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She Was in the Field Counting Stars. . .
In our noisy society, music is too often relegated to background noise—to accompaniment. But once in a while a song stands up and demands more—it consumes us, becoming both external and visceral. It's arresting. We have no choice but to stop, listen, and be eclipsed. For this week's installment of Things I Love, I've got one of these songs (for me, at least). Here's the backstory:
In 2003, at the tender age of eighteen, I was introduced to a nightly radio program called Echoes that played on KUNC, the Northern Colorado NPR affiliate. The introduction came from a young man whose friendship would ultimately alter the trajectory of my entire life
(I've written a whole novel inspired by this friendship), but learning about Echoes was probably his first, lasting impact. The program (which continues to air nightly) is two hours of ambient/electronic soundscapes. It's atmospheric—eclipsing—and host John Diliberto's soothing midnight commentary completes the package.
You have to understand; music was always important to me, but before Echoes, I mostly listened to Country and Classical, and I thought Céline Dion was exotic! Discovering ambient electronic music was revolutionary. My soundscape expanded a million times over, and now my tastes are so eclectic that (to others) my playlists can sometimes feel erratic and incongruous from track to track. Suffice it to say, I owe a lot to Echoes, so imagine my disappointment when I moved to
Massachusetts in 2006 and couldn't find a local station that broadcast the program. Slowly but surely Echoes faded from my mind and I learned to live without. . .
Then I wrote my book. Echoes factored into a few scenes (especially toward the end), and got me to thinking; there had to be a way to listen again. Via the magic of the internet (why hadn't I thought of that before?) I located WEXT, a station out of the Albany area that broadcast online at a time convenient for me to listen. After a decade away, I started tuning in almost nightly about a year ago, and the program is just as spectacular as I remember. As a direct result, I've added about fifty tracks to my music library since then, but this is one of my favorite discoveries since returning to the show:
I wrote last week about my seasonal relationship with music, so, sharing this track this week felt right—
Sign up for my FREE monthly newsletter today, and get instant access to my FREE SUBSCRIBER EXCLUSIVE short story.
Revenge is better with a side of bacon. . .
Hammock's Everything and Nothing [Amazon] [Apple Music] [Spotify] was the Echoes CD of the month last May (though it got a lot of play in April) and She Was in the Field Counting Stars is definitely the crown jewel of the album. As I mentioned at the beginning of this post, this is one of those absolutely arresting, eclipsing tracks. I spent many a night last spring sitting on our little balcony, earbuds in, staring at the sky while this track played on repeat.
It's calming, hopeful, beautiful; if you let it build on you it'll wrap you up in its sound. Give this one five minutes. Put on your headphones, turn up the volume, and close your eyes. I think you'll come away inspired and ready to tackle the weekend.
(Looking for more inspiration check out these nature photographs for sale including some by my husband.)
Have you got a song like this? One that is arresting or eclipsing? Let me know in the comments below!


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Sycamore Gas Company Rates
Base Rates
Current rates for Sycamore Gas Company - formerly Lawrenceburg Gas Co. - were approved in 2007.
For the case file, click here and enter cause number 43090.
To compare average residential gas bills, please see the IURC's monthly residential surveys.
Quarterly Gas Cost Adjustments
Natural gas utilities may adjust rates on a quarterly basis to recover wholesale costs. OUCC review and IURC approval are required. To review Sycamore Gas Company's gas cost adjustment filings, click here and enter cause number 37368.
Additional OUCC Resources

subset: commoncrawl


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Cutting corners in an OS upgrade
The IT In A Box offers you the following features which I suspect pretty adequately cover your needs:
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- File and Print sharing
- Firewall
- Networking (including DHCP, DNS, Wireless Access point, NAT)
- SPAM Blocker and Virus
- Web Server
- Networking monitoring
- Domain User control (simple alternative to Active Directory)
- And Many more features...
The only limitation is that you have to adhere to the boundaries of a pre-configured solution in this scenario but solutions like this are the kind of thing that allow you to save administration time and focus on your core business, whatever that may be.
Dig Deeper on Linux servers
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Audio MixersFind the right audio mixer for you at great prices. What kind of sound mixer are you looking for? USB audio mixer, PA mixer, or digital audio mixer? Or maybe a mini audio mixer or 4 or 8 channel audio mixer? We have it all. Take a look now and buy direct at manufacturer prices!
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sam has the right idea.suck off both cock and swallow both loads of cum.
i wanna fuck that guy on the left so much, i feel like i wanna cum. send him to the uk
i'd like to be there and suck them both off and swallow both loads of cum.
yeah lets do it
This is so wrong on many levels. Guys shouldn't be jacking themselves off together, they should have helped each other.
like to sit in the middle and jack them both off
Guy on the right can't get it up, guy on the left has no prob and has a decent looking cock, but what a derp face.
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How To Play ?
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- Tags:,action, Hill, race, rush, uphill Added by peze
Description:Can you survive this extreme uphill battle to the finish line? Grab stacks of cash as you race through the intense 4th installment of the popular Uphill Rush series. Use winnings to upgrade your racing gear.
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Rhonda's Cheesy Potatoes
Rhonda Greig
Everyone I make this for loves these potatoes and they are so easy to make. I came up with this recipe one day while making some dinner for myself.
- 5-6
- 1 pkg cream cheese room temp
- 1/2 c
- bacon bits
- 1 c
- favorite shredded cheese
- 1/4 c
- minced onion
- 1/4 tsp
- garlic powder and onion powder
- milk-u be the judge
- 1/8 tsp
- black pepper (optional)
How to Make Rhonda's Cheesy Potatoes
- 1Cook potatoes in the microwave and while potatoes are cooking mix the cream cheese with enough milk to make it thin but yet a little thick but pourable consistancy and when that is done add all the rest of the ingreadients and mix well. When potatoes are done cut up into a 8x8 inch pan and then pour cheese mixture over top and bake til a light golden brown on top and then enjoy.
- 2You have to use an electric mixer to make the cheese topping. Enjoy and if u make these let me know how u liked them please and thank u.
About Rhonda's Cheesy Potatoes
Course/Dish: Potatoes
Main Ingredient: Potatoes
Regional Style: American
Other Tag: Quick & Easy
Hashtag: #cheesy


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It took just a couple, however, to trigger kids to want to play around that we purchased the 8″ Independently-Encased Coil Premium Full Futon Mattress. Buying Sarah Peyton Convection Cooled 14-Inch Firm Support Memory Foam Mattress, King adding a night light particularly important for the people in different sizes and come in different measurements just the right places to move a child slips under the childrens bunk beds but configuration, will have different mattress thicknesses. The problem with these beds can be taken down and put back together easily and quickly. After 6 months, your baby so his feet can touch the best brands of bunk bed.
Also, if you are going to be very hard to achive, but in return you will eventually be used as another. It does not exactly save space, and low price sleep inc. 8-inch complete comfort 200 plush mattress, twin can be found on the size of the world. The sofa can be made of cozy materials and depth, including Bunks Dark Pine Finish Wood Kids Twin over Twin Bunk Bed in White-With Trundle ,Find great deal on best bunk beds may come with a pull out twin Murphy wall beds if you are in need of a mattress measure 39 inches and 3 1/2 inches from slipping about loft beds.
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This loft bed is a twin bed casters or wheels.


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- You get awards (which is always nice) for doing what you do (and love doing) anyway. You get to create a home and decorate it with lomowalls, you hang out with friends and you can participate in contests.
- The cameras are the love. I own 3 (Diana Mini, Diana + Edelweiss Edition, Lubitel 2). And I want more Diana clones because they are so pretty. Also, they'll probably differ from mine, this being in the nature of them being made out of plastic, allowing for them being individuals and unpredictable most of the time. Just like us people. My Diana Mini e.g. sucks at transporting film. This is okay, I have my faults as well.
- The people behind Lomography are clever. Instead of saying "Look, you buy a plastic camera (e.g. Diana) with a plastic lens, of course your photos will lack sharpness and will look weird." They say "This is what its about. Character, surprise, no need to worry about messing up (oh so liberating) because there are no mistakes, just art. Just have fun, cross-process because who needs natural colors anyway."
As someone who delights in using expired film, this suits me fine. Also they do not lie. You will meet random strangers on the street who will be fascinated by that strange little camera dangling from your neck or that loud winder. So, you want to make friends? Grab a brightly colored Lomo Cam.
- It is so liberating. Just do whatever the hell you want. Shoot from the hip. Follow the Golden Rules. Especially the last one, which states that there are no rules. Grab a camera that fits your personality. The Action Sampler maybe? Or the Horizon? It's there.
- Take a break from soulless digital. Don't get me wrong, I love my Canon 5D Mark ii. I couldn't work without it, its flawless and great. But I also have to work my behind off to edit the photos to suit my understanding of … soul. Character. Life. I always get the feeling with film photography. And with Lomography, it is simply life. Unpredictable, colorful, flawed, beautiful, messy, dark, light, fast.
So, go out there, grab a camera, grab a cheap film and just shoot. Stop to worry, stop to look for the perfect shot because it is the one you are going to take next.
I cannot wait to pick up my next film.


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SUS Membership
One-Year Membership
Two-Year Membership
SUS Donations
Donate to the Society for Utopian Studies
Donate to the Nicole LaRose Graduate Student Travel Fund
If you plan to attend this year's conference, you can pay for your conference registration at the same time as paying for your membership by using the option below. For more information about this year's conference in Toronto, check out our conference site.
Upcoming Conferences
Upcoming Conferences


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|Buy Now
Cetaphil Cleansing Bar
Olay White Bar Ultra Moisture With Shea Butter
What is the Best Soap for Dry Skin?
When it comes to cleansing our skin, from face up to our whole body, there's definitely no better companion for the task other than our good old soap. However, if you have dry skin, whether extreme or not, there's definitely one or two cleansing moments of yours that turned awry in the worst way possible. This is because many soap dry out skin and this in turn, gives those with dry skin already, the possibility to experience irritation or even increased in skin sensitivity. This is definitely a big no-no which only makes it empirical for us to find the best soap for dry skin out there.
It goes without saying that the best soap for dry skin out there would be the one that holds moisturizing prowess unlike the other common soaps out there. Though some may claim to have the outstanding hydrating prowess you need, most of them turn out to be false hopes, which makes it harder to scour the fleet of products available in the market. If you're tired to experience that 'reject' feeling over and over again, then revel on the best soap for dry skin I have on this list that will surely work enchantingly over your skin to give you a boost on your hygiene and beauty life.
Here's one critically acclaimed soap bar that will definitely be a saving grace to any of your problem, especially those with dry skin. This bar, though not equipped for extreme hydrating prowess, is free from cruel chemicals that may irritate your skin which makes it perfect for any type of skin. This bar lathers perfectly on skin and once you rinse it, you'll surely feel more revitalized and more cleansed than ever. It will also leave your skin feeling fully moisturized unlike other regular soaps out there.
- Free from cruel and harsh chemicals that causes irritation and breakouts.
- Leaves skin feeling moisturized, revitalized, cleansed and super soft.
- Relatively affordable since a bar goes a long way.
- Won't cause breakouts and extremely gentle
- Doesn't possess brightening, moisturizing prowess that exceeds other brands.
- Some users with extremely dry skin that's severely sensitive as well, didn't find much of a use to this.
Olay White Bar Ultra Moisture With Shea Butter
When it comes to hydrating prowess, you definitely won't go wrong with this product from Olay that even utilizes Shea butter for a completely moisturized finish to die for. With this product, you can already say goodbye to your dry skin and prep your face up with a more revitalized, supple, and hydrated complexion. This bar lathers on your magically and leaves a velvety smooth finish to your skin while giving off an extremely alluring smell that would complete your heavenly experience.
- Utilizes shea butter and other ingredients for a completely moisturized complexion to die for.
- This product will leave your skin cleansed, revitalized, smooth and supple all throughout the day.
- It packs an alluring smell that renders you the full-packaged heavenly experience.
- For sensitive users, the smell may not be that appalling.
- The bar doesn't last that long, especially to those who take a bath more often than the regular gal.
If you think that Dove has left you all alone when it comes to your soap needs, then think again as they have this Chanel Coco Bath Soap that tops their soap category. This soap comes with vegetable-based ingredients that will certainly prove to be gentle enough for every skin type out there. It even has Palm Kernel oil that will leave your skin outstandingly supple through its beautiful, seamless and heavenly lather that will render you with a refreshing, revitalizing and cleansing finish you won't get enough of.
- Comes with cruelty-free ingredients for a gentle application.
- Lathers beautifully and softly for a heavenly experience you won't get enough of.
- Hydrating, refreshing, revitalizing and extremely great for cleansing.
- Smells very nice.
- This bar goes a long way.
- Expensive
- Though the smell is great, it may not be that ideal for sensitive users.


text: Here comes a new wired laser mouse from Sanwa, the MA-LS20. Measuring 58mm x 99mm x 38mm, this compact mouse features a 5-button design, a laser sensor, an 800/1000/1600cpi resolution (switchable) and a USB 2.0 connector. The MA-LS20 is available now for 2,940 Yen (about $38) in black, white and red color options. [Sanwa]


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A group of students from ECU "adopted" Love A Sea Turtle for their freshmen Honors College project. They set up a booth on campus to raise awareness about sea turtles, promoted volunteer opportunities with Love A Sea Turtle, and had a bake sale to raise funds for our programs.
MLK Day of Service
Service Project Video
A group of ECU Honors College students partnered with Love A Sea Turtle for a monofilament recycling service project. Here's their video recapping the project. "Together, you and me can keep a turtle safe at sea!"
Monofilament Recycling & Sea Turtle Awareness
Thank you East Carolina Honors College students! A group selected Love A Sea Turtle to help with a semester long service project. These students set up an awareness table that included assembling monofilament recycling containers. They are collecting empty tennis ball containers on campus from tennis clubs!!!


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Accelerate Sydney is a free event hosted by Google to help LGBT and LGBT-friendly owned and operated businesses grow their online presence.
Google Australia would like to offer help to all businesses who own, manage, or cater to the LGBT community.
We have an exciting array of sessions lined up for you from 9:30AM to 4PM on Friday, March 3rd.
These include:
- Optimising your site for today's mobile-first world
- Learning how to engage LGBT audiences with your brand
- Managing and developing your AdWords account
- Engaging with audiences through YouTube
You will also get access to free 1:1 consultations with experienced Google employees to help you build and implement the right strategy for your business.
Friday, March 3rd, 2017
Google Sydney, 48 Pirrama Rd, Pyrmont NSW 2009
Add to Google Calendar | iCalendar


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Awful driving habits
Because I have a bit of a commute each day I spend a couple of hours in the car, and come across some bloody awful driving habits that seem to be deeply entrenched in New Zealand.
1/. People driving the the right hand lane of the motorway, under the stated speed limit or in a way that obstructs traffic behind them (doing exactly 100 km/h despite left hand lane being empty). Why people do this I cannot fathom. There is definitely a bloody minded aspect to it because if you flash your headlights at them they slow down and refuse to budge. The worst thing about this is that often the left hand lane is either empty, has traffic moving at the same speed or is even moving faster.
Do people feel safer in the right hand lane? Do they not care, or do they not even think about it? The road code clearly states that the right hand lane is for passing and in every other country I have driven in that's what it gets used for. Obstinate drivers are actually placing themselves at risk – in the right hand lane you're at more risk of being hit by a vehicle coming the other way (yes, trucks can make it through the medium barrier), and by causing other drivers to pass on the left they are risking accidents caused by weaving traffic.
It's also just inconsiderate, if you want to cruise along at 80km/h on the motorway, chat on the phone, or day dream go for it, just don't do it in the right hand lane – it's for passing, use it and if possible get back into the left lane. And if someone flashes their head lights at you, don't be a silly prick and slow down and refuse to move on the basis that you are within the law, because actually you aren't…
2/. Indicators… you know, the little orange flashing lights on the corners of the car, operated with the stalk thing on your steering column? This clever invention was designed to give plenty of warning to those around you of your intentions. Why do people suddenly decide to use their indicators when they are already half in your lane and you have utilised the ABS? I guess it would help a bit if when you did use your indicators that the person in the lane into which your trying to turn didn't see it as some sort of threat to which counter measures need to be taken – i.e. accelerating into the gap to prevent you from turning.
If everyone just exercised a bit of common sense, this war of attrition with indicating could end, allow turning cars into that gap in front of you, and then I hope people will start to indicate because maybe they aren't indicating because they are trying to avoid a pre-emptive strike!
Three seconds warning people, not one second, or two, or none at all, three…
3/. Smokers… the roads aren't an ash tray, there's one in the car, use it. What is it with smokers? Look if you want to kill yourself it's a free world, and I suppose I can overlook that I'm subsidising your higher health costs, but what makes you think you can dump your dirty stubs everywhere? You're already giving the big finger to authority isn't that enough? You don't have to use the world as an ash tray as well!
The driving in Auckland has improved as I guess we are maturing and discovering slowly that if everyone works cooperatively on the roads and shows a bit of courtesy, the traffic and the journey will be better for it.
The best driving I've seen was in the South Island, people driving slowly actually pulled over to let you past and everyone was polite and friendly, but there were so few cars around that sometimes you wonder whether there's been a nuclear strike and the rest of the population has been wiped out.


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harold pitts
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mt.sterling, Kentucky, United States
|Let the memory of harold be with us forever
This memorial website was created in memory of our loved one, harold pitts, . We will remember him forever.
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What is Net Earnings?

Net earnings (also called net income or profit) is your gross business income minus business expenses. The IRS says,

You calculate net earnings by subtracting ordinary and necessary trade or business expenses from the gross income you derived from your trade or business.

No matter what kind of business you have, you begin with gross income and deduct allowable expenses to get net income. Gross income is the income received directly by an individual, before any withholding or deductions or taxes.

How you calculate net earnings for your business depends on the type of business. For example, a business that has an inventory of products must include a calculation for cost of goods sold A corporation must include compensation of corporate officers in the net earnings calculation (the IRS wants to make sure corporate officers are compensated reasonably. For a partnership tax return, guaranteed payments to partners must be included in the calculation for net earnings.

The calculation for net earnings changes based on the type of report and also for the type of business.

How is Net Earnings Used in My Business?

Net earnings is an important number because it is used for business reporting and taxes.

In Business Reports and Calculations. Net earnings is used in your business financial reports. Details of net earnings over a period of time (monthly, quarterly, yearly) are reported in your business Net Income (Profit and Loss) statement.

The net earnings amount is also used to analyze the success of a company. The most common profitability ratio is net profit margin, which compares net income to net sales. The result is a percentage, and the higher the percentage the higher the net profit.

For Tax Reporting. The net earnings amount is the basis for calculating your business income tax. For all business legal types, the amount of tax the business pays begins with the calculation of net earnings.

If you are self-employed, your net earnings from self-employment are used to calculate your Self-employment Taxes. Self-employment tax is the tax that self-employed individuals pay for Social Security and Medicare.

Calculating Net Earnings For Business Taxes

On Schedule C. To calculate net earnings, a small business will use Schedule C (Profit or Loss from Business), which is part of the individual tax return forms. Some of these calculations are done on separate schedules, and the totals are brought into the main part of Schedule C.

Here's how the net earnings calculation works:

Income Calculation.

Your business income is calculated, starting with gross receipts or gross sales. Returns and allowances are deducted.

Then, cost of goods sold is calculated, for businesses that sell products.

The result is the gross profit (gross business income).

Other income is also listed. For example, your business may have income from inerest, tax credits, or other non-sales sources.

Expenses Calculation

 Expenses are listed, in specific categories, in alphabetical order. There is a category for miscellaneous expenses too. The result if total expenses before use of your home (called "tentative profit or loss).

If you have a home business, you can do a separate calculation for home business expenses, and add those to the tentative profit/loss. (There are two methods to calculate these expenses.)

Net Profit or Loss Calculation

The net profit or loss calculation is Gross Income less expenses (including home business expenses).

For Partnerships and Corporations. You will see a similar process for partnership, corporation, and S corporation income tax calculations.

Calculating Net Earnings for Self-employment Taxes

 the net earnings total forms the basis for calculating self-employment taxes on Schedule SE. Some income does not count for Social Security and should not be included in figuring your net earnings:

 Dividend income, unless it is received as a dealer in stocks and securities

Interest from loans, unless you are a real estate dealer or you regularly provide services mostly for the convenience of the occupant, or

Income received from a limited partnership.

For more information on net earnings for Social Security, see SSA Publication "If you are self-employed"

Check the tax return for


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This Black History Month BET and CENTRIC will pay tribute to the range and richness of the African American experience with a line-up of programming celebrating the cultural contributions of black America.
The carefully curated line-up of thought-provoking black films, BET News specials and compelling original programming include: the 4th Annual BET HONORS; the Network movie premiere of Tyler Perry's "Daddy's Little Girls," "Cadillac Records," "Mr. 3000″ and "Sounder"; and, new 106 & PARK and BET NEWS joint project MODERN BLACK HISTORY HEROES. (more…)


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'Detola has helped me so much in becoming a better mum and making good use of my time. Setting goals and making sure I get to achieve those goals. It feels so good to know that I have achieved so much in such a short time.
Dear Mum,
What are your BIG God given Dreams… that you have been putting off? You know you need to do it but for some reason you can't seem to find the time to work on your dreams.
I know how it feels. You are busy trying to juggle everything. So many different things are demanding for your attention. So because of this you are in fire fighter mode everyday and find yourself postponing your God given dreams and goals for the future.
Does this sound familiar?
- You know you have gifts and big dreams that God has given you but you are distracted with everything else and not sure how to manifest those dreams?
- You sometimes feel like you are just coasting along in life. You want to be successful, but you're not ready to sacrifice your family or your personal life for a superficial definition of success?
- You sometimes struggle to get clarity or focus, because you have so many ideas and so much on your plate that it's a challenge to decide, "what comes first" so instead you procrastinate?
- You want to make a difference and do your best as a mum and in your business/career?
- You are overwhelmed and stressed with all sorts going on in your life so you keep postponing what matters to you.
- When you experience set backs and challenges you find it difficult to bounce back quickly?
- You see other women achieving their dreams and wonder when it will be your turn.
- You want to avoid the learning curve and immediately implement the essential strategies you need to launch a successful & thriving business?


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Movie Review: The Family
Justin Morales wrote this review 4 years and 3 months ago
Director: Luc Besson
Starring: Robert De Niro, Tommy Lee Jones, Michelle Pfeiffer
Giovanni Manzoni (Robert De Niro) is a former Mafia boss who with the help of Agent Stansfield (Tommy Lee Jones) and the Witness Protection Program, have been relocated to a small town in Normandy after snitching on the mob. This isn't the first time Giovanni, who is now going under the name Fred Blake, has been relocated. "Fred Blake" and his family have been relocated to other places within the United States, Paris and the South of France in order for the Manzoni family to attempt to start over. The reason for constant relocation? Giovanni, his wife Maggie Blake (Michelle Pfeiffer) and their two children Belle (Dianna Agron) and Warren (John D'Leo) cannot resist their old ways. After all on the first day of living in their new location, Maggie blew up a supermarket, Belle beat up a student with a tennis racket and stole another one's car and Warren came up with a scheme to ruin a group of student's plan who jumped him prior.
With all the mischief the Manzoni family gets into, Agent Stansfield always gets them out before the Mafia that Giovanni snitched on finds them. But that is all about to change when Warren writes a saying in the school newspaper that was once said by Mafia boss Don Mimino (Dominic Chianese), "If it is good enough for you, it is good enough for me". The school newspaper is heavily read in Normandy and ends up finding its way into the States and eventually into Mimino's cell. Mimino, who is locked up because of Giovanni's betrayal, has been on the hunt for the Manzoni's family and could never get his hands on them. Now with the help of the school paper, he has the upper hand on Agent Stansfield and the Manzoni family.
The Family gives us an entertaining new twist on the classic genre of Mafia movies. We are used to Mafia films where we have seen a mob boss rise and fall in their Mafia or characters had to start their life over. Instead The Family explores what happens to a former Mafia family when they have to go undercover. To make it more entertaining, the director Luc Besson throws this family into a small village in France that doesn't match the Manzoni's way of living - making them fish out of water.
If the Manzoni family don't get their way they will make sure that it doesn't stay that way. In the French countryside, plumbers are considered gods in the sense that they are not many of them and are in high demand. If you get on the wrong side of them your wait will increase and will take up to years to finally be seen. That isn't okay with Giovanni, if you try to cheat him, he's going to kill you. And that is a theme that is constantly brought up - locals trying to cheat the American family and each time it doesn't end well for them. The casting was well done as each member of the Manzoni family added a different element that demonstrates how hard of a change it is to adjust. We have Giovanni who still whacks people when they do him wrong, Maggie who lets her temper get the best of her, Belle, who shares the same temper as her mother, struggles with her identity and her new change of scenery and Warren who looks up to his father as a role model and wants to repair the family name.
The Family builds up to the Mafia finally catching the Manzoni family after they found out their new location. It builds up the drama through comedy but when the time finally comes for the two to be reunited it is short lived. We also understand that the reason why the Manzoni family was relocated in a small town in Normandy but we are never told why he snitched or what he said. When Giovanni starts writing his memoir and narrates as he types, you get a feeling you are going to be introduce to the back story of the Manzoni's current situation but is short lived as well.
Overall The Family is an entertaining time and gives a fresh new twist to the Mobster film genre. But with the short lived ending, I wouldn't recommend this movie to see in theaters. But I do recommend checking this movie out at one point because you will get an amazing performance from the entire cast.
What The Delio?: 7.5/10
The Family is based on Tonino Benacquista's novel Malavita.


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Web Marketing To Company Goals
For years now most people would agree that the Internet is here to stay. It's not a fad. It has legitimately redefined the way people communicate and how companies advertise. Yet many small-to-medium businesses remain completely disconnected from knowing how to effectively approach the web as a marketing vehicle.
Even to this day, many businesses view the Internet like a planet in some foreign universe where the laws of physics are completely different from our own. They wrongly impose a distinction between "running their business" and "dealing with the Internet." And it is precisely this assumed separation that stymies so many companies in figuring out their approach at the most basic levels.
Almost without question all small-medium businesses now accept the Internet as a necessary challenge. Yet many companies continue to miss the forest for the trees. I've said it before, and it keeps ringing true the more I help clients develop their Internet strategies: The devil is most assuredly in the details. All too often, businesses inadvertently leapfrog themselves into the thick of branches, leaves, and bramble, without giving any attention to what tree they are standing under, or where on the map this forest even stands.
It's not that the details aren't important—we must tend them in order to grow and refine tactics. But a business must always be answering more broad questions when it decides where to forge ahead, when to cut, and what to cultivate. How does the current decision serve the ultimate strategic goal of the company? Tying Internet strategy to the foundational measures of a company itself is often missed completely when approaching the online space.
There is, however, a fundamental aspect of Internet marketing that ties the core goals of a business to its online efforts. Use it, and it can clear confusion and guide decisions:
Hold Your Internet Strategy Accountable.
It's not enough to re-build a website on the desire to improve your company's image. You must develop an approach which will foster the measurement of this goal as it relates to the metrics your company uses to track success overall. How will your online efforts be tied back to serving the company's bottom line?
To figure this out, start with one question: Six to twelve months from now, how are you going to know if your Internet strategy is working? The answer to that question reveals exactly which slivers of data will be meaningful to you, and can guide your content development and user path architecture.
Manage your web strategy like you would an employee in your company. Set goals, brainstorm tactics, and don't be afraid to change direction when needed. Business on the Internet is deeply intertwined with the business most people think stands so separately from it. It follows and responds to the same guideposts. Imposing accountability is a key step in succeeding online, and it can clear the misconception that the Internet is happening on another planet.


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2. Do you get more frustrated by your home being in a state of disarray or your workplace being in a state of disarray? Without a doubt my workplace. If my desk reaches an untenable point of mess, I will drop everything to weed through it all and reorganise myself, so as not to have to be distracted by the mess.
4. Take the quiz: Are You High Maintenance? I'm driving through Montana (I'm not driving physically; David has a small laptop with Verizon's log-distance WiFi, so I can work on my blog whilst driving through the eastern/southern Montana.
I'll finish this later - but I know I'm high maintenance!
6. Do you prefer spending more on a birthday gift for a close friend of having them spend more on a gift for you? No, I enjoy spending on them as much as I receive - I love receiving next gifts!


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Consultation Workshop on New Long-Term CAREC Strategy
Participants at the CAREC consultation workshop in Kazakhstan
Consultations were held with key stakeholders in Kazakhstan and the Kyrgyz Republic on a new long- term strategy for CAREC.
A mission led by Safdar Parvez, director, Asian Development Bank (ADB) Regional Cooperation and Operations Coordination Division, Central and West Asia Department, met with Ruslan Dalenov, first vice minister, Ministry of National Economy, Kazakhstan, and Sanjar Umetaliev, deputy chief of staff, Prime Minister's Officer, Kyrgyz Republic.
Participants at the CAREC consultation workshop in the Kyrgyz Republic
Consultation workshops involving key government ministries and agencies were convened in Bishkek on 21 April and in Astana on 25 April.
Giovanni Capannelli, country director, ADB Kazakhstan Resident Mission, and Candice McDeigan, country director, ADB Kyrgyz Republic, participated in the mission.
Related Links


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Back in High School there was a teacher who told us that the bottom of the ocean, in its deepest parts, would contain the whole and totally preserved bodies of dinosaurs, whales, and seamen who had been lost. Every shipwreck would be totally intact, except for the damage due to extreme pressure and one day, when our technology permitted, we would be able to open up a whole new world of historic treasures. The ocean floor, she assured us, would be totally devoid of even so much as bacterial life. She was, of course, very wrong, as she was about many of the things she so strongly believed in.
I had a dream one night, long ago, and in the dream I was standing still and I was bathed in flame. Not just some bon-fire for a witch or caught in a burning house fire, but a conflagration that encompassed all that I could see and taste and feel. It was hot, hotter than anything I can remember but there wasn't a feeling of being burned. It was the same feeling of having a fever; the heat seemed to come from within me, not around me.
The light from the fire was so overwhelming that sight was something akin to echolocation. The picture I received from vision was incomplete and distorted from the heat waves. The shimmering and swaying fire was nearly aquatic in its thickness. Vision failed totally after a very short distance just as it would in water that roils and turns with violence. With all of this, however, I felt grounded and stable. I was able to move within the maelstrom of flame without dizziness or clumsy steps.
Underwater or on land, here on earth, if a human being looks up there will be more light, not less light, yet where I stood the flames and light blasted out of the surface as if flung with alacrity from the core itself. Looking up gave an appearance of less light and looking at my feet was an act that was hurtful to the eyes. With my hands and arms, and to an extent, by body, I threw shadows up into the darkened sky, which was dark only when compared to the fire beneath me.
Were you to travel to a place where everyone was mute and deaf and there were no sounds, how would you, how could you, explain speech and words? If you were blind how could you explain to another person who was blind how facial expressions translate emotions? In a world devoid of all light and in that dark world, how would you explain sight? Put these thoughts into your head, foremost, and then allow me to tell you what it meant to express myself inside the fire.
What fuel burned underneath me I cannot say but with the flame and with the heat, and with the energy that it carried with it, there was something else. With my hands, arms, and to a certain extent, my body, I could deflect, reflect, and cause ripples and eddies in this energy, and with that, sent my thoughts and words out beyond where sight and hearing failed completely.
To whom, or to what, I spoke, I cannot say, but I knew that outside my field of vision and far past what might have been any audio function, the motion of my body and limbs carried everything that my thoughts might reveal. The dancing of the flames was a conversation within a world of fire. Everything here, in these words, and more, very much more, was there. Every breath and movement, every gesture and every shrug, and every slight change in position said something about how I felt.
Is this so hard for you to believe or understand? We humans have been transfixed by those who dance for longer than we have been capable of writing about it. Sexual desire is easily transferred from body to mind yet this is no more to the point than using the internet to look up porn. A writhing body backed by incomprehensible music is one thing but a body set in motion to produce a message backed by sheer emotion is another.
Please, look and feel outside the box of your voice and hearing and outside touch and taste. Was there not a time in your life when you were far too young to allow a song to bring tears to your eyes? As a child you might not have had a song than could bring forth the memories of a love lost yet here you are, as an adult, and now, all alone with your mind and heart, one song floods your mind with emotion and the lost are recovered for just one moment.
Is it so terribly hard for you to feel the energy in the flames, shaped by a heart, flung towards you with emotions, received as eagerly as sent, shaped by the body of a dancer taught since birth, to say the same things as a song?
Look at what you are doing right now and what is happening to you. These words before you were created with a machine and they were sent by a machine, yet it is in your brain where all of this is taking place. My mind has produced the words that your mind has translated. The creatures of the world of fire would think all of this much more unlikely than their own form of communication.
At this point, wouldn't you have to agree with them?
The dream of fire, I think, was a dream of what it would be like to live on the sun. Teachers in High School right now will tell us that no life could exist there because the conditions are too extreme. Yet I have danced with the people of the sun and they have told me their life is good and their way of life, within the flames, is every bit as wonderful as any lived with a spoken word.
Dance in the light they have sent to you. They will hear you. Tell them you believe they exist and you will discover that you, too, can live in conditions others may doubt can support life. For life to exist, for dreams to become real, to be able to reach out past what we have been taught, we need only to dance to the fire in our own minds.
Take Care,


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- A presser sent from State House on Friday, July 1 by the Deputy chief of Staff, Nzioka Waita sets the record straight on the presumed firing of Dennis Itumbi and the PSCU team
- According to the presser, Itumbi and team are still staff members of PSCU and are performing duties assigned to them as they await a relaunch of the team which will focus on coherency and consistency of messaging
- It is believed that the team's inconsistent and quick responses to the opposition on matters 2017 and 2022 elections led to the decision, as this and other such past instances "belittled the presidency" frequently
When a directive of a few days ago hit Kenyan media houses- that Dennis Itumbi and the Presidential Strategic Communications Unit (PSCU). had been disbanded, Kenyans went wild. A faction of Kenyans, mostly the opposition, rejoiced.
READ ALSO: Why Uhuru broke up PSCU, and alleged new roles for the team
Itumbi, a pain, had finally been put down- or so it seemed.
In later speculation, it was reported that the director of Digital communications at State House and the rest of the team would assume the duties of a secretariat, crucial for Uhuru Kenyatta's 2017 election campaign.
READ ALSO: MUST-READ: Dennis Itumbi talks about how to rig elections 'effectively'
Yet another directive from State House seems to suggest that Itumbi and team had not been fired, exactly, but were still part of the PSCU. Their previously presumed firing was misconstrued.
A presser from Deputy Chief of Staff at State House, Nzioka Waita which was sent out on Friday, July 1 read in part:
READ ALSO: Uhuru's take on DP Ruto's 2022 presidential bid
The team which was disbanded according to Waita is still intact and has not been kicked to the curb as previously stated.
The unit according to Waita, will continue to improve on the coherency and consistency of messaging in order to keep the public informed of the President's transformative development agenda.
Waita had previously said that PSCU would be relaunched after review and ensuring a more organised communication channel, where only the State House spokesperson would be allowed to issue statements related to the Presidency.
It is believed that the team's inconsistent and quick responses to the opposition on matters 2017 and 2022 elections led to the decision, as this and other such past instances "belittled the presidency" frequently
Cover Image: Dennis Itumbi/Facebook.com
Source: Tuko.co.ke


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Since 1977, pediatricians and other health professionals have used standardized growth charts to help parents keep track of their children's growth. There are different sets of growth charts that can be used. Learn about the World Health Organization (WHO) growth charts and how they differ from those of other agencies.

Growth charts help a parent figure out whether a child's measurements are average, above average, or below average. For instance, say a parent discovers through a BMI measurement that his or her kid is overweight or obese. This knowledge allows a parent to work with the pediatrician to make changes to the child's eating habits or exercise routines to help the child get back into a healthy, normal BMI range. This type of early action can help prevent the child from developing complications that are related to being overweight, such as high blood pressure or high blood sugar.

NCHS and CDC Growth Charts

In 2000, the original National Center for Health Statistics (NCHS) growth charts were replaced with growth charts from the Centers for Disease Control and Prevention (CDC). The revised CDC growth charts include eight charts each for boys and girls, such as charts that follow a child's height, weight, head circumference, and body mass index at various ages.

WHO Growth Charts

The World Health Organization (WHO) released its own set of revised growth charts in 2006. Unlike the CDC versions, which are a growth reference, the WHO charts are true growth standard. They describe the ideal growth of healthy children in optimal conditions, measuring children who were being breastfed in many different countries (Brazil, Ghana, India, Norway, Oman, United States).

One issue that some experts have had with the CDC growth charts is that they simply describe how children—most of whom were fed formula—grew at a particular time and place, instead of representing how children should grow.

The real problem with the CDC growth charts occurs when you try to observe the growth of an infant who is exclusively breastfed, as it often seems like the child is not gaining weight well enough. Often, the baby is gaining weight just fine, though. It's just that his or her pattern of weight gain is different from an infant who is fed formula. This pattern of weight gain for breastfeeding babies—faster weight gain than formula-fed babies in the first few months, but then slower weight gain for the rest of the first year—is easier to see on the WHO growth charts.

It is now recommended that the WHO growth charts be used for infants and toddlers who are under two years old. The CDC growth charts can still be used for older children.

The WHO growth charts can be used for all children, no matter their ethnicity or socioeconomic class, or whether they are breastfed or formula fed.

WHO Growth Charts for Girls

WHO growth charts are available from the World Health Organization and from the CDC:

Length

Weight

BMI

Head Circumference

WHO Growth Charts for Boys

Separate WHO growth charts for boys are also available:

Length

Weight

BMI

Head Circumference

WHO Growth Charts vs. CDC Growth Charts

If your pediatrician thinks that your exclusively breastfed infant isn't gaining weight well enough, make sure that he or she is using the WHO growth charts to monitor your child's growth.

Does it really matter which growth chart is used? Well, consider the following scenario.

Think about a baby who is growing at the 25th percentile on the WHO growth charts. She would be about 12 pounds at three months of age, 14 1/2 pounds at six months, 16 1/4 pounds at nine months, and 18 pounds at the one-year mark.

In contrast, if those same weights were referenced on the CDC growth charts, she would have started at the 50th percentile at three months of age, moved down to the 25th percentile at six months, down again to the 10th percentile at nine months, and ended up just below the 10th percentile on her first birthday. If using the CDC growth chart, a health professional may have thought that something was wrong with the way that the baby was growing, even though it was likely a normal pattern for a breastfeeding baby.

Sources

MMWR: Use of the WHO and CDC Growth Charts for Children Aged 0-59 Months in the U.S. MMWR. September 10, 2010 / 59(rr09);1-15.

WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Growth velocity based on weight, length and head circumference: Methods and development. Geneva: World Health Organization, 2009.


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TCW Looks To Skirt Carlyle Merger Injunction
TCW attorneys submitted the brief after U.S. District Judge Christina Snyder said in a hearing Monday that she was leaning toward granting EIG's motion to block the sale until an arbitration action challenging the proposed deal is completed. TCW has insisted that a holdup...
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Don't miss out on a lower price on this hotel
Get an overview of this hotel4-star Seville hotel in Casco Antiguo, walk to Alcazar
Popular property highlights
Located in Casco Antiguo, this hotel is steps from Amalio Foundation, Alcazar, and Seville Cathedral. Giralda Tower and Torre del Oro Watchtower are also within 10 minutes.
Hotel Features
This hotel features a restaurant, a coffee shop/café, and a rooftop terrace. WiFi in public areas is free. Other amenities include tour/ticket assistance and a front-desk safe.
Room Amenities
All 12 rooms offer comforts like Select Comfort beds and down comforters, plus free WiFi and flat-screen TVs with satellite channels. Minibars, room service, and hair dryers are among the other amenities available to guests.Information missing or incorrect? Tell us! Opens in a new window.
Palacio Alcazar
Hotel Amenities
Hotel Amenities
Dining options at the hotel include a restaurant and a coffee shop/café. Public areas are equipped with complimentary wireless Internet access. This Seville hotel also offers a rooftop terrace, tour/ticket assistance, and room service (during limited hours).
- Safe-deposit box at front desk
- Luggage storage
- Elevator/lift
- Rooftop terrace
- Breakfast available (surcharge)
- Tours/ticket assistance
- Restaurant
- Total number of rooms - 12
- Coffee shop or café
- Number of floors - 3
- Free WiFi
- Number of buildings/towers - 1
Family Friendly Amenities
- Family Hotel
- Free Wi-Fi
- Cribs/infant beds (complimentary)
Available in all rooms: Free WiFi
Available in some public areas: Free WiFi
Room Amenities
- Private bathroom
- Air conditioning
- Phone
- Minibar
- Daily housekeeping
- Turndown service
- Bidet
- Hair dryer
- Bathtub or shower
- In-room safe
- Desk
- Iron/ironing board (on request)
- Satellite TV service
- Flat-panel TV
- Free WiFi
- Room service (limited hours)
- Down comforter
- Sleep Number by Select Comfort mattress
- Sofa bed size
- Free cribs/infant beds
- Rollaway/extra beds (surcharge)
- Connecting/adjoining rooms available
Where to Eat
Buffet breakfasts are available for a surcharge.
Palacio Alcazar has a restaurant on site.
Room service (during limited hours) is available.
Nearby Things to Do
The recreational activities listed below are available either on site or nearby; fees may apply.
- Bicycle rentals nearby
If you have requests for specific accessibility needs, please note them at check-out when you book your room.
- In-room accessibility
Hotel Policies
Check-in time starts at 2 PM
Check-in time ends at 11:30 PM
Check-out time is noon
Payment types
Children and extra beds
- Children are welcome.
- Kids stay free! One child 12 years old or younger stays free when using existing bedding.
- Rollaway/extra beds are available for EUR 25 per night.
- Free cribs (infant beds)!
- Pets allowed for an extra charge of EUR 20 per pet, per stay
- Restrictions apply
- For more information contact the property at the number on the booking confirmation
You need to know
Extra-person charges may apply and vary depending on property policy.
- No onsite parking is available.
Optional extras
- Fee for buffet breakfast: EUR 9.8 per person (approximately)
- Pet fee: EUR 20 per pet, per stay
- Rollaway bed fee: EUR 25 per night
Hotel Name
- Palacio Alcazar
- Palacio Alcazar Hotel
- Palacio Alcazar Hotel Seville
- Palacio Alcazar Seville
We should mention
Cash transactions at this property cannot exceed EUR 2500, due to national regulations. For further details, please contact the property using information in the booking confirmation. One child 12 years old or younger stays free when occupying the parent or guardian's room, using existing bedding. The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation. Guests can arrange to bring pets by contacting the property directly, using the contact information on the booking confirmation (surcharges apply and can be found in the Fees section).


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1Resurrection Medical Center, USA
2Jefferson Medical College, USA
3Thomas Jefferson University, USA
Received date: December 10, 2010; Accepted date: January 20, 2011; Published date: January 22, 2011
Citation: Tefft KA, Andrews J, Lee JB, Gulati R (2011) Is Warfarin Usage A Risk Factor for Cutaneous Calciphylaxis? A Retrospective Analysis. J Clin Exp Dermatol Res 2:114. doi: 10.4172/2155-9554.1000114
Copyright: © 2011 Tefft KA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Visit for more related articles at Journal of Clinical & Experimental Dermatology Research
Currently the pathogenesis of cutaneous calciphylaxis, also known as calcemic uremic arteriolopathy, is poorly understood. We sought to evaluate potential risk factors for cutaneous calciphylaxis (CC), specifically warfarin usage prior to CC diagnosis, other anticoagulant usage prior to CC diagnosis, an elevated serum calcium level, an elevated serum phosphate level, a serum calcium and phosphate product greater than 50, hyperparathyroidism, and a history of chronic (stage III-V) kidney disease. We performed a retrospective analysis of all histopathologically confirmed cases of cutaneous calciphylaxis diagnosed at Thomas Jefferson University Hospital between January 1 st 1990 and March 1 st 2010. Of the thirteen study patients, five (38%) patients had a history of warfarin use, 12 (93%) of patients had elevated intact parathyroid hormone levels, and 12 (93%) of patients suffered from chronic (stage III-V) kidney disease. Of those that are deceased, median and average survival since original cutaneous calciphylaxis diagnosis was 2 months (range 0-165 months). The constructed Kaplan – Meier survival rate suggests a rapid decline in survival rate during the first sixth months following CC diagnosis. Limitations of our study include the small patient population size, largely due to the rarity of cutaneous calciphylaxis, and the study's retrospective nature.
Cutaneous calciphylaxis; Calcemic uremic arteriolopathy; Hyperparathyroidism; Chronic kidney disease; Matrix gla protein; Warfarin; Coumadin; Anticoagulant
The goal of our research is to evaluate potential risk factors for cutaneous calciphylaxis (CC), specifically warfarin usage prior to CC diagnosis, other anticoagulant usage prior to CC diagnosis, an elevated serum calcium level, an elevated serum phosphate level, serum calcium and phosphate product greater than 50, hyperparathyroidism, and a history of chronic stage III-V kidney disease. In particular, the study will focus on the relationship between cutaneous calciphylaxis and exposure to warfarin. Current research suggests that warfarin usage may be a risk factor for the development of cutaneous calciphylaxis via the inhibition of matrix gla protein, a vitamin K-dependent protein [1,2,4,7,8,13]. The relationship has been well studied in rats; however, there are limited studies in human populations addressing this potential relationship. Matrix gla protein is thought to be involved with calcium trafficking in blood vessels, specifically via the inhibition of BMP-2 induced mineralization. Therefore, theoretically, if this protein was inactivated by warfarin, excess calcium would accumulate in endothelial cells [7]. This analysis will supplement the current available information by presenting a retrospective analysis on the relationship between warfarin usage and cutaneous calciphylaxis in patients treated at a tertiary university hospital.
Study design
IRB approval to conduct a retrospective chart review for patients diagnosed with cutaneous calciphylaxis was obtained from Thomas Jefferson University Hospital. A diagnosis keyword search of the Thomas Jefferson University pathology database from January 1, 1990 to the present was done for the term "cutaneous calciphylaxis." The description of each specimen was reviewed. Specimens consistent with cutaneous calciphylaxis were required to demonstrate vascular calcification with associated endothelial injury and overlying necrosis. Patients with specimens meeting these criteria were then located using Jefferson's electronic clinical record system, JeffChart. The patients' diagnoses were then confirmed by discharge summaries describing symptomatology consistent with cutaneous calciphylaxis and containing the ICD-9-CM diagnosis code 275.49. (This diagnosis code is used to bill for cutaneous calciphylaxis under the broad category of "other disorders of calcium metabolism.").
Additional information was then collected on patients who meet enrollment criteria using JeffChart and the Social Security Death Index. Variables obtained include patient's sex, age at diagnosis of cutaneous calciphylaxis, date of death, kidney transplant status (none or post), hemodialysis status (none or post), serum parathyroid hormone level, serum creatinine level, serum phosphate level, and serum ionized calcium level. All laboratory values were obtained within seven days of the specimen diagnostic of cutaneous calciphylaxis. Patients currently undergoing hemodialysis were designated as having stage 5 kidney disease. The four variable (serum creatinine, age, race, and gender) MDRD formula was used to determine the presence and/ or stage of chronic kidney disease in post renal transplant and transplant naive patients. Survival since diagnosis was calculated in months using the date of death cited in the social security death index.
Statistical analysis
Median survival since diagnosis was calculated for each patient. A Kaplan- Meier survival analysis was performed. The percentage of cutaneous calciphylaxis patients with warfarin usage prior to CC diagnosis, other anticoagulant usage prior to CC diagnosis, abnormal serum calcium level, abnormal serum phosphate level, serum calcium and phosphate product greater than 50 mg2/dL2, abnormal intact parathyroid hormone level, and a history of chronic (stage III-V) kidney disease was calculated.
Patients and enrollment
The keyword search for cutaneous calciphylaxis identified 17 specimens. A total of 4 specimens were excluded from the study. One specimen did not meet the study's histopathologic diagnostic criteria for cutaneous calciphylaxis. Two other specimens were taken from patients whose diagnoses could not be confirmed using Jefferson's electronic clinical records. Two specimens were obtained from the same patient. After the aforementioned exclusions, thirteen patients with cutaneous calciphylaxis were included in the study.
A total of 13 patients with confirmed diagnoses of cutaneous calciphylaxis (CC) were included in this study. Of the thirteen patients, 8 were female (62%) and 5 were male (38%). The median age at cutaneous calciphylaxis diagnosis was 56 (range 27-75) years of age. One and six month survival rate was 31%. Two and five year survival was 23%. One patient is alive at the present time, diagnosed on 7/22/1999. Of those that are deceased, median and average survival since original cutaneous calciphylaxis diagnosis was 2 and 83.5 months, respectively (range 0- 165 months). A Kaplan – Meier survival rate was constructed and suggests a rapid decline in survival rate during the first sixth months following CC diagnosis (Figure 2).
Specific risk factors suspected to be associated with CC were evaluated and are presented in Table 1 and Figure 1. The risk factors of interest to this study include the use of warfarin prior to CC diagnosis, the use of other anticoagulant use prior to CC diagnosis, history of chronic stage III-V kidney disease, elevated serum calcium level, elevated serum phosphate level, a serum calcium and phosphate product greater than 50 mg2/dL2, and elevated intact parathyroid hormone level.
|Number of Patients:
|Risk Factor
|Not Present
|% Cases
|Warfarin use
|Other Anticoagulant usage
|Elevated Total Serum Calcium
|Elevated Serum Phosphate
|Calcium X Phosphate > 50 mg2/dL2
|Elevated Intact Parathyroid Hormone (normal: PTH: 10- 55 pg/mL)
|History of Chronic Kidney Disease Stages III-V
Table 1: Analysis of potential risk factors for cutaneous calciphylaxis.
Five (38%) patients had a history of warfarin use. The documented duration of warfarin use prior to CC diagnosis varied considerably from 2 days to 17 years. The average warfarin dosage was 5mg daily. Anticoagulant use other than warfarin was found in 5 patients (38%) and included both high and low molecular weight heparin. Two of the thirteen patients were exposed to both warfarin and another anticoagulant.
Serum calcium levels varied from 7.7-11.4 mg/dL (reference range 8.5-10.5 mg/dL) among the patient population. 6 patients (46%) had a low serum calcium level, 6 patients (46%) had a normal serum calcium level, and 1 patient (8%) had a high serum calcium level. The number of patients with low, normal, and high ionized serum calcium levels followed the same trend. Serum phosphate levels ranged from 2.5- 8.3 mg/dL (reference values 2.5- 4.5 mg/ dL) among the patient population. 0 patients (0%) had a low serum phosphate level, 6 patients (46%) had a normal serum phosphate level, and 7 patients (54%) had a high serum phosphate level. Five (38%) of patients had a calcium-phosphate product greater than 50 mg2/dL2, range 19.04- 76.36 mg2/dL2 (mean = 42.02 mg2/dL2, median = 45.18 mg2/dL2). Intact parathyroid hormone was elevated in 12 (93%) patients, with levels ranging from 66- 944 mg/ dL.
12 patients (92%) suffered from chronic kidney disease stages III-V, and eight (62%) of the patients were dialysis dependent at the time of CC diagnosis. One (8%) of the patients had no chronic kidney disease (MDRD stage 2). Since the patient did not suffer from chronic kidney disease and experienced cutaneous calciphylaxis, her history is of particular interest.
This patient was a 60 year old female diagnosed with cutaneous calciphylaxis 9/17/2008. She presented to the ER 9/14/2008 with a chief complaint of leg pain and skin ulcers. She had been started on warfarin 5mg due to atrial fibrillation two years prior. Her past medical history was significant for type II diabetes mellitus, congestive heart failure, and ulcerative colitis. At the time of CC diagnosis, total serum calcium was decreased at 7.7 (reference 8.5- 10.5 mg/dL), ionized serum calcium was decreased at 4.4 (reference 4.5-5.3 mg/dL), serum phosphate was within normal limits at 2.8 (reference 2.5- 4.5 mg/ dL), calcium-phosphate product was within normal limits at 21.56 (reference <50), serum creatinine was within normal limits at 0.9 (reference 0.7-1.4 mg/dL), and GFR was 64 mL/min/1.73m2. The patient's coumadin was stopped, per hematology recommendation, and she was started on fondaparinux for anticoagulation (necessitated by her atrial fibrillation). The patient was given a trial of hyperbaric oxygen treatment, but was unable to tolerate it secondary to becoming anxious and short of breath when in the chamber. She refused further treatments with the hyperbaric chamber and opted for medical management including local wound care of her necrotic skin ulcers. There was also a question of starting the patient on sodium thiosulfate but it was deemed best to wait until outpatient follow up to consider this medication. The patient was discharged to her home 9/30/2008 and instructed to apply bacitracin ointment to her ulcers daily. The patient was asked to follow up with dermatology six weeks following discharge but died only four weeks later, 10/28/2008. (Records from her date of death are unavailable.)
Cutaneous calciphylaxis is a relatively poorly understood syndrome which predominantly affects small and medium sized blood vessels and may manifest as ischemic cutaneous necrosis. It is usually associated with chronic renal disease and secondary hyperparathyroidism, but is known to occur in the absence of renal or parathyroid disease. Mortality ranges from 60-80%, with death most commonly related to sepsis and organ failure [7]. The condition typically presents clinically with violaceous reticulate or mottled areas of cutaneous discoloration which are painful. Eschar formation may or may not be present. Histopathologically, circumferential mural calcification of affected arterioles is often accompanied by perineural calcification with haematoxylin and eosin stain.
It has been postulated in previous studies that the use of warfarin may be a risk factor in the development of calciphylaxis [1-2,4,7-8,13]. In 1998, Price et al. established warfarin as a potential risk factor for calciphylaxis through the inhibition of matrix gla protein (MGP), a vitamin K dependent protein [6]. To review, warfarin inhibits vitamin K dependent proteins. Vitamin K is comprised of both vitamin K1 and Vitamin K2. It is postulated that vitamin K1 is most important in hepatic clotting factor activation. Vitamin K2 is involved in the inhibition of vascular calcium deposition through the activation of MGP [7]. Since the 1998 study, several papers have suggested warfarin as a potential risk factor, however to date; none have definitively confirmed this suspicion [2,7,8,19].
In our study, 5 (including one patient without CKD) of 13 patients had a documented history of warfarin use prior to the development of cutaneous calciphylaxis. It is important to note that one study patient did not suffer from chronic kidney disease and had a documented history of diabetes and warfarin use. This patient's history is similar to that of two cutaneous calciphylaxis' patients with a history of diabetes, warfarin usage, and no chronic kidney disease described by Asobie et al and Banerjee et al, respectively. [2,3] Mrs. M, the patient described in the case report by Banerjee et al, was successfully treated by discontinuation of warfarin therapy, enoxaparin 1 mg/kg subcutaneously twice daily, and hyperbaric oxygen service. Similarly, in a case series by Coates et al, the only 2 surviving cutaneous calciphylaxis patients were on warfarin therapy with ESRD at the time of CC diagnosis and subsequently switched to therapeutic dose enoxaparin.5 While no standard treatment exists for CC, these observations have lead some authors to assert that warfarin should be discontinued immediately and an alternative anticoagulant should be started among CC patients on warfarin therapy.[3]
While a causative relationship between diabetes or warfarin usage and the development of cutaneous calciphylaxis has not been proven, a plausible biological mechanism exists and thus further investigation should be pursued. Unfortunately, neither this study nor the existing published case reports can confirm or refute this suspicion due to their retrospective nature and small size. Clinicians must be aware that cutaneous calciphylaxis can occur in the absence of chronic kidney disease. A high degree of suspicion for cutaneous calciphylaxis should be maintained when evaluating any patient (i.e. those with or without chronic kidney disease) presenting with violaceous mottling or stellatelike livedo reticularis. If the presenting patient is taking warfarin, the existing literature suggests discontinuation and initiation of enoxaparin.
Other risk factors that have been implicated in calciphylaxis development include a history of chronic (stage III-V) kidney disease, renal transplant/dialysis, elevated parathyroid hormone level, and elevated serum creatinine level. Our study confirms these assertions, with 92% of patients having chronic kidney disease and an elevated serum parathyroid hormone level. Compared to a previous study by Weenig et al. [19] in which 51% of patients had a serum calciumphosphate product greater than 50 mg2/dL2, 38% of our patients had a serum calcium phosphate product greater than 50 mg2/dL2 [19]. Our study supports Weenig et al. [19] conclusion that the calciumphosphate product can not reliably confirm or exclude a diagnosis of calciphylaxis. In addition, our data also indicates that only one patient had an elevated serum ionized calcium level. The lack of correlation between high ionized serum calcium level and the development of cutaneous calciphylaxis has been noted in several other studies, thus serum ionized calcium's role in the development of calciphylaxis has yet to be determined. [2,18,19] As such, further analysis investigating the mechanism by which serum ionized calcium level contributes to the pathogenesis of cutaneous calciphylaxis is needed.
The treatment of cutaneous calciphylaxis remains difficult since there are currently no universally accepted treatment regimens proven to decrease disease morbidity or mortality. Anecdotal medical therapies for cutaneous calciphylaxis include parathyroidectomy, heparinization, hyperbaric oxygenation, long term intravenous sodium thiosulfate, and surgical debridement [17]. While appropriate prevention and treatment of cutaneous calciphylaxis remains undetermined, it is prudent to limit patient exposure to modifiable risk factors outlined in this and similar studies. In addition, the mortality rate among patients diagnosed with cutaneous calciphylaxis is very high, with survival rates reported as low as 20%.[19] We also found a very low survival rate (Figure 2) and that the average length of survival among currently deceased patients postcalciphylaxis diagnosis was 2 months. Of the 13 patients included in this study, only two are presently living. The Kaplan—Meier survival rate in Figure 2 demonstrates a rapid decline in the probability of patient survival post cutaneous calciphylaxis diagnosis, suggesting a 10% one year survival rate. Considering that studies have reported the incidence of cutaneous calciphylaxis among patients with chronic renal failure to be 1% and as high as 4.1% in patients on hemodialysis, the improvement of CC treatment and prevention is paramount [17]. These data necessitate the need for further research addressing the causes and, perhaps more importantly, the prevention and treatment of cutaneous calciphylaxis.
In conclusion, our study asserts that cutaneous calciphylaxis is a multi-factorial disease with a low survival rate and generally poor outcome. In addition, this study supports several of the key risk factors that have been suspected in the calciphylaxis disease process, including female gender, a history of chronic kidney disease, renal transplant/dialysis, and an elevated intact parathyroid hormone level. Until recently, calciphylaxis was considered a form of metastatic calcification with passive precipitation of mineral deposits secondary to an elevated calcium- phosphate product [6]. Current insight into the pathophysiology of cutaneous calciphylaxis, including the role of matrix gla protein in vascular calcium trafficking, suggests that warfarin could potentiate cutaneous calciphylaxis. Although the exact role of warfarin in cutaneous calciphylaxis remains unknown, our study and previous case reports, featuring CC occurrences in patients with a normal calcium-phosphate product, normal intact parathyroid hormone level, and lack of chronic kidney disease suggest the process is more dynamic and complex than previously thought.


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STEPHEN King and the wildly popular Harry Potter books are acceptable, but the Malaysian government has banned other books containing elements of mysticism, fantasy and superstition.
The move, which appears to target mainly Malay and Chinese publications flooding the market, follows steps in recent months to stop or limit the airing of Malay television programmes featuring supernatural elements.
There are no clear guidelines, but Deputy Home Minister Chor Chee Heung said books that do not 'give children nightmares' will be allowed.
Book importers in the dark here are unhappy because the latest action can cover most horror and fantasy books.
'It is very vague. There are books with chapters dealing in ghostly areas. Do we have to check every book brought in?' said the president of the Malaysian Book Exporters and Importers Association, Mr Kevin Sugumaran.
A Home Ministry official told The Straits Times that the ban covered mainly Malay and Chinese books.
He explained the government's concern: Many of these 'entertain by frightening' publications are particularly popular with the younger generation, who may be unduly influenced by 'negative elements'.
Some English-language books with too many of these elements may also be banned, he said.
Publishers want the government to state clearly which books and publications will not be allowed into Malaysia.
'We need more clarification. We want to know what the Deputy Minister means by ghostly tales,' said the president of the Malaysian Book Publishers Association, Datuk Ng Tieh Chuan.
Datuk Chor said earlier on Thursday that books by horror writer Stephen King are permissible as they are written for adults.
'It is OK because his stories have been around for a long time,' he said.
'It is those local superstition stories like the man cycling home and meeting a beautiful ghost from the graveyard. That has no educational value.'
He also singled out the Harry Potter and Goosebumps series as types of 'OK' books.
But he did not mention if popular books on local ghost stories from Singapore would be allowed.
He said: 'We have come across many applications where they want to import or publish stuff on haunted houses or superstitious stories.
'When you read them, you can feel goosebumps.'
Promising that his ministry will look at all books on a case-by-case basis, he said publishers should get advice from his ministry.
Earlier this year, the government also tried to stop the airing of the popular Pelik Tapi Benar (Strange But True) television programme.
The programme, shown on RTM, was suspended temporarily because it apparently featured stories with elements dismissed by the government as 'nonsense' and 'superstition'.
The suspension was later lifted after complaints from viewers and a commitment from the producer to tone down the 'negative elements'.


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Personal Update
I am currently the victim of online stalking and harassment on Facebook.
I accepted the friendship from an imposter account pretending to be someone I know from a place I only spent a few years living in, but was not already friends with on Facebook. This person proceeded to then steal pictures and information from my personal Facebook account as well as pictures from the accounts of family members, which included children. There was a considerable amount of time spent on this - hurtful messages sent, threats etc. This has been going on for quite some time now and I am glad that it is finally over. I have been to the RCMP regarding this situation and they are fully aware of everything that is going on. They now have a file on all of this. I have chosen to delete my personal Facebook account for the time being as recommended by the officer I have been in contact with. Sadly, The Brunette Shake fan page will be down until further notice.
This person is someone I have never met in my entire life, someone whose very name I had never even heard until they started to stalk and harass me. For whatever reason my personal happiness and success is obviously causing this person pain on some level. I am sorry that they feel this way - that my happiness can hurt someone so much that they would say and do the things they have done.
Ripping apart every physical insecurity I have ever had about myself some how makes them feel better about themselves. I hope that this person will gain some maturity after all of this and that she tries to better herself and perhaps be happy with herself and her own life.
Thank you readers and please understand if I do not blog as often as I usually do.
I'll be back in full force after a few days of rest and reflection.
3 comments
- LoLy said...
WOW, Lovely
Plz visit my blog this time, I need a little help :p
- February 06, 2013
- thesetwolanes.com said...
So sorry to hear this. Cowardly people tend to hide behind the anonymity of the Internet and take their issues out on others. Don't take it personally! Keep up the good work and enjoy your little break!
- February 06, 2013
- Parisian Fairytale said...
What a shame to know that theres still people like this who use internet for stalking people. Anyway, I think you're acting really good in front of this. If it happened to me, I would insult this person, but I think it's not the better thing to do. It must be a lonely guy who has nothing else to do. I pity people like this. Enjoy your break ! xoxo
- February 06, 2013
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LONELINESS is as bad for us as smoking 15 cigarettes a day and increases our risk of dementia.
There are more than 800,000 older people in England who are chronically lonely.
This can be caused by many things that can happen as we get older, including bereavement, ill health and sensory loss.
It is not too late for action to reduce loneliness.
In the next six months, new local forums for health and care officials will make decisions that could affect the future of these services.
These forums, known as health and wellbeing boards, are there to listen to us.
Loneliness Harms Health is a new campaign from the Campaign to End Loneliness, aiming to inspire people to urge health and wellbeing boards to act on loneliness.
They need local campaigners now.
As someone that cares about quality of life in older age, I encourage everyone to get involved in the campaign to ensure that local decision makers act on loneliness.
Ruth Jackson
Address supplied
Autistic people need more help
Wednesday was World Mental Health Day.
A staggering 71% of children with autism also have a mental health problem, such as depression.
In addition, a third of adults with autism told us that they had developed a severe mental health problem as a result of a lack of support.
Yet autism is not a mental health problem, and people with autism can and do enjoy good mental health.
Given the right support, mental health problems can be prevented. All too often they either get no help at all or help is inappropriate or, on occasion, even harmful.
This has a devastating effect on families, many of whom develop their own mental health problems as a result.
The National Autistic Society is calling for this tragic waste of lives and money to stop.
We all need to know that by giving people with autism the understanding and support they need, we help promote their health and happiness.
Sarah Lambert
Head of Policy
The National Autistic Society
Progress needs tough decisions
IF we want energy then we have to put up with power generation of some form and home-produced gas seems preferable to the uncertainty of imports.
The Industrial Revolution would never have got underway if NIMBYism had held sway at that time.
No coal mines would have ever been allowed and no railway network, which was the big factor in transforming Britain, would have been built.
Consequently very little progress would have been made and our modern life would have been quite different and much poorer.
We certainly could not have supported a population of much more than five million burning wood for fuel.
Perhaps NIMBYS should withdraw from modern life and go back to the good old days.
Name and address supplied


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Published on February 7th, 2015 | by Varuna Singh2
The Top 5 National UAE Drone Projects (Update: Winner announced!)
His Highness Sheikh Mohammed bin Rashid Al Maktoum was present at today's UAE Drones for Good event and we got a chance to witness the event in his presence.
Update: The Winning team that will take with them AED 1 million is Wadi Drones. Congratulations to you guys.
The event today ended by some great conversations with the teams and their plans for the future.
The event was not just for international organisations, but government and Dubai Police were present too showcasing their ideas.
We are live at the UAE Drones for Good competition, which is becoming the World Cup of drones. If you are interested even remotely in drones, this is the event to focus on. After about 800 worldwide submissions from 57 countries, the semi-finalists have been chosen in 3 different categories.
A Drone is an Unmanned Aired Vehicle. Keeping aside its controversies, there are some facts in this disruptive transportation and access medium. As the Award site states, there is an $8 to $10 billion projected economic impact of drones by 2025. That translates to over 100,000 anticipated worldwide jobs created by drones that are ten times cheaper than helicopters and other ways.
So what are the uses of drones apart from battle? Well, we are about to see a bunch of innovations. However at this point, it's important to step back a bit and see what models the drone industry might disrupt.
"We want to reach to people before they reach us. We want to save time, to shorten distances, to increase effectiveness and to make services easier."
This was said by Sheikh Mohammed Bin Rashid Al Maktoum, VP and Prime Minster of the UAE and the ruler of Dubai. We have a clear indication on how this subject is to be addressed.
We have seen drones making its foray in transportation, navigation and deliveries. However there are many applied science applications and even health possibilities. Here are the top 5 selected ideas from yesterday's Semi Finalists. These ideas will be pitching and presenting again today to win the grand prize of AED 1 million.
1. Health Sector Drones
"All drones can be utilized as portable pharmacies"
The idea behind Health Sector drones is to provide pharmaceutical needs directly to the point of alert. The drone is able to provide immediate medicines and a way to even communicate with the ambulance and nearest hospitals. This drone will also be able to move and transfer blood to the house of the patient in need.
We got a quick look at this drone at the event where it was showcased along with other interesting robotics courtesy of Emirates robotics a group specializing in new robotics including 3D printing as well.
Great event ! Not to be missed #UAEd4g نبارك لفريق #طائرة_الصحة على التأهل إلى المرحله النهائية في مسابقة الإمارات للطائرات بدون طيار لخدمة الإنسان عقبال المركز الأول بإذن الله غدا المرحلة الحاسمه لاتفوتوا العرض التقديمي الأخير لطائرة الصحة في تمام الساعة (11:30 صباحا ) بمدينة دبي للإنترنت @mishal35 @saeedalnazari
The health drone is able to provide a person in need with required medical assistance before ambulances get there. The drone can also provide medicines and tools at a crash site. This quick assistance can save some lives. If needed blood can also be transferred from clinic to homes and the general public. The Health Sector drone got a score of 74.6% The highest score in the national category.
2. Automated Parking System
Ever been annoyed at this guy? We might not see people like these anymore. With Automated parking system drone, we saw it guiding the cars pretty well and efficiently. This drone is fully automated and assists in paid parking as well. This drone will also report car park violators.
My favorite one is the fully automated parking system. Very efficient, very practical and a smart way to use the drones to make our lives much easier. Well done! #drones4good #Dubai #UAE #UAEd4g @uaed4g A photo posted by منى الحَيمود (@mouna_elhaimoud) on
3. Sanad
Sanad (support in Arabic) is a drone built by an engineer at Dubai Police. In fact, Dubai Police showcases this octa-copter at GITEX last year. Sanad means support in Arabic and it can fly up to 1 km and lift about 40-50 kg of weight.
The reason for choosing 8 fans instead of four or six is about control and speed. Having octa-copter setup enables heavier lifting and better speed and control.
This does come at a cost and this keeps the battery of Sanad at about 40-50 minutes.
"Sanad" is capable of lifting drowning people to safety #UAEd4g #National #drone #Drones4Good pic.twitter.com/Xlx6TZfykd
— UAE Drones for Good (@uaeD4G) February 7, 2015
Sanad can be controlled via an iPad and it was traditionally designed to watch over Dubai waters. It has security and monitoring purposes too.
#uaed4g #drones4good #SANAD تجربه انقاذ غريق
A video posted by Mansour Abdulkarim (@falconeyesap) on
Sanad drones got a score of 72.6 % keeping them at a good 3rd place.
4. Wadi Drones
Wadi (Valley in arabic) drones motive is purely environmental. They aim to track and scan areas of the nation to enable better detection of Wadies flora and fauna. Wadi drones comes from the New York University Abu Dhabi and their aim is to document the vast diversity of the UAE's wildlife.
The Wadi Drone team demo's innovative data collecting drone; direct application to disaster response! #uaed4g pic.twitter.com/7jaQSn2xNS — Patrick Meier (@PatrickMeier) February 7, 2015
This drone does not look like a traditional drone with its fans and choppers. It is a fixed width drone with one propeller. This drone also works in extreme conditions monitoring the landscape with motion sensor cameras and wireless communications for data transmission. Wadi drones got a score of 72.6% putting them at 4th.
5. Site Inspector Drone
The site inspector drones' purpose is reduce the dangers in construction for both the workers and people around them. It also increases efficiency by monitoring activity. This site inspection drone is fully autonomous. That means it can navigate around a construction site on its own and provide a live feed of the site itself to a representative. Actions can be made that can result in lives being saved and problems detected early on. The region has gotten some attention on the construction workers safety and this drone aims to lower risk and accidents due to construction sites.
"Site Inspection Drone" from @KhalifaUni during detecting humans @uaeD4G @DIC_Community, great young innovators pic.twitter.com/Jqjj4SnING — Mohamad Harastani (@MoHarastani) February 7, 2015
This drone idea is from Khalifa University Robotics Institute that has the previously discussed idea on fog dissipation and cloud seeding.
Site inspector drones got a score of 67.1 % putting them at 5th place.
The winner of the UAE Drones for Good Award in the National category will be announced soon, so stay tuned.
What do you guys think of drones in the UAE, and in the Middle-East in general? Do let us know in the comments.


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Posts tagged as ' medicine ' ...
Posted By Tommy
Army halts use of new first aid item to study more – Yahoo! News
23 Dec 2008 @ 10:17 PM Email • Permalink • Comments (0)
Army halts use of new first aid item to study more – Yahoo! News.
The Army is using two new methods to stop bleeding from areas that tourniquets cannot be applied. They both use some kinds of chemicals to stop the bleeding. But the second one, which is only applied as a last resort, may cause some complication, possibly causing damage while it stops blood loss.
Posted By Tommy
22 Dec 2008 @ 12:05 AM Email • Permalink • Comments (0)
The Korean cellphone company LG is now selling a cellphone that can read the blood sugar levels. That way, the phone can send the reading from diabetics to a database, automating the process.