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To evaluate sleep modifications induced by chronic benzodiazepine (BDZ) abuse.
Cohort study, comparison of sleep measures between BDZs abusers and controls. Drug Addiction Unit (Institute of Psychiatry) and Unit of Sleep Disorders (Institute of Neurology) of the Catholic University in Rome. Six outpatients affected by chronic BDZ abuse were enrolled, (4 men, 2 women, mean age 53.3 ± 14.8, range: 34-70 years); 55 healthy controls were also enrolled (23 men, 32 women, mean age 54.2 ± 13.0, range: 27-76 years). All patients underwent clinical evaluation, psychometric measures, ambulatory polysomnography, scoring of sleep macrostructure and microstructure (power spectral fast-frequency EEG arousal, cyclic alternating pattern [CAP]), and heart rate variability.
BDZ abusers had relevant modification of sleep macrostructure and a marked reduction of fast-frequency EEG arousal in NREM (patients: 6.6 ± 3.7 events/h, controls 13.7 ± 4.9 events/h, U-test: 294, p = 0.002) and REM (patients: 8.4 ± 2.4 events/h, controls 13.3 ± 5.1 events/h, U-test: 264, p = 0.016), and of CAP rate (patients: 15.0 ± 8.6%, controls: 51.2% ± 12.1%, U-test: 325, p < 0.001).
BDZ abusers have reduction of arousals associated with increased number of nocturnal awakenings and severe impairment of sleep architecture. The effect of chronic BDZ abuse on sleep may be described as a severe impairment of arousal dynamics; the result is the inability to modulate levels of vigilance.
Mazza M; Losurdo A; Testani E; Marano G; Di Nicola M; Dittoni S; Gnoni V; Di Blasi C; Giannantoni NM; Lapenta L; Brunetti V; Bria P; Janiri L; Mazza S; Della Marca G. Polysomnographic findings in a cohort of chronic insomnia patients with benzodiazepine abuse. J Clin Sleep Med 2014;10(1):35-42.
Benzodiazepines (BDZs) are used as anxiolytics, hypnotics, anticonvulsants, muscle relaxants, and to induce anesthesia. Although guidelines emphasize that BDZs are not drugs of first choice and should only be used short term (recommended use should not exceed 4-6 weeks' duration), their use beyond the licensed duration is common.1 Within weeks of chronic use, tolerance may occur, leading to unwanted dose increases, and withdrawal becomes apparent once the drug is no longer available: these conditions are both indicative of BDZ dependence.2 BDZs are also drugs of abuse, either on their own or in conjunction with opioids and stimulants. The diagnosis of addiction is made in presence of compulsive use of the drug despite negative consequences.3 Recently it has been suggested that specific psychological and situational factors differentiate benzodiazepine addicts from non-addicted benzodiazepine users; in particular, benzodiazepine addiction might be associated with higher neuroticism, introversion, less effective coping mechanisms, previous accumulation of adverse life events, and/or inadequate BDZ treatment.4 These drugs may initially lead to prolonged total sleep time as a desired effect. Acute and short-term usage of BDZs is usually associated with a reduction of nocturnal wake time, subjective improvements of quality and depth of sleep, as well as improved sleep continuity and total sleep time as reported by polysomnography.5,6
Current Knowledge/Study Rationale: Chronic use and abuse of benzodiazepines is common in chronic insomnia patients, and it can lead to modifications of sleep patterns. The aim of this study was to evaluate the modifications of sleep, at macro- and microstructural level, in patients with abuse of benzodiazepines.
Study Impact: The study demonstrates that abuse of benzodiazepines has a severe impact on sleep: in particular, abusers have a marked reduction of arousals associated with increased number of nocturnal awakenings. These effects of chronic abuse may be related to a modification of the thalamic GABAergic gating of incoming stimuli during sleep.
Regarding the microstructure of sleep, BDZs lead to a reduction of slow frequencies and an increase of fast frequencies in the EEG.7–12 It has been demonstrated that BDZ users have less delta and theta activity than good sleepers.7 When compared to drug-free insomniacs, chronic BDZ users have less delta and theta activity only within the second sleep cycle.7 The effect of BDZs on sleep microstructure have been tested in a model of situational insomnia, i.e., a condition in which sleep is disrupted by exposing normal subjects to variable levels of noise.3 In this model, BDZs (as well as other non-BDZ hypnotics) are able to reduce the instability of NREM sleep (CAP rate) and have a protective action against the perturbation induced by white noise. All hypnotic drugs, including BDZs, may determine a significant decrease in EEG arousals, as measured by CAP parameters.13 The intake of BDZs may have a negative long-term effect on sleep.8
The aim of the present study was to evaluate the sleep structure and the pattern of arousability in a cohort of patients with chronic abuse of BDZs. For this reason, we evaluated the macrostructure of sleep (by means of nocturnal polysomnographic recordings), EEG power spectral analysis, pattern of arousal (by means of the cyclic alternating pattern [CAP] analysis), and autonomic activity (by means of heart rate variability analysis).
Six patients affected by chronic BDZ abuse were enrolled: 4 men and 2 women, mean age 53.3 ± 14.8 (range: 34-70 years). Patients were recruited consecutively from the Drug Addiction Unit of the Catholic University in Rome over 12 months (January to December 2012). Inclusion criterion was a diagnosis of by chronic BDZ abuse according to the criteria of the DSM-IVTR,14 not associated with other drug or substance dependence or abuse. Exclusion criteria were: presence of other medical, neurologic, or psychiatric diseases; presence of heart disease, arrhythmias, intake of cardiovascular active drugs; diabetes; uncontrolled hypertension; severe obesity (BMI > 35 kg/m2); chronic respiratory disease; obstructive sleep apnea syndrome; restless legs syndrome; and thyroid diseases. All patients underwent a full psychiatric, medical, and neurological evaluation. The diagnosis of BDZ abuse was assessed on a clinical basis, according to DSM-IV-TR criteria.14 All patients were still taking BDZs at the time of the sleep study.
Patients were compared with a control group of 55 healthy subjects, matched for age and sex: 23 men and 32 women, mean age 54.2 ± 13.0 (range: 27-76 years). Control subjects were healthy volunteers. Controls underwent a full medical and neurological evaluation and a hypnological interview to rule out present or previous history of sleep disorders. The same exclusion criteria were applied to patients and controls. To compare patients with controls of same age, we chose from the entire control group 3 subgroups, defined by age ranges: age 30-40 years (n = 12), age 50-60 years (n = 17), and age > 65 (n = 14). The study was approved by the local ethics committee; the study was designed according to the Helsinki Declaration of 1975. All patients and control subjects were fully informed, and all gave a written consent to participate.
All patient underwent a full clinical psychiatric evaluation, followed by a psychometric evaluation which included the following self-administered scales: Self-Administered Anxiety Scale (SAS#54),15 Beck Depression Inventory (BDI),16 Maudsley Obsessive Compulsive Inventory (MOCI),17 and Snaith-Hamilton Pleasure Scale (SHAPS).18
The SAS #54 is used in order to measure anxiety-related symptoms. It consists in a 4-point Likert-type scale, ranging from 1 to 4; higher scores correspond to higher levels of anxiety. The BDI is a 21-item validated instrument which measures characteristic attitudes and symptoms of depression. Scores range from 0 to 36; scores > 9 indicate mild to severe depression. The MOCI is a questionnaire with true-false format developed for evaluating obsessive-compulsive symptoms. The total score ranges between 0 (absence of symptoms) and 34 (maximum presence of symptoms). The SHAPS is a 14-item instrument that is used to measure hedonic capacity. Total scores range from 0 to 14; a higher total SHAPS score indicates higher levels of anhedonia.
Subjective evaluation of sleep quality was performed using the validated Italian version of the Pittsburgh Sleep Quality Index (PSQI).19 A global score > 5 was considered an indicator of poor sleep quality.20 The validated Italian version of the Epworth Sleepiness Scale (ESS)21 was used for the evaluation of excessive daytime sleepiness (EDS). A score > 9 was considered indicative of EDS. In all participants, patients and controls, an evaluation of the symptoms and clinical signs predictors of obstructive sleep apnea syndrome (OSAS) was performed by means of the Berlin Questionnaire.22 The clinical evaluation included the measure of neck circumference, body mass index (BMI), presence of habitual snoring, nocturia, morning headache, arterial hypertension, and apneas reported by the bed partner.
Twenty-four hour ambulatory (home-based) polysomnography was recorded. This recording technique was chosen in order to allow the patients to sleep in their habitual home setting.23 Recording montage included EEG leads filled with electrolyte applied to the following locations: F4, C4, O2 or F3, C3 O1; reference electrodes applied to the contralateral mastoid (M1); 2 EOG electrodes applied to the outer ocular canthus and referred to the contralateral mastoid, surface EMG of submental muscles, and EKG. Patients were asked to indicate in a sleep log the times of lights-off and lights-on. Patients were not asked to keep a defined schedule, but were left free to follow their spontaneous sleep-wake cycle. Sleep recordings were analyzed on computer monitor, and sleep stages were visually classified according to the criteria of the American Academy of Sleep Medicine (AASM).24
In order to compare subjective sleep quality with results of PSG, in the morning after the PSG recording, all subjects were asked to make an estimate of their sleep latency, sleep duration, number of awakenings, and sleep quality (according to a visual analogue scale [VAS] ranging from 0 to 100). In order to quantify the degree of sleep misperception we calculated a misperception index (MI),25 which was computed using the following formula25:
Sleep microstructure was evaluated by means of the detection of the fast-frequency EEG arousals and the analysis of CAP. Arousal were visually detected and quantified in accordance to the rules of the ASDA26; separate arousal indexes (number of arousals/time) were calculated for the entire sleep period time, NREM sleep, and REM. To evaluate the dynamics of arousal, we quantified the arousal fluctuations during sleep by means of CAP. CAP scoring was performed visually, according to the criteria established by Terzano et al.27 We quantified, within NREM sleep stages, the percentage of NREM sleep occupied by CAP. This ratio (CAP duration/NREM sleep), referred to as CAP rate, is the expression of the percentage of NREM sleep spent in a state of arousal instability.
Sleep EEG power spectral analysis was performed using a central monopolar scalp derivation (C4 or C3 referred to the contralateral mastoid M1 or M2). Recordings from leads placed centrally reflect EEG activity summed from both frontal and parietal regions and are considered the most sensitive for recording sleep related activity.28–31 Sleep power spectral analysis was performed on all NREM and REM stages. Each 30-sec epoch was visually screened for artifacts (EMG, temporary disconnect spikes, sweating, body movements), and epochs with artifacts were removed from further analysis. The remaining data were extracted from the scored sleep data file by a software program (Rembrandt SleepView, Medcare) and stored in separate ASCII file. Spectral analysis was performed on 1-sec windows with a frequency resolution of 0.5 Hz using a discrete Fourier transform algorithm. Four spectral bands (delta: 0.5-4 Hz, theta: 4.5-7.5 Hz, alpha: 8-13 Hz, beta: 13.5-30 Hz) were computed per 30-sec epochs for the entire recording period. These spectra were converted to data file for statistical analysis. To compensate for variability among subjects and across the night in EEG power, the spectra were normalized: values in each frequency band were expressed as percentage of the total power.
Heart rate variability (HRV) analysis is the measure of the variations of the interval between consecutive heart beats. It is widely accepted that HRV represents a quantitative marker of autonomic activity.32,33 The variations in heart rate may be evaluated by time domain methods and frequency domain methods.
The time domain methods are based on the detection of the QRS in a normal EKG and on the determination of normal-to-normal (NN) intervals, which are all the intervals between adjacent QRS sinusal complexes. Time domain variables used in the present study were heart rate and heart rate standard deviation.
The frequency domain methods consist in the calculation of the power spectral density analysis of a plot of consecutive NN intervals, called the tachogram. The auto-regressive method used in this study allowed an accurate estimation of power spectral density even on a small number of samples on which the signal is supposed to maintain stationarity. Two major spectral components were computed: low-frequency (LF) and high-frequency (HF). The HF component of the spectrum is widely recognized as a measure of vagal activity; the significance of LF component is more debated and seems to reflect at the same time both vagal and sympathetic activity. Overall, the LF/HF ratio may provide a quantitative estimation of the balance of the 2 branches of the autonomic nervous system (sympathovagal balance). The power of LF and HF bands was expressed in normalized units (nu), and the LF/HF ratio was calculated. Normalization was performed according to the formula:
Data obtained from the patient group were compared to those obtained from controls. The following sleep variables were compared: sleep latency (subjective and objective), total sleep time (subjective and objective), number of awakenings (subjective and objective), sleep efficiency, percentages of each sleep stage (N1, N2, N3, REM), sleep quality (subjective VAS), and CAP parameters. The HRV parameters considered were: HR, HR standard deviation, power of LF and HF bands in normalized units, and the LF/HF ratio. All sleep parameters and HRV measures were compared in these 2 groups by means of a nonparametric test (Mann-Whitney U-test). To avoid type I errors, a formal Bonferroni correction was applied to each family of comparisons. The threshold for significance was p = 0.05.
The mean duration of BDZ abuse was 3.5 years (range 2-6 years); BDZs used were lorazepam in 3 cases (mean daily dose: 7.8 mg), lormetazepam in 1 case (10 mg/day), alprazolam in 1 case (9 mg/day), and bromazepam in 1 case (31 mg/day). In all cases, BDZs were initially prescribed for the treatment of chronic insomnia.
All patients completed the study. In the subjective sleep evaluation, the mean PSQI score was 9.7 ± 4.1; all patients had PSQI ≥ 5, indicating poor subjective sleep quality. The ESS mean score was 3.7 ± 4.3; only one patient had ESS > 9, indicating excessive daytime sleepiness. As concerns the evaluation of anxiety symptoms, the mean SAS score was 48.7 ± 11.8 (2 patients were in the normal range, 3 had mild to moderate anxiety levels, 1 had a score indicating severe anxiety). Mean BDI was 5.5 ± 4.8: all patients but one were below the threshold indicating mild depression symptoms. The mean score of the MOCI was 12.7 ± 2.0; all patients had scores ≥ 10; these scores appear greater that those reported in literature for normal subjects.34 SHAPS scores were normal in all subjects. Results of psychometric and sleep quality tests are in Table 1.
Results of subjective sleep evaluation and psychometric tests in BDZ abusers
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As concerns sleep macrostructure, BDZ abusers, compared to controls, had shorter SOL (patients: 14.8 ± 18.0 min, controls: 31.3 ± 23.7, U-test: 249, p = 0.042) and increased WASO (patients: 133.4 ± 54.9 min, controls: 54.3 ± 40.7 min, U-test: 49, p = 0.005); no differences were observed in sleep stage percentages. Three patients had negative MI (indicating underestimation of sleep duration), and 2 patients had positive MI (indicating overestimation of sleep duration). The most relevant differences between the groups were observed in sleep micro-structure: BDZ abusers had lower indexes of fast-frequency EEG arousal in total sleep (patients: 7.0 ± 3.2 events/h, controls 13.6 ± 4.6 events/h, U-test: 292, p = 0.002), NREM (patients: 6.6 ± 3.7 events/h, controls 13.7 ± 4.9 events/h, U-test: 294, p = 0.002), and REM (patients: 8.4 ± 2.4 events/h, controls 13.3 ± 5.1 events/h, U-test: 264, p = 0.016). Moreover, BDZ abusers showed much lower levels of CAP time (patients: 46.5 ± 26.3 min, controls: 169.9 ± 49.5 min, U-test: 325, p < 0.001) and CAP rate (patients: 15.0% ± 8.6%, controls: 51.2% ± 12.1%, U-test: 325, p < 0.001). Results of polysomnographic and subjective sleep evaluations and the MI are in Table 2. Detailed results of sleep scoring and of CAP analysis are shown in Table 3 and Table 4. Sleep hypnograms of all patients enrolled are shown in Figure 1.
Objective and subjective measures in BDZ abusers
Results of polysomnographic analysis, arousal and CAP scores, and HRV analysis in patients and controls, and statistical comparison
Results of polysomnographic analysis, arousal and CAP scores, and HRV analysis in patients and controls
Twenty-four-hour sleep hypnograms in BDZ abusers
Relative spectral power analysis showed that abusers, as compared to controls, had more beta activity (patients 13.7% ± 11.3%, controls: 6.3% ± 5.7%, U-test: 44, p = 0.028) and less theta activity (patients 7.1% ± 4.4%, controls: 14.1% ± 4.0%, U-test: 179, p = 0.004), whereas no significant differences were measured in the relative amount of delta and alpha frequency bands. Detailed results of EEG power spectral analysis and comparison between patients and controls are shown in Figure 2.
Histograms of relative power spectra in BDZ abusers and controls
No significant differences were measured between BDZ abusers and controls in HRV parameters, with the exception of an increased HF component (patients: 48.2 ± 12.2 nu, controls: 35.2 ± 20.2 nu, U-test: 84, p = 0.050). Results of HRV analysis and comparison are shown in Table 3.
The objective of the present study was to investigate the modification of sleep pattern in chronic benzodiazepine abusers. Our results, though obtained from a small cohort of patients, seem to indicate that chronic BDZ abuse is associated with a peculiar pattern of sleep modification involving all levels of sleep organization.
As concerns sleep macrostructure, all patients showed poor subjective sleep quality, and polysomnography showed a marked increase in wake after sleep onset, associated with a gross disruption of the ultradian NREM/REM cycle (Figure 1). Despite these modifications in sleep macrostructure, the most relevant findings observed in the abuse cohort concerned microstructure: in particular, abusers, compared to controls had significantly lower indexes of EEG arousal in all sleep stages and lower indexes of NREM sleep instability, measured by CAP. It seems likely that also HRV modifications, and in particular an increased HF component (a marker of vagal tone) reflect the reduced activity of the autonomic branch of the arousal system.35 It has been reported that physiological fluctuations of the EEG arousal level influence cardiac autonomic activity in normal subjects during sleep.36
Arousal mechanisms comprise ascending networks projecting to the cerebral cortex, which stimulate cortical activation reflected as fast EEG activity, and descending networks project to the spinal cord, stimulating sensory-motor activation.37 Nevertheless, the role of arousal systems is not simply to induce and maintain wake and EEG activation. Arousal modulations act as a filter that gates the flux of information from the peripheral receptors to the cortex; anatomically, this filter is situated in the thalamocortical connections where the incoming signals are blocked or attenuated via synaptic inhibition.35 The major role in this mechanism is played by the thalamic reticular nucleus (TRN), which is a GABAergic nucleus placed between the thalamus and the cortex; it receives excitatory afferents from both cortical and thalamic neurons and sends inhibitory projections to nuclei of the dorsal thalamus. The TRN is involved in the regulation of bottom-up activities, including sensory gating and the transfer to the cortex of sleep spindles.38,39 This mechanism modulates the susceptibility of the cerebral cortex to all the activating stimuli. Seen in this view, the modulation of arousal levels during sleep have a complex role: that is, to allow prompt awakening from sleep, but at the same time, to allow processing of incoming inputs and to define a threshold of intensity or relevance, above which the stimulus may cause awakening and below which the stimulus is dumped and sleep may go on.
Fluctuations of arousal, measured by CAP, constitute therefore an essential mechanism in sleep regulation. CAP acts as a constitutive element of sleep architecture, since arousal fluctuations are essential to allow the physiological balance between slow wave and desynchronized sleep (NREM/REM). Moreover, arousal fluctuations are also essential to dump the effect of incoming disruptive stimuli and to protect sleep from external perturbations.
Our patients, overall, did not show abnormal scores on tests of psychological measures, with the exception of the MOCI. MOCI score is a measure of obsessive-compulsive behaviors. Several data indicate a strong association between obsessive-compulsive disorder (OCD) and drug abuse. Obsessive-compulsive personality disorder (OCPD) has been reported as the most common personality disorder in hypnotic-dependent adults40; the co-occurrence of substance abuse in OCD is higher than in other psychiatric disorders41; and, in a neuroimaging study, orbitofrontal connectivity was reduced in both OCD and drug abusers, suggesting that the two conditions share important cognitive and neurobiological substrates.35,41 Anxious hyper-arousability, a hallmark of Cluster C personality, and in particular of OCPD and avoidant features, is a sensitive risk marker for chronic insomnia, which was the initial reason for BDZ intake in all our patients.
Seen in this view, the effect of chronic BDZ abuse on sleep may be described as a severe modification of the thalamic gating of incoming stimuli and, consequently, of arousal dynamics. As result, abusers seem to have a reduced ability to elaborate afferent stimuli during sleep. Incoming stimuli in normal subjects can induce increased amount of arousal and CAP rate, without causing awakenings (as happens in the experimental model of noise-induced situational insomnia13,42). Conversely, in BDZ abusers, the chronic GABAergic stimulation makes the thalamic filter less adaptive: when exposed to stimuli, abusers either produce no response (and keep sleeping without arousal) or fully awaken. As a consequence, abusers have a marked reduction of arousals associated with increased number of nocturnal awakenings without relevant modifications of sleep macroarchitecture.
The main limitation of the present study is the small number of patients enrolled. This is a consequence of the strict inclusion criteria: we decided to study sleep in a cohort of patients with pure BDZ abuse not associated with consumption of other drugs or substances. Moreover, the sleep study lasted 24 hours: this could have prevented evaluation of the circadian sleep-wake cycle and its variability.
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
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Bulger's ex-partner tries to link him to pedophilia
Stephen "The Rifleman" Flemmi recounts the killing of his stepdaughter.
BOSTON — In his fourth straight day on the witness stand, Stephen "The Rifleman" Flemmi on Tuesday got into a heated exchange with the lawyer for accused Boston gangster James "Whitey" Bulger, pointing at the defendant to accuse him of pedophilia.
The allegation came as defense attorney Hank Brennan pressed Flemmi about "discrepancies" in his answers regarding the 1985 murder of his stepdaughter, Deborah Hussey.
Brennan challenged Flemmi for saying in 2006 that Bulger strangled Hussey with a rope, but later saying Bulger might have used his bare hands.
"I assumed it was a rope," Flemmi said. "That's what I thought. I wasn't sure ... I was in a state of anxiety at the time."
Throughout Bulger's 32-count racketeering trial, defense attorneys have worked to discredit key government witnesses by questioning their integrity and saying they have long histories of lying. Flemmi tried to explain why his accounts vary on what happened the day Hussey was murdered.
"There were 20 different attorneys questioning me (in 2006), so there are bound to be a few discrepancies here and there," Flemmi said.
As Bulger's closest partner from 1974 to 1994, Flemmi knows where the bodies are buried and could influence jurors on whether Bulger, 83, was involved in 19 murders, plus extortion and other crimes.
Flemmi, who is serving a life term in prison, portrayed Bulger as an egomaniac who overruled other gang members, insisted on murders to eliminate threats and killed troubled women with his own hands. He implicated Bulger in four murders.
Flemmi vehemently denied Brennan's allegation that it was Flemmi, not Bulger, who killed Hussey.
"Did you take a stick, put a rope around it and twist it around her neck?" Brennan asked.
"No," Flemmi said. "Absolutely not."
Flemmi explained that if he'd wanted to kill Hussey, he could have done it without bringing her to a house where Bulger was waiting, but he never wanted her killed.
At one point, Bulger's lawyer was pressing Flemmi about his own admission that he engaged in oral sex with Hussey, his teenage stepdaughter. Flemmi testified that Bulger strangled Hussey after she started using drugs, getting arrested and dropping their names when she got in trouble.
Brennan then suggested that Flemmi, not Bulger, killed Hussey after she told her mother he molested her. Brennan said Flemmi didn't want to be seen as a pedophile.
Flemmi then said that if Brennan wanted to talk about pedophilia, "right over there at that table," gesturing toward where Bulger was seated.
Bulger glanced at Flemmi but did not visibly react.
Flemmi, who began describing the Hussey killing in Monday's court appearance, said he took her to a South Boston house where, he testified, Bulger murder victims were already buried in the basement. Holding a rope, Bulger stepped out from behind a basement door. They tumbled to the floor as Bulger strangled her.
"It didn't take long," Flemmi said. "She was a very fragile woman."
Flemmi's account of Hussey's death had Bulger reclining upstairs on the floor while Flemmi dug a hole and removed her clothes and teeth to prevent identification. When asked why Bulger always seemed to rest while others cleaned up, Flemmi offered a theory.
"Maybe he was mentally or physically exhausted," Flemmi said. "Maybe he got a high on it — that was my interpretation."
Flemmi appeared agitated as Brennan pressed him about his past, including relationships with murder victims and his history of violence. Several times, Judge Denise Casper interrupted proceedings to remind Flemmi to limit his comments to answering questions.
Flemmi apologized several times for interjecting and for "trying to read (Brennan's) facial expressions."
"Your honor, I'm sorry," Flemmi said. "It's just sometimes I get a little emotional here."
Flemmi said he regrets all his murders except one: the 1965 murder of Edward "Punchy" McLaughlin. That's because Flemmi said he believed McLaughlin had shot Flemmi's brother, Jimmy, in the Boston gang wars that raged in the 1960s. Flemmi had attended to his wounded brother and never forgot what his brother said to him.
"I thought he was going to die," Flemmi said. "I had my ear to his mouth. I asked who shot him, and he told me." Flemmi later shot McLaughlin at a bus stop.
In cross-examination of Flemmi, Brennan suggested Flemmi killed Debra Davis for reasons that went beyond the fact that she knew Flemmi and Bulger had a relationship with corrupt FBI agent John Connolly.
Brennan suggested Flemmi was also jealous of Davis' relationship with another man. Brennan alleged Flemmi had tapped her phone. (Flemmi said Bulger tapped it.) He said Davis was found murdered just a few weeks after Flemmi learned that she "liked" a man named Gustav, whom she'd met on vacation in Mexico.
"Were you jealous Mr. Flemmi?" Brennan asked.
"Well, I'm a human being, I get a little jealous, but not enough to kill anybody," Flemmi said.
Flemmi assured Brennan that his questions reflect a lack of understanding of organized crime.
"You don't understand the underworld at all," Flemmi said at one point. "You're an attorney. I'm giving you the real world."
Contributing: The Associated Press


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kgj necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 94 diseños de 20 diseñadores freelance.
Hi. I've just finished my training as a Doula in order to assist women & couples in their aim for a beautiful, respectful, empowering birth & post-natal experience. I have travelled extensively, worked with women in Indonesia, gave birth in New Zealand & currently in UK - I am a global thinker & citizen! I am a committed environmentalist but certainly not wishy-washy; I am pragmatic, organised & ambitious with a real zest for life...
For my new venture I want to convey ideas of respect, companionship, support, partnership, the reality of childbirth (without glorifying horror or blood).
Many people have never heard of a Doula. Doulas are additional to a midwife or obstetrician; they're not medically trained but are there to give personal emotional & practical birthing support to an individual (the client). They attend home, birth centre or hospital births & their presence has been shown to significantly reduce the pain & length of labour & improve "bonding". There are three types of women/couple who employ a Doula:
1) first-timers (perhaps fearful, certainly nervous, maybe even anxious because of the stories & experiences they have heard of through friends or family of less than pleasant "birth journeys")
2) Women who have had caesarean births but who want to give birth vaginally (but medical professionals are being less than supportive so the women wants additional support in the birthroom)
3) Women who are giving birth or adapting to parenthood following traumatic personal experiences e.g. abuse.
I will be working in the UK rural district of Shropshire; based in Shrewsbury town. There are other doulas in the area; more business generally coming from the town dwellers than the other more rural folk. Doulas are hired by a family or woman on an individual basis; there's no religious or ethnic affinity, no economic or social boundaries. A woman can still birth with her partner or family in attendance; but often feels more comfortable with a doula there.
I want a striking logo; nothing too abstract. In addition to a website & literature, I intend to use this logo on my car's rear window, so I want something that people will instantly understand.
I like the idea of two hands cupping the scene of a woman giving birth. Something like the logo of Bumi Sehat <http://www.bumisehatbali.org> perhaps more contemporary. I also like the primitive or global art of women giving birth. The anthropoligst Sheila Kitzinger's book "Rediscovering Birth" has some great images <http://www.sheilakitzinger.com/BOOK…vering.htm>. I am comfortable with powerful birth images but I'm not sure whether most families employing a doula would be! If you are a parent &/or have witnessed or supported a birth, or just have children, what images are generated..? So, what portrayal would encourage you to contact me to care for your pregnant friend in her most dramatic, vulnerable, primal time of her life?
I need a 1-colour linear logo; nothing childlike, not sure whether to have mama-doula.com incorporated (or mama doula), probably beneath the logo image. Circular shaped designs are good, as are spirals. Common birthing visioning includes waves (for the contractions), opening flowers (to convey thoughts of the softening, contracting layers of a woman's cervix), the cycle of life. There needs to be space between any image of a doula, the woman & her baby. Njoy!
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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LAGUNA NIGUEL, Calif., June 13 (UPI) -- A California woman who hid her $23,000 diamond wedding ring in a watch box said her husband sold the box for $10 because he thought it was empty.
Racquel Cloutier, 31, of Laguna Niguel said she hid the ring in the watch box in her husband's closet to keep it safe from her 2-year-old twins while she was in the hospital giving birth to another child, ABC News reported Thursday.
Cloutier said she went looking for the ring when she returned home June 5 and was dismayed to learn her husband, Eric, had sold the seemingly empty watch box for $10 at a June 1 garage sale.
"I go into my husband's closet, can't find the box, and then he tells me he sold it. I said, 'You sold it? What do you mean you sold it?' I immediately started crying," Cloutier said.
"I'm very, very, very upset," she said. "I'm trying to remain optimistic but I don't know anymore. There's a small chance whoever bought the box doesn't know the ring is in there."
Cloutier said her husband described the buyer as a blonde woman.
She said her husband "feels really terrible" and they are hoping the ring will be returned.


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Social network helps college coaches find players
OMAHA, Neb. -- College baseball coaches have looked nearly everywhere for players.
Now, they can try somewhere else -- cyberspace.
From behind their desktop computers, or on their mobile devices, coaches are expanding their pool of potential recruits on a networking site akin to the popular LinkedIn for business professionals.
A coach in need of a power-hitting first baseman, a fleet outfielder or a hard-throwing left-hander can go to FieldLevel and put out the word. Chances are that within hours he'll hear back from high school and junior-college coaches eager to play matchmaker.
FieldLevel has gone from the brainchild of a couple of University of Southern California undergraduates five years ago to a tool that has gained popularity since winning "Best in Show" at the American Baseball Coaches Association trade show in January.
For a decade there have been sites and software that help coaches organize their recruiting efforts and keep track of prospects. FieldLevel is the first site where coaches can connect and help each other out.
Appalachian State recruiting coordinator Josh Jordan sent out a message this spring that he's desperate for right-handed pitchers who can throw at least 89 mph. Within 48 hours, Jordan had received profiles of 14 junior-college righties, and he said about seven are legitimate prospects.
"I would have never known about them otherwise," Jordan said. "We've got budget constraints like most everybody. It's not like we have scouts and national cross-checkers who can get on a plane and find guys in California."
Santa Monica, Calif.-based FieldLevel has signed up almost 1,000 coaches from colleges, high school and club programs since launching in July 2008. That includes coaches from more than 260 junior colleges and 100-plus Division I programs.
Brenton Callahan and Kai Sato, USC classmates who graduated in 2007, came up with the idea for a senior project in the Lloyd Greif Center for Entrepreneurial Studies.
Callahan, a baseball player, and Sato, a lacrosse player, attended small boarding schools and had difficulty attracting attention from college recruiters.
"We were both under-recruited and felt the personal pains of going through the process," Callahan said. "The problem came down to one thing: our coaches didn't know anybody."
Both accepted academic scholarships to USC, with Callahan walking on as a catcher and Sato playing on a club lacrosse team.
In developing their business plan, Callahan and Sato talked to lots of coaches and found out that their biggest challenge was coming up with an efficient way to find players.
Coaches typically are inundated with unsolicited emails and voice mails, and highlight DVDs often sit on their desks collecting dust. In old-school recruiting, thick manila folders and loose scraps of paper containing information on prospects often are strewn about offices.
Taking their cue from a host of popular social networking sites, Callahan and Sato looked for a way to connect coaches who wanted to promote their players to coaches who were looking for them.
Their concept was named 2007's top business plan in the USC business school. A group of California investors headed by Reid Dennis provided seed money. Callahan is now chief executive and Sato is chief operating officer.
They plan to gradually transition FieldLevel into other sports.
"Everything needs to be built around the coaches. They are the decision-makers," Sato said.
Once a coach subscribes to FieldLevel, a member of the company's nine-person staff vets him to make sure he is who he claims to be. If he's legitimate, he can begin communicating with others in the network.
Coaches, typically at the high school and junior-college level, put out information on their players. If a coach is interested in recruiting a specific player, he's able to gain access to that player's contact information.
Callahan said the information is secure and that no one outside the network can access it.
Basic FieldLevel service is free. Add-on features can bring the cost up to about $100 a month, Sato said.
Similar to other recruiting software, FieldLevel offers safeguards that warn a coach if he is about to commit an NCAA violation, such as making too many phone calls or sending too many text messages to a prospect. Also, a FieldLevel app can be put on the phones of all coaching staff members so each coach knows what the others are doing in recruiting.
South Alabama recruiting coordinator Jerry Zulli said the new technology allows him to make better use of his time.
"I can email every junior college in the network and say I need a shortstop," Zulli said, "and I'll get 101 replies. Imagine the amount of (individual) emails and phone calls that saves me."
A number of power programs use FieldLevel, but the teams that might benefit most are the ones that are lesser known.
"Everybody knows LSU, Florida, Miami and Texas," Appalachian State's Jordan said. "It, to me, isn't as valuable to those programs as it is to Appalachian State or a Southern Mississippi. Players may have heard our name, but don't know much about us. Once you reach out and connect with them through their coaches, they start to do more research and it becomes possible for you to get those kids."
At NAIA power Bellevue University, near Omaha, about 65 percent of the roster is made up of players who come from junior colleges.
Coach Duane Monlux said FieldLevel has become invaluable.
"I don't know how to turn on Facebook, and I don't Twitter," he said.
But he does log on to FieldLevel at least once a day to check on prospects and see what types of players are available.
Bob Kittle, the 44-year-old coach at Cabrillo College in Aptos, Calif., said baseball coaches are slow to change their ways. He said he uses FieldLevel to recruit players to his junior college. He plans to use it more for promoting his players to four-year schools once he gets more comfortable with the technology.
"You've got to put a little time into it to learn it. Once you do, you realize how much time it saves," Kittle said. "Just as a whole, us coaches are kind of Neanderthals. But if you don't learn the new technology, you might get left behind in this business."
Copyright 2012 by The Associated Press
This story is from ESPN.com's automated news wire. Wire index
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Le, C.H., Okereke, M.I. ORCID: 0000-0002-2104-012X, Nguyen, V.H., Dao, V.D., Soe, S., Zlatov, N. and Le, T.H. (2011) Personalised medical product development: Methods, challenges and opportunities. Romanian Review Precision Mechanics, Optics and Mechatronics, 40. pp. 11-20. ISSN 1584-5982


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I know we've likely still got 6 months to go before Warlords of Draenor is released and Mists of Pandaria is officially over, but honestly, the end feels overdue already. I thought this would be a good time to look back at the expansion and think about what aspects were great and which ones were not so good.
The Good
1. Pandaria is beautiful. The zones are varied and interesting. From the wildlife to the landscapes, everything looked good. The final cut scene in Jade Forest took my breath away the first time I saw it, and opening up the gates to the gorgeous Vale of Eternal Blossoms for the first time was one of my favourite moments from any expansion.
2. Challenge modes. I loved doing challenge modes the first time around. Small group content that was actually challenging? Amazing. These were a whole lot of fun. I will say though, I found they lost their luster a bit after I got my first set of golds. Maybe it was because healing them on my Druid was more challenging than dpsing on my Hunter. Maybe because by the time I got around to them on my Hunter the people I was running with had already done them so many times, and there were countless CM guides and videos out so the problem-solving aspect was gone. Either way, when these became less challenging, I found them less rewarding. But they were amazing the first time around.
3. Different types of solo content. MoP added a lot of things that people
could do to occupy themselves. Proving grounds were a nice challenge, the individual parts of the legendary quest line were unique, pet battles (more the collection aspect really) gave me a lot to do, even farms provided me with something to do for a little while. There was also Brawler's Guild, rare hunting, and many treasures to find.
4. Raid content, for the most part, was good. There were a lot of different, interesting bosses. The devs played with some new mechanics and gimmicks (some successful, some not). I found tier to be 14 the strongest raid tier (even though it didn't last long enough), buts tiers 15 and 16 had their shining spots as well.
The Bad
1. The grind. MoP had a lot of grindy components – dailies, rep, valor, coins, lesser charms. That kind of thing is never really enjoyable. However, I'm putting this in the 'bad' category instead of 'ugly' because it wasn't that huge a deal. I know many raiders claim they were forced to do everything all the time, but I'm not one of them. I didn't want to do Golden Lotus dailies when MoP launched, so I didn't. I lived. My raid killed bosses. Besides, by the time you farmed the rep and the valor to get that revered for that chest or ring you wanted, one would drop for you in raid the very next day – that's how it works.
2. Legendary Cloaks. How do you make a legendary item feel anything but legendary? Give it to everyone. Then give it to all of their alts. Besides feeling completely unspecial, making the legendary so ubiquitous also meant that if you wanted to raid occasionally on an alt (especially as a dps) you basically needed the legendary to be at all viable. If you didn't want to grind through item collection, rep and valor, you pretty much had to resign yourself to the fact that your output would suck. I did find that 90% of the legendary questline was enjoyable – but only once.
3. All the things that made guild/raid administration so much harder than it needed to be.
- Some raid encounters (heroic Ji-Kun, Dark Animus, Spoils of Pandaria) required spreadsheets in order to organize everyone. It went so far beyond "assign x healer to use a cooldown, y dps to interrupt this mob, and group z to stand here" it was ridiculous. The 9 different mobs in the Paragons of the Klaxxi encounter have a total of roughly 40 different abilities. I killed those guys a dozen times on normal and never actually understood what was going on.
- Things like Thunderforged/Warforged gear and the ability for raiders to coin loot made loot systems more difficult to deal with.
- Six different ilvls of loot in a tier and four different raid difficulties.
- Raid comp requirements varied wildly from fight to fight. Some fights heavily favoured comps with lots of rogues and hunters, some were better with many warlocks (most of them, really). Heroic Thok required 8 healers. Garrosh – 3 or 4. What are those other 5 healers supposed to do?
- All of the raid meta achievements that had multiple requirements (like Megaera, Lei Shen, Dark Animus trash) made getting people their metas in raid complicated and repetitive. I didn't even get mine in ToT, and I'm the GM who rarely missed a raid 🙁
The Ugly
1. Spending a year in the last tier of content. I know, I'm a broken record on this, but it's awful piled on top of more awful because it's the 3rd time it's happened. People are bored and it's a problem.
2. Healing became a game of cooldowns and button mashing. During the first tier of the expansion, healing was interesting. Mana mattered, I used most of the spells in my spellbook. As time went on this changed and healing turned into spam all the AoE/smart heals all the time. Very dull. Healing was also made less interesting my the amount of non-healer raid cooldowns available. With 3 offpsec HTTs, a few DAs, a boomkin to Tranq and a Warrior or two to do all the things they do, the way to defeat harder encounters usually involved dropping healers. I thought I'd be a healer forever, but the progression of healing in MoP managed to drive me into a dps role.
3. Lag and disconnects. There were a few things in the game that caused some awful lag, especially in 25s. Things like smart heals and Stampede were blamed, though they apparently got fixed. Lag stuck my raid most fiercely on Lei Shen and Siegecrafter, and we lost more than a few raid nights to it, as the game was basically unplayable for some people. It's one thing to not kill a boss because people couldn't perform adequately, it's another to not kill it because half your raid has so much lag they can't move out of spell effects fast enough.
Those are the highs and lows that stand out for me in MoP. What parts of the expansion did you love or hate?


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The Emmanuel Leadership Initiative (ELI) Student Advisory Board will host the 3rd Annual ELI Leadership Banquet in Taylor Auditorium on April 18 from 6:30 - 8:30 p.m. The banquet is designed to honor and encourage student leaders while providing them with a social, entertaining atmosphere.
The theme of this years banquet is "A Black and White Affair." It is an invitation only, semi-formal event, with a live jazz band, catered meal, encouraging speakers, award presentations and student leader highlights collected throughout the year.
The key speakers for the event include President Michael Stewart, Vice President for Student Life Jason Croy and Vice President for Development Brian James. Their messages will encourage and challenge student leaders to persevere and finish strong in the race of life.
Throughout the night, the board will award three 2nd Mile Service Awards to students who have gone above and beyond the call of duty; these are given to students who are continually serving, walking in the highest level of integrity, and striving for excellence in and out of the classroom.
For more information, email Katlyn Moncrief at email@example.com.


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This story was originally by Norah Dooley at the Public Humanist
There is a bell or a buzzer and then--an explosion of noise! It's the change of classes. Whether in Everett or Newburyport, we were carried on waves of energy and words from the quiet end of one class to the subdued beginning of the next. Yes! Here was the natural drive of teenagers to communicate and connect that we wanted to engage.
When we started teaching high school students we were pumped, ready and excited. It was also bit scary. Even though I have been teaching storytelling for decades, this was a high school program of greater depth and breadth than I had ever attempted. Would the "story magic" work as it always had in the past? I felt like I do about baking: all that careful measuring and planning, then the long wait to see how something turns out. I am too impatient to be a good baker. And human beings are not inert ingredients. And teaching is only a little like baking.
Still we planned and approached StoriesLive® like expert pastry chefs. The prep was way longer than the baking. We had met with teachers and administrators and crafted our lessons down to the minute. In each school, students had seen our performances and a short workshop that followed had already elicited a few stories in each assembly. We had good materials. We had plans. But as any teacher knows, teaching is an art because the
reproducible results of science are only possible when you have control of your materials. And humans are only partly "material." Besides, our plan was to open up the world of junior and senior high school students to the creative energy in the art of storytelling. We were about release and direct energy, not control it. It seemed a natural fit.
Especially as we walked in the halls from class to class-- stories were being told all around us. But it was also a bit risky. In some schools we were going to teach all the English classes in a cohort: all the juniors in Newburyport and Everett and all the seniors in Lynn Classical High School. This was our dream come true, but it also happened all at once, from March 11th until April15th. It was way more students and classes than we had anticipated at one time, and it was a bear to organize.
In the end we taught over 1,100 students in 5 high schools. This meant we had many students who are taking English Language Arts because it is required. And in some classes we struggled to get the students to open up and tell their personal stories. They all loved listening to stories, but telling their own? That was not on their agenda. At first.
But things happen when you mix live stories and people. One good story calls another. Collectively we massmouth storytellers heard over a thousand stories. And by the time we had the mini- story slam in classrooms, all of the StoriesLive® storyteller-educators started to hear some amazing things.
In one of my classes a young man who was clearly in English class under protest, sat back and offered low-level disruption whenever he could. When his turn came, he grumbled a mild protest as he walked to the front of the class to present. Then he started to tell his story. He told about how when it was time for him to leave his country, his grandmother was so sad she would not stay to see him on board the airplane. Instead she left early and walked back, a long, long way from the city, to her home. Some years later, when she was very ill back home, he was riding in a car with his family. He had his iPod on, listening to his tunes. Then . . . he thought he heard the voice of his grandmother in his headphones. He heard her say "Goodbye, son." It scared him. It seemed so real. But he kept it to himself because he knew his mother and whole family were worried about his grandmother. When they got home the phone rang. It was the news that his grandmother had just passed. He ended by saying that he was glad that his grandmother had spoken to him one last time. He had established a context and the meaning and had created a clear beginning, middle, and end. There was a hushed respect and silence as he finished. Then there was a thunderous burst of applause.
When I told the ELA department head that I just heard an amazing story from "Jorge," she was more than mildly surprised. He was neither a participator, nor cooperative, nor an "A student," but he had told something deep and important about his life. And he told it well.
And this is what we had wanted. A chance to show educators that oral expression is not only the natural format of language but also a discipline that can be learned. Given some tools and guidance, all students have a story and a voice. We wanted to show the teens that their stories mattered to each other and the wider community. In One Thousand and One Nights, Scheherazade told stories to stay alive.
Storieslive® was created to teach high school students the art of storytelling in part to keep storytelling alive. We created a new audience for storytelling and we showed students how they are more connected and alive to the possibilities of their lives by knowing and telling their own stories.
The first ever regionalStoriesLive® Scholarship High School slam was held on Saturday, April 30th, 2011, starting at 2:30 PM in the auditorium of the Cambridge Public Library (Main Branch). Free and open to the public, this event was supported by a Mass Humanities "Engaging New Audiences" grant and StoryStream, Cambridge's city wide storytelling initiative and massmouth.org. StoriesLive® has brought forth many more stories;poignant, funny, sad and joyful. Check out our Youtube channel for more videos of student storytelling.


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Wabash Day 2010 - Fulton Countyby Andrew Perkins '97 • October 13, 2010 Share:
A couple Wabash faithful managed a Wabash Day project on October 10, during a very busy weekend in Fulton County. Doug Morton '68 and Andy Perkins '97 helped the City Park by painting a portion of the area playground, dubbed the "Manitou Mountain," a popular activity spot for area children.
Pictured: Doug Morton '68 climbs an extension ladder to paint part of area playground equipment.


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The Academy's activities in education and training tackle the strategic challenge of creating a system of engineering education and training that satisfies the aspirations of young people while delivering the high calibre engineers and technicians that businesses need.The Academy works with partners to encourage more young people to study science, technology, engineering and mathematics (STEM) subjects in schools, FE colleges and universities, where the Academy enriches outcomes by bringing real-world engineering practice into the student experience. The Academy is working to encourage more people, especially young women and people from a wider range of backgrounds, to work as engineering technicians, graduate engineers and engineering researchers.The Academy's education activities are organised into four main strands of activity: schools, post-16 education, higher education, education policy and research. The Academy also hosts Engineering for Education (E4E).


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Three Dead, Seven Injured in Swiss Factory Shooting
(MENZNAU, Switzerland) -- A shooting at the Kronospan wood processing factory in the Swiss town of Menznau on Wednesday left three people dead, including the 42-year old gunman, and another seven injured. Five of the injured are in serious condition.
The shooting occurred during the morning while factory workers were snacking in the plant's cafeteria. The shooter, described by the chief executive of Kronospan Mauro Capozzo, was an unassuming and quiet man.
Capozzo denied rumors that job cut announcements were imminent, leaving the motivations for the massacre unclear at this point.
Gun violence and mass shootings of this sort arerare in Switzerland, despite the country boasting the third highest rate of gun ownership in the world. However, the rate of domestic homicides and suicides involving firearms is the second highest in Europe.
Copyright 2013 ABC News Radio


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Decision : 27 COM 8C.41
Historic Quarter of the Seaport City of Valparaíso (Chile)
The World Heritage Committee,
1. Inscribes the Historic Quarter of the Seaport City of Valparaíso, Chile, on the World Heritage List on the basis of cultural criterion (iii):
Criterion (iii): Valparaíso is an exceptional testimony to the early phase of globalisation in the late 19th century, when it became the leading merchant port on the sea routes of the Pacific coast of South America.
2. Encourages the State Party to continue its efforts to inventory and protect the infrastructure related to the historic functions of the harbour area and transport systems;
3. Further encourages the State Party to develop conservation management plans in the entire maritime port area;
4. Requests the State Party to clarify with more precision the norms and guidelines in areas that are adjacent to the protected zones, e.g. Plaza de Intendencia, Cementerio, and Plaza de San Francisco.
DocumentsDecisions Report
Context of DecisionWHC-03/27.COM/8C
WHC-03/27.COM/INF.8A Add


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Here you will find a wonderful, unique and high-quality selection of Oriental items.
Express a distinct style and taste with our elegant Oriental home pouffes. This style combines vintage charm with modern-day functionality and adds a delightful atmosphere to any room.
Items are hand finished and hand carved by artisans. Each piece is unique in its design and is prepared with a great attention to details. The technique takes a lot of time, patience and above all, a lot of experience.
So choose an item that you like and add these outstanding items to your office or your home.


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Charles Tillman came to the Bears in the 2003 draft as a relative unknown. Nine years later he is a Pro Bowl cornerback, special teams ace, fan favorite and fumble-forcing master. RedEye spoke with him about his first opening day, his 10th opening day and everything in between.
Charles Tillman: I didn't have any idea what team was going to draft me, or even if I was going to get drafted. But the Bears picked me up. I knew about the '85 Bears a little bit, but as far as the history, the titles, George Halas, things like that, I didn't know anything about it.
[Vice president of communications] Scott Hagel made all the rookies take a Bears history class—you know, "What does the GSH stand for on the jersey?" "George Halas played baseball. He played football. He got drafted into the war." Just gave us a little bit of history on the team and the organization.
Do you remember your first opening day? I was talking to Alshon Jeffery about prepping for his first opening day …
I don't. It might have been an away game? Oh, San Francisco. We played San Francisco, now that I think about it. I think we ended up losing. T.O. [Terrell Owens] beat me on a third down. It wasn't one of my best games as a rookie [laughs], but I didn't start so I didn't really get in that much.
You forced a fumble.
I did?
I didn't remember that. I just looked it up.
I don't even remember the score. Obviously I don't even remember my own stats. I just remember T.O. beat me on a third down, something like that. That's the only thing I remember. The second game, [editor's note: it actually was the third game] we played Green Bay. It was the opening of the new Soldier Field. First time we'd been there, seeing the stadium, the locker room. It was packed. It was Green Bay. That was when I realized, "Wow, the oldest rivalry in football." That was when it sunk in.
What sort of research have you done on the Bears since that point?
[Looks at Brandon Marshall, who is posing on the grass for a photographer, one knee on the ground and a football under his arm.] What are you doing? Really? Are you in high school, taking photos?
He's very focused.
I know.
So did you study the Bears?
No, nothing like that. Just over the years I would learn new things here and there.
Do you know how your career numbers stack up franchise-wise?
I don't. I think they're up there. I think my name will just get tossed in the hat with a bunch of other great players who have come here over the years.
You need nine interceptions to pass Gary Fencik for all time.
That'd be sweet.
What's the difference going into your 10th opening day as opposed to your first?
Nothing. Still get butterflies. Still excited. Still nervous. You know, I'm happy. It's a good day. Excitement. Trying to focus, lock in, things like that. It never changes for me.
So after 10 years, what is it that is special about being a Chicago Bear?
Just the history, the legacy, what this franchise and organization is and what they stand for. They stand for good quality guys. They don't care about how great a player you are. They want to know how good of a person you are. They take that all into account when they draft you.
Jack M Silverstein is a RedEye special contributor. Say hey @readjack.
Want more? Discuss this article and others on RedEye Sports' Facebook page.


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Please select a state for your search.
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UnityPoint Health - Finley Hospital
I can't imagine a more fulfilling or rewarding career than physiatry. I have the privilege of optimizing function and returning patients to the people, pursuits and passions that distinguish life from mere existence.
I strive to partner with the patient and rehabilitation team to provide the best individualized care respecting the patient's specific goals and values.
My mission is to maximize the conscientious pleasures, minimize unnecessary suffering and optimize meaning. Health care is rife with opportunities to fulfill this mission and these principles inform every decision I make.
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Oklahoma State University College of Osteopathic Medicine, Tulsa, OK


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The National Security Agency surveillance programs that swept up information on domestic phone calls and Internet traffic from abroad played a key role in the prosecution of four Somali immigrants in San Diego for funding the terrorist group al-Shabaab.
Testifying on Capitol Hill on Tuesday in front of the House Intelligence Committee, the head of the NSA and the deputy director of the FBI said the San Diego case was one of dozens of plots uncovered as a result of the controversial spying programs.
FBI Deputy Director Sean Joyce said that the NSA gave the agency a phone number from San Diego that had been in contact with an "extremist" outside the U.S. That apparently was the start of the case that led to the indictment in 2010 of the Somalis for providing material support to a terrorism organization.
The four men — Mohamed Mohamed Mohamud, the imam at a local mosque, cabdrivers Basaaly Sayeed Moalin and Ahmed Nasiri Taalil Mohamud, and Issa Doreh, who worked at a money remittance business in City Heights — were convicted in February following a jury trial in federal court.
They were charged with funneling about $8,500 to al-Shabaab in 2007 and 2008. The Somali-based group has been accused of suicide bombings, beheadings, kidnappings, and attacks on U.N. peacekeeping and government forces in Somalia. It espouses a radical Islamist view and is aligned with al-Qaeda.
During the trial of the Somali men in San Diego, dozens of recorded phone calls among the men and people in Somalia were played for the jury.
Moalin's lawyer, Joshua Dratel, said in court filings in December 2011 that the government intercepted a year's worth of Moalin's calls, eventually turning over 1,800 to the defense for trial preparation. In addition, he said investigators intercepted 680 pages of Moalin's email traffic.
Court records show prosecutors with the U.S. Attorney's Office filed three notices informing defense lawyers they planned to use information obtained through the Foreign Intelligence Surveillance Act, known as FISA.
The notices were filed in November 2010 and again in January 2011 and January 2012, and said the government planned to use "information obtained or derived from electronic surveillance and physical search" conducted under the act.
Assistant U.S. Attorney William Cole, the lead prosecutor on the case, confirmed Tuesday that Joyce was referring to the Moalin case. He declined to comment more extensively on how the information was used.
He said the FISA notices are required under the law to allow defense lawyers to know the source of evidence against their clients. The notice is distinguished from more common notices of wiretaps approved by federal judges in non-terrorism cases, Cole said.
None of those types of wiretaps were used in the Somali case, he said.
Before the trial started, the defense lawyers tried to get the phone calls disallowed as evidence, arguing they violated the constitutional rights of the defendants and FISA. The defense lawyers were not allowed to see the FISA warrants because they are secret. Those motions were denied, and the calls were used at the trial.
All four men were convicted of terrorism support charges and money laundering, and they each face at least 15 years in prison. The men are set to be sentenced in September.


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Comedian George Lopez says his rescue dog changed his life.
Lopez, 55, met the 1-year-old Chihuahua while he was hosting the World Dog Awards, he told People Magazine. The pup, Owen, had been rescued by Wags and Walks and was looking for his forever home.
"Owen had been turned over a few times," Lopez told People. "People had kind of looked at him and passed on him."
The comedian described Owen as loving, affectionate and "a master at getting you to pet him."
"This guy's all about people and all about connecting. I thought, 'Wow, what a special dog,'" he told People.
He said Owen helps keep him active and enriches his life.
"He's been great for me," Lopez told People. "This business closes you off, and a dog opens you up."


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Perfectly tailored black polo shirt made of 100% polyester featuring the Akrapovic and Alpinestars logo embroided on the chest and back. Available in XS, S, M, L, XL, and XXL.
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A zip-front fleece lined hoodie with embroidered Akrapovic and Alpinestars logos on front and back, made of 80% cotton and 20% polyester. Available in XS, S, M, L, XL, and XXL.
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so that we can contact you about the specific news and offers we have applicable to your specific model of bike.
We will never share your data with any third party, and we will only contact you with products and offers specifically of interest to you.
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Local SEO
Local SEO is a lot different from the traditional concepts of SEO. While doing search engine optimization for a local business, one needs to understand that the market lies within a small radius of location of the business.
Rene's Auto repair would get majority of its business from Ocean st, Bixby St, Clay st, Pearl St, Windsor St, Windham St, James St and Sea bright Ave. Residents of these locations as well as travelers of these checkpoints would prefer to go to Rene's Auto Repair since it is the closest. SEO companies in San Jose take local SEO as conventional SEO and directly target the entire city which is not the right order of approach. If this caught your attention you would fall in love in with my checklist.
Branding can easily be accomplished through advertisement. The most economic advertisement channel is social media. You must be wondering we are speaking of organic and I am talking paid as my first measure in the checklist! Told you, this is not the traditional SEO.
A local business thrives in the market because of its popularity. A lot of time is required to gain popularity naturally considering that the quality of goods or service the business provides is good. If that popularity needs to be brought faster, advertisement is needed.
Social media marketing can be really cheap for branding considering we have a very small region to target as explained in this page before.
Follow these simple steps to make sure that your Google my business is completely optimized
- Step A: Claim your Google my business page
- Step B: Setup your Google my business. Watch this video to know how.
- Step C: Input detailed and unique description of your business. Make no grammatical errors, spelling mistakes and include a few links to your site.
- Step D: Populate correct categories suiting your business.
- Step E: Upload attractive photos of your business showing your offerings and office space.
- Step F: Add local phone number
- Step G: Enter the address of your business.
- Step H: Upload high quality cover image showing your office/shop from the outside and a profile picture (logo is recommended)
- Step I: List your opening/closing hours
- Step J: List Google posts for offers , custom message
Users making local searches are in immediate need. Making decisions on someone they found online is hugely based on reviews. In fact, reviews have a very immense impact on the local search results and rankings for any physical business.
As a local business, make sure that there is an easy review system in place on your site. Encourage the users who have had a great experience with the business to review it online. There are a lot of services which can help build reviews through a trusted process of reaching out to your customer base. Some good ones are– Getfivestars , Yext and Revleap.
The website must be perfectly optimized. To know more about On page SEO, click here. A few tactics that are exclusive to Los Angeles SEO are listed below:
- 1. Footer must have a Google map of your business. (Makes it the common element for all pages)
- 2. Target landmarks within a 2 mile radius of the business in the content.
- 3. Target other popular local businesses nearby in the content which are not your peers.
- 4. Use meta description to target areas/streets where you get 80% of your business.
- 5. Optimize images with alt-text containing region/street/city the business is targeting.
- 6. List your address on each page of the site (keep it in header or the footer of the site).
If the site is perfectly optimized along with schema markup then Google will start showing site links when someone makes a search for your brand. This can lead to a better CTR. This is how site links look like –
Citations refers to the online directories which contain the name of your business, address and the phone number. The key here is to keep consistency between the three parameters which are name, address and the phone number across all local directory submissions.
Services like whitespark have turned out to be a huge relief for getting it done easily and it's highly recommended by me as well.
Traditional off page SEO strategies have lesser impact under local SEO. Local link building has the highest impact for Los Angeles SEO. While doing local link building, authority of the site and citation/trust flow doesn't matter much. The business agreeing to provide the link must be local and should be somehow inter-related and relevant.
Some tips for performing an outreach for getting local links are as follows –
Bing also has business listing just like Google my business.
Below are step-by-step instructions to setup your business with Bing Places:
- Step 1: Get Started on the Welcome Screen
- Step 2: Claim Your Existing Business or Add a New Business Listing
- Step 3: Add Your Business and Login to Your Microsoft Account
- Step 4: Manage Your Listing(s)
Click here to know more about the steps
Local SEO service
Agreed Technologies can analyze the rankings of your business locally easily through tools like SEOprofiler. We send out free analysis reports as a part of our Los Angeles SEO service. If you'd like us to analyze your website, just fill this contact form and send it over to us.
If you liked this article, please share it. Call us if you'd like to know more about our prices for Los Angeles SEO services.


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Clubs Calendar
Caloosa Dive Club
10-24 The Caloosa Dive Club welcomes all SCUBA divers — new and experienced. The group usually meets the first, second and third Thursday of the month at the Tony Rotino Center at the Cape Coral Yacht Club, 5817 Driftwood Parkway. Social hour, with snacks, is at 7:15 p.m. more »»
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Clubs Calendar


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One in 10 Viewers Watched Debates on TV Plus One Additional Screen
(NEW YORK) -- Take a look at the constant stream of tweets during the debates (there were 10 million within two hours of the first debate between Obama and Romney), and it's obvious that not only are people watching the feuding candidates on TV but also on their phones, computers or tablets.
According to a study released by the Pew Research Center for the Press and the People, 85 percent of those who tuned in to the debate last week watched it on live TV, but 11 percent followed it online, either on a computer, phone or tablet. That means that one in 10 Americans used the two- or double-screen approach, watching TV while also holding a mobile device (phone or tablet) or computer.
Most of those who were following online were younger. Thirty-two percent of those younger than 40 said they tracked the debate online. The post-debate survey was conducted after the first presidential debate in a series of phone interviews with a national sample of 1,006 adults.
Pew also has some interesting stats when it comes to the social media activity. Only one-third of that five percent who followed the debates online said they shared their reactions online via Facebook or Twitter. Interestingly, there wasn't a major difference along party lines in technology usage.
More details on the survey can be found on the Pew website, but it's pretty clear that while the majority continues to stick to the boob tube for these major political events, the smaller, more portable screens are starting to provide another avenue for at least 10 percent.
Copyright 2012 ABC News Radio


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Commentary: God gives us the shepherd we need
By Monsignor James P. Moroney, Rector, St. John's Seminary
It may have been a late night for the Cardinals in the Conclave Tuesday night as they had supper in the Casa Santa Marta and prayed and consulted following the first and inconclusive ballot.
After Night Prayer, each of the Cardinals would have retired, only to get up for an early breakfast and Mass in the Pauline Chapel at 8:15 a.m. Wednesday.
After Mass in the Pauline Chapel they entered the Sistine Chapel again and voted, albeit with a second inconclusive result. Then there was the third ballot of the Conclave, again marked by black smoke. And then the afternoon was marked by yet another vote and yet another puff of smoke, but this one was white.
The crowd jammed Saint Peter's square and greeted their new Holy Father with an ecstatic roar of Viva il Papa!
And the Papa they welcomed, Pope Francis I, welcomed them as their new Bishop and like any good priest, invited them to pray to "the Father who blesses us and the Blessed Virgin who cares for us."
Then a quarter-of-a-million people in the square were joined by the whole world in praying with their chief shepherd and finally receiving his blessing.
The first Pope named Francis, took the name of the greatest reformer in the history of the Church: Saint Francis, who taught us simplicity and love are the only true reflections of the face of God, Saint Francis who prayed "where there is hatred, let me bring your love, where there is injury, your pardon."
Much will be said of Pope Francis I in the coming days, this first Jesuit Pope, this first Latin American Pope. But nothing so profoundly expressed who he is and why God has called him to be for us as when he asked the world to pray for him in silence, and then bowed down that we might ask God's blessings upon him.
In every age, God gives us the shepherds we need, each reflecting the Good Shepherd in different ways. How blessed we are to be the flock who will be loved by Francis I, Pope and Bishop of Rome.


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With the biggest game in the history of local football set to kickoff Friday night when the Lamar County Trojans host the Cadets of Benedictine, The Herald Gazette is searching for the LC's #1 fan.
UPDATE; Thus far those nominated are Matthew Smith, Khris Burk, Ryan Christopher, Kenny Green, Buddy Lanier, Lee Otis Butler, James Mann, Danny Turner, Tom Coffey, Taylor Burk, Coach Wimberly, Dr. & Mrs. Harris, Mr. Hightower, Mr. Smith, Mrs. Byars, Dr. Olivier & Mrs. O'Neal!!! Make your opinion known in the comments section.
Matthew Smith and Khris Burk have been nominated along with their support team of Ashley Oglesby, Christa Smith and Ray Smith. Also nominated is Ryan Christopher (in face paint). What sayeth you, the voters? Use the comments function to respond.
List grows: Who is LC's #1 fan?
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Reflects the mana (prestige) of the great navigator Kiwa, the eponymous ancestor of Te Moana nui a Kiwa — the Pacific Ocean. The taniko cloak border depicted on the vessel; the attachment of a pounamu jade eardrop; the moko (tattoo) on the face, are all references to the mana of the man.
Te Popoto o Ngā Puhi Ki Kaipara
Largely self-taught, Colleen developed her interest in pottery while completing an art major at Auckland Teachers College. She continued to experiment during the 1970s, encouraged by Alec Musha, one of the first Māori potters. She believes strongly in tradition, decorating with traditional Māori weaving patterns or by adding muka (flax fibre), feathers or shell to her works. For her, "working with clay means working with the body of Mother Earth, she who influences and sustains us physically and spiritually."
Spirit Wrestler Gallery
101-1669 West 3rd Ave.
Vancouver, BC
Canada V6J 1K1
Toll Free: 1-888-669-8813
Phone: 604-669-8813
one block West of the Granville Island gates
Between Pine St. and Fir St.
Tuesday to Saturday, open 10-5
Sunday and Holidays, open 12-5
© 2019 Spirit Wrestler Gallery. All Rights Reserved.


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You'll find nationally award-winning, estate-grown table and dessert wines from our vineyards in the Ohio River Valley Appellation. Since 1970, the Schuchter family has been dedicated to bringing you a wide variety of fine wines, and craft beers.
Valley Vineyards is located in Morrow, Ohio between Dayton and Cincinnati, a region of glaciated soils especially beneficial for growing premium wine grapes.
At Valley Vineyards, join us for weekend cookouts, wine and beer tasting, good food and friendly people in a congenial atmosphere. Our family invites you.
While you're online here, keep up on the latest news and events, find helpful information, look over our tasting notes, and explore our growing variety of quality Ohio wines through the online store, which makes buying local convenient.
Valley Vineyards • 2276 East US 22 & 3 • Morrow, Ohio 45152 USA • Ph: 513.899.2485 • Fx: 513.899.9022
Home | About Us | Weekend Cookouts | News & Events | Shop | FAQ | Contact | Privacy | Terms & Conditions | Site Map
Copyright © 2009-2019, Valley Vineyards Farm Corp.


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Probably the best part of the overall dreadful remake of Paul Verhoeven's Total Recall by Len Wiseman was the three breasted sex worker. Purely because she reminded us of the original — and nothing else did. And now newly revealed concept art shows that she went through many different versions. NSFW because boobs, three of them to be precise.
We can't help but laugh at all the time and attention given to this character by artists Christian Cordella and Robert McKinnon. (She looks great both in concept and in the film — hey, it was a pretty movie.) But Holy Hell, that script could have used a little love. Check out more Total Recall concept art below:
[via Comic Book Movie]


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Please visit our FAQs page to see if your question has already been answered.
There is a link to our contact us form at the bottom if you still need your question answered.


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Difference between revisions of "Hack+Remix Party against TPP"
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Saturday May 4th, 2013
On the hour between noon and six there will be ten minute introductions to the Transpacific Partnership trade agreement and how it affects hackers and creators, by Danny O'Brien and Maira Sutton of EFF.
- 12:00PM introductions, setting up equipment, finding space to work and explaining TPP
- 1:00PM-1:30PM We'll try for a Google Hangout with Escuelab and other Latin American hackerspaces
- 2:00PM lunch. Trans-pacific pizza participation.
- 4:00PM another checkin with Latin America. Visits from mystery online guests!
- 6:00PM food + movies
- 7.30PM summary and what's next!
Hackers, tinkerers, artists, file sharers, and everyone else who cares about the health and future of the Internet.
What is the Trans-Pacific Partnership? The TPP is a massive trade agreement between more than 12 countries around the Pacific, and it covers everything from textiles, cars, tobacco, and financial regulation. The reason why we're meeting is to talk about the chapter that carries horribly expansive copyright policies.
The TPP could lead to even worse US copyright laws than the DMCA. It'd strengthen legal protections for DRM, carries vague but daunting language to increase criminal/civil penalties for infringement, and threatens to extend copyright term lengths even *further* than in the US.... and that's just a few of the problems we're fighting. These copyright laws will further restrict us from our right to share, remix, hack, and tinker with digital content and devices. Go here for more details about the copyright enforcement provisions.
The worse part is that it's all being done in secret in a process that completely shuts out public interests from its considerations. Through trade agreements, corporations have been able to get their way and make countries pass copyright and patent laws to protect their profits at the expense of the public and our freedoms. TPP is the biggest agreement yet, and we need to stop Big Content interests from lobbying our policymakers into making laws that lock up technology, culture, and knowledge.
The next round of TPP negotiations will be held in Lima, Peru from May 15-24. We're partnering with the local hackerspace in Lima, EscueLab, which is holding the same event there at the same time. We'll be checking in with them remotely throughout the day.
Let's talk about the Internet, technology, art, and why copyright threatens our freedom to create and innovate.
We're gonna work on videos, images, and other media to meme up the TPP so the Internet knows that this is happening.
Let's show our policymakers that we won't let back room trade deals determine what we can do with our technology. Let's show them that we, the users, are unified against corporate efforts to restrict our rights.
The Internet is ours. It's up to us to show up and defend it.
Who's behind this?
This is being organized by some of the folks at the the Electronic Frontier Foundation, including Maira Sutton, EFF Global Policy Analyst.
If you have other ideas for projects, would like to contribute somehow, or have any questions at all, please contact maira [at] eff [dot] org.
For more information on TPP and how it threatens the Internet and access to knowledge, check out EFF's TPP issue page.