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Alexander G. Nein MD, MS
About the Practice
Practice Philosophy
Our only goal is to meet your goals, and since 1995 my team and I have served cosmetic and reconstructive patients from across Tennessee with an exceptional combination of educational training, skill, and care for the individual patient.
Patients commend our dedication to creating terrific patient experiences, reviewing us with high compliments for being friendly, understanding, accommodating, professional, and knowledgeable.
We bring together a distinguished combination of sensitivity, expertise, and innovative procedures. We combine aesthetic talents with superb surgical skill to meet the unique needs of our patients. Your comfort, confidentiality and safety are our top priority.
Whether you are considering cosmetic or reconstructive surgery, we are proud to help you discover how plastic surgery can help you achieve your best looks effectively, safely, and comfortably.
Practice Specialization
Dr. Nein specializes in Cosmetic Surgery and Reconstruction of the breast. Dr. Nein also specializes in:
- Facelift * Ear reshaping
- Neck lift * Liposuction
- Eyelid lift * Breast augmentation
- Browlift * Breast reduction
- Endoscopic surgery * Breast lift
- Nose reshaping * Thigh lift
- Tummy tuck
Patient Photo GallerySee all cases submitted by Alexander G. Nein MD, MS
Background & Certification
Board Certification
American Board of Plastic Surgery
American Board of Surgery
Professional Background
University of Alabama Birmingham (1987)
Completed the regular core courses and electives. Also conducted a research study into the acute changes in the Nuclear Magnetic Resonance (NMR) parameters of cardiac tissue immediately after excision.
Master of Science in Mechanical Engineering - Purdue University (1981)
Masters thesis topic was the study of flashback in premixing/prevaporizing gas turbine combustors. The thesis consisted of both experimental and analytical work.
Awarded Outstanding Fellow Research Assistantship.
NATO Study Fellowship - von Karman Institute de Dynamic des Fluides (1981)
Attended the von Karman Institute for Fluid Dynamics in Brussels, Belgium. Research grant focussed on the study of lasers and laser doppler velocimetry.
Bachelor of Science in Mechanical Engineering - University of Alabama (1979)
Attended the University of Alabama in Tuscaloosa, AL. Graduated Magna Cum Laude.
Vanderbilt University Medical Center, Nashville, TN: Plastic Surgery
Louisiana State University - Medical Center, Shreveport, LA: General Surgery
Medical College of Ohio, Toledo, OH: General Surgery Internship
Publications and Presentations
Nein, A.G.; Mellor, A.M.: "Flashback in Premixing/Prevaporizing Combustion Systems", ASME No. 83-GT-94. Presented at the Annual Combustion Institute Meeting, July 1982, Los Angeles, CA.
Rush, B.M.; McDonald, J.C., Nein, A.G: "Anorectal Abscesses", J. LA State Medical Society, July 1990, 22.25.
Mancini, Mary; Smith Lou M.; Nein, Alex G.; Buechter, Kennan J.: "Early Evacuation of Clotted Blood in Hemothorax Using Thoracoscopy: Case Reports", The Journal of Trauma, Vol. 34, No. 1, 1993.
Hageman, John H.; Nein, Alexander G.; Davis J. Terrance: "Primary Aortoesophageal Fistula Caused by an Atherosclerotic Thoracoabdominal Aortic Aneurysm: A Case Report and Review of the Literature", Cardiovascular Surgery, Vol. 3, No. 5, 1995.
Awards & Honors
President Pi Tau Sigma Mechanical Engineering Honorary
Vice President ASME Student Chapter
Member Tau Beta Pi Engineering Honorary
Gorgas Foundation Scholarship
ALCOA Foundation Scholarship
Affiliations & Memberships
Hospital Affiliations
Baptist Womens Pavillion
Baptist Hospital
Centennial Medical Center
Summit Hospital
Society Memberships
American Society for Aesthetic Plastic Surgery
American Society of Plastic Surgeons
American College of Surgeons
International Society of Aesthetic Plastic Surgery
International Confederation of Plastic, Reconstructive and Aesthetic Plastic Surgeons
Nashville Surgical Society
Your Consultation
Dr. Alexander Nein offers a complete range of cosmetic plastic surgery. Our whole team welcomes you to our office and we would like to thank you for coming to discuss your wishes in plastic surgery with us. Please feel comfortable in our office and allow us to assist you in any way that we can. We are all dedicated to helping you find out more about your choices in plastic surgery so that you can make the best decisions. Feel free to ask any questions that you might have and ask to see samples of our work.
All consultations are done personally by Dr. Nein. He will talk to you about your wishes and desires. Dr. Nein will discuss the various options and choices open to you. He will examine you and give his opinion about how best to achieve your goals.
We believe that this is your consultation. We want you to be well-informed about every aspect of the procedure. We encourage you to ask questions and Dr. Nein will spend as much time with you as you need to feel comfortable about how we can help you achieve your goals. We believe that the formation of a personal bond between you and each member of our group is an integral part of the entire experience. Together, we will be a part of assisting you through the consultation, surgery and recovery process. Our goal is to make this process pleasant and enjoyable and give you the best result possible.
Staff & Facilities
Surgical Facility
Exclusively use certified operating rooms associated with major medical facilities
Skin Care Products
SkinRenu, Revision, Revale', Neocutis and PCA
Languages Spoken
English, German
Payment Options
Cash, MasterCard, Visa and Financing Options
"Ask a Question" Responses
Tummy Tuck
Can I have a tummy tuck done after 15 months of having tumescent/power assisted liposuction...
The short answer is probably. In most cases a tummy tuck can solve issues such as you describe, however, every situation is unique. Your best option...
I've had 2 consults and 2 different answers.
I had a breast augmentation 6 years ago. I had 450 over the muscle. They have had a significant drop. It's very painful. I have neck and shoulder...
Either surgery will probably work although I'm impressed that the second procedure can be done well in 1.5 hrs. The first option is safer and will...
Serious difference in size of each of breast
I'm 15 years old. I'm a 38D in my right breast, but I'm about a 38C in my left breast. It's very noticeable, and at first it only bothered me...
You have a condition which is not uncommon and very treatable. At your age the breasts have not yet finished their development. Consequently, if...
Breast lift while still breastfeeding?
This may be a stupid question but can you have a breast lift while still breastfeeding? I have a 4 month old and plan to breastfeed for a couple of...
Having a beast lift or an augmentation is not a good idea while breast feeding. The size and shape of the breast changes dramatically after breast...
Can I safely have more surgery to reduce from a post surgical 34GG?
I had a breast reduction 6 months ago, and I am still way too big, and the surgeon left a foreign object in me. Can I safely have more surgery to...
I'm sorry to hear of the situation that you are in. It is, however, possible to have additional breast reduction surgery and it can be done safely...
Devices Utilized
Alexander G. Nein MD, MS
2400 Patterson Street,
Suite 202, Nashville, TN,
Request More Information
- Add to "My Doctors"
- View Website
View phone number
Phone: 615-327-0201


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Cordless blinds and shades offer a convenient and safe option now available on most styles of window treatments. Instead of a traditional lift cord, the shade is operated with a gentle push or pull on the bottom rail to position the shade at any height. With no dangling cords, shades are safer for children and pets and have a clean, uncluttered look. Simply select the cordless option when customizing your shade and be sure you can reach the window at the maximum height you would raise the shade - if not, consider a motorized window treatment.
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subset: commoncrawl


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- Inside Athletics
- Tickets
- Fan Zone
- Media Zone
- Social
- Shop
- Donate Now
OXFORD, Miss. (Sept. 11, 2009) - After holding Mississippi scoreless throughout the first half the ETSU women's soccer team could not overcome a late Ole Miss rally falling 4-0 Friday night to the regionally ranked Rebels at the Ole Miss Soccer Stadium.
With the win Ole Miss improves to 4-1 on the season, while the Bucs fall to 1-5.
"Tonight I was proud of our player's effort and how we stayed together as a team throughout the entire match," said head coach Heather Henson. "Our goal these last three non-conference matches is to work our system and prepare the girls for league play in a couple of weeks. This evening our pace was good and I thought our passing was a lot cleaner in the attacking third."
After both teams failed to find the back of the net in the first 62 minutes of play, Ole Miss forward Hannah Weatherly opened the scoring with a
Ole Miss forward Taylor Cunningham added to the deficit with her team-leading fourth goal, off an outstanding long pass from teammate Kelsey Breathitt in the 66th minute.
Six minutes later the Rebels were at it again, as midfielder Mary Bailey placed a outstanding corner kick to teammate Brittany King, who converted three yards inside the box for a 3-0 lead.
Ole MIss added one final goal in the 75th minute, as forward Danielle Johnson ripped home her season's second score off of a long assist from sophomore defender Meredith Snow.
"Ole Miss is a deep team with 14 scholarship players," said Henson. "That depth was the difference in the second half. Early our girls stuck to our attack and that allowed us to play a quality opening 62 mintues. Unfortunately, Ole MIss has great team speed and their counterattack showed up as the match progressed."
ETSU continues with its second straight Southeastern Conference road contest with a , kickoff at
For more information on the ETSU women's soccer team please visit www.ETSUBucs.com. Also you can follow daily post and updates on the official ETSU women's soccer team Twitter page at www.twitter.com/ETSUSoccer.


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Monday, November 24, 2008
My World with turkeys
I drummed my fingers on the steering wheel as I crept down the road. There was no accident or heavy equipment or school bus causing the slow down on this early morning ride to work. Just the usual mountain traffic.
To see other parts of the world, or participate in the weekly meme, check out My World
12 comments:
- Louise said...
I guess sometimes we just need to slow down. At least something in natures thinks we do! Nice capture.
- November 25, 2008 at 9:20 AM
- fishing guy said...
I love to see those wild turkeys, that is so much fun. They seem mighty brave.
- November 25, 2008 at 10:40 AM
- kjpweb said...
Oh - so you got your free turkey, huh? Good one!
Cheers, Klaus
P.S.: Since it's my World - it would be interesting to as of where in the world you did see this...
- November 25, 2008 at 1:03 PM
Come on let's turkey trot
Let's Turkey Trot
by Little Eva 1963
Do you remember?
- November 25, 2008 at 1:03 PM
- Sparverius said...
Happy Thanksgiving! Nice turkey backside. I do enjoy slowing down for nature. :)
- November 25, 2008 at 4:56 PM
- Bevson said...
LOL. I totally remember that song. I almost titled this the Turkey Trot. Gobble-diddle-ip
- November 25, 2008 at 5:59 PM
- Carver said...
That is great. I think wild turkeys are such a hoot.
- November 25, 2008 at 6:56 PM
- Leora said...
Oh, do I love this shot! So lucky you had your camera with you. He's a cutie, with one foot up...
- November 25, 2008 at 8:36 PM
- SandyCarlson said...
So why did he cross the road--or didn't he?
That's a great photo.
- November 25, 2008 at 8:36 PM
- Gaelyn said...
LOL! Those turkeys are taking their chances this week. What a nice morning traffic jam.
- November 25, 2008 at 9:33 PM
Too funny. Don't you hate rush hour?
I started to ask if he was trotting, but someone already used a similar line.
- November 26, 2008 at 7:09 AM
- Lawstude said...
awesome shots of these walking and flying meals lol.
thanks for sharing your world. you may visit mine here
have a wonderful weekend ahead. :)
- November 28, 2008 at 1:16 AM


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Raekwon & Snoop From The Wire Talk On Rappers Who Are Gay In The Industry! "I Can't Stand F*cking Homos. My Mouth Too Small To Suck D*ck"
Angela Yee reports "Raekwon the Chef and Snoop from the Wire stop by the Morning After with Angela Yee and discuss "Hiding in Hip Hop." "
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How To Win The War For Your Mind
January 1, 2013 by Brandon Smith
In fact, the technologically advanced adversary with all his fancy firepower is often more vulnerable than his low-tech counterparts. This fact is, of course, counterintuitive to our Western manner of thinking, which teaches us to believe that the man with the bigger gun (or the bigger predator drone) always wins. Sadly, we have had to suffer through multiple defeats and overdrawn occupations in Asia to learn otherwise. One of the great unspoken truths of our era is the reality that the modernization of warfare has changed little the manner in which wars are won. Since the beginning of history, intelligence, force of will and guiding principles are the dominant factors in any campaign.
Therefore, it only stands to reason that the most vital battle any of us will ever face is the psychological battle; for success in the mind will determine success in all other endeavors.
Unfortunately, very few people ever consider the importance of the mind war, let alone know how to defend themselves against psychological attack. As with any method of self-defense, constant training is required.
For the past century, at least in the United States, a subversive and secret cold war has been waged against the people in the form of psychological subjugation. This cold war is designed to weaken our resolve, our heritage, our self-belief, our confidence and our integrity in preparation for a "hot war" against our time-honored Constitutional rights. The power elite know well that the most effective strategy for victory in any battle is to convince your enemy to surrender before the fight even begins. Today, the American populace is being conditioned to lie down and die a mental death, to give up the inner war, so that when the outer war comes, they will already be defeated.
Corrupt governments rely heavily on what they call "psyops," which are primarily propaganda initiatives meant to demoralize their target (usually the citizenry). In the case of a despotic regime, psyops involves the insinuation of lies, half-truths, threats and brutality that is choreographed to elicit a very specific response. It is used to instigate strong emotional responses en masse that will work in favor of the oligarchy. The following guidelines can shield you from the arrows of deceit, allowing you to maintain control and avoid being unconsciously influenced to labor against your own cause:
Do Not Fear Hypothetical Dangers
Fear is the weapon of choice when it comes to totalitarian proponents. Conquering armies and bureaucracies are notorious for exaggerating their strength and numbers in order to squelch the fighting spirit of those they intend to rule. Genghis Kahn, for instance, used the tactic of exaggerated numbers, along with vicious genocide, to strike terror in regions he had not yet attempted to overtake. Upon his arrival, the Mongol hordes had received such a reputation (some of it fabricated) that many regions surrendered immediately without question.
When becoming an activist against a criminal establishment, it is very common to be the target of fear campaigns. Today, those of us in the liberty movement hear warnings from "random" concerned parties constantly telling us that our efforts are "all for nothing," that we are "making ourselves targets." That the globalist system is far too strong and far too advanced to be defeated.
Their hope is to make us afraid of hypothetical situations which can neither be confirmed nor denied. To undo this tactic, you must remain focused on your objective regardless of the possible danger. That is to say, the strength of the enemy, whether real or fantasy, is irrelevant. It is meaningless. Goliath is nothing but an obstacle, and all obstacles can be dealt with. Move forward toward the objective and never stop.
Do Not Be Distracted By Minor Inconveniences And Personal Problems
At the height of communist power in East Germany, the Stasi secret police deployed a tactic which they called "Zersetzung," which means to "corrode" or "undermine." The Zersetzung policy involved the use of subtle manipulations of a particular person's life in order to interfere with his ability to function normally and participate fully in dissenting activities. The Stasi would send agents to a person's home to rearrange items or fake a break-in. Often, they would attempt to create emotional conflicts between the dissident and his wife, family and friends and to damage business relationships. The purpose is to force the target to divert his attention from his political and social work to more minor inconveniences.
Personal firestorms are destructive only when you give them too much credence and attention. Some people become utterly obsessed with their own private soap operas, and this weakness is often exploited by government elements.
The truth is, our home lives and the tensions in them are secondary when it comes to defending our principles and our culture against enslavement and oblivion. Woman troubles, family arguments and invasions into our private lives are not important. Only the mission is important; and in the liberty movement, our mission is to awaken the public, disrupt the indoctrination of the masses and, if necessary, physically remove the elites from power. Family and friends who get in the way or are manipulated into getting in the way should be ignored.
Do Not Be Seduced By Gifts
Tyrants love to offer gifts to the populace, especially at the onset of their rise to dominance. It may be the promise of new jobs, better infrastructure, free healthcare, more food, more safety or even free cellphones. The point is to entice citizens with something for nothing, or at least the lie of something for nothing. If a government official (or anyone else for that matter) is pouring gifts into your lap, it is time to become suspicious.
Governments do not "pay" for the gifts you receive. You pay for the gifts you receive either through taxation or inflation. Free goodies should never influence the mind warrior to endear himself to any bureaucratic or corporate entity. Never allow yourself to be bought.
Never Trust The Media Machine; Always Verify Information
There is no such thing as "objective journalism" in the mainstream media anymore. What you see and hear is not the truth but a facsimile of the truth, twisted to benefit the establishment alone. Media outlets today do not investigate events. Instead, they obstruct investigation by promoting only one side of every story and attacking anyone who questions their asserted narrative. The "official version" of any news story is almost always a fabrication that protects the oligarchy from harm.
No one who considers himself an intelligent human being should accept the official narrative at face value. It is important to question always that which we are told and to investigate using independent or original sources. Never allow yourself to be "taught." Always examine the facts on your own.
Do Not Concern Yourself With Ridicule
Our personal pride is not important. Safeguarding our egos is not important. Trying to please everyone all the time is impossible and also not important. Ridicule is used not only to discredit activists; it is also used to make them question their own resolve. If you cannot be embarrassed or browbeaten, then you cannot be made afraid and you cannot be defeated by mere words.
Accept The Risk Before Confronting The Enemy
I am still amazed by those dissenters and freedom fighters who act as though they are surprised when the potential wrath of the system is directed at them. Did they not understand the risk when entering into the battle? Did they really believe it wouldn't be all that bad?
In any conflict against a larger and more ruthless opponent, always assume that you will have to go through hell to accomplish anything. Accept that your life will no longer be peaceful or comfortable. Know that you may not survive to see the fruits of your efforts. Realize that you may have to walk through fire and embrace pain. Otherwise, you will remain a pathetic and laughably inadequate fighter in the mind war.
Understand Your Own Weaknesses
Pretending as if you have no weaknesses is the best way to help your enemy. If you are prideful, your overconfidence will be used against you. If you are spiteful, your jealousy will be exploited to distract you. If you are easily angered, your rage will be used to lure you into destroying yourself. Examine yourself as deeply and as thoroughly as you would the enemy. Though it might sound like a cliché, you actually can become far worse an enemy to your own cause than any army your opponent can muster.
Do Not Buy Into Petty Authority
Perhaps it is in our tribal nature, but many people seem to suffer from an insatiable desire for hierarchy and leadership — even if that leadership is based on falsehoods. The ultimate protection against corruption is to become one's own leader, rather than waiting around for a miraculously infallible overseer to guide the way for you. Relying on others to choose your path for you opens the door to having your right to choose removed from the picture completely.
Petty authority is authority derived from false pretenses, rather than earned respect and recognition. No man, regardless of title or uniform, is above the truth; and he is certainly not more worthwhile than you. If anyone wants to determine whether you go left or right, he should be put to the most stringent tests imaginable. He should have to prove that he has your best interests at heart.
Acknowledge The Power Of Symbolism And Myth
Oligarchs use theater and pageantry to influence the collective unconscious because the human mind gravitates toward rituals that feed our inherent need for myth and symbol. Psychologist Carl Jung often referred to the inborn symbolic processes of the psyche as "archetypes," which exist in the art, dreams and spiritualism of every society regardless of time, place, religion or culture. Knowing these universal symbols and how we react to them emotionally allows a person to prevent himself from being conditioned or influenced by them.
Not all fantastic events in history are spontaneous. Some are staged as a means to appeal to a particular side of a nation's collective psyche. These "false flag" actions very often revolve around a symbol that is culturally valued. The construction or destruction of this symbolic edifice, famous person, social mechanism or loved representation of the future leaves a lasting and deep-rooted impression on thousands, if not millions, of people. They become emotionally invested in the event — frantic, fearful or furious — without having the slightest inkling why. In the end, they can be conned into acting in disastrous ways just to appease the inner imbalance. They can be led to war, to enslavement and to death — all on the promise of preventing a myth from appearing or disappearing.
The secret is to explore our inner life with more vigor than we waste on outer fantasy. By discovering our own internal myth and, thus, our own individuality, we make ourselves impervious to false-flag conditioning. Our emotions remain within our control, our biases become non-existent and our fears become irrelevant. The theater of the mind loses its power; and from that point on, we choose our own destinies.
Facing down an adversary with arms or with fists is an easy thing to grasp. Facing down a lie, or an idea meant to destroy one's mental capacity for resistance, is incredibly complex. When an opponent attempts to play mind games, though, it is a sure sign that he does not have the capacity to thwart you with physical strength alone. The fact that our government and the power structure behind it has so desperately relied on such strategies for so many years shows that they believe they cannot enact centralized authority over our Nation and undo our freedom imperative on the shoulders of military indifference and ignorance. No gun, no matter how big, will get them what they want. So they continue to play the game.
In order to prevail, we must make ourselves immune to the game. We must walk away, separating ourselves from it completely. We must relinquish all unnecessary fear, doubt and hatred and do what we know needs to be done. If we cannot take lordship of our own psychological world, we are doomed to failure in every other fight that envelops us. Without impervious will, we cannot overcome, and we cannot find peace.
–Brandon Smith


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- 1 cup sugar
- ½ cup sweet butter
- 1 cup unbleached flour
- 1 tsp. baking powder
- pinch of salt
- 2 eggs
- 12 purple plums pitted, cut into 24 halves*
- Topping: sugar, lemon juice and cinnamon
- Cream sugar and butter.
- Add flour, baking powder, salt and eggs, beat well.
- Spoon batter into 9 inch spring form pan.
- Place plum halves, skin side up, on top of batter.
- Sprinkle lightly with sugar and lemon juice, depending on sweetness of fruit.
- Sprinkle with about 1 tsp. of cinnamon, depends on how much you like cinnamon.
- Bake at 350 degrees for 1 hour, test with a toothpick.
- Remove from oven and cool; refrigerate or freeze if desired.
- Or cool to just lukewarm and serve plain, or topped with vanilla ice cream or whipped cream!
Terri's Notes
This recipe freezes well. To serve frozen tortes, defrost and reheat briefly at 300 degrees.
*I have used larger plums and sliced them…tart ones are best, it only takes 4 or 5.
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"Summer of '77" is an incomplete cfnm story, Will another author build on it?
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tadams9 is offline
Join Date: Sep 2012
Location: baltimore, maryland
Posts: 25
"Summer of '77" is an incomplete cfnm story, Will another author build on it?
The story series "Summer of '77" hasn't been updated in 2-3 years, but i want more.
The author, natalieprendergast, has not added to their cfnm series (2-3 year). Will another author add to this story? I am guessing that she is not a writer anymore. Reading about Oscar (Dick) & his prized size "Penis" was fun but, reading about Shy Adam's first cfnm experience was more enjoyable. I love reading about the first time cfnm and how it later builds.
As a short recap so far the, at first shy, inexperience Adam had gotten Curious and later bolder with, the more experienced & usual ringleader, his step mom Natalie. Natalie has also gotten more playful with her step son, Adam's dick. Adam over heard Natalie and her co-worker, Annette, talking about a possible cfnm barbecue she was holding at the end of next month. Rachel had gotten to play with Uncle Dick's (not related just a nick name) giant 11, maybe 11 and a half inches member.
It would be nice to center around Adam's cfnm adventures more thou. Since he is used to being nude in front of his step mom, maybe the author who decides to build on this story will start with add to the list of characters hes not familiar with. Maybe add some of Adam's & Rachel's friends from school. Have Rachel make plans to have her friends over for a swim or/and sleepover. It would be a nice read if Adam somehow got exposed to two or three of them. Since he was accidentally walked-in on by Natalie, have him accidentally walk into the line of sight of others to start building on this story. As some starting ideas;
1) They are working late Adam has to get changed in an empty office room at work to get walked-in on by Natalie & one of her coworkers.
2 ) Adam thinks he has the house to himself and doesn't bother with wearing clothes
3) Adam is bold without Natalie and decides since he swam nude before, why not do it alone, then gets caught
4)or as an alternative to 2; he finds a place to hide but Rachel comes home early with her friend, so he desperately has to sneak around changing his hiding place, they leave (just a walk to her friend's house to get her swimsuit) but the is door locked. He then gets caught by his step sister's other friends. Rachel called them to meet her there, under the impression Adam's not home & they'll have the pool to themselves. Rachel comes back and decides not to let Adam in at first.
5) After a long day's work Adam goes to bead early. Natalie doesn't need him at the office in the morning. To the best of his knowledge Rachel is staying at her friend's house for the night. He wakes up thinking he is home alone & walks out of the bathroom/shower nude to get clean clothes or a forgotten towel from the dryer. But unknown to him last night Rachel & her friends had a last minute change of plans of where there sleepover will be held.
6) Natalie's going on a trip for three days & Rachel has plan's to stay at her friend's house. Rachel's plans change and comes home early with a friend or two. They find Adam skinny dipping.
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The Game Gets The Crowd Screaming "F*ck Jay-Z" In Spain! + Goes In On Jay-Z With A Freestyle "Lips So Big He Can Suck On My Coc... Ah"
The Game in Spain. Shout out to Shout Out Hurricane-Game.net
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Journey 2: The Mysterious Island includes The Rock flexing his biceps while fighting off a giant electric eel and screaming, "Show me that 1,000 Watt Smile!" Watch six new clips — including Michael Caine acting like a lunatic and Josh Hutcherson channeling the sex appeal of a child's teddy bear. This could pose a severe challenge to Nic Cage's Ghost Rider 2 for "most ludicrous sequel of 2012."
Journey 2: The Mysterious Island hits theaters on February 10th, bring your own bottle of wine, you'll need it.


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What's happening is actually weirder than that. The DB lives on a separate machine. The intermittent errors all fail on the absence of a Unix socket. But since the DB lives on a separate machine, the Rails app should never even be looking for a Unix socket in the first place. It should be looking for a TCP socket.
Here's the code in Rails where the error originates:
if (host == nil or host == "localhost") and defined? UNIXSocket then
unix_socket = socket || ENV["MYSQL_UNIX_PORT"] || MYSQL_UNIX_ADDR
sock = UNIXSocket::new(unix_socket) # stack trace points here
@host_info = Error::err(Error::CR_LOCALHOST_CONNECTION)
@unix_socket = unix_socket
sock = TCPSocket::new(host, port||ENV["MYSQL_TCP_PORT"]||(Socket::getservbyname("mysql","tcp") rescue MYSQL_PORT))
@host_info = sprintf Error::err(Error::CR_TCP_CONNECTION), host
(activerecord-1.15.3/lib/active_record/vendor/mysql.rb, lines 105-113)
The value of host, on entering the above if, should be the same as the value specified (for this particular environment) in database.yml. This code pulls from the config file, and it's invoked during the initialize phase of the app, so the only explanation which makes sense to me is that the Rails app is somehow losing the data in the config file. Except I've never seen that happen, nor heard of it happening, and I can't imagine why it would happen. In fact it's difficult to imagine it happening at all.
It's possible there could be some error in the config-file-reading code, but I kind of doubt it. MySQL is the most popular DB for Rails, and I think if this were a Rails problem I would have heard of it before. I think it's some problem in the deployment, but even then, what kind of deployment problem could result in Rails becoming confused about the contents of its own config files? Possibly, if the YAML-reading code assigns a nil to host after reading the value, for some reason, that could explain what's happening, but that also seems highly unlikely.
Update: I thought this might be due to the app being in dev mode, but a direct check on ENV['RAILS_ENV'] reveals a value of 'production'. However, if I change controller code, I see the results of that change immediately, without a mongrel restart, which I do not think should be happening in production mode.
Update 2: the problem is inconsistent via the Web but consistent via script/console.
Update 3: it seems very probable that I've fixed this. It appears to be a dumb load-balancing thing. One stale process with bad data loaded in memory.


text:
The Miss Delaware Scholarship Organization is offering little girls the opportunity to share some quality time with Miss Delaware 2012 Alyssa Murray and all the 2013 contestants on and off the stage during this year's pageant.
The Miss Delaware Scholarship Organization is offering little girls from five to 12 years old the chance to share the stage with Miss Delaware 2012 and all the contestants of the 2013 pageant.
The opportunity is part of Miss Delaware's Little Sister program, which offers girls an up-close and backstage view of the pageant process.
Participation requires a tax deductible donation of $125 and includes the following:
Performing onstage with Miss Delaware 2012 Alyssa MurrayEscorting the 2013 contestants during the evening gown competitionA Little Sister Program tiaraA Little Sister Program t-shirtA personalized autographed picture of Miss DelawareFree admission for al l the preliminary competition shows for the Little Sister*A private pizza party that includes the 2013 contestants and Miss Delaware's Outstanding TeenEach "little sister" gets her name printed in the official Miss Delaware programOne required rehearsal will take place at 5:30 p.m., Tuesday, June 25 and includes a pizza party. No dance training is required or needed. Miss Delaware Press and Publicity coordinator Carolyn Nelson said that two choreographers will work with the girls to teach them a short routine that is performed at the outset of the pageant.
The full donation of $125 must be submitted to reserve a spot in the program. For more information or to start the registration process, email program coordinator Aimee Voshell String at email@example.com. For more information about the Miss Delaware Scholarship Organization, visit www.missde.org.


text:
Abdullah the Butcher is saying goodbye to Canadian wrestling fans, leaving a trail of blood in his path.
Born Larry Shreeve in Windsor, the Canadian Abdullah will return to Montreal on April 4 (Centre Notre Dame-du-Rosaire, 955 Villeray Est, show starts at 7:30 p.m.) in his "retirement" match, when he'll face Hannibal.
Abdullah hopes to do the same later in the year in Calgary, where he long ago had a series of bloodbaths against Archie "The Stomper" Gouldie.
At 73, Abdullah should be thinking about playing cribbage, gardening ... relaxing a bit. Instead, he's on his retirement tour, with an assortment of kitchen utensils bloodying a string of opponents along the way.
"One day, a fan threw a fork at me, so I started stabbing my opponent with it. I've been using it ever since," says the Butcher. "I bring one with me now. It's inscribed 'Mr. Butcher.'
"I started hardcore wrestling. I want to give people something different every night they're asking: 'What's he going to do next?' "
Already a member of the Canadian Wrestling Hall of Fame, Abdullah should be in the WWE Hall of Fame, even though he didn't work for Vince McMahon's company.
"I never kissed a promoter's ass," says the Butcher. "Vince McMahon can't control Abdullah the Butcher ... with everyone else, he controls their name. There have been letters written, petitions ... it's politics."
After some 48 years in the wrestling business, Abdullah has no regrets.
"I need a hip, but I'm not going to have it done," he says. "I go to the doctor and I'm good for another 3-4 months.
"I never took bumps. With wrestling today, you might as well go to the circus. That's how these guys get hurt, they'll jump off buildings."
And he's not really a Butcher.
"In the ring, I'm a businessman," he says. "But outside, I'm a gentleman."
For more information on the Montreal card, check out wrestlingsupershow.com


text:
New York magazine is running a series of insider-account essays written by anonymous professionals, which are alternately interesting and terrible. Falling more towards the latter end of the spectrum is a piece from an anonymous plastic surgeon, which ends on the following note:
When I walk down the street now, I look at people and I think, "I can do this, I can do that." That's a curse. You become hypercritical. My wife-when I'm just standing there looking at her, if I'm not saying anything for a while, she'll be like, "What? What? You're trying to … !" I'll say, "No, I'm not!" But that does sort of happen.
Consider yourselves warned.
The Plastic Surgeon Who Basically Says Lipo Is Useless [NYM]
Image via Benko Zsolt/Shutterstock.


text:
Read the full brief and details on how to enter the Future Reception competition
You arrive at Derwent's new building, the White Collar Factory, for your appointment with the creative director of a design agency. You enter at the ground floor and begin looking for the reception desk, but this isn't just any reception – this is the future. What happens next is up to you…
The brief
The brief is to design a reception and arrival sequence for a real project – Derwent's new building, a 16-storey 26,590m² office block designed by AHMM, located just off Old Street roundabout. The winning scheme will not be built. This competition is an opportunity for Derwent London and Office Concierge to meet fresh talent and to explore how future receptions will provide a more inclusive experience for anyone who visits office buildings. The winning idea will reflect changing work practices and the need for a dramatic, enjoyable and efficient arrival sequence. It should include your ideas about possible technology, space and the flow of people – 2,500 employees will arrive at the office daily and 500 visitors. There should be no sense of waiting; visitors should be welcomed by at least one person, and, if you are heading upstairs to the offices, or returning to reception from a meeting, for fire and security reasons, you need to be accounted for, and may also require a visitor pass.
Your design may, or may not, include a 'desk'. A plan of the reception space for the real building is provided, but this is an ideas competition, and the project will not be realised, however Derwent and Office Concierge are keen to discover new talent. How the reception space is organised is up to you. The main entrance and elevators are indicated, there is also a mezzanine overlooking the space that could be included as part of the design concept.
Read the full brief here
How to enter
Simon Silver, director, Derwent London
Simon Cooney, director, Office Concierge
Simon Allford, director, AHMM
Peter Murray, chair, NLA
Christine Murray, editor, AJ
Ideas contest: Deadline 5 July 2013: Design the Future Reception to win £5,000
Have your say
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Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions.
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(c) Pocumtuck Valley Memorial Association, Deerfield MA. All rights reserved.
Contact us for information about using this image.
Angelina Grimke (1805-1879) and her sister Sarah (1792-1873) were the first women in the United States to publicly argue for the abolition of slavery. Cultured and well educated, Angelina had moved from her father's large plantation in South Carolina to join her sister in Philadelphia in 1829. The sisters were touring the northeast in 1837, which is when Angelina spoke in Greenfield, Massachusetts, to a packed house at the Methodist Church. In 1838, Angelina became the first woman to address a legislative body when she spoke to the Massachusetts State Legislature on women's rights and abolition.
The Gazette & Mercury was the newspaper in Greenfield, Massachusetts, from June 27, 1837 to July 13, 1841, when it changed its name to the Gazette & Courier.
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"Miss Lucy Stone" article from Gazette and Courier newspaper
"Narrative of Sojourner Truth, A Northern Slave, Emancipated From Bodily Serviture By the State of New York in 1828"
"The American Anti-Slavery Almanac for 1838"
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I've always been intrigued by the FIRST_ROWS hint, so I paid special attention when we reached it in the 11g SQL Tuning class. But I'm still puzzled.
The course notes said that although you shouldn't be using hints generally, when you do, FIRST_ROWS is the most useful of the hints (in the form FIRST_ROWS(n) where you specify how many rows to optimize for). Also that it's not effective when the query block contains any "sorting or grouping" operations.
Now, I always assumed that this hint would be used like so:
select /*+ FIRST_ROWS(10) */ * from
select count(*) howmany, x from t group by x order by count(*) desc
where rownum < 11;
which would get you the top 10 items from a particular table. Notice that the ORDER BY is in an inner block, so presumably not covered by the "no sorts in the block with the hint" restriction.
However, when you put a WHERE ROWNUM < (N+1) clause in the query, the plan will show a line with COUNT STOPKEY that presumably means the optimizer knows only N rows are needed. So shouldn't the hint be a no-op in that case? I always figured there must be some other case where it's needed. I've been trying to find some authoritative information.
If the WHERE clause uses a variable, e.g. ROWNUM < N, maybe the hint is just a way of suggesting what the likely value of N is, for purposes of COUNT STOPKEY. But that's just speculation on my part.
I got one suggestion that the FIRST_ROWS hint makes the optimizer spend less time looking for the ideal query plan, since it's not going to traverse the whole table anyway, speeding up the hard parse phase. Could that be the meaning of "optimized for throughput"? One of the SQL internals guys didn't think so.
I got another suggestion that it could really change the execution plan, but you would use it not in a top N situation, rather where you wanted arbitrary values. E.g. I wonder if certain values in my table are uppercase or lowercase, so I'll just look at a few, don't care which ones (and in real life might be some devilishly complicated join):
select /*+ FIRST_ROWS */ my_col from my_table where rownum < 6;
In this scenario, I could imagine a change in the execution plan producing different results, depending on how exactly the query ran through the index. But I don't have confirmation that could ever happen.
If you are getting the top N values from an inner query block, maybe the hint helps figure out how to efficiently process the inner results, which after all aren't a real table with indexes and such. That's just my speculation again.
The SQL Reference states: The optimizer ignores this hint ... in SELECT statement blocks that include any blocking operations, such as sorts or groupings. However, I find explicit advice and examples featuring ORDER BY here in the Oracle Text docs. The PSOUG page on hints is a little more specific in its language -- it mentions a bunch of things that render FIRST_ROWS inoperative, including GROUP BY and DISTINCT but not ORDER BY; and it also uses ORDER BY in its examples.
So, after much thought... I'm back where I started. FIRST_ROWS is useful for doing top N queries... or for filtering top N queries done inside an inner block... or only for getting arbitrary values, not top N at all. It does this by speeding up parsing... or choosing a different explain plan (which might or might not change the order since no sorts are allowed)... or just confirming to the COUNT STOPKEY operation how many results are likely to come back from WHERE ROWNUM < N.
Any performance mavens who can say from hands-on experience which, if any, of these likely stories are true?
I will update the original post, as new answers (or new questions) come in, and with responses to suggestions in the comments.
One other top-N-almost-but-not-quite scenario I sometimes encounter is this: display the top N results, but if there is a tie for Nth place, keep going until you've exhausted all the tied values. It's common for traffic analysis on new or lightly visited sites, where many pages may be tied with 1 visitor, and the value 1 makes the top N rankings. The intuitive, strictly correct thing to do is to include AND howmany >= (subquery to find the value of Nth item; then either bump up the value of N in WHERE ROWNUM < (N+1), or leave out ROWNUM entirely and just stop fetching after getting the top N values plus all successive values tied for Nth. I've never delved deep into what is the best performing way to do this, since like I say it usually happens where relatively small amounts of data are being analyzed. But I could surmise that FIRST_ROWS might help in cases where you omit WHERE ROWNUM < (N+1), yet you stop fetching before exhausting the whole result set.
One of the reasons I stopped including FIRST_ROWS hints in my new queries was that mod_plsql always processes the whole procedure before returning any HTML output. So if there is a query that takes 5 minutes, it doesn't matter if FIRST_ROWS starts sending back output after a few seconds; the user won't see anything until the full 5 minutes are elapsed. (Unlike the client-side GUI situation mentioned by one commenter, where presumably the output could start appearing before all the result set rows were available.)
The Jonathan Lewis blog post referenced by a commenter provides some useful information, but still leaves me wanting more information. I feel like I need a FIRST_ROWS FAQ, with short direct answers -- even if some of them are "it depends". Here are my FIRST_ROWS FAQs and the best answers I have:
Q: Any version dependencies?
A: The optimizer is smarter in 9i, meaning less need for the hint. It's smarter again in 10g (especially as regards WHERE ROWNUM < (N+1) so even less need for the hint.
Q: Any effect on parse time, does FIRST_ROWS result in faster hard parses?
A: Have heard both "think so" and "don't think so".
Q: Does ORDER BY totally negate the performance benefits?
A: It depends. Sometimes the query results come back from an index already in the ORDER BY order, in which case ORDER BY doesn't hurt the potential FIRST_ROWS optimization. If the FIRST_ROWS hint goes on the outer block and ORDER BY is on a subquery... don't know if FIRST_ROWS might still help, or if the sorting in the subquery has already lost the chance to make the outer query any faster.
Q: Are those longstanding Oracle Text examples with ORDER BY wrong or obsolete?
A: Don't know for sure, see above. Might depend on results already being sorted and ORDER BY being a no-op. Might be obsolete based on optimizer improvements in 9i and 10g. Might be immaterial when using Oracle Text for a web-based application through mod_plsql, due to the lack of incremental output.
Q: Any difference when a query includes WHERE ROWNUM < (N+1) using a variable N instead of a constant?
A: Don't know if bind variable peeking plays any role here. I know that I am tempted to use e.g. FIRST_ROWS_10 in cases where the number of items is a variable, but the default or most common case is top 10. However, given all the other factors above (particularly the interaction with ORDER BY), this might just be superstition on my part.
The comments in the Jonathan Lewis blog post discuss different approaches to displaying "top N results" combined with "page X of Y" like in a search engine. I personally prefer the technique "figure out the top N * pages results, then skip all pages prior to the current one". What I do in the Tahiti search engine is just grab the ROWIDs of those top N * pages results, find the desired range of values, then query based on ROWID; so I'm only retrieving the actual data for the 10 or so on the page that's really displayed.


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Longboard Vs Formula
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Joined: 13 Dec 2012
Posts: 112
Posted: Mon Jun 03, 2013 4:02 am
Post subject: Longboard Vs Formula
Hi guys,
I recently had the opportunity to try out a starboard longboard and was shocked to see how smoothly it cut through the water unlike my Jp Funster 180 wide board in around 10 knots wind.
Now I love to plane (who doesnt) but i rarely get any planning days as the wind averages are about 10-15 knots for most months...After trying out the longboard I was wondering if it would plane faster than a formula.
Im currently using a funster 180 with a 5.5 sail but I've just picked up a 7.5m 3cam NP Streetracer from ebay (not used it as yet though) which I think should get me planning in 15knots with my board
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Joined: 10 Oct 2010
Posts: 1049
Location: Montréal
Posted: Mon Jun 03, 2013 4:56 am
Post subject:
ah, the eternal question - longboard vs formula
the longboard will glide and plane
the formula will plane and schlogg
depending on your weight - the formula requires LARGE sails
{and long fins too}
the longboard can do well with smaller sizes
i typically cruise and plane on my old Fanatic CAT with an 8.4
bigger sails will feel heavy if not enuff wind
and smaller sails i use on short boards
i am starting to look at the Phantom 320 - since i am a havyweight
since i do like to plane in lighter winds - i have a freeformula
BIC Techno Formula with 94 cm width
this way i have the best of both worlds
for me both worlds are fun
have not gone the entire Formula route
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Joined: 10 Feb 2012
Posts: 1120
Posted: Mon Jun 03, 2013 5:06 am
Post subject:
This is the problem with light wind sailing, do we try to chase the elusive planing with special wide boards and giant heavy sails? Then fail because there's still not enough wind or the technique is too difficult and specialized.
Or do we just say screw it and sail a longboard, gliding and planing.
Lot's of things to consider, your weight, water depth, wind consistency, budget etc...
With a giant sail the formula would plane sooner but is the wind consistent enough to stay on the plane? Can you afford an 11M sail, a 520 mast and a giant carbon boom? is the water deep enough for a 65cm fin?
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Joined: 27 Jan 2012
Posts: 250
Location: Farmerville, Louisiana
Posted: Mon Jun 03, 2013 9:34 am
Post subject:
I was faced with the same decision. I had a bunch of formula stuff that I got with my first board, a Starboard Start. The guy I got it from was using the Start as a formula board. The sails were huge and storing them was a major pain. I sold all that stuff except the Start and bought a Kona One and the 9.0 rig. It doesn't always plane out but it is a lot of fun to sail and you can also paddle it when there is no wind. I think I made the right choice with the Kona as it is a very versatile board.
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Joined: 10 Apr 2006
Posts: 2166
Location: Killer Sturgeon Cove
Posted: Mon Jun 03, 2013 9:43 am
Post subject:
If your prevailing wind is really 10-15 knots, and you weigh 180 or less,
then a formula board and a 9M sail will have you planing pretty much all
the time in those conditions, and that would be my recommendation
(or maybe something formula like that is more freeride). A fast slog
on a displacement hull boarcd is fun ........... for about an hour, and then
unexciting (for me). But, if your prevailing wind is more like 7-12 knots,
then a displacement hull board will get you on the water, will be more
fun than a slogging a "formula" board, and will plane up once in a while
and give you a little thrill.
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Joined: 28 May 2004
Posts: 1196
Location: Bonita Springs, Florida
Posted: Mon Jun 03, 2013 9:54 am
Post subject:
I think you'll enjoy a longboard more than a formula board at this stage in your windsurfing career.
Compared to the Funster and 5.5, a good longboard with a 7.5 will feel very fast and powerful. The challenges of figuring out how to best use the daggerboard, adjustable mast track, and many footstrap positions will keep things exciting for you in both light and moderate winds.
For you, with a 7.5, there won't be much difference in planing ability between a longboard, a formula board, and your funster. An expert rider could get the formula board to plane earlier than the other boards, but a formula board is not an "easy" planer, and you would probably have a hard time getting it "over the hump" from shlogging mode to planing mode. By contrast, a longboard will smoothly accelerate from gliding to planing, without such a noticeable hump. The funster will be in between the feel of the longboard and the formula board, and might be the best board for learning the shortboard planing skills that you'll need to one day ride a formula board.
James' Blog: Windsurfing Equipment Size Calculator
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Joined: 10 Sep 2000
Posts: 2648
Posted: Mon Jun 03, 2013 12:11 pm
Post subject:
Im with Craig here. 10-15 knots is more than enough wind to plane without a formula board if you have good technique and weigh less than 180 lbs. At your stage I would say no to formula board as that is a very wide nose for your mast to impact in the learning stage. Your JP should be fine for now with the 7.5
If you do go the formula route, disregard the myth about needing 9+ meter sails, a formula board will plane fine with your 7.5 and an upper 58-60 cm fin for a rider around 170 lbs, it just wont go as far up/down wind as it will with a larger setup.
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Joined: 28 Mar 2001
Posts: 3269
Posted: Mon Jun 03, 2013 2:27 pm
Post subject:
Keep in mind that early planing on a formula board takes good pumping skills and can be good exercise. For me on a formula board and 9.2 race sail, it takes about 9-11 knots to plane with pumping. I weigh 170 lbs. Without pumping it takes about 11-13 knots to plane.
If you don't have steady winds, you will fall of plane often with the formula if winds are in the 6-15 knot range = more pumping. Where I live, a forecast of 10-15 mph winds actually means 3-15.
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Joined: 19 Jul 2009
Posts: 206
Posted: Mon Jun 03, 2013 2:41 pm
Post subject:
Both, because if you are like me you will want the other one as soon as you try either.
Neither yet, because it sounds like you haven't sailed with anything bigger than 5.5 which is pretty small outside high wind locales. You will really enjoy the board you have more with a bigger sail. I have never sailed a Formula board (excitedly waiting for my Ultrasonic) - but I think you would get more out of a longboard first.
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Joined: 08 Nov 1993
Posts: 9230
Posted: Mon Jun 03, 2013 2:56 pm
Post subject:
One good thing to remember about longboards is that they aren't all displacement designs. The F2 Strato that I bought in 1985 was a planing hull design with footstraps, and it would do all the things you would expect from a much smaller planing design. However, despite its great planing characteristics, it wasn't nearly as quick and efficient as a displacement design in non-planing conditions.
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News Briefs
Summer/Autumn 2002
For the latest updated treatment guidelines for adults and adolescents, children, and pregnant women; postexposure prophylaxis guidelines for occupational and non-occupational HIV exposure; and opportunistic illness (OI) prevention guidelines, visit www.hivatis.org.
Retrovirus Conference Highlights
The 9th Conference on Retroviruses and Opportunistic Infections (the Retrovirus conference) took place February 24-28, 2002, in Seattle, Washington. Along with the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), the Retrovirus conference is the major venue for presentations of new medical research on HIV/AIDS. For detailed conference reports, see the following web sites:
A study by Margaret Fischl, MD, of the University of Miami, Florida, and colleagues showed that in people with advanced HIV disease, a four-drug combination regimen containing AZT (zidovudine, Retrovir), 3TC (lamivudine, Epivir), indinavir (Crixivan), and efavirenz (Sustiva) led to better viral suppression (77%) than a regimen containing the same three drugs minus efavirenz (69%) or a four-drug regimen that substituted nelfinavir (Viracept) for efavirenz (52%). Side effects were similar in the efavirenz group and the three-drug group, but toxicity was higher in the nelfinavir group. This trial suggests that a regimen that includes all three of the major available antiretroviral drug classes -- nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs) -- may be superior to a two-class regimen, even if the same number of drugs is used.
Other research at the conference showed that people who switch to a protease-sparing regimen may be able to lower blood fat levels. High blood lipid levels are commonly seen in HIV positive people receiving antiretroviral therapy, and are a known risk factor for cardiovascular disease in the general population. Switching to a regimen containing nevirapine (Viramune, an NNRTI) produced the best results, but switching to either efavirenz (another NNRTI) or abacavir (Ziagen, an NRTI) also lowered lipid levels. However, other studies have produced conflicting results, and many physicians are reluctant to switch regimens if a person is otherwise doing well. For more new research related to cardiovascular disease, see Cardiovascular Disease in People With HIV.
The issue of when to begin anti-HIV therapy remains controversial. Despite recently revised federal treatment guidelines that suggest beginning therapy later, researchers from the University of Washington presented results indicating that early treatment may be more beneficial. At their clinic, people who began treatment within the first year of enrollment had less than half the risk of death or serious illness compared with those who waited more than a year to begin therapy. A team from the EuroSIDA study also showed that delaying or interrupting treatment may increase the likelihood of serious illness or death. In this 25-country study of 5,400 participants, those who stopped treatment for three months had a six times greater risk of dying or developing a serious opportunistic illness (OI). However, this increased risk was seen only in people with CD4 cell counts below 200 cells/mm3. The revised federal guidelines recommend treatment for people with fewer than 350 CD4 cells/mm3.
Data on several new drugs -- including atazanavir (Zrivada), tipranavir, T-20, and a new class of entry inhibitor drugs -- were presented at the conference; for an update, see The HIV/AIDS Drug Pipeline: A Status Report.
Mitchell Wolfe, MD, MPH, and colleagues from the Centers for Disease Control and Prevention (CDC) gave an update on causes of death in people with HIV since the advent of highly active antiretroviral therapy (HAART). The overall death rate for HIV positive people has fallen since effective combination therapy became widely available in 1996. Deaths due to OIs such as Pneumocystis carinii pneumonia (PCP) and tuberculosis have declined dramatically. When such OI-related deaths still occur, it is often because people are unaware of their HIV positive status or do not begin antiretroviral treatment or recommended OI prophylaxis. In contrast, rates of deaths due to non-Hodgkins lymphoma, wasting, sepsis (systemic infection), and kidney, heart, and liver disease have risen. The researchers suggested that the increase in liver disease is likely related to adverse effects of antiretroviral drugs, coinfection with hepatitis C virus (HCV), and extended lifespan.
Ronald Reisler, MD, MPH, from the National Institute of Allergy and Infectious Diseases (NIAID) and colleagues studied the incidence of life-threatening (grade 4) adverse events in over 3,000 people receiving HAART in five large Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) trials. Overall, about one-quarter experienced a grade 4 event after 30 months on therapy. The most common serious side effects were liver damage (6.1%), neutropenia (low white blood cell count, 3.9%), pancreatitis (inflammation of the pancreas, 2.2%), anemia (low red blood cell count, 2.1%), psychiatric conditions (2.1%), heart and cardiovascular conditions (1.6% each), kidney damage (1.5%), thrombocytopenia (low platelet count, 1.2%), and hemorrhage (bleeding, 0.9%). The 30-month rate of AIDS-defining illnesses was 13.4% and the 30-month mortality rate was 10.6%. The researchers concluded, In this large U.S. HIV cohort treated with HAART, the rate of grade 4 events is higher than the rate of AIDS; and the risk of death associated with a grade 4 event and the risk of death associated with AIDS were similarly high.
Preliminary results from a study by Michelle Roland, MD, and colleagues from the University of California at San Francisco (UCSF) indicate that rates of successful organ transplants in people with HIV are comparable to those in HIV negative persons; 95% of HIV positive people in the study with kidney transplants and 84% of those with liver transplants were still alive after one year.
Finally, researchers from Brazil presented data showing that the availability of postexposure prophylaxis (PEP) for HIV does not appear to lead to an increase in risky sexual behavior.
Combivir/Abacavir Drug Label Switch
In mid-May GlaxoSmithKline (GSK) warned people with HIV and their health-care providers to be alert for counterfeit drug labels. The company reported that fake labels for Combivir (AZT/3TC) had been found on some sealed bottles that actually contained abacavir; both drugs are produced by GSK. Suspect labels were found on four bottles of abacavir in California, Connecticut, Maryland, and Florida. It is recommended that people examine the contents of drug bottles labeled as Combivir. Combivir is a white tablet marked GX FC3 (as depicted on the label), while abacavir is a yellow tablet marked GX 623. People who have suspicions about their medications should contact their pharmacists; suspected tampering can be reported to GSK at 888-825-5249.
The mix-up could be dangerous because about 5% of individuals who take abacavir develop a potentially life-threatening hypersensitivity reaction; persons who experience such a reaction should stop the drug and not use it again. An unintended medication switch also could interfere with the effectiveness of therapy. A spokesperson for GSK said the label switch appeared to be financially motivated, since Combivir sells for considerably more than abacavir. The company said the tampering appeared to be isolated and limited in scope, and that no related adverse reactions had been reported. The Food and Drug Administration (FDA) is investigating the situation.
Fatal d4T Lactic Acidosis Spurs New Label Warning
In March the product label for d4T (stavudine, Zerit) was changed to reflect the possible side effect of lactic acidosis and associated neuromuscular toxicity. The action comes after the drugs manufacturer, Bristol-Myers Squibb, issued a letter to health-care providers in February warning of the possible adverse reaction. Lactic acidosis is a build-up of lactic acid in the body, and is known to be associated with NRTI drugs. The FDAs Adverse Event Reporting System has received reports of 25 cases of neuromuscular weakness resembling Guillain-Barré syndrome in people taking the drug; six of these individuals died. Fatal lactic acidosis previously has been reported in pregnant women who took d4T plus ddI (didanosine, Videx). The revised d4T label includes symptomatic hyperlactatemia syndrome among the drugs adverse effects. Symptoms may include abdominal pain, nausea, vomiting, fatigue, and respiratory difficulty in addition to muscular weakness, especially in the arms and legs. Most severe cases occurred in people who continued the drug despite early symptoms. Persons who experience such symptoms while taking d4T should consult their health-care providers. If lactic acidosis is suspected, the label recommends that all antiretroviral medications should be discontinued. If the condition is confirmed, permanent discontinuation of d4T should be considered.
FDA Approves New HIV and HCV Tests
In May the FDA gave preliminary approval to a rapid HIV-1 antibody test called OraQuick, produced by OraSure Technologies. The new test requires a drop of blood from a finger stick and can yield results in 20 minutes; in contrast, traditional HIV antibody tests require a vial of blood to be drawn from a vein and take several days to yield results. Public health officials have eagerly awaited a rapid HIV test that can provide on-the-spot results because as many as one-third of people tested in public clinics do not come back after their blood draw to obtain their results.
In March the FDA approved a nucleic acid test called Procleix that can detect small amounts of HIV-1 and hepatitis C virus genetic material in the blood. The genetic fingerprinting assay, manufactured by Chiron, works by amplifying viral genetic material to a detectable level. Because it can detect smaller amounts of HIV and HCV RNA, Procleix can register the presence of the viruses sooner after infection. The assay will allow blood banks to more rapidly test donated blood for the viruses. Procleix has been tested worldwide and already is in use in about two-thirds of U.S. blood banks. Some experts question the cost-effectiveness of the new test since the risk of contracting HIV from donated blood in the U.S. is already very low. The assay is expected to cost about $15 per pint of blood. In a three-year study at U.S. blood banks, Procleix detected seven HIV and 88 HCV infections that were not revealed by older blood screening tests. Roche Diagnostics also is seeking FDA approval for its own nucleic acid test, which is currently undergoing trials.
Genetic Test for Abavacir Reaction
As noted above, about 5% of people taking abacavir develop a hypersensitivity reaction, which may be characterized by fever, skin rash, vomiting, abdominal pain, muscle aches, and/or shortness of breath. Abacavir should be discontinued in people who experience such symptoms; restarting the drug can be fatal.
A new genetic test may help predict who is likely to experience this life-threatening reaction. Researchers from the Royal Perth Hospital in Australia examined DNA from 200 people taking abacavir and discovered three genetic variants associated with drug hypersensitivity. The results were presented at the February Retrovirus conference and published in the March 2, 2002 issue of The Lancet. Eighteen persons developed hypersensitivity; of these, 72% had a combination of the HLA-B*5701, HLA-DR7, and HLA-DQ3 gene variants. People with the HLA-B*5701 variant were over 100 times more likely to experience the reaction than those without the variant. Researchers from GSK have found that 46% of people who experience abacavir hypersensitivity have the HLA-B*5701 variant; this is considerably lower than the percentage reported by the Perth team, perhaps due to different frequencies of the gene in the two populations studied. Simon Mallal, MD, one of the authors of the Perth study, reported that he now routinely tests for the gene variants before prescribing abacavir, and has reduced the occurrence of hypersensitivity reactions among his patients from 9% to 2.5%. Such genetic tests are currently expensive -- about $500 -- making the cost per case of hypersensitivity detected between $10,000 and $50,000.
New Test for Mitochondrial Toxicity
A new test has been developed to measure mitochondrial toxicity in people receiving antiretroviral therapy. Mitochondria are organelles within cells that play a role in energy production. NRTI drugs have been associated with mitochondrial dysfunction. The new blood test, developed by Julio Montaner, MD, of the University of British Columbia in Vancouver and colleagues, can detect mitochondrial damage early, giving physicians a chance to change drug regimens before symptoms -- including fatigue, shortness of breath, and rapid heartbeat -- occur. The test measures the level of mitochondrial DNA circulating in the bloodstream. Although mitochondrial damage is associated with lactic acidosis, measurement of lactic acid in the blood is not a reliable indicator of mitochondrial dysfunction. The researchers found that mitochondrial DNA was significantly depleted in people taking antiretroviral drugs who experienced symptoms associated with mitochondrial toxicity. Once the offending drugs were discontinued, mitochondrial DNA levels again increased. The test is currently in the research stage and is not yet commercially available. Study results were reported in the March 14, 2002 issue of the New England Journal of Medicine.
Kava Kava Linked to Liver Damage
In March the FDA warned that kava kava, a popular herbal supplement, may cause serious liver damage. Kava kava often is used to relieve anxiety and as a sleep aid. Problems may be especially likely in people with existing liver damage (such as those with chronic hepatitis) and those taking anti-HIV drugs that can affect the liver. The FDA began to investigate the supplement after a previously healthy woman experienced liver failure and required a transplant after using it. Similar cases have been reported in other countries. Regulatory agencies in Europe, Canada, and Australia also have issued warnings. Advisors to the German government have recommended that the herb be available only by prescription. People who experience early symptoms of liver damage -- which may include fatigue, nausea, abdominal pain, loss of appetite, and jaundice (yellowing of the skin and whites of the eyes) -- should consult their health-care providers promptly.
HIV in Natural Killer and CD4 Cells
Researchers reported in the May 14, 2002 issue of the Proceedings of the National Academy of Sciences that natural killer (NK) cells, a type of immune system white blood cell, can be infected by HIV and may be reservoirs for the virus. NK cells are lymphocytes that contain chemical granules and act as a first line of defense, destroying cells that are cancerous or infected with microorganisms. George Pavlakis, MD, from the National Cancer Institute and colleagues examined ten treatment-naive HIV positive persons who had been taking HAART for 1-2 years. While combination therapy reduced HIV viral load, viral material still could be detected in NK cells as well as in CD4 helper T cells. Not only do these cells get infected, said Dr. Pavlakis, they stay infected even with antiretroviral therapy.
It has long been known that CD4 cells and macrophages also serve as HIV reservoirs. In the May 2, 2002 issue of Nature researchers confirmed a long-standing suspicion that HIV specifically targets CD4 cells that are programmed to attack the virus. Daniel Douek, MD, of NIAID and colleagues studied immune cells from 12 HIV positive individuals and found that HIV-specific memory CD4 cells contained 2-5 times more HIV genetic material than non-HIV-specific memory CD4 cells. The research team also looked at four individuals who underwent structured treatment interruptions (STIs). They found that stopping antiretroviral drugs led to a rebound in HIV viral load, which in turn spurred an increase in HIV-specific CD4 cells, thus providing the virus with more potential cells to infect. The researchers noted that their results imply that treatment interruptions should be done with extreme caution. The results also suggest that stimulating HIV-specific CD4 cell production may be a risky HIV vaccine strategy.
Measles Suppresses HIV
Researchers from Johns Hopkins University in Baltimore, Maryland, reported in the April 15, 2002 issue of the Journal of Infectious Diseases that measles appears to suppress HIV. The research team looked at 93 HIV positive children in Zambia infected with the measles virus. They found that while the measles virus was most active, HIV replication was inhibited. William Moss, MD, said that the researchers were surprised by the results; they had expected that, because measles usually suppresses the immune system, HIV replication would increase during measles infection. Instead, immune system activation in response to measles led to increased CD8 killer T cell counts and a temporary suppression of HIV. After the children recovered from measles, their HIV viral loads once again increased. A similar effect has been seen with scrub typhus, a bacterial infection that is much less common than measles.
Gene Mutation May Make Whites Less Susceptible to HIV
Harold Burger, MD, of the Wadsworth Laboratory in Albany, New York, and colleagues reported results at the February Retrovirus conference that may shed light on why the rate of heterosexual HIV transmission in the U.S. and Europe is lower than the rates in Asia and Africa. Dr. Burgers team compared 2,047 HIV positive U.S. women and 558 HIV negative women matched for race and age. They found a statistically significant difference in the frequency of the delta-32 gene mutation, which has been shown to be protective against HIV infection. People with two delta-32 alleles (a persons has two alleles for each gene, one from each parent) produce abnormal CCR5 cell surface receptors; because HIV does not recognize the receptor, it cannot infect the cell. People with one delta-32 allele appear to be partially protected. The researchers found that HIV negative women were about twice as likely to have the protective gene mutation. Among white women, 1.2% of HIV negative women had at least one delta-32 allele compared with 0.6% of HIV positive women. In addition, they found that white women had a considerably higher frequency of the delta-32 mutation than African-American women (1.2% vs 0.2% for HIV negative women; 0.6% vs 0.1% for HIV positive women). The researchers suggested that the lower frequency of the genetic mutation in non-Caucasians may increase their susceptibility to HIV infection.
HIV Treatment Effective in Older Persons
Older people with HIV respond at least as well to antiretroviral therapy as their younger counterparts, according to research published in the April 2002 issue of the Journal of the American Geriatrics Society. Kenneth Schmader, MD, of Duke University in Durham, North Carolina, and colleagues looked at the effectiveness of antiretroviral therapy in 101 HIV positive persons aged 50 years or older and in 202 people aged 18-39. The two groups experienced similar CD4 cell count increases, and the older participants were more likely to achieve an undetectable viral load (47% in the older group vs 34% in the younger group). The new research contradicts a prevalent belief that older people do not benefit as much as younger people from anti-HIV therapy. Past research has shown that older HIV positive people progress more rapidly to AIDS than do younger individuals, but those studies were conducted before the advent of HAART. Dr. Schmader and colleagues suggested that older people may be more likely than younger people to adhere to complex anti-HIV regimens.
While older and younger people derive similar benefit from HAART, it appears that older people face a greater risk from foregoing antiretroviral therapy. At the February Retrovirus conference researchers from Johns Hopkins presented results showing that HIV positive people over age 50 with CD4 cell counts below 200 cells/mm3 who did not take HAART had twice the mortality rate of younger people who were not treated.
Birth Control Linked to Aggressive HIV
New research in Africa suggests that women who use hormonal contraceptives may be more likely to develop what researchers call more aggressive HIV infection. The research team, from the Fred Hutchinson Cancer Research Center in Seattle, Washington, studied 115 HIV positive female sex workers in Mombassa, Kenya. Women who were taking hormonal contraceptives -- primarily birth control pills or injectable progesterone (Depo-Provera) -- were 5-7 times more likely than women not taking such contraceptives to become infected with multiple strains of HIV, which appears to lead to more rapid disease progression. Julie Overbaugh, PhD, an author of the study, suggested that hormonal contraceptives may cause thinning of the vaginal lining and also may increase the number of cells in the genital tract that are susceptible to HIV infection. The research was presented at the February Retrovirus conference.
Mothers Anti-HIV Therapy Associated With Infant Seizures
A French research team reported in the February 16, 2002 issue of The Lancet that use of anti-HIV drugs by pregnant women appears to increase their babies risk of febrile seizures. Such seizures, which typically occur in children under five years of age, are associated with high fevers; they are not linked to epilepsy. The researchers looked at data from over 4,400 infants in the French Perinatal Cohort. Most of the children were HIV negative; a majority had been exposed to anti-HIV drugs in the womb, during delivery, or after birth. Overall, febrile seizures were uncommon, occurring in just 30 children. However, children who had been exposed to anti-HIV drugs were twice as likely as unexposed children to experience seizures. There were no significant differences in seizure rates based on which specific drugs children had received. Febrile seizures generally are not life-threatening, but may affect brain function. The researchers are conducting follow-up studies to see if these children exhibit mental development problems. Study author Stephane Blanche said these results should not discourage women with HIV from using antiretroviral medications during pregnancy because the risk of seizures is small and the drugs have been shown to greatly reduce the risk of mother-to-child HIV transmission.
Cocaine Speeds HIV Progression
According to a study published in the March 1, 2002 issue of the Journal of Infectious Diseases, cocaine use accelerates the progression of HIV disease in mice. Researchers from the University of California at Los Angeles AIDS Institute studied specially bred HIV-infected laboratory mice with human CD4 cells. The mice were administered injected cocaine or a saline solution placebo. The mice exposed to cocaine experienced a greater CD4 cell decline and higher HIV viral loads. After ten days the cocaine-exposed mice had nine times fewer CD4 cells and 200-fold higher viral loads than unexposed mice. It is not known how cocaine stimulates HIV, although cell surface receptors or cytokines may play a role. Study author Gayle Baldwin, MD, suggested that the effect would likely be similar in humans. Previous research has shown that HIV disease progresses more rapidly in cocaine users, although this may be related to other factors such as poor diet or repeated exposure to different strains of HIV. While other experts maintain that more research is needed before Dr. Baldwins conclusion can be verified, most nevertheless recommend that people with HIV should avoid cocaine.
Promising HCV and HBV TreatmentsClinical trial results indicate that a new form of pegylated interferon -- Hoffmann-La Roches Pegasys -- is highly effective in suppressing HCV when used in combination with the antiretroviral drug ribavirin (Rebetol). Pegylated interferon is a longer-acting formulation of interferon-alpha that can be injected less often. At the 37th annual meeting of the European Association for the Study of the Liver, held this past April in Madrid, Spain, Donald Jensen, MD, from Rush-Presbyterian-St. Lukes Medical Center in Chicago and colleagues presented results from a trial involving nearly 1,300 participants at 99 medical centers worldwide, including 29 in the U.S. (the Global 942 study). The study showed that Pegasys plus ribavirin led to a sustained virological response (undetectable viral load six months after the end of treatment) in 61% of study participants -- the highest HCV suppression rate ever reported. Breaking this down by HCV genotype, Pegasys/ribavirin suppressed the virus in 51% of participants with genotype 1 and in 78% of those with genotypes 2 or 3. Genotype 1 is the most common genotype in the U.S. and is the most difficult to treat. This study showed that successful treatment for people with non-genotype 1 HCV can be accomplished with shorter duration (24 weeks) and lower dose therapy; the best results for people with genotype 1 were seen with longer duration (48 weeks) and higher dose therapy. Another formulation of pegylated interferon -- Shering Ploughs Peg-Intron -- was approved by the FDA last year and also has been shown to be more effective than standard interferon-alpha; in studies Peg-Intron/ribavirin suppressed HCV in 52% of participants. Pegasys currently is awaiting FDA approval. Pegasys and Peg-Intron have yet to be compared in head-to-head trials.
Studies to date have shown that pegylated interferon is superior to standard interferon in people coinfected with HCV and HIV; however, response rates are lower than in people with HCV alone. At the February Retrovirus conference Ray Chung, MD, of Massachusetts General Hospital in Boston and colleagues reported results from a controlled trial comparing the safety and effectiveness of combination therapy with ribavirin plus either Pegasys or standard interferon in 133 people coinfected with HCV and HIV (ACTG 5071). After 24 weeks, 44% of those in the pegylated interferon group achieved an undetectable HCV viral load compared with 15% in the standard interferon group. Among those with genotype 1 HCV, the response rates were 33% for pegylated interferon and 7% for standard interferon; among those with genotypes 2 or 3, the respective response rates were 80% and 40%. CD4 cell counts declined in both groups (more so in the pegylated interferon group), but HIV viral load did not increase. Also, in an uncontrolled study using Peg-Intron in HIV/HCV-coinfected persons, a research team from Madrid found that 54% of 65 participants achieved an undetectable HCV viral load at the end of treatment (37% for genotype 1 and 63% for genotypes 2 or 3).
Several researchers at the Retrovirus conference presented promising results of treatment for hepatitis B virus (HBV) infection. Yves Benhamou, MD, and colleagues from Paris studied 35 HIV/HBV-coinfected subjects who were receiving combination anti-HIV therapy that included 3TC, an antiretroviral drug that is active against HBV as well as HIV. Adefovir (Preveon) was added to participants existing antiretroviral regimens. After 72 weeks participants experienced a nearly 5-log drop in HBV viral load, and four achieved an undetectable HBV viral load. Adefovir failed to win FDA approval for use as an anti-HIV therapy in part due to its potential for kidney toxicity; toxicity was less of a problem in this study, which used doses about ten times lower than those used for HIV. Data from two studies of tenofovir DF (Viread), a successor to adefovir that can be taken once daily, showed that the drug was effective against HBV. A forthcoming trial (ACTG 5127) will compare adefovir and tenofovir DF in people with HIV/HBV coinfection.
Many HIV Positive People Begin Treatment Late
At the February Retrovirus conference researchers from the CDC reported that two-thirds of people with HIV do not start antiretroviral therapy in a timely manner. A.D. McNaughton, MD, and colleagues examined the medical records of over 4,000 people at 100 clinics in ten U.S. cities. They found that during the five-year period from 1996 to 2000, 33% of people began antiretroviral therapy early (with CD4 cell counts of 350 or more cells/mm3), 26% initiated HAART at the generally recommended time (with 250-350 CD4 cells/mm3), and 40% began treatment late (with 250 or fewer CD4 cells/mm3). African-Americans, Latinos, heterosexuals, and injection drug users were more likely not to receive treatment until they had advanced disease. Latinos were 1.8 times more likely and African-Americans were 1.7 times more likely to initiate HAART late. Women and people under age 25, in contrast, were less likely to start treatment late. Dr. McNaughton said it was unclear whether untreated individuals were being diagnosed with HIV disease later, were accessing care later, or were waiting until CD4 cell levels fell before starting therapy.
Patricia Flemming, MD, also of the CDC, reported at the same conference that as many as one-half of people with HIV in the U.S. either do not know they have the virus or are not receiving therapy. Dr. Flemmings team looked at HIV data from 25 states and used these figures to extrapolate numbers for states that do not report HIV infections. The researchers estimated that 180,000-280,000 Americans do not know they are HIV positive and 223,000 know they are infected but are not receiving treatment.
Antiretroviral Therapy for Developing Countries
In a reflection of the increasing attention devoted to the global AIDS epidemic, several studies at the Retrovirus conference showed that triple combination antiretroviral therapy is feasible and can be effective in developing countries. Paul Weidle, PharmD, of the CDC and colleagues looked at the used of triple combination therapy in over 200 Kenyans with advanced HIV disease. Sixty percent had undetectable viral loads after six months, 47% maintained viral suppression after one year, and 32% still had undetectable viral loads after two years. Notably, the subjects in this study attended private medical practices and could afford to pay for their drugs, so were not representative of the poorest people who must rely on public health resources. Other studies in Senegal and India found that treatment success rates were similar to those in developed countries. Although many have argued that the complexity of antiretroviral regimens and the lack of health-care infrastructure and resources in poor countries would make use of anti-HIV drugs difficult or even dangerous, the main roadblock appears to be the cost of the drugs.
In related news, the World Health Organization (WHO) in April released guidelines for HIV treatment in developing countries. The guidelines recommend triple combination regimens and include information about when to start therapy, how to determine whether treatment is working, how to alter failing regimens, and what laboratory tests should be done. While the recommendations are similar to standards of care in the U.S. and Europe, there are some differences. For example, the WHO guidelines recommend treatment for people with CD4 cell counts below 200 cells/mm3 rather than below 350 cells/mm3 as in the most recently revised U.S. federal HIV treatment guidelines. The WHO recommendations also allow for starting treatment on the basis of clinical condition when laboratory tests are not available. In addition, the WHO added ten new antiretroviral drugs to its essential medications list; nevirapine and AZT previously were included for reducing mother-to-child transmission. The list, updated every two years, includes drugs that the agency identifies as essential to treat major diseases and that governments are encouraged to make available.
Meanwhile, at its April board meeting in New York City, the Global Fund to Fight AIDS, Tuberculosis, and Malaria awarded its first grants. In the first round of funding $378 million was distributed to 40 programs in 31 countries. Over 50% of the money will fund projects in Africa. Eighteen additional proposals were slated for fast-track approval, which will bring the total amount awarded to $616 million. At the same meeting the board also announced the appointment of Richard Feachem, MD, as executive director of the Fund. Dr. Feachem is director of the Institute for Global Health, a joint initiative of UCSF and UC Berkeley.
Liz Highleyman is a freelance medical writer and editor based in San Francisco.
This article was provided by San Francisco AIDS Foundation. It is a part of the publication Bulletin of Experimental Treatments for AIDS. Visit San Francisco AIDS Foundation's Web site to find out more about their activities, publications and services.


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Friday, February 10, 2012
still not a seamstress
I did try to make that 90-minute shirt from MADE. The issue wasn't with the tutorial, which is great, but with the pattern I drafted from one of Cooper's old onesies. Let's just say boatneck tops are not his thing. He's saying "cheese" in the photo but had previously yelled, "No Mama! No, no, no!" when I put it on him. I've since tried the raw-edged raglan shirt from Sewing for Boys, with some success up to sewing on the neckband. Problem is it uses only a sewing machine! No serger! Next try will be the envelope tee pattern from Growing Up So Liberated. And I'm going to do some simple flannel pajama pants for the girls.
Next, a success:
I'd say more about this project, but I've recently learned that Claire and her friends sometimes read my blog during computer lab at school. I don't think they'll have a chance again until next week, but I don't want to ruin any surprises. I'm working on Valentine's gifts for the kids-- and the serger was so dreamy for finishing off some edges in the construction phase. I'm still in love with the turquoise thread too and might never change it out.
So I've had better luck with projects of the non-clothing variety. I'm definitely going to keep trying though! I do love my serger.
I hope you all have a great weekend!
6 comments:
- Jennie {Clover and Violet} said...
Love the "cheese" face...my little guy's smile looks like an angry face. Your Valentine's project is too cute too, and how sweet that your daughter reads your blog! Have a great weekend!
- February 10, 2012 at 8:08 AM
- Heidi @ Boys, Buttons, and Butterflies said...
You are tempting me to get mine out....but I have to see the finished project!!!
- February 10, 2012 at 8:39 AM
- Alli said...
Hahahaha! I your boat neck shirt is adorable. Might be the model. :D
- February 10, 2012 at 9:02 AM
- Mrs. Sew and Sew - Karen said...
Such a cute little guy...he is adorable. Have you looked at the videos on Sewing with Nancy. Also check out the you tube videos. Just a suggestion, we found a few helpful tuts on those places.
The valentine gifties are great. Love the colors! Ps. I am not a seamstress either. :0)
- February 10, 2012 at 11:45 AM
- Pam said...
If you have a sewing machine center in your area, see if they have a basic serger class. If not, find a simple serging book, such as http://www.amazon.com/Complete-Serger-Handbook-Chris-James/dp/0806998075/ref=sr_1_1?s=arts-crafts&ie=UTF8&qid=1328924514&sr=1-1. Here is a link to a tute for neckbands, http://www.amazon.com/Complete-Serger-Handbook-Chris-James/dp/0806998075/ref=sr_1_1?s=arts-crafts&ie=UTF8&qid=1328924514&sr=1-1 you can put tjis type of neckband on any knit type t-shirt. The biggest thing is to not stretch the fabric too much as you sew, let the differential feed do it for you. Just stretch the neckband enough to evenly match the shirt opening, as the neckband should be smaller. If you are sewing a pattern for the first time, it sometimes helps to actually sew up the basic seams to check for fit, then serge them, and don't forget it's still a 5/8 seam. I wish i could spend an hour or two with you, because once you learn a few tricks, you will be zipping up clothes for your kids left and right. I cut out many pairs of jammie bottoms, serge them all, then hems and elastic waists. It takes longer to cut them out, lol. I hope this helps a little.
- February 10, 2012 at 4:50 PM
- Leslie said...
the shirt and that little face are too funny! i love the projects you are working on. how cute that your daughter shows off your blog to her friends.
- February 11, 2012 at 4:45 AM


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Update on Fantasy World Building
February 6, 2009 in Fantasy, On Writing by pacejmiller
Just a quick update on my earlier posts about building/creating a fantasy world and how to create a map of that world.
Today I came across the One of Us creative writing website, which has a fabulous article called 'How to Create Fantasy Worlds'. It's an introductory article but it has links to other resources, including mapping, information on mythical creatures, names and languages. There's even a forum on it.
The website also has separate pages on writing tips and a more general discussion forum with various writing sub-categories as well as specific articles.
I think it's a pretty cool website and aspiring writers should check it out.