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When non-small cell lung cancer (NSCLC) has progressed or returned following an initial treatment with surgery, radiation therapy, and/or chemotherapy, it is said to be recurrent or relapsed.
Patients experiencing a recurrence of NSCLC historically have had few treatment options. For those who have never been treated with chemotherapy, the approach is similar to treatment of Stage IV cancer. For patients who have already been treated with chemotherapy, new drugs—including chemotherapy and targeted therapy drugs—appear to kill more NSCLC cells.
About this NSCLC Treatment Information
The following is a general overview of treatment for recurrent NSCLC. Cancer treatment may consist of chemotherapy, targeted therapy, or a combination of these treatment techniques. Combining two or more of these treatment techniques—called multi-modality care—has become an important approach for prolonging survival and increasing a patient's chance of cure.
In some cases, participation in a clinical trial utilizing new, innovative therapies may provide the most promising treatment.
Circumstances unique to each patient's situation influence which treatment or treatments are utilized. The potential benefits of multi-modality care, participation in a clinical trial, or standard treatment must be carefully balanced with the potential risks. The information on this website is intended to help educate patients about their treatment options and to facilitate a mutual or shared decision-making process with their treating cancer physician.
- Chemotherapy
- Targeted Therapy
- Maintenance Therapy
- Treatment of the Elderly
- Managing Bone Complications
- Managing Brain Metastases
- Managing Pleural Effusion
- Strategies to Improve Non Small Cell Lung Cancer Treatment
Chemotherapy for Recurrent
Chemotherapy uses drugs that kill rapidly dividing cells, a hallmark of cancer. Cancer chemotherapy may consist of single drugs or combinations of drugs. It can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill.
Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread; it thus can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.
Patients with advanced NSCLC are treated with chemotherapy to alleviate the symptoms of their disease and prolong their duration of survival. Most treatments involve a combination (regimen) of two chemotherapy drugs. The most commonly used regimens include either cisplatin or carboplatin; combined with one of several other drugs approved for the treatment of NSCLC; Alimta® (pemetrexed), Taxol® (paclitaxel), Taxotere® (docetaxel), Gemzar® (gemcitabine), Camptosar® (irinotecan), or Navelbine® (vinorelbine).1
Treatment of Elderly Patients
Many NSCLC cases occur in people over the age of 70, but there is limited information about how best to treat older patients. As a result of the limited information and concern that elderly patients will not be able to tolerate aggressive treatment, older patients may be treated with single-agent chemotherapy rather than the combination chemotherapy that is commonly used in younger patients. Studies have suggested, however, that although combination chemotherapy increases side effects, it also improves survival among elderly patients.9
Targeted Therapy for Recurrent
A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that "target" cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes. Targeted therapies are playing an increasing role in the treatment of NSCLC.
Avastin® (bevacizumab): Avastin®is a type of targeted therapy that slows or stops the growth of blood vessels that deliver blood to the cancer, effectively starving the cancer of the oxygen and nutrients it requires to survive and grow. Avastin®, in combination with the chemotherapy drugs paclitaxel and carboplatin, is FDA-approved for the treatment of advanced, non-squamous NSCLC2
EGFR: Mutations in the epidermal growth factor receptor (EGFR) gene may affect how NSCLC responds to certain drugs. EGFR contributes to the growth of several types of cancer, and drugs that block the activity of EGFR can slow cancer growth. One EGFR-targeted drug that has been shown to benefit selected patients with NSCLC is Tarceva® (erlotinib). Tarceva® is currently approved for the treatment of advanced NSCLC and as maintenance therapy after chemotherapy.3,4
EGFR mutations are most common in people of Asian ethnicity, women, never-smokers, and those with a type of lung cancer known as adenocarcinoma. Researchers have reported that EFGR positive individuals treated with Tarceva® plus chemotherapy have delayed time to cancer progression and improved survival compared to those treated with chemotherapy alone.4
Xalkori (crizotinib): Up to 7% of NSCLC's have an abnormal version of the ALK gene that contributes to the growth and development of cancer. Xalkori is an oral medication that blocks certain proteins, including the protein produced by this abnormal gene. For advanced NSCLC that test positive for the ALK gene mutation, Xalkori has produced very promising rates of response and appears to have some activity treating cancer that has spread to the brain5,6 A recent clinical trial involving 343 NSCLC patients with overactive ALK reported the results of individuals treated with Xalkori or a standard chemotherapy regimen using pemetrexed, and either carboplatin or cisplatin. On average, individuals treated with Xalkori, experienced control of their cancer for almost 11 months compared to only 7 months for those receiving the chemotherapy treatment regimen. Xalkori treated patients also experienced a greater reduction in symptoms related to their cancer and improved quality of life.
Maintenance Therapy
Maintenance therapy refers to treatment that is given after initial treatment but before cancer progression. It is a relatively new approach to lung cancer treatment. Drugs that have been approved for maintenance therapy in selected patients include Alimta® (pemetrexed) and Tarceva®. For patients who are candidates for maintenance therapy, the approach has been shown to delay cancer progression and improve overall survival.7, 8
Treatment of Elderly Patients
Many NSCLC cases occur in people over the age of 70, but there is limited information about how best to treat older patients. As a result of the limited information and concern that elderly patients will not be able to tolerate aggressive treatment, older patients may be treated with single-agent chemotherapy rather than the combination chemotherapy that is commonly used in younger patients. Studies have suggested, however, that although combination chemotherapy increases side effects, it also improves survival among elderly patients9
Managing Bone Complications
NSCLC cells commonly spread to the bone, causing bone metastases. Bone metastases may cause pain, bone loss, increased risk of fractures, and a life-threatening condition characterized by a high level of calcium in the blood, called hypercalcemia.
Preventing or delaying these skeletal-related events (SREs) can preserve quality of life and reduce healthcare costs. Bisphosphonate drugs such as Zometa® (zoledronic acid) and a newer type of bone drug, Xgeva®(denosumab) can be used to reduce the risk of complications from bone metastases. Xgeva® is a drug that targets a protein known as the RANK ligand. This protein regulates the activity of osteoclasts (cells that break down bone). Xgeva® is approved for the prevention of bone complications such as fracture in patients with bone metastases from solid (not blood-related) cancers.
Xgeva® has been directly compared to Zometa® for the treatment of bone metastases in 702 with NSCLC and 109 with small-cell lung cancer (SCLC). Xgeva® is associated with a decrease in SREs and improved overall survival when directly compared with Zometa.10
Managing Brain Metastases
When NSCLC spreads to the brain, it can symptoms such as headaches and seizures. Depending on the number, size, and location of the tumors in the brain, treatment may involve radiation therapy and/or surgery to remove the tumor.
Managing Pleural Effusion
In some patients with advanced NSCLC, fluid collects in the space around the lungs. This is called pleural effusion. The fluid can compress the lung and make it difficult to breath. If a patient is experiencing symptoms due to pleural effusion, the fluid may be drained using a catheter.
Strategies to Improve Non Small Cell Lung Cancer Treatment
The development of more effective treatment for advanced NCSLC requires that new and innovative therapies be evaluated with cancer patients. Future progress in the treatment of NSCLC will result from the continued evaluation of new treatments in clinical trials.
Patients may gain access to better treatments by participating in a clinical trial. Participation in a clinical trial also contributes to the cancer community's understanding of optimal cancer care and may lead to better standard treatments. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician.
Areas of active investigation aimed at improving the treatment of lung cancer include some of the following:
New Drugs in Development: More-targeted and more-individualized treatments for NSCLC has recently became a reality. Results from studies evaluating ALK-inhibitors continued to show promise and initial studies exploring immunomodulatory approaches using anti-PD-1 antibodies demonstrated high response rates and slowed cancer progression in previously untreated stage IV NSCLC. The optimal approach to using these and other novel drugs has not been established and researchers continue to evaluate different ways of combining these drugs with each other and with other therapies in order to further improve outcomes.
The Lung-MAP Trial for Squamous Cell Carcinoma
In Lung-MAP (Lung-MAP.org), researchers with several public institutions, including the National Cancer Institute (NCI), are working with pharmaceutical companies to study treatment for advanced squamous cell lung cancer. Though only a fraction (about a quarter) of all lung cancer diagnoses as squamous cell, it's an important area of research, as there are few treatment options for these patients.
Lung-MAP will evaluate several investigational treatments and match patients with the therapy most likely to benefit them. Participants will undergo genomic profiling—a type of testing that provides information about all the genes in an organism, including variation, gene expression, and the way genes interact with each other and the environment. The drugs studied in Lung-MAP are designed to target genomic alterations involved in the growth of cancer, and researchers will use genomic profiling to match patients with the therapy designed to target the particular genomic alterations that their cancer expresses.
This more comprehensive approach marks a change in the typical clinical trial model for targeted therapies, in which separate studies for the same disease focus on particular genomic abnormalities and treatments. Potential participants are tested for that genomic biomarker (a molecule that is a sign of a normal or abnormal process or of a condition or disease), and only individuals who test positive are enrolled in the study. As a result, many patients are left out of each trial and—with multiple, separate trials—overall progress in treatment development is made less efficient.
In Lung-MAP, however, everyone who's tested will be eligible for a therapy. And several treatments for advanced squamous cell lung cancer will be evaluated under one protocol in an effort to accelerate safe drug development.
X-396 iis a novel ALK inhibitor that is well tolerated and has antitumor activity in patients with ALK positive NSCLC. X-396 is being developed for the treatment of solid tumors where ALK is deregulated. X-396 has been validated in potency and selectivity assays indicating that it is more selective and up to 10 times more potent than competitive ALK inhibitors.
The interim results of one study have demonstrated that among 11 ALK positive patients evaluable for response 6 patients had a partial response (55%) and 2 had stable disease (18%). Of the three patients with progressive disease, and acquired resistance to Xalkori® anti-cancer activity was also observed.11
EGFR: Mutations in the epidermal growth factor receptor (EGFR) gene may affect how NSCLC responds to certain drugs. EGFR contributes to the growth of several types of cancer, and drugs that block the activity of EGFR can slow cancer growth. One EGFR targeted drug that is currently approved for the treatment of advanced NSCLC and as maintenance therapy after chemotherapy is Tarceva®.3, 4
Erbitux® (cetuximab) is another targeted therapy that has produced promising results in selected patients with NSCLC.12
Ganetespib is an investigational drug that targets a protein known as heat shock protein (Hsp) 90. Hsp90 is necessary for the function of several other proteins that are known to play an important role in lung cancer. In a Phase II clinical trial, second-line treatment with a combination of chemotherapy and the investigational drug ganetespib improved overall survival among patients with advanced lung adenocarcinoma.13
Cyramza (ramucirumab) is a targeted therapy that inhibits the growth of new blood vessels in tumors and, therefore, slows tumor growth. When combined with Taxotere®, Cyramza has been shown to extend overall survival and delay time to cancer progression14
Nintedanib is an angiokinase inhibitor that when combined with Taxotere® improves progression-free and overall survival in patients with NSCLC-adenocarcinoma.15
References for Non Small Cell Lung Cancer
1 Chemotherapy for non small cell lung cancer: http://www.cancer.net/research-and-advocacy/asco-care-and-treatment-recommendations-patients/chemotherapy-stage-iv-non-small-cell-lung-cancer
2 Second Phase III Study of Avastin Plus Chemotherapy Shows Improved Progression-Free Survival in First-Line Non-Squamous, Non-Small Cell Lung Cancer. Available at:http://www.gene.com/gene/news/press-releases/display.do?method=detail&id=10727.
3 Zhou C, Wu Y-L, Chen G et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomized, phase 3 study. Lancet Oncology. Early online publication July 22, 2011.
4 Cappuzo F, Ciuleanu T, Stelmakh L, et al. Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: A multi-center, randomized, placebo-controlled phase 3 study. The Lancet Oncology. Published early online May 20, 2010.
5 Solomon, B., et al. (2014). First-Line Crizotinib versus Chemotherapy in ALK-Positive Lung Cancer New England Journal of Medicine, 371 (23), 2167-2177 DOI.
6 Kwak EL, Bang Y-J, Camidge DR et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. New England Journal of Medicine. 2010;363:1693-1703.
7 Ciuleanu T, Brodowicz T, Zielinski C et al. Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study. Lancet. 2009;374:1432-40
8 Cappuzzo F, Ciuleanu T, Stelmakh L et al. Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled phase 3 study. Lancet Oncology. 2010;11:521-529.
9 Quoix E, Zalcman G, Oster J-P et al. Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial. The Lancet. Early online publication August 9, 2011.
10 Scagliotti GV, Hirsh V, Siena S, et al. Overall survival improvement in patients with lung cancer and bone metastases treated with denosumab versus zoledronic acid: Subgroup analysis from a randomized phase 3 study. Journal of Thoracic Oncology. 2012; 7(12): 1823-1829.
11 Horn L, Infante J, Blumenshcein G, et al. A phase I trial of X-396, a novel ALK inhibitor, in patients with advanced solid tumors. J Clin Oncol 32:5s, 2014 (suppl; abstr 8030^)
12 Pirker R, Pereira JR, Szczesna A et al. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX): an open-label randomised phase III trial. Lancet. 2009;373:1525-1531.
13 Ramalingam SS, Goss GD, Andric ZG et al. A randomized study of ganetespib, a heat shock protein 90 inhibitor, in combination with docetaxel versus docetaxel alone for second-line therapy of lung adenocarcinoma (GALAXY-1). Presented at the 49th Annual Meeting of the American Society of Clinical Oncology. May 31-June 4, 2013; Chicago, IL. Abstract CRA8007.
14 Perol M, et al. REVEL: A randomized, double-blind, phase III study of docetaxel and ramucirumab versus docetaxel and placebo in the second-line treatment of stage IV non-small cell lung cancer following disease progression after one prior platinum-based therapy. ASCO 2014; Abstract LBA8006.
15 Reck M, Kaiser R, Mellemgaard A, et al: Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer (LUME-Lung 1): a phase 3, double-blind, randomised controlled trial. The Lancet Oncology. 2014; 15(2): 143-155.
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Extreme obesity associated with higher risk of death for 2009 H1N1 patients
For those infected with the 2009 pandemic influenza A (H1N1) virus, extreme obesity was a powerful risk factor for death, according to an analysis of a public health surveillance database. In a study to be published in the February 1, 2011, issue of Clinical Infectious Diseases, researchers associated extreme obesity with a nearly three-fold increased odds of death from 2009 H1N1 influenza. Half of Californians greater than 20 years of age hospitalized with 2009 H1N1 were obese. (Please see below for a link to the study online.)
Data from 500 adults hospitalized with H1N1 in the first four months of 2009 in California were analyzed to test the hypothesis of obesity as a risk factor for increased fatality. Extreme obesity is defined as having a body mass index (BMI) equal to or over 40. The data was collected April 20 – Aug. 11, 2009, by health providers and reported to local health departments, which subsequently provided the data to the California Department of Public Health. During this period, H1N1 accounted for 50 percent of influenza-like illnesses. Patients under 20 years of age and pregnant patients were excluded from the study.
"Extremely obese persons with a body mass index equal to or over 40 should get vaccinated annually for influenza," according to study author Janice K. Louie, MD, MPH, of the California Department of Public Health.
"They should also see their health provider early if symptoms of influenza develop, so that they can get diagnosed and treated as quickly as possible. This is especially important if the influenza virus is known to be circulating in the community and causing illness." Dr. Louie stressed that more research is needed to understand why extremely obese people are more likely to die from the 2009 H1N1 influenza infection.
NOTE: The study is available online. It is embargoed until 12:01 a.m. EST on Wednesday, Jan. 5, 2011:
"A Novel Risk Factor for a Novel Virus: Obesity and 2009 Pandemic Influenza A (H1N1)" http://www.oxfordjournals.org/our_journals/cid/ciq152.pdf
Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Arlington, Va., IDSA is a professional society representing more than 9,000 physicians and scientists who specialize in infectious diseases.
Contact: John Heys
Infectious Diseases Society of America

subset: commoncrawl


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Brimming with personality and panache, this exquisite botanical celebration highlights the effervescence of tulips in assorted colors complemented by white Monte Casino blooms. A charming blue mason jar completes the uniquely expressive look of this arrangement. Measures 11"H X 19"L. Suggested Retail Price: $44.99.
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Seminar on SDI in Beijing - with financial support for travel
The National Geomatics Center of China (NGCC) is organizing the 2nd International Seminar on Construction and Application of Spatial Data Infrastructure, being held in Beijing, May 2-11, 2018. The Seminar is co-organized by Capital Normal University and has support from National Administration of Surveying, Mapping and Geoinformation of China, ISPRS, and UN-GGIM-AP.
NGCC is providing financial support to about 40 participants from Surveying and Mapping Agencies of Southeast Asian Nations (ASEAN) or other developing countries. The support includes accommodations during May 2-10, 2018 and registration fee for the ISPRS Technical Commission III Symposium on "Developments, Technologies and applications in Remote Sensing" ( http://www.isprs-tc3.tianditu.com/ ). Limited international travel costs will be provided to participants from LDC countries (https://www.un.org/development/desa/dpad/wp-content/uploads/sites/45/publication/ldc_list.pdf). The financial support will be arranged on a first-come-first-served basis.
The Seminar will consist of two periods. The first part (May 2-6, 2018) focuses on lectures and technical visits, while the second part (May 7-10, 2018) will be the ISPRS TC III Symposium. The symposium will include plenary sessions, technical sessions, tutorials, social activities, exhibitions and will provide an inter-disciplinary platform for experts, scholars and practitioners to present the latest developments and applications, discuss cutting-edge technologies, exchange research ideas, and promote international collaboration in the field of remote sensing. Over 700 papers have been submitted from around the world.
To apply for financial support, complete application and submit by 15 April 2018.


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Chair of Baylor's Department of Psychology and Neuroscience Is Named Chair of the Council of Graduate Departments of Psychology
Follow us on Twitter:@BaylorUMediaCom
Contact: Terry Goodrich,(254) 710-3321
WACO, Texas (April 11, 2013) -- Jim Diaz-Granados, Ph.D., chair of the department of psychology and neuroscience in Baylor University's College of Arts & Sciences, has been named chair of the Council of Graduate Departments of Psychology (COGDOP), a national organization.
Comprised of nearly 300 of the nation's graduate psychology programs, the council represents the voice of academic psychologists regarding research and practice to a variety of relevant national organizations including, but not limited to, the Association for Psychological Science, the American Psychological Association, and relevant directorates of the National Science Foundation and National Institutes of Health.
Diaz-Granados also serves as a commissioner on the 32-member Commission on Accreditation, which is recognized by the U.S. Department of Education and the Council of Higher Education Accreditation as the national accrediting authority for education and training in psychology. This includes all psychology graduate, internship, and postdoctoral programs.
Diaz-Granados also is a professor of psychology, neuroscience and biomedical studies at Baylor University. He received his Ph.D. in Psychology (Behavioral Neuroscience concentration) from The University of Texas at Austin.
He joined the Baylor faculty as an assistant professor in 1996 and became chair in 2006. Before coming to Baylor, he was a post-doctoral fellow in the Center for Drug and Alcohol Programs at the Medical University of South Carolina in Charleston, S.C. He is an active investigator in the developmental, behavioral, and neurochemical aspects of alcohol abuse and addiction. He has worked with animal models of fetal alcohol syndrome, adolescent alcohol abuse, and most recently, in aging. In addition, he has investigated the effects of early stress on subsequent susceptibility to alcohol use, anxiety, and ensuing stressors.
His work has been funded by the National Institutes of Health and the Department of Defense. He has been a member of COGDOP since 2006 and was elected to the board in 2010. He just finished his first year as a commissioner on the APA Commission on Accreditation. He is a member of the American Association for the Advancement of Science, the American Psychological Association, the Association for Psychological Science, the International Society for Biomedical Research on Alcoholism, the International Society for Developmental Psychobiology, and the Research Society on Alcoholism.
Baylor University is a private Christian university and a nationally ranked research institution, characterized as having "high research activity" by the Carnegie Foundation for the Advancement of Teaching. The university provides a vibrant campus community for approximately 15,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating university in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 11 nationally recognized academic divisions. Baylor sponsors 19 varsity athletic teams and is a founding member of the Big 12 Conference.
The College of Arts & Sciences is Baylor University's oldest and largest academic division, consisting of 26 academic departments and 13 academic centers and institutes. The more than 5,000 courses taught in the College span topics from art and theatre to religion, philosophy, sociology and the natural sciences. Faculty conduct research around the world, and research on the undergraduate and graduate level is prevalent throughout all disciplines.


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Thursday, December 11, 2014
Free movement: Why reforming rules on in-work benefits doesn't require treaty change
In some cases, the speech was ambiguous about what exactly was being proposed. For example, did Cameron really say EU migrants will need a job offer before coming to the UK? This is important because it has legal implications regarding whether some, all, or none of the proposals require treaty change, changes to secondary EU legislation or simply changes to domestic law. Although, politics will of course also play a major part.
In addition, some have questioned whether the proposal, outlined by Professor Damian Chalmers and our Research Director Stephen Booth and adopted by Cameron, to limit EU migrants' access to in-work benefits for a certain period of years could be achieved without treaty change, as the authors claim.
Today we have published Chalmers' and Booth's assessment of the legal implications of the measures proposed in the Prime Minister's speech and a restatement of the case for why access to in-work benefits can be restricted via amendments to EU legislation rather than a treaty change.
Safe to say much of this is legally complex, but below is a summary of a summary of a longer legal note by Professor Damian Chalmers, which you can read in full here.
David Cameron's speech can be divided into four broad types of demand:
1. Four-year restriction on EU migrants' access to in-work and child benefits
David Cameron mentioned two proposed reforms:
a) "once they are in work, they won't get benefits or social housing from Britain unless they have been here for at least four years."
This could be achieved via amendments to EU legislation: This is the most legally complex of the proposals but we argue that it does not require Treaty change for two reasons. Firstly, access to in-work benefits is currently granted in EU law by virtue of a piece of secondary legislation, rather than by the Treaty article on free movement of workers. Secondly, the Treaties grant considerable discretion to the EU legislature (the Council of Ministers and the European Parliament) to place restrictions on access to such benefits provided that the legislation facilitates free movement more generally (which the relevant Directive would continue to do), the restrictions are based on objective criteria and are not disproportionate to the objectives they pursue.
b) "If their child is living abroad, then there should be no child benefit or child tax credit at all no matter how long they have worked in the UK and no matter how much tax they have paid."
Depending on what is sought this could be achieved under domestic law or amendments to EU legislation but if the objective is a hard and fast residence requirement this could be achieved via amendments to EU legislation rather than Treaty change.
2. Tighter restrictions on EU jobseekers
David Cameron mentioned two proposed reforms:
a) "We want EU jobseekers to have a job offer before they come here and to stop UK taxpayers having to support them if they don't."
This depends on exactly what is proposed. If he meant that any EU citizen must have a job offer before they can come into the UK, this would certainly require Treaty change.
However, read in combination with the pledge to "stop UK taxpayers having to support them", the proposal is better interpreted as suggesting that no social benefits will be granted to jobseekers. EU law already establishes that jobseekers are not entitled to social assistance and therefore such a reform would not require changes to EU legislation.
b) "We also want to restrict the time that jobseekers can legally stay in this country. So if an EU jobseeker has not found work within six months, they will be required to leave."
In principle, the UK can already do this under its domestic law. EU law only grants a right of residence for more than three months to those who are employed, self-employed, and economically self-sufficient as well as their family members.
However, the ECJ has ruled that individuals cannot be expelled as long as they "can provide evidence that they are continuing to seek employment and that they have a genuine chance of being engaged". While the onus is on the individual to prove this, clarifying what this condition means could be achieved by amending EU legislation. A hard and fast six month deadline would likely require Treaty change.
3. Abuse of free movement
David Cameron mentioned two proposed reforms:
a) "stronger powers to deport criminals and stop them coming back…and tougher and longer re-entry bans for all those who abuse free movement including beggars, rough sleepers, fraudsters and people who collude in sham marriages."
Those deported at the time of conviction can be refused re-entry under existing EU law. Indeed, the German government has said it will use its domestic law to impose re-entry bans of five years for those who commit benefit fraud. The potential difficulty is for those EU citizens with family in the UK, who may be able to appeal deportation under the rights to family life guaranteed by the European Convention on Human Rights.
In the case of significant criminal offences where the individual has served a long prison term, the deportation may be several years after the offence, and it is open to the individual to argue that they are a reformed character. This poses difficulties as the individual threat to public policy must be a present threat. Albeit this requirement is currently imposed by an EU Directive, we believe that, if the provision were repealed, there is a strong chance that the ECJ would reinstate it as a Treaty requirement.
b) "We must also deal with the extraordinary situation where it's easier for an EU citizen to bring a non-EU spouse to Britain, than it is for a British citizen to do the same. At the moment, if a British citizen wants to bring, say, a South American partner to the UK, then we ask for proof that they meet an income threshold and can speak English. But EU law means we cannot apply these tests to EU migrants."
This would likely require Treaty change: There are a number of judgments where the ECJ has stated that refusing to grant a non-EU national family member residence would violate the Treaty because it would discourage the EU citizen from exercising their rights to free movement.
Alternatively, it would be possible for new EU legislation to harmonise requirements on family reunification between EU citizens and non-EU nationals, so that the latter could only join the EU citizen in another member state if they meet certain requirements. However, this would entail harmonisation in an area (non-EU migration) where successive UK Governments have sought to limit the EU's influence. Concern to prevent marriages to citizens from other member states being used as a vehicle for marriages of convenience can be addressed through tightening up existing EU legislation.
4. Tighter restrictions on migration from new EU member states
David Cameron proposed:
"So we will insist that when new countries are admitted to the EU in the future, free movement will not apply to those new members until their economies have converged much more closely with existing Member States."
The UK could use its existing veto over new countries joining the EU to insist on these terms.
9 comments:
- Rollo said...
You silly people: Cameron is bigging up the idea of Turkey joining the EU. He is on record of acting towards this end. Can you imagine a spineless twerp like him threatening to stop enlargement if he does not get his way?
- 12/12/14 11:14 am
- Rollo said...
Cameron is all for Turkey joining the EU. Can you imagine a spineless twerp like him threatening to stop them joining if he does not get his way? He is only capable of saying what he thinks his audience wants to hear.
- 12/12/14 11:16 am
But even if the ECJ agreed with you that "access to in-work benefits can be restricted via amendments to EU legislation rather than a treaty change" it would make little difference to the volume of immigration from the poorer EU member states, given that the in-work benefits from the welfare system here are usually dwarfed by the in-work benefits just from having jobs here rather having no jobs or much lower paid jobs back home.
- 12/12/14 12:34 pm
"The UK could use its existing veto over new countries joining the EU to insist on these terms."
Well then, why didn't the UK do that for Croatia?
The interesting question is what would have happened if Hague had not deliberately put a blanket exemption for all EU accession treaties into the fine print of his so-called "referendum lock" law: would the British people have voted to allow Croatia to join the EU?
- 12/12/14 12:45 pm
1. Serial messing up by Cameron.
Everytime like now when Mr Ed is for the take something is messed up.
2. Doesnot send a clear message on the EU. Turkey in while Rumanians (sort of) out simply doesnot go together.
Even worse as the credibility on this issue is still rather poor. He simply never succeeds to show he really means it.
3. This is not the solution of the EU immigration issue. The EU electorate will decide what is enough not the possibility to change rules without treaty change or with remaining an EU member.
4. He better realises that if he wants to remain PM after May.
Basically the Tories should have replaced him by Boris J a few months ago. Other candidates are simply too unknown (for that short period) or perceived as similar by the electorate or lacking charisma (or (usually all of these).
Unlikely that Mr Ed would still have a realistic chance by now.
Hard to believe this guy has a PR background. Bringing Turkey up when it is completely unnecessary. How stupid can you get? - 12/12/14 7:13 pm
Reform will not go without a fight (very unlikely at least).
Proper EU management should have tried to get this issue out of the way by now. But the EU management is mediocre at best.
A proper strategy would have to establish a point at which you will have to kick the other side in the private parts (and hard when necessary).
However before that the full picture in all its nastiness (from an EU perspective) should be communicated to the other side. Preferably in a way that doesnot reflect on UKs PM in his relation with the continent.
Unlikely eg that Poland will be very good friends for a few years after the reneg.
What Cameron however is doing is create unnecessary irritation at the other side of the table while at the same time (when opportunities come let them pass without using them). Timing of things is simply awful.
Not even to mention the rubbish communicationstrategy at home on this. - 12/12/14 7:29 pm
we have to leave--cameron and clegg and milliband are spineless non-entities--trade only--stop our country being invaded.
- 15/12/14 11:31 am
we cannot let everyone come here--no settlement should be allowed and no british passports either--450 million plus in eu--in theory they can all come here to live - 15/12/14 11:34 am
It's quite amusing that on the same day the Telegraph reveals Labour's strategy to defeat UKIP over immigration - just don't talk about it - the FT floats Tory "eurosceptic", "Fresh Start", ideas for duping the electorate over reform of the EU - "How to achieve treaty change without changing the treaties!".
And other connected articles referenced there.
I look forward to the Open Europe analysis of their various proposed dodges and wheezes. - 15/12/14 2:54 pm


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I always know that 歩く is the verb to use when talking about walking. But I'm aware the kanji 歩 has another verb 歩む. In WWWJDIC, the example sentence given is:
Bill climbed the ladder of success until he became the president of the company.
There is also this one line from the lyrics of the song 「未来へ」 by KIRORO:
It seems to me from these usage examples that 歩む is better suited to refer to the abstract type of walking, like walking down the path of life, while 歩く is used when referring to the actual act of walking on foot. Is this always true?


text:
Apparently, flannel zebra jammies only look good in music videos.
Seattle rapper Macklemore's song "Thrift Shop," which celebrates snagging "awesome" bargains on second-hand clothes, has sold more than 4 million digital copies and become the first indie track in nearly 20 years to top the Billboard charts. But it hasn't boosted sales at actual thrift shops, reports the International Business Times.
(MORE: No Money, No Problem: Independent Rapper Macklemore Soars Onto Billboard Chart)
National sales at Goodwill Industries, one of the largest thrift store chains, haven't been significantly impacted since the song went viral (a Goodwill representative interviewed by the Times said data for the Seattle outlet branch where Macklemore filmed parts of the video, was not available). And while news spread around the Pacific Northwest that Seattle's Fremont Vintage Mall makes a cameo in the video, representatives for the basement collective said sales haven't noticeably increased since the video's release in August. Macklemore's homage may appeal to the masses, but it looks like it really spoke to people who already know the wonders of Value Village (another shooting location for the video).
(LIST: 10 Things You Should Be Buying Used)
Macklemore told GQ that he's been shopping at thrift stores "literally" his whole life. "My tally of purchases has got to be in the thousands. I would say probably 3,000 items." And even though he hasn't helped boost sales of velour jumpsuits or second-hand house slippers, Macklemore did partner with Goodwill to auction off signed t-shirts to raise money for the chain's job training program.
The upside of not thrifting? No one will ask if you're wearing your grandma's coat.
MORE: The Thrift Store: Not Just for Penny-Pinching Grandmas Anymore


text:
The Picture of Dorian Gray (audiobook in English with the original text). Part 14
Chapter 14
At nine o'clock the next morning his servant came in with a cup of chocolate on a tray and opened the shutters. Dorian was sleeping quite peacefully, lying on his right side, with one hand underneath his cheek. He looked like a boy who had been tired out with play, or study.
The man had to touch him twice on the shoulder before he woke, and as he opened his eyes a faint smile passed across his lips, as though he had been lost in some delightful dream. Yet he had not dreamed at all. His night had been untroubled by any images of pleasure or of pain. But youth smiles without any reason. It is one of its chiefest charms.
He turned round, and leaning upon his elbow, began to sip his chocolate. The mellow November sun came streaming into the room. The sky was bright, and there was a genial warmth in the air. It was almost like a morning in May.
Gradually the events of the preceding night crept with silent, blood-stained feet into his brain and reconstructed themselves there with terrible distinctness. He winced at the memory of all that he had suffered, and for a moment the same curious feeling of loathing for Basil Hallward that had made him kill him as he sat in the chair came back to him, and he grew cold with passion. The dead man was still sitting there, too, and in the sunlight now. How horrible that was! Such hideous things were for the darkness, not for the day.
He felt that if he brooded on what he had gone through he would sicken or grow mad. There were sins whose fascination was more in the memory than in the doing of them, strange triumphs that gratified the pride more than the passions, and gave to the intellect a quickened sense of joy, greater than any joy they brought, or could ever bring, to the senses. But this was not one of them. It was a thing to be driven out of the mind, to be drugged with poppies, to be strangled lest it might strangle one itself.
When the half-hour struck, he passed his hand across his forehead, and then got up hastily and dressed himself with even more than his usual care, giving a good deal of attention to the choice of his necktie and scarf-pin and changing his rings more than once. He spent a long time also over breakfast, tasting the various dishes, talking to his valet about some new liveries that he was thinking of getting made for the servants at Selby, and going through his correspondence. At some of the letters, he smiled. Three of them bored him. One he read several times over and then tore up with a slight look of annoyance in his face. "That awful thing, a woman's memory!" as Lord Henry had once said.
After he had drunk his cup of black coffee, he wiped his lips slowly with a napkin, motioned to his servant to wait, and going over to the table, sat down and wrote two letters. One he put in his pocket, the other he handed to the valet.
"Take this round to 152, Hertford Street, Francis, and if Mr. Campbell is out of town, get his address."
As soon as he was alone, he lit a cigarette and began sketching upon a piece of paper, drawing first flowers and bits of architecture, and then human faces. Suddenly he remarked that every face that he drew seemed to have a fantastic likeness to Basil Hallward. He frowned, and getting up, went over to the book-case and took out a volume at hazard. He was determined that he would not think about what had happened until it became absolutely necessary that he should do so.
When he had stretched himself on the sofa, he looked at the title-page of the book. It was Gautier's Emaux et Cam"Sur une gamme chromatique,
Le sein de peries ruisselant,
La V Sort de l'eau son corps rose et blanc.Les domes, sur l'azur des ondes
Suivant la phrase au pur contour,
S'enflent comme des gorges rondes
Que soulL'esquif aborde et me d Jetant son amarre au pilier,
Devant une fa Sur le marbre d'un escalier.How exquisite they were! As one read them, one seemed to be floating down the green water-ways of the pink and pearl city, seated in a black gondola with silver prow and trailing curtains. The mere lines looked to him like those straight lines of turquoise-blue that follow one as one pushes out to the Lido. The sudden flashes of colour reminded him of the gleam of the opal-and-iris-throated birds that flutter round the tall honeycombed Campanile, or stalk, with such stately grace, through the dim, dust-stained arcades. Leaning back with half-closed eyes, he kept saying over and over to himself:—
Devant une fa Sur le marbre d'un escalier.
The whole of Venice was in those two lines. He remembered the autumn that he had passed there, and a wonderful love that had stirred him to mad delightful follies. There was romance in every place. But Venice, like Oxford, had kept the background for romance, and, to the true romantic, background was everything, or almost everything. Basil had been with him part of the time, and had gone wild over Tintoret. Poor Basil! what a horrible way for a man to die!
He sighed, and took up the volume again, and tried to forget. He read of the swallows that fly in and out of the little caf He was an extremely clever young man, though he had no real appreciation of the visible arts, and whatever little sense of the beauty of poetry he possessed he had gained entirely from Dorian. His dominant intellectual passion was for science. At Cambridge he had spent a great deal of his time working in the laboratory, and had taken a good class in the Natural Science Tripos of his year. Indeed, he was still devoted to the study of chemistry, and had a laboratory of his own in which he used to shut himself up all day long, greatly to the annoyance of his mother, who had set her heart on his standing for Parliament and had a vague idea that a chemist was a person who made up prescriptions. He was an excellent musician, however, as well, and played both the violin and the piano better than most amateurs. In fact, it was music that had first brought him and Dorian Gray together—music and that indefinable attraction that Dorian seemed to be able to exercise whenever he wished—and, indeed, exercised often without being conscious of it. They had met at Lady Berkshire's the night that Rubinstein played there, and after that used to be always seen together at the opera and wherever good music was going on. For eighteen months their intimacy lasted. Campbell was always either at Selby Royal or in Grosvenor Square. To him, as to many others, Dorian Gray was the type of everything that is wonderful and fascinating in life. Whether or not a quarrel had taken place between them no one ever knew. But suddenly people remarked that they scarcely spoke when they met and that Campbell seemed always to go away early from any party at which Dorian Gray was present. He had changed, too—was strangely melancholy at times, appeared almost to dislike hearing music, and would never himself play, giving as his excuse, when he was called upon, that he was so absorbed in science that he had no time left in which to practise. And this was certainly true. Every day he seemed to become more interested in biology, and his name appeared once or twice in some of the scientific reviews in connection with certain curious experiments.
This was the man Dorian Gray was waiting for. Every second he kept glancing at the clock. As the minutes went by he became horribly agitated. At last he got up and began to pace up and down the room, looking like a beautiful caged thing. He took long stealthy strides. His hands were curiously cold.
The suspense became unbearable. Time seemed to him to be crawling with feet of lead, while he by monstrous winds was being swept towards the jagged edge of some black cleft of precipice. He knew what was waiting for him there; saw it, indeed, and, shuddering, crushed with dank hands his burning lids as though he would have robbed the very brain of sight and driven the eyeballs back into their cave. It was useless. The brain had its own food on which it battened, and the imagination, made grotesque by terror, twisted and distorted as a living thing by pain, danced like some foul puppet on a stand and grinned through moving masks. Then, suddenly, time stopped for him. Yes: that blind, slow-breathing thing crawled no more, and horrible thoughts, time being dead, raced nimbly on in front, and dragged a hideous future from its grave, and showed it to him. He stared at it. Its very horror made him stone.
At last the door opened and his servant entered. He turned glazed eyes upon him.
"Mr. Campbell, sir," said the man.
A sigh of relief broke from his parched lips, and the colour came back to his cheeks.
"Ask him to come in at once, Francis." He felt that he was himself again. His mood of cowardice had passed away.
The man bowed and retired. In a few moments, Alan Campbell walked in, looking very stern and rather pale, his pallor being intensified by his coal-black hair and dark eyebrows.
"Alan! This is kind of you. I thank you for coming."
"I had intended never to enter your house again, Gray. But you said it was a matter of life and death." His voice was hard and cold. He spoke with slow deliberation. There was a look of contempt in the steady searching gaze that he turned on Dorian. He kept his hands in the pockets of his Astrakhan coat, and seemed not to have noticed the gesture with which he had been greeted.
"Yes: it is a matter of life and death, Alan, and to more than one person. Sit down."
Campbell took a chair by the table, and Dorian sat opposite to him. The two men's eyes met. In Dorian's there was infinite pity. He knew that what he was going to do was dreadful.
After a strained moment of silence, he leaned across and said, very quietly, but watching the effect of each word upon the face of him he had sent for, "Alan, in a locked room at the top of this house, a room to which nobody but myself has access, a dead man is seated at a table. He has been dead ten hours now. Don't stir, and don't look at me like that. Who the man is, why he died, how he died, are matters that do not concern you. What you have to do is this—"
"Stop, Gray. I don't want to know anything further. Whether what you have told me is true or not true doesn't concern me. I entirely decline to be mixed up in your life. Keep your horrible secrets to yourself. They don't interest me any more."
"Alan, they will have to interest you. This one will have to interest you. I am awfully sorry for you, Alan. But I can't help myself. You are the one man who is able to save me. I am forced to bring you into the matter. I have no option. Alan, you are scientific. You know about chemistry and things of that kind. You have made experiments. What you have got to do is to destroy the thing that is upstairs—to destroy it so that not a vestige of it will be left. Nobody saw this person come into the house. Indeed, at the present moment he is supposed to be in Paris. He will not be missed for months. When he is missed, there must be no trace of him found here. You, Alan, you must change him, and everything that belongs to him, into a handful of ashes that I may scatter in the air."
"You are mad, Dorian."
"Ah! I was waiting for you to call me Dorian."
"You are mad, I tell you—mad to imagine that I would raise a finger to help you, mad to make this monstrous confession. I will have nothing to do with this matter, whatever it is. Do you think I am going to peril my reputation for you? What is it to me what devil's work you are up to?"
"It was suicide, Alan."
"I am glad of that. But who drove him to it? You, I should fancy."
"Do you still refuse to do this for me?"
"Of course I refuse. I will have absolutely nothing to do with it. I don't care what shame comes on you. You deserve it all. I should not be sorry to see you disgraced, publicly disgraced. How dare you ask me, of all men in the world, to mix myself up in this horror? I should have thought you knew more about people's characters. Your friend Lord Henry Wotton can't have taught you much about psychology, whatever else he has taught you. Nothing will induce me to stir a step to help you. You have come to the wrong man. Go to some of your friends. Don't come to me."
"Alan, it was murder. I killed him. You don't know what he had made me suffer. Whatever my life is, he had more to do with the making or the marring of it than poor Harry has had. He may not have intended it, the result was the same."
"Murder! Good God, Dorian, is that what you have come to? I shall not inform upon you. It is not my business. Besides, without my stirring in the matter, you are certain to be arrested. Nobody ever commits a crime without doing something stupid. But I will have nothing to do with it."
"You must have something to do with it. Wait, wait a moment; listen to me. Only listen, Alan. All I ask of you is to perform a certain scientific experiment. You go to hospitals and dead-houses, and the horrors that you do there don't affect you. If in some hideous dissecting-room or fetid laboratory you found this man lying on a leaden table with red gutters scooped out in it for the blood to flow through, you would simply look upon him as an admirable subject. You would not turn a hair. You would not believe that you were doing anything wrong. On the contrary, you would probably feel that you were benefiting the human race, or increasing the sum of knowledge in the world, or gratifying intellectual curiosity, or something of that kind. What I want you to do is merely what you have often done before. Indeed, to destroy a body must be far less horrible than what you are accustomed to work at. And, remember, it is the only piece of evidence against me. If it is discovered, I am lost; and it is sure to be discovered unless you help me."
"I have no desire to help you. You forget that. I am simply indifferent to the whole thing. It has nothing to do with me."
"Alan, I entreat you. Think of the position I am in. Just before you came I almost fainted with terror. You may know terror yourself some day. No! don't think of that. Look at the matter purely from the scientific point of view. You don't inquire where the dead things on which you experiment come from. Don't inquire now. I have told you too much as it is. But I beg of you to do this. We were friends once, Alan."
"Don't speak about those days, Dorian—they are dead."
"The dead linger sometimes. The man upstairs will not go away. He is sitting at the table with bowed head and outstretched arms. Alan! Alan! If you don't come to my assistance, I am ruined.
Why, they will hang me, Alan! Don't you understand? They will hang me for what I have done."
"There is no good in prolonging this scene. I absolutely refuse to do anything in the matter. It is insane of you to ask me."
"You refuse?"
"I entreat you, Alan."
"It is useless."
The same look of pity came into Dorian Gray's eyes. Then he stretched out his hand, took a piece of paper, and wrote something on it. He read it over twice, folded it carefully, and pushed it across the table. Having done this, he got up and went over to the window.
Campbell looked at him in surprise, and then took up the paper, and opened it. As he read it, his face became ghastly pale and he fell back in his chair. A horrible sense of sickness came over him. He felt as if his heart was beating itself to death in some empty hollow.
After two or three minutes of terrible silence, Dorian turned round and came and stood behind him, putting his hand upon his shoulder.
"I am so sorry for you, Alan," he murmured, "but you leave me no alternative. I have a letter written already. Here it is. You see the address. If you don't help me, I must send it. If you don't help me, I will send it. You know what the result will be. But you are going to help me. It is impossible for you to refuse now. I tried to spare you. You will do me the justice to admit that. You were stern, harsh, offensive. You treated me as no man has ever dared to treat me—no living man, at any rate. I bore it all. Now it is for me to dictate terms."
Campbell buried his face in his hands, and a shudder passed through him.
"Yes, it is my turn to dictate terms, Alan. You know what they are. The thing is quite simple. Come, don't work yourself into this fever. The thing has to be done. Face it, and do it."
A groan broke from Campbell's lips and he shivered all over. The ticking of the clock on the mantelpiece seemed to him to be dividing time into separate atoms of agony, each of which was too terrible to be borne. He felt as if an iron ring was being slowly tightened round his forehead, as if the disgrace with which he was threatened had already come upon him. The hand upon his shoulder weighed like a hand of lead. It was intolerable. It seemed to crush him.
"Come, Alan, you must decide at once."
"I cannot do it," he said, mechanically, as though words could alter things.
"You must. You have no choice. Don't delay."
He hesitated a moment. "Is there a fire in the room upstairs?"
"Yes, there is a gas-fire with asbestos."
"I shall have to go home and get some things from the laboratory."
"No, Alan, you must not leave the house. Write out on a sheet of notepaper what you want and my servant will take a cab and bring the things back to you."
Campbell scrawled a few lines, blotted them, and addressed an envelope to his assistant. Dorian took the note up and read it carefully. Then he rang the bell and gave it to his valet, with orders to return as soon as possible and to bring the things with him.
As the hall door shut, Campbell started nervously, and having got up from the chair, went over to the chimney-piece. He was shivering with a kind of ague. For nearly twenty minutes, neither of the men spoke. A fly buzzed noisily about the room, and the ticking of the clock was like the beat of a hammer.
As the chime struck one, Campbell turned round, and looking at Dorian Gray, saw that his eyes were filled with tears. There was something in the purity and refinement of that sad face that seemed to enrage him. "You are infamous, absolutely infamous!" he muttered.
"Hush, Alan. You have saved my life," said Dorian.
"Your life? Good heavens! what a life that is! You have gone from corruption to corruption, and now you have culminated in crime. In doing what I am going to do—what you force me to do—it is not of your life that I am thinking."
"Ah, Alan," murmured Dorian with a sigh, "I wish you had a thousandth part of the pity for me that I have for you." He turned away as he spoke and stood looking out at the garden. Campbell made no answer.
After about ten minutes a knock came to the door, and the servant entered, carrying a large mahogany chest of chemicals, with a long coil of steel and platinum wire and two rather curiously shaped iron clamps.
"Shall I leave the things here, sir?" he asked Campbell.
"Yes," said Dorian. "And I am afraid, Francis, that I have another errand for you. What is the name of the man at Richmond who supplies Selby with orchids?"
"Harden, sir."
"Yes—Harden. You must go down to Richmond at once, see Harden personally, and tell him to send twice as many orchids as I ordered, and to have as few white ones as possible. In fact, I don't want any white ones. It is a lovely day, Francis, and Richmond is a very pretty place—otherwise I wouldn't bother you about it."
"No trouble, sir. At what time shall I be back?"
Dorian looked at Campbell. "How long will your experiment take, Alan?" he said in a calm indifferent voice. The presence of a third person in the room seemed to give him extraordinary courage.
Campbell frowned and bit his lip. "It will take about five hours," he answered.
"It will be time enough, then, if you are back at half-past seven, Francis. Or stay: just leave my things out for dressing. You can have the evening to yourself. I am not dining at home, so I shall not want you."
"Thank you, sir," said the man, leaving the room.
"Now, Alan, there is not a moment to be lost. How heavy this chest is! I'll take it for you. You bring the other things." He spoke rapidly and in an authoritative manner. Campbell felt dominated by him. They left the room together.
When they reached the top landing, Dorian took out the key and turned it in the lock. Then he stopped, and a troubled look came into his eyes. He shuddered. "I don't think I can go in, Alan," he murmured.
"It is nothing to me. I don't require you," said Campbell coldly.
Dorian half opened the door. As he did so, he saw the face of his portrait leering in the sunlight. On the floor in front of it the torn curtain was lying. He remembered that the night before he had forgotten, for the first time in his life, to hide the fatal canvas, and was about to rush forward, when he drew back with a shudder.
What was that loathsome red dew that gleamed, wet and glistening, on one of the hands, as though the canvas had sweated blood? How horrible it was!—more horrible, it seemed to him for the moment, than the silent thing that he knew was stretched across the table, the thing whose grotesque misshapen shadow on the spotted carpet showed him that it had not stirred, but was still there, as he had left it.
He heaved a deep breath, opened the door a little wider, and with half-closed eyes and averted head, walked quickly in, determined that he would not look even once upon the dead man. Then, stooping down and taking up the gold-and-purple hanging, he flung it right over the picture.
There he stopped, feeling afraid to turn round, and his eyes fixed themselves on the intricacies of the pattern before him. He heard Campbell bringing in the heavy chest, and the irons, and the other things that he had required for his dreadful work. He began to wonder if he and Basil Hallward had ever met, and, if so, what they had thought of each other.
"Leave me now," said a stern voice behind him.
He turned and hurried out, just conscious that the dead man had been thrust back into the chair and that Campbell was gazing into a glistening yellow face. As he was going downstairs, he heard the key being turned in the lock.
It was long after seven when Campbell came back into the library. He was pale, but absolutely calm. "I have done what you asked me to do," he muttered "And now, good-bye. Let us never see each other again."
"You have saved me from ruin, Alan. I cannot forget that," said Dorian simply. As soon as Campbell had left, he went upstairs. There was a horrible smell of nitric acid in the room. But the thing that had been sitting at the table was gone.


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Word Count:
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text:
Brussels, London, 16 July 2014 - Zetes (Euronext Brussels: ZTS) has recently implemented its latest generation ZetesAthena In-Store Management solution to The Entertainer, one of the UK's largest toy retailers. The Entertainer selected ZetesAthena to help improve stock auditing across its growing network of UK stores.
ZetesAthena is a cloud-based in-store mobile management solution helping omni-channel retailers optimise stock and pricing processes centrally and consistently across individual store locations. It streamlines time-consuming inventory related tasks to provide real time transparency of stock availability within the store, helping to eradicate stock 'blind zones'.
The Entertainer operates a growing chain of 89 high street toy stores located across the UK. Each year the company is required to complete a physical stock count to ensure its assets can be accurately recorded for accounting purposes. The company outsources the physical counting to a third party specialist who uses ZetesAthena running on a mobile device to complete stock counts in up to 3 different stores per day, over a 3 month period. As a result of ZetesAthena's cloud-based architecture, The Entertainer's management team has real-time access to immediate stock count results from any location, which are directly integrated with the company's main ERP system.
Powered by the MCL™ Mobility Platform, ZetesAthena enables quick deployment and management of software applications and hardware with minimal ongoing management resource required. The MCL™ Mobility Platform is a cloud-based mobile enterprise application platform (MEAP) dedicated to supply chain operations. It allows organisations to develop, deploy, run and manage mobile applications, users and devices centrally and easily.
"Using ZetesAthena we have an efficient solution for stock auditing based on the latest cloud technology which means we have full visibility of the counting process from a decentralised location. In addition, because ZetesAthena is also a full in-store management solution, we can potentially scale our use of the software to manage other retail processes in the future, ensuring we have an accurate picture of stock availability and visibility at all times."
Stuart Molyneux, Head of Risk at The Entertainer
"This deployment for The Entertainer is a good illustration of how Zetes' new technology can be used by retailers in a scalable way to cost-effectively streamline basic in-store processes whilst providing flexibility to easily add more applications as needs evolve. Moreover, this can be done quickly and easily from one central point without resorting to expensive development processes".
Marco Malaihollo, Country Manager, Zetes UK


text:
Alphacool's Eiszapfen Connector Series is the high-end execution of these tried-and-true connectors!
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text:
Monkeys go to Spa therapy to fight weather stress, WHAT ABOUT YOU?
You might be virtually on frypan in scorching summer months following evaluating mercury and grope for solutions to fight hot climate stress in India. But in contrast, Snow monkeys in Japan ward off weather stress by the regular bath in hot springs, the latest study says.
Japanese macaques, also known as snow monkeys, have been enjoying regular baths in the hot spring at Jigokudani in Japan for decades – and have even become a popular tourist attraction.
Also Read: World's first cloned monkeys
A team of researchers led by Rafaela Takeshita of Kyoto University in Japan have now published the first study to scientifically validate the benefits of this behavior. These findings indicate how behavioral flexibility can help counter cold-climate stress and have likely implications for reproduction and survival. The study is available in Primates, the official journal of the Japan Monkey Centre, which is published by Springer.
Japanese macaques (Macacafuscata) are the most northerly species of nonhuman primates in the world and have adapted to extremely cold winters.
Researchers believed that those living in the Jigokudani Monkey Park in Nagano maintain their normal body temperature due to having thicker and longer fur during winter. These primates are also the only group of monkeys known to take hot spring baths, a behavior that was first observed in 1963 when a young female was seen in an outdoor hot spring belonging to a nearby hotel one snowy day.
Other monkeys soon copied this behavior, and for hygienic purposes, the park management has since built a hot spring for the exclusive use of the monkeys. By 2003, one in every three females in the group bathed regularly in winter.
Although the fact that snow monkeys bathe more often during winter suggests that they use the hot spring to stay warm, to date no physiological data had been collected to support this idea. Takeshita and her colleagues studied twelve adult females during the spring birth season, from April to June, and winter mating season, from October to December. They determined how much time the monkeys spent in the hot springs, and which monkeys bathed the most.
The researchers also collected fecal samples during times of extreme cold and analyzed the concentration of fecal glucocorticoid (FGC) metabolite present. This was done because thermoregulatory stress and the management of a body temperature is known to influence concentrations of glucocorticoids, which belong to the family of steroid hormones.
The results confirmed that female snow monkeys use the hot spring more often in winter than in spring, and especially during colder weeks. Dominant females benefited from their status and spent longer time bathing, but they were also involved in more aggressive conflicts, resulting in higher energy expenditure than subordinate females. But taking a spa reduced stress hormone levels in those females.
So high social status in this group of snow monkeys has a trade-off between the costs of high-rank position and the benefits from a hot spring, which is advantageous for conserving energy by reducing the loss of body heat and lowering stress levels.
"This indicates that, as in humans, the hot spring has a stress-reducing effect in snow monkeys," says Takeshita, who believes that further investigation using serum or saliva samples might be useful to detect whether there are any further short-term changes in stress levels.
"This unique habit of hot spring bathing by snow monkeys illustrates how behavioral flexibility can help counter cold-climate stress, with likely implications for reproduction and survival."
In addition, Takeshita and her colleagues found that around 500 visitors per day, who watch the snow monkeys bathe, had no effect on the levels of stress hormones released.


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Orthodox Rabbi Stuns Agudath Gala With 'Heresy' Attack on Open Orthodoxy
The leading rabbi of Agudath Israel of America, the ultra-Orthodox umbrella group, condemned non-Orthodox streams of Judaism and called the religiously progressive Open Orthodox movement heretical at the group's annual gala.
"The Torah must be guarded from the secular forces that seek to corrupt its values and the lives of [Jews], from intruders who sometimes in the name of Judaism completely subvert and destroy the eternal values of our people," said Rabbi Yaakov Perlow, the Novominsker rebbe and the rabbinical head of Agudath Israel, at the May 27 dinner.
New York City Mayor Bill de Blasio, who spoke directly after Perlow, did not address his remarks. The mayor praised Agudath Israel, some of whose lay leaders were key backers in his mayoral campaign.
De Blasio said that the push for universal prekindergarten that has been a key achievement of his administration so far was conceived, in part, with the Orthodox community and Jewish schools, or yeshivot, in mind.
"From the very beginning I knew this would succeed for all of New York City if it was also something that succeeded for this community," de Blasio said. "The yeshivot were such a crucial part of it. I knew if we did that so many children would benefit."
At an event that read as both an assertion of ultra-Orthodox power and a call to vigilance, thousands of ultra-Orthodox Jews gathered at the Hilton Hotel in Midtown Manhattan to applaud their leaders and to show solidarity against perceived threats. The Hilton's ballroom was a sea of black hats and black suits.
Perlow's speech, the evening's most fiery, condemned non-Orthodox streams of Judaism and used particularly harsh language to condemn Open Orthodoxy, the movement led by Rabbi Avi Weiss and centered at Yeshiva Chovevei Torah in Riverdale that pushes for a greater role for women in Jewish ritual, among other things. Perlow criticized the Israeli Chief Rabbinate for not being harsh enough in their treatment of Open Orthodoxy.
Perlow said that the threat posed by the Conservative and Reform movements had largely passed. "They've become oblivious, and they've fallen into the pit of intermarriage and assimilation," he said. "They have no future, they almost have no present."
Yet he warned of the danger to the ultra-Orthodox posed by Open Orthodoxy. Perlow said that Open Orthodoxy is "steeped in apikorsos," or heresy.
"There's a grave danger out there…outside New York City, that positions of leadership amongst Orthodox Jews is being taken over by people who have completely deviated from [the preservation of holiness.]" Perlow said that Isareli Chief Rabbinate is "not sensitive this," and called on the Modern Orthodox to "stand up and reject these new deviationists, cloaking themselves in the mantle of Orthodoxy."
One Jewish leader who attended the gala and was not ultra-Orthodox criticized the remarks.
"The comments were absolutely appalling and divisive, and really have no place in Jewish communal life," he said. "This guy is basically saying that 95% of Jews aren't Jewish."
Avi Shafran, a spokesman for Agudath Israel, disputed the leader's characterization of Perlow's speech. "It was not the Jewishness of any Jews that Rabbi Perlow questioned, but rather the Jewish legitimacy of heterodox theologies," Shafran wrote in an email. "He was simply acting as a religious whistle-blower — out of deep concern, not God-forbid, disdain, for innocent Jews."
De Blasio, who spoke immediately after Perlow, appeared without a yarmulke. He praised Agudath Israel, greeting some of its leaders by name, including Rabbi David Zweibel, the group's executive vice president.
"In City Hall we consider it our obligation to work closely with the community," de Blasio said, referring the city's Orthodox Jews. "It's natural to us."
De Blasio said that the universal pre-k program, the key initiative of the early months of his tenure, had been intended, in part, to benefit the ultra-Orthodox community. "Now our pre-k program is going to have a strong yeshiva program, and I am proud of that fact," de Blasio said
De Blasio did not address questions about his administration's enforcement of Bloomberg-era regulation of metzitzah b'peh, the controversial ritual involving direct contact between a mohel's lips and the child's circumcised penis.
Agudath Israel opposes a current city regulation that requires parents to sign a consent form acknowledging that they are aware of the risk of transmission of herpes that the procedure entails. The de Blasio administration has refused to say how many consent forms have been submitted, or what enforcement action has been taken.
Echoing previous remarks made at an AIPAC event at the same venue in January, de Blasio again suggested that defending the state of Israel is part of his job as New York City mayor.
"Vigilance is called for in defense of someplace we love deeply, which is the state of Israel," de Blasio said. "And one of the great honors I have is to be the mayor of the city on this earth with the largest Jewish population. It is a true honor, and it comes with an obligation to protect that population here, but it also gives me an instantaneous link to the state of Israel, a link that's been furthered by my visits there, and a sense that it's part of what I do to defend the state of Israel."
The comments may not have gone over as well as at AIPAC. Just before de Blasio spoke, Perlow had criticized the Isareli government's effort to draft yeshiva students, a law bitterly opposed by Agudath Israel, which is theologically non-Zionist.
In a final gesture, de Blasio ended his address with a quote from Rabbi Nachman of Breslov, a Hasidic sage born in 1772.
De Blasio wasn't the only political figure at the Hilton looking to court the powerful ultra-Orthodox gathering. Rob Astorino, the Westchetser County Executive and the New York State Republican gubernatorial hopeful, was circulating during the cocktail hour, shepherded by an Orthodox aide. "It's one of the organizations that's a must to stop in," Astorino told the Forward. "I had a lot of support in the Orthodox community in Westchester."
Astorino was promoting his support for the Education Investment Tax Credit, a proposed New York State tax incentive for donations to public and private schools that is supported by Agudath Israel. "It can pass," Astorino said. "The governor's got to be the one to get that done."
Other elected officials greeted from the podium included Congresswoman Yvette Clarke, Congressman Hakeem Jeffries, Congresswoman Grace Meng, Congressman Jerry Nadler, former New York State Governor David Patterson, Kings County District Attorney Ken Thompson, Manhattan Borough Present Gail Brewer, and a handful of members of the New York City Council.
Dignitaries were seated on a three-tiered riser at the front of the room. The bottom level of the riser was nearly as wide as the hall itself; the top two were narrower, the seating arrangements no doubt conveyed deep internal political significance.
Men and women were seated in separate halves of the Hilton's ballroom. The women's tables were separated from the men's and the podium by a barricade formed by leafy green potted plants on long tables.
Rabbi Shmuel Kamenetsky, a leading ultra-Orthodox rabbi based in Philadelphia, announced a new Agudath Israel program to encourage young boys to study the Mishnah, a foundational book of Jewish law that makes up part of the Talmud. Called "One Mishnah, Together," the program appears to be modeled on the Siyyum Hashas, which coordinates the study of the Talmud on a seven-year cycle.
Honorees including Alexander Rapaport, executive director of the Boro Park soup kitchen Masbia, and Rubin Schron, the event's guest of honor, a reclusive New York City developer whose vast Manhattan holdings include the Woolworth building and the building where Agudath Israel's offices are located.
A message from our editor-in-chief Jodi Rudoren
We're building on 127 years of independent journalism to help you develop deeper connections to what it means to be Jewish today.
With so much at stake for the Jewish people right now — war, rising antisemitism, a high-stakes U.S. presidential election — American Jews depend on the Forward's perspective, integrity and courage.
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Cas d'application
Environmental progress in China supported by Grundfos products
TONGREN, CHINA: In recent years, the Chinese government has adopted several very ambitious plans to improve the environment. Many of the projects carried out as part of these plans involve the creation and expansion of wastewater treatment plants. In fact, the dual objectives of having treatment plants for all cities and of boosting treatment rates in cities to 45–60% call for the establishment of 1137 plants.
One such plant is located in Tongren in the Guizhou province in Western China. For this facility, Grundfos presented a sophisticated yet very environmentally-friendly solution that was persuasive enough to make the customers reconsider their original preference and go for Grundfos instead.
The Situation
The city of Tongren is located in the north-east of the Guizhou province. It is home to some light industry and is a well-known source of mercury. The city is located close to the mountain of Fanjing Shan, a site revered by Buddhists and nature-lovers alike. The mountain is famed for its extraordinarily rich plant life and wildlife and was appointed as a nature reserve in 1981. Access routes were improved in the early 1990s, and since then the area has attracted many visitors eager to enjoy the stunning landscape.
Tongren is among the cities included in the Chinese government's ambitious plans for environmental improvements. As a result, a new wastewater treatment plant was planned.
The Grundfos Solution
When it was time to establish a wastewater treatment plant with a daily capacity of 50,000 m3 at Tongren, the project attracted several interested pump suppliers. In fact, negotiations with another major pump manufacturer had already reached an advanced state when Grundfos presented an alternative solution.
The Grundfos proposal was tailored to meet the real needs of the contractor, Malthe Winje AS, and the end user, presenting so many advantages that a deal was eventually struck in March of 2003. The whole process was supported by the Central Customer Service Unit (CCSU), a special Grundfos department devoted to handling largescale project management anywhere in the world.
The Outcome
The system design accurately matched the customer's requirements, and the equipment delivered has been thoroughly inspected to ensure full satisfaction. With final installation and commissioning scheduled for 2005, the city of Tongren will benefit from efficient wastewater treatment in the years to come. What is more, the area surrounding the city will be protected by an environmentally-friendly system, preserving the beauty of Fanjing Shan for future generations.


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Impact seen as roughly comparable to radiation-related deaths after Chernobyl; infants are hardest hit, with continuing research showing even higher possible death count.
An estimated 14,000 excess deaths in the United States are linked to the radioactive fallout from the disaster at the Fukushima nuclear reactors in Japan, according to a major new article in the December 2011 edition of the International Journal of Health Services. This is the first peer-reviewed study published in a medical journal documenting the health hazards of Fukushima.
Authors Joseph Mangano and Janette Sherman note that their estimate of 14,000 excess U.S. deaths in the 14 weeks after the Fukushima meltdowns is comparable to the 16,500 excess deaths in the 17 weeks after the Chernobyl meltdown in 1986. The rise in reported deaths after Fukushima was largest among U.S. infants under age one. The 2010-2011 increase for infant deaths in the spring was 1.8 percent, compared to a decrease of 8.37 percent in the preceding 14 weeks.
Continue reading at Study: US Deaths Tied to Fukushima Disaster Fallout
◇For further reading:
• An Unexpected Mortality Increase In The United States Follows Arrival Of The Radioactive Plume From Fukushima: Is There A Correlation?" by Mangano and Sherman
• For a critical view: "Researchers trumpet another flawed Fukushima death study"


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Every year students flock to the college bookstore to purchase the various textbooks that they require for their classes. Little do these students realize that, in doing so, they are throwing good money away. As unbelievable as it may seem textbooks, in some cases, actually cost as much, if not more, than tuition.
On the surface the college bookstore may seem like a convenient source for textbooks. Titles are usually in-stock and students may purchase new textbooks or opt for the cheaper alternative of used books. In truth the money saved by purchasing used textbooks from the college bookstore is only a fraction of the amount that students could be saving if they shopped online.
More and more online booksellers have begun selling textbooks at a considerable discount off of the cover price. In fact, many major booksellers now have special areas of their web sites that are devoted to selling nothing but textbooks. Online used bookstores are another source for college books as they stock a large number of textbooks, which means sizable savings for students. There are also web-based retailers whose inventory is entirely devoted to college books.
Students should avoid purchasing their textbooks at the first store that they browse. Instead, they should investigate the alternatives offered by other online booksellers. Price isn't the only factor to consider when making an online purchase. Students should also factor in shipping costs and delivery time when making their buying decision.
Online auctions are another option for students seeking a bargain. This option, however, has its pros and cons. A plus is that students can get incredible bargains when obtaining books via online auctions. One downside is that established retailers have channels in place to ensure that you receive your order within a reasonable amount of time. With an auction purchase, however, you are at the mercy of the auction seller's timetable.
One way that students can really save is by obtaining books for free. Project Gutenberg is one resource that English majors will find invaluable. At this site students can peruse a vast collection of classics that have entered the public domain. In the past students seeking assistance with their studies had to pay for the privilege of that help by purchasing study guides. Today that is no longer the case. Cash-strapped students can now visit Spark Notes for free downloadable study guides as well as free downloadable classics.
Students who elect to buy online will no longer be able to resell their books to the college bookstore at the end of class, but that doesn't mean that they are stuck with the textbooks. Many web sites that sell textbooks also offer students the option of selling their books to fellow bargain-seekers. This allows students to easily recouping a portion of their money.
Textbooks normally consume a major portion of a student's budget, but that doesn't have to be the case, because while the cost of tuition may be set in stone the price of textbooks isn't. By taking the time to do a little research on the best textbook values available college students can save money now rather than acquiring debt to be paid back later.


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Written by commericial on . Posted in Uncategorized
Welcome to My Site Sites. This is your first post. Edit or delete it, then start blogging!Todd did an awesome job getting all the components into our basement home theater system that my techy husband wanted plus making it easy for me to run with only one remote. We are very happy! The guys that came to install the systems were polite and patient with me and took time to explain how to work it all!
-Maureen Mitchell
Great products! Exceptional Service! I was out of idea for what to buy my wife. I stopped at The Easy Living Store and they had all I needed to make her happy. I would have never thought of a self opening garbage can as a great gift idea, but they said she would love it and she did! I was amazed at everything the store had to offer and how helpful the staff was there. I will go back.
-H.A. Gross
I have hard wood floors and Beam has a attachment I bought it at the store and it is a God send I simply love it, it is a dry mop on the vac! Amazing! I'm buying a spare mop when I go back! I bought my vac at Van Berkum's in Pella (Where I live) never will I go back there, they sent my head out for as a loaner and gave me some one elses. How is that for doing business! We argued for a long time about this and was getting no where she kept saying that it was my head, I will never go back there to buy anything! I'm 60 minutes from Des Moines and I will take my vac to be serviced at the Easy Living Store anytime!
-Jo Owens-Lovett
I live in a 50's home. I had A Tech come and redo my closets for me. They had great ideas, listened to my input and now I have great closets, even though I live in an older home!
-Nancy Plagman
Todd designed a whole house audio system with separate controls for every room with one receiver. He was extremely knowledgeable about speaker placement, size and quality. The end product is amazing. He also recommended a remote that controls everything. This is one of my favorite features. I have also purchased several items for my garage organization that I love. They have everything from home audio, garage organization to kitchen items in the store. Will continue to do business with them as I still need closet organization.
-Gabe Bosma
We have had our Beam Central Vac for over 15 years and absolutely love it! It is convenient, easy to use and best of all - keeps the 'dust' out of the home!. We have had very good service when we needed it, we replaced the motor in the unit once (very reasonable) and had replaced the power brush handle once. Pretty good for a unit that is over 15 years old! The folks at A Tech Easy Living Store are knowledgeable and very willing to assist in any way they can. Highly recommend visiting the store! They have LOTS of items that can make your life easier in your home!
-John Mauch
Todd at A Tech did an awesome job setting up all the electronics in our basement. We have surround sound and all of the electronics are hidden in a closet with only 1 remote. My husband is techy so he worked with A Tech more than I did but my only request to Todd was that I needed to be able to watch tv and play a dvd without asking for help (I am not techy!) One fabulous remote runs everything and has pictures and an easy menu! They also fixed the internet issue in our house! Very Happy Customers!
-Maureen Mitchell
This is the perfect place to go when you have no idea what to get your relatives for Christmas/birthdays. They have fun gadgets all the way up to amazing electronics. Their customized closets are also something just about anyone can use. Who doesn't want to save some space in their home? Stop by and check it out sometime.
-Chandler Faldet
A Tech Easy Living is the "go to" place for my organization needs. They have items I didn't even know existed that solved my organization needs. And the service is impeccable. They are very attentive and help me find what I need to solve my problem.
-Ernie Moore
wish every home repair could be this easy!!! My central vacuum was having issues, burned out motor, poor connection and an outlet issue. The technician called me a bit early and said he was ahead of schedule, perfect! He was waiting when i got there, diagnosed it in about 10 minutes, I asked how long it would take to get the parts, he said he had them on the truck! I thought maybe they were generic, but when they made the appt they asked what model. He made the right diagnosis and fixed in about 20 minutes! Couldn't really ask for much more!!! The only remote downside was when I called on saturday the lady asked me to call back on monday. Great service and a great experience!
-Sean Sellers
Todd and his staff were very professional and easy to work with during our recent project of updating our home entertainment system. I wouldn't think twice about referring A Tech Easy Living Store!!! Thanks
-DJ Bork
ATech is a great company to work with. Todd T. works hard to ensure your project is completed on time and on budget. He has great attention to detail and has many solutions for many different areas of your home. The Company has been around for a long time and has a great reputation in our community. Thanks!
-Jacob Burkhart
Easy living best describes the results you get from this store. From hi-tech entertainment systems, whole house vacuums, closet organizers and much more...this store has it all. And for kitchen gadgets and accessories, they are well stocked.
-Nick Gelormino


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Flower Power Capri w/ Butt Pockets
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With interest rates so low, one could argue that money is essentially on sale.
It's actually half off.
30-year mortgage rates hit 3.75% which is exactly half of their long term average.
Rates have averaged 7.5% over the last 40 years so today buyers are getting half of that rate.
The "sale" on mortgage rates creates a significant savings in monthly payment because of the 1%/10% rule.
For every 1% change in interest rate, the monthly payment will change roughly 10%.
So when rates go up to 4.75%, a buyer's payment will be 10% higher.
For example, the principal and interest payment on a $400,000 home with a 20% down payment at today's rates is $1,482.
If rates were 1% higher, the payments jump up to $1,669.


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What is Spinal Fusion?
Spinal fusion is the surgical technique of combining two or more vertebrae. A fusion of the vertebrae involves the insertion of secondary bone tissue obtained either from an autograft (tissues from your own body) or allograft (tissues from another person) to enhance the bone healing process.
The lumbar (lower back) region of the spine is more prone to spine fusion when compared to the other regions such as cervical (neck) and thoracic (mid-back) parts of the spine. Usually, spinal fusion is recommended for neurological problems or severe pain that have not responded to conservative treatment.
Indications for Lumbar Spinal Fusion
Various spinal conditions may be treated through lumbar spinal fusion such as:
- Spinal stenosis
- Damaged disc
- Spinal tumor
- Fractures of the spine
- Scoliosis and kyphosis (abnormal curvatures of the spine)
Spinal Fusion Procedure
- Spinal fusion can be performed through different angles depending upon the specific advantages of each and the choice of your surgeon. It may involve interbody fusion where bone graft is placed in the space present between the two vertebrae.
- Other techniques may also be employed for spinal fusion that involves the entire removal of the disc between the affected vertebrae. A specially designed device, made either from plastic or titanium, may be placed between the vertebrae. This helps in maintaining spine alignment and normal height of the disc.
- The fusion process is followed by fixation, which involves the fitting of metallic screws, rods, plates or cages to stabilize the vertebrae and accelerate bone fusion. After surgery, 6-12 months is the ideal time for complete fusion to take place.
Complications of Spinal Fusion
The complications associated with spinal fusion include infection, nerve damage, blood clots or blood loss, bowel and bladder problems and problems associated with anesthesia. The primary risk of spinal fusion surgery is the failure of fusion of vertebral bones, which may require additional surgery.