text: Vascular Remodeling after Spinal Cord InjuryOLIVE, JENNIFER L.; DUDLEY, GARY A.; MCCULLY, KEVIN K.Medicine & Science in Sports & Exercise: June 2003 - Volume 35 - Issue 6 - p 901-907 doi: 10.1249/01.MSS.0000069755.40046.96 CLINICAL SCIENCES: Clinical Investigations Abstract Author Information Article Outline OLIVE, J. L., G. A. DUDLEY, and K. K. MCCULLY. Vascular Remodeling after Spinal Cord Injury. Med. Sci. Sports Exerc., Vol. 35, No. 6, pp. 901–907, 2003. Purpose Our purpose was to determine whether spinal cord injured (SCI) subjects have decreased femoral artery diameter and maximal hyperemic blood flow when expressed per unit of muscle volume compared with able-bodied (AB) individuals. A secondary purpose was to determine whether blood flow recovery rates were similar between groups. Methods Blood flow was measured in the femoral artery using Doppler ultrasound after distal thigh cuff occlusion of 4 and 10 min. Muscle mass of the lower leg was determined by magnetic resonance imaging (MRI). Results SCI individuals had smaller muscle cross-sectional areas (37%, P = 0.001) and volumes (38%, P = 0.001) than AB individuals. Furthermore, femoral artery diameter (0.76 ± 0.14 vs 0.48 ± 0.06 cm, AB vs SCI, P < 0.001) and femoral artery maximal blood flow (2050 ± 520 vs 1220 ± 240 mL·min−1, AB vs SCI, P < 0.001) were lower in SCI than AB individuals. Femoral artery diameter and maximal blood flow per unit muscle volume did not differ between SCI and AB individuals (P = 0.418 and P = 0.891, respectively). Blood flow recovery after ischemia was prolonged in SCI compared with AB individuals for both cuff durations (P = 0.048). Conclusions In summary, femoral artery diameter and maximal hyperemic blood flow response per unit muscle volume are not different between SCI and AB individuals. Vascular atrophy after SCI appears to be closely linked to muscle atrophy. Furthermore, the SCI compared with AB individuals had a prolonged time to recovery, which may suggest decreased vessel reactivity. University of Georgia, Department of Exercise Science, Athens, GA Address for correspondence: Kevin McCully, Ph.D., 115 Ramsey Center, Department of Exercise Science, University of Georgia, Athens, GA 30602; E-mail: email@example.com. Submitted for publication September 2002. Accepted for publication January 2003. Abstract METHODS Subjects. Protocol. Blood flow. Near infrared spectroscopy (NIRS). MR imaging. Statistical analysis. RESULTS Resting. Postcuff ischemia. DISCUSSION REFERENCES Spinal cord injury (SCI) results in muscle and vascular changes below the level of injury (7,8,14,16). These peripheral circulatory and skeletal muscle adaptations may contribute to the increased risk of cardiovascular disease in SCI patients (12). Severe muscle atrophy occurs after an SCI. Muscle cross-sectional area (CSA) is one half to two thirds of that of able-bodied individuals (3,6,14,24). Decreases in CSA occur as early as 6 months after injury but stabilize 12–17 months after injury (2,24). Several other studies have reported that vascular atrophy occurs as well in this population. Thigh blood flow in paraplegics is reduced by 35% compared with able-bodied controls as early as 1 month after injury when measured by plethysmography (29). Femoral artery diameter size is 50% of able-bodied subjects in both paraplegics (1,7) and tetraplegics (16), indicating that vascular atrophy occurs to a similar extent regardless of the level of injury. Resting blood flow in paraplegics is reduced by 28% (8) and venous capacity reduced by 50% of able-bodied subjects (7). Furthermore, a 50% reduction in maximal blood flow was reported in sedentary tetraplegics after 5 min of cuff occlusion (16). A shortcoming of these studies is that vascular changes were not studied in relation to changes that occur in the muscle. A previous study in healthy individuals reported that vessel diameter size did not limit peak blood flow or oxygen uptake (21). It is not known, however, whether the large decreases in the vessel size of SCI individuals decreases muscle blood flow and impairs muscle function during exercise. Vascular reactivity can be thought of as the ability of the vessel to regulate vascular tone (19). Vascular reactivity increases after exercise training (19) while it is impaired in deconditioned (10,26), immobilized patients (13), and in incomplete SCI individuals (17). Furthermore, vascular reactivity is impaired in individuals with diabetes (27,28), heart disease (4), and obesity (31). Alterations in vascular reactivity have been related to insulin insensitivity, hypertension, and increased risk of cardiovascular disease (31). SCI individuals who are inherently inactive and have high levels of obesity (12) vascular reactivity may be particularly affected in this population. The purpose of this study was to compare femoral artery diameter size and reactive hyperemic response by Doppler ultrasound in complete, chronic SCI individuals, and in able-bodied individuals. Femoral artery diameter and blood flow was expressed per unit of muscle volume (as measured by MRI) to determine whether alterations in the vascular system are related to alterations in muscle volume. Halftime to recovery of blood flow was also investigated to determine whether vascular reactivity was altered in SCI individuals. We hypothesized that SCI subjects would have a smaller arterial diameter size and reduced blood flow response after cuff occlusion. However, this smaller difference would not persist when diameter and blood flow are expressed per unit of muscle volume. A second hypothesis was that SCI individuals will have a delayed recovery to reactive hyperemia compared with the able-bodied individuals. Back to Top | Article Outline METHODS Subjects. Nine male chronic (>1 yr), complete (ASIA A) spinal cord injured (SCI) subjects and eight male able-bodied (AB) subjects volunteered to participate in the study. The AB group was recruited from a university community, whereas the SCI group was recruited from the Shepherd Center in Atlanta, GA. The physical characteristics of the SCI and AB subjects are shown in Table 1. The time since injury and level of injury for the SCI individuals are shown in Table 2. The AB subjects, who served as controls were included if they were similar to the SCI group on age, height, and weight and if they did not report exercising more than 3 d a week and were not engaged in any formal exercise-training program for 6 months before the study. Exercise history in the AB subjects was obtained by self-report. Subjects were excluded if they reported that they were smokers. None of the subjects had any history of disease or other confounding factors. Medications were recorded and the only medication that was used in either group was antispasticity medication (Baclofen) in three of the SCI individuals. Baclofen has had no known reported vascular effects. Magnetic resonance (MR) image collection for all subjects occurred at Shepherd Center, Atlanta, GA, or Health South, Athens, GA. The study was conducted with the approval of the Institutional Review Board at the University of Georgia, and all subjects provided written informed consent. TABLE 1 TABLE 2 Back to Top | Article Outline Protocol. Subjects were asked to abstain from fatty foods, caffeine, and alcohol for at least 12 h before testing. Subjects were placed in a supine position on a table for at least 10 min before testing. Blood pressure was measured in the arm throughout the entire testing period using an automated blood pressure machine (Datascope, Mahwah, NJ). Resting artery diameter and blood flow were measured in the femoral artery using Doppler ultrasound. Two trials of leg ischemia were performed by inflating a 12-mm–wide cuff just above the knee. Ischemia was induced in the distal thigh and leg by inflation of a blood pressure cuff distal to the probe to a pressure 100 Torr above systolic pressure. A minimum of 5 min of recovery was allowed between trials. The durations of cuff ischemia were 4 and 10 min. Preliminary studies in our laboratory indicated that there is no order effect for duration of cuff ischemia. Thus, longer durations of ischemia were done last to minimize discomfort to the subject. Cuff inflation and deflation were rapid (1–2 s) and performed using a Hokanson (Bellevue, WA) device. Back to Top | Article Outline Blood flow. Blood flow was measured in the femoral artery using quantitative Doppler ultrasound (General Electric LogiQ 400CL, Rainbow City, AL). A linear array transducer was used at a frequency of 6–9 MHz. The imaging site was located on the upper third of the thigh and was marked to ensure replication of probe placement. Doppler measurements were made proximal to the cuff to ensure that the vessel placement was maintained throughout cuff occlusion. Resting diameter was measured in the axial view during diastole. Pulsed Doppler ultrasound was recorded in the longitudinal view using an insonation angle between 45° and 60°. The velocity gate was set to include the entire arterial diameter. Velocity measurements were auto calculated every heartbeat by General Electric's advanced vascular program software for the LogiQ 400 CL. The minimum, maximum, and time-averaged maximum velocity measurements were saved directly to a computer allowing data acquisition on a beat-by-beat basis. Images were saved to magnetic optical disks for measurement of vessel diameter by custom-made software (Labview 6i, Austin, TX). Blood flow was calculated by the product of vessel CSA and the time average maximum velocity. The resting vessel diameter was used for calculation of blood flow, as no dilation was found in the femoral artery during cuff occlusion. The observation that the femoral artery does not significantly dilate during cuff occlusion has been reported previously (20) and has been seen in our previous studies with exercise (18) and cuff occlusion (17). Conductance was calculated by the blood flow divided by the mean arterial pressure (MAP). Maximum blood flow was determined as the highest blood flow for each ischemic test. The halftime to recovery was determined as the point at which blood flow dropped to one half the difference between maximum flow and resting flow. This was used as an index of vascular reactivity as it reflects the ability of the arteries to return blood flow to resting values (19). Back to Top | Article Outline Near infrared spectroscopy (NIRS). Muscle oxygen delivery was determined by the use of NIRS halftime to recovery (15). NIRS measurements were made using a continuous light source, dual wavelength spectrophotometer (Runman, NIM, Inc., Philadelphia, PA). The probe (2 × 6 cm) contained two small tungsten filament lamps 6 cm apart, which emit white light, and two photo detectors with filters for 760- and 850-nm light located between the lights (effective separation distance between lamps and detectors of 3 cm). The light sources were a pair of small tungsten flashlight bulbs, which gave brief flashes of light every 1.2 s with a power level of less than 1 W. The light photons migrated through the tissue and were collected by the detectors at wavelengths set by two optical filters. The difference in signal between light-on and light-off was used to correct for the presence of ambient light. Oxyhemoglobin has a greater absorbance at 850 nm compared with 750 nm, with deoxyhemoglobin absorbing more at 760 than 850 nm. The difference signal between 760 and 850 nm was used as the index of relative oxygen saturation. Back to Top | Article Outline MR imaging. Skeletal muscle average CSA was determined using proton-weighted MR imaging. This method has been shown to be highly reproducible and reliable for determination of skeletal muscle composition. MR images of the both legs and thighs were collected with a 1.5-T magnet (TR/TE 500/14, 40-cm field of view, 1 NEX, 256 × 256 matrix, General Electric, Milwaukee, WI). Transaxial images, 1-cm thick and 0.5 cm apart, were taken from the knee joint to the ankle joint (leg) and from the hip joint to the knee joint (thigh) using a whole-body coil. Each of the subject's feet was strapped to a brace to maintain the ankle joint at approximately 90° and the knee and hip joint extended. Data were downloaded to a disk and analyzed on specifically designed software (X-Vessel, East Lansing, MI). The methodology for the image data analyses has been reported previously (11). Briefly, images were automatically segmented into fat (high-intensity), muscle (mid-intensity), and background/bone (low-intensity) regions as follows. A preliminary segmentation of each two-dimensional slice into fat and nonfat regions was obtained by simplex optimization of the correlation between a Sobel-gradient image computed from the original image and the corresponding gradient images computed from single-threshold fat-segmented images. This first-pass segmentation was used to correct for intensity variations across the original image caused by RF heterogeneity. The corrected original image was then re-segmented into the three intensity components using a fuzzy c-mean clustering algorithm. Manual selection of a pixel of muscle subsequently highlights all muscle pixels in the region, and provides a total number of muscle pixels exclusive of any fat or low pixels. The individual collecting the data performed two trials on sample images to determine test retest reliability (r = 0.99). Pixel number was converted to area by multiplying by the field of view and dividing by the total number of pixels in the entire image. For each subject, leg CSA was determined with the first distal slice containing the head of the soleus and continuing proximally toward the knee until the end of the tibia was reached. Thigh CSA was determined with the first slice not containing gluteal muscle and continuing distally toward the knee until the patella could be seen. Muscle volume was calculated by determining the CSA for each slice, multiplying it by the thickness of the slice taking into account interslice distance and then summing them together. Leg muscle volume was used to normalize peak blood flow measurements from the cuff occlusions. Limb muscle volume (leg + thigh muscle volume) was used to normalize femoral artery diameter to total muscle volume of the lower limb. Back to Top | Article Outline Statistical analysis. Independent samples t-tests (SPSS version 10.0) were conducted to compare for differences in subject characteristics and femoral artery diameters between the two groups. The data were analyzed to verify normality and to test for any outliers. Levene's test was conducted to determine equality of variances and was corrected for if inequality was found. A mixed-model repeated-measures analysis was used to determine differences between AB and SCI groups across cuff durations for blood flow, conductance, and halftime to recovery. Mauchly's test was conducted to determine if sphericity was violated. If sphericity was violated, the repeated measures ANOVA was corrected using the Greenhouse-Geiser correction factor. Femoral artery diameter and peak blood flow were expressed as a ratio to limb and leg muscle volume, respectively, to determine whether differences between groups in these variables were explained by muscle volume differences. All analyses were conducted at a significance level of 0.05. Back to Top | Article Outline RESULTS Resting. The AB and the SCI groups were not significantly different in age, height, weight, resting heart rate, or blood pressure (Table 1). Individual data for the duration of injury and level of injury in the SCI subjects can be found in Table 2. Limb muscle volume was significantly lower (≈ 40%) in SCI compared with AB individuals (t (15) = 4.116, P = 0.001, d = 2.0) (Fig. 1). Similarly, SCI individuals had smaller volumes for the thigh and leg. FIGURE 1 SCI individuals had significantly smaller (37%) femoral artery diameters than the AB individuals (t (12) = 4.965, P < 0.001, d = 2.53). However, the ratio of femoral artery diameter to limb volume was not significantly different between groups (P = 0.418) (Fig. 2). Absolute resting blood flow was not significantly different between AB (200 ± 80 mL·min−1) and SCI (280 ± 110 mL·min−1) individuals. However, the ratio of resting blood flow to lower leg volume was approximately twice as high in SCI (11 ± 6 mL·100 cm−3·min−1) than AB (5 ± 2 mL·100 cm−3·min−1) individuals (t (10.120) = 2.946, P = 0.014, d = 1.4). FIGURE 2 Back to Top | Article Outline Postcuff ischemia. There were no significant differences between the SCI and AB groups in heart rate (SCI −75 ± 14 bpm; AB −71 ± 14 bpm;t (15) = 0.684, P = 0.504) or blood pressure during or immediately after cuff occlusion (systolic: SCI −124 ± 16 mm Hg; AB −125 ± 8 mm Hg;t (15) = 0.234, P = 0.818; diastolic: SCI −79 ± 13 mm Hg; AB −76 ± 5 mm Hg;t (15) = 0.656, P = 0.522; MAP: SCI −97 ± 14 mm Hg; AB −96 ± 5 mm Hg;t (15) = 0.148, P = 0.884). During cuff ischemia, the proximal placement of the Doppler probe relative to the cuff reduced blood flow to ≈25% of resting flow. Upon release of the cuff, there was an initial burst of blood flow with the first heartbeat and then a large hyperemic response. Ignoring the first heart beat, the flow response increased to a peak value approximately 2–15 s after release of the cuff and then returned to the resting value (Fig. 3). The peak blood flow response was dependent upon duration of ischemia (10 min > 4 min, F (1,15) = 44.062, P < 0.001, η2 = 0.746). Peak blood flow was significantly lower (≈ 40%) in the SCI compared with AB individuals for both cuff durations (F (1,15) = 21.832, P < 0.001, η2 = 0.593). However, the ratios of peak blood flow to leg volume were not significantly different between the SCI and AB groups (P = 0.891) (Fig. 4). Conductance was significantly different between cuff durations (F (1,15) = 50.855, P < 0.001, η2 = 0.772) and was significantly reduced in the SCI (0.17 ± 0.03 mL·s−1·mm Hg−1 and 0.22 ± 0.03 mL·s−1·mm Hg−1 for 4 and 10 min cuff, respectively) compared with AB individuals (0.31 ± 0.07 mL·s−1·mm Hg−1 and 0.39 ± 0.09 mL·s−1·mm Hg−1 for 4 and 10 min cuff, respectively) (F (1,15) = 32.618, P < 0.001, η2 = 0.685). The conductance followed the trends of blood flow as would be expected, as there were no changes in MAP throughout cuff occlusion. FIGURE 3 FIGURE 4 The halftime for blood flow to return to resting values also increased with increasing duration of cuff ischemia for each group (10 min > 4 min, F (1,15) = 70.490, P < 0.001, η2 = 0.825). The SCI group took significantly longer compared with the AB group for blood flow to return to baseline from peak blood flow across cuff durations (F (1,15) = 4.635, P = 0.048, η2 = 0.236) (Figs. 3 and 5). SCI individuals showed a similar pattern of oxygen desaturation with cuff ischemia to those of normal subjects (Fig. 6). Halftime to recovery of oxygen saturation as measured with NIRS was not significantly different between the SCI (14 ± 6 s and 16 ± 10 s for 4 and 10 min cuff, respectively) and the AB (12 ± 5 s and 15 ± 6 s for 4 and 10 min cuff, respectively) groups for either cuff duration. These findings indicate that there was no difference in oxygen delivery between the two groups. FIGURE 5 FIGURE 6 Back to Top | Article Outline DISCUSSION The primary findings of this study were that femoral artery diameter and peak blood flow response after cuff occlusion were reduced in the SCI compared with able-bodied individuals. However, these reductions were evident only for the absolute values, as correcting for the reduced muscle volume in SCI individuals eliminated the differences in diameter and blood flow. To our knowledge, this is the first study to investigate vascular changes in SCI individuals in relation to changes in muscle volume. This result suggests that adaptations in muscle vascular function closely parallel skeletal muscle atrophy in SCI individuals. Furthermore, we observed a prolonged blood flow recovery after cuff occlusion in SCI individuals possibly indicating altered vascular reactivity. We found approximately a 35% reduction in lower limb muscle CSA and volume of chronic, complete SCI compared with AB subjects. It is well documented that significant muscle atrophy occurs after complete SCI due to extreme inactivity. Mean CSA of single fibers from SCI individuals is two thirds the size of able-bodied muscle (14). Muscle CSA as determined by MRI, is reduced by one third in the muscles of the lower limb (3) and in the quadriceps femoris (6) compared with age-matched control subjects. Other studies have indicated that muscle CSA decreases from 1 to 17 months after injury and is roughly 50% of able-bodied controls (24). It should be noted that our measurements of muscle volume underestimated the total leg muscle volume. This was done to conform to the sensitive volume of the magnetic resonance magnet and to make use of reproducible landmarks. The muscle volume measures should be relatively consistent between SCI and able-bodied individuals. Interestingly, by excluding the thigh muscles above the start of the gluteal muscle, we may be more accurately matching muscle mass perfusion to the femoral artery at the level where vessel diameter measurements were made. Our results indicate that femoral artery diameter size was significantly reduced by 40% in SCI compared with able-bodied individuals. However, this difference was no longer significant when the diameter was expressed relative to muscle volume. Our finding without normalization to muscle volume is consistent with previous literature in chronic tetraplegics (16) and paraplegics (1,7,8). These results are significant as they suggest that decreases in arterial diameter size may be matched to muscle atrophy that occurs in SCI individuals. Peak blood flow response to reactive hyperemia was significantly lower in the SCI compared with the able-bodied group. This finding is consistent with previous literature that has shown blood flow is lower in SCI compared with able-bodied individuals after 5 min of cuff occlusion (16) and with exercise (8). However, when we expressed blood flow relative to lower leg muscle volume there was no longer a significant difference in response to cuff occlusion (Fig. 4). These findings indicate muscle blood flow per unit muscle mass is not impaired in SCI individuals after reactive hyperemia. NIRS was used as an independent measure of blood flow. A previous study has used the rate of recovery of oxygen saturation after cuff ischemia as a marker of the ability to deliver oxygen (15). With short cuff durations (up to 4–5 min), there is little or no depletion of phosphocreatine, and thus the hyperemic flow response after cuff release should reflect the inflow of oxygenated blood. The lack of difference in rate of reoxygenation between SCI and able-bodied individuals supports the hypothesis that normalized blood flow is not impaired in SCI individuals. In this study, we used 10 min of cuff ischemia, which should have resulted in some depletion of phosphocreatine (15) and thus an increase in postcuff oxygen consumption. As SCI patients have reduced mitochondrial density (2) and impaired muscle oxidative enzymes (23), we expected the recovery from the 10 min cuff to be slower in SCI than for able-bodied individuals. This was not the case, and we can only suggest that the amount of phosphocreatine depletion with 10 min of cuff ischemia (not measured) was not enough to demonstrate the expected differences in oxidative capacity. We did not find a significant difference in resting blood flow between groups. This finding is in contrast to several studies in which a lower resting blood flow has been reported in SCI individuals (8,29). The difference between results could be due to methodological differences between studies. By normalizing our resting data by muscle mass, we actually found that resting blood flow was higher in the SCI group than the able-bodied group. It is possible that the high resting blood flows in the SCI group in our study were a result of our not obtaining a "true" resting condition. Some of our SCI subjects had muscle spasms when they were transferred to the examination table. This increase blood flow coupled with a slow rate of recovery of blood flow may have elevated our resting values. Our study design included waiting 10 min after transferring to try to account for this, but it is possible that resting blood flow was still elevated. Another possibility is that blood flow at rest may be in excess after disuse due to poor coupling between metabolic demand and blood flow (30). This would be consistent with a deconditioned vascular system or the decrease in sympathetic activity found below the level of injury in SCI subjects (9). A prolonged halftime to recovery of blood flow was found in the SCI compared with the able-bodied group. The prolonged halftime to recovery of blood flow is in agreement with our previous results in incomplete SCI (17) and complete SCI individuals (18). Halftime to recovery of blood flow has been used previously as an index of vascular reactivity (22,25), and this would suggest that SCI individuals have reduced vascular reactivity. Activity status has been related to vascular reactivity as inactivity is associated with reduced vascular reactivity (26) and exercise training improves vascular reactivity (19). Furthermore, reduced vascular reactivity has been associated with many diseases including diabetes (27) and heart disease (4). This study was not designed to address the mechanism behind the reduced vascular reactivity. It could indicate a greater buildup of metabolic factors/vasoactive substances after cuff occlusion and/or a diminished ability to remove them. Reduced sympathetic tone may also play a role. The lack of any differences between SCI and able-bodied individuals in the pattern of desaturation during cuff ischemia or the rate of recovery after ischemia suggest that the reduced vascular reactivity is not due to differences in metabolic rate or in oxygen delivery. Regardless of the exact mechanism, the prolonged halftime to recovery would suggest that vascular reactivity is altered in the SCI subjects. Future studies could be designed to look at the exact mechanism behind this finding. Consequences of reduced vascular reactivity are abnormal oxidative metabolism, increased insulin insensitivity, or hypertension (31); all of which are prevalent in SCI individuals (12). Lastly, our results indicate that a maximal blood flow response is not elicited with 4 min of cuff occlusion, as there was a significant increase in peak blood flow from 4 to 10 min of cuff occlusion. Furthermore, the groups were similar in their responses to both 4 and 10 min of cuff occlusion. This finding is contrary to others that suggest using different cuff durations to obtain maximal flow for various populations (5). Our results suggest that similar cuff durations should be used when comparing between able-bodied and SCI subjects and that at least a 10-min cuff is needed to elicit a maximal response. Previous results in our laboratory have indicated that flow after 10 min of cuff occlusion has been sufficient to elicit a maximal response in able-bodied subjects (Olive, J. L., unpublished observations, July 2001). In conclusion, this study found that lower-limb muscle volume, femoral artery diameter size, and blood flow were significantly reduced in complete, chronic SCI individuals compared with able-bodied individuals. The significant reductions in femoral artery size and blood flow in SCI individuals were no longer different when expressed per unit muscle volume. This study is one of the first studies that have demonstrated that vascular remodeling and muscular atrophy are closely linked. Furthermore, we found a significant prolonged recovery of blood flow to baseline after cuff occlusion, which may suggest reduced vascular reactivity in complete SCI subjects. Future studies need to investigate the mechanisms and the time course for vascular remodeling and muscle atrophy to determine whether they are dependent upon each other. The authors would like to acknowledge Ron Meyer, Ph.D., for his assistance in magnetic resonance image analysis by use of X-Vessel, and Scott Bickel and Jill Slade for their assistance with subject recruitment. We would also like to thank Chris Black, Vanessa Castellano, Lee Stoner, Allison DeVan, Chris Elder, Kristen Dudley, and Michelle Layton for their assistance in data collection. Financial support was provided by the Paralyzed Veterans Association and NIH grants HL65179 and HD39676.Back to Top | Article Outline REFERENCES1. Boot, C. R. L., J. T. Groothuis, H. van Langen, and M. T. E. Hopman. Shear stress levels in paralyzed legs of spinal cord-injured individuals with and without nerve degeneration. J. Appl. Physiol. 92: 2335–2340, 2002. Cited Here... | PubMed | CrossRef 2. Borisov, A. B., S. K. Huang, and B. M. Carlson. Remodeling of the vascular bed and progressive loss of capillaries in denervated skeletal muscle. Anat. Rec. 258: 292–304, 2000. 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Grundy, and I. Swain. Limb blood flow, cardiac output and quadriceps muscle bulk following spinal cord injury and the effect of training for the Odstock functional electrical stimulation standing system. Paraplegia 31: 303–310, 1993. Cited Here... | PubMed | CrossRef 30. Tyml, K., and O. Mathieu-Costello. Structural and functional changes in the microvasculature of disused skeletal muscle. Front Biosci. 6: d45–d52, 2001. Cited Here... | PubMed | CrossRef 31. Villa, E., O. Gonzalez-Albarran, A. Rabano, and R. Garcia-Robles. Effects of hyperinsulinemia on vascular blood flow in experimental obesity. J. Steroid Biochem. Mol. Biol. 69: 273–279, 1999. Cited Here... | PubMed | CrossRef Keywords:BLOOD FLOW; COMPLETE SPINAL CORD INJURY; DOPPLER ULTRASOUND; MUSCLE MASS; VASCULAR REACTIVITY ©2003The American College of Sports Medicine Article Outline Abstract METHODS Subjects. Protocol. Blood flow. Near infrared spectroscopy (NIRS). MR imaging. Statistical analysis. RESULTS Resting. Postcuff ischemia. DISCUSSION REFERENCES Source Vascular Remodeling after Spinal Cord Injury Medicine & Science in Sports & Exercise35(6):901-907, June 2003. Full-Size Email + Favorites Export View in Gallery Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Medicine & Science in Sports & Exercise. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Medicine & Science in Sports & Exercise. Send a copy to your email Your message has been successfully sent to your colleague. 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This item is currently unavailable
Contemporary commuter backpack with dedicated technology storage expands or compresses to accommodate a variety of gear.
- Padded, dedicated compartment protects both a 15" MacBook Pro and an iPad
- SafeEdge Construction lines MacBook compartment for superior bumper protection
- Crush proof SafeZone compartment for sunglasses or scientific calculator plus a dedicated phone pocket
- Removable SafeZone compartment for versatile storage
- Suitcase style opening provides easy packing and locating of items
- Pleated gussets on front panel allow for flexible storage capacity
- Personal organization for smaller accessories comprised of multiple storage pockets and key fob
- Base compression straps also secure a jacket or yoga mat
- Durable, water-resistant 500D nylon with TPE backing and water-resistant YKK zippers
- Two side mesh pockets for water bottles or accessories
Technical specifications
- External height: 17.7 in
- External length: 12.4 in
- External depth: 12 in
- Laptop compartment height: 0.9 in
- Laptop compartment length: 14.3 in
- Laptop compartment depth: 9.8 in
- Weight: 2.31 lb
- Capacity: 1343 cu in
- Material: Nylon
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Clock Plans
Whether you want to build a replica grandfather clock with intricate joinery and cabinetry or create a wooden wall clock, there are free clock plans that will add a decorator touch to your home or office.
Whether you choose beautiful hardwoods or simple, clear pine you can build an attractive, functional timepiece, using free clock plans available with material lists, instructions and creative tips.
Artsy Desk Clock
Rich wood tones are created using red cedar, cherry, red oak and sassafras for a unique and handsome desk clock.www.howtomakepens.com
Airplane Time
With the use of a scroll saw and this detailed plan you can create an Airplane clock for the enthusiast in your family.fssp-arpop.blogspot.ca
Rustic Wall Clock
Turn a piece of burl wood into an eye catching wall clock using these easy to follow instructions.www.leeswoodprojects.com
This tall shaker style clock has a 19th century appeal and will become a family heirloom for years to come.www.finewoodworking.com
Clock Plan
This detailed plan with pictures uses pine wood to create a handsome wall clock with three wooden pegs.canadianhomeworkshop.com
Sun Burst
Here is an easy weekend project that requires a band-saw and bobbin sander to make this attractive sun burst clock.www.woodworkersinstitute.com
Curio Clock
Built using quarter-sawn wood this beautiful clock has an enclosed display area for placing collectables or knick-knacks.canadianhomeworkshop.com
Mantel Clock Plan
This plan will help you build a cherry wood mantel clock that has the same design as a grandfather clock.www.bobsplans.com
Up-Up and Away
Use your scroll-saw to make this wooden plane then add a small insert clock for an Airplane wall clock for home or office.www.saw4fun.com
Wall-Clock Plan
This attractive wall clock is made using layered wood with a cut out design achieved with a scroll-saw.fssp-arpop.blogspot.ca
Scotty Dog
Using 1/4 inch stock or plywood cut out a Scotty dog then paint it black and add a micro-mini clock insert.fssp-arpop.blogspot.ca
Geometric Style
The geometric design sets this clock apart from other and is easy to create when following these detailed instructions.www.saw4fun.com
Scooter Clock Plan
Here is a downloadable pattern to help you create this wall clock that is in the shape of a scooter.fssp-arpop.blogspot.ca
The Block Clock
Turn blocks of painted wood, aluminum and a clock mechanism into a stylish wall clock for home or office.dadand.com
Clock Plans
4 variations of Grandfather Clocks to choose from.


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WOBURN, Mass. (AP) — A Louisiana man has been charged in connection with a body found on a Massachusetts highway last month.
Middlesex District Attorney Marian Ryan said 50-year-old Nicandro Velasquez, of Haughton, Louisiana, was arraigned Thursday in Woburn District Court on charges of leaving the scene of a death and unlicensed operation of a motor vehicle.
The body of 54-year-old Cliserio Cordova Ferral, also of Louisiana, was found July 26 in the roadway on Route 128 in Burlington.
Investigators say Velasquez and Ferral were driving to Maine for work when Ferral fell out of the truck. Instead of seeking help, prosecutors allege Velasquez continued driving.
A truck matching the description of one seen in Burlington was later found in Orland, Maine.
Bail was set at $4,000 for Velasquez. It wasn't known if he had retained an attorney.


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There's a new theater company in town.
Bangers and Mash Theatre Works, founded by D.J. Queenan and Warren Heilman, will present "Falsettos" as its first production.
With music and lyrics by William Finn of "The 25th Annual Putnam County Spelling Bee" and book by James Lapine of "Into the Woods," the musical won two Tonys in 1992 for Best Book and Best Musical Score.
"We wanted to do productions that speak to our creative hearts and that present issues to adults," Queenan says. "I'm a drama teacher and have been for five years and love it, but I'm interested in doing theater that is not geared toward youth."
BMT seems dedicated to its goal, with the motto "Adult Food for the Stage!"
"We started the gears in motion last year," Queenan says. "We reserved time at Muse Arts Warehouse.
"Then we started to pick and choose and worked our way along to our auditions at the end of April."
"Falsettos" follows Marvin, who leaves his wife and young son to live with another man. His ex-wife marries his psychiatrist, and Marvin ends up alone.
Later, Marvin is reunited with his lover on the eve of his son's bar mitzvah.
"It's a fun and touching gay romp through love, sex and a bar mitzvah," Queenan says.
"'Falsettos' is a theater piece that has been on my heart for many, many years," he says. "It spoke to me as an artist, it spoke to me as a gay man, it spoke to me about family and love.
"It's about a family dissolving, and through the love of a child, coming back together again," Queenan says. "It's very heartwarming and very funny."
Queenan is directing the production and Heilman is doing musical production. The cast of seven includes six adults and one sixth-grader.
Members of the cast are Ray Ellis, Cecelia Arango, Dan Finn, Christopher Stanley, Finn Repella, Carol Melton and Josie Streiff, with design by Jeroy Hannah and Erin Muller.
"It's a difficult piece, very challenging artistically, but at the same time, the cast and production team has been amazing and so easy to work with," Queenan says. "We've assembled some of the most talented Savannah performers I've ever worked with. We had a of lot of help from our friends at the Bay Street Theater."
What: Bangers and Mash Theatre Works presents "Falsettos"
When: 8 p.m. June 14, 15, 21 and 22; 3 p.m. June 16 and 23
Where: Muse Arts Warehouse, 703 Louisville Road
Cost: $20 adults, $15 students
Info: 912-920-3594


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Benefits of Masters degree?
Posted 04 January 2010 - 02:35 PM
The local GIS/Cart job scene continues to cool down here. My short term part-time GIS internship is quickly becoming my long term part-time GIS job with no prospect of full time (or interesting) work. Looks like I may be in stasis for a while and am thinking about using my work flexability to go back to school, again, this time for my Masters. However I'm struggling with the question of why? Or how will this effect my career future if I don't have a particular goal or job associated with getting the degree?
Your input is greatly appreciated.
Posted 04 January 2010 - 08:32 PM
lots of it is contract, so nothing very stable, but sometimes can be.
and hey, there were more GIS jobs in Cali this last year than anywhere i think. i saw many, some of them cartog stuff.
if you search, check the GIS 'Analyst' jobs, sometimes they want more map production skills than programming.
i think getting out and working will be more beneficial than a master's, and there's always GIS (cont. ed.) classes around to stay in tune. going back to a masters will do no more for your future than just going and getting practical experience of some kind, even if it is on your own. (unless you dive into some crazy specific form of rare-water-snail-habitat-modeling, etc.)
the big question for going solo is...are you an idea man? you must be very creative in coming up with maps that you think might sell for any particular area. if you need someone else to give you ideas for maps, then go with a company
Posted 05 January 2010 - 03:32 AM
A few years ago -cough- I had a bachelors in engineering, interest in an entry-level GIS job, but no takers as I didn't have the education or experience. I got a Masters in Geography with a focus on GIS/Cart, and afterwards I had the/a job I wanted. It was my _general_ intention ahead of time to get this professional masters, as opposed to continuing with research/PhD. I also learned the most, and picked up the most marketable skills while working on independent projects including my thesis. I learned -cough- Avenue scripting for example, so afterward I could market myself as an "masters educated" GIS/Cart person with programming skills.
Even though you already have a Bachelors in a similar field (I think), if you are interested, for example in further developing your technical skills, or looking deep into domains such as mobile or web cartography, it seems like you could find a program (Masters or even certificate) which would allow you to pursue those interests, gain experience, and in the end also have an advanced degree or cert on your cv... something employers (and probably also customers) definitely look for when hiring.
-C in Z
Posted 05 January 2010 - 08:41 AM
"There is much beauty that we fail to see through our own eyes teeming with life forms that give us that perception of our reality. Leaves on the trees blowing gently in the wind, or scarily, the waves pounding through high surf, or lightly on a warm summer's day; that opportunity to sit or swim in the water on a white beach. That comfort to shout, "The universal conscious do you hear me? I am alive, guide me dear logos towards the path of rightnesses." Earned what has been kept, no longer to be absorbed into a life filled with cold damn winds and that stubborn fog clouding my vision with nothing but darkness."
Posted 05 January 2010 - 10:18 AM
If you go into a Master's program without a goal then it may be more difficult. It can be a lot of work and you have to be self-motivated so it helps to have some stronger motivation than just getting "a" degree. If not a career goal then maybe a strong interest in some particular subject - you'll likely have to focus fairly narrowly on something for your thesis at least, although you don't have to know what that will be going in.
Having a goal would be good. Then you could target your education better. For example, (taking a cue from Derek) if your goal is to be a freelance cartographer or start your own shop it might help to get some business training/experience. If your goal is to get into more advanced GIS work some training and experience in programming would be useful. I would also echo ceicher's point about getting some practical experience at the same time. Whether it's school projects or better yet, actual projects as a student assistant, intern, etc. That's at least as important as the classroom learning in my opinion.
If you can't come up with a goal you are really interested in then at least look at pursuing subjects/projects you enjoy or find fascinating.
Dave Barnes
Map Geek
Posted 05 January 2010 - 12:45 PM
If I had to identify a goal (besides simply making myself more marketable) it would be to find work in Conservation/Resource/Scientific Research mapping. Or possibly Urban Design & Planning. They have a project option that I may do instead of a traditional thesis.
My big concern is not having a focused goal, a specific industry I amreally focused on getting into. But that's how it was with Geography as well, I never intended to become a cartographer and in fact purposely didn't take Cart 101 in college... I figured it was way to detail oriented for me!
This is good information. Keep the anecdotes coming.
Posted 06 January 2010 - 08:51 AM
US Census Bureau
Posted 06 January 2010 - 10:03 AM
Posted 06 January 2010 - 11:52 AM
The problem is, in the UK cartography masters courses are few and far between, and I don't really want to choose a route heavily oriented to GIS programming. I guess I'll just keep looking and wait for something to kick me into action.
Petroleum Geoscientist
Bournemouth, UK
"Common sense is the collection of prejudices acquired by age eighteen" - Albert Einstein
Posted 06 January 2010 - 06:55 PM
So I think if you are going to do a Masters it's best not to be doing the work at the same time.
Posted 07 January 2010 - 01:16 AM
Just my Thoughts
Posted 06 February 2010 - 01:05 AM
Posted 09 February 2010 - 03:54 PM
A lot of people now are getting GIS graduate certificates, which are awarded after 20-something graduate credit hours. The trouble with those, from an inside perspective, is that students finish the program too fast. One of the best ways to get a "government job" is to come in as a student, and the three years I spent completing my Masters allowed me to make contacts, prove myself, and make it hard for my managers to replace me. Hard to do that in the time it takes to get a graduate certificate.
Cartographer, Bureau of Land Management
Oregon State Office
Portland, Oregon
Posted 09 February 2010 - 04:02 PM
The benefit that I feel I have from my Masters in Geography has more to do with the knowledge I acquired than the degree itself (my Bachelors was not in Geography). In my job the benefit of having a Masters is pretty much equal to a year on the job in terms of pay level.
A lot of people now are getting GIS graduate certificates, which are awarded after 20-something graduate credit hours. The trouble with those, from an inside perspective, is that students finish the program too fast. One of the best ways to get a "government job" is to come in as a student, and the three years I spent completing my Masters allowed me to make contacts, prove myself, and make it hard for my managers to replace me. Hard to do that in the time it takes to get a graduate certificate.
I actually just finished a 21 unit GIS certificate course last year. I agree it's not much of an in depth education but compared to a weekend GIS certificate it's a huge improvement IMO. Maybe this is different from what you mean by "GIS graduate certificate"?
At any rate my certificate did little more than reacquaint me with the frustrating nature of GIS software interfaces and programming.
I'm not sure what I will focus on in my MA work but I anticipate the real benefit coming from, as you mention, making contacts and getting experience. The same was true of the certificate, it gets you very little in terms of work credit but the internship I did while getting my cert is now my only steady paying job!
Posted 10 February 2010 - 01:09 AM
What I learned was how to identify a problem, how to research various methods and techniques to solve the problem, how to implement those methods in the field to collect data about the problem, how to analyze the data collected, and finally how to report those findings to the general public.
All other things aside, would you rather hire someone who knows how to problem solve, or someone who doesn't.
I would also state, that someone could also learn those same problem solving techniques with experience. And experience trumps all in my book.
Strabo 22AD
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We're ready! Now what?
Your next step should be to document the
size of your network, your total IT
budget and a prioritized list of IT
problems that you want a prospective
managed service provider to address. This
is important because managed service
providers tend to focus on appropriately
sized & funded clients with needs
that they can meet profitably, so it
saves everyone time if you specify this
information up front.
Once you
have a couple of qualified MSP's or
MSSP's competing for your business, you
can get quotations for the levels of
service that you require - what is called
in the trade an SLA or Service Level
Agreement. Your SLA is the legal contract
that governs the delivery of the services
that you have contracted for, how
performance standards will be measured,
and how your payments for services will
be rendered.


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This Ajmer Uber promo sure will not disappoint! Remember that relative you've been meaning to visit? Or that store you once hurried past and never went back to? That famous monument in the city you are guilty of never going to, that friend who lives on the other side of the city who you haven't met in a long time or that new restaurant in town you are yet to try out – Have you been delaying all these and more thinking 'Kabhi Aur'? This week get all your plans rolling, because, Abhi nahi toh Kabhi nahi! For this week only, all Uber rides across Ajmer will cost ₹40, flat during this Ajmer Uber promo in India. That's right, it is hassle free – no promo codes, no cash-backs. Just request a ride, get off at your destination and pay ₹40. Step out and visit all your favourite people and places without breaking a sweat in this sweltering heat. Even if it's a quick trip to the local store or a visit to the mall, just Tap, Request and Get Riding Now! If you are wondering, here is how this Ajmer Uber promo will work:
- Open the Uber app. Enter your pickup location and request for a ride.
- Uber will show your driver's details straight away – name, photo and the details of the car.
- At the end of the trip, you will be charged a flat rate of ₹40. No promo code needed.
- Promotion is valid on all rides.
Here are the terms and conditions of this Ajmer Uber promo:
- Flat fares will be valid across all Uber rides in Ajmer and Pushkar.
- Flat fares are only valid for the first 8Km, post which regular fare will be charged.
- Valid till 23 May only.
- Click to view Service Area.
- Surcharges as applicable.
For more information about the Uber promo in Ajmer, read the Uber India website.
Take the time to visit the main Uber Promotional Codes website for all updates to all ongoing Uber promotions.


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Have you ever wanted to live your guitar hero dreams and open for The Offspring, A Day To Remember and Bad Religion? Seems pretty badass, right? Well, Ernie Bell is offering local, unsigned bands that opportunity to live their dreams on the big Verizon Wireless Amphitheater stage on September 21.
The prize, in addition to playing at the fifth annual Epicenter show, will be a slot on the Ernie Bell stage. Bands can enter Ernie Ball's Epicenter Battle Of The Bands — and fans can vote for their favorite artists here now through September 13, 2013.
The top 100 "Buzz Rated" bands that sign up for the Ernie Ball Epicenter Battle Of The Bands will be eligible to win. A panel of judges will choose the winner of this global search for the best undiscovered rock band. The winning band will be announced on Monday, September 16.
Ernie Ball will provide the winning band with an all-expense paid trip to the festival, an Ernie Ball Music Man endorsement, and a slot at this year's show.
As of now, the lineup for Epicenter is:
The Offspring
A Day To Remember
Bad Religion
Pierce The Veil
All Time Low
Falling In Reverse
The Wonder Years
New Beat Fund
Plague Vendor
And Ernie Ball Battle Of The Bands Winner TBA
That TBA group could be you, so hustle over to the website listed above and get your fans to vote. Good luck!
Follow us on Twitter @ocweeklymusic and @danielkohn. Like us on Facebook at Heard Mentality


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Really interesting project here. Those of you who know Martha Redbone may be more familiar with her funk, soul, R&B and rock-influenced sounds. And while that's a part of who she is, she's also an artist who's won awards for mining the Native-American side of her identity (she's part Shawnee and Choctaw). Knowing that, it's less of a stretch to find her doing an album that's set squarely in the heart of Appalachia.
Her current project, five years in the making, takes the words of the Romantic poet William Blake (1757-1827) and sets them amidst an Americana landscape of "swampy slow grooves, ancient chants, field hollers and gospel mayhem". At first glance, it might sound odd, but upon hearing it, you realize it works. The songs, swirled in folks, country, gospel and blues are made timeless and relevant. According to a press release, Redbone had this to say about Blake:
"Blake teaches us that the imagination is a portion of the divine principle, and that 'Energy is Eternal Delight,' and 'everything that lives is holy'. These are songs that celebrate community, empathy and love, messages the world desperately needs at a time of atomization, emotional disconnect, and widespread hardship."
It's worth noting what's probably been an ongoing reclamation of American roots music by Redbone, as well as artists such as the Carolina Chocolate Drops, former Chocolate Drop Justin Robinson, Lizz Wright, Kamara Thomas & others too numerous to name.
Check out the song, and let us know what you think!
Additional link:


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The Capital Region was full of news stories in the past year. What do you think was the year's biggest story?
For round one, please select three from each quarter of the year. The next round will include all the finalists from each quarter. If you need a refresher on the stories listed below, here is a full list with links to each piece.
Polls are below the jump.


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Enbridge Gas New Brunswick's general manager says a new fee for large industrial users of natural gas is a move in the right direction, but it doesn't fix the problems created by the provincial government in 2011.
The provincial government introduced legislative changes this week that will allow Enbridge Gas to receive higher payments from six of the province's largest buyers of natural gas starting in 2019.
However, Gilles Volpé, the general manager of Enbridge Gas New Brunswick, said the natural gas company is still feeling the pain from controversial reforms imposed by the Alward government in 2011.
"[Company investors] look at New Brunswick and say, 'Wow, we've invested a bunch of money. We followed the contract. Now there's $200 million that we can't recover. I think I'd rather put my money in Colombia," Volpé said.
'So they see, as an example, they see New Brunswick as a riskier place to do business than Colombia.' - Gilles Volpé, Enbridge Gas New Brunswick
"So they see, as an example, they see New Brunswick as a riskier place to do business than Colombia."
Enbridge was given a 20-year monopoly in 1999 to build and operate a natural gas distribution system in New Brunswick, but the cost of the expansion greatly outstripped customer demand for service.
Enbridge was allowed to put much of the expenditures it incurred building its network into a deferral account to be recovered later. But a lack of customers meant the deferral account kept growing with distribution rates kept high to cover the costs.
Energy Minister Craig Leonard introduced the reforms in 2011 that were intended to lower the cost of natural gas for consumers.
The changes, which were imposed without the company's consent, barred Enbridge from charging customers anything for the cost of the deferral account, which the company claimed had grown to $176 million by the beginning of 2012.
The legislative changes announced this week have been recommended by Enbridge for 15 years.
The changes will mean the six largest natural gas users, which are known as single-end use franchises, will be paying a larger share of the cost of natural gas in 2019.
That will mean other natural gas customers will see a benefit in their rates, according to Enbridge's Volpé.
"Ratepayers should see a reduction if these funds materialize. The size of the reductions in five or six years from now will depend on how much [large industrial customers] contribute," Volpé said.
Volpé said it is difficult to determine how much of a savings will be passed onto other customers five years from now.


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Only £4695
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Hello! It's been 15 years since our launch and from humble beginnings we have achieved a lot over the years, growing to be one of the most successful hot tub companies in the industry. In fact in an industry that has been finding its feet during this period, we can proudly say that we have been at the forefront and shaped many of the practices that are now considered standard!
Many of you reading this will not have owned a hot tub before and with so many options to choose from it can seem like a bewildering experience. We keep things simple here at Hot Tub Megastore; we offer the best hot tubs at the best prices and most importantly offer you back up and service that is second to none in the industry.
Life is getting more stressful and at the end of a hard day we believe that the ability to jump in your own hot tub and wind away the stresses and strains of the day is a luxury you can't afford to do without (plus they are proven to keep the rest of the family happy for hours). No matter what choice you make from us, you can be assured that your evenings won't be quite the same again!
Enjoy the latest range and if you have any questions please don't hesitate to contact us. We are still the same friendly family owned company, we have just grown with a few more members of staff over the years.
Founder, Hot Tub Megastore
I just wanted to say thank you to Simon and everyone else, we've just had our hot tub fitted yesterday and we love it.
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We have had a great experience with Hot Tub Megastore, with second to none service.
Everyone we spoke to was informative and helpful with great product knowledge. Thank you for great customer service.


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Please click on the links to the right to view more information about our church.
We're located on Wall Triana Highway, just north of Highway 72 and Capshaw Rd.
Sunday School: 9:30 AMSunday AM Service: 10:45 AMWednesday Service: 6:30 PMView More Details
firstname.lastname@example.com Highway Baptist Church6597 Wall Triana HighwayMadison, AL 35757


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For a year, fellow North St. Paul officers wore memorial pins in Rick Crittenden's honor after he was killed in the line of duty on Labor Day 2009.
His widow says that for some, a year is not long enough.
On Thursday, Christine Crittenden canvassed North St. Paul businesses and residences in a petition drive to revise the city's uniform policy to allow officers to wear the pins beyond a year. She has 400 signatures.
"It's what I hear the officers want," she said. "They say every time they take a call, they have a little piece of Rick with them when they wear it."
Police Chief Tom Lauth said the yearlong period is city policy.
"There's no disrespect intended," he said. "There was an exception in order to allow (the pins in the first place.)"
Lauth said uniform policies are in place for reasons. Police departments need limits on the many requests to wear pins for various causes, he said. Safety is another concern; North St. Paul police uniforms, for example, once included nameplates that could catch on things, so the department switched to monogram patches.
Rick Crittenden, 57, was killed when answering a call at Aspen Village apartments in North St. Paul. A woman fearing her estranged husband was in her apartment had called for an officer escort.
When she and the officer entered, 34-year-old Devon Dockery charged at them with a burning rag. Dockery and Crittenden struggled; Dockery grabbed the officer's holstered gun and shot him in the head.
Dockery died in an exchange of gunfire with Maplewood police officer Julie Olson. A bullet fragment hit Olson's right arm.
After Crittenden's death, Lauth gave the "special order" allowing officers to wear the memorial pin, carrying Crittenden's name and badge number, until the year anniversary. The day after the Sept. 7 anniversary, the uniform policy fell back into place.
Christine Crittenden said officers have said they want to continue wearing the pins but fear retaliation if they challenge the policy. So she is speaking out for them, she said.
"I just want the chief and council to know that they still want to wear it," she said.
Crittenden and a handful of supporters, petition in hand, asked the North St. Paul City Council this week to reconsider the police uniform policy. Council members said they would review the policy.
On Thursday, the widow sought to build support, going door to door for petition signatures. The goal is giving officers the option of wearing her husband's memorial pin, or others like it, year-round.
Lauth said the community memorializes Crittenden in other ways. Officers will be asked to wear the memorial pin on the anniversary of his death, as well as mourning bands and their dress uniforms.
"Out of our respect for Richard, we'll put out our best every year on the anniversary of his murder," he said. "He demands respect."
A replica of a North St. Paul police badge with Crittenden's badge number, 933, has been added to squad cars, he said.
And a life-size bronze of Crittenden was unveiled in front of North St. Paul City Hall on the one-year anniversary last month. The North St. Paul Law Enforcement Officers Association spearheaded the effort, which was paid for through community fundraisers.
Christine Crittenden said she plans to urge the North St. Paul City Council again later this month to reconsider the policy.
Such policies vary. The St. Paul police department, for example, has no limit on how long officers can wear such pins as long as certain requirements are met, department spokesman Andy Skoogman said.
St. Paul officers are allowed to wear up to two pins — a flag and another, as long as it represents "a commendation received by the officer, seniority status, St. Paul logo or professional law enforcement affiliation."
Nancy Ngo can be reached at 651-228-5172.


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1. Be Identified For A Thing- Whether it is blogging, internet marketing, geeky stuffs, humour etc : what ever it is that truelly catches your passion, tweet about it. Be known for what you know. People who are interested in thesame subject will follow you and maybe even put you on their list which will recommend you even more as an authority on that subject. I'm yet to find someone who does not know how to do any thing, therefore, what you know is what you should tweet about.
Follow your Mentors- It is quite unlikely that your mentors are without followers as they are often celebrities. This means that they have thousands upon thousands of followers or probably even millions. So part of the essence of following your mentors is to learn how they tweet their stuffs. I would recommend that you take things to the next level by improving upon it, add something extra (whatever it may be). Your reward would be that you will start to attract thesame loyal followers like them. My advise is that it will take a lot of patience as thousands won't jump on your ship overnight.
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text:
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The estimates presented in this publication provide an early indication of short-term visitor arrival movements prior to final data becoming available for the reference month. Monthly data prior to the reference month are final estimates. The ABS encourages users of these data to refer to the ABS monthly publication, Overseas Arrivals and Departures, Australia (cat. no. 3401.0) for final ABS estimates of short-term visitor arrivals for the reference period. Final estimates for February 2007 will be released on 5 April 2007.
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The Dumb Waiter
Tickets can be reserved 2 weeks prior to show dates.
November 17-20, 2010
7:30 p.m.
Morris Experimental Theatre
Tickets are free to MVC Students, Faculty, Staff
$5.00 for non-MVC unless otherwise stated
Box Office: (660) 831.4208
House opens at 7:00 p.m. for open seating!
Cast: 2 men
The Dumb Waiter, by Harold Pinter, is one of Off-Broadway's most successful entries (where it was presented with The Collection under the overall title of The Pinter Plays). This mysterious and moody study in suspense concerns two professional killers who wait apprehensively in a grubby, windowless basement room for word of their next macabre assignment.
The Dumb Waiter is a suspense play, mysterious almost mystic." —NY World-Telegram & Sun. "…a distinguished gift for sheer, old-fashioned theatrical effectiveness, including the use of melodramatic suspense and the hint of sinister forces lying in ambush." —NY Post.


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I am having trouble using a specific blend mode for my sprites, the one called "copy"
What i am aiming for is that when sprite A moves across sprite B, it should render sprite B transparent where the sprite A has been.
To make this happen i though of adding a bit of transparency behind sprite A and using the copy blend mode.
This is what i imagined sprite A should be like.
Now, when i add the image with the normal blend mode, it appears as it should, but when i change to the copy blend mode, the transparency appears black. When i run the project with the copy blend mode, the transparency appears gray.
Here is a .capx file of the project i am testing the transparency with.


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The report estimates that in 2016, orthopedic surgeons will be able to perform just 231,071 hip replacements and 287,759 knee replacements, which falls 46% and 72% short, respectively, of the numbers demanded.
Senior author Dr. Thomas K. Fehring told Reuters Health that in the next decade there will likely be a "perfect storm" for access to joint replacement surgery.
On the demand side, "the baby boomers will be entering the years in which joint replacement is common," noted Dr. Fehring, from OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. We have an obesity epidemic in the United States which will affect the need for joint replacement as obesity increases the need for joint replacement."
At the same time, he added, surgeon supply is falling. "Because of declining reimbursement, young surgeons are not entering the field. Reimbursement for joint replacement has decreased 60% in inflation-adjusted dollars since 1990."
"Unless things change, (these forces) will lead to excessive waiting times for our senior citizens requiring joint replacement. Wait times of 1-2 years may ensue which will be unacceptable to the general public."
To estimate the workforce in 2016, Dr. Fehring's team analyzed data from the AAOS database, which includes information on the number of graduating orthopedic residents, the ages of surgeons with a hip or knee focus, and the average retirement age of surgeons. This information, coupled with Census data, was used to generate an economic supply and demand model.
The authors calculate that there will be 5038 orthopedic surgeons who will perform hip and knee replacements in 2016. The supply numbers were calculated by multiplying this workforce by the average number of hip and knee replacements performed each year by either a hip and knee specialist or by a generalist with a hip or knee focus.
As for a solution to the supply side crisis, Dr. Fehring said that "a viable pragmatic option that would maintain access for future arthritis patients would be for the government to allow balance billing. This solution may draw young surgeons into the field of arthroplasty, encourage general orthopedists to share in the increased demand for arthroplasty, and encourage established arthroplasty surgeons to practice longer at their current rate of production."


text: Historians believe that in newspost <1132159514.159552.279750 at g47g2000cwa.googlegroups.com> on Wed, 16 Nov 2005, Alex <ayboro at yahoo.com> penned the following literary masterpiece: >We are looking for a system that allows HTP generation of mkg amounts >of protein from linear PCR products. It seems that coupled prokaryotic >T7 driven is a way to go. Any suggestions or ideas? What would be the >most critical parameters? What yield to expect? Are there any >preferences among the commercial products? >Any help or advice will be greatly appreciated. mkg? mg's or ug's? From what I have heard (never used it) the highest production seems to be using the Roche system. Maybe a look at how they do wit will give you some ideas of what to look for. Duncan -- I love deadlines. I especially like the whooshing noise they make as they go flying by. Duncan Clark GeneSys Ltd.


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How hedonism became America's official religion
by Jennifer Roback Morse
This article was first published at Mercatornet.com on February 9, 2012.
No, I'm not exaggerating. The American experiment in religious liberty is officially over. The First Amendment provided institutional structures that allow different religions to peacefully coexist. All groups agree to not try to capture governmental structures for the benefit of their own particular denomination.
But the Obama administration has ended that truce. The administration made a decision to require all employers to provide contraception, abortion-inducing drugs and sterilization. The administration offers no religious exemption for people who have the audacity to believe that pregnancy is not an illness that needs to be always and everywhere prevented.
In effect, we have a new state religion, a new Established Church of the United States of America, with Barack Obama as its head. It is the religion of Secular Hedonism, the worldview that sex is a sterile recreational activity, with babies thrown in as an afterthought, an optional extra, for people with quirky life-style preferences. The contraceptive mandate uses the full might of the US government to scrub the public square clean of any competing religious voices that dissent from the new orthodoxy.
But because this worldview is fundamentally irrational, it cannot stand on its own two feet. Some sexual activity does result in babies. Not everyone wants their government acting as if the highest goal is that pleasure is to be sought. Not everyone believes that the purpose of the government is to allow people to indulge themselves sexually, without a live baby ever resulting.
The Catholic Church for instance, famously opposes every precept of Secular Hedonism. As a matter of fact, so did all of the Christian churches, right up until five minutes ago. The ancient Christian teaching is that marriage is the proper context for sexual activity and for child-bearing, for the good of children, women, and men alike, as well as society as a whole.
The government believes that this dissenting voice cannot be tolerated. It must be crushed. And, of course, from their point of view, they are perfectly correct. They have an established religion that says that every sexual act is intrinsically meaningless except for the meaning we might happen to assign it. They simply can't allow someone to go around saying that each and every sexual act is sacred, and endowed by our Creator with inalienable significance. From the point of view of Secular Hedonism, Catholicism must be crushed.
And of course, anyone else who dissents from the new orthodoxy must be crushed as well. That is why so many other faith traditions have joined in criticizing the Obama administration's usurpation of power from civil society. The National Association of Evangelicals, the Lutheran Church Missouri Synod, Orthodox Christians and Orthodox Jews have all criticized the administration's attack on religious liberty. These religious bodies know that their religious liberties are at stake as well.
The religious truce is officially over. The Established Church of Secular Hedonism has declared war on the rest of us, enlisting the might of the United States government on their side. We will respond using nothing but peaceful means.


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I came across an article saying that in some restaurants, chefs are discouraging customers from photographing their food. They have reasons like- the food gets cold by the time they are done clicking, and that it disturbs other diners who prefer to enjoy their meal quietly.
Eating good food at a good place is what makes MOST of the normal people on this planet happy. Food is, after all, one of the very primary reasons that the entire human race work their asses off for. Night shifts, 7 days-a-week shifts, work-at-home jobs, over-time, working in a different city away from family, thus missing out on numerous precious moments at home–we do it all! And when we do so much, and when we finally manage to take out time to go to a nice place to sit and eat, and when you pin up all your happiness on the moment when that perfectly made meal arrives at your table in 'picture-perfect' state, the last thing you need at that point is someone disapproving of your instant reaction to taking pictures of it! Believe me, it can be the biggest turn off!
How do you explain to that person that it is not just food to you at that point, it is something personal, your achievement, the result of your little sacrifices that you do in day-to-day routine. It is something you used to dream of doing when you were in college and had no job or money to afford eating out at a fancy place. Sometimes, it is the 'only' good thing happening to you after a rough day at work. And then, to put up with the snobbery of these people who go all cynical the moment you take out your smartphone to capture that beautiful piece of art on your table! My only advice to you in that situation- I-G-N-O-R-E!!
For they don't realize that food made like that, is actually a great piece of art in itself! Why do we like paintings? They appeal to your sense of vision. Why do we like perfumes? They appeal to your sense of smell. And why do we like food?? Because food appeals to your sense of vision, sense of smell, sense of taste, sense of touch. That is why, it is the greatest piece of art. And the makers of it are the artists. Why else do chefs take great pains in the 'presentation' of the dish? But that is exactly why it is confusing and unconvincing when we hear that certain chefs discourage customers to take pictures at the table. OK, say the food might get cold if we go overboard in clicking, but have you ever heard of an incident where the customer then complains about the meal gone cold because they were too busy clicking? Come on! People have that much common sense to take responsibility for it and eat nevertheless.
The other reason that food-clickers tend to get too loud, please! People are WAY more louder when they come in groups for a birthday party, or reunion with friends over drinks, in which case the noise grows only louder and louder! That can beat a few gasps and clicking noises any time! Not to forget our cute little noise-generators, the kids 🙂 woah! They are a warehouse of all kinds of noises you possibly can or want to hear. Haha!
Having said that, I am absolutely not in favor of clicking food pictures badly! Yes, now and then, I come across really badly-taken food pictures, where the place's lights are not right, and so the flash is turned on, and the picture taken is so bad that you lose your appetite by looking at it. As I said earlier on, it is a piece of art. Give it the respect it deserves. (And get a better camera for God's sake!)
And the obvious statement-in-defense needs to be made here. The clicking and sharing of food pictures on social media does an instant publicity for the restaurant, bringing in more business for them at no cost at all.
So please don't judge, dear 'haters-of-food-clicking-moments'! Let people enjoy their moments! The world has enough matters to disapprove of, already.


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Date: October 16, 2007
Source: EWI (East West Institute)
There are deep flaws in the structure of global regimes designed to control access to WMD technology and sharp disagreement among major powers over the use of sanctions and military force to address potential threats. Often overlooked is the role of the private sector in issues surrounding WMD proliferation and responding to the threat of bioterrorism.
Distinguished leaders from business and the United States government will join Columbia and EWI experts to explore how the private sector can collaborate with governments to devise an effective response to these threats.
The presenters are:
Dr. Mark Chandler
Chairman and CEO, Biophysical Corporation
Member of the Board of Directors, the EastWest Institute
Brandon D. Declet
Counsel to the US House of Representatives, Committee on Homeland Security
Stuart Gottlieb
Lecturer in the Discipline of International and Public Affairs, Columbia University
Dr. Greg Austin
Vice President at the EastWest Institute and Director of EWI's Global Security Program and Policy Innovation (EWI, 2007).


text:
2010-2011 Kluge Fellows Selected
New at the John W. Kluge Center
by Robert Saladini
Kluge Fellows are selected by the Librarian of Congress based on the appropriateness of their proposed research application to Library collections by LC staff and recommended by a panel of their peers assembled by the National Endowment for the Humanities. While in residence they pursue humanistic and social science research making use of the Library's large, varied collections and expert staff.
Below is a listing of those arriving in Autumn 2010 and beyond, followed by their proposed research project.
Bell, Richard, "Tear Down the World: Suicide and Power in the Newly United States"
Brienen, Rebecca, "The Dutch Republic circa 1700: Artists, Travelers, and Collectors in the Circle of Nicholaas Witsen (1641-1717)"
Chekuri, Christopher, "Hindu and Turk: Sovereignty and Religion in Pre-colonial India"
Chrissochoidis, Illias, "From the London Stage to Westminster Abbey: Cultural Mobility of Handel's Oratorios in Britain, 1732-1784"
Capper, Eleanor, "Government Activism and Consumer Politics in the U.S., 1933-2008"
Foray, Jennifer, "Imperial Aftershocks: The Legacies of Decolonization in the Netherlands"
O'Dwyer, Emer, "Imperialism and Democracy in the Context of Japan's Modern Nationhood"
Reed, Peter, "Staging the Haitian Revolution: Race, Revolution, and American Theater, 1790-1865"
Schiltz, Michael, "An Economic History and Sociocultural Reconstruction of Japan in the Age of the Great Depression"
Simon, Josep, "Shaping Physics in Three Nations: Ganot's Franco-British Canon and the Pedagogical Economy of American College Life"
Yellin, Eric, "In the Nation's Service: Racism and Federal Employment in Woodrow Wilson's Washington"


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Business Travelers: Do you recommend Tapestry for
Wednesday 2/29/2012 about 8:30 PM, Happy Leap Day. I've been anxious to go to Tapestry since it changed from Adsum. Some say Adsum had lost its way and Tapestry is focused on being a great neighborhood spot. They do not disappoint. I sit down and the barback is very aggressive about helping by taking my drink order only to just pass it along to the bartender who was standing nearby. It's nice to get great attention and service and the barback was extremely nice but seemed like he was trying to do everything, I think even the bartender was a little confused. I felt like I had a middle man between me and the bartender. The barback worked very hard and kept extremely busy, I've got to give him a thumbs up, until he tried to change the channel (more on that later). Got my drink from the bartender, nice friendly guy, great beer, liquor and wine selection. I tasted the Doc's Pear Cider, very good and a little light, how I like it but watch the alcohol content. Barback gives me a menu (who else) and I order Fish and Chips. The food was excellent, nice and fresh and a real treat, well done. Neighbors at the bar were friendly with a nice neighborhood vibe about the place.
I settled in with my drink and my food to watch the Sixers play the Thunder, a very tight game. Suddenly the barback is trying to change the channel. I ask the bartender if the Sixers are going away and he shakes his head and says no. A new couple sits to my left and say they are looking forward to watching the Knicks. When the channel does not change they ask and find out it is not changing, they are annoyed and leave. Their annoyance was a little much. This is Philly, what would you expect on the TV, Sixers or Knicks? Apparently they asked the barback to change the channel, he agreed, but was eventually overruled.
Made a quick trip to the bathroom ran into a girl and asked her if she was in line. She said she was looking for the restroom and what did "Water Closet" mean? I answered her question and she meekly went in and closed the door.
I especially like the low profile beer taps making the seats behind the taps seem open with the TVs viewable. Bar has been lengthened from the size of the old Adsum bar. Two large TVs, one at either side of the bar, one had ESPN and the other had the Sixers game. Good place to sit and watch TV. The barback will take your channel requests. Nice Bartenders and very good food. Neighborhood crowd and friendly as well. Standard bar stools. I recommend and will go back to sample more of the menu. Bar faces the wall so you miss the action in the restaurant and through the large windows facing the street.
BarTaste Rating
700 South 5th Street
Philadelphia, PA 19147
(215) 923-1620
Tapestry Menu


text: A.karmarain.club is a malicious domain involved in causing many unwanted pop-ups to appear in your browser. If you see these pop-ups all the time then your computer is deeply contaminated with some horrible adware. This could be programs like Albireo, Triangulum, or some other junk software. These specific pop-ups have the intention to scare users into thinking that their PC is infected with virus in order to scare you into paying money in favor of cyber frauds who stand behind their massive distribution.


text:
Australian drug trafficker Schapelle Corby set for parole from Bali jail
After eight years in Bali jail, Australian may be released to live on island and be home by 2015
The corrections board on the Indonesian resort island of Bali said yesterday it had recommended jailed Australian drug trafficker Schapelle Corby for parole.
The board said the 36-year-old should be released from Kerobokan jail to serve out the rest of her sentence on the island living with her sister.
Bali corrections board chief Ketut Artha told reporters the recommendation had been made to the justice ministry on Friday, in part based on Corby's "good behaviour".
"All that is left for her parole to be granted is a decision from the justice minister," Artha said.
While he said the decision could be made in "a month or so", justice ministry director general of corrections Nugroho, who goes by one name, said it would likely take longer.
"With foreigners, cases usually take two to three months, possibly longer," Nugroho said.
Corby was handed a 20-year sentence in 2005 for smuggling 4.1 kilograms of marijuana into Bali the previous year.
Having received several remissions and a five-year sentence cut from the president, Corby is currently due for release in March 2017.
If she continues to receive the usual sentence reductions during her parole period, she could be free to return home to Australia by mid-2015.
But Corby's name was not on the list of 202 inmates at Kerobokoan prison whose remission was approved yesterday. Sentences are routinely cut to mark Indonesia's August 17 independence day.
Warden I Gusti Ngurah Wiratna said he had recommended a six-month reduction, and that it "could still be approved" by the justice ministry in the coming days.
If granted parole, Corby would still be bound to the island and obliged to report regularly to authorities.
Corby has gained the required letters of support from the prison, the head of the village where she would live in Bali, her family and the Australian government.
Australian Foreign Minister Bob Carr threw in his support after the board made its recommendation, telling Sky News he had been "encouraging the minister to do the compassionate thing" and that he hoped the minister would take a "sympathetic view".
"Our view is ... Schapelle Corby, whatever her offence, has paid a price for it and deserves quick, fair consideration of this parole application, for which we provided a guarantee," Carr said.
She has been eligible for parole for around one year, but has held off lodging an application as authorities mulled the conditions of her release.
Renae Lawrence - part of a group of Australian drug traffickers known as the Bali Nine jailed at Kerobokan - was also missing from the remissions list.
Wiratna said he recommended a six-month cut for Lawrence and 11 other foreign prisoners.
British drugs convicts Julian Ponder and Paul Beales were given recommendations for two-month cuts from their jail terms of six and four years respectively.
They were jailed in connection with British drug trafficker Lindsay Sandiford, who is on death row.
Indonesia enforces stiff penalties for drug trafficking, including life imprisonment and death.
Most Popular
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Sorry, no definitions found. You may find more data at nilgiri.
Sorry, no etymologies found.
They are known as the Nilgiri flower-pecker (_Dicæum concolor_) and
The same practice occurs among the Coorgs of the Western Ghats, among the Nairs at the coastal piedmont of this range, among the Todas of the mountain stronghold known as the Nilgiri
Influences of Geographic Environment On the Basis of Ratzel's System of Anthropo-Geography
On its centenary, the Nilgiri Mountain Railway (NMR), also called the Nilgiri's Queen, the lone rack and pinion railway in India, ran on a steam engine for the first time after 14 years.
Old-timers such as Nilgiri's and 5-Star Supreme have caught on as well, as have specialty outlets such as Nuts and Spices and Brown Tree.
The founders hold 35% of Nilgiri Dairy, with Mr. Ramachandaran owning 28%.
Nilgiri's IPO plan comes at a time when the Indian stock markets have been rocked by global macroeconomic concerns as well as high local inflation, leading to fears of slowing economic growth.
Bangalore-based Nilgiri Dairy was founded by the Ramachandaran family in 1905, and operates about 140 retail stores branded as Nilgiri 1905 through franchisees in southern India.
Nilgiri Dairy is targeting sales of 10 billion rupees $203 million in 2011.
NEW DELHI -- Nilgiri Dairy Farm Pvt. Ltd. is considering an initial public offering to raise more than $60 million and also pave the way for its majority shareholder, private-equity firm Actis Capital LLP, to exit the retail venture.
The former miss world is shooting in the Nilgiri hills in south India for her forthcoming Tamil movie 'Endhiran' (the robot).


text:
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|Related Sections:
|Lafayette County
Lafayette City Park Golf Course1121 Mudd Ave
Lafayette, LA 70501
Phone: (318)291-5557Fax: (318)268-5584
This rigorous course features many mature trees and out-of-bounds stakes lining its fairways and framing its greens. There are water hazards that come into play several times on this difficult course.
|Holes: 18
|Greens: Bermuda Grass
|Fairways: Bermuda Grass
|Greens Fees:
|$20 or Less
|Course Type:
|Dress Code:
|No tank tops or cutoffs
|Open all year
|Guest Policy:
* Update this Course: Update/modify the details for this golf course's listing.
*All Greens Fees provided are subject to change. Please call the golf course to confirm the current fees.