management plans creating mutual benefits and better living conditions, and gender sensitive water governance.
Water cooperation is crucial to preserve water resources, ensure their sustainability and protect the environment
Water cooperation makes possible and promotes the exchange of scientific knowledge, including gender disaggregated data and information, management strategies and best practices, which is fundamental for the protection of the environment and to achieve sustainable development.


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Wade H. Berrettini, MD, PhD
Karl E. Rickels Professor of Psychiatry
Department: Psychiatry
Graduate Group Affiliations
Contact information
University of Pennsylvania School of Medicine
Room 2206
125 S. 31st Street
Philadelphia, PA 19104
Room 2206
125 S. 31st Street
Philadelphia, PA 19104
Office: (215) 898-0092
Fax: (215) 573-2041
Fax: (215) 573-2041
Education:Permanent link
Dickinson College, 1973.
Jefferson Medical College, 1977.
Ph.D. (Pharmacology)
Thomas Jefferson University, 1979.
Dickinson College, 1973.
Jefferson Medical College, 1977.
Ph.D. (Pharmacology)
Thomas Jefferson University, 1979.
Description of Research ExpertiseRESEARCH SUMMARY
The research program is dedicated to delineating genetic influences on behavior, including behavioral disorders. The program includes both human studies and genetic investigations of animal models for behavioral disorders. One investigation has been a genetic association study of bipolar (manic-depressive) disorder. A bipolar susceptibility gene has been localized to the peri-centromeric region of chromosome 18, and efforts are devoted to examining regional candidate genes for mutations which explain the linkage statistics.
Genetic dissection of a murine model for opioid addiction has revealed that most of the genetic variance in voluntary morphine intake is attributable to a locus on proximal chromosome 10, where the mu opioid receptor gene maps. This suggests that naturally-occurring variation in the mu opioid receptor gene influences voluntary morphine intake. Currently, we are examining two inbred strains of mice for genetic differences in the regulation of the mu opioid receptor gene. In a human extension of this research, the mu opioid receptor gene sequence is being examined among individuals on methadone maintenance for variations which may convey risk for opioid dependence. In an extension of the study of the mu opioid receptor gene in addictions, we are investigating mu opioid receptor interacting proteins for the roles they may play in human opioid dependence and in murine models of this addiction. We are examining the pharmacogenetics of naltrexone response among alcoholics, determining whether a functional mis-sense SNP (A118G, N40D) in the mu opioid receptor gene predicts therapeutic response among alcoholics.
We have also studied genetics of nicotine dependence, establishing a role for the alpha 3 and alpha 5 nicotinic receptor subunit genes in risk for nicotine addiction. The biological significance of the associated SNPs is being investigated.
We are studying genetics of anorexia nervosa, using a whole genome association approach.
Selected PublicationsLohoff FW., Dahl JP., Ferraro TN., Arnold SE., Gallinat J., Sander T., Berrettini WH.: Variations in the vesicular monoamine transporter 1 gene (VMAT1/SLC18A1) are associated with bipolar i disorder. Neuropsychopharmacology 31(12): 2739-47, Dec 2006.
Crowley JJ., Brodkin ES., Blendy JA., Berrettini WH., Lucki I.: Pharmacogenomic evaluation of the antidepressant citalopram in the mouse tail suspension test. Neuropsychopharmacology 31(11): 2433-42, Nov 2006.
Corradi JP, Ravyn V, Robbins AK, Hagan KW, Bostwick R, Buono RJ, Berrettini WH, Furlong ST: Alternative transcripts and evidence of imprinting of GNAL on 18p11.2, a region linked to schizophrenia and bipolar disorder displaying parent-of-origin effects. Mol Psychiatry 10: 1017-25, November 2005.
Ferraro TN, Golden GT, Smith GG, Martin JF, Schwebel CL, Doyle GA, Buono RJ, Berrettini WH: Confirmation of a major QTL influencing oral morphine intake in C57 and DBA mice using reciprocal congenic strains. Neuropsychopharmacology 30: 742-6, 2005.
Berrettini W, Bierut L, Crowley TJ, Cybells JF, Frascella J, Gelernter J, Hewitt JK, Kreek MH, Lachman H, Leppert M, Li MD, Lachman H, Leppert M, Li MD, Madden P, Miner C, Pollock JD, Pomerleau O, Rice JP, Rutter JL, Shurtleff D, Swan GE, Tischfield JA, Tsuang M, Uhl GR, Vanyukov M, Volkow N, Wanke K: Setting priorities for genomic research. Science 304: 1445-7, November 2004.
Oslin D, Berrettini WH, Kranzler HR, Pettinati H, Gelernter J, Volpicelli JR, O'Brien CP: A functional polymorphism in the mu opioid receptor gene is associated with therapeutic response in alcohol-dependent patients treated with naltrexone. Neuropsychopharmacol 28: 1546-52, 2003.
Berrettini WH: Are schizophrenic and bipolar disorders related: Review of family and molecular studies. Biological Psychiatry 48: 531-538, 2000.
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Last updated: 08/23/2012
The Trustees of the University of Pennsylvania
Last updated: 08/23/2012
The Trustees of the University of Pennsylvania


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In the world of stuffing, this one is relatively light, though no less satisfying than a more traditional mix. And it tastes like a gift from the forest, with hearty cremini mushrooms, fresh sage, and the crunch of toasted hazelnuts.
Leave a Review
i really like the way in which this recipe looks i eaten it before with my loved ones all of us enjoyed this we can have a household gathering again and cook this recipe again soon this really is one tasty recipe you have to test it i guarantee you whatever you should this its very tasty
I meant to give this 3 "forks" but the interface isnt working. Everyone loved this stuffing at Thanksgiving dinner -- I followed the recipe exactly except for using pre packaged dried bread cubes (from a good bakery) -- but as others noted, the recipe serves way more than eight. I doubled the recipe for a party of 11 adults and 5 children, and had at least half left over. It was pretty labor-intensive and not inexpensive, so don't make the same mistake. I agree that it would have been better with fewer nuts and slightly less butter. The amount of stock worked ok for me, but I cooked it fully, then let it cool and reheated it (covered in foil) for 30 min before dinner, so it might have dried out more than it would have otherwise.
I was worried it would be bland, so I nearly doubled the mushroom and added a fennel bulb chopped coarsely. Based on other reviews I used a bit less nuts, and kept them aside to the last minute to maintain their crunch. Also went lighter on the stock. The results were a huge hit, and really appreciated by my vegetarian guests.
This stuffing was amazing! So flavorful without being too heavy. I found it did not require nearly as much stock/broth as the recipe called for though - I put in 4 cups instead of 6 and it was still a bit to wet. I'm sure the hazelnuts would be nice but it was nearly perfect without them.
This was an excellent, solid stuffing recipe for our Thanksgiving table. I made this with the proscuitto-based turkey recipe also on epicurious, and added a little of the prosciutto butter to the shallots and celery while they cooked -- that was a nice addition.
Wow! This is the best stuffing I have ever had. Will be making it again and again.
Could do with WAY less hazelnuts - stuffing was good overall, but I was picking out the nuts as I didn't like to have that overpowering flavor and crunch in every bite... crunch every now and then would have been nicer. I vote for the Porcini Onion stuffing recipe on this site as #1 and will make that over this one any day.
Thought it was a little bit bland over all. It was much better as leftovers when left to get browner on top (I reheated it for 40 whole minutes in the oven at 400 degrees!) Would not make it again.
This stuffing was simply beautiful in taste, texture as well as aesthetics. Everyone of our guests raved and wanted the recipe. I made this stuffing as per recipe except added more of almost all ingredients: approximately double of sage, thyme and shallots, a couple more ribs of celery and about 5 ounces more of mushrooms. It was perfect and the flavors really came out. Also used chicken stock instead of turkey. I used an alternative to hazelnuts, macadamia nuts straight out of the shell. toasted in the oven at 350 for about 10 minutes. This added an extra dimension of yummy. This recipe is a keeper, every year I will make it again.
My family are all pretty picky, and they said it was the best stuffing they've ever had! I doubled the sage and instead of reducing the nuts like other reviewers, I "chopped" them in a blender so there were still small chunks for texture but most was finely ground so you still got the nutty flavor without too much crunch. I also made half with egg and half without for my brother who's vegan (he'll let butter slide), and both were great. The eggy one was just slightly stickier. Not that noticeable. Also, make sure to butter the pan well to avoid the bottom from getting too brown/almost burnt. Delicious!!


text: What brand of dog food are you guys feeding your dogs? I feed Purina One (Lamb and Rice) because my vet suggested it for high protein, and it was good for working dogs. I was recently told that you can buy high protein dog food at Feed stores and they are cheaper in price. What is comparable to Purina One at Feed Stores and what are your thoughts on this?


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Provides practitioners with a single source reference for keeping current in all areas of the law affecting children. The author Jeffery Wilson and other specialists in the field deliver a thorough analysis of the changes and developments in the laws affecting children.


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It is a month into the NHL's regular season and the Canadiens are in first place in the Northeast Division and survived the first part of a tough week on Tuesday with a 2-0 win over the Vancouver Canucks. The next test is Thursday night in Boston against a Bruins team that is four points behind the Habs, but have four games in hand heading into action on Wednesday night.
In today's PuckCast, Pat Hickey, Dave Stubbs, Mike Boone and Kevin Mio discuss Carey Price's play, the struggles on the power play, scorers who are not scoring and Andrei Markov's return to action.
The PuckCast | Download it now
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Einhorn Sues Apple Over Preferred Stock Plan
Hedge fund manager David Einhorn sued Apple Inc. AAPL -0.10% Thursday over a plan by the company to make it more difficult to issue preferred shares that pay a dividend—something Mr. Einhorn has urged the company do to return more of its cash pile to investors.
Mr. Einhorn, who runs Greenlight Capital Inc., has been lobbying Apple's board to exercise its authority to issue such shares, though so far it hasn't done so.
Apple's board already has the right to issue preferred stock, but it is asking shareholders at its annual meeting later this month to vote on a proposal that would require shareholder approval to issue the stock.
Related Video
Mr. Einhorn's lawsuit, filed in the federal court in Manhattan, argues that the very formulation of Apple's proxy statement violates Securities and Exchange Commission rules that allow shareholders to vote on "each matter" in the proposals. The suit seeks a court injunction against Apple's proxy vote, and says he asked twice this week for the company to stop the vote or to "unbundle" the proposal at issue, but was rejected by the company.
Apple said in a statement Thursday that its management team "has been in active discussions about returning additional cash to shareholders." The company said it will evaluate Greenlight's proposal to issue preferred stock, and emphasized that adoption of its own proposal wouldn't prevent the issuance of the security.
Mr. Einhorn is asking Apple to create a "perpetual preferred stock" using operating cash flow. Preferred shares are often viewed as high-yielding securities that are less volatile than common shares and typically pay generous income akin to high-yield bonds. Mr. Einhorn suggests the preferred stock could yield a 4% dividend rate.
Apple's stock is down about 9% since issuing disappointing fiscal first quarter earnings. Shares rose after Apple's statement Thursday, finishing the day up 3% to $468.25.
Apple continues to attract scrutiny from investors about its fast-growing cash stockpile as the company generates strong profits from its computers and mobile devices. While it has recently created a dividend and stock buyback program, some investors believe Apple should deliver more of its cash—which was at $137.1 billion, including short and long-term securities—to shareholders.
"Greenlight is hopeful that when Apple and its advisers review the idea afresh, it will see the merits and act to unlock value for all shareholders," the hedge fund said Thursday.
Mr. Einhorn's firm owns 1.3 million Apple shares and has been an investor since 2010. On Thursday, Mr. said on CNBC that Apple has a hoarding problem and acts like a person with a depression-era mentality that "can never have enough cash."
The hedge-fund manager recently has been deeply critical of some publicly traded companies, speaking out against Chipotle Mexican Grill Inc.'s business and publicly proclaiming a short position in Herbalife Ltd. But with Apple, Greenlight has been a shareholder since 2010 and described the firm as "a phenomenal company filled with talented people creating iconic products that consumers around the world love."
Still, Greenlight added that it is "dissatisfied" with Apple's current capital allocations, believing that the company's contested proposal unnecessarily limits the board's flexibility to distribute preferred stock.
"We think for every $50 billion of preferred that they issue it will unlock about $32 a share in Apple. If Apple used about half of their earnings towards this program, we think they would be able to issue approximately $500 billion which would unlock about $320 a share," Mr. Einhorn said on CNBC.
When asked about Greenlight's position on Apple, Mr. Einhorn said they were "long," adding "we own more Apple stock now than we ever have before."
—David Benoit contributed to this article.
Write to Ben Fox Rubin at firstname.lastname@example.com


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Indivi 2 sofa, the product is available in fabrics and leathers. As shown, black Bahia leather 0930/brushed steel. H81xW172xD91cm. [Indivi 2 - CB30]
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Education may be the key to preventing a real assault on firearms ownership in the next few years. This may be especially true in the area of semi-automatic guns.
The National Shooting Sports Foundation (NSSF) has put together some information that can be used to educate media, politicians and others who are truly unaware of the differences in fully automatic weapons and semi-automatics that are used for sport, target shooting and hunting.
You can access this information at http://nssf.org/media/FactSheets/Semi-A ... ground.cfm and feel free to share it with anyone.
We understand that this type of factual information will not deter anti-gunners but it may well help others who just don't know or understand the differences.
Please share this with all of your friends and with anyone else that you believe would benefit from it.


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"Sixth Annual Juried Summer Exhibition" | Tufts University Art Gallery, 40R Talbot Ave, Medford | Through August 2
"Salt of the Earth" | Montserrat College of Art, 23 Essex St, Beverly | Through July 24
The payoff is the inclusion of two Somerville artists who have made breakthroughs in the past couple of years: Resa Blatman and Raúl González (who is a friend of mine). Both are ripe for major one-person shows — like, say, an ICA "Momentum" exhibit.
Blatman had been making paintings of flowers, birds, and arabesque patterns for a while, but the compositions felt awkward, flat. The realist flora and fauna seemed too separate from the decoration. I wonder whether she was just holding back. Last year, something clicked and her paintings became sharper, lusher. Suddenly they were over the top — in a ravishing way.
You can probably date the change to last July, when she began painting on PVC panels with her decorative Art Nouveau–style patterns jigsawed out of the edges. (She designs the patterns on a computer, then has them sliced by a laser-cutting shop.) This wove the decoration through the entire composition, activating the space in and around the paintings. And the patterns grew bigger, more dynamic, and more sexual. A mushroom ejaculating an arabesque is not just a mushroom. A subject came into focus: the biological imperative of beauty. In other words: beauty for sex's sake.
Blatman debuted these works in "Overflow," a group show she organized at South Boston's Laconia Gallery last fall. Her two paintings here are even better. They continue her mix of realist critters (bats, mice, butterflies, dragonflies) and floral patterns, but in increasingly asymmetrical compositions that are more animated, more surprising, more seductive.
González's breakout show was "Chingasos" at East Boston's New England Gallery of Latin American Art last spring. He's a member of the Miracle 5 collective, and his previous work riffed goofily on superheroes and monetary currency, but it felt corny and stunted in the way that superhero stuff often is. His jam-packed East Boston show played on boxing and his Mexican-American ancestry. He created the story of a boxer as a way of showing how people reinvent themselves when they come to the United States. The subject gave his art more emotional heft and focused his skills, with the energy of the early work now poured into a folksy blend of bright cartoons and street graphics. His four pieces here build on that breakthrough; they're even more substantial and assured.
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/ NRCS ag adviser teaches agriculture to young Afghans
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By Spencer Miller
Kim Lively, a resources team leader with USDA's Natural Resources Conservation Service in Meridian, Texas, taught school children about agriculture while serving as an ag adviser in Afghanistan – an effort to instill the knowledge of good agriculture in future generations.
Stationed near Khost, a city on the Pakistan border, Lively said he was quickly impressed by the local farming potential.
"They have excellent soil," said Lively, who served December 2009 to December 2011. "Some of the best crops I've ever seen were in Afghanistan. Peaches, plums, rice, alfalfa…you name it, they could grow it."
But decades of war have prevented that agricultural potential from being realized. Khost has an especially violent history. During the Soviet war from 1979 to 89, Khost was besieged for more than 8 years.
Though less intense, the violence continues today. Lively was never far from danger. On average, the base suffered mortar attacks once or twice per week. He accepted the risk philosophically. "If it's my time, what can I do about it anyway? No reason to worry."
Lively is a trained paramedic. That skillset earned him an eager welcome from the Indiana National Guard unit stationed in Khost. Though never called upon for his emergency medical skills, he said, the Guardsmen felt reassured having him near and invited him to join any of their convoys.
The rapport with his host military unit led to effective collaboration to address the main agricultural issue in Khost: lost knowledge. As a result of prolonged war, some communities in Afghanistan no longer remember how to raise chickens, how pollination works, or other basic facts of agriculture that are typically handed down generation to generation. Several Indiana Guardsmen, who are teachers in their civilian life, helped Lively develop projects to educate Afghan schoolchildren about agriculture.
With Lively's 35 years of experience at NRCS, he brought invaluable conservation knowledge that he transferred to the local farmers.
"I've spent a lot of time helping farmers improve their methods," said Lively, "And that's exactly what we did in Khost."
Working with local government and university professors, Lively introduced projects in greenhouse management, drip irrigation, raising chickens, solar dehydration and composting. These projects taught Afghan high school students conservation and agriculture skills that had been lost. "The great thing about what we were doing is that it's self-sustaining," Lively said, noting that the curriculum he set up has continued since his departure.
The project on raising chickens was especially successful. Students sell the eggs and use that money to buy grain and other supplies. The project teaches a skill, provides income and gives the young generation of Afghans entries into agriculture.
Lively feels a great deal of satisfaction in his work abroad. "In my opinion, agriculture is the number one thing that can pull Afghanistan together," he said.
Though he extended his deployment from one year to two, he said he would go back again if his grandkids would let him.
"I feel great about what we did," he said. "Our mission was right and we made an impact."
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Currently what I do is, serialize the 2D Tile array that I've made. The size I test on is 10240 * 512. Now I know I can optimize the file size further, but currently this gives me a file size of roughly 305MB.(I am planning to have worlds much bigger than this one) My problem occurs when I try to deserialize the array. The game freezes, and rapidly swallows more and more memory, and after a while (5-10 mins) it will throw an out of memory exception. Is this due to the huge size of the file? Or are there other factors I should consider. My code for serializing and deserializing is here:
public void SerializeWorld(string fileName) { using (Stream stream = File.Open(fileName, FileMode.Create)) { BinaryFormatter bf = new BinaryFormatter(); bf.Serialize(stream, world); } } public static void DeserializeWorld(string filename) { using (Stream stream = File.Open(filename, FileMode.Open)) { BinaryFormatter bf = new BinaryFormatter(); world = (Tile[,])bf.Deserialize(stream); } }
In the above code world is the array where I keep my tiles. I've tested this in two ways:
On both tests I create the world as I usually do, and then serialize it into a file right after the creation. The difference is when I load it. First I tried loading it while the game was running, to see if It would be able to load the world without having to leave the game session. Failing this I tried simply loading the world when I start the game, but with the same results- Game freezes for 5-10 mins, swallows memory and ends up with Out of memory exception.
Now the way I believe I should do this is divide the world into chunks, and only keep 9 chunks loaded at any one time. (Normally it would be 3, but I need to consider up and down as well). This would also require me to keep each chunk in its own file, giving me tons of smaller files. This is sort of okay with me as long as this does not cause any other issues? I would then load those 9 chunks into my in memory world array, and release the ones out of range. Currently I'm not quite sure how to do this effectively.
Maybe keeping it in small files, might fix the problem with deserialization?
So to sum it up:
- Am I right to assume that the 305MB file, is the cause of the freeze and out of memory exception when I deserialize?
- How should I correctly handle chunks?
- Will it be an issue to have multiple smaller files, where each file represents one chunk?
- Are there anything wrong with the way I de- and serialize right now, and should I consider other methods?
Thank you for reading.


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The lineup is topped by Paul McCartney, Mumford & Sons and Tom Petty & The Heartbreakers, with Wilco, Bjork, Jim James of My Morning Jacket, R. Kelly, The Lumineers and Wu-Tang Clan also among the major artists on the bill.
Also on board for Bonnaroo are David Byrne & St. Vincent, Passion Pit, The xx, The National, Kendrick Lamar, Grizzly Bear, The Gaslight Anthem, Of Monsters and Men, Animal Collective, Nas, ZZ Top, Cat Power, Macklemore & Ryan Lewis, Matt & Kim and many, many more acts. The webcast also ended with the "shocking" reveal that Yankovic himself will be performing at Bonnaroo. The lineup can be seen at lineup.bonnaroo.com, with additional acts still to be added.
Bonnaroo 2013 will run June 13-16 in its annual home of Manchester, TN.
Nikki Nite, VP of Prog. & Ops, Entercom/Austin
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Dragon King Swords in Canada...
We only ship to Canadian & U.S. addresses. U.S. Orders by PayPal only.
(Click Here) to go to our "Advanced Search"
"The Dragon King is a group of artisans who have been adeptly trained to duplicate ancient skillsets that can't be automated by machines on an assembly line. Not every blade that is forged becomes a sword. Not every casting that is poured becomes a component of a greater piece. The goal for improvement and innovation starts every day under master designer Frenchie Jin's guidance." - CAS Iberia


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Main Content
- Synthetic back strap for a secure fit
- Comfortable synthetic NuBuck upper with jersey lining
- Durable, high density Reef rubber outsole
- High frequency welded Reef accent & logo
- Soft compression molded EVA footbed with anatomically correct arch support
- Imported
- Made in the USA
- Brand: Reef
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PHP texis plugin
Several months back I wrote a hackish PHP extension to natively connect and talk with Thunderstone's texis SQL daemon and now it's just sitting around unused and unfinished. What I can't figure out is whether there's anyone out there who'd actually want such a beast - we were only thinking about going that route because we had a poorly deployed search index running out of texis, and replacing vortex with PHP seemed like a good idea.
Syndicated 2008-04-11 03:02:35 from papasian.org - lifehacking


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I just thought I would provide some common spelling mistakes I notice from time to time, and some common misuse of words. This isn't an English lesson, but I thought it would be helpful. I am sure I missed some, and would be glad to post them if anyone wants to share.
Hear - As in listening. Can you hear me now?
Here - As in location. Are you here in the building?
Where - Where are you?
Wear - As in clothing or to adorn oneself with.
Were - Were you coming to dinner?
We're - Contraction for - "We are" so glad you could make it.
Effect - See
Affect - Below
There - Location. Direction. There is a long line at the bank.
Their - Showing plural possession. Their deeds were hidden from sight.
They're - Contraction for - "They are" the new neighbors.
To - To go where no man has gone before.
Two - The number 2.
Too - Excess - as in Also. Can be used interchangeably. I can do that too (also)!
Know - As in knowledge present tense. I know what you are saying.
No - As an answer to a question. A command. No I don't understand.
Knew - As in kowledge past tense. He knew him well before he died.
New - As in recent, just made, fresh. This car is brand new.
Through - As in completing a process, or passing through something. He went through a tough time.
Threw - To throw a ball.
Thru - This is not a word. It is slang.
Then - referring to a point in time. Back then things were different.
Than - To be used as a comparison. I like peas rather than carrots.
You're - Contraction for "you are" as in you're a nice guy.
Your - Showing possession of. Please restrain your dog.
Effect or Affect?
Affect and effect are two words that are commonly confused.
"Affect" is usually a verb meaning "to influence".
- The drug did not affect the disease.
"Effect" is usually a noun meaning "result".
- The drug has many adverse side effects.
"Effect" can also be used as a verb meaning "to bring about".
- The present government effected many positive changes.


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Maybe if they'd be able to keep ammo in stock, they'd see more of my business.
2017 Goals:
1) Win the next game.
2) See #1
"The problem with internet quotes lies in verifying their authenticity."
-Abraham Lincoln
"Lucille" is my BanHammer!!!
People's cash is being sapped right now due to the mark up in GAS.
Gas is reaching almost $4 and some places around the country are past that mark. Prices have somewhat retreated in the last few days on the market but that wont filter down to the pumps anytime soon. It might slightly halt the rise, for now though.
For those that think (non talk radio listeners), it was pretty easy to see the issue..."February sales got a slow start, due in large part to the delay in income tax refunds, said Wal-Mart U.S. Chief Executive Bill Simon in a statement. As a result, the division expects same store sales for the quarter ending on April 26 to be around flat."
Last edited by DeathStar; 02-21-2013 at 10:58 PM.
And even when income taxes do come in they still expect sales to be around flat for the first quarter ending in April 26. Pretty crazy considering all the money Wal-Mart makes from ebt and income taxes. Let's not forget the economy shrunk the last quarter and unemployment still continues to be high. Factor in high gas prices and inflation and it's quite possible we might see 2 quarters of negative gdp. All is not hunky dory with this economy. FAR from it.
"Politics is the Art of Looking for Trouble, Finding it Everywhere, Diagnosing it Incorrectly, and Applying the Wrong Remedies".
CEO's are just the face the company wants to show you. He's responsible for damage control so shareholders dont get nervous. Its like believing everything the POTUS tells you.....you'd be naive to think there isnt more to the story
Fat, drunk and stupid is no way to go through life
FACT: You can easily get advances on tax returns. FYI most Wal-Marts have specific areas in their stores to do this very thing!
I'm amazed at the things some ppl are willing to eat just so their guy won't look bad. How long does Obama have to be President before it's his fault/economy?


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April 21, 2009
NYT – Up, Up and Out
This illustration for the Times' Op/Ed Page accompanies Paul Kane's article suggesting, among other substantial reforms to our armed forces, that the Air Force be eliminated entirely and have its resources redistributed throughout the Army, Navy and Marines (apparently, this leaves squat for the Coast Guard). To hear him tell it, the proposal sounds a lot crazier than it actually is.
As I am a sucker for dots, here's a detail:
Leanne Shapton contacted me about working on this on a Friday night, giving me the weekend to experiment and brood. This turned out to be a blessing of sorts as I really struggled to land an idea for this article that I felt confident was going to stick come Monday morning when the comps were due. The article makes two additional reformation proposals which, while not as headline-grabbing as the Air Force suggestion, were powerful ideas nonetheless and I performed a healthy amount of self-flaggelation trying to concoct an image that could potentially encompass all three of these ideas. Ultimately, I failed in that task and Leanne, whether for good or for ill, endured more comps than usual from me on this one. The most ridiculous one below depicts an F-15 landing trajectory flying directly into a black hole before touching down.
Also of interest, the design firm Fogelson-Lubliner, who regularly contribute great pieces to the Op/Ed page, did an excellent spot for the Letters section today on the opposite page regarding U.S. torture and accountability. Good stuff.
UPDATE: Esteemed design guru Paul Sahre and his co-conspirator Sebastian Rether did the Letters' piece documenting the responses to Kane's piece. The letters (including one from the understandably nonplussed Air Force Chief of Staff), are all over the board, but the illustration is uniformly awesome.


text: apparently raph can't make decisions for himself, and must do what a select few of his band-wagoneers tell him to do: that is, to prevent my entries from showing up in the recent entries. prove me wrong, raph, but at this very instant I am relieved that I don't have social delinquents like yourself working with me. The leeches surrounding you, they know who they are, are all that is wrong with the computing world. You make Bill Gates look like the Mother Theresa of Digital Nirvana.


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- Home
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EHC Component
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Topic Title
- Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update
Full Report
- Research Review (Update) Jun. 13, 2011
Related Products for this Topic
- Research Protocol May 7, 2010
- Disposition of Comments Report Oct. 7, 2011
- Surveillance Report Mar. 28, 2016
Related Links for this Topic
Executive Summary – Jun. 13, 2011
Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update
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Archived. Findings may be used for research purposes but should not be considered current.
Table of Contents
Almost 75 million American adults—approximately one-third—have hypertension. The prevalence of hypertension increases with advancing age such that more than half of people 55 to 74 years old and approximately three-fourths of those age 75 years and older are affected. In addition to being the primary attributable risk factor for death throughout the world, hypertension results in substantial morbidity because of its impact on numerous target organs, including the brain, eyes, heart, arteries, and kidneys.
Despite the high rates of morbidity and mortality attributable to hypertension, control of the condition remains suboptimal. In addition to several effective nonpharmacological interventions—including diet, exercise, and control of body weight—many people require antihypertensive medication to lower blood pressure.
Among the many choices in antihypertensive therapy, some of the most common are those aimed at affecting the renin-angiotensin-aldosterone (renin) system. The renin system is an important mediator of blood volume, arterial pressure, and cardiac and vascular function. Components of this system can be identified in many tissues, but the primary site of renin release is the kidney. The renin system can be triggered by sympathetic stimulation, renal artery hypotension, and decreased sodium delivery to the distal tubule. Through proteolytic cleavage, renin acts on the oligopeptide substrate angiotensinogen to produce the decapeptide angiotensin I. In turn, two terminal peptide residues of angiotensin I are removed by the angiotensin-converting enzyme (ACE) to form the octapeptide angiotensin II. Angiotensin II acts directly on the resistance vessels to: increase systemic vascular resistance and arterial pressure; stimulate the adrenal cortex to release aldosterone, which leads to increased sodium and water reabsorption and potassium excretion; promote secretion of antidiuretic hormone, which leads to fluid retention; stimulate thirst; promote adrenergic function; and increase cardiac and vascular hypertrophy.
Therapies aimed at modifying the renin system have been used extensively for treatment of hypertension, heart failure, myocardial infarction, diabetes, and renal disease. Currently, three classes of drugs that interact with this system are used to inhibit the effects of angiotensin II: the angiotensin-converting enzyme inhibitors (ACEIs), the angiotensin II receptor blockers/antagonists (ARBs), and the direct renin inhibitors. ACEIs block the conversion of angiotensin I into angiotensin II; ARBs selectively inhibit angiotensin II from activating the angiotensin-specific receptor (AT1); and direct renin inhibitors block the conversion of angiotensinogen into angiotensin I.
Although ACEIs and ARBs both target the renin system and are treated by clinicians as being equivalent, this may not be appropriate. While both drug classes reduce the downstream effects of angiotensin II, it is not clear that these medications are in fact clinically equivalent. ACEIs, for example, do not entirely block production of angiotensin II because of the presence of unaffected converting enzymes. Also, ACEIs have well-known side effects not shared by ARBs, including cough (estimated incidence 5 to 20 percent) and angioedema (estimated incidence 0.1 to 0.2 percent, with a lesser reported risk with ARBs). Additional considerations arise with the newer direct renin inhibitors, because their side-effect profiles and efficacy may differ significantly from ACEIs or ARBs. Given the public health importance and widespread use of these agents, it is important to understand their comparative effects on clinical outcomes.
This review summarizes the evidence on the comparative long-term benefits and harms of ACEIs, ARBs, and direct renin inhibitors, focusing on their use for treating essential hypertension in adults. It is an update of a 2007 report that evaluated the scientific literature on ACEIs and ARBs for adults with essential hypertension and adds an evaluation of direct renin inhibitors, which were not covered in the original report. The need for this updated report was determined by an analysis conducted by the Southern California Evidence-based Practice Center. In that analysis, investigators assessed the conclusions from the original comparative effectiveness review, performed a limited literature search of potentially new evidence, and solicited expert opinions concerning the state of the evidence and validity of the original report.
Key Questions addressed are:
Key Question 1. For adult patientsa with essential hypertension, how do ACEIs (angiotensin-converting enzyme inhibitors), ARBs (angiotensin II receptor antagonists), and direct renin inhibitorsb differ in blood pressure control, cardiovascular risk reduction, cardiovascular events, quality of life, and other outcomesc?
a "Adult patients" are defined as adults, age 18 years or older.
b ACEIs evaluated are: Benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik). ARBs considered are: Candesartan cilexetil (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan medoxomil (Benicar), telmisartan (Micardis), and valsartan (Diovan). Direct renin inhibitors considered are: Aliskiren (Tekturna).
c Outcomes considered include:
Primary outcomes:
- Blood pressure control (we will prefer seated trough blood pressure, where reported).
- Mortality (all-cause, cardiovascular disease-specific, and cerebrovascular disease-specific).
- Morbidity (especially major cardiovascular events [myocardial infarction (MI), stroke] and measures of quality of life).
- Safety (focusing on serious adverse event rates, overall adverse event rates, and withdrawals due to adverse events, withdrawal rates, and switch rates).
- Specific adverse events (including, but not limited to, weight gain, impaired renal function, angioedema, cough, and hyperkalemia).
- Persistence/adherence.
- Rate of use of a single antihypertensive medication for blood pressure control.
Secondary outcomes:
- Lipid levels (high-density lipoprotein, low-density lipoprotein, total cholesterol, and triglycerides).
- Rates of progression to type 2 diabetes.
- Markers of carbohydrate metabolism/diabetes control (glycated hemoglobin [HbA1c], dosage of insulin or other diabetes medication, fasting plasma glucose, or aggregated measures of serial glucose measurements).
- Measures of left ventricular mass/function (left ventricular mass index and ejection fraction).
- Measures of kidney disease (creatinine/glomerular filtration rate [GFR], proteinuria)
Key Question 2. For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in safety,d adverse events,e tolerability, persistence with drug therapy, and treatment adherence?
d Safety outcomes considered include: Overall adverse events, withdrawals due to adverse events, serious adverse events reported, withdrawal rates, and switch rates. (For practical reasons, we separate safety/adverse events and tolerability/persistence [including switch rates], as the latter may or may not be due to identifiable adverse events.)
e Specific adverse events: These included, but were no limited to, weight gain, impaired renal function, angioedema, cough, and hyperkalemia.
Key Question 3. Are there subgroups of patients—based on demographic and other characteristics (i.e., age, race, ethnicity, sex, comorbidities, concurrent use of other medications)—for whom ACEIs, ARBs, or direct renin inhibitors are more effective, are associated with fewer adverse events, or are better tolerated?
Table A provides an aggregated view of the strength of evidence and brief conclusions from this review of the comparative long-term benefits and harms of ACEIs, ARBs, and direct renin inhibitors for adults with essential hypertension.
|Key Question
|Strength of Evidence
|ACEI(s) = angiotensin-converting enzyme inhibitor(s); ARB(s) = angiotensin II receptor blocker(s)/antagonist(s); CI = confidence interval; GFR = glomerular filtration rate; LV = left ventricular; MI = myocardial infarction; RCTs = randomized controlled trials
|1. Key Question 1. For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in the following health outcomes:
|a. Blood pressure control?
|High (ACEI vs. ARB);
Low (DRI vs. ACEI or ARB)
|ACEIs and ARBs appear to have similar long-term effects on blood pressure among individuals with essential hypertension. This conclusion is based on evidence from 77 studies (70 RCTs, 5 nonrandomized controlled clinical trials, 1 retrospective cohort study, and 1 case-control study) in which 26,170 patients receiving an ACEI or an ARB were followed for periods from 12 weeks to 5 years (median 24 weeks). Blood pressure outcomes were confounded by additional treatments and varying dose escalation protocols.
Evidence concerning the effect of direct renin inhibitors on blood pressure is very limited and currently based on only three studies. These studies found the direct renin inhibitor to have a greater reduction in blood pressure compared to the ACEI ramipril (two studies) and no significant difference compared to the ARB losartan (one study).
|b. Mortality and major cardiovascular events?
|Low (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|Due to low numbers of deaths or major cardiovascular events reported, it was difficult to discern any differential effect of ACEIs versus ARBs versus direct renin inhibitors with any certainty for these critical outcomes. In 21 studies that reported mortality, MI, or clinical stroke as outcomes among 38,589 subjects, 38 deaths and 13 strokes were reported. This may reflect low event rates among otherwise healthy patients and relatively few studies with extended followup.
Only 3 of these 21 studies (including 1 death) evaluated direct renin inhibitors versus ACEIs or ARBs, and therefore the evidence to discern any differential effects between these drug classes on mortality and major cardiovascular events was insufficient.
|c. Quality of life?
|Low (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|No differences were found between ACEIs and ARBs in measures of general quality of life; this is based on four studies, two of which did not provide quantitative data.
No study evaluated the comparative effectiveness of direct renin inhibitors for quality-of-life outcomes.
|d. Rate of use of a single antihypertensive medication?
|High (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|There was no statistically evident difference in the rate of treatment success based on use of a single antihypertensive for ARBs compared to ACEIs. The trend toward less frequent addition of a second agent to an ARB was heavily influenced by retrospective cohort studies, where medication discontinuation rates were higher in ACEI-treated patients, and by RCTs with very loosely defined protocols for medication titration and switching.
There were no relevant studies evaluating direct renin inhibitors.
|e. Risk factor reduction and other intermediate outcomes?
|Lipid levels, markers of carbohydrate metabolism/ diabetes control, progression of renal disease:
Moderate (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|There were no consistent differential effects of ACEIs, ARBs, on several potentially important clinical outcomes, including lipid levels and markers of carbohydrate metabolism/diabetes control. There appears to be a small difference in change in renal function between ACEIs and ARBs (favoring ACEIs), but this difference is both small and most likely not clinically meaningful or significant. Relatively few studies assessed these outcomes over the long term.
There were no studies that evaluated these outcomes in direct renin inhibitors.
|Progression to type 2 diabetes and LV mass/function:
Low (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|There was no evidence for an impact of ACEIs, ARBs, or direct renin inhibitors on glucose or A1c, and no included studies evaluated rates of progression to type 2 diabetes mellitus. Although we included 13 studies of LV mass/function, these were dominated by poor-quality studies with small sample sizes, and only one study included evaluation of a direct renin inhibitor.
|2. Key Question 2. For adult patients with essential hypertension, how do ACEIs, ARBs, and direct renin inhibitors differ in safety, adverse events, tolerability, persistence with drug therapy, and treatment adherence?
High (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|ACEIs have been consistently shown to be associated with greater risk of cough than ARBs (odds ratio 0.211; 95% CI 0.159 to 0.281). For RCTs, this translates to a difference in rates of cough of 7.8 percent; however, for cohort studies with lower rates of cough, this translates to a difference of 1.2 percent. There were only two studies comparing direct renin inhibitors to ACEIs and these gave an estimated odds ratio of 0.333 (95% CI 0.2241 to 0.4933).
|Withdrawals due to adverse events:
High (ACEI vs. ARB);
Low (DRI vs. ACEI or ARB)
The withdrawal rate for ARBs was found to have an estimated odds ratio of 0.565 (95% CI 0.453 to 0.704) compared with ACEIs. For RCTs, this translated to an absolute difference in withdrawals of 2.3 percent (5.4% vs. 3.1%). The direct renin inhibitor trials did not find a statistically significant difference (odds ratio 0.886; 95% CI 0.458 to 1.714) when compared with the withdrawal rate associated with ACEIs.
Low (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|Although several studies collected data on angioedema, the event rates were very low or zero for all studies; this limited our ability to accurately characterize the frequency of angioedema. In the four studies that did report episodes of angioedema, this adverse event was observed only in patients treated with an ACEI (five patients from three studies) or a direct renin inhibitor (one patient in one study).
|Persistence with drug therapy/ treatment adherence:
Moderate (ACEI vs. ARB);
Insufficient (DRI vs. ACEI or ARB)
|ACEIs and ARBs have similar rates of treatment adherence based on pill counts; this result may not be applicable outside the clinical trial setting. Rates of continuation with therapy appear to be somewhat better with ARBs than with ACEIs; however, due to variability in definitions, limitations inherent in longitudinal cohort studies, and relatively small sample sizes for ARBs, the precise magnitude of this effect is difficult to quantify. The three included studies evaluating direct renin inhibitors did not find evidence of differences in treatment adherence compared with ACEIs or ARBs. Persistence was not evaluated in any of the studies including direct renin inhibitors.
|3. Key Question 3. Are there subgroups of patients—based on demographic and other characteristics (i.e., age, race, ethnicity, sex, comorbidities, concurrent use of other medications)—for whom ACEIs, ARBs, or direct renin inhibitors are more effective, are associated with fewer adverse events, or are better tolerated?
|Insufficient (ACEI vs. ARB; DRI vs. ACEI or ARB)
|Evidence does not support conclusions regarding the comparative effectiveness, adverse events, or tolerability of ACEIs, ARBs, and direct renin inhibitors for any particular patient subgroup.
Remaining Issues
Despite the importance of both ACEIs and ARBs for treatment of essential hypertension, there is little comparative evidence for long-term benefits and harms of these two classes of agents. In particular, there is a lack of information about death or major cardiovascular events, and inconsistently reported data on adverse events. Only nine studies compared ACEIs and ARBs for periods longer than 1 year. In addition, although direct renin inhibitors have been proposed as a new class with potentially more favorable side-effect profiles and efficacy, the number of studies with comparative evidence for this new drug class versus ACEIs or ARBS is extremely limited. Only three studies focusing on direct renin inhibitors met our inclusion criteria, with the longest followup being 36 weeks.
Future Research
With the exception of rates of cough, the hypothesis that ACEIs, ARBs, and direct renin inhibitors have clinically meaningful differences in long-term outcomes in individuals with essential hypertension is not strongly supported by the available evidence. Given the importance of these issues, it is notable how few large, long-term, head-to-head studies have been published.
Further comparative studies in this area should emphasize:
- Subgroups of special importance such as individuals with essential hypertension and diabetes mellitus, congestive heart failure, chronic kidney disease, and dyslipidemia.
- Pragmatic designs such as clinical trials in which treatment is consistent with typical clinical practice, or randomization by organizationally meaningful clusters such as practice organizations or health plans.
- Outcomes over several years.
- Outcomes measured according to current clinical standards.
- Broader representation of groups such as the elderly and ethnic and racial minorities.
- Evaluation of specific pairs of ACEIs and ARBs to allow differentiation within class. (Only one direct renin inhibitor, aliskiren, is currently available.)
- Long-term comparisons of direct renin inhibitors with ACEIs and ARBs.
In addition, we think that research aimed at generating additional evidence regarding four specific areas should be prioritized. These areas include:
- The incidence, timing, and clinical consequences of angioedema in patients treated with ACEIs, ARBs, or direct renin inhibitors.
Comment: Angioedema is a well-known adverse reaction to ACEIs and ARBs; however, due to its infrequent occurrence, we lacked sufficient evidence to directly compare the incidence, timing, and clinical consequences of this reaction among patients treated with ACEIs, ARBs, or direct renin inhibitors. Others have estimated that angioedema is experienced by 1 in every 1,000 patients treated with an ACEI, and 1 to 5 of every 10,000 of those treated with an ARB. Furthermore, others have reported a three- to fourfold increased risk of angioedema in African-American patients treated with an ACEI versus Caucasian patients treated with an ACEI. Future research should utilize large databases with sufficient sample sizes to obtain more precise estimates of this rare but serious event. Assessment of study designs or analyses that could explore the impact of angioedema should be prioritized.
- Relative persistence with drug therapy across the different classes of drugs.
Comment: Although we report with moderate confidence that persistence with drug therapy is greater with ARB treatment than with ACEI treatment, medication discontinuation rates varied significantly across studies. Because medication discontinuation often requires followup visits and initiation of alternative medications, it has important health economic implications. Future studies that more precisely estimate discontinuation rates in usual clinic settings, the additional health care utilization following discontinuation, and the conditional tolerability of an ACEI or ARB following prior intolerance to one of these agents would be valuable in understanding the consequences of differential medication discontinuation.
- The impact of cough on patients' quality of life.
Comment: Given the demonstrated higher incidence of cough with ACEIs, it would also be valuable to gain more precise understanding of the impact of cough on quality of life, care patterns (e.g., use of therapeutic agents for cough symptoms or conditions associated with cough), and health outcomes, particularly for individuals who continue to use ACEIs.
- The potential to gain insight on the comparative benefits and harms of ACEIs, ARBs, and direct renin inhibitors based on findings from studies evaluating patients with other, related conditions such as congestive heart failure, ischemic heart disease, and chronic kidney disease.
Comment: While our review is restricted to patients with essential hypertension, the agents studied here have been compared in large studies for related conditions such as congestive heart failure, ischemic heart disease, and chronic kidney disease. Trials comparing ACEIs, ARBs, and direct renin inhibitors in these target conditions often report the outcomes of interest in this review. For evaluation of rarer events (e.g., mortality or angioedema) it may be worth combining data across target conditions. Future research should consider this strategy and evaluate the extent to which results differ across target conditions.
This executive summary is part of the following document: Sanders GD, Coeytaux R, Dolor RJ, Hasselblad V, Patel UD, Powers B, Yancy WS Jr., Gray RN, Irvine RJ, Kendrick A. Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update. Comparative Effectiveness Review No. 34. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-02-0025.) AHRQ Publication No. 11-EHC063-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2011. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.


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Universal Fit
Bling Buds #3024 Purple Crystal Covered Headphones in Retractable Case
Bling buds add sparkle to your music
Digital Age DAP-010A Eara In Ear Earphones
You enjoy your iPod and other digital media players. Move up a couple of comfort notches with Eara from Digital Age. Eara Earphones deliver the brightest treble, clearest fidelity and deep tonal bass of any earphone on the market. From the moment you put them on you are taken aback at the rich amplified sound. Never muddy or shrill, you hear everything as accurately as it was recorded. The...


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i am in the middle of designing a very simple door alarm. please can someone help me decide which way to proceed on the wireless side.(data to be transmitted simple on off) please advise me on the cheapest option. distance max 10m.
also how would i be able to play music through arduino.
You could have the arduino operate a transistor which which controls the power to a gizmo that can play music.
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