text: Natural History of Human Papillomavirus Infections Involving Anal, Penile, and Oral Sites Among HIV-Positive MenVidela, Sebastian MD, PhD*; Darwich, Laila DVM, PhD†‡; Cañadas, Mari-Paz MSC, PhD†§; Coll, Josep MD*†; Piñol, Marta MD, PhD¶; García-Cuyás, Francesc MD, PhD¶; Molina-Lopez, Rafael A. DVM*; Cobarsi, Patricia MS*; Clotet, Bonaventura MD, PhD*†∥; Sirera, Guillem MD, PhD*∥; on behalf of HIV-HPV Study GroupSexually Transmitted Diseases: January 2013 - Volume 40 - Issue 1 - p 3–10 doi: 10.1097/OLQ.0b013e31827e87bd Original Study Abstract In Brief Author Information Article Outline Aim: The aim of this study was to characterize the natural history of human papillomavirus (HPV) infection at anal canal, penile, and oral sites in HIV-positive men based on their sexual behavior. Methods: This is a single-center, prospective cohort study. The prevalence, clearance, and incidence of HPV infection at anal, penile, and oral sites were studied in HIV-positive men who have sex with men (MSM) and heterosexual individuals using multiplex polymerase chain reaction. Risk factors associated with HPV infection were analyzed. Results: In total, 733 patients (538 MSM, 195 heterosexual) were included in the study between 2005 and 2009. The prevalence, clearance, and incidence of HPV infection were 73%, 30%, and 36% at anal site; 26%, 56%, and 17% at penile site; and 16%, 44%, and 11% at oral site, respectively. At anal site, MSM had a higher HPV prevalence (84% vs. 42%; odds ratio,7.3; 95% confidence interval [CI], 5.2–10.6) mainly for multiple (≥3) HPV types, higher incidence rate (324 vs. 92 new HPV-infected person per 1000 person-years [hazard ratio, 8.1; 95% CI, 3.8–17.3]), and a lower clearance rate (125 vs. 184 cleared HPV-infected person per 1000 person-years [hazard ratio, 0.5; 95% CI, 0.3–0.9]) than did heterosexuals. Similar prevalence, clearance, and incidence rates of penile and oral HPV infection were found between groups. The most common high-risk HPV type for the 3 body sites studied was the HPV-16. Finally, a similar proportion of heterosexuals (7%) and MSM (6%) presented concurrent HPV infections (anal-penile-oral sites). History of anal warts was associated with higher HPV prevalence in the 3 body parts. Conclusions: Although MSM presented the highest risk of anal HPV infection, heterosexual men also showed a remarkable prevalence of anal HPV infection and a comparable risk to MSM for penile and oral HPV infection. Taking into account all these results, the careful inspection of the anal canal, penile, and oral sites should at least be routine in each clinic visit of HIV-infected men independently of their sexual behavior. This is a prospective cohort study of HIV-positive men (men who have sex with men [MSM] and heterosexuals) with the aim of studying the natural history of human papillomavirus infection at anal, penile, and oral sites. As expected, HIV-infected MSM presented the highest risk of anal human papillomavirus (HPV) infection, but heterosexual men also showed a remarkable prevalence of anal HPV infection and a comparable risk for MSM from HPV infection at penile and oral sites. From the *Lluita Contra La SIDA Foundation, Barcelona, Spain; †Retrovirology Laboratory IrsiCaixa Foundation, Barcelona, Spain; ‡Department of Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona, Catalonia, Spain; §Labco.General-Lab, Barcelona, Spain; Departments of ¶Surgery and ∥Medicine, HIV Clinical Unit, University Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, Catalonia, Spain. The authors thank Dr Christian Brander and Dr Roger Paredes (HIVACAT, Barcelona, Spain) for the critical revision and Mr Eric Goode for the English correction of this manuscript. Special thanks also go to the male patients of the HIV Unit. HIV-HPV Study Group: University Hospital Germans Trias i Pujol, Badalona (Barcelona), Autonomous University of Barcelona. Department of Proctology: Ms I. Fernández; Department of Pathology: Dra E. Castella and Dra M Llatjós; • HIV Clinical Unit and Internal Medicine Department: Dra A. Bonjoch, Dra P. Echevarría, Dr M. Jabaloyas, Dr A. Jou, Dr J.M. Llibre, Dr J. Moltó, Dra E. Negredo, Ms N. Pérez-Alvarez, Dr C. Rey-Joly, Dr J. Romeu, Dr JR. Santos, and Dra C. Tural; Nurses of HIV Clinical Unit: Ms C. Alcalde, Ms R. Guerola, and Ms A. Salas; Lluita contra la SIDA Foundation: S.Gel; Labco.General-Lab, Department of Molecular Biology: Ms I. Castilla, Dr V. Cirigliano, Dr M. Ejarque, Ms E. López, Ms E. Ordóñez, and Ms L. Rueda. Supported by grants from Red de Investigación en SIDA (RIS), ART AIDS Foundation, Gilead Sciences, Obra Social Caixa Sabadell, and Gala contra la SIDA-Barcelona 2011. S. Videla and L. Darwich contributed equally to this study. B. Clotet and G. Sirera contributed equally to the design and direction of this work. S.V. has received honoraria for collaborating with Laboratorios Dr Esteve for work unrelated to human papillomavirus/HIV. B.C. has received honoraria for speaking and participating in advisory boards from Abbott, Bristol-Myers Squibb, Boehringer-Ingelheim, Gilead Sciences, GlaxoSmithKline, Pfizer, Merck, Janssen-Tibotec, and Siemens. The remaining authors have no conflict of interest. S. Videla, G. Sirera, and B. Clotet designed and wrote the study protocol; G. Sirera and J. Coll visited and interviewed the patients; M.P. Cañadas and L. Darwich performed human papillomavirus detection and genotyping with multiplex polymerase chain reaction; F. García-Cuyás, M. Piñol, and P. Cobarsi collected anal, penile, and oral specimens; S. Videla, L. Darwich, M.P. Cañadas, J. Coll, and B. Clotet wrote the manuscript; data management was performed by R. Molina, L. Darwich, and S. Videla; and statistical analysis was performed by R. Molina. All authors have read and approved the final manuscript. Correspondence: Laila Darwich, DVM, PhD, Veterinary Faculty, Department of Sanitat i Anatomia Animal, Universitat Autònoma de Barcelona, 08193, Spain. E-mail: email@example.com. Received for publication February 21, 2012, and accepted August 28, 2012. Abstract PATIENTS AND METHODS Study Design Questionnaires Sample Collection HPV Testing Statistical Analysis Sample Size Definitions Statistical Comparison RESULTS Subject Recruitment and Follow-Up Patient Characteristics HPV Infection at Anal Canal Site HPV Infection at Penile Site HPV Infection at Oral Site Concurrent HPV Infection in the Anus, Penis, and Mouth Risk Factors DISCUSSION REFERENCES High-risk (H-R) oncogenic human papillomavirus (HPV) types are the etiologic agent for several specific squamous cancers such as cervical,1 anal,2 and some penile3,4 and oropharyngeal5,6 cancers. Some of these HPV-associated malignancies occur at higher rates in persons with HIV/AIDS.7 Likewise, the incidence of anal cancer among HIV-positive men who have sex with men (MSM) has been estimated to be twice that seen in HIV-negative MSM.8,9 It is widely accepted that the persistence of HPV infection is a prerequisite for abnormal anogenital cytology. In HIV-negative people, most HPV infections are self-limiting and do not progress to histologic lesions.10 It is currently unknown whether this also happens in HIV-positive patients. Furthermore, although HIV-1 and HPV are both sexually transmitted diseases, the risk of HPV infection is increased in certain sexual behaviors.11 Among the HIV-infected population, MSM are particularly susceptible to HPV infection in the anal canal.12–14 The incidence and clearance rates can differ among HPV types, and a lower clearance rate for anal infection with HPV-16 in MSM has been reported.14 In this line, Silva et al.,15 also found that HIV infection was a risk factor for the clearance and persistence of HPV in the penis. Data on the spread of HPV infection of different body sites involved in sexual practices in both MSM and heterosexual men are limited. A prospective cohort study of HIV-positive men (MSM and heterosexual) was conducted to obtain a better understanding of the natural history of HPV infection in the anus, penis, and mouth. Back to Top | Article Outline PATIENTS AND METHODS Study Design The Can Ruti HIV+ Men cohort was a single-center, prospective cohort study, annually assessing HPV infection at anal, penile, and oral sites of HIV-positive men attending the Outpatient HIV Clinic of the Hospital Germans Trias i Pujol (Badalona, Spain). The study was approved by the hospital's independent ethics committee. HIV-positive men were eligible for participation if they were older than 18 years and reported no previous diagnosis of HPV-related pathology at anal, penile, and oral sites. Consecutive patients' recruitment, based on outpatients who attended their AIDS routine clinic visit, was carried out by 1 staff care provider from 2005 to 2007, and it has been done by 2 staff care providers since 2008. The patients were informed of the study and invited to be seen in the Clinical Proctology HIV Unit–created ad hoc (2 afternoons per week). If they accepted to participate, written informed consent was obtained. The following data were collected: date of birth, date of HIV-positive diagnosis, baseline CD4 cell counts (the closest value determined during participants' usual clinical follow-up visits before the sample collection), CD4 nadir counts (the lowest CD4 value abstracted from medical records), plasma HIV load (the closest value determined before the sample collection), highly active antiretroviral therapy (HAART) previous to inclusion and time on HAART, other previous treatments, and history of sexually transmitted infections (STIs). Cellular counts were determined by flow cytometry (HIV viral load by Nuclisens; bioMerieux, Inc, Durham, NC). The schedule of visits was as follows: all participants completed a detailed self-administered baseline questionnaire and then a clinical examination (visual inspection) of the 3 body sites studied (anal canal, penile, and oral sites), and a digital rectal examination was performed at the baseline visit. Samples from the 3 areas were collected to detect HPV infection (multiplex polymerase chain reaction [PCR]). The sample from the anal canal was also used to carry out the cytologic analysis (Papanicolaou test; data not shown). After baseline visit, all patients had to be evaluated and monitored annually. Patients who were diagnosed as having HPV-related pathology at the anal canal (anal warts or anal intraepithelial neoplasia grades II–III), penile, or oral sites at baseline visit or during follow-up visits completed their participation in this study. Back to Top | Article Outline Questionnaires Behavioral data were collected at the enrollment visit through a questionnaire administered by a health professional who was not the participants' primary caregivers. The information collected was as follows: sociodemographic characteristics (including sexual history and sexual practices), history of STI, circumcision, history of drug consumption (tobacco, alcohol, intravenous drug), and HIV history (including HIV treatment). In the follow-up visits, the questionnaire contained a reduced set of questions and also elicited responses aimed at verifying the consistency of the information given at baseline. Back to Top | Article Outline Sample Collection Anal samples were obtained introducing a cytobrush (Eurogine SL, Spain) 3 cm into the anal canal and gently rotating it for 30 to 45 seconds. The cytobrush was introduced into and shaken in a 20 mL of PreservCyt/ThinPrep Papanicolaou test solution (Cytyc Iberia SL, Spain) for 30 seconds. Two different dacron swabs were used for the penis. Trained clinicians collected the first 2 cm of the urethral epithelium with a dacron urethral swab. A second saline prewetted dacron swab was used to obtain cells from the 4 quadrants of penile shaft, glans penis, and coronal sulcus. The glans penis was first scratched with sandpaper to increase the cellular yield. Both penile samples were pooled in the same tube and suspended in 1 mL of 0.1 M phosphate-buffered saline. Oral samples were obtained by brushing both sides of the oral cavity with a cytobrush and by vigorously swishing and gargling 5 mL of phosphate-buffered saline for 30 seconds and spitting it into a collection recipient. Both oral samples were combined into one sample. Oral and penile samples were stored at −20°C until analysis. Back to Top | Article Outline HPV Testing DNA extraction was performed by the Qiamp Viral DNA kit (QIAGEN, Hilden, Germany). Human papillomavirus detection and typing were performed using the commercial IVD-CE F-HPV typing (Molgentix SL, Barcelona, Spain). The assay permits the detection of 13 H-R genotypes, including 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68, and 2 low-risk (L-R) genotypes, including 6 and11. A human short tandem repeat sequence included in the same multiplex was amplified as the internal control to check for DNA integrity and the absence of PCR inhibitors. If the baseline anal sample was not satisfactory because of the lack of PCR internal control amplification, the sampling was repeated up to 3 times over the first 6 months. However, only 1 sample from the penile and oral sites at baseline was obtained. In the follow-up controls, only 1 sample from the anal canal, penile, and oral sites was collected per visit. Back to Top | Article Outline Statistical Analysis Sample Size A sample size representative of our HIV-positive male patients was calculated, assuming that the prevalence of anal HPV infection in our HIV-positive men was 75%.12 In addition, we assumed a 10% cumulative incidence of anal HPV infection per year. Moreover, we assumed that a 30% of the patients would have anal warts at baseline or would be lost during the follow-up. We attempted to conserve an MSM/heterosexual ratio of 3:1, taking into account the characteristics of the overall population attended to in our clinical unit. Back to Top | Article Outline Definitions The MSM or heterosexual status was obtained through the questionnaire and then verified by checking the medical record. The existence of a current HPV infection was considered when 1 or more HPV types were detected in a sample. Prevalent HPV infection was defined as detectable HPV infection at baseline. Clearance, assessed using the prevalent HPV infection, was defined as detection of HPV infection at baseline and the absence of detection in follow-up samples. Incidence was defined as the absence of any HPV infection at baseline and positive detection in the next sampling. No HPV infection was defined as nondetectable HPV infection at any sampling time point. Back to Top | Article Outline Statistical Comparison Prevalence and 95% confidence intervals (95% CIs) were calculated. Differences were evaluated by the χ2 test for qualitative variables, and their 95% CIs were calculated. Clearance and incidence of HPV infection were analyzed using the Kaplan-Meier method, and differences were assessed using the Mantel-Haenzel log-rank test. Clearance and incidence rates were also calculated based on person-time denominator (1000 person-years). Bivariate and multivariate logistic analyses and Cox proportional hazard regression models were performed, when appropriate, to determine potential factors associated with the prevalence, clearance, and incidence of HPV infection. Multivariate regression models were adjusted to different covariates (sexual behavior; age; HIV infection (years); time on HAART; presence of HAART; nadir, basal CD4 counts; history of STI; tobacco, alcohol, intravenous drug users; sexual partners (number); practice of receptive anal intercourse (RAI); oral sex practices; presence of circumcision; treatment with interferon). The association between potential explanatory variables and HPV infection was tested in 3 steps. First, a bivariate regression model was performed to obtain an indication of the relevance of the explanatory variables in the risk of HPV infection. Second, factors showing a P value less than 0.25 were further scrutinized for associations using the Pearson correlation coefficient (r) so as to avoid colinearity problems. The third step involved a multiple regression model using a stepwise selection of variables. Confounding was considered to be clinically relevant if changes in the association measure from the crude analyses were more than 10%. Odds ratios (ORs) for prevalence and hazard ratios (HRs) for clearance and incidence were estimated as well as their corresponding 95% CI. A P value of 0.05 or less was considered statistically significant. Data analysis was carried out using SPSS version 15.0 statistical software (Chicago, IL, USA). Back to Top | Article Outline RESULTS Subject Recruitment and Follow-Up A total of 911 HIV-positive men were approached for participation in the study, of which 764 (84%) signed the informed consent form. Thirty-one patients never attended the baseline visit, leaving 733 men included in the cohort. The inclusion period comprised the period between January 2005 and May 2009. The database was closed when the last patient included had had at least 1 year of follow-up. Seventeen percent (127/733) of the patients were lost from this study for different reasons. No differences based on sexual behavior (17% [90/538] MSM and 19% [37/195] heterosexual, P = 0.4789) were found. In 127 patients, information from their baseline visit was only used: 22 patients (3% [17/538] MSM, 3% [5/195] heterosexual) were dropouts (10 decided to end their collaboration and 12 changed their hometown residence) and 105 patients (14% [73/538] MSM, 16% [32/195] heterosexual) were withdrawn (93 had been treated in the past for anal warts and 12 died for different reasons unrelated to HPV infection). A total of 606 (83%) patients were included to assess the evolution of HPV infection. The median (interquartile range) follow-up time was 24 (12–36) months: 38 individuals (6%) completed 5 years of follow-up (6 visits); 21% (126/606), 4 years (5 visits); 22% (132/606), 3 years (4 visits); 29% (176/606), 2 years (3 visits); and 22% (134/606), 1 year (2 visits). Back to Top | Article Outline Patient Characteristics The patients included in the cohort were stratified by sexual behavior into 2 groups: MSM (n = 538) and heterosexual (n = 195). The MSM population had a shorter time from HIV diagnosis to enrolment, a lower percentage of AIDS diagnosis, and higher nadir CD4 counts in comparison with the heterosexual population (P < 0.001). Moreover, heterosexual patients had a higher percentage of past intravenous drug use and smoking. Furthermore, a larger number of those patients had been treated with interferon, mainly due to hepatitis C. As expected, MSM had RAI practices and a higher number of lifetime sexual partners compared with the heterosexual men (Table 1). No patient had a history of or presented with HPV-related cancer during this study. Table 1 Back to Top | Article Outline HPV Infection at Anal Canal Site Prevalence could be estimated including all patients (538 MSM, 195 heterosexual); clearance, including 387 MSM and 66 heterosexual with prevalent HPV infection at baseline; and incidence, including 70 MSM and 83 heterosexual with nondetectable HPV infection at baseline. The overall baseline prevalence, cumulative clearance, and incidence of anal HPV infection were 73% (534/733), 30% (136/453), and 36% (55/153), respectively. The MSM group presented a higher prevalence (84% vs. 42%; OR, 7.3; 95% CI, 5.1–10.6) and a lower cumulative probability of clearance of anal HPV infection (28% vs. 42%; HR, 0.5; 95% CI, 0.3–0.9) than the heterosexual group (Table 2). The cumulative probability of an incidence of anal HPV infection was also higher in the MSM group (Table 2). Most of the anal infections in MSM were caused by multiple HPV types (Table 3). It is worth mentioning that the prevalence of anal HPV infection in the heterosexual group was also high (42%) and principally involved a single HPV type (Table 3). Table 2 Table 3 The most commonly detected H-R HPV types at the baseline were HPV-16 (32%), HPV-33 (22%), HPV-51 (18%), and HPV-58 (18%) in the MSM group and HPV-16 (11%), HPV-39 (7%), and HPV-33 (5%) in the heterosexual group. Among the 2 L-R HPV types analyzed, HPV-6 was the most frequent type in both groups (23% in MSM and 13% in heterosexuals, respectively). Back to Top | Article Outline HPV Infection at Penile Site The prevalence could be estimated including 457 MSM and 191 heterosexual. Clearance was estimated including 86 MSM and 42 heterosexuals, and incidence could be estimated including 301 MSM and 104 heterosexuals. The overall baseline prevalence, the cumulative probability of clearance, and the incidence of HPV infection in the penis were 26% (166/648), 56% (72/128), and 17% (70/405), respectively. Men who have sex with men presented a higher cumulative incidence of penile HPV infection than the heterosexual group (HR, 2.3; 95% CI, 1.2–4.8) (Table 2), but this difference was not statistically relevant in the multivariate model (Table 4). The HPV prevalence (Table 3) and clearance at the penile site were similar between groups. The most prevalent HPV types were HPV-6 (8%), HPV-16 (5%), and HPV-39 (4%) in MSM and HPV-6 (9%), HPV-16 (7%), HPV-51 (4%), and HPV-58 (4%) in heterosexual men. The prevalence of HPV-18 was 1% in MSM and 2% in heterosexual HIV-positive men, and HPV-11 was 2% in both groups. Similar clearance and incidence rates of HPV-16 were observed between groups. Table 4 Back to Top | Article Outline HPV Infection at Oral Site Oral prevalence could be estimated including 458 MSM and 192 heterosexual. Clearance was estimated including 60 MSM and 29 heterosexuals, and the incidence was estimated, including 333 MSM and 118 heterosexuals. The overall prevalence at baseline, the cumulative probability of clearance, and the incidence of oral HPV infection were 16% (107/650), 44% (39/89), and 11% (49/451), respectively. Slightly higher prevalence and lower clearance of oral HPV infection were observed in the heterosexual group with respect to MSM group, although differences did not reach statistical significance (Tables 2 and 3). A similar incidence of oral HPV infection was observed in both HIV-infected groups. The most prevalent HPV types in MSM were HPV-16 (4%), HPV-33 (3%), and HPV-6 (3%), whereas they were HPV-16 (8%) and HPV-39 (4%) in heterosexual men. Only 1 MSM presented with a detectable HPV-18 infection in the mouth, and 2 patients showed the presence of HPV-11 (1 MSM, 1 heterosexual). Back to Top | Article Outline Concurrent HPV Infection in the Anus, Penis, and Mouth The overall baseline prevalence of concurrent HPV infection in 3 different body sites was 7% (43/648), with a prevalence of 6% (29/457) in MSM and 7% (14/191) in heterosexual men. Concurrent infection with HPV-16 at the 3 body sites studied was only found in 2 (1%; 2/191) heterosexual patients. The prevalence of concurrent HPV infection at anal and penile sites was 21% (135/648), with a prevalence of 23% (104/457) in MSM and 16% (31/191) in heterosexual men; concurrent infections of 14% were observed at anal and oral sites (89/650), with a prevalence of 14% (65/458) in MSM and 13% (24/192) in heterosexual men. The prevalence of concurrent infections at penile and oral sites at baseline was 7% (47/648), with a prevalence of 7% (30/457) in MSM and 9% (17/191) in heterosexual men. A history of anal warts was the unique factor associated with a higher prevalence of HPV infection at the 3 sites (Table 4). Back to Top | Article Outline Risk Factors Risk factors associated with prevalence, clearance, and incidence of HPV infection at the 3 anatomical sites are represented in Table 4. Sexual behavior (MSM) was only a risk factor for prevalence and incidence of the anal HPV infection, and RAI was only a risk factor for the anal canal clearance of this infection. The history of anal warts was a common risk factor for the prevalence at the 3 body sites studied. In contrast, it was a protective factor for clearance of the oral HPV infection. It is noteworthy that to be on HAART at baseline was a risk factor for the oral HPV infection prevalence. On the other hand, to be on HAART was a protective factor for the anal prevalence. It was the same for the period on HAART in terms of anal and penile prevalence. Back to Top | Article Outline DISCUSSION Few studies have systematically assessed the presence of HPV infection at different body sites involved in sexual practices in HIV-positive MSM and heterosexual men in parallel and with up to 5 years of follow-up. Our results corroborate the high prevalence and incidence of anal HPV infection in MSM HIV-positive population in comparison with the heterosexual HIV-infected subjects.14 However, it is worth mentioning the high prevalence of anal HPV infection in the heterosexual HIV-positive men in comparison with the expected in healthy men and the similar prevalence and clearance of HPV infection at penile and oral sites compared with the MSM of this cohort. The anal canal site was the site with the highest presence of detectable HPV, especially among MSM, and was higher than the cervical prevalence of HPV infection in our cohort of HIV-positive women.16 Only limited data (based mainly on cross-sectional studies) regarding the epidemiology of anal HPV infection in heterosexual HIV-positive population are available.17,18 Our results show a high prevalence (42%) of anal HPV infection in heterosexual HIV-infected men, which was considerably higher than that reported for heterosexual HIV-negative men (12%).19 The aforementioned suggests that anal HPV infection may also be acquired by HIV-infected men independently of the sexual behavior and even in the absence of RAI, in agreement with other reports.20 Thus, the immunosuppressant effects of HIV coinfection might favor the colonization of the anal canal by HPV. Another important result obtained was the role of a history of anal warts as the only risk factor associated with a higher HPV prevalence at the 3 body sites examined. The total and HPV type–specific prevalence and clearance rates found at the anal canal site of our MSM group were similar to those reported in an MSM HIV-positive cohort,14 with HPV-16 being the most frequently detected genotype found at the 3 body sites. In addition, HPV-33, HPV-51, HPV-52, and HPV-58 were the codominant genotypes at the anal canal site, and all have been associated with invasive cervical cancer,21 This suggests that other genotypes, aside from HPV-16 or HPV-18, may be involved in anal carcinogenesis. Multiple HPV infections at the anal canal site were considerably more prevalent in the MSM population.9,14 It is possibly due to the frequency of anal sexual practices. Despite the introduction of HAART, anal cancer among the HIV-positive is increasing.18,22–24 This fact might imply that improvements of HIV-related immunosuppression due to HAART are insufficient to reduce the incidence of anal cancer. In our study, a longer period on HAART was associated with a lower prevalence of anal HPV infection, but this effect was weak, given the high prevalence observed. Owing to the well-established association between HPV infection and squamous cell cancers and the elevated risk of anal cancer among HIV-positive men,24–26 periodic assessments of HPV infection in anal canal should be considered in both MSM and heterosexual HIV-infected men. One of the objectives of this study was to gather insights into the natural history of HPV infection at the penile site in HIV-positive men. The only difference found between sexual behavior groups was the elevated incidence of penile HPV infection in the MSM group. According to the adjusted regression model results, this finding should not be attributed to the sexual condition. Other factors such as a shorter period of HIV infection or time under antiretroviral treatment may be related to this outcome. In this line, no differences in persistence and clearance of HPV infection at the penile site were found between HIV-positive and HIV-negative men.15 Nevertheless, it is noteworthy that the prevalence found in our HIV-infected men was considerably lower than that reported for HIV-negative men27; this difference may be due to the sampling method used. The overall prevalence (16%) of oral HPV infection in our HIV-infected men was notably higher than the described prevalence in a small population of healthy men (4%).28 Conversely, HPV infection at the oral site was less prevalent than HPV infection at the anal and penile sites in our cohort. It is reasonable to suppose that the oral site may be less susceptible to HPV infection than the anogenital sites or that oral sex and autoinoculation may be less likely to result in oral infection. There are several limitations in this study. The defined clearance terms may be overestimated for patients with only one sample in the follow-up. Similarly, a 1-year sampling interval may be too long to determine incidence rates because many incident infections could have already been cleared by the time of the next study visit, leading us to underestimate the true incidence rates. However, shorter intervals, which were not possible to set in the protocol because of economic and logistic constraints, may result in lower patient compliance in the follow-up. Another drawback may be the detection method, which only allowed for the detection of 13 H-R HPV and 2 L-R HPV types. However, these H-R types are the ones most commonly associated with malignant lesions at anogenital sites, and L-R types are the ones most involved in condylomatous lesions and targeted by the current HPV vaccine. Likewise, another limitation has to be considered; this study only involves one center. In conclusion, the present study provides important information about the natural history of HPV infection at the different body sites involved in sexual practices in HIV-infected men. Although MSM presented the highest risk of anal HPV infection, heterosexual men also showed a clinically remarkable prevalence of anal HPV infection and a comparable risk of penile and oral HPV infection than MSM. Taking into account all these results, the careful inspection of the anal canal (including at least a digital rectal examination and a cytologic examination once per year), penile and oral sites should at least be routine in each clinic visit of HIV-infected men independently of their sexual behavior. Furthermore, whenever possible, carrying out the screening for type-specific HPV infection, at least at the anal canal site, should be recommended. Ongoing surveillance of this cohort will help to better understand the natural history of HPV infection. Back to Top | Article Outline REFERENCES1. Bosch FX, de San José S. Chapter 1: Human papillomavirus and cervical cancer—burden and assessment of causality. J Natl Cancer Inst Monogr 2003; 31: 3–13. Cited Here... | PubMed | CrossRef 2. Welton ML, Sharkey FE, Kahlenberg MS. The etiology and epidemiology of anal cancer. Surg Oncol Clin N Am 2004; 13: 263–275. Cited Here... | PubMed | CrossRef 3. Dillner J, von Krogh G, Horenblas S, et al.. 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Sirera G, Videla S, Piñol M, et al.. High prevalence of human papillomavirus infection in the anus, penis and mouth in HIV-positive men. AIDS 2006; 20: 1201–1204. Cited Here... | View Full Text | PubMed | CrossRef 13. Critchlow CW, Hawes SE, Kuypers JM, et al.. Effect of HIV infection on the natural history of anal human papillomavirus infection. AIDS 1998; 12: 1177–1184. Cited Here... | View Full Text | PubMed | CrossRef 14. de Pokomandy A, Rouleau D, Ghattas G, et al.. Prevalence, clearance, and incidence of anal human papillomavirus infection in HIV-infected men: The HIPVIRG cohort study. J Infect Dis 2009; 199: 965–967. Cited Here... | PubMed | CrossRef 15. Silva RJ, Casseb J, Andreoli MA, et al.. Persistence and clearance of HPV from the penis of men infected and non-infected with HIV. J Med Virol 2011; 83: 127–131. Cited Here... | View Full Text | PubMed | CrossRef 16. Videla S, Darwich L, Cañadas MP, et al.. Epidemiological data of different human papillomavirus genotypes in cervical specimens of HIV-1–infected women without history of cervical pathology. J Acquir Immune Defic Syndr 2009; 50: 168–175. Cited Here... | View Full Text | PubMed | CrossRef 17. Piketty C, Darragh TM, Da Costa M, et al.. High prevalence of anal human papillomavirus infection and anal cancer precursors among HIV-infected persons in the absence of anal intercourse. Ann Intern Med 2003; 138: 453–459. Cited Here... 18. Wilkin TJ, Palmer S, Brudney KF, et al.. Anal intraepithelial neoplasia in heterosexual and homosexual HIV-positive men with access to antiretroviral therapy. J Infect Dis 2004; 190: 1685–1691. Cited Here... | View Full Text | PubMed | CrossRef 19. Nyitray AG, Carvalho da Silva RJ, Baggio ML, et al.. Age-specific prevalence and risk factors for anal human papillomavirus (HPV) among men who have sex with women and men who have sex with men: The HPV in men (HIM) study. J Infect Dis 2011; 203: 49–57. Cited Here... | View Full Text | PubMed | CrossRef 20. Ogunbiyi OA, Scholefield JH, Raftery AT, et al.. Prevalence of anal human papillomavirus infection and intraepithelial neoplasia in renal allograft recipients. Br J Surg 1994; 81: 365–367. Cited Here... | PubMed | CrossRef 21. de Sanjose S, Quint WG, Alemany L, et al.. Human papillomavirus genotype attribution in invasive cervical cancer: A retrospective cross-sectional worldwide study. Lancet Oncol 2010; 11: 1048–1056. Cited Here... | PubMed | CrossRef 22. Hessol NA, Pipkin S, Schwarcz S, et al.. The impact of highly active antiretroviral therapy on non–AIDS-defining cancers among adults with AIDS. Am J Epidemiol 2007; 165: 1143–1153. Cited Here... | View Full Text | PubMed | CrossRef 23. Bower M, Palmieri C, Dhillon T. AIDS-related malignancies: changing epidemiology and the impact of highly active antiretroviral therapy. Curr Opin Infect Dis 2006; 19: 14–19. Cited Here... | View Full Text | PubMed 24. D'Souza G, Wiley DJ, Li X, et al.. Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr 2008; 48: 491–499. Cited Here... | View Full Text | PubMed | CrossRef 25. Piketty C, Selinger-Leneman H, Grabar S, et al.. Marked increase in the incidence of invasive anal cancer among HIV-infected patients despite treatment with combination antiretroviral therapy. AIDS 2008; 22: 1203–1211. Cited Here... | View Full Text | PubMed | CrossRef 26. Chaturvedi AK, Madeleine MM, Biggar RJ, et al.. Risk of human papillomavirus–associated cancers among persons with AIDS. J Natl Cancer Inst 2009; 101: 1120–1130. Cited Here... | View Full Text | PubMed | CrossRef 27. Giuliano AR, Lee JH, Fulp W, et al.. Incidence and clearance of genital human papillomavirus infection in men (HIM): A cohort study. Lancet 2011; 377: 932–940. Cited Here... | PubMed | CrossRef 28. Kreimer AR, Villa A, Nyitray AG, et al.. The epidemiology of oral HPV infection among a multinational sample of healthy men. Cancer Epidemiol Biomarkers Prevent 2011; 20: 172–182. Cited Here... © Copyright 2013 American Sexually Transmitted Diseases Association Article Outline Abstract PATIENTS AND METHODS Study Design Questionnaires Sample Collection HPV Testing Statistical Analysis Sample Size Definitions Statistical Comparison RESULTS Subject Recruitment and Follow-Up Patient Characteristics HPV Infection at Anal Canal Site HPV Infection at Penile Site HPV Infection at Oral Site Concurrent HPV Infection in the Anus, Penis, and Mouth Risk Factors DISCUSSION REFERENCES Source Natural History of Human Papillomavirus Infections Involving Anal, Penile, and Oral Sites Among HIV-Positive Men Sexually Transmitted Diseases. 40(1):3-10, January 2013. 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text:
Download Greedy Panda apk 1.4 free for Android smartphone
Posted by Alfredp in Arcade | June 21, 2014 | 0 Comments
Apk file size: 7.9 MB
Greedy Panda is an addictive game, you should not miss.
The gameplay is very simple but fun to play.
Help the panda eats bamboo as much as you can.
But be careful with the red toxic. Do not let the panda eats it.
Do not forget about the health bar. Keep the bar safe by the green potion.
Try Greedy Panda now for free!!
Do not let the panda hungry anymore!!
If you have any problem about Greedy Panda, please contact me at [email protected]
Please rate Greedy Panda if you love it ;)
I hope you enjoy Greedy Panda.
Whats new
-Bugs fixed
Alfredp part of our Arcade and have average installs from 100 to 500. Last Update June 21, 2014. Google play rating is 100.0. Current verison is 1.4. Actual size 7.9 MB.

subset: commoncrawl


text:
- This event has passed.
Coordinating Council General Meeting
August 14 @ 11:45 am - 1:00 pm
Event Navigation
Continental Restaurant, lunch $14.00, no lunch $5.00 please visit and enjoy a great program and volunteer awards.
Related Events
Summer Reading Challenge
May 31 – July 23
Join this year's Summer Reading Challenge for Children, Teens, Young Adults and Adults! Register online at www.glendoralibrary.org or come to the Library. For a complete list of programs and events call 626/852-4891 or visit the Library's website.
Super 8-Day Sale
June 2 – 11/ Main Floor
Come to the Library and browse the sale tables on the main floor for bargains on travel and paperbacks. Authors & Artists: Meet Your Local Authors
June 11, 11 am / Bidwell Forum
Meet local authors as they share their work and experiences. And if you are a local author interested in speaking with the public about your book(s), this is the event for you! Applications and event guidelines are now available on the Library's website. Deadline to apply is May 13th.
Novel Idea
June 22, 5:30 pm / Friends Room
Book discussion group: My name is Lucy Barton by Elizabeth Strout
Homework Buddies, 3:00 pm to 5:00 pm / Friends Room
Every Monday through Thursday
Students can get assistance with their homework; assistance provided by high school students
Youth Advisory Meetings / Friends Room
Teen Advisory Board: Library Advisory group for students in grade 5-7; meets every 2nd Wednesday of every month, 4 pm – 5 pm in the Friends Room
Young Adult Council: Library Advisory group for students in grade 8-12; meets every 2nd Wednesday of every month, 6 pm – 7 pm in the Friends Room
Weekly Children's Storytimes / Friends Room
Mondays at 10:30 am: Infant & Toddler Storytime
Tuesdays at 10:30 am: 2-3 year old Storytime
Wednesdays at 10:30 am: 3-5 year old Storytime
Friends Book Loft / Plaza Level
Visit the Bookstore for great bargains on gently used books, magazines, DVDs, CDs and new greeting cards.
Monday – Friday 9:30 am to 4:30 pm
Saturday 10:00 am to 4:00 pm
Unless otherwise noted, events are free to the public and will take place at the Glendora Public Library, 140 South Glendora Avenue. For more information, call the Library at (626) 852-4891 or check out our website at www.glendoralibrary.org.


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I'm going to take singing lessons 😂
And guitar classes 🙂
Most Helpful Girl
gonna go for long walks by the Detroit river00|00|0
I'm going to take singing lessons 😂
And guitar classes 🙂
gonna go for long walks by the Detroit river
IF the UNI I applied to accepts my request I won't study.
IF the UNI doesn't accept my request I will study for September's exam session.
I will go 1 month in Saudi Arabia and 1 month in Tunisia. I'm going to work out a lot, go out with my HS friends, spend time with my family, shopping, go to the beach and study hahha😊
Going houseboating for a week, camping for a couple long weekends, and possibly back to my home province for a weekend visit if I can get a reasonably priced plane ticket. Also doing one of those mud run obstacle courses, playing soccer 2 nights a week and softball. Other than that, most weekends we'll be working in the yard finishing things off so we can list my bfs house next spring :)
Working, working, taking a weekend trip, working, possibly taking another trip, working...
Did I mention working?
Yay guitar classes
I've been playing for 5 years now and trust me it's not worth it lol
It takes 2 years to play the first line of Canon in D smoothly, with 1 year of it on chord-changing practice and another year for finger-picking and bar chords.
:') if you want girls, go for it man
HOMEWORK! make-up! Jogging! And volunteering!
Work on music auditions. Maybe do some theatre stuff. Hang out with my boyfriend. Maybe actually hang out with my friends this summer, haha. I kind of go AWHOL on people, haha.
I'll be working mainly. I do hope to travel, though.
Hopefully a lot of traveling and fun activities. I wanna go to the boardwalk and I'd like to go visit a friend.
I'll be in school but I'm gonna go home to the west coast for a couple weeks in July and visit my dad and family and relax.
People do stuff for summer? I'm usually working or just doing nothing.
Hopefully be working. If not, still job interviews lol
Maybe head to Pennsylvania to Sister & Bro in law's house,
take some summer classes, & work.
Oh && play basketball & cycle daily, learn to cook more healthy dishes.. that's the goal.
I am going to be working and getting ready to go to college.
Not sure yet except work
Work out, get a job and do my volunteer hours.
I'm going to work and save up so I can vacation next summer
School and Externship!!
Me and my mom are going up to Indiana to see my grandma and my dad and I'm probably going to get lots of rest.
I have no clue but boredom is a sure thing
Surf Camp :)
I'm going to, hopefully, be a camp counselor and save up money for college/car
Travel softball and football. Then hang with my friends after my SB & FB practices are done.
Going to school, maybe working and hopefully going on lot more adventures than last summer...
taking summer courses, volunteering somewhere, working and swimming a lot.
I'd like to write a book and send it to the publisher.
Have fun with my friends.
Going to the city library.
Etc... Haha xD
The usual, hang at the beach when im not working...
I'm going to play basketball
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I think I'll go fishing in the Thames river. Maybe I'll go to a cabin in the mountains all alone to chill out, not sure yet...
What I wanna do is play beachvolleyball, swim in the river to cool off, talk to a girl I like, go to a music festival, chill, listen to music and of course be on the internet. I think I'm gonna be quite busy though so dunno if I can do that T_T
I'm going to go fishing
Go out to the lake and do some boating
Bodybuild outside
Train outside
Take a lot more walks
Walk around half naked more
Tis it for now.
Working and living a life of success when possible.
hopefully finish my studies and get a job
Pool parties baha
Taking classes like Accounting, Business Writing, etc and spend time outdoors
After my semester ends I'll be searching for a job. Other than that I'll be going to the gym
Going to SA in June for my 30th birthday. That's about it really.
Do yoga/aerobics and play soccer a lot to get athletic body
vaginal sex, having fun
Sit in my basement and stare at the wall, and look over the list of women I rejected this year and wish that just one of them was attractive AND not weird so that I could finally get a girlfriend. Seriously, I've rejected 6 girls in the past 10 or so months, 4 of them just weren't good looking, and 2 of them looked good but were just crazy. There are tons of good looking and not crazy girls out there, I dont understand why I dont attract them.
Then I'll probably play a lot of xbox and eat McDonalds every day.
@Daynada I know the problem isn't me. If I was the problem, I wouldn't attract the number of girls that I do.
@Daynada I'm just looking at the facts, if I am the problem then a lot of girls suck at choosing guys, and if they suck at choosing guys then that's their problem, not mine.
You cannot undo this action. The opinion owner is going to be notified and earn 7 XPER points.


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text: The East India Company was originally named Governor and Company of Merchants of London trading into the East Indies or Honourable East India Company. It was a private, joint-stock company founded in 1600 through a Royal Charter by Queen Elizabeth I of England, and came to rule large areas of India with its own private army. It remained active throughout the regime changed in England, until the Crown took control of the Company's powers and assets in 1858. In the meantime, the Company grew and established trading posts in many important cities of India and soon enjoyed a complete trade monopoly in the region. This was done through multiple wars against colonial competitors and local populations.


text:
: ('11-'14)
2012 2.0 trailer hitch?
View Single Post
Scooby Specialist
Join Date:
Apr 2012
Bryant, AR
2012 Impreza Sport
this is what i just posted on the SOA facebook page.
Do you know what make me mad the most about my new 2012 Impreza 2.0i Sport Premium? It's not the car, it's the company. I love my car. I called SOA twice about installing a tow hitch to use it for a cargo carrier and my back rack. I asked if it would be ok if I installed it to use it to carry those items. I also mentioned that i will not wire for a trailer, because I will not tow with it. I get a load of crap saying, "the transmission and the rear differential is not designed for the weight of it." I told them its about 40 pounds for the tow hitch. Come on, four grown adults weight about 550ish-580ish. The person on the phone repeated the same thing. Then, I did a little research. Apparently, the Australian version can tow with both manual and CVT. And there is a Subaru genuine "Tow Bar" or tow hitch accessory option. I emailed SOA about this. and asked what are the design differences between my car and the Australian's? The representative told me that they don't know what they are and that both car could be the same. Then, the person goes on to talk about regulations on towing of different countries. How is that remotely relavent when "the transmission and the rear differential is not designed for the weight of it"? Apparently, the transmission and the rear differential are going to break anyway. The reason that i am worried about installing a hitch is because I bought the Subaru extended warranty for 100K miles. It would be a waste if my transmission broke for whatever reason and if I had a hitch SOA would not cover the repairs. Also, I am not very tall and would hate to put stuff on top of my roof such as a bike. I would hate to slip and scratch my paint or make dents.
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text:
Doctor insights on:
Paget Desease
My nipple itchy and some sore what do you call this its a paget desease?
Itchy nipple: Unlikely to be Paget's disease, but you must see your doctor about itchy nipple and some sore pain. Hope all goes well. ...Read more
What is paget's disease?
Bone or breast?: Paget's disease of the bone is characterized by an accelerated rate of bone metabolism, resulting in overgrowth of a bone at a single or multiple sites and affects integrity of the bone. Paget's of the breast is an eczema-like eruption on the nipple and areola with commonly a yellow exudate. It commonly suggests an underlying breast malignancy. Hope this helps. ...Read more
Is paget's disease common?
1-2% of population: Paget's disease of bone affects 1-2% of the population over 50 years of age. It is inherited in about 20% of patients. ...Read moreSee 2 more doctor answers
Does paget's disease get worse?
It can: It can get worse, stay stable or get better over time. ...Read moreSee 1 more doctor answer
Who is at risk for paget's disease?
Anyone: There are some genetic associations, but the disease can affect anyone. ...Read moreSee 1 more doctor answer
Can diet help control paget's disease?
Avoid toxic foods : Avoid sugars, fried foods, vegatable oils like canola & soy, meats that are cured wth nitrates & nitrites, aspartame, splenda, partially hydrogenated vegetable oils, maragarine, soy based products, sweetened beverages like juice & soda, microwaved foods, artificial colors & flavors. All of these products cause damage to the cells, tissues & organs in your body contributing to various diseases. ...Read moreSee 1 more doctor answer
What are the symptoms of Paget's disease?
Bone pain: Some people who have paget's disease will have absolutely no symptoms. Others may experience symptoms that are confused with arthritis. Others may have bone pain not in the joints. ...Read more
Is Pagets disease an example of an eponym?
Yes: An eponym is a person, a place, or thing for whom or for which something is named. Sir James Paget first described Paget disease (PD) of the breast in 1874. He also described Pagets disease of bone. He served both as a well known surgeon as well as Pathologist in the mid 18 hundreds . His famous works included Lectures on Tumours (1851) and Lectures on Surgical Pathology (1853) ...Read more
What is the death rate for paget's disease?
Around 1%: Paget's disease of the bone (and i assume you bone, not nipple) in about 1% of cases gives rise to aggressive cancers. Let's hope this does not happen to you. A few patients with paget's died as a result of high-output heart failure from the arteries connecting directly with veins in the bone; hopefully with today's treatment this will not happen. Good luck. ...Read moreSee 1 more doctor answer
How can paget's disease effect my eyesight?
Pagets and eye: Pagets disease increases bone density which can gradually close off nerves and blood vessels in any part of the body that they pass through. There are a few cases in which the nerves and vessels leading to the eye are narrowed affecting the health and vision of the eyes. ...Read moreSee 1 more doctor answer


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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|Andy Wenk <a...@nms.de>
|Re: Need help for Couch DB data export
|Fri, 22 Nov 2013 21:21:22 GMT
Hi Sreedhar, On 21 November 2013 14:51, Sreedhar P V <email@example.com> wrote: > Hi Team, > > I am using couchdb for one of my projects and need to import the client > data in couchdb. I have good experience on RDBMS but not on NoSQL. I need > your assistance for the below scenario. > > To export the data I have used below curl command: > *curl -X > GET http://127.0.0.1:5984/testdb/_all_docs?include_docs=true > <http://127.0.0.1:5984/testdb/_all_docs?include_docs=true> > FILE.txt* > > To import the FILE.txt, I used _bulk_docs as below: > *curl -d @FILE.txt -H "Content-type: application/json" -X POST * > *http://localhost:5984/testdb1/_bulk_docs*< > http://localhost:5984/testdb1/_bulk_docs> > > > Below is the sample data for GET with _all_docs. But it is not is not > working for POST with _bulk_docs and it is expecting "docs" in the txt > file. > > {"total_rows":2,"offset":0,"rows":[ > > {"id":"docid1","key":"docid1","value":{"rev":"2-d872217c576ee407a11a5de30ce2bb30"},"doc":{"_id":"docid1","_rev":"2-d872217c576ee407a11a5de30ce2bb30","sdfs":"data"}}, > > {"id":"docid2","key":"docid2","value":{"rev":"1-f58d4c586789ca8e166a53ece008b23b"},"doc":{"_id":"docid2","_rev":"1-f58d4c586789ca8e166a53ece008b23b","f2":"dsvsd"}} > ]} > We need to import the huge data dump which we got from client. Please guide > me to import the huge client data. Thank you in advance. > > > > Thanks, > Sreedhar > don't think in terms of a SQL-dump. The example above looks like you export all documents form testdb and you want to put them into testdb1. For this job, CouchDB provides the _replication mechanism. It would look something like: curl -X POST http://127.0.0.1:5984/_replicate \ -H "content-type:application/json" \ -d '{"source": "testdb", "target": "testdb1", "create_target": true}' If you just need a subset of the data, you can use a filter you created create this in a _design document: curl -X PUT http://127.0.0.1:5984/kina/_design/default \ -H "content-type: application/json" \ -d '{"filters":{ "country": "function(doc, req) { return \"US\" == doc.lang; }" } }' Then within the replication: curl -X POST http://127.0.0.1:5984/_replicate \ -H "content-type:application/json" \ -d '{"source": "testdb", "target": "testdb1", "create_target": true, "filter": "default/country"}' For more info on replication please see http://docs.couchdb.org/en/latest/intro/api.html#replication Cheers Andy -- Andy Wenk Hamburg - Germany RockIt! http://www.couchdb-buch.de http://www.pg-praxisbuch.de GPG fingerprint: C044 8322 9E12 1483 4FEC 9452 B65D 6BE3 9ED3 9588
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text:
IndusInd Bank Recruitment 2014
Indusind Bank is going to issue IndusInd Bank Recruitment 2014 for current openings. Capable and desirous candidates can read out the job notification and may apply online by filling the application form on or before the end date.
Those job hunters who want to clutch this chance they must check the entire details of IndsuInd Bank Vacancies 2014 which are well displayed below by the team of bharatrecruitment.com
Organization Name:
IndusInd Bank
Type of Announcement:
IndusInd Bank Recruitment 2014
Numbers of Vacancies: 55
Offers Posts and Vacancy details:
|Post Name
|Relationship Managers Business Banking
|Relationship Managers Financial Institution and Public Sector
|Associate Credit Administration Manager Credit Administration-Risk Management
|Associate Manager Trade Operations
|Associate Manager Operations
|Manager Customer Service and Operations
|Relationship Manager – Emerging Corporates
|Relationship Manager Trade and Forex
|Credit Analyst Senior Credit Analyst-Risk Management
|Relationship Manager – Wealth
|Branch Managers
Essential Qualification:
Job fighters are required to possess the MBA/Graduation/ Master degree in related discipline from an affiliated university or institution with required experience (as per the post applied).
Selection Method:
On the basis of personal interview contestants would be selected for the applied post.
How can apply?
- Entrants who are eager to apply for this recruitment they may apply online only through the official site i.e. www.indusind.com
- Then search the "Career" and then press on the "opportunities with us" link.
- Choose the post for which you want to apply.
- Read out the whole details and press on "Apply Now" to fill the application form.
- Upload the updated resume and after filling all the sections precisely submit it in correct manner.
Last Date to fill the application:
As soon as possible
Follow the official site
You may also like to read-
|Bank Exam Pattern (PO/Clerk/SO)
|Bank Interview Questions and Answers
|Career Objective for Bank Jobs
|How to prepare for Bank exam
|Bank – Preparation Books
|Bank syllabus (PO, Clerk, SO)
|Bank Jobs
|Bank Question Papers


text:
- Description
Function and sleek design define these set of tables. The group includes an end table, coffee table, and sofa table with a similar, distinct c-shaped design. The unique, attractive style of each piece is complemented by a dark cappuccino finish for a rich, warm look. All the tables feature smooth, rectangular table tops with plenty of space to display miscellaneous living room items. Along with this, the base of each of piece offers an open bottom shelf for additional storage of additional pieces. The distinct and exquisite design of these handsome tables will bring a modern, charming look to your living room.Includes
1 Coffee Table, 1 End Table and 1 Sofa TableDimensions
End Table, 22"L x 20"D x 22"H
Coffee Table, 48"L x 24"D x 16"H
Sofa Table, 58"L x 22"D x 30"H
- Additional Information
Additional Information
SKU 12611024 GTIN No Collection No Assemble Length No Assemble Width No Assemble Height No Assembly Required Yes Material No Finish Cappuccino Styles Traditional Shapes No Sizes N/A Shipping Time 1-2 Weeks Free Shipping No
- Reviews


text:
That's right my friend. This is a page dedicated to professional growth. EdReads is like a free 20-minute university. My goal is to feature 3 WEEKLY EDUCATIONAL ARTICLES that provoke thought, reflection, and growth. Let's level up together!
Serendipity Happened One Year Ago by Allyson Apsey
Awesome post by Allyson Apsey, a Michigan principal, about how blogging has changed her personal and professional life. Read this 4 minute post to learn why blogging is a game changer. Get inspired. Then, try it for yourself. But be warned! Once you start blogging, your life will never be the same.
Why do we make students sit still in class? by Carolina Blatt-Gross, Special to CNN
Good question! Seriously... Read this 8 minute article to learn about how moving your body helps your brain learn. The author describes three roles movement plays in the classroom: optimizing focus and attention, releasing pent-up energy, and as a medium for learning.
Get Up, Stand Up! by Sean A. Thom
Thought provoking blog by Sean A. Thom, a New Jersey school science department head. Read this 6 minute post about standing up and fighting for the greater good and identifying and embracing problems in American society. Sean challenges us to think differently and question the status quo and inspires to take action on social justice issues.


text:
Hometown: Rio de Janeiro
August 7, 2013
Hello, would be great to meet other members from the Bonn/Koeln area. I just moved back to region.
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text:
$60.00 $36.00
This powerhouse of a racerback sports bra has it all. An interior unicup gives support, shape, and complete modesty, while an interior front yoke prevents vertical breast movement. Powermesh zones on the back keep you cool, while adjustable straps and back closure enable the best fit and total control. This Brooks sports bra offers the ultimate in support, shape, and customizable fit.
- Interior unicup design gives support, shape, and complete modesty
- Interior front yoke prevents vertical breast movement
- Powermesh zones on back offers increased ventilation
- Bonded front-adjustable straps with concealed hook-and-loop closure offer a custom fit on the move
- Adjustable, soft-padded keyhole back closure for proper fit and support
- Encapsulation/Compression
- 1 UNICUP DESIGN gives support, shape, and complete modesty
- 2 INTERIOR FRONT YOKE prevents vertical breast movement
- 3 POWERMESH ZONES on back offer maximum ventilation
- 4 FRONT-ADJUSTABLE STRAPS with concealed hook-and-loop closure offer a custom fit on the move
- 5 SOFT-PADDED KEYHOLE BACK CLOSURE for added comfort
- 6 ENCAPSULATION/COMPRESSION provides shapely support
DriLayer Burst
The energy burst of a second wind smells like victory. Thanks to the engineering of this inherently odor-resistant fabric, you will too.
Fabric & Care
Our signature sweat-wicking fabric is thoroughly tested for comfort, performance, and durability and optimized to keep you, the runner, performing at your best.
Handwashing is ideal, but not always possible. Fasten all hooks and straps, place in a lingerie bag and use the gentle or delicate cycle. Always line dry, and never use dryer sheets or fabric softeners—they can clog the fabric and shorten the life of the bra.
- Breast Shape: Shallow, Semi-Full, Full
- Country of Origin: Imported
You Might Also Like...
1,130 Reviews
Displaying reviews 1 - 10 Next >
★★★★★ ★★★★★
Great support and comfortable
2017/08/10 | Summerville, SC | Carolyn
This is a great bra for running. It holds the girls in place. The straps are tricky to loop through the holes in the front of the bra at first, but when you get the hang of it, it's pretty easy. I find that if I pull the straps tight enough to Velcro them above my collar bone, I don't chafe.
Yes, I would recommend this!
★★★★★ ★★★★★
Love it
2017/07/29 | Daville KY | Jaja
Love it i have 3 them
Yes, I would recommend this!
★★★★★ ★★★★★
Favorite sports bra!
2017/07/28 | Lacey, WA | Mom of kiddos
I started purchasing these sports bras for my petite/large chested daughter back in middle school on the recommendation from the local running store in GA. She is a long distance runner (for fun!), has PE regularly by choice, and plays competitive soccer. A few days ago she was telling me that she is waiting for the back problems to start, but hasn't had a single issue. We discussed about how her sports bras are an excellent preventative measure for future pain, and that is why we buy these! Further confirmation came when during a medical course she is taking (in high school) from a nurse who also recommended Brooks sports bras for large chested girls/women to help deter back pain later in life! If you are hestitant about price, jump in! Make sure to use their sports bra finder. This particular sports bra has been comfortable during all of my daughters activities, and will occasionally choose to wear it to school just because of comfort! Excellent product!!!
Yes, I would recommend this!
★★★★★ ★★★★★
Better than expected
2017/07/26 | Tell City, IN | Jennifer
This bra has good support but I do not like the velcro straps. Otherwise, this is a good bra.
Yes, I would recommend this!
★★★★★ ★★★★★
like it!!
2017/07/25 | North Dakota | JRo
great sports bra, feel confident in it. The adjustable straps are very nice to have! The do irritate my skin just a tish as the straps need to be stiff. Maybe a few washes will help that out! Overall, it's great!
Yes, I would recommend this!
★★★★★ ★★★★★
No bounce for these DD's
2017/07/25 | Texas | Beka
This is my second time purchasing this product, because I want to have several of them! I'm a 32 years old runner, and had years struggling to find a bra that would not bounce and be comfortable --as I'd been used to having to wear double sports bras for this effect. I can't recommend this enough. When you put it on, it does feel as if it's going to be too small, but once you place the ladies in the cups, they aren't going anywhere! I will definitely purchase a third pair. I ran the 2016 New York Marathon in this without chaffing.
Yes, I would recommend this!
★★★★★ ★★★★★
Very comfortable and great support
2017/07/25 | Interlaken, NY | Drumwife
It was very hard to put on the first 2 times, then it was okay. Still a bit of a struggle to put on but totally worth it. Adjustable fit means it fits perfect, and it stays put. It gets soaked with sweat, but I'm pretty sweaty and that's normal for me. I really like it and would pay full price.
Yes, I would recommend this!
★★★★★ ★★★★★
I want 10 more of these!
2017/07/24 | Woodbridge, VA | Momma Runner
I love this bra! Unlike the prior model, this version slips on with ease. At first you think it is a light support bra until you fasten it up and realize it completely supports everything, but in a way that you barely feel it is there. It's hard to explain, but I felt nothing move, but also felt like I had nothing on. It was amazing. I will be buying several more for my running days!
Yes, I would recommend this!
★★★★★ ★★★★★
2017/07/05 | State College, PA | lizzbethj
I bought this sports bra on a suggestion from a friend and I am hooked! I have not worked out, let alone RAN in only one sports bra in 12 years. I am a 38F and sports bras have always been the worst. Size up and you loose support, size down your girls are sticking out of some side or the top... I was never able to achieve support AND fit until now. I have never been happier and I will be phasing out all of my old double up bras with these exclusively. THANK YOU BROOKS!
Yes, I would recommend this!
★★★★★ ★★★★★
I should've bought more when I had the chance!
2017/06/30 | Chattanooga, TN | Running mom
I love that I can actually run and not worry about bouncing around everywhere. I wish I had bought more since the new model isn't as highly rated.
Yes, I would recommend this!
Displaying reviews 1 - 10 Next >


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The Promenade Bolingbrook is an outdoor shopping destination that features a pedestrian-friendly gathering place where you can shop, dine and be entertained. The Promenade offers an exciting variety of specialty shops and restaurants, plus Macy's department store, Bass Pro Shops, Barnes & Noble, and Gold Class Cinemas.
Located just steps away from The Promenade you'll find great shopping at IKEA, Bed Bath & Beyond, and Meijer and if you're looking for a place to eat, try one of the many restaurants in the area: Longhorn Steakhouse, Famous Daves, Potbelly Sandwiches, and more. Come Explore Bolingbrook. You'll find everything you need all in one place.
Edmonton CIty Centre is your downtown destination of choice for shopping, dining and enjoying Edmonton's urban centre. Convenient underground parking, a wide selection of stores and a trendy downtown buzz make Edmonton City Centre the ideal location for commercial and retail tenants.
This downtown mall offers more than 170 stores and services including The Bay, Eveline Charles Academy, Edmonton's only Talbots and a nine screen Empire Theatre. The East and West sections of the Centre are connected by a transparent retail bridge. The Delta Edmonton Centre and Sutton Place hotels are also part of this downtown shopping destination.
Flagstaff Mall provides the best of both worlds – a traditional indoor shopping center along with a beautify outdoor shopping village. Come and enjoy a tabulous shopping, dinning and entertainment experience! The mall offers multiple Food Court retailers from Flaming Wok to Subway and with a brand new Food Court featuring more seating and improved amenities you will be sure to find what you are hungry for. In addition, Ruby Tuesday offers a casual sit-down dining atmosphere.
Anchored by JC Penney, Dillard's and Sears, the mall offers everything from boutique clothiers to toy stores, gift shops, salons, electronics retailers, shoe and sporting goods stores and jewelers. You'll also find tasty snacks and full meals at the mall's food court and a two-screen theater playing the latest releases. A stacked stone fireplace in the center court adds a cozy welcome to the otherwise bright and spacious mall. Stores are open extended hours during the holidays and for some special events and sales.
Download FastMall 3.0 for iPhone or iPod Touch FREE – http://getap.ps/fastmall


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Monday, November 19, 2007
HelioVolt Expands Board
Austin-based HelioVolt, a developer of thin film photovoltaics, said Monday morning that it has named two new directors to the firm's board of directors. HelioVolt said that E. Kenneth Pentimonti of Paladin Capital, and Ronald D. Bernal of Sequel Venture Partners, have joined its board. Both Paladin and Sequel were investosr in the firm's recent $101M Series B funding round.


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FEA by using C++ Programming and Visual Studio for Graphical Representation
Bajet $250-750 CAD
***Use of Visual Studio (C++) is necessary
In this project, you have to implement and
demonstrate how FEA can be applied for the analysis of a particular metal forming operation, e.g.,
cold forming, drawing, and stretching. The output of this project is a simulation program and a report
describing all the implementation details. This is based on the report describing how you realize and implement the simulation program:
Mathematical formulation of FEM (including isoparametric mapping)
Read/generate/refine mesh
Calculate local stiffness/mass matrix
Assemble stiffness/mass matrix
Solve the equation system
Stress recovery
Triangular v.s. Quadrilateral elements
2D v.s. 3D FEA (i.e., tetrahedral/hexahedral elements)
result finally. Although C++ is suggested and a basic MFC platform will be provided for visualization
18 pekerja bebas membida secara purata $718 untuk pekerjaan ini
I want to discuss this project with you further, let me know the best suitable time for you to schedule the meeting, Feel free to message me at any time, i used to be online 14 hrs in a day on this website so probably Lagi
hello,how are you. i read your bid carefully. i am c/c++, mfc expert and have full experience for 10 years. c/c++, mfc language is my top skill. i can provide most quality and high speed. if you want to success, pl Lagi
Hello, It's a pleasure to let you know that I've Completed and Delivered similar project before. All I need to work on customization part if we can proceed towards more discussion. I have gone through your project Lagi
Hello, I'm a retired engineer who used to work in a dozen or so corporate R&D environments. I specialise in C++ and may be able to assist you, but your budget will not even begin to peek my interest. Best wishes Lagi
Hi,dear. I am a senior software developer. I have just checked your project report, I am able to perform this task with my developer team. I am looking forward to your proposal...
Dear Sir, Your have recently advertised for website and App developer . After reading the job description I am confident that I would be a perfect fit for this position as my experience and abilities precisely match y Lagi
-------------------------------Professional C++ Developer! Best Result in Time!------------------------------ Dear sir. I read your project description very carefully. I've really rich experience in developing soft Lagi
Dear Sir, I'm writing in response to your task post. As a highly competent software specialist with more than nine years of experience , I would bring a high quality and service focused mindset to this job. Based Lagi
Hello pal! I see you have the same project as baljindershadi. Is it the same deadline 4 april? Anyways you seem to be more generous.
Hello..I would like to help you in this project...I am aerospace engineer have excellent experience with finite element analysis..I promise to give excellent results...
Hi, I am a serious developer who aims to provide high quality services. If you contact me, we can discuss more things detail and will be achieved with each other's purpose. Good luck for your business…
I actualy did all this steps and implimented FEA for plastisity. It's a very big task to do. Or the budget is to small ). Do you suppose external FEM library usage? Or you interested in implementation of your own? Fo Lagi


text: Culture 28 May 2001 Weeping in a Rolls-Royce Blood, Sweat and Tears: the evolution of work Richard Donkin<em> Texere, 400pp, £18.99</em> ISBN Sign up for our weekly email * It is difficult not to feel a sense of betrayal about technological progress. We have invented machines to do work for us, but the more ingenious our inventions, the harder we find ourselves working. We have exchanged 40 hours of slavery in a soot-covered factory for a 70-hour week chained within the granite-faced confines of the giants of the new global service economy. The average American now works one month a year longer than he or she did in the 1960s. Britons, similarly, seem to be increasingly choosing work over leisure. As Richard Donkin makes clear in his broad history of work, Blood, Sweat and Tears, we have only ourselves to blame for so readily giving up our lives to our employers. It is a combination of our desires always staying one step ahead of our ability to afford them, our psychological need to define ourselves by our work, and an immutable work ethic, that continues to drive us long after the religion that spawned it ceased to be relevant. The history of work has a disturbing aspect: unlike political history, there seems to be no liberating force behind it. It gets better, then it gets worse, with no overall trend towards greater freedom. The industrial revolution created inhuman working practices, particularly for children, which took a hundred years to eliminate. Then came the introduction of scientific management and Fordist production techniques, which treated workers as dehumanised automatons, creating an alienated, and politically threatening, mass working class. The expansion of education and mobility offered more choice and created a class of knowledge-workers whom employers need to value. However, the hope of preferment in a hierarchical organisation, together with the fear of redundancy, has tied us to our employers, ensuring our continuing serfdom. Too many of us are giving away too much of our lives to indifferent employers. "It is as if the world has become split into two societies - one with the means to enjoy leisure but not the time, and one that has the time but not the means," Donkin writes. Although his primary message is about ensuring that work is worthwhile, his study is of much broader relevance: it is the flip-side of our current concern about the impact of the globalisation of the world economy by large corporations. Both issues are related to the increasing power of institutions that are only accountable in financial terms. Both issues have arisen as a result of the choices we make - whether for better pay or cheaper goods. The anti-globalisation protesters are mainly concerned with the external impact of these institutions. The internal impact on the people who make them up is equally important. Important recent studies have highlighted the pathological side of our relationship with work, particularly Robert Lane's The Loss of Happiness in Market Democracies. "Amidst the satisfaction people feel with the material progress," he writes, "there is a spirit of unhappiness and depression haunting advanced market democracies throughout the world, a spirit that mocks the idea that markets maximise well-being." Whether it is ever increasing instances of clinical depression, suicide, divorce rates or the results of surveys of well-being, every measure of happiness shows a negative correlation with GDP per head in the postwar years. The problem would seem to be that, although we know how to earn money, we don't know how to be happy. As a result, we tend to take the money, which can offer security and a source of respect that extends beyond happiness. As Patrizia Gucci famously said: "I would rather be weeping in a Rolls-Royce than happy on a bicycle." This attitude is deeply entrenched in our politics, with tax cuts now speaking much louder to the electorate than the services they support. Blood Sweat & Tears and The Loss of Happiness in Market Democracies hint at the start of a new intellectual opposition to a world in which the only accountability is financial. One doubts, though, that it will ever amount to much of a political protest movement: if we are wasting our lives at work, the only people we can throw a brick at is ourselves. Subscribe from just £1 per issue This article first appeared in the 28 May 2001 issue of the New Statesman, And men shall speak unto men More


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|By The Sacramento Bee
|McClatchy-Tribune Information Services
If Rep.
McClintock says it's unfair for people living on high ground to subsidize "those who freely choose to live in floodplains." He'd require that any federal assistance be in the form of loans, as opposed to the current cost-share arrangement involving local, state and federal funds.
The 100,000 people who live in Natomas should take notice. They've been paying higher flood insurance rates and levee assessments since the
If McClintock had his way, Natomas property owners would pick up the tab for the remaining
People who live in
The answer appears to be yes. "Ideally,
McClintock's position reflects how far some elected leaders have drifted away from the concept of shared societal responsibilities. When levees are upgraded in Natomas, they not only benefit property owners there, they protect an international airport, a interstate highway and all the travelers that use that infrastructure. We suspect that many taxpayers in
McClintock also seems to have forgotten the origins of federal flood control. The federal government got involved with levees -- through the Federal Flood Control Act of 1928 -- because so many historic U.S. cities are located in dangerous flood areas. Ideally, our nation's forefathers might have located
It should also be noted that the 1928 federal law made clear that local governments must share in the cost of levee protection. In particular, cities such as
In all likelihood, McClintock's policy perspective is not widely shared, and we are not sure even he is truly committed to it. In 2009, McClintock helped secure a
Asked how he justified the grant, which McClintock touted on his website, his spokeswoman
In other words, a very rough-and-ready set of principles.
(c)2013 The Sacramento Bee (Sacramento, Calif.)
Visit The Sacramento Bee (Sacramento, Calif.) at www.sacbee.com
Distributed by MCT Information Services
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The hotel has been listed as a national monument since June 1931 and is located on a rocky outcrop on the highest hill in Illueca. Its construction during the 13th century was ordered by Juan Martínez de Luna whose son, Pedro Luna, is known to history as Benedict XIII, Pope Luna. This 3-storey hotel was renovated in 2006 and comprises a total of 26 rooms of which 2 are junior suites, 2 are suites and 2 rooms have been adapted to cater to disabled guests. Amongst the facilities at this air-conditioned historical hotel count a foyer with a reception desk, a lift, a bar, an à la carte restaurant, a lounge, a caf� and a breakfast. The conference and seminar centre has a capacity of 100 persons. A car park is on offer to those arriving by car.The rooms each feature a bathroom with a hairdryer, a minibar, a direct dial telephone, a TV, a radio, a double or king-sized bed and a terrace. The heating and air conditioning are individually controllable. The 4 suites come with 2 double beds. There is a room on the top of the southwest fortified tower affording breathtaking views out over the surrounding area. Four rooms have private balconies facing towards the north.
Take the National road II (E-90) and exit at junction 255. Take the A1503 in the direction of Illueca.


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Welcome to Funny Olympic's OLYMPIC FLAG page! Do You think you have seen Olympic Flag? Prepare yourself for some Funny Olympic Flag stuff. Yes! We search the entire web just to bring you the most funny images from Olympic Flag. Also, you may check some olympic flag videos and funny olympic flag pictures, and much more!
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This property has been removed by the agent. It may be let or temporarily removed from the market
Property Description
Letting information:
|Reduced on Rightmove:
|24 November 2016 (266 days ago)
Full description
A very well presented TWO bedroom DUPLEX apartment situated in the heart of Swindon. This property offers a modern kitchen with white goods and has a good size lounge/diner. There are two double bedrooms, the master bedroom with EN-SUITE. Offered UNFURNISHED with off road parking. Available Immediately.
FLOOR PLANS-These are intended as a GUIDE only. Dimensions are approximate. NOT TO SCALE. We have taken every care with the preparation of these details. They do not form any part of an offer or contract and are a guide only. We have not tested any apparatus, equipment, fitting or services and cannot verify they are in working order. All measurements are approximate.
More information from this agent
To view this media, please visit the on-line version of this page at www.rightmove.co.uk/property-to-rent/property-45479988.html
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Cats will damage your mind - Morgan
A "mind-bending" disease found in cat faeces and spread to human brains has been enlisted in Gareth Morgan's war on moggies.
About 40 per cent of people in New Zealand are infected at some time in their lives with toxoplasmosis - an incurable disease caused by a parasite that lives only in cat faeces and has been linked to a raft of psychological disorders.
They include schizophrenia, impaired memory, suicidal thoughts, risky behaviour, poor concentration, headaches, extreme fatigue and a higher risk of post-natal depression and self-harm in new mothers.
Although usually dormant in healthy people, the disease could flare up at any time, in ways that were only just being understood, Morgan said.
"Forty per cent of New Zealanders getting toxoplasmosis is an indictment of our nonchalance toward wandering cats. This mind-bending parasite is yet another reason why we need to manage cats like dogs," said the Cats To Go campaigner, who once said any free-ranging cat should be "a dead cat".
Morgan wants cats kept indoors to protect native wildlife, and wants councils to register and microchip them, as with dogs.
Until people had the right to keep cats off their property, they would not be free to garden or let their children play outside without the risk of catching toxoplasmosis, he said.
About two-thirds of cats carry the pathogen but Mark Thomas, associate professor of clinical molecular medicine and pathology at Auckland University's School of Medical Sciences, said that although links to human health had been established, the parasite was not a threat to most people.
In 2012 Thomas released research showing toxoplasmosis could be much more severe and disabling than previously thought.
While chronic toxoplasmosis had been shown to have a strong association with brain conditions such as schizophrenia, and with suicide and self-harming behaviour, the disease in its acute phase was usually benign, trivial and self-healing, he said.
Thomas has since called for further research on the effects of brain infection as tests on lab rats have shown the parasite can lift the production of dopamine - the brain's reward hormone - making the rats less risk-averse and becoming more vulnerable to being eaten.
Infected rats then passed the disease to cats - where the parasite can reproduce. "Given the impact on rats, and that dopamine is our reward chemical, toxoplasmosis seems to be altering the way our brain weighs up risks and rewards," Morgan said.
One European study found latently infected people were also likely to be more involved in car crashes.
The disease is a well-known risk for pregnant women and can cause miscarriage, stillbirth, newborn deaths and a range of serious health problems for children later in life. In New Zealand, around 164 pregnant mothers contract the disease every year, passing it on to 66 babies, which is about one in 1000 births.
"It doesn't matter if you are worried about becoming a crazy cat lady, or the growing evidence of links between toxoplasmosis and schizophrenia or even traffic accidents. The fact is that this is a scary, mind-altering parasite that scientists are just starting to understand," Morgan said.
"Cats should be kept on their owners' property. When you think about toxoplasmosis, it's a no-brainer - literally."
Toxoplasmosis can be picked up from cat litter, garden soil, unwashed vegetables and contaminated water so keep your cat indoors but well away from kitchen surfaces.
If you don't live with a cat, either keep them out of your garden, or wear gloves when gardening and be wary of allowing children to scratch around, burrow and dig in soil. The parasite can be transmitted through soil so thoroughly cook or wash potentially tainted food.
Pregnant women and those with compromised immunity are particularly susceptible and should avoid cat faeces and eating undercooked meat and eggs, and unpasteurised milk.
Sunday Star Times


text: 5 November 2001 The New Statesman Poem of the Month Keighley by George Szirtes. Poetry Editor: Adam Newey Sign up for our weekly email * At night you can see the north wind as you lie sleepless, because the net curtains bulge with it, and the whole room seems to sigh and billow as if the moors were about to divulge a dreadful secret: black earth, scrub, thin grass. The weather here is willing to indulge its resident Heathcliffs from the deep bass of fogged valleys or screaming tips of rock. On a bend down Keighley way you might pass a cannibalised Morris Minor in a state of shock, its big end gone, its eyesockets picked bare by scavengers, dewdrops dangling from the lock of its open door. There is something in the air stripping the paint away, nature perhaps nothing more, the power concentrated there escaping through the bleak beauty that claps its arms around things, around trees and cars and old men dropping ash in their own laps in front of the TV and the latest soap stars, with the dog by the door wanting to go out into the wind across the becks and scars. From An English Apocalypse (Bloodaxe Books, £8.95) Subscribe from just £1 per issue This article first appeared in the 05 November 2001 issue of the New Statesman, The rise and rise of President Blair More


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Bearing Persecution – 30 Days with Teresa of Avila – Reflections on Day 29
October 23, 2015 by Dan Burke
Filed under 30 Days Teresa Avila, Dan Burke, Divine Intimacy Radio and Podcast, Show Notes, Suffering, Temptation
Bearing Persecution 30 Days with Teresa of Avila Day 29 Reflections Divine Intimacy Radio Are we bearing persecution in the right way? Learn from a saint how to respond to persecution. St. Teresa advises a Carmelite nun to avoid the temptation to indulge in righteous indignation in response to an accusation. Dan and Melissa reflect on letters from St. Teresa from the book 30 Days with Teresa of Avila. Topics/Questions... Read More
Demonic Attacks – 30 Days w/ Teresa of Avila Day 27 Reflections Pt 2
October 2, 2015 by Dan Burke
Filed under 30 Days Teresa Avila, Dan Burke, Divine Intimacy Radio and Podcast, Show Notes, Spiritual Direction, Spiritual Warfare
Demonic Attacks 30 Days with Teresa of Avila Part 2, Day 27 Reflections Divine Intimacy Radio St. Teresa orders her brother, Lorenzo, to get some sleep. She also counsels him on how to deal with attacks of the enemy. Dan and Melissa discuss evil spirits and demonic activity as they reflect on letters from St. Teresa in the book 30 Days with Teresa of Avila. LISTEN TO THE SHOW THROUGH THE PLAY BUTTON... Read More
Spiritual Warfare: Tonic Soup & Near Collision
April 27, 2015 by Nancy Ward
Filed under Challenges, Nancy HC Ward, Spiritual Direction, Spiritual Warfare, Trust in God
Spiritual Warfare: Tonic Soup and a Near Collision In the classic struggle between good and evil, the Genesis account of Joseph and his brothers shows how God's power far surpasses Satan's. Joseph's jealous brothers sold him into slavery, yet that's how their tribe was able to survive the famine. When God saved the family from starvation and reunited them, Joseph told his brothers, "Even... Read More
Feast of Sts Michael, Gabriel and Raphael, Archangels
September 29, 2014 by Liz Estler
Filed under Angels, Feast Days, Liturgy, Liz Estler
"You should be aware that the word "angel" denotes a function rather than a nature. Those holy spirits of heaven have indeed always been spirits. They can only be called angels when they deliver some message. Moreover, those who deliver messages of lesser importance are called angels; and those who proclaim messages of supreme importance are called archangels. "And so it was... Read More


text:
Murdered by her mum! She killed our girl because I dumped her
When I split from my pregnant wife I could never have guessed the terrible length she'd go to to punish me…
By Nabil Dahane, 36, from Oxford
I looked at my wife's flat tummy and pictured our tiny child growing in her womb.
Angela had been pregnant for a couple months and it wouldn't be long until she started to show.
My stomach churned. We both couldn't wait to become parents but the pregnancy couldn't save our marriage.
Our child couldn't erase all the arguments and the months of verbal abuse. I'd had enough.
'I'm sorry Angela,' I stuttered, 'but I can't do this any more.'
She glared at me with her large brown eyes.
'You're not leaving the house,' she growled. I'd grown terrified of her.
'I'll still support you and our child,' I replied. 'That goes without saying, of course.'
When I realised she wasn't going to back down, I changed my tactic. 'Just give me a few weeks break. Maybe it's just the pregnancy hormones and everything will return to normal.'
Finally she relented and I packed my bags and left.
Angela and I first met in Morocco, where we fell in love and married in 2007. We moved to the UK to start a new life together and settled in Oxford. But by the time Angela fell pregnant, there was no denying our relationship had disintegrated.
We argued constantly and the wonderful woman I fell in love with seemed to no longer exist. Angela had grown so controlling and abusive that despite our situation, I felt I had no choice but to escape.
When she invited me to the 20-week scan and we found out we were having a girl, I was delighted.
That was until the police showed up at my door to tell me Angela had accused me of attacking her because she wasn't giving me a son.
She'd made it crystal clear. Angela was going to make my life a misery until she got her way. Thankfully I was finally able to reason with her.
'We have to give our daughter the best possible upbringing and two arguing parents won't help,' I reasoned. Angela nodded and we agreed to keep our relationship amicable for the sake of our child.
However once little Sarah was born in September 2011 nothing else mattered. As I held her in my arms, something inside me changed. I'd fallen instantly in love. Everything I did from now on, I did for Sarah.
'Look at you two,' Angela gushed. 'Daddy's little girl already.'
I smiled. She was right.
'Why do we have to separate?' She asked. 'Why don't we try again for the sake of Sarah? We could be a happy family together.'
I loved Sarah and the thought of being able to see her everyday filled me with joy. But I couldn't take Angela back. I'd felt like a caged animal in our relationship and now I was finally free.
'You know I can't,' I sighed. 'I'm here for you though and I want to see Sarah as much as possible.'
'No!' She spat. 'You'll never see Sarah again.'
'You can't do this to me,' I pleaded. I was distraught. We'd agreed to put our differences aside for the sake of Sarah but Angela seemed hellbent on getting her way. Compromise wasn't in Angela's vocabulary.
'Yes I can,' she cried. 'I am her mother and I can do what I like. I'll move her to Kenya and make sure she's out of your life for good.'
I was devastated. Angela had always been stubborn and selfish but using my child against me was a new low – even for her.
Heartbroken and betrayed, I went through the courts to win visitor rights and over the course of 18 months we endured a bitter custody battle for our child.
It was hell. During that time Angela made false allegations against me including domestic violence and child abduction and as a result I was forced to see Sarah in contact centres with supervision for seven months. I felt like a common criminal. All I wanted was my chance to be a dad.
Over that period she tried her best to disrupt my time with Sarah, relocating to several distant towns as far away as possible within the legal jurisdiction set by the family courts.
But this was a battle I wasn't prepared to lose, after all my daughter was at stake and I persevered to increase my visitation rights from just one hour to three full days, including two overnight stays.
Although I saw Sarah under supervision, they were the most precious moments of my life. I lived to see my little girl's happy, beaming smile and to hear her shout 'Dada' was like music to my ears. So when I was told a court report in May 2013 had ruled in my favour, I was over the moon.
The very next day, I was due to see my daughter at 9am. I always picked areas where there were lots of CCTV cameras as Angela's made-up allegations knew no bounds.
I couldn't wait and arrived at our agreed venue, the local Tesco Express, but there was no sign of her. I waited and waited but when she didn't pick up her phone, I had an ominous feeling something was wrong. Angela had broken court orders before. She was a law unto herself.
There was nothing else I could do, I had to call the police. They directed me to the nearest station to wait while they carried out checks.
An hour-and-a-half after I was due to see my beautiful 20-month-old girl, an officer guided me into a side room.
'We are sorry Mr Dahane, but Angela is in Kenya,' the officer explained.
I burst into tears. Angela had fulfilled her promise and taken Sarah to another continent so I'd never see her again.
'We searched Ms Whitworth's property and have found the body of a child,' continued the officer.
The room began to spin. This can't possibly be happening.
'Is it Sarah?' I sobbed. The officer's pause said everything. In that instant my world fell apart.
The following day I was taken to the John Radcliffe Hospital in Oxford to identify the body of the child I had spent 18 months fighting tirelessly for.
I knew Angela could be cruel but I had no idea she was capable of such evil. She had told me I'd never see Sarah again but if I'd known of her sickening plan, I would have stayed with her to protect our daughter.
I would have done anything. She murdered our daughter to punish me. If she couldn't have her, no one could.
Angela's deceit and manipulative ways had caught up with her so she had used her trump card, Sarah, our daughter. She was a sick psychopath.
She'd booked a same-day flight then hopped on a plane to Kenya leaving me to deal with the loss of my child, the police, the investigation, the media… Everything.
Angela fled to Nairobi but was seized in March this year by Ugandan police. In August she admitted murdering our daughter and in October she was jailed for life, with a minimum term of 15 years.
The prosecution revealed that the police had broken into Angela's flat and found it in a state of disarray. They'd discovered Sarah's lifeless body on her tummy in the middle of a bed.
Angela had gagged Sarah with a pair of tights, then smothered her with a bin bag before fleeing.
Watching her shed tears as details of the murder were laid bear for the first time in court made my blood boil. She wasn't crying for Sarah, she was crying because she'd been caught.
In the period between finding out about Sarah's death and Angela's sentence, I have been to hell and back.
But I have survived to see justice served for my innocent child who would have turned five this year had her life not been cruelly and prematurely ended by her mum.
I've waited three long painful years but now Angela is finally where she belongs – behind bars.
I still battle every day to come to terms with not just my daughter's loss but how she died. Sometimes it's too much to bear.
Parents are supposed to protect their children, above all others. If only I could have protected Sarah from her murderous mother.