text:
SEARSPORT, Maine — Locavores who live in or visit the Pine Tree State can meander along the Maine Beer Trail, sipping their way from one microbrewery to the next. They could eat their way from lobster roll to lobster roll along the coast or farm hop to see where their food is grown.
There is another type of trail to add to the Maine mix: the Downeast Fisheries Trail, which showcases the state's fisheries heritage, from salmon farming to lobster fishing to the crucial sardine canneries of yore.
"A trend in travel is that people want to connect to the real thing on the ground," Natalie Springuel of Maine Sea Grant, the coordinator of the trail, said recently. "They want to connect with local people. They want to know how they make a living. They want to know how to lobster, and how to pull up a trap. They want really concrete experiences to understand a place on a deeper level, and then they want to taste it at the end. So yeah, I think the fisheries trail provides a deeper understanding of a place and its people."
The trail was first developed in a much smaller form in Washington County in 2000, featuring just 14 sites. But several years ago, a number of organizations there decided to revive it and expand it to foster tourism. The trail was broadened to include Hancock County and a little bit beyond.
The Downeast Fisheries Trail includes nearly 50 sites, ranging from historical societies and small fisheries museums to places such as the Cherryfield Cable Pool, where Atlantic salmon fly fishermen would flock every year.
"The project has really focused on celebrating what exists and pulling it together," Springuel said. "One of the things that has been so neat about the project is that it has sparked incredible collaboration between the fishing industry and the tourism industry — two industries in Maine that don't often talk. That's been really great."
The trail also features places important to the future of fishing in Maine, such as the Penobscot East Fisheries Center in Stonington, a nonprofit organization that aims to secure a diversified fishing future for Down East Maine and beyond.
"Our fisheries have been changing a lot in the last years, [even since 2000]" Springuel said. "We've become increasingly dependent on lobster, and the diverse nature of our fisheries has declined a little bit. There's a continued and growing need to show to people both the historic fisheries, like ground fish and cod, but also that fisheries remain an important part of coastal economy and culture. It's about celebrating the past, but also the present."
Both the past and the present matter at the Penobscot Marine Museum in Searsport, at the western end of the Downeast Fisheries Trail. Collections manager Cipperly Good said that the museum was a natural fit for the trail. The 19th century buildings on the museum's campus house collections such as the photographic archives of the National Fisherman magazine, oral histories from fishermen, boats and gear from the state's maritime and fisheries heritage.
There also is a permanent exhibit called "Gone Fishing," a play on words that points out that fishing in Maine could become a part of the past and not the future of the state "unless we wake up," Good said.
"When we get these scares — like that lobsters are no longer found in Long Island Sound — it's a wake-up call," she said. "Fish are our livelihood. It's hard to imagine Maine without fisheries."
Ronnie Peabody, the curator of the Maine Coast Sardine History Museum in Jonesport, said that his museum is packed with artifacts from one of the state's most recent bygone fisheries, which he described as the financial backbone of the coast.
"People on the coast should come," he said. "This is how their ancestors had to earn their living."
According to Springuel, the Downeast Fisheries Trail map and concept has helped people, both residents and visitors, to realize that there are deep connections from place to place along the coast.
"The hope is that it will give people a chance to remember our heritage and engage in it, so that the aspect of fisheries that has been so important to our economies historically and today will stay alive into the future," she said. "People from away are really curious about Maine's unique coastal economy. It's also a way for locals to remember where we came from."
Downeast Fisheries Trail maps can be found by calling Natalie Springuel at 288-2944, ext. 5834, or by downloading it from www.seagrant.umaine.edu/downeast-fisheries-trail.


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Nursing Care Partner
- Employer
- Sentara Healthcare
- Location
- Norfolk, VA
- Posted
- Sep 17, 2018
- Closes
- Oct 16, 2018
- Function
- Nurse
- Industry
- Healthcare
- Career Level
- Experienced (Non-Manager)
- Hours
- Full Time
High School Grad or Equivalent
None, unless noted in the "Other" section below
Required: None, unless noted in the "Other" section below
Preferred: Basic Life Support, Cert Patient Care Tech/Asst
None, unless noted in the "Other" section below
One of the following programs is acceptable for Education: Sentara Care Partner Certificate Program, successful completion of a Certified Nursing Assistant (CNA) program, National Certified Medical Assistant (NCMA), National Certified Patient Care Technician (NCPCT), Completion of US Navy Hospital Corps School, Current student enrolled in clinical program (e.g., RN, LPN, Respiratory or Physical Therapy). Current work experience within last three years as a PCT or Nursing Assistant. One year of health care experience preferred. AHA BLS certification within 90 days of hire.
Hours/Shift: 7:00am - 7:00pm or 7:00pm-7:00am/Rotating
Click here to learn more about Sentara Norfolk General Hospital!

subset: commoncrawl


text:
Biological Status Reviews
Biological Status Reviews
The FWC adopted a management system in September 2010 to conserve threatened species. In addition to significant conservation provisions, the system includes measurable criteria that are used to determine those species that should be on Florida's list, which are species facing a high risk of extinction. Biological review groups appointed by the Commission evaluated 61 species (listed below) grandfathered on the FWC's imperiled species lists in fall 2010. Groups of FWC staff and external experts completed a biological status review (BSR) for each of these species.
The groups specifically reviewed:
- population size and trends;
- distribution and range;
- threats to the species;
- published population viability models; and
- specific aspects of the species' life history that may influence the range-wide and Florida-specific status of the species.
The biological status reports were completed in December 2010 and sent out for peer review.
Based on the status reviews and other information, staff recommended that 40 of the species be included on Florida's Threatened list in addition to the three species (gopher tortoise, Miami blue butterfly and Panama City crayfish) that were reviewed in the past decade. Staff recommended that 16 species be removed from the existing list. Three of these are currently classified as threatened species, and 13 are classified as species of special concern. Based on the FWC's listing criteria, evidence indicated that species recommended for removal from the list are not facing a high risk of extinction.
The final reports with staff recommendations were presented to the Commission at the June meeting in St. Augustine. The Commission voted to agree with staff's recommendations and directed staff to continue working on management plans. The changes to a species' listing status will not be made until management plans are presented and approved by the Commission, which may take a few years for some of the species.
Note: There are provisions in FWC rules to ensure that species that are delisted in Florida thrive and that their status does not decline to the point where they need to be re-listed. Before the species can be removed from FWC's threatened or species of special concern lists, staff must develop a management plan, with input from stakeholders and the public, and the Commission must approve the plan.
For more detailed information on reading BSR reports, please refer to the presentations on How to Read a BSR and the BSR training Presentation.
Atlantic sturgeon (Acipenser oxyrinchus) Atlantic sturgeon BSR | Atlantic Sturgeon Supplemental Information
Blackmouth shiner (Notropis melanostomus) Blackmouth Shiner BSR | Blackmouth Shiner Supplemental Information
Bluenose shiner (Pteronotropis welaka) Bluenose Shiner BSR | Bluenose Shiner Supplemental Information
Crystal darter (Crystallaria asprella) Crystal darter BSR | Crystal Darter Supplemental Information
Key silverside (Menidia conchorum) Key Silverside BSR | Key Silverside Supplemental Information
Harlequin darter (Etheostoma histrio) Harlequin darter BSR | Harlequin Darter Supplemental Information
Lake Eustis pupfish (Cyprinodon hubbsi) Lake Eustis pupfish BSR | Lake Eustis Pupfish Supplemental Information
Rivulus (Rivulus marmoratus) Mangrove rivulus BSR | Mangrove Rivulus Supplemental Information
Saltmarsh topminnow (Fundulus jenkinsi) Saltmarsh topminnow BSR | Saltmarsh Topminnow Supplemental Information
Southern tessellated darter (Etheostoma olmstedi maculaticeps) Southern tessellated darter BSR | Southern Tessellated Darter Supplemental Information
Florida bog frog (Lithobates okaloosae) Florida bog frog BSR | Florida Bog Frog Supplemental Information
Georgia blind salamander (Haideotriton wallacei) Georgia blind salamander BSR | Georgia Blind Salamander Supplemental Information
Gopher frog (Lithobates capito) Gopher Frog BSR | Gopher Frog Supplemental Information
Pine Barrens treefrog (Hyla andersonii) Pine Barrens Tree Frog BSR | Pine Barrens Tree Frog Supplemental Information
Alligator snapping turtle (Macrochelys temminckii) Alligator Snapping Turtle BSR | Alligator Snapping Turtle Supplemental Information
Barbour's map turtle (Graptemys barbouri) Barbour's map turtle BSR | Barbour's Map Turtle Turtle Supplemental Information
Florida brown snake (Storeria victa)-lower Keys population only Florida Brown Snake BSR | Florida Brown Snake Supplemental Information
Florida Keys mole skink (Plestiodon egregius egregius) Florida Keys Mole Skink BSR | Florida Keys Mole Skink Supplemental Information
Florida pine snake (Pituophis melanoleucus mugitus) Florida Pine Snake BSR | Florida Pine Snake Supplemental Information
Gopher Tortoise (Gopherus polyphemus)
Gopher Tortoise BSR
Key ringneck snake (Diadophis punctatus acricus) Key Ringneck Snake BSR | Key Ringneck Snake Supplemental Information
Peninsula ribbon snake (Thamnophis sauritus sackenii)-lower Keys population only Peninsula Ribbon Snake BSR | Peninsula Ribbon Snake Supplemental Information
Red rat snake (Elaphe guttata)-lower Keys population only Red Rat Snake BSR | Red Rat Snake Supplemental Information
Rim rock crowned snake (Tantilla oolitica) Rim Rock Crowned Snake BSR | Rim Rock Crowned Snake Supplemental Information
Short-tailed snake (Stilosoma extenuatum) Short-tailed Snake BSR | Short-tailed Snake Supplemental Information
Striped mud turtle (Kinosternon baurii)-lower Keys population only Striped mud turtle BSR | Striped Mud Turtle Supplemental Information
Suwannee cooter (Pseudemys suwanniensis) Suwannee Cooter BSR | Suwannee Cooter Supplemental Information
American oystercatcher (Haematopus palliatus) American oystercatcher BSR | American Oystercatcher Supplemental Information
Black skimmer (Rynchops niger) Black Skimmer BSR | Black Skimmer Supplemental Information
Brown pelican (Pelecanus occidentalis) Brown Pelican BSR | Brown Pelican Supplemental Information
Burrowing owl (Athene cunicularia) Burrowing Owl BSR | Burrowing Owl Supplemental Information
Florida sandhill crane (Antigone canadensis pratensis) Florida Sandhill Crane BSR | Florida Sandhill Crane Supplemental Information
Least tern (Sterna antillarum) Least Tern BSR | Least Tern Supplemental Information
Limpkin (Aramus guarauna) Limpkin BSR | Limpkin Supplemental Information
Little blue heron (Egretta caerulea) Little blue heron BSR | Little Blue Heron Supplemental Information
Marian's marsh wren (Cistothorus palustris marianae) Marian's marsh wren BSR | Marian's Marsh Wren Supplemental Information
Osprey (Pandion haliaetus)-Monroe County population only Osprey BSR | Osprey Supplemental Information | Regional Assessment White Paper
Reddish egret (Egretta rufescens) Reddish egret BSR | Reddish Egret Supplemental Information
Roseate spoonbill (Platalea ajaja) Roseate Spoonbill BSR | Roseate Spoonbill Supplemental Information
Scott's seaside sparrow (Ammodramus maritimus peninsulae) Scott's Seaside Sparrow BSR | Scott's Seaside Sparrow Supplemental Information
Snowy egret (Egretta thula) Snowy egret BSR | Snowy Egret Supplemental Information
Snowy plover (Charadrius alexandrinus) Snowy Plover BSR | Snowy Plover Supplemental Information
Southeastern American kestrel (Falco sparverius paulus) Southeastern American Kestrel BSR | Southeastern American Kestrel Supplemental Information
Tricolored heron (Egretta tricolor) Tricolored heron BSR | Tricolored heron Supplemental Information
Wakulla seaside sparrow (Ammodramus maritimus juncicola) Wakulla seaside sparrow BSR | Wakulla Seaside Sparrow Supplemental Information
White-crowned pigeon (Patagioenas leucocephala) White-crowned pigeon BSR | White-crowned pigeon Supplemental Information
White ibis (Eudocimus albus) White Ibis BSR | White Ibis Supplemental Information
Worthington's marsh wren (Cistothorus palustris griseus) Worthington's Marsh Wren BSR | Worthington's Marsh Wren Supplemental Information
Big Cypress fox squirrel (Sciurus niger avicennia) Big Cypress Fox Squirrel BSR | Big Cypress Fox Squirrel Supplemental Information
Eastern chipmunk (Tamias striatus) Eastern chipmunk BSR | Eastern Chipmunk Supplemental Information
Everglades mink (Neovison vison evergladensis) Everglades mink BSR | Everglades Mink Supplemental Information
Florida black bear (Ursus americanus floridanus) Florida black bear BSR | Black Bear Supplemental Information
Florida bonneted bat (Eumops glaucinus floridanus) Florida bonneted bat BSR | Florida Bonneted Bat Supplemental Information
Florida mouse (Podomys floridanus) Florida mouse BSR | Florida Mouse Supplemental Information
Homosassa shrew (Sorex longirostris eonis) Homosassa shrew BSR | Homosassa Shrew Supplemental Information
Sanibel Island rice rat (Oryzomys palustris sanibeli) Sanibel Island rice rat BSR | Sanibel Island Rice Rat Supplemental Information
Sherman's fox squirrel (Sciurus niger shermani) Sherman's fox squirrel BSR | Sherman's Fox Squirrel Supplemental Information
Sherman's short-tailed shrew (Blarina carolinensis shermani) Sherman's short-tailed shrew BSR | Sherman's Short-tailed Shrew Supplemental Information
Pillar coral (Dendrogyra cylindricus) Pillar Coral BSR | Pillar Coral Supplemental Information
Florida treesnail (Liguus fasciatus) Florida tree snail BSR | Florida Tree Snail Supplemental Information
Black Creek crayfish, also known as Spotted royal crayfish (Procambarus pictus) Black Creek crayfish BSR | Black Creek Crayfish Supplemental Information
Santa Fe Cave crayfish (Procambarus erythrops) Santa Fe Cave crayfish BSR | Santa Fe Cave Crayfish Supplemental Information


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Game Changing Z-Force™ Technology: 100+ Mi Range / 300,000+ Mi on a Power Pack
The 2012 Zero S leverages a completely new battery cell chemistry and configuration. Not only does the ZF9 power pack enable riders to go beyond 100 miles, it is also designed to last the life of the motorcycle. The result of cutting edge research and development, each cell in the power pack is individually controlled and monitored at all times to ensure maximum health. The integrated onboard charger minimizes charge time and can work in parallel with Zero's quick charge accessories to cut charge times by as much as 75%. What's this all mean? Simply put, the Zero S is the leader for production electric motorcycles in acceleration, range, recharge time and longevity.
- Available in two configurations: ZF6 (76 mi) and ZF9 (114 mi)
- State of the art new power pack configurations and cell chemistry
- Cells last 3,000 full charge-discharge cycles before hitting 80% capacity, yielding as much as 308,000 miles on the original power pack
- Up to 95% higher energy density power packs that yield significant range and performance advantages
- Elegant new low resistance and highly robust cell interconnect technology
- New battery management system with enhanced 24/7 cell monitoring and a 92% reduction in power consumption
- New, higher voltage power system that allows the motor to run cooler and with more RPMs than ever before
- Scalable quick-charge options available to cut recharge times by as much as 75%
- Isolated power systems and 12 volt system for running accessories
- Onboard charger that uses a specially developed charge profile
Brushless Motor and Regenerative Braking: 88 mph Top Speed
A compact and powerful brushless motor provides riders with exhilarating acceleration to a top speed of 88 mph. Completely air cooled, the motor is designed to provide riders with years of fun minus the need for any regular maintenance. When slowing down, the motor works with a new brushless motor controller to recharge the power pack.
- Completely new maintenance-free, clean, forced-air cooled brushless motor
- Increased torque and broader power band for much stronger acceleration
- Quad-level regenerative system recharges the power pack when decelerating
- Re-gen level is increased during brake application vs. "neutral" deceleration
- Both braking and "neutral" re-gen levels are set higher in Eco vs. Sport mode
Frame and Bodywork: Lightweight and Stealthy
Aircraft grade aluminum is exclusively used in the construction of the lightweight and rigid Zero S twin spar frame. One look at the frame and it speaks for itself. It is aggressive, strong and one of the main reasons that the Zero S can take on anything in an urban environment. Designed to have a low center of gravity, the Zero S is highly maneuverable and responsive. The body is completed using bold new bodywork to give it a contemporary, aggressive and naked look. The 2012 frame is designed to accommodate a rider and passenger with an optional accessory.
- Frame and bodywork designed from the ground up by Zero Motorcycles
- Ability to accommodate a passenger with an optional accessory
- Better handling with refined frame geometry for 2012
- Extremely rigid and lightweight black twin spar aircraft grade aluminum frame
- Designed to have a low center of gravity for better maneuverability and responsiveness
- Sleek new headlight and turn signals
- New scoop for ventilating the fully air cooled powertrain
- New trunk-pan and belt guard
Wheels and Brakes: Robust and Responsive
The Zero S has completely new weight and strength optimized cast wheels for 2012. Developed specifically for the Zero S by Zero Motorcycles, the sporty new design represents Zero's first ever cast wheel. The Zero S also features more powerful brakes than ever before with a larger front master cylinder bore and new Zero designed rotors.
- Only model to feature Zero's new weight and strength optimized cast wheels
- Brakes are more precise, easier to modulate and require less effort
- Zero designed rotors for optimized performance and reduced unsprung weight
- Larger front master cylinder bore size for increased stopping power
- Steel braided lines for superior lever feel and more precise brake modulation
- High performance compound brake pads
Suspension: The Magic Ride
The suspension on the Zero S was developed by Zero to take advantage of the motorcycle's lightweight design. Its inverted front fork is among the lightest in the industry and can be externally adjusted to dial in compression and rebound damping. A rigid double diamond rear swing arm keeps the wheel planted using a custom rear shock with a fully adjustable spring preload and easily tuned damping. The smooth suspension combines with the silence of the powertrain to yield an exhilarating ride that needs to be experienced to be understood.
- Robust triple-clamps for improved bearing pre-loading and durability
- Specialized fork and shock internals
- Aluminum stanchions for reduced weight and superior control
- Unique double diamond aircraft grade aluminum rear swingarm for reduced weight and increased torsional rigidity
- Front adjustments: Compression and rebound damping
- Rear adjustments: Spring preload, compression and rebound damping
Dash and Controls: Focus on the Ride
The dash is designed by Zero to quickly and accurately provide information on speed, charge and motor temperature. For 2012, the Zero S allows riders to set the motorcycle's performance to either Sport or Eco.
- Sport / Eco switch to allow riders to select motorcycle performance
- New high intensity headlight
- Exceptionally accurate charge indicator
- New and innovative State of Charge (SOC) algorithm
- Ergonomic and durable switch gear (for operation of lights, turn signals, etc.)
- Keyed ignition switch and steering lock for improved security and peace of mind
- More comfortable seat to accommodate longer rides
Gearing: Maintenance Free Belt Drive
Featuring a clutchless direct drive, the Zero S is geared for rapid acceleration and increased efficiency. Using a maintenance free belt system, the Zero S is able to achieve minimal frictional losses. This increases its overall range and channels power more efficiently into speed. The result is a motorcycle that is quick and responsive.
- New maintenance free and virtually silent belt drive system
- Clutchless one speed that simplifies operation
- Geared for rapid acceleration and maximum efficiency
- Minimal maintenance


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SAN FRANCISCO (MarketWatch) — An unusual group of tech geeks and fashionistas gathered at a development office of Zappos this week to talk about an odd topic for Silicon Valley: fashion.
In an industry where the best dressed people are often venture capitalists in khaki pants and button-down shirts, and the uniform of most software developers is — as illustrated by Facebook Inc. FB, +1.34% CEO Mark Zuckerberg — a hoodie, t-shirt and jeans, fashion has never been very important for most of tech's geekiest nerds or super-casual Silicon Valley.
The crowd that gathered at the small office of Amazon.com's AMZN, +1.31% popular shoe-selling site, Zappos, was a combination of techies in their usual attire, stylish women decked out in the fads-of-the-moment, such as chartreuse-colored skinny jeans, platform stiletto heels and partial leather pants.
A panel discussion, though, highlighted that fashion has become a big focus for a new wave of tech startups. One common theme among some of the young companies was combining mobile apps and social sharing to create shopping alternatives to eBay Inc. EBAY, +0.92% EBAY, +0.92% or Etsy, the Brooklyn-based startup known for selling handmade and vintage items that has evolved into an alternative to eBay, minus the auctions.
• Wine flash deals are a maturing category
• Australia aiming to change wine image
• New Zealand wine growers count on U.S.
• Champagne fans toast farmer fizz
• Under the radar in Napa Valley
• Making of sommelier documentary (WSJ.com)
• Jay McInerney on Shafer's smart move (WSJ.com)
• Slide Show: Top 10 cities for bar flies
"We track about 500 startups," said Liza Kindred, founder of Third Wave Fashion, a consulting firm based in New York that helps build and create fashion startups. "Obviously this space is exploding."
Some of the local firms in this field are trying to help consumers, mostly women, buy used clothes and accessories from each other, in a much easier way than buying and selling on eBay. Both Poshmark of Menlo Park, Calif. and Threadflip of San Francisco have created mobile apps that let you take photos of clothes you no longer wear, and easily post them in a kind of online clothing swap.
Both companies try to make it easier to sell. Poshmark, for example, charges buyers a flat fee of $7.00 for any item shipped. Threadflip offers a white-glove service that will handle photos, create listings and ship for sellers who don't have time or patience to list their items.
The social component is also a core part of each service. Another San Francisco startup that did a brief demo is Copius, which described itself as a social marketplace to buy and sell all sorts of things, not just clothing.
All three of these companies appear to be taking cues from Pinterest, the popular image-sharing site, in how their apps look either on the Web or on a mobile phone. EBay too has mimicked Pinterest with a redesign and its new eBay feed for discovering new items. Poshmark also hosts real-time themed "Posh Parties" where its growing number of users can post items from a certain designer, for example, at a particular day and time.
Poshmark started out as an iPhone app on Apple Inc.'s AAPL, +1.86% App Store, but a full desktop, iPad and Android apps are coming soon.
"I am an accidental tourist in the fashion world," said Manish Chandra, founder and CEO Poshmark, who also founded Kaboodle, a social site for shopping now owned by Hearst Corp. Chandra got the idea for Poshmark after seeing shopping bags full of clothes his wife was not wearing in the closet. Poshmark was founded in 2011 and raised $3.5 million in venture funding led by the Mayfield Fund.
Enrico Beltramini, a former Gucci board member, is now founding partner of the Ahead of the Fashion, a technology accelerator program which helps companies raise money, generate revenue, accelerate growth and form partnerships. Beltramini said the events they host have grown quickly in the last year, as well as the number of applicants to the accelerator. "We received 130 applications," he said. "We selected five companies."
One of those companies was another startup called Combatant Gentlemen, or CombatGent, which also gave a brief pitch on Tuesday night at the Zappos Lab event. Combatant Gentlemen is a new menswear brand offering budget-conscious professional men early in their careers high-quality attire from their website, at lower prices than men's stores.
Many of these shopping startups generate revenue by taking a cut of the sale. While there are items up for sale, data on what percentage of items are sold is harder to come by. In addition, some of these clean-out-your-closet startups, including a few others like Twice, appear to be doing the same thing. A shakeout or mergers could eventually ensue.
Whether the nerds and the tragically hip can pair up to create long-lasting companies remains to be seen. But it's adding an unusual style quotient to the tech business. Perhaps it will help geeks improve how they dress.


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A 200 p: mobile amplifier with digital-to-analog converter (DAC) in a pocket-format
A 200 p: mobile amplifier with digital-to-analog converter (DAC) in a pocket-format
Transforming the digital sound data to a connected player often leads to a loss of music quality. Many top headphones such as the beyerdynamic T 51 p cannot be used to their full potential with mobile devices. The A 200 p from beyerdynamic is a solution to this problem. It meets demanding audio requirements and results in a level of quality that was previously not possible for traveling audiophiles.
The A 200 p is a brilliant headphone amplifier in a pocket-format. Its integrated DAC circumvents the internal converter of the player. A high-quality amplifier with analogue output stage controls the genuine playback of the songs to the connected headphones. Previously unheard details, better contoured and deeper bass, as well as more natural instrument and vocal reproduction transform standard portable sound into a true hi-fi experience.


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Southern African Journal of HIV Medicine
versão On-line ISSN 2078-6751
versão impressa ISSN 1608-9693
South. Afr. j. HIV med. (Online) vol.15 no.2 Johannesburg Fev. 2014
Association between symptomatic vulvovaginal candidiasis and HIV RNA levels in plasma and genital secretions among women on HAART
T ApalataI, II; W H CarrIII, IV; B Longo-MbenzaV; W A SturmVI; P MoodleyVII
IMB ChB, MMed, Department of Medical Microbiology and Infection Prevention and Control, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
IIMB ChB, MMed, Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa
IIIDVM, PhD, HIV Pathogenesis Programme, Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
IVDepartment of Biology, Medgar Evers College, The City University of New York, USA
VMD, PhD, DSc, Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa
VIMD, PhD, Department of Medical Microbiology and Infection Prevention and Control, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
VIIMB ChB, MMed, PhD, Department of Medical Microbiology and Infection Prevention and Control, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
BACKGROUND: Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART).
METHOD: Women with VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients' medical records.
RESULTS: Plasma HIV RNA was detected in 42 of 60 (70%) patients on HAART. The mean duration (± standard deviation) on HAART for these patients was 4.2 (±1.6) months v. 10.7 (±1.4) months for the remaining 18 patients (p<0.0001). Of the 42 women with detectable plasma HIV RNA, 12 (28.6%) had detectable genital HIV RNA. Plasma HIV RNA levels ranged from 2.5 (±0.8) to 4.1 (±0.8) log10 copies/ml. Genital HIV RNA levels ranged from 1.4 to 2.5 (±1.1) log10 copies/ml. The adjusted odds ratios of plasma HIV RNA levels increased for patients <35 years (p=0.039) and in those with VVC (p=0.008). Detectability of HIV in genital secretions was significantly increased in patients with a plasma HIV load >10 000 copies/ml (p=0.032) and genital absolute counts of neutrophils >10 cells/5 high microscopic fields (p=0.007).
CONCLUSION: Given that the majority of women had recently initiated HAART (allowing a high rate of detectable plasma HIV RNA), there was insufficient evidence to conclude that VVC was predictive of high plasma HIV RNA levels. It is more likely that this cohort of immunosuppressed women were prone to develop VVC. Plasma HIV loads and local genital inflammation were predictors of genital HIV detectability.
Ulcerative and non-ulcerative lower genital tract infections (LGTIs) are thought to play a major role in early HIV pathogenesis and transmission.[1] LGTIs and plasma HIV viral load (VL) partially explain HIV shedding in the female genital tract (GT).[1,2] Some studies have suggested that changes in the normal microbial flora of the female GT contribute to viral shedding.[1-3]
Conditions associated with genital inflammation, particularly genital ulcers, have been associated with HIV shedding in the GT.[4,5] While the association between non-ulcerative LGTIs such as bacterial vaginosis (BV) and GT HIV shedding has been well established,[6,7] current studies have shown a less well-defined relationship between vulvovaginal candidiasis (VVC) and HIV shedding. In addition to BV that is not an established sexually transmitted infection (STI), vaginitis , an STI caused by Trichomonas vaginalis, has also been shown to increase the risk of HIV acquisition among women,[8,9] and sexual and perinatal HIV transmission.
Data on the effect of highly active antiretroviral therapy (HAART) on vaginal infections among HIV-infected women are limited. Factors such as changes in vaginal immunological cell populations, cellular activation and cytokine production have been reported to alter susceptibility or response to genital infections.[10-13] However, it remains unclear whether chemokines and cytokines interfere with the activity of polymorphonuclear neutrophil (PMN) cells and macrophages in the mucosa, or whether they facilitate the development of VVC.
Our objective was to determine the association between symptomatic VVC and HIV RNA levels in the plasma and GTs of HIV-infected women on HAART. We hypothesised that in HIV-infected women, the presence of symptomatic VVC would affect local HIV shedding, but not systemic levels.
Study population
For this cross-sectional study, consecutive adult (>18 years) women (all HIV-infected) attending Umlazi D clinic, a primary healthcare facility in KwaZulu-Natal (KZN) Province, South Africa, between June 2011 and December 2011 were enrolled after giving informed consent. Data on current symptoms suggestive of LGTIs were obtained by means of a standard questionnaire. Patients on HAART were defined as those receiving treatment with >2 nucleoside reverse transcriptase inhibitors (NRTIs) and >1 protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI).
A physical examination was performed by the attending medical practitioner and signs of LGTIs were noted. Sixty paired plasma and cervicovaginal samples were collected from HIV-infected women receiving HAART. Patients aged <18 years and those who were menstruating or had visible blood contamination of genital samples were excluded from the study.
The study was approved by the Biomedical Research Ethics Committee of the University of KZN (Ref. BE 224/11). Consent forms were signed by all participants and confidentiality was maintained throughout the study.
Collection and processing of cervico-vaginal fluid
A vaginal tampon (8 Ks), Tampax Regular (Compak), was inserted into the vagina, left in situ for 3 minutes, and then placed in a sterile container containing 10 ml of phosphate-buffered saline (Oxoid Ltd Basingstoke, UK) (pH 6.9). Samples were stored at 4oC for 4 hours prior to transport to the laboratory. Vaginal fluid was expressed using an autoclaved wooden tongue depressor and filtered through 0.22 µm Costar Spin-X cellulose acetate filter membranes (Sigma). The filtered soluble fraction was aliquoted (in 1 ml cryotubes) and stored at -70oC until use.
Measurement of absolute PMN cell counts from lower GT samples
A vaginal swab (Becton Dickinson (BD)) was used to collect cells from the posterior fornix and to prepare a tissue smear on a glass slide for Gram staining. Absolute counts of neutrophils were determined by counting the total number of PMN cells in five randomly selected microscopic fields under oil immersion (x1 000 magnification) as previously described. The scores were as follows: score 1: 1 - 10 PMN cells/5 high microscopic fields (HMFs); score 2: 11 - 20 PMN cells/5 HMFs; score 3: >20 PMN cells/5 HMFs.[14-16]
Diagnostic criteria for symptomatic VVC and VVC colonisation
The diagnosis of symptomatic VVC was based on a combination of clinical and laboratory criteria (evidence level III, recommendation grade B).[17-19] Symptoms suggestive of VVC included vulval pruritus, vulval soreness, superficial dyspareunia, and/or non-offensive vaginal discharge. Signs included vulval erythema, vulval oedema, fissures, excoriation or thick curdy vaginal discharge.
A vaginal swab (BD) taken from the anterior fornix was directly plated onto Sabouraud Dextrose agar with chloramphenicol (BBLTM, BD) and incubated at 29oC for 48 hours to estimate the relative vaginal fungal burden. The numbers of yeast colonies were recorded as the number of colonies per plate.[17-19]
In addition to the self-reported symptoms listed above and observation of signs suggestive of VVC on physical examination, cases of symptomatic VVC were confirmed if one of the following criteria was fulfilled (evidence level III, recommendation grade B):[17-19] (i) a positive Gram-stain preparation with budding yeasts, pseudohyphae, and/or hyphal forms; and (ii) positive culture with either moderate (10 - 99 colonies per plate) or heavy (>100 colonies per plate) Candida growth.
Participants without symptomatic VVC were defined as: (i) patients whose genital specimens were negative for yeasts, pseudohyphae, and/ or hyphal forms of Candida on microscopy, together with negative culture; and (ii) patients whose genital specimens were negative for yeasts, pseudohyphae on microscopy, and/or hyphal forms of Candida together with light Candida growth (<10 colonies per plate). The latter was considered to indicate vaginal Candida colonisation rather than infection.
Definitions of HIV-induced immunosuppression
As part of the routine management and standard of care in the clinic, CD4+ T-cell counts were measured in the blood of all HIV-infected patients. The CD4+ T-cell counts used in this study were obtained from the past 3 months of measurements in patients' medical records. However, for the purpose of this research, HIV RNA was measured from the plasma and cell-free fraction of vaginal secretions using Nuclisens Easyq HIV-1 version 2.0 (BioMerieux, France) with a lowest detection limit of 20 copies/ml.[20-22]
Absolute values of CD4+ T-cell counts (cells/µl) were used to determine the degree or severity of immunosuppression as per the World Health Organization immunological staging criteria: severe immunosuppression (<200/µl); advanced immunosuppression (200 - 349/µl); and mild immunosuppression (350 - 499/µl).[23] HIV VL and CD4+ counts were used as markers of disease progression.[23-25] For the purpose of this study, plasma viraemia was classified as follows: <20 copies/ml (below detectable level of the test used); 20 - 9 999 copies/ml; and >10 000 copies/ml. We also log-transformed HIV loads for improved symmetry and included them in multivariate logistic regression models as continuous values.
Diagnosis of other LGTIs
For each study participant, clinical symptoms and signs suggestive of LGTIs were recorded and categorised as absent, mild, moderate or severe. The diagnosis of BV was made using Nugent's scores.[15,16] BD nucleic acid amplification tests (BD Probetec Assays, Sparks) were performed on all cervical swabs to detect Chlamydia trachomatis and Neisseria gonorrhoeae. In addition, polymerase chain reaction amplifications of DNA isolated from vaginal swabs were performed as described previously to detect Mycoplasma genitalium, Trichomonas vaginalis and herpes simplex virus type 2.[26,27]
Statistical analyses
Categorical variables were expressed as proportions (%), and quantitative (discrete ordinal) variables were presented as mean (± standard deviation). For univariate analyses, the χ2 test was used to compare proportions, while the R coefficient was computed to analyse the correlations between quantitative variables. Fur-thermore, univariate association between HIV RNA detectability (in plasma or vagina) and putative risk indicators was defined by odds ratios (ORs) with 95% confidence intervals (CIs). For multivariate analyses, linear multiple and logistic regressions were used to identify independent determinants associated with HIV RNA detectability in the vagina or plasma. Multivariate ORs (95% CI) of HIV RNA genital/plasma detectability were computed after adjusting for confounding factors. Excess risks were measured using the risk difference method.
All tests were two-sided and p<0.05 was considered significant. Data were analysed using SPSS* statistical software version 21.0 (SPSS Inc., Chicago, USA).
The median age of the 60 women enrolled in the study was 30 years (range 18 - 46). All were black Africans.
Plasma HIV RNA was detected in 42 (70%) patients. The mean duration on HAART was 4.2 (±1.6) months for patients with detectable plasma HIV RNA (CD4+ T-cell count <350 cells/µl) while for the remaining 18 patients (CD4+ T-cell count >350 cells/µl) it was 10.7 (±1.4) months (p<0.0001).
Of the 42 women with detectable plasma HIV RNA, 12 (28.6%) had detectable genital HIV RNA. Only one patient had detectable genital HIV RNA in the absence of detectable plasma HIV RNA. Plasma HIV RNA levels ranged from 2.5 (±0.8) log10 copies/ml to 4.1 (±0.8) log10 copies/ml. Genital HIV RNA levels ranged from 1.4 log10 copies/ml to 2.5 (±1.1) log10 copies/ml (Table 1). Eight patients out of 12 (66.7%) with detectable genital HIV RNA had plasma HIV loads >10 000 copies/ml, while the remaining patients had plasma HIV loads of between 20 and 9 999 copies/ml. Fig. 1 shows the distribution of plasma HIV loads and genital HIV RNA detectability according to duration of HAART.
All patients were on HAART regimen 1, namely two NRTIs and one NNRTI. No patient received PIs.
The univariate analysis (Table 2) showed a significant association between symptomatic VVC and plasma HIV RNA detectability (p=0.006), and patients who complained of symptoms suggestive of symptomatic VVC had significantly increased plasma HIV RNA levels (p=0.039). In addition, a recent history (within the past 3 months) of STIs (p=0.035) and patients age <35 years (p=0.018) were also significantly associated with detectable HIV RNA in the plasma. Furthermore, the presence of both advanced and severe HIV-associated immunosupression was significantly associated with HIV RNA detectability in the plasma (p<0.0001). In contrast, no patient with a CD4+ T-cell count >350 cells/µl had detectable plasma HIV RNA.
In the multivariate analysis (Table 3), logistic regression was used to identify independent determinants of HIV RNA levels in plasma after adjusting for univariate confounding factors (presenting complaints and recent history of STIs). CD4+ T-cell counts were not included in the logistic regression model because all patients with detectable plasma HIV RNA had either advanced or severe immunosupression.
Multivariate analysis showed that a cur-rent episode of symptomatic VVC was inde-pendently (p=0.008) associated with detectable HIV RNA in the plasma. It was also found that HIV-infected women aged <35 years were more likely to have higher HIV RNA levels in their plasma than women aged >35 years (p=0.039) (Table 3).
Factors associated with genital HIV RNA shedding
Of the 42 women with detectable plasma HIV RNA, 12 (28.6%) had detectable levels of HIV RNA in cell-free vaginal fluid.
Table 4 shows univariate factors associated with genital HIV RNA detectability among the patients. Women with a recent history of vaginal discharge syndrome (p=0.05) and genital ulcer syndrome (p=0.038) were more likely to have detectable HIV RNA in their GTs (Table 4). However, the data showed no association between gonococcus, VVC or BV and genital HIV shedding.
Women with a neutrophil cell count score of >1 had a five-fold higher risk (OR 5.3, 95% CI 1.6 - 17.2; p=0.004) of having detectable HIV RNA in their GTs than women with a neutrophil cell count score of 1. A recent history of use of broad-spectrum antimicrobial agents was shown to be associated with detectable HIV shedding in the univariate analysis (p=0.048) (Table 4).
In the multivariate analysis, after adjusting for the presence of univariate confounding factors (use of broad-spectrum antibiotics and recent history of STIs), an increase in the vaginal absolute neutrophil counts (p=0.007) and plasma HIV RNA levels (p=0.032) remained independently associated with genital HIV shedding (p=0.005) (Table 5; Fig. 3). Plasma VL (20 - 9 999 copies/ml) tended to correlate positively with genital HIV shedding, but this correlation did not reach statistical significance (p=0.166). However, plasma HIV RNA levels >10 000 copies/ml (p=0.032) were independently associated with genital HIV RNA detectability to a detection limit of 20 copies/ml (Table 5).
Furthermore, when using transformed log10 HIV RNA values, correlations between plasma HIV RNA levels and genital PMN cell counts >10 cells/5 HMFs with detectability of genital HIV RNA shedding showed significant associations (Fig. 3). Detectability and levels of mean log10 HIV RNA in the vaginal fluid increased with the increase of plasma HIV RNA levels (log10) (r=0.2, R2=0.04; p=0.032) (Fig. 3A) and increased absolute counts of genital PMN cells (r=0.21, R2=0.045; p=0.007) (Fig. 3B).
Inflammation of the GT during LGTIs, particularly STIs and BV, has been reported to predict increased plasma VLs in HIV-infected women.[28,29] In this study, given that the majority of women had just initiated HAART (and therefore had a high rate of detectable plasma HIV RNA and low CD4+ counts), there was insufficient evidence to demonstrate that VVC was predictive of high plasma HIV RNA levels. Although cause and effect was difficult to unravel in the current study design, it seemed more likely that the observed higher level of immunosuppression among the study participants influenced the occurrence of VVC. In addition, plasma HIV loads and local genital inflammation were predictors of genital HIV shedding, but did not predict the presence of VVC. Women aged <35 years were more likely to have increased plasma HIV RNA levels than women aged >35 years. A previous study of the relationship between age and plasma VL in HIV-infected individuals showed that older ages (>50 years) compared with individuals aged 18 - 39 years were associated with lower levels of HIV-1 replication.[30] This finding was independent of antiretroviral therapy use, regimen adherence and disease stage. One possible explanation of the relationship between the plasma VL and age category would be immunological differences. It has been shown that older age was associated with an increase in peripheral CD4+ and CD8+ T lymphocytes and that thy-mic involution was associated with this effect, leading to lower expression of plasma HIV-1 RNA.[30]
Studies of the association between HIV VL in the female GT and in the plasma have shown conflicting results. In this study, 28.6% of the patients shed HIV in their genital secretions. This finding is consistent with pre-vious reports of HIV-1 DNA and/or RNA being detected in the GT of 28 - 60% of HIV-1-seropositive women.[29,31-33] These previous studies also demonstrated that genital HIV-1 was more likely to be detected from either the cell-associated fraction of the cervicovaginal fluid or whole genital fluid than from cell-free vaginal fluid.[29,31-33] Although within the published range, our finding of a relatively low frequency of viraemia in the GT of our study population may be attributed to the type of sample that was analysed (measurement of HIV loads in cell-free fraction alone). It is difficult to conclude that antiretroviral therapy significantly lowered HIV RNA levels in genital secretions, given the fact that the women had just started HAART.
We found that women with a recent history of vaginal discharge syndrome and genital ulcer syndrome were more likely to shed HIV in their GTs than women without a recent history of such STIs. However, after testing for the most common causes of LGTIs, none of the tested aetiological agents of vaginal discharge syndrome (VDS) showed significant association with genital HIV shedding.
The fact that HIV VL was only measured from the cell-free fraction of genital secretions may account for the lack of an association between GT viraemia and tested causes of VDS, including symptomatic VVC.
We identified two independent factors asso-ciated with HIV RNA shedding in the vagina; of these factors, one had been previously identified, namely the association between higher levels of plasma HIV RNA and the ability to detect HIV in genital secretions.[31,34] Consistent with previous studies, we found that genital HIV RNA detectability strongly correlated with plasma HIV VL, but that these correlations were weak, except when plasma HIV VL was >10 000 copies/ml. Other studies have suggested that compartmentalisation of the vaginal immune response from systemic immunity may account for such weak correlations.[35,36] This might also be explained by the fact that HIV VL was only measured from the cell-free fraction of the genital secretions.
We also found that the absolute neutrophil count in the genital mucosa was another factor associated with genital HIV RNA shed-ding. Previous studies have shown the role of genital inflammation in HIV-1 shedding.[8,37] It has been reported that following HIV-1 infection, cytokines and chemokines are produced by infected leukocytes that attract more target cells for HIV-1 infection and allow further stimulation of the expression of HIV-1 via toll-like receptors.[8-10] In this study, we found that the number of neutrophils in the female GT was associated with HIV shedding. Of particular interest, our study did not show an association between symptomatic VVC and HIV shedding in the vagina. In addition to the fact that HIV was quantified only in the cell-free fraction of genital fluids, this lack of association could also be the result of strong recruitment of neutrophils in the vagina - various immunomodulators have been reported as associated with the anti-Candida activity of neutrophils.[35,36] Cytokines such as TNF-α and IL-8 increase the activity of neutrophils against Candida albicans.[35] Gumbi et al.[36] reported that women who were detectably shedding HIV-1 in the GT had significantly increased cervical levels of TNF-α, IL-β, IL-6 and IL-8 compared with women who were not detectably shedding the virus. It remains unclear from our observations whether or not symptomatic VVC is more likely to occur among HIV-infected women who are not detectably shedding the virus.
Another possible reason why symptomatic VVC was not associated with genital HIV shedding could be the challenges associated with the diagnosis of VVC. A clinical definition of VVC could be problematic even when microscopic tests and cultures of genital samples are used to support the clinical diagnosis. While Gram staining has a sensitivity of 75% in supporting the clinical diagnosis of VVC, up to 30% of women with significant chronic symptoms suggestive of VVC may have negative cultures at presentation.[38]
Limitations of this study include its cross-sectional design and small sample size. In addition, the impact of factors such as HAART regimen composition, adherence to HAART and effects of HIV disease stages were not explored.
The majority of our patients had just started HAART. Therefore, it is difficult to say that they were not successfully treated. A plausible hypothesis for why we did not find an association between VVC and genital HIV shedding could have been the fact that HIV RNA was only measured from the cell-free fraction of cervicovaginal secretions. If both HIV complementary DNA and HIV RNA had been measured, results could have been different. This might also explain why plasma HIV loads <10 000 copies/ml were not significantly associated with genital HIV shedding in the multivariate logistic analysis.
Finally, findings present insufficient evidence of the true impact of VVC on HIV RNA levels in plasma and genital secretions.
Identified factors associated with HIV RNA loads in plasma and female genital secretions were consistent with previously published factors from the literature. Of particular note, our study did not have enough evidence to demonstrate that symptomatic VVC was predictive of higher levels of HIV RNA in plasma and genital secretions. However, unlike STIs and BV, symptomatic VVC was less likely to occur among HIV-infected women who were detectably shedding the virus in their lower GT, possibly owing to the observed strong recruitment of neutrophils that possess anti-Candida activity or the challenges associated with the diagnosis of VVC. About 70% of the study population had detectable HIV RNA in their plasma; this finding was supported by the fact that all these patients had a CD4+ T-cell count <350 cells/µl, which is a marker of systemic immunosuppression. It is highly likely that the observed higher rate of HIV RNA detectability was purely the result of immunosuppression and that the associated high prevalence of symptomatic VVC could have been a consequence of overall immunosuppression. Further studies are required to ascertain the impact of VVC on HIV RNA levels in plasma and genital secretions.
Acknowledgments. We are grateful to the Hasso Plattner Foundation, the National Research Foundation and the National Institutes of Health for partially funding this study by means of grants to T Apalata, P Moodley and W H Carr, respectively.
1. Coetzee D, Johnson L. Sexually transmitted infections. In: Karim ASS, Karim AQ, eds. HIV/AIDS in South Africa. Cape Town: Cambridge University Press, 2010:219-220. [http://dx.doi.org/10.1017/CBO9781139062404.0141] [ Links ]
2. Plummer FA. Heterosexual transmission of human immunodeficiency virus type 1 (HIV): Interactions of conventional sexually transmitted diseases, hormonal contraception and HIV-1. AIDS Res Hum Retroviruses 1998;14(1):S5-S10. [ Links ]
3. Sobel JD. Vulvovaginal candidiasis. Lancet 2007;369(9577):1961-1971. [http://dx.doi.org/10.1016/S0140-6736(07)60917-9] [ Links ]
4. Miller CJ, Shattock RJ. Target cells in vaginal HIV transmission. J Microbes Infect 2003;5(1):59-67. [http://dx.doi.org/10.1016/S1286-4579(02)00056-4] [ Links ]
5. Anderson BL, Wang CC, Delong AK, et al. Genital tract leukocytes and shedding of genital HIV type-1 RNA. Clin Infect Dis 2008;47(9):1216-1221. [http://dx.doi.org/10.1086/592303] [ Links ]
6. Cu-Uvin S, Hogan JW, Caliendo AM, Harwell J, Mayer KH, Carpenter CCJ. Association between bacterial vaginosis and expression of human immunodeficiency virus type 1 RNA in the female genital tract. Clin Infect Dis 2001;33(6):894-896. [http://dx.doi.org/10.1086/322613] [ Links ]
7. Sha BE, Zariffard MR, Wang QJ, et al. Female genital-tract HIV load correlates inversely with Lactobacillus species but positively with bacterial vaginosis and Mycoplasma hominis. J Infect Dis 2005;191(1):25-32. [http://dx.doi.org/10.1086/426394] [ Links ]
8. Martin HL, Richardson BA, Nyange PM, et al. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis 1999;180(6):1863-1868. [http://dx.doi.org/10.1086/315127] [ Links ]
9. Sorvillo F, Kovacs A, Kerndt P, Stek A, Muderspach L, Sanchez-Keeland L. Risk factors for trichomoniasis among women with human immunodeficiency virus infection at a public clinic in Los Angeles County, California: Implications for HIV prevention. Am J Trop Med Hyg 1998;58(4):495-500. [ Links ]
10. Warren D, Klein RS, Sobel J, et al. A multicenter study of bacterial vaginosis in women with or at risk for human immunodeficiency virus infection. Infect Dis Obstet Gynecol 2001;9(3):133-141. [http://dx.doi.org/10.1155/S1064744901000242] [ Links ]
11. Duerr A, Heilig CM, Meikle SF, et al.; HER Study Group. Incident and persistent vulvovaginal candidiasis among human immunodeficiency virus-infected women: Risk factors and severity. Obstet Gynecol 2003;101(3):548-556. [http://dx.doi.org/10.1016/S0029-7844(02)02729-1] [ Links ]
12. Jamieson DJ, Duerr A, Klein RS, et al. Longitudinal analysis of bacterial vaginosis: Findings from the HIV epidemiology research study. Obstet Gynecol 2001;98(4):656-663. [http://dx.doi.org/10.1016/S0029-7844(01)01525-3] [ Links ]
13. Barousse MM, Van Der Pol BJ, Fortenberry D, Orr D, Fidel PL Jr. Vaginal yeast colonization, prevalence of vaginitis, and associated local immunity in adolescents. Sex Transm Infect 2004;80(1):48-53. [http://dx.doi.org/10.1136/sti.2002.003855] [ Links ]
14. Hitti J, Hillier SL, Agnew KJ, Krohn MA, Reisner DP, Eschenbach DA. Vaginal indicators of amniotic fluid infection in preterm labor. Obstet Gynecol 2001;97(2):211-219. [http://dx.doi.org/10.1016/S0029-7844(00)01146-7] [ Links ]
15. Cauci S, Guaschino S, Driussi S, De Santo D, Lanzafame P, Quadrifoglio F. Correlation of local interleukin-8 with immunoglobulin A against hemolysin and with prolidase and sialidase levels in women with bacterial vaginosis. J Infect Dis 2002;185(11):1614-1620. [http://dx.doi.org/10.1086/340417] [ Links ]
16. Cauci S, Guaschino S, De Aloysio D, et al. Interrelationships of interleukin-8 with interleukin-1b and neutrophils in vaginal fluid of healthy and bacterial vaginosis positive women. Mol Hum Reprod 2003;9(1):53-58. [http://dx.doi.org/10.1093/molehr/gag003] [ Links ]
17. Sonnex C, Lefort W. Microscopic features of vaginal candidiasis and their relation to symptomatology. Sex Transm Infect 1999;75(6):417-419. [http://dx.doi.org/10.1136/sti.75.6.417] [ Links ]
18. Eckert LO, Hawes SE, Stevens CE, Koutsky LA, Eschenbach DA, Holmes KK. Vulvovaginal candidiasis: Clinical manifestations, risk factors, management algorithm. Obstet Gynecol 1998;92(5):757-765. [http://dx.doi.org/10.1016/S0029-7844(98)00264-6] [ Links ]
19. Abbott J. Clinical and microscopic diagnosis of vaginal yeast infection: A prospective analysis. Ann Emerg Med 1995;25(5):587-591. [http://dx.doi.org/10.1016/S0196-0644(95)70168-0] [ Links ]
20. de Mendoza C, Soriano V. Update on HIV viral-load assays: New technologies and testing in resource-limited settings. Future Virol 2009;4(5):423-430. [http://dx.doi.org/10.2217/fvl.09.24] [ Links ]
21. Gomes P, Carvalho AP, Diogo I, et al. Comparison of the NucliSENS EasyQ HIV-1 v2.0 with Abbott m2000rt RealTime HIV-1 assay for plasma RNA quantitation in different HIV-1 subtypes. J Virol Methods 2013;193(1):18-22. [http://dx.doi.org/10.1016/j.jviromet.2013.05.001] [ Links ]
22. Kébé K, Ndiaye O, Diop Ndiaye H, et al. RNA versus DNA (NucliSENS EasyQ HIV-1 v1.2 versus Amplicor HIV-1 DNA Test v1.5) for early diagnosis of HIV-1 infection in infants in Senegal. J Clinical Microbiol 2011;49(7):2590-2593. [http://dx.doi.org/10.1128/JCM.02402-10] [ Links ]
23. World Health Organization. Interim WHO clinical staging of HIV/AIDS and HIV/ AIDS case definitions for surveillance. Geneva: World Health Organization, 2005. [ Links ]
24. Coombs R, Collier A, Allain J, et al. Plasma viremia in human immunodeficiency virus infection. N Engl J Med 1989;321:1626-1631. [http://dx.doi.org/10.1056/NEJM198912143212402] [ Links ]
25. Ho D, Moudgil T, Alam M. Quantitation of human immunodeficiency virus type 1 in the blood of infected persons. N Engl J Med1989;321(24):1621-1625. [http://dx.doi.org/10.1056/NEJM198912143212401] [ Links ]
26. Zimba TF, Apalata T, Sturm AW, Moodley P. Aetiology of sexually transmitted infections in Maputo, Mozambique. J Infect Dev Ctries 2011;5(1):41-47. [ Links ]
27. Apalata T, Zimba TF, Sturm AW, Moodley P. Antimicrobial susceptibility profile of Neisseria gonorrhoeae isolated from patients attending a STD facility in Maputo, Mozambique. Sex Transm Dis 2009;36(6):341-343. [http://dx.doi.org/10.1097/OLQ.0b013e3181982e3c] [ Links ]
28. Roberts L, Passmore JAS, Mlisana K, et al. Genital tract inflammation during early HIV-1 infection predicts higher plasma viral load set point in women. J infect Dis 2011;205(2):194-203. [http://dx.doi.org/10.1093/infdis/jir715] [ Links ]
29. Goulston C, McFarland W, Katzenstein D. Human immunodeficiency virus type 1 RNA shedding in the female genital tract. J Infect Dis 1998;177(4):1100-1103. [http://dx.doi.org/10.1086/517404] [ Links ]
30. Goodkin K, Shapshak P, Asthana D, et al. Older age and plasma viral load in HIV-1 infection. AIDS 2004;18(Suppl 1):S87-S98. [http://dx.doi.org/10.1097/00002030-200401001-00013] [ Links ]
31. Uvin SC, Caliendo AM. Cervicovaginal human immunodeficiency virus secretion and plasma viral load in human immunodeficiency virus-seropositive women. Obstet Gynecol 1997;90(5):739-743. [http://dx.doi.org/10.1016/S0029-7844(97)00411-0] [ Links ]
32. Mostad SB. Prevalence and correlates of HIV type 1 shedding in the female genital tract. AIDS Res Hum Retroviruses 1998;14(Suppl 1):S11-S15. [ Links ]
33. Henin Y, Mandelbrot L, Henrion R, Pradinaud R, Coulaud JP, Montagnier L. Virus excretion in the cervicovaginal secretions of pregnant and nonpregnant HIV-infected women. J Acquir Immune Defic Syndr 1993;6(1):72-75. [ Links ]
34. Shacklett BL. Mucosal immunity to HIV: A review of recent literature. Curr Opin HIV/AIDS 2008;3(5):541-547. [http://dx.doi.org/10.1097/COH.0b013e32830ab9ee] [ Links ]
35. Fidel PL Jr. Innate and adaptive cell-mediated immunity against vaginal candidiasis. Fungal Immunology 2005;5:323-344. [http://dx.doi.org/10.1007/0-387-25445-5_16] [ Links ]
36. Gumbi PP, Nkwanyana NN, Bere A, et al. Impact of mucosal inflammation on cervical HIV-specific CD8 T-cell responses in the female genital tract during chronic HIV infection. J Virol 2008;82(17):8529-8536. [http://dx.doi.org/10.1128/JVI.00183-08] [ Links ]
37. Zara F, Nappi RE, Brerra R, Migliavacca R, Maserati R, Spinillo A. Markers of local immunity in cervicovaginal secretions of HIV-infected women: Implications for HIV shedding. Sex Transm Infect 2004;80(2):108-112. [http://dx.doi.org/10.1136/sti.2003.005157] [ Links ]
38. Beigi RH, Meyn LA, Moore DM, Krohn MA, Hillier SL. Vaginal yeast colonization in nonpregnant women: A longitudinal study. Obstet Gynecol 2004;104(5):926-930. [http://dx.doi.org/10.1097/01.AOG.0000140687.51048.73] [ Links ]
T Apalata


text:
Bedford were hard done by as London Welsh registered five tries to run out 29-11 winners in their Green King IPA Championship clash at the Kassam Stadium in Oxford on Sunday afternoon.
With only eight points in it late on, Bedford's Tony Fenner looked to break clear for a certain try which might have changed the game, only for referee Darren Gamage to bring the Blues back for crossing.
The Exiles scored a penalty try and four further scores in total on the day, with Seb Jewell bagging a brace alongside tries from Tom May and Nick Scott, with Will Robinson converting two in windy conditions.
Blues captain James Pritchard was the only player to get on the scoresheet for Bedford as he registered a try and two penalties.
Bedford kicked the encounter off as the heavens opened at the Kassam Stadium.
Pritchard was given the nod after Welsh impeded at the scrum and looked for the first points of the game, but the wind was too much as he skewed his kick wide.
However, the Canadian claimed the first score of the afternoon moments later after Nic Auterac had made great ground down the left.
Auterac slipped in Pritchard to touch down in the corner, but the wind denied Bedford's skipper as neither side had much luck from the tee.
Bedford were certainly the better side in the opening stages, while the Exiles showed their strength at scrum time.
The windy conditions meant the ball was spending a lot of time in the air, but the Blues were pressuring the home side well and making territory.
Pritchard had another chance on 20 minutes, but was again unsuccessful with his penalty attempt.
Mark Atkinson tried to break through for the Blues, but Welsh snatched the ball back.
Then, as play broke down, there was a small bust-up as referee Gamage gave Justin Burnell's team the put-in at a scrum.
Bedford stole it back though and, as the half-hour mark approached, the visitors looked to throw more phases together.
Exiles were using the scrum to good effect though as they made their way into Bedford's half, before a catch-and-drive move a lineout moved them to within 10m of the line.
Having switched sides, Scott broke down the left and, with Pritchard committing himself, Jewell was able to dive over to level the scores.
Fly-half Robinson couldn't convert as the Exiles continued to look for more tries. Ollie Stedman went closest to finding a gap, but was taken down.
Fenner forced the hosts back into their own land with a good hit and, as the Blues then looked to work a maul, unfortunately they had no luck.
Darryl Veenedaal's grubbered earned them further territory and from the lineout the ball found its way to Atkinson.
He off-loaded brilliantly to Michael Le Bourgeois as Bedford strung some phases together and earned a penalty, which this time Pritchard converted as the visitors retook the lead.
Welsh restarted play and pressed for a way back in as Scott flew through two Blue tackles, but Veenendaal was able to bring down the Exiles winger.
Bedford messed up a quick lineout by knocking on as they gifted Welsh a scrum five metres out and exerted more pressure to win a penalty.
Welsh went again and and got their desserts with the penalty try as Robinson converted to put them 12-8 up as the half time whistle came.
Bedford maintained their intent from the first half as they looked to break out of their own half through Corey Hircock at the start of the second period.
The winger cleared several tackles as he gave the Blues real momentum, only for the visitors to impede at a ruck as the Exiles kicked clear.
The hosts then rolled a scrum to earn a penalty, which they opted to kick to the corner rather than taking three relatively easy points.
Welsh threw phase-after-phase together as they looked to kill of the dangerous Blues.
And the hosts worked the ball left for May to dive over in stylish fashion, with Robinson's conversion putting Welsh 19-8 ahead.
Patrick Tapley broke clear next as Bedford restarted, but scrappy play ensued, as Welsh soon nicked the ball back.
Blues scrambled well as May made a messed up a catch as Bedford proceeded to keep the Exiles at bay.
Le Bourgeois looked to break from his own 22, but Welsh held firm as Bedford forced them right back.
Exiles strayed offside and Prtichard couldn't miss from right in front of the sticks as he reduced the gap to eight points.
Both sides proceeded to battle it out, with Nick Fenton-Wells tackling superbly around the next scrum.
Welsh earned another penalty as they pinned the Blues back, but struggled to find a way through.
Alan Awcock was introduced by Welsh as the Blues forced their hosts into touch as they threatened down the left.
Another decision allowed the home side to press again and their back produced some lovely stuff, only for a misplaced pass to find touch.
Blues looked to be in again when Fenner suddenly broke clear, only for Gamage to questionably deny a certain try for crossing with five minutes left on the clock.
Hurt by the call, Blues lost concentration and Welsh capitalised as Scott powered his way over to make it 24-11.
Things went from bad to worse as Le Bourgeois failed to gather a grubber cleanly under pressure from May and Jewell was able to keep the ball in with a dink as he dived over for his second try.
It was a flattering victory for the Exiles as, although the Blues came away with nothing, they certainly have a platform to build on for next week's visit of Rotherham Titans.
Exiles: Tom Bristow (Alec Hepburn 56), Nathan Morris (Kevin Davis 60), James Tideswell (Paddy Ryan 65), Ben West, Pete Browne (Ian Nimmo 54), Daniel Browne, Carl Kirwan (John Quill 63), Ollie Stedman, Rob Lewis (Chris Cook 54), Will Robinson (Alan Awcock 72), Nick Scott, Sonny Parker, Tom May (C), Seb Stegmann, Seb Jewell. T: Jewell 2, Penalty Try, May, Scott. C: Robinson 2.
Blues: Nick Auterac (Ben Cooper 46), Charlie Clare (TJ Harris 79), Tomas Gilardon-Paz (Nico Steenkamp 46), Paul Tupai, Harry Wells (Mike Howard 56), Gregor Gillanders, Darren Fox (Don Barrell 56), Nick Fenton-Wells, Darryl Veenendaal (Harry Peck 71), Tony Fenner, Corey Hircock, Mark Atkinson (Brendan Burke 51), Mike Le Bourgeois, Patrick Tapley, James Pritchard (C). T: Pritchard. P: Pritchard 2.
Attendance: 1,353.
Referee: Darren Gamage.
Assistant Referees: Thomas Davis and Michael Patz.


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The Centre for Spatial Law and Policy is hosting a discussion on location privacy in the United States on Thursday, September 13, 2012 at Morton's The Steakhouse in the Reston Town Center. This two-hour program will take place in two parts. The first hour will be a presentation, "Location Privacy: Recent Legal and Policy Developments". The presentation will outline (i) proposed legislation in the United States involving location privacy, (ii) recent efforts by federal agencies (e.g. Federal Trade Commission, Department of Commerce, etc.) to address location privacy concerns (iii) important court cases, including U.S. v. Jones and (iii) the unique aspects of location information that will make it difficult to regulate from a privacy standpoint. (The Centre has applied for 1-hour of Continuing Legal Education (CLE) credit for attorneys practicing in Virginia.) The second hour will consist of a discussion among all the attendees on the potential impact of these developments for businesses and government agencies.
Attendance is limited. For more information please contact the Centre for Spatial Law and Policy at email@example.com.


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"Who are we? We are a group of regular people. Just like you. We all had experiences that lead us to hire spellcasters on internet. Many of them.
We know what you are
feeling right now. We were there too!
So, we decide to help people like you, we put all the info recollected in these years online. And, with the help of many users, we rank the best spellcasters around the net for you.
If you have questions or any queries related to black magick, white magic or voodoo spells, do not hesitate to contact us so we can help you asap.
Check out BlackMagicWorld.com Recommended black magic spells informative website
If you are looking for a solution to your love problem , We recommend Barbara Smith, Who is an expert in love spells and love rituals to reconcilie lovers and save marriages. Her love spells are powerful enough no matter how far your loved one is or how long ago you lost him/her. She uses white magic forces and entities that will bring magic results in a blink of an eye. She also casts white magic protection and magic money spells.
- KUYB Team
Voodoo Charm Bag
Voodoo Dolls and Protection
Elements Used in Voodoo
Candles on Voodoo
Spirits of Voodoo
Is Voodoo Just a Superstition?
Voodoo Basics
Dictionary of Voodoo Candles
Spells to make someone love you
Black Magick
What Is Black Magick
Start With Black Magick
How to Know If You are a Victim
Black Magick Dangers
Wicca and White Magic
The Altar of Incense
Starting In White Magic
History of Wicca
Color and elements on White Magic
Types Of Candles In Wicca
Magical arts continue to intrigue sorcerers today, even more than in previous years. Every day people ask me things about techniques and types of magic. Since 80s I have been researching and practicing the art of magic and I realized that the questions vary little new. Their questions are repeated.
Is this dangerous? Can I harm myself with a failed spell? Can I learn it or I need to hire a spell caster? Do I need any tool or massive knowledge to become a spell caster?Do Spells and Magick Really Work?
Magic is an art that make things happen. When using a magic spell, we alter our reality. The magic was part of the witchcraft for thousands of years.
In Europe and North America, magic was known as the transformation of magic in the doctrine (group exercise) or quasi-scientific discipline, there was a set of definitions formulated practicing occultists. So, Eliphas Levi writes that magic - a "traditional science of the secrets of nature."
Piobb argues that magic - "the study of astral forces and their management."
According to Papus magic - "the use of the dynamics of human will to the rapid development of the forces of nature."
In the fundamental work "Magick in Theory and Practice" (1929) Aleister Crowley gives this definition: Magic is "Change, being accomplished in accordance with the Will."
Carlos Castaneda used the term "magic" to describe the method of implementation of human possibilities concerning the nature of perception.
To be sure you are serious I will immediately send you an email that you must open and click the confirmation link. If you do not do it, I will not cast your spell!
The Benefits of Black Magic Love Spells
Falling in love is something that people would always want to experience. This gives them the feeling of incomparable happiness like there is no room for problems. Whenever you are with the person you love, it seems that you can do everything despite of what you are going through. Issues concerning money, health, or work will not be a burden instead you can easily find ways on how to resolve it in a positive way.
This is how powerful love is, that it can control the lives of people and on how they will react with what is happening around them. You will notice that when a person is in love, he seldom gets mad or feel lonely. Every day is a gift that they can spend with the person they love. You cannot compare it with the other riches in life because this can give a long lasting effect. As a matter of fact you can consider it as the main reason why people live.
It only shows that falling out of love or being rejected will give you unbearable pain. There are people who lose direction in life because of break up. They feel that there is no longer hope and no reason for them to keep on going. Worst thing is that it might lead to suicide or getting addicted with drugs.
Instead of ruining your life, why not think of using love spells ? Besides, a lot of people have already tried it to bring back a lost love with spells. With plenty of sources you can find online, for sure you will be tempted to give it a try. You just have to make sure that you go for the one that can offer you love spells that truly works so that you won't fail in the end.
But before you finally make up a decision of using a black magic spell, there are things that you have to consider to make it meaningful.
What to Think of Before You Cast a Love Spell
• Don't use it to control someone.
• You have to take it seriously and as much as possible perform the steps rightly.
• Make sure that it won't cause you harm or other people.
• You have to believe with the spell to make it more powerful.
• You have to find a good place where you will do the incantation.
Magic spells are getting popular from all over the world because of its accessibility. You will see teenagers who are getting interested of doing this activity just to improve their love life. You can think of casting black magic love spells to someone you want to win back or to a person you really desire.
As much as possible, never use it to hurt people because obviously this is not the real essence of love. Don't be too selfish and perform magic spells when necessary. If you feel that you can fix the problem without it then better, yet if you know that this can be the answer to your love problem then say the incantation right away.
(People's choice)
We rank spell casters and witches that many of our users experiences . We are a third party website and we aren't connected in any way with these websites. We also revise reviews and testimonials sites of love spells like : real love spells and check if the information is real or not.
You can visit their websites to hire them, or to get more information about his services and fees. If you have any suggestion, recommendation or comments about a spell caster, please write us a short email.
You can stay in touch with us on the Contact section.
Black Magick.
White Energies.
Forest gods.


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"Excuse me, but is this vegan?"
I drank too much wine last night. I ate too much cake, and too much food in general. I stayed up too late and had too much caffeine. So how come the amount of fun I had was just right?
The boyfriend and I threw a small dinner party last night. Because I love to cook, I enjoy the preparation of dinner parties sometimes more than the event itself (which wasn't the case last night, but I'll admit I've sweated over a meal for days only to provide it to its intended guests, then wished I could hide upstairs with some hummus and carrot sticks and original Star Trek.)
Catering provided by Play-doh
Last night's meal consisted of curried vegetable pasties, asparagus with nutmeg hollandaise, and a raspberry-chocolate flourless cake with homemade whipped cream. Naked ladies dancing with abandon beneath a decaying Sun*. I was most proud of the cake. You know how sometimes you'll taste a dessert and you immediately feel that you're doing something so wrong but it feels so right? I guess the word is sinful. You're stomach screams "This is blasphemy!" but your taste-buds whimper, "Do it again…!" (If you're interested, I've included the recipe below.)


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Fewer teams, fewer spectators and fewer super yachts mean the America's Cup regatta is no longer expected to generate more than $1 billion for the Bay Area's economy, according to a new report, but it also means it will cost substantially less to host sailing's most storied event.
The upshot is that the Bay Area is still expected to see about $902 million in economic activity as it hosts the contest for the first time, down from a projected $1.4 billion.
San Francisco's costs have similarly shrunk from an estimated $32 million to $22.5 million, leaving an eminently reachable target of about $3 million more in private fundraising to cover the city's costs if tax revenue comes in as projected, according to reports The Chronicle obtained Tuesday.
Those findings, including a new economic report that the city commissioned from the Bay Area Council Economic Institute, will be presented Wednesday at a Board of Supervisors hearing requested by Supervisor John Avalos. Avalos called for a hearing after learning last month that the event could cost taxpayers millions more than anticipated. At the time, Avalos said the city got "played" in signing the host agreement.
But with the latest projections, city regatta organizers said that's far from the case.
"Things are going well," said Michael Martin, the city's America's Cup project director. "This is a good thing. It's good for the city, and it's good for the economy. Let's seize this opportunity."
Sean Randolph, president of the economic institute, said, "It will still be a very strong event – not on the scale originally thought – but still very strong."
Avalos still cautious
Avalos was more cautious in his assessment, saying he didn't believe the initial economic projections in the 2010 report by the Bay Area Council Economic Institute and Beacon Economics, and remained skeptical of the institute's update of that report.
"Until I see, so shall I believe," Avalos said as the city prepares for about three months of racing starting July 4, culminating in the America's Cup finals in September. "There's not any way to really measure that."
The America's Cup effort has been buffeted in recent weeks by the revelation that Mayor Ed Lee was personally leading efforts to raise $20 million from private donors, because fundraising by a group of civic leaders to defray city costs lagged behind expectations. Then came Telegraph Hill residents upset about the expanded size of a temporary amphitheater at Piers 27-29 for related concerts, and an audit showing that workers who provided the setup for two preliminary Cup races last year were owed $400,000 in back pay after not being paid prevailing wage, as specified in the city's agreement with race organizers.
Still a big draw
Lee's administration, however, is upbeat about preparations for an event that has already pushed the city to complete a number of waterfront improvements such as a new cruise ship terminal at Pier 27 and a promenade at Fisherman's Wharf. The contest is still expected to draw 2 million people over almost three months of racing.
That's about 700,000 fewer than projected in 2010, which has helped lower city costs. After preliminary races last August and October, officials also have a better sense of the amount of police, transportation and other services needed, and how to best deploy them, which is also expected to minimize costs, Martin said.
The America's Cup Organizing Committee, the civic fundraising group, has already reimbursed the city for $6.8 million of its projected $22.5 million in expenses, city documents show. Bills for another $1.6 million in city costs have yet to be reimbursed. If revenue from hotel, payroll and retail taxes linked to the event come in at the projected $13 million, that leaves a $2.7 million shortfall in city coffers.
Achievable goal
Raising that amount is "very achievable," said Kyri McClellan, CEO of the America's Cup Organizing Committee.
"We raised $6 million on the hope-and-prayer campaign," McClellan said. "We are infinitely better positioned now to ask for support given what's been accomplished already."
The committee originally agreed to "endeavor" to raise up to $32 million over three years to defray city costs. A memo from city Controller Ben Rosenfield for Wednesday's hearing before the board's Budget and Finance Committee says fundraisers have brought in almost $14 million in cash and pledges for future payment.
Some $8 million of that was a loan from the America's Cup Event Authority to be partially repaid through a corporate fundraising program. Beyond paying $6.8 million to reimburse city costs, another $3 million went toward marketing, promotion and things like setting up an office at Pier 23 that provides information to the teams about navigating life in the Bay Area, McClellan said.
Return on investment
"While we hope the tax revenue and fundraising will cover our reduced costs, if our city had another opportunity to spend a few million dollars for $900 million of economic benefit for our workers and local businesses, I think we'd do it again," said board President David Chiu.
Avalos said he would be satisfied if city government breaks even on its costs for hosting an event that he acknowledged would have "some major economic impact" on San Francisco as a whole.
But he added that he is "most concerned" about the America's Cup Event Authority, the arm of Oracle co-founder Larry Ellison's racing syndicate that is organizing the regatta, fulfilling its commitments about hiring city residents, supporting small businesses and paying prevailing wage on construction-type work.
"I just want to make sure we're getting the benefits we're committed to getting," Avalos said.
America's Cup by the numbers
A new economic impact report on the America's Cup provides an updated look at how sailing's premier event will affect San Francisco and the Bay Area.
Sources: Bay Area Council Economic Institute, Beacon Economics, San Francisco Office of Economic and Workforce Development
John Coté is a San Francisco Chronicle staff writer. E-mail: firstname.lastname@example.com
America's Cup to cost S.F. millions less – San Francisco Chronicle


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Declaring independence from the mother country England was to be celebrated with devotion to God, pomp, parades, shows, games, sports, guns, bells, bonfires and illuminations from one end of the United States to the other – forever more. That was how John Adams said the American colonies were to claim their freedom on July 2, 1776.
However, the official declaration day wasn't until two days later and some historians still debate the official day.
The Andrew Jackson High School Volunteer Regiment is going to be in some "high cotton" come July Fourth.
The school's award-winning band will be among the nation's elite when it goes to Washington, D.C., for the annual National Independence Day Parade.
The AJ band earned its trip to the nation's capital after its division-winning performance in the Hartsville High Tournament of Bands last fall.
We search the various greeting cards for just the right words. Words that adequately reflect how we feel in our hearts for that important man.
Today is that important man's special day – Father's Day. It's a day set aside to thank that man who plays such a pivotal role in our lives. He provides and protects his family. His love is unconditional. A father's daily presence in children's lives provides a stable family foundation.
The bowling lanes at the Kershaw Recreation Center at Stevens Park are taking on a new life.
Thanks to a major renovation project, the lanes sport a more pleasing, modern look.
Back in February, Kershaw Town Council voted to allocate $118,330 from the town's reserve fund for the bowling alley's major improvements.
Town officials have considered ways to increase attendance at Stevens Park and use of its facilities, and the bowling alley has been a major part of those discussions.
Richard Band devoted 35 years to the Lancaster County Library and it's likely his legacy will be felt for years to come.
Band, 64, retired May 31 after spending nearly half of his life improving and expanding the Lancaster County Library system.
Band's impact is obvious.
"When I came, we had no branches and were only open one night a week," Band said. "We had a big old card catalog in the middle of the room with 40,000 cards that took up all the room. There wasn't a lot of technology."
On May 20, we were reminded that natural disasters of all kinds can bring devastation on a massive scale. In just a few seconds, the lives of Moore, Okla., residents were changed by an EF5 tornado that destroyed entire buildings while injuring or killing residents as they took shelter.
We can't prevent natural disasters, but we can prepare for them. By being ready and knowing what to do in a disaster, we can minimize risk, reduce the time it takes to recover and most importantly, prevent the loss of life.
Take a good look at the Graduation 2013 special section. It's full of the graduates from all four county high schools.
Today, about 787 Lancaster County students will march across four graduation stages to receive their high school diplomas.
Later, they'll flip the tassels on their mortarboards as they celebrate their graduation with the friends, family, teachers and administrators who helped them along the way.
Occasionally The Lancaster News receives an email from Gov. Nikki Haley's office announcing that flags across the state will be flown at half-staff on a certain day.
Often the reason is because a South Carolina soldier has been killed in action, usually in Iraq or Afghanistan. We post those announcements on our website.
Those half-staff flags are reminders of why we observe Memorial Day. It is so easy to get caught up in the celebration of the holiday with picnics, cookouts and get-togethers that we forget just why there is a Memorial Day.
The 2013 Celebration of Excellence, the annual Lancaster County School District's salute to the best in education and service, included its annual induction of hall of fame members.
Four deserving individuals, who made an impact in the classroom and beyond, took center stage on Monday, April 29, at the Lancaster Golf Club's Fairway Room.
The latest inductees included Bennett Gunter, C.C. Hanson, Ann Hough and Floyd White.
After more than four years of waiting, the excitement was palpable as Lancaster County officials cut the ribbon April 24 to officially open Walnut Creek Park.
The event, originally slated for last October, but delayed due to legal issues, drew local officials and residents, all eager to see the new 60-acre, $7 million county park complex in Indian Land.
Copyright © 2019
The Lancaster News is your source for local news, sports, events, and information in Lancaster County and Lancaster, South Carolina, and the surrounding area..


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Lost password March 6, 2017
Mon-Thur. 5am-9pm
Fri. & Sat. 5am-10pm
Sun 5am-7pm
If you are passionate about the outdoors and love to fish or hunt, Anglers is the place for you. With a wide selection, knowledgeable staff and great customer service, this is your go-to place for hunting and fishing in Annapolis, Maryland.


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By Mike Lehman, TTU Sports Information
JACKSON, Tenn. - The Austin Peay Governors (44-13) proved just why they have been ranked in several polls over the past weeks, defeating the Tennessee Tech baseball team (40-16) 6-2 in the third round of the Ohio Valley Conference Tournament Friday evening.
The Golden Eagles came out a little flat in the contest, walking three and hitting an additional batter in the first inning. The Governors took advantage of the situation, scoring twice in the first without recording a hit. APSU used an RBI ground out by Reed Harper and a bases-loaded walk issued by Tech starter Ross Spurgeon to jump out to a 2-0 lead.
Tech never could quite recover, allowing four more runs during the game, while scoring just two itself on seven hits.
Peay's Casey Delgado threw a strong 6.1 innings for the Governors, allowing just two earned runs while striking out six batters.
David Hess entered the game for the Golden Eagles in the top of the first and threw five innings of relief. The sophomore tossed 105 pitches, allowing four earned runs on seven hits while walking four and striking out four as well.
Senior reliever Zane Morton put together the his best outing of the year, saving the Tech bullpen by pitching the final 3.1 innings for the Golden Eagles. The submarine-style righty allowed just one hit while walking three and striking out two.
Both Zach Zarzour and Austin Wulf led the Tech scoring effort with an RBI apiece. Daniel Miles was the only batter from either team to record multiple hits, singling twice throughout the contest.
The Golden Eagles will look to keep their championship hopes alive when they take on No. 5 seed Eastern Kentucky in an elimination game on Saturday at noon. The winner will advance to take on Austin Peay in a 3:30 p.m. game. Tech took two-of-three from EKU on the road earlier this season.
Fans can watch the entire 2013 OVC Baseball Tournament live on the OVC Digital Network. There is no charge to watch the event and the games are available on any computer, tablet or smart phone.
Tickets for the event will be $10 per day or $28 for an all-session pass (up to 11 total games). There is also an $8 a day rate (or $25 for an all-tournament pass) for students/faculty of OVC-member schools (with valid ID) or for groups. All seats at the 6,000-seat park are general admission for the OVC Championship.
Fans can purchase tickets in person at the Jackson Generals box office or by calling (731) 988-5299 or going online here: https://www.ticketreturn.com/prod2/team.asp?sponsorid=4577.


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