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After the whirlwind start to the season that gave us rounds one to three in just six weeks everyone had the chance to kick back for a month, repair and recover before psyching themselves up for the finals in Pingtan China.
Running from the 8 -12 May the KTA finals marked the second visit to Pingtan Island for the tour in what is regarded as China's windiest location. Regular wind speeds of over 30kts are recorded over the winter monsoon season here and it's so windy in fact that all of the island's old traditional style stone houses need to have rocks placed on top of their tiled roofs to keep them in place when it blows.
The island is being trust forward as one of China's economic development zones, which in the case of Pingtan due to its location gives it a focus on being the gateway into China for Taiwan. Which means for this formally somewhat forgotten part of the country it is now at full speed in its rebirth, with construction taking place at every corner that will turn Pingtan into a slick hi-tech business and commerce location over the next five years, something which even in the space of one year we could all see is moving at quite a pace.
Our hosts and sponsors for the event were the Management Committee of Pingtan Comprehensive Experimental Zone (the local provincial government) who provided not only the richest cash prize package of the season for the KTA China round itself at USD30,000 but also free accommodation and food for all the riders. This combined with our regular tour support and sponsorship from Cabrinha that adds an equipment prize table of USD15,000 worth of kit made this the richest KTA event ever. So as you might imagine this combination with the finals attracted a healthy slice of attention from riders far and wide. For the first time the KTA hit its max registration limit with 120 riders from 30 countries signing up well before the deadline date.
The event began with a formal but spectacular opening ceremony with all the riders lined up behind their country flags Olympic style, which with 30 this year formed an impressive sight. Speeches then followed to the thousands of people crowded onto the beach from a stage filled with the provinces top government officials, surreal but an amazing experience for us all once again and all topped off by a blast of fireworks to signal the event was underway. Well sort of as unfortunately day one was not to see any wind as it turned out.
Luckily though it did not stay this way for the whole week, although it's fair to say that the wind did not live up to expectations for the location and unfortunately made things touch frustrating for the riders and hard work for the competition team.
Day two though greeted us with warm sunshine and a steady cross-offshore wind of around 16kts. So a tricky day for the freestylers who stayed firmly on the beach, but a high speed flat water heaven for the racers, who headed out to show the gathering crowds how we race kite style. With riders from New Zealand, Australia, the USA, Canada and Europe joining the Asia crew it was the largest men and women's combined raceboard (RB) fleet we have seen that led off proceedings with the first of the week's back-to-back races.
All eyes were on the KTA tours top RB riders Yo Narapichit Pudla (THA) and Ken Nacor (PHL) in the men's fleet and Kathrin Borgwardt and Fon Benyapa Jantawan (THA) on the women's side, to see how they would compare to the big names joining this event – Katja Roose (HOL), Nura Goma (SPN), Torrin Bright (NZL) and Climent Hermandez Alejando (SPN) to name a few. Certainly for the women's fleet Roose was showing her world class level and dominated those first races, as she was to continue to do over the rest of the competition also. Both Borgwardt and Jantawan pushed again and again, but could not find the extra edge to get them passed Roose.
For the guys though a different but familiar story as Yo (Narapichit Pudla, THA) blasted away from start line in most races leaving the rest of the fleet well and truly in his wake. Yo has dominated the Asian RB class all season and even with the rest of the world in town, he still showed that he too was now a world level player. He did not however quite achieve a straight line of 'bullets' as Roose did, with Nacor and Alejandro both taking races off him, but overall from the shape of the racing as it unfolded there was never going to be any doubt of who be standing on top of the podium at the end of the week.
With 66 men and 9 women TT racers registered the KTA race team had elected for a staggered start with the women's fleet leading off to add some control to the start line dash, for KTA's most popular discipline. Chinese interest was high for the TT racing with two very local Pingtan and Xiamen riders in the mix. Both 13yrs old Jing Yue Chen and Xiao Cheng Deng had made quite an impact on their first appearance into the KTA during the 2nd round of the season as they both took podium positions, which they then repeated in the 3rd round. Chen was also the poster girl for the KTA China round so it was clear that all eyes in Pingtan were on her as she took to the water.
Although only racing one lap in comparison to the RB two lap races, TT is just as hard fought at every level. At the front of the fleet you will see riders dedicated to TT racing and every bit as competitive as the RB fleet, while a little further back you can witness the private battles of the new comers and the not so serious that make TT class racing the open door class for every kiter to be part of the KTA experience. At the top though for men the season's battle royal continued with the Philippine, Norway, China mix as Jay Ortiz (PHL), Atte Kapel (NOR), Doque Delos Santos (PHL) and Xiao Cheng Deng (CHN) again locked horns. Unfortunately, for the TT class the wind that began its fade on their first day of racing was to in the end keep them off the water for the remainder of the event, leaving them to complete only for races – in those though Delos Santos was to take three wins and Kappel one, giving them the lead on the pack for this round.
For the women things faired a little better and being lighter they manage to pull out 7 races in total for the week. Chen on home water came 'into her own' and began to control the girls TT racing. Her season's rivals though were not to let her have it all her own way as Anny Barlow (USA) and Rebecka Maudal (NOR) both took wins from Chen. Also guesting in the TT mix for China was a familiar RB face Kathrin Borgwardt, who showed she was equally at home on the small board and also took a top slot during the week. In the end though despite her young years Chen kept a cool head and brought home the gold for Pingtan and China – certainly a rider then to be looking out for in the future.
Following an overnight storm the KTA woke to a complete wind shift for day three and freezing conditions. It did however mean with the wind was back blowing onshore and getting up to around 20kts, meaning the freestylers could finally break loose. The men's freestyle in particular was eagerly awaited with the likes of Victor Borsuk (POL), Nicolas Gambier (FRA), Michaeal Khromykh (UKR) ready to face off with the top Asian's Ken Nacor, Yo Narapichit Pulda, Japan's Hironobu Nakano and Vietnam's Long Nguyen Duc.
For the women the medal hunt was on between the season leader so far Kristin Oja (EST), the UK's Polly Crathorne, Aya Oshima (JPN) and Rachel Baglin (AUS). It was the women who took first heats out onto water and things looked good with the girls landing their passes and nailing the switches, but it was soon to become evident that the forecast was going to be right as wind speed begun to slowly fade. Not before however Oja again demonstrated she is the force to be reckoned with this season as she powered her way through to the finals that should have seen her up against Oshima. Oshima who has been improving round by round as the tour as unfolded was looking for that first win of the season, but it was a final battle we were robbed of in the end as the wind fell below 10kts in the early afternoon.
For the men the story was the same wind wise of course. The riders though began with so much promise and the battles we all had hoped for started to emerge. In the early morning strong winds Khromykh and Borsuk were displaying great skill and power in their mobes and passes as they headed smoothly through towards the final rounds. The top Asian's were also on fire with Nakano as consistent as ever, seeming landing every move with minimal effort and Yo as always pulling out an insane combination or 5 just when it was needed. Only Long seemed to be struggling a little with the cold conditions, missing passes he sticks a thousand times over as numb fingers refused to catch the bar. In end however the wind was the left the master of the games and left the guys high a dry before they could complete their final rounds.
So a little disappointing for all concern that we did not even make it through a full single eliminator for the freestylers, the first time this has ever happened on the Asian Tour. On the positive side of things a valid result had still been achieved as enough rounds in total had been completed, although it did leave the rather bizarre outcome of four guys in 1st place, with two of the girls on 1st and two in equal 3rd.
The KTA competition team was determined as always to squeeze the most it could out the day and once again in lighting time set a new race course and managed to deliver another RB class race before the wind finally did disappeared completely. This meant once again the skills of the KTA rescue crews were back in action, something they had fine-tuned only the day earlier with a 40 TT rider rescue when the wind stopped completely in the space of 10 minutes during the final race of that day. The Pingtan finals where certainly proving to be a challenge to riders and race team alike, but everyone was meeting it fair and square and enjoying it to the max.
The last day for the KTA 12/13 Asian Tour, thankfully appeared with much warmer weather in tow, sadly though the wind was not choosing to come along with it. However, it did at least hold enough strength to allow a further blast of racing and thankfully with a Sunday beach crowd of thousands and a wind direction that allowed the race officer to set a 'close to shore' course, a great morning's competition unfolded.
Both the RB and the women's TT saw action, giving some riders the opportunity to consolidate their earlier positions, while others changed their fortunes and pulled themselves back up the rankings. For the RB men though it was still Pudla, Alejandro and Nacor who controlled the pack, while in the women's fleet Roose remained dominant over Borgwardt and Jantawan. For TT though it was Chen all the way as she put in some crushing wins to seal the deal on a much loved local home win for China.
Still in the end this was Pingtan and what do you do in Pingtan when the sun is out and the wind has gone – the KTA is in town and thousands of people are crowded onto the waterfront to see the action? Well its easy you teach them how to dance!
Yes once again the KTA dance and this time crowd singing phenomena erupted and the atmosphere for day and for the whole event was left on a fantastic high with riders and locals joining together to enjoy an afternoon in the sun.
What an event then from bikini's to snowboard jackets and back again. A challenging event to end an amazing KTA season, one with many new friends made who we all hope to see again next season for the KTA 13/14 Asia Tour – see you then ……….
Special thanks to all our sponsors and partners listed below who help make the KTA events happen, not a chance it would be this cool without you all.
KTA China Event Results
Asian Freestyle Championship
KTA Asian Kiteboard Championship Tour Results
"final awarding for the entire tour & event of 2012/13 season!"
From KTA China 2013 – Awards Ceremony, posted by KTA – Kiteboard Tour Asia on 5/14/2013 (30 items)
Generated by Facebook Photo Fetcher 2
The post KTA China final report 2013 – Tour Finals! appeared first on KTA - Kiteboard Tour Asia.
Read original article: KTA News:KTA China final report 2013 – Tour Finals


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text: As we get ready for the 2008 hunting season we must thank all our customers and TEAM Sport trainers for their efforts and success they have accomplished this year. Their efforts will add 12 AKC Master hunters, 8 AKC Senior hunters, 7 AKC Junior hunters, 1 AKC Field Champion, 1 AKC Amateur Field Champion as well as 9 NAVHDA Utility and Natural Ability Prize dogs to the hunting fields this season. 2009 will mark our 16th year in our Family business of breeding, raising and training German Shorthaired Pointers. We could not have accomplished the recognition we have received without the efforts of our customer's commitment to the same goals of testing, trialing and hunting these quality animals. Our goal remains the same in making a positive contribution to this breed; by teaching others that being selective in breeding by using proven genetics will reward the training in a better German Shorthair, and most important is making new Friends and many enjoyable memories.


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| 9.5°C Belfast
Leonardo DiCaprio has revealed it isn't just beauty that attracts him to a woman, even though he has dated a string of supermodels.
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text: Wait a minute, before you all get in line to answer that it was meant as a rhetorical question! :ddog What I'm referring to is this: I'm getting tired of the cold. And it's not even really COLD! yet. Just barely bounced off 50 below this morning. In years past, I remember being pleased when it warmed up to 45 below. But this morning the Jeep couldn't cope with the low temperature and the ECM had it pouring gas into the engine, giving me 6 mpg where it would normally deliver over 18 mpg. With half a tank of gas when I pulled out of Glennallen it should have made it to Anchorage and through half of my shopping without running out. But at the rate it was burning petrol we would not have been able to reach Palmer. :eek1 Had to turn around 25 miles out and go back for more dead dinos. Then, when I drove into the coldest spot, the transmission started acting up, with the torque converter clutch locking and unlocking and shifting up and down violently. Finally went back to the apartment and parked it. There's something to be said for carburetors and manual transmissions. Besides vehicles, there are heating systems. Or, more accurately, systems that are supposed to produce heat. And I'm tired of them. A wood stove. Simple (like me), works even when there's a power outage (unlike me), romantic (definitely not like me!). Everything is being controlled by little squares, octagons, trapezoids, tiny cans on two or more legs all glued together on a little board in patterns discernible only to electronics wizards who speak in strange tongues. Inductor Diode Nand gate NPN transistor NMOS (how the heck are you supposed to pronounce that?) Bipolar transistor (how do you administer lithium to a transistor?) And so on. And you know what? The literature for those little devices often says Storage at 0° to 40°C In automotive use they often test these things clear down to are you ready for this? - the incomprehensible temperature of -40°C/F!! Yeah, a balmy day in wintertime Alaska. Okay... maybe I'm just getting old and cranky. Naw, it can't be that. Guess I'm just not into this "Global Warming". But I'm sure looking forward to summer.


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Connecticut volunteers help New Yorkers clean up after Sandy
GREENWICH -- On a recent Sunday, Neesha Rahim filled a truck and a van with cleaning supplies, sump pumps and industrial brooms and headed south to Breezy Point, N.Y.
There, in the Queens neighborhood devastated last month by Hurricane Sandy, Rahim, her two children and two other Greenwich families helped people literally pick up the pieces of their lives.
The group cleaned up trash and debris that couldn't be moved by bulldozers. They helped pump water from people's basements.
The families were among many people and religious organizations in Greenwich who have helped out victims in the most devastated parts of the tri-state area.
Rahim said she and her friend Trina O'Carroll had purchased tons of supplies for Sandy victims over the previous several days, collected more from friends and neighbors and spent $1,300 in donations at Home Depot. They contacted a firehouse in Breezy Point, and arranged to drop off the donations and spend the day helping out. Garden Catering in Old Greenwich supplied them with food to bring down to the volunteers and workers. O'Carroll rented a truck.
When Rahim arrived with the O'Carrolls and the Monteiros, there was devastation everywhere.
"One house had been literally pushed away from the chimney," Rahim said.
The adults and children quickly got to work.
"There's piles and piles of supplies and all of these people working," Rahim said. "You couldn't tell who the volunteers were and who the residents were. Even in the middle of this destruction, everybody's attitude was still wonderful."
O'Carroll, who lives in Riverside, said she never lost power, and she felt compelled to reach out to those who lost everything.
"We felt so lucky through the whole storm," O'Carroll said. "As my kids sat there with their feet propped up on the couch, I said, 'We need to start thinking about things we can do.'"
O'Carroll's 6- and 8-year-olds took garbage bags and helped pick up debris, and helped sort donations.
Also this past weekend, a group of 50 people from Trinity Church, a small Greenwich congregation, went down to Staten Island.
The group helped people remove sheetrock and rotten floorboards from homes, said Senior Pastor Drew Williams. They worked with Steven Martino, the pastor of a Staten Island church, who has been helping organize recovery efforts there. Martino pointed the Connecticut volunteers in the right direction.
"The concern is you're going to get in the way, but that wasn't the case," Williams said. "There was a lot to be done."
Other local organizations have helped collect donations. Temple Sholom has been collecting cleaning supplies, canned food, gently used coats and new blankets at the temple, and then taking it to the UJA-Federation in White Plains, N.Y., which arranges for trucks to deliver the donations to hard-hit locations.
"We started collecting as soon as the power came back on," said the temple's senior director, Lori Baden. "We have a storage area that keeps filling up every time we empty it."
Like Rahim, an untold number of people around Greenwich also felt compelled to help those in need.
One of them is Cos Cob resident Rick Novakowski. The former candidate for town tax collector is seeking donations of coats and winter clothing for New York Sandy victims.
Anyone interested in donating clothing can call him at 203-536-6704 and he will come to the donor's home to collect the items. Novakowski will be collecting items until Dec. 10.
Rahim said she was glad that she and her two children could help out with "boots on the ground," especially in the days before Thanksgiving. As an alternative to Black Friday and Cyber Monday, Rahim considers her trip to New York "Silver Lining Sunday."


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Gallbladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]Skip to the navigation
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
General Information About Gallbladder Cancer
Incidence and Mortality
Estimated new cases and deaths from gallbladder (and other biliary) cancer in the United States in 2017:[1 ]
- New cases: 11,740.
- Deaths: 3,830.
Cancer that arises in the gallbladder is uncommon.
Clinical Features
The most common symptoms caused by gallbladder cancer are jaundice, pain, and fever.
Histopathology and Diagnostics
In patients whose superficial cancer (T1 or confined to the mucosa) is discovered on pathological examination of tissue after gallbladder removal for other reasons, the disease is often cured without further therapy. In patients who present with symptoms, the tumor is rarely diagnosed preoperatively.[2 ] In such cases, the tumor often cannot be removed completely by surgery and the patient cannot be cured, though palliative measures may be beneficial. For patients with T2 or greater disease, extended resection with partial hepatectomy and portal node dissection may be an option.[3 ,4 ]
Other Prognostic Factors
Cholelithiasis is an associated finding in the majority of cases, but less than 1% of patients with cholelithiasis develop this cancer.
- American Cancer Society: Cancer Facts and Figures 2017. Atlanta, Ga: American Cancer Society, 2017. Available online. Last accessed October 13, 2017.
- Chao TC, Greager JA: Primary carcinoma of the gallbladder. J Surg Oncol 46 (4): 215-21, 1991.
- Shoup M, Fong Y: Surgical indications and extent of resection in gallbladder cancer. Surg Oncol Clin N Am 11 (4): 985-94, 2002.
- Sasson AR, Hoffman JP, Ross E, et al.: Trimodality therapy for advanced gallbladder cancer. Am Surg 67 (3): 277-83; discussion 284, 2001.
Cellular Classification of Gallbladder Cancer
Some histologic types of gallbladder cancer have a better prognosis than others; papillary carcinomas have the best prognosis. The histologic types of gallbladder cancer include the following:[1 ]
- Carcinoma in situ.
- Adenocarcinoma, not otherwise specified (NOS).
- Papillary carcinoma.
- Adenocarcinoma, intestinal type.
- Clear cell adenocarcinoma.
- Mucinous carcinoma.
- Signet-ring cell carcinoma.
- Squamous cell carcinoma.
- Adenosquamous carcinoma.
- Small cell (oat cell) carcinoma.*
- Undifferentiated carcinoma.*
- Spindle and giant cell types.
- Small cell types.
- Carcinoma, NOS.
- Carcinosarcoma.
- Other (specify).
*Grade 4 by definition.
- Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
Stage Information for Gallbladder Cancer
Definitions of TNM
The American Joint Committee on Cancer has designated staging by the TNM classification to define gallbladder cancer.[1 ]
|a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
|Primary tumor cannot be assessed.
|No evidence of primary tumor.
|Carcinomain situ.
|Tumor invades lamina propria or muscular layer.
|Tumor invades lamina propria.
|Tumor invades muscular layer.
|Tumor invades perimuscular connective tissue; no extension beyond serosa or into liver.
|Tumor perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as the stomach, duodenum, colon, pancreas, omentum, or extrahepatic bile ducts.
|Tumor invades main portal vein or hepatic artery or invades at least two extrahepatic organs or structures.
|a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
|Regional lymph nodes cannot be assessed.
|No regional lymph node metastasis.
|Metastases to nodes along the cystic duct, common bile duct, hepatic artery, and/or portal vein.
|Metastases to periaortic, pericaval, superior mesenteric artery, and/or celiac artery lymph nodes.
|a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
|No distant metastasis.
|Distant metastasis.
|a Reprinted with permission from AJCC: Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
|Any T
|Any T
|Any N
Localized (Stage I)
These types of patients have cancer confined to the gallbladder wall that can be completely resected. They represent a minority of cases of gallbladder cancer. Patients with cancers confined to the mucosa have 5-year survival rates of nearly 100%.[2 ] Patients with muscular invasion or beyond have a survival of less than 15%. Regional lymphatics and lymph nodes should be removed along with the gallbladder in such patients.
Unresectable (Stage II-IV)
With the exception of some patients with focal stage IIA disease, these types of patients have cancer that cannot be completely resected. They represent the majority of cases of gallbladder cancer. Often the cancer invades directly into adjacent liver or biliary lymph nodes or has disseminated throughout the peritoneal cavity. Spread to distant parts of the body is not uncommon. At this stage, standard therapy is directed at palliation. Because of its rarity, no specific clinical trials exist; however, such patients can be included in trials aimed at improving local control by combining radiation therapy with radiosensitizer drugs.
- Gallbladder. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 211-7.
- Shirai Y, Yoshida K, Tsukada K, et al.: Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann Surg 215 (4): 326-31, 1992.
Localized Gallbladder Cancer
When gallbladder cancer is previously unsuspected and is discovered in the mucosa of the gallbladder at pathologic examination, it is curable in more than 80% of cases. Gallbladder cancer suspected before surgery because of symptoms, however, usually penetrates the muscularis and serosa and is curable in fewer than 5% of patients.
One study reported on patterns of lymph node spread from gallbladder cancer and outcomes of patients with metastases to lymph nodes in 111 consecutive surgical patients in a single institution from 1981 to 1995.[1 ][Level of evidence: 3iiiA] The standard surgical procedure was removal of the gallbladder, a wedge resection of the liver, resection of the extrahepatic bile duct, and resection of the regional (N1 and N2) lymph nodes. Kaplan-Meier estimates of the 5-year survival for node negative tumors pathologically staged as T2 to T4 were 42.5% ± 6.5% and for similar node positive tumors, 31% ± 6.2%.
Standard treatment options:
- Surgery: In previously unsuspected gallbladder cancer, discovered in the surgical specimen following a routine gallbladder operation and confined to mucosa or muscle layer (T1), the majority of patients are cured and require no further surgical intervention.[2 ,3 ] Re-exploration to resect liver tissue near the gallbladder bed or extended or formal hepatectomy and lymphadenectomy including N1 and N2 lymph node basins may be associated with delayed recurrences or extended survival in patients with stage I or II gallbladder cancer.[4 ,5 ] Apparently localized cancers that are suspected before or during the operation can be surgically removed with a wedge of liver and lymph nodes and lymphatic tissue in the hepatoduodenal ligament. Long-term disease-free survival will occasionally be achieved. In jaundiced patients (stage III or stage IV), there should be consideration of preoperative percutaneous transhepatic biliary drainage for relief of biliary obstruction.
Implantation of the carcinoma at all port sites (including the camera site) after laparoscopic removal of an unsuspected cancer is a problem. Even for stage I cancers, the port sites must be excised completely.[6 ]
- External-beam radiation therapy (EBRT): The use of EBRT with or without chemotherapy as a primary treatment has been reported in small groups of patients to produce short-term control. Similar benefits have been reported for radiation therapy with or without chemotherapy administered following resection.[7 ,8 ]
Treatment options under clinical evaluation:
- Clinical trials are exploring ways of improving local control with radiation therapy combined with radiosensitizer drugs. When possible, such patients are appropriately considered candidates for these studies.
Current Clinical Trials
Use our advanced clinical trial search to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. General information about clinical trials is also available.
- Tsukada K, Kurosaki I, Uchida K, et al.: Lymph node spread from carcinoma of the gallbladder. Cancer 80 (4): 661-7, 1997.
- Fong Y, Brennan MF, Turnbull A, et al.: Gallbladder cancer discovered during laparoscopic surgery. Potential for iatrogenic tumor dissemination. Arch Surg 128 (9): 1054-6, 1993.
- Chijiiwa K, Tanaka M: Carcinoma of the gallbladder: an appraisal of surgical resection. Surgery 115 (6): 751-6, 1994.
- Shirai Y, Yoshida K, Tsukada K, et al.: Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann Surg 215 (4): 326-31, 1992.
- Yamaguchi K, Chijiiwa K, Saiki S, et al.: Retrospective analysis of 70 operations for gallbladder carcinoma. Br J Surg 84 (2): 200-4, 1997.
- Wibbenmeyer LA, Wade TP, Chen RC, et al.: Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder. J Am Coll Surg 181 (6): 504-10, 1995.
- Smoron GL: Radiation therapy of carcinoma of gallbladder and biliary tract. Cancer 40 (4): 1422-4, 1977.
- Hejna M, Pruckmayer M, Raderer M: The role of chemotherapy and radiation in the management of biliary cancer: a review of the literature. Eur J Cancer 34 (7): 977-86, 1998.
Unresectable, Recurrent, or Metastatic Gallbladder Cancer
These patients are not curable. Significant symptomatic benefit can often be achieved with relief of biliary obstruction. A few patients have very slow-growing tumors and may live several years. Patients with unresectable, recurrent, or metastatic gallbladder cancer should be considered for inclusion in clinical trials whenever possible. Information about ongoing clinical trials is available from the NCI website.
Treatment options:
- Relief of biliary obstruction is warranted when symptoms such as pruritus and hepatic dysfunction outweigh other symptoms from the cancer. The preferred approach is percutaneous transhepatic drainage or endoscopically placed stents;[1 ] surgical bypass may be appropriate when these approaches are infeasible.
Palliative radiation therapy after biliary drainage may be beneficial, and patients may be candidates for inclusion in clinical trials that explore ways to improve the effects of radiation therapy with various radiation sensitizers such as hyperthermia, radiosensitizer drugs, or cytotoxic chemotherapeutic agents.
- Systemic chemotherapy is appropriate for selected patients with adequate performance status and intact organ function. Fluoropyrimidines, gemcitabine, platinum agents, and docetaxel have been reported to produce transient partial remissions in a minority of patients.
A randomized, phase III study of up to 6 months of gemcitabine versus gemcitabine and cisplatin in 410 patients with unresectable, recurrent, or metastatic gallbladder cancer demonstrated an improvement in median overall survival (OS) among patients treated with combination therapy (11.7 months vs. 8.1 months; HR, 0.64; [95% confidence interval, 0.52-0.80], P < .001).[2 ][Level of evidence: 1iiA] A similar median OS benefit was demonstrated in all subgroups, including 149 patients with gallbladder cancer. Grade 3 and 4 toxicities occurred with similar frequency in both study arms, with the exception of increased hematologic toxic effects in patients randomly assigned to gemcitabine-cisplatin and increased hepatotoxicity in patients randomly assigned to single-agent gemcitabine.
A multi-institutional, randomized, phase III study (NCT01149122) of advanced biliary cancers that evaluated the benefit of chemotherapy (gemcitabine and oxaliplatin) with or without erlotinib failed to meet its endpoint of improvement in OS and progression-free survival.[3 ][Level of evidence: 1iiD]
Other drugs and drug combinations await evaluation in randomized trials.
Current Clinical Trials
Use our advanced clinical trial search to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. General information about clinical trials is also available.
- Baron TH: Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med 344 (22): 1681-7, 2001.
- Valle J, Wasan H, Palmer DH, et al.: Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 362 (14): 1273-81, 2010.
- Lee J, Park SH, Chang HM, et al.: Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 13 (2): 181-8, 2012.
Changes to This Summary (02 / 02 / 2017)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
General Information About Gallbladder Cancer
Updated statistics with estimated new cases and deaths for 2017 (cited American Cancer Society as reference 1).
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
About This PDQ Summary
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of gallbladder cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
- be discussed at a meeting,
- be cited with text, or
- replace or update an existing article that is already cited.
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewer for Gallbladder Cancer Treatment is:
- Jennifer Wo, MD (Massachusetts General Hospital)
Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's Email Us. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Adult Treatment Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
Permission to Use This Summary
PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary]."
The preferred citation for this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Gallbladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/gallbladder/hp/gallbladder-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389371]
Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online, a collection of over 2,000 scientific images.
Based on the strength of the available evidence, treatment options may be described as either "standard" or "under clinical evaluation." These classifications should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website's Email Us.
Last Revised: 2017-02-02


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The Alzheimer's Drug Discovery Foundation Launches ADDF Access
Optimizing the Use of CROs to Accelerate Preclinical Drug Discovery
The Alzheimer's Drug Discovery Foundation (ADDF) today launched the ADDF ACCESS program to give the academic and small biotechnology communities online access to a marketplace of contract research organizations (CROs) and the industry standard preclinical drug discovery and development services they provide. Additionally, ADDF ACCESS offers educational resources and a network of expert consultants and collaborators who focus on drug discovery for diseases of the central nervous system (CNS) (www.alzdiscovery.org/access/).
A related editorial will be published today in Nature Reviews Drug Discovery (http://www.nature.com/nrd) providing recommendations to optimize the use of CROs by academia and small companies. The authors of this article were expert participants in a recent advisory panel convened by the ADDF to provide recommendations for identifying, contracting and managing partnerships with CROs.
"Improving the efficiency of this interaction will accelerate drug discovery programs, improve their quality and efficiency, increase the probability of success and add value to attract pharmaceutical partners and investors," said Rachel Lane, PhD, Assistant Director, Scientific Affairs at the ADDF.
"ADDF ACCESS is a virtual networking program that effectively brings together academic and industry drug discovery scientists to create interdisciplinary teams that are essential for success in the development of new drugs," said Howard Fillit, MD, Executive Director for the ADDF and Chief Science Officer. "As a foundation, ADDF is strategically positioned to facilitate these critical interactions through ADDF ACCESS."


text: Some months ago, while traveling in Colombia, I encountered the fruit Granadilla for the very first time. It's a variety of passion fruit, but very sweet and mild rather than sour. It quickly became a favourite and as my husband wasn't too fond of it I always got his Granadilla too whenever it was served to us as a dessert.


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Looking ahead? See our list of Summer Farmers Markets including those opening in the coming weeks.
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|Farmers Market
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Maserati Bora for saleLook at this stunning Maserati Bora from 1973 that we now offer for sale. This is a very original car in wonderful condition. See more of it in the "for sale" section.
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You'll also receive support for any further education you decide to undertake. One of our leading programs is designed to structure exam leave and the provision of monetary support for your pursuit of professional certifications.
Helping you excel through education ensures not only your personal development but that of the firm, forming part of Deloitte's mission to be Always One Step Ahead.
Mentoring Program
In any job the entrance phase is always the most daunting.
However your first step will never be one you take alone. In fact, none of your steps will ever be taken alone. With our comprehensive career planning and performance reviews you will always be guided by a counsellor.
Together, you'll meet on a quarterly basis to review career goals and objectives as well as comparing performance to previously established benchmarks. Our human resources team is also always ready to help with any inquiries you may have at any time.


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WASHINGTON (AP) Charlie Villanueva scored 19 points, Rodney Stuckey added 18 and the Detroit Pistons got their second win in as many nights over the Washington Wizards, 96-87 on Saturday night.
It was only the second time this season that Detroit had won consecutive games.
The Wizards, who trailed throughout the game, have lost seven straight and dropped to an NBA-worst 3-22.
For the second straight night, Detroit had 58 rebounds, a season high.
The Wizards closed to 88-81 with 6:15 to play, but didn't score for nearly four minutes as Detroit built a 94-81 lead with 2:55 to play.
Jordan Crawford, who scored his only point of the first half with 1:05 to play, scored 20 in the second half to lead Washington with 21. Emeka Okafor had 14 points and tied a season high with 14 rebounds.


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Your phone model is: Sonyericsson Aino(U10)
Version for your phone is: UC Browser 18.104.22.1689
Updated date: 2014-06-23
Change phone model:
UC Browser is a pioneer among mobile browsers. It has more than 400 million users around the world. It is speedy, safe, stable, data usage saving and with proprietary kernel. It is the mobile browser with the best reputation. UC Browser is one of the applications that most users would install on their phones. Come and give it a try!
UC Browser is the leading mobile internet browser with more than 400 million users across more than 150 countries and regions. This product is currently available on all major operating platforms in 7 different languages.
Sony Mobile Communications AB (formerly Sony Ericsson Mobile Communications AB) is a multinational mobile phone manufacturing company headquartered in Tokyo, Japan, and a wholly owned subsidiary of Sony Corporation. It was founded on October 1, 2001 as a joint venture between Sony and the Swedish telecommunications equipment company Ericsson, under the name Sony Ericsson.
Sonyericsson Aino(U10) is an non-touchscreen phone manufactured by Sonyericsson, with a resolution of 240X432.Sonyericsson Aino(U10) users can download the latestUC browserfor Sonyericsson Aino(U10) via UCWeb's official website.


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How to get T-Mobile's $30/month unlimited data smartphone plan
If you don't talk on your mobile phone much, but like to use apps, navigation, or any other kind of data-absorbing functions, you know how important a good data plan is. What if we told you that you could pay about $30/month for unlimited data, with the first 5MB at top speeds? Now we're talking!
The Consumerist recently highlighted the low-cost plan, so we thought it was a good opportunity to let everyone know how to get it. The monthly plan is for 100 minutes of talk, with unlimited data and text. This is great for data hogs who may not need to chat much. Data consumption with decreased talk minutes are increasingly the need of many users, which is why we see data sharing plans from carriers like Verizon.
Keep in mind, this is on the T-Mobile network, which may not be the best in your area. We suggest using Open Signal Maps before considering any new plan, as it will give you a detailed map of which carriers and what service works best in your area.
Finding the plan
On a personal note, this is the plan I have, and can say it is a really nice option for me. I make most calls at home, via Google Talk (I have kept Google talk alive in Gmail until Hangouts can make calls). I rarely make phone calls on my phone, so 100 minutes of talk per month is fine for me. I do use navigation quite a bit when out and about, and also subscribe to All Access on Play Music.
Finding the plan can be tricky, as T-Mobile doesn't make it immediately noticeable. To find it, you'll need to visit T-Mobile's prepaid site, which is also not easy to locate from their main site. After you find the landing page, you'll see a header of "Unlimited talk + text + web plans". Tucked at the bottom of that little box, you'll see a "Browse plans" link. Once you click that, you're on your way.
After navigating to that page, you'll see a listing for the plan. There is no way to select it, but if you navigate back towards the top of that page, you'll see the header "Get Started". Under that, there will be the option to shop for phones, or bring your own device. This is the turning point.
Via: Android Authority


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Get extra coverage with personal umbrella insurance
Umbrella policies aren't just for the wealthy—they're for anyone who has assets that might be at risk if they are sued. If you don't have enough liability coverage to resolve a claim or lawsuit, the person bringing the action might go after your other assets. A personal umbrella policy can cover damage claims that exceed home, auto, and any other insurance policies you may have.


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Is Processed Fructose Stealing Your Smarts?
By Michael A. Smith, MDA new study from UCLA (University of California, Los Angeles) shows that what you eat can influence how you think.
Specifically, the researchers were worried about all of the fructose in the American diet. They reported that eating a diet heavy in processed fructose over the long term alters your brain's ability to learn and remember information.
Let's start by looking at fructose itself. What is it, and is it ever okay to eat it?
Fructose is a Natural Fruit SugarFructose in its natural form is called fruit sugar. It's a simple sugar found in many plants and is one of the three dietary monosaccharides, along with glucose and galactose. These simple sugars are absorbed directly into the bloodstream during digestion and can be used for immediate cellular energy.
From plant sources, fructose is found naturally in honey, tree and vine fruits, flowers, berries and most root vegetables. In plants, fructose may be present naturally as the monosaccharide or as a component of sucrose.
Here's the point we're trying to make: Fructose in its natural form is not the problem. In nature, sugars can be found in foods that are also rich in antioxidants and fiber. And those accompanying nutrients can help minimize the impact of natural sugar.
The UCLA researchers agree with us. They said, "We're less concerned about naturally occurring fructose in fruits, which also contain important antioxidants. We're more concerned about the fructose in high-fructose corn syrup, which is added to manufactured food products as a sweetener and preservative."1
So, yes, natural sources of fructose are okay. It's the all of the fructose found in processed foods and syrups that is causing the problem. The stuff is literally everywhere.
Processed Fructose Lowers Brain PowerUCLA researchers studied two groups of rats that each consumed a fructose solution as drinking water for six weeks. Some of the rats were also given flaxseed oil concentrated with the omega-3 fat, DHA (docosahexaenoic acid). The researchers wanted to measure the impact of high dietary fructose (like what we get in syrups and processed foods) on brain function and whether or not DHA could counter any negative effects.1
Why DHA? Because research is showing that this omega-3 fat in particular is essential for healthy brain and nerve cell connections. And the more brain cell connections you have, the better your memory and problem solving prowess will be.
The rats were tested using a standard maze with visual landmarks before administering the fructose solution or fructose/DHA solution. Six weeks later, after administering the solutions, they were tested again using the same maze. Here's what the researchers found:1
- The fructose-only rats were slower and their brains showed a decline in synaptic activity (that's the level of activation between brain cells). Their brain cells had more trouble signaling each other, disrupting the rats' ability to think clearly and recall the route they had learned six weeks earlier.
- The fructose-only rats developed signs of insulin resistance, a hallmark of type 2 diabetes. The UCLA scientists suspect that high doses of fructose can block insulin's ability to regulate how cells use and store sugar for energy.
- The fructose/DHA rats completed the maze significantly faster than the rats given fructose only.
Now, let's be fair and balanced here. This was a rat study that looked at fructose from no particular source. But we do agree with the researchers' statement that natural fructose found in fruits is better for you because it comes with antioxidants and fiber. Fructose found in sugary drinks and almost all processed foods is devoid of those additional nutrients and probably has an overall negative effect on your health.
So, what do you think about fructose, specifically processed fructose? Do you agree with the National Corn Growers Association that it's perfectly safe and no different from table sugar?
- J Physiol. 2012 May 15;590(Pt 10):2485-99. Epub 2012 Apr 2.


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5. This one can be adjusted for a longer skirt if needed.
6. A regular pencil or a fabric pencil, not a marker. If you use a fabric marker and apply Fray Check to it, it will smear and get all over.
*Starting and ending the basting stitches at each seam, gives you more places to gather from, which makes it easier, you'll see.
Then stitch the right side of the ribbon down. Fold the ribbon under to finish the end.
6. Repeat 1-5 to add the middle tier to the top tier. This is what the top tier at the ribboned seams should look like:
Almost done. . .
Now, if you have skirt such as this:
Add the lovely petticoat you just made:
And you get something like this:
Also, when you are done with yours, I would love to see it. Send me a picture to email@example.com. And if you want I will post it on my blog (with a link to yours), so you can show it off, because unfortunately all this hard work is just going under something else.
I made another petticoat with tulle and eyelet fabric. Here's a mini tutorial for that one.


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Why common errors in residential, commercial, and industrial wiring can lead to fire and electric shock hazards.
Proper grounding and bonding prevent unwanted voltage on non-current-carrying metal objects, such as tool and appliance casings, raceways, and enclosures, as well as facilitate the correct operation of overcurrent devices. But beware of wiring everything to a ground rod and considering the job well done. There are certain subtleties you must follow to adhere to applicable NEC rules and provide safe installations to the public and working personnel. Although ground theory is a vast subject, on which whole volumes have been written, let's take a look at some of the most common grounding errors you may run into on a daily basis.
1. Improper replacement of non-grounding receptacles. Dwellings and non-dwellings often contain non-grounding receptacles (Photo 1). It's not the NEC's intent to immediately replace all noncompliant equipment with each new edition of the Code. In fact, it's perfectly fine to leave the old "two prongers" in place. But because an intact functioning equipment ground is such an obvious safety feature, most electricians tend to replace these old relics whenever possible.
There are several ways you can complete this upgrade, many of which are erroneous and strictly against the Code. For example, never apply the following non-NEC-compliant solutions:
Hook up a new grounding receptacle on the theory that this is a step in the right direction. This can lead future electricians and occupants to believe they are fully protected by a non-functioning ground receptacle.
Connect the green grounding terminal of a grounded receptacle via a short jumper to the grounded neutral conductor. This practice is totally noncompliant and dangerous because when a load is connected, voltage will appear on both the neutral and ground wires. Therefore, any noncurrent-carrying appliance or tool case will become energized, causing shock to the user, who is typically partially or totally grounded.
Run an individual ground conductor from the green grounding terminal of a grounded receptacle to the nearest water pipe or other grounded object. This "floating ground" presents various hazards. It is likely that this ground rod of convenience will have several ohms of ground resistance so that, in case of ground fault within a connected tool or appliance, the breaker will not trip — and exposed metal will remain energized.
Run an individual ground conductor back to the entrance panel and connect it to the neutral bar or grounding strip. This solution is somewhat better, but still noncompliant. Any grounding conductor must be within the circuit cable or raceway. One objection is that an individual conductor could be damaged or removed in the course of work taking place in the future.
What are the correct ways to handle this type of situation, when you find yourself working with non-grounded receptacles?
The best approach is to run a new branch circuit back to the panel, verifying presence of a valid ground. Because this procedure usually involves fishing cable behind walls or, in some cases, removing and then replacing wall finish, it's not always feasible unless a total rewiring job is being performed.
Another possibility is to replace the two-prong receptacle with a GFCI. Hook up the two wires and leave the grounding terminal unattached. Included with the GFCI is a sticker that says, "No equipment ground." This sticker must be in place so that future electricians and users are not misled. The thinking behind this strategy is that even though the tool or appliance case is not grounded, the GFCI will provide enhanced safety. It's important to note that a GFCI functions properly without the presence of a grounding conductor. The device compares current flowing through the hot and neutral conductors and trips if a difference of more than 5 milliamps is detected.
Non-grounding receptacles are still manufactured. If replacement is necessary (and acquiring a ground is not feasible), installation of a new non-grounding receptacle is a way to go.
2. Installation of a satellite dish, telephone, CATV, or other low-voltage equipment without proper grounding. If you look at a number of satellite dish installations in your neighborhood, a certain percentage will inevitably not be grounded at all. Of those that are grounded, there is still a high probability many are not fully compliant. For example, the grounding electrode conductor could be too long, too small, have unlisted clamps at terminations, have excess bends, or be connected to a single ground rod but not be bonded to other system grounds.
For NEC purposes, a satellite dish is an antenna, and installation requirements are found in Chapter 8, Communications Systems. Article 810, Radio and Television Equipment, details the installation requirements. Part II deals with receiving Equipment — Antenna Systems. This type of equipment, which includes the satellite dish, must have a listed antenna discharge unit, which can be either outside the building or inside between the point of entrance of the lead-in conductors and the receiver — and as near as possible to the entrance of the conductors to the building. The antenna discharge unit is not to be located near combustible material and certainly not within a hazardous (classified) location.
The antenna discharge unit must be grounded. The grounding conductor is usually copper; however, you can use aluminum or copper-clad aluminum if it's not in contact with masonry or earth. Outside, aluminum or copper-clad aluminum cannot be within 18 inches of the earth.
The grounding conductor can be bare or insulated, stranded or solid, and must be securely fastened in place and run in a straight line from the discharge unit to the grounding electrode (Photo 2). If the building has an intersystem bonding termination, the grounding conductor is to be connected to it or to one of the following:
Grounding electrode system.
Grounded interior metal water piping system within 5 feet of point of entrance to the building.
Power service accessible grounding means external to the building.
Metallic power service raceway.
Service equipment enclosure.
Grounding electrode conductor or its metal enclosure.
If this grounding conductor is installed within a metal raceway, you must bond the metal raceway to it at both ends. For this reason, if raceway is deemed necessary for extra protection, UL-listed PVC (rigid non-metallic conduit) is generally used. The grounding conductor must be no smaller than 10 AWG copper.
Where separate electrodes are used, you must connect the antenna discharge unit grounding means to the premises power system grounding system by a 6 AWG copper conductor. Needless to say, grounding a satellite dish goes well beyond simply driving a ground rod at the point of entrance.
Grounding for CATV is slightly different. Typically, CATV is brought into the building via coaxial cable, which has a center conductor, insulating spacer, and outer electrical shield. Because of the spacer, capacitive coupling is diminished so that the cable provides a high-quality signal for data, voice, and video transmission. Improper grounding of coaxial cable used for CATV is very common.
There is no antenna discharge unit as required for satellite dish installation. Instead, the shield of the coaxial cable is connected to an insulated grounding conductor that is limited to copper but may be stranded or solid. The grounding conductor is 14 AWG minimum so that it has current-carrying capacity approximately equal to the outer shield of the coaxial cable.
The major distinguishing characteristic is that for one- and two-family homes the grounding conductor cannot exceed 20 feet in length and should preferably be shorter. If a grounding electrode such as the Intersystem Bonding Termination is not within 20 feet, it is necessary to drive a ground rod for that purpose. However, even after this dedicated grounding means is established, in order to be NEC-compliant, the installation must have a bonding jumper not smaller than 6 AWG or equivalent, which is connected between the CATV system's grounding electrode and the power grounding electrode system for the building. Omitting this jumper is a serious Code violation, second only to no grounding at all. You must bond all system grounds, antenna, power, CATV, telephone, and so on with a heavy bonding jumper.
3. Non-installation of GFCIs where required. Recent Code editions have mandated increased use of GFCIs. In dwelling units, GFCIs are required on all 125V, single-phase, 15A and 20A receptacles in: bathrooms; garages; accessory buildings with a floor at or below grade level not intended as a habitable room, limited to storage, work and similar areas; outdoors; kitchens along countertops; within 6 feet of outside edge of laundry, utility, and wet bar sinks; and boathouses. In other than dwelling units, GFCIs are required on all 125V, single-phase, 15A and 20A receptacles in bathrooms, kitchens, rooftops, outdoors, and within 6 feet of the outside edge of sinks.
Other areas requiring the use of GFCIs include: boat hoists, aircraft hangers, drinking fountains, cord- and plug-connected vending machines, high-pressure spray washers, hydromassage bathtubs, carnivals, circuses, fairs (and the like), electrically operated pool covers, portable or mobile electric signs, electrified truck parking space supply equipment, elevators, dumbwaiters, escalators, moving walks, platform lifts/stairway chairlifts, fixed electric space heating cables, fountains, commercial garages, electrical equipment for naturally and artificially made bodies of water, pipeline heating, therapeutic pools and tubs, boathouses, construction sites, health-care facilities, marinas/boatyards, pools, recreational vehicles, sensitive electronic equipment, spas, and hot tubs.
4. Improperly connecting the equipment-grounding conductor to the system neutral. You must connect a grounded neutral conductor to normally noncurrent-carrying metal parts of equipment, raceways, and enclosures only through the main bonding jumper (or, in the case of a separately derived system, through a system bonding jumper). Make this connection at the service disconnecting means, not downstream. When you buy a new entrance panel, a screw or other main bonding jumper is usually included in the packaging. Attached to it are instructions stipulating that it is to be installed only when the panel is to be used as service equipment.
It's a major error to install a main bonding jumper in a box used as a subpanel fed by a 4-wire feeder. It's also wrong not to install it when the panel is used as service equipment. Improper redundant connection of grounded neutral to equipment-grounding conductors can result in objectionable circulating current and presence of voltage on metal tool or appliance casings. You should connect grounded neutral and equipment-grounding conductors at the service disconnect. Then separate them — never to rejoin again. Additional optional ground rods may be connected anywhere along the equipment-grounding conductor but never to the grounded neutral.
5. Improperly grounding frames of electric ranges and clothes dryers. Prior to the 1996 version of the NEC, it was common practice to use the neutral as an equipment ground. Now, however, all frames of electric ranges, wall-mounted ovens, counter-mounted cooking units, clothes dryers, and outlet or junction boxes that are part of these circuits must be grounded by a fourth wire: the equipment-grounding conductor.
An exception permits retention of the pre-1996 arrangement for existing branch-circuit installations only where an equipment-grounding conductor is not present. Several other conditions must be met. If possible, the best course of action is to run a new 4-wire branch circuit from the panel. If you must keep an old appliance, be sure to remove the neutral to frame bonding jumper if an equipment-grounding conductor is to be connected.
6. Failure to ground submersible well pumps. At one time, submersible well pumps were not required to be grounded because they were not considered accessible. However, it was noted that workers would pull the pump, lay it on the ground, and energize it to see if it would spin. If, due to a wiring fault, the case became live, the overcurrent device would not function, causing a shock hazard. The 2008 NEC requires a fourth equipment-grounding conductor that you must now lug to the top of the well casing. Many people assume that in a 3-wire submersible pump system one wire is a "ground." In actuality, submersible pump cable consists of three wires (plus equipment-grounding conductor) twisted together and unjacketed. Yellow is a common 240V leg, black is run, and red is start, which the control box energizes for a short period of time. Prior to the new grounding requirement, everything was hot.
7. Failure to properly attach the ground wire to electrical devices. Wiring daisy-chained devices in such a way that removing one of them breaks the equipment grounding continuity is a common problem. The preferred way to ground a wiring device is to connect incoming and outgoing equipment-grounding conductors to a short bare or green jumper. The bare or green insulated jumper is then connected to the grounding terminal of the device.
8. Failure to install a second ground rod where required. A single ground rod that does not have a resistance to ground of 25 ohms or less must be augmented by a second ground rod. Once the second ground rod is installed, it's not necessary for the two to meet the resistance requirement. As a practical matter, few electricians do the resistance measurement.
You cannot use a simple ohmmeter because that would require a known perfect ground. Special equipment and procedures are needed, so it's common practice to simply drive a second ground rod. You must locate them at least 6 feet apart. Greater distance is even better (Figure). If both rods and the bare ground electrode conductor connecting them are directly under the drip line of the roof, ground resistance will be further diminished. This is because the soil along this line is more moist. Ground resistance greatly increases when soil becomes dry.
9. Failure to properly reattach metal raceway that is used as an equipment-grounding conductor. When equipment is relocated, replaced, or removed for repair, many times equipment ground paths are broken. If these connections are not fixed, there's an accident waiting to happen (Photo 3). Setscrews, locknuts, and threads should be fully engaged and continuity tests performed before equipment is put back into service. Dirt and corrosion can also compromise ground continuity.
NEC Article 250.4 requires that electrical equipment, wiring, and other electrically conductive material likely to become energized shall be installed in a manner that creates a low-impedance circuit from any point on the wiring system to the electrical supply source to facilitate the operation of overcurrent devices.
10. Failure to bond equipment ground to water pipe. Improper connections are often seen in the field. Screw clamps and other improvised connections do not provide permanent low impedance bonding. The worst method would be to just wrap the wire around the pipe or to omit this bonding altogether.
In a dwelling, a conductor must be run to metallic water pipe, if present, and connected with a UL-listed pipe grounding clamp (Photo 4). This bonding conductor is to be sized according to Table 250.66, based on the size of the largest ungrounded service entrance conductor or equivalent area for parallel conductors.
Herres is a licensed master electrician in Stewartstown, N.H. He can be reached email@example.com.


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(888) 768-5759
As per our Shipping and Returns Policy, custom cuts and fabricated parts are non-returnable. If you need an over- or undersized item, note it under "Comments" during Checkout. Cut-to-size orders have an acceptable cut tolerance of 1/8" (0.125"), so clarify if the adjustment is to be made on the (+) or (-) side of the saw blade. Please review our full return and shipping policy here.
Since custom cuts and fabricated parts are non-refundable, be very careful while measuring your dimensions. As each cut is nominal, even the slightest miscalculation could be costly.
Extend your tape measure several inches to find the 1 and 2 inch markers. In between the inch markers you'll find 16 equally spaced tick marks.
Measure by counting the increments beyond the nearest inch. As the increments decrease, so does the length of the mark. For example, 1/2" has a bigger mark than 1/4" which has a bigger mark than 1/8". The smallest mark follows at 1/16". Please be aware that some measuring tapes may have even smaller increments.
The sliding end hook is designed for two different types of measurements. An outside measurement (where the hook of the tape hangs over an edge), requires the hook to slide out a bit to account for the thickness of the material. When making an inside measurement (where the hook will push up against a surface), the clip slides in, again, accounting for its thickness. The measuring tape self-adjusts to guarantee an accurate measurement (as far as the tape is concerned).
Marine Board HDPE (or High Density Polyethylene) is a lightweight, tough thermoplastic, environmentally stabilized to withstand the most challenging marine environments.
Marine Board HDPE is a superior alternative to wood at a very economical price. It's resistant to salt water, a wide range of chemicals and UV exposure, and unlike other alternatives, Marine Board doesn't splinter, crack, delaminate, rot, swell or absorb water. Even under heavy foot traffic on yacht decks, Marine Board remains virtually maintenance free.
Interstate Plastics also carries King Starboard® HDPE Marine Board, the industry standard for extreme outdoor weather performance. Interstate Plastics provides Marine Board as a more economical version of Starboard®, without sacrificing material specifications or performance, and also offers varying grades of Marine Board plastic including King StarBoard®, King StarBoard® A/S, King StarBoard® XL, and King Starlite® XL Utility.
Wear ResistanceWith a self-lubricating formula and a high sliding resistance alongside excellent long-term durability and weather resistance, Marine Board HDPE is an ideal marine plastic for a variety of applications including replacing wood, metal or laminate walkways, hatches, walkways, cabinetry and countertops as well as ship and boat components regularly exposed to harsh outdoor environments.
Textured SurfaceIn addition to its resistance to marine and other outdoor conditions, Marine Board has a decorative, textured surface that does not show wear, dirt or scratches.
Salt Water and Moisture ResistancesHDPE Marine Board is a lightweight and extremely tough, chemically resistant plastic. It does not absorb water and has a good sliding abrasion resistance in addition to a specialized self-lubrication. Unlike many other marine-based materials, Marine Board is environmentally stabilized to resist salt water, and will not rot or degrade.
[PDF Spec Sheet]
Interstate Plastics Marine Board is a very light and extremely tough, chemically resistant plastic. It does not absorb water and has good sliding abrasion resistance in addition to being self-lubricating.


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More Gourmet
In today's food court column, I bemoaned the recent passing of Gourmet magazine.
I also noted a few other ways to get your Ruth Reichl (and Doc Willoughby and Ian Knauer and Zanne Stewart and…) fix, including their new cookbook and television show.
I mentioned that KRMA-Channel 6 is running "Gourmet's Diary of a Foodie," on Saturdays at 11. But it's not the only outlet in town with the program on the schedule. KBDI-Channel 12 is also featuring the show — in fact, you can catch back-to-back episodes today at 4 and 4:30 p.m.
In my opinion, both public TV stations here offer the best food and cooking-related programming in Denver. Think Rick Bayless's "Mexico: One Plate at a Time," Ming Tsai's "Simply Ming," Lidia Bastianich's "Lidia's Italy," reruns of Julia Child and Jacques Pepin. All good.
Get a look at both station's programming schedules at their web sites.
Click here for KBDI: www.kbdi.org


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Use our patient tools for secure, convenient, 24/7 access. Learn more
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The staff at Adventist Midwest Health's Rehabilitation Services specialize in individualized physical rehabilitation treatment programs for our unique array of patients.
We commit to your recovery by:
For more information on our rehab services, click on one of the 10 Adventist Rehabilitation Services locations throughout the Chicago metropolitan area listed below:
*Both fitness training and massage are open to former patients and to the community.