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Condition Basics
What is bursitis?
Bursitis is a painful swelling of a small sac of fluid called a bursa. Bursae (plural of bursa) cushion and lubricate areas where tendons, ligaments, skin, muscles, or bones rub against each other. People who repeat the same movement over and over or who put continued pressure on a joint in their jobs, sports, or daily activities have a greater chance of getting bursitis.
What causes it?
Bursitis is commonly caused by:
- Overuse and repeated movements. These can include daily activities such as using tools, gardening, cooking, cleaning, and typing at a keyboard.
- Long periods of pressure on an area. For example, carpet layers, roofers, or gardeners who work on their knees all day can develop bursitis over the kneecap.
- Aging, which can cause the bursa to break down over time.
- Sudden injury, such as a blow to the elbow.
Bursitis can also be caused by other problems, such as arthritis or infection (septic bursitis).
What are the symptoms?
Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch.
Bursitis is most common in the shoulder, elbow, hip, and knee. Bursitis may also occur near the Achilles tendon or in the foot.
Symptoms of bursitis may be like those of tendinopathy. Both occur in the tissues in and around the joints.
How is it diagnosed?
Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area.
If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.
How is bursitis treated?
Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints.
- Rest the affected area. Avoid any activity or direct pressure that may cause pain.
- Apply ice or cold packs as soon as you notice pain in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 3 days (72 hours). You can try heat, or alternating heat and ice, after the first 72 hours.
- Use pain relievers. Use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and inflammation. NSAIDs come in pills and also in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Don't rely on medicine to relieve pain so that you can keep overusing the joint.
- Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint through its full range of motion, even during the time that you are resting the joint area. This will prevent stiffness. As the pain goes away, add other exercises to strengthen the muscles around your joint.
- Avoid tobacco smoke. Smoking delays wound and tissue healing.
If you have severe bursitis, your doctor may use a needle to remove extra fluid from the bursa. You might wear a pressure bandage on the area. Your doctor may also give you a shot of medicine to reduce swelling. Some people need surgery to drain or remove the bursa.
Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics.
Bursitis is likely to improve in a few days or weeks if you rest and treat the affected area. But it may return if you don't stretch and strengthen the muscles around the joint and change the way you do some activities.
How can you prevent it?
You may be able to prevent bursitis from happening or coming back.
- Continue your home treatment with rest, ice, pain relievers, and gentle exercises.
- When you are ready to try the activity that caused the pain, start slowly and do it for short periods or at a slower speed. Warm up before and stretch after the activity. Increase your activity slowly, and stop if it hurts. Use ice afterward to prevent pain and swelling.
- Change the way you do activities with repeated movements that may strain your muscles or joints. For example:
- If using a certain tool has caused bursitis, start switching hands or change the grip size of your tool.
- If sitting for long periods has caused bursitis, get up and walk around every hour.
- If a certain sport is causing bursitis, consider taking lessons to learn proper techniques. Have an expert check your equipment to make sure it's well suited to your size, strength, and ability.
- If certain activities at work may be causing bursitis, talk to your human resources department about other ways of doing your job, equipment changes, or other job assignments.
- Protect your joints from pressure. Cushion knees or elbows on hard surfaces, and wear shoes that fit you well and have good support.


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Adult Crewneck Sweatshirt - Design: Brood Moms Rooool!!!
Brood Moms Rooool!!!
Adult Crewneck Sweatshirt
ACNS – Adult Crewneck Sweatshirt
Available sizes:
Small, Medium, Large, XL, 2XL, 3XL, 4XL, 5XL
Available colors (subject to manufacturer availability):
Ash, Black, Cardinal Red, Carolina Blue, Charcoal, Dark Chocolate, Dark Heather, Forest Green, Gold, Heliconia, Indigo Blue, Irish Green, Light Blue, Light Pink, Maroon, Military Green, Mint Green, Navy, Orange, Orchid, Purple, Red, Royal Blue, Safety Green, Safety Orange, Safety Pink, Sand, Sapphire, Sport Grey, Violet, White.
** Use the drop-down menu in the section above to select size, then type your color choice into the next box and add item to cart.
Shirts are made-to-order and are non-returnable. Color swatches are approximate.
Fabric is 50% cotton, 50% polyester.
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Blue & White Floral 3.75" Sauce Dish
Blue and white is the new neutral! Mix and match to your heart's content. Be creative and have some fun with your table setting!
- The Blue & White Collection.
- 3.75" diam. x 1.25"h.
- Microwave, dishwasher safe.
- Made in Japan.


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FREE SHIPPING to the EU, USA, CAN, GBR, NOR, CHE and MCO
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Color: Electric green, dyed especially for our designs. Exterior: 100% craft suede with hydrophobic treatment - Origin: Spain. Interior: 100% alcantara leather - Origin: Spain. Sole: 100% natural rubber - Origin: Spain. Collar: reinforced with memory foam for driving comfort. Blind eyelets: reinforced lace holes with glass fiber, stopping them from wearing away. Seam free: the shoe's tongue is sewed directly to the vamp, ensuring there are no seams in the shoe's interior.
Our workshop opened in 1969.
The professionals responsible for our design consider their trade as an art form. Starting out by developing the designs, a prototype is then produced, and adjustments are made. Then it's on to elaborating and classifying the suede, the sewing process and quality control. The entire process is placed in expert hands working alongside the most cutting-edge technology.
Proudly produced and designed 100% in Spain.
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Includes updates and/or revisions.
Nationwide, the push to shutter low-performing or financially unsustainable schools is starting to conflict with the even sharper rise in homeless students, some research is beginning to suggest.
The latest of those studies, released last week by the Institute for Children, Poverty and Homelessness in New York City, zeroes in on New York City, where Mayor Michael Bloomberg ordered the school system to close or phase out the 20 schools identified as among the city's lowest-performing 10 percent of schools and replace them with new small schools this school year. Researchers found that the closings often disproportionately affected schools attended by homeless students and that those students, arguably among the system's most vulnerable, received little support for making the transition to a new school.
"The system can be very complex for a student who may be in a shelter or doubled up and living with friends," said Alexandra E. Pavlakis, a senior policy analyst for the Institute and author of the report. "If a school is phasing out, it can be a complicated [process] to get a school that fits the student's needs."
The Institute for Children, Poverty and Homelessness, in New York City, tracked homeless students and support for them in city schools slated for closure in the 2007-08 school year. At the time, researchers found higher concentrations of homeless students in many of these schools than the average for their New York boroughs.
For the study, researchers examined plans for homeless students during closures. Particularly among the high schools, researchers found the percentage of students living in temporary shelters who attended schools slated for closure met or exceeded the average for the borough. Problems in the transition plan for homeless students, English-language learners and special education students prompted the New York State Supreme Court to block the closures for the 2010-11 school year, a move which the appellate court upheld in July.
The lack of attention to those students' needs is important because prior research has shown homeless students are twice as likely as peers with stable homes to repeat a grade. But, as some of the high schools were to be phased out, students were guaranteed to be allowed to graduate from their home school only "assuming they continue to earn credits on schedule."
Rough Transition
Principal Lisa Fuentes, of Christopher Columbus High School 415, one of those studied, agreed that the uncertainty surrounding the school's status has been difficult, but argued that the provision requiring students to stay on track for graduation would not necessarily pose problems for her students,
"Just because they're homeless doesn't mean they are any less capable to graduate than the other children," she said. "Right now, we wouldn't be closing for another four years, so we definitely work on making sure they understand their transcript and their needs to graduate from high school"
The report also found homeless students transferring from a school were at greater risk of ending up in another low-performing school. That finding echoes that of a 2009 study on Chicago school closures, which concluded that the effect of having to shift to another school eliminated the benefit for students of closing the first low-performing school
Jennifer Pringle, project director for the New York State Technical and Education Assistance Center for Homeless Students, or NYS-TEACHES, agreed with the report's finding that homeless students frequently become concentrated in low-performing schools. Because homeless students tend to be highly mobile—prior research finds more than 40 percent change schools at least once a year—they often get placed in whatever school has the most seats available at the time of enrollment, she said. "And that's often these low-performing schools," Ms. Pringle added. "In the most sought-after schools there aren't too many seats."
'One More Wrinkle'
The New York study is limited and ongoing, but highlights problems in planning, transition support, and monitoring of homeless students after closure. Twenty-six states reported a more-than-50-percent increase in homeless students from 2007 to 2009, according to the most recent estimates by the Washington-based National Association for the Education of Homeless Children and Youth. Homeless education experts say issues like those in New York could hinder the effectiveness of closure as an option for cash-strapped districts and those implementing Race to the Top and School Improvement Fund turnaround programs.
"I thought it was very eye-opening," said Barbara Duffield, policy director for NAEHCY. "As the world changes, whether the economic world, the housing world or the school world, we have to look at how are we adapting the law to ensure we're meeting the needs of these students. A lot of schools are looking at 'at-risk students' more broadly, and they don't drill down to the specific types of students at risk and what their different needs are. [School closure] is one more wrinkle we're contending with."
Rene Heybach, the director of the Law Project at the Chicago Coalition for the Homeless, who advised in a lawsuit on behalf of homeless students during the Chicago closures, agreed. She noted that some Chicago students had changed schools five to 11 times, sometimes moving from one shuttered school to another on the road to closure.
"You began to see a trail of exacerbation of mobility," Ms. Heybach said. "What reduces the harmful effects of mobility is having somewhere positive to go to, but no thought had been given to the question of appropriate transitions for these students." The district now operates under a court settlement requiring it to provide transition planning for homeless students.
Minneapolis public schools, by contrast, are trying to brace for both the increase in homeless students and ongoing school closures and attendance zone restructuring.
Elizabeth Hinz, district liaison for homeless and highly mobile students in Minneapolis, said the district weighs the stability of a school when deciding where to place a homeless student; it tries to keep them out of schools slated for major restructuring or closure. The students' records are tagged electronically to ease transfer to new schools, and the district assigns liaisons for the homeless to individual schools to serve students.
Yet even in Minneapolis, Ms. Hinz said school closure can throw homeless services for a loop. "We're transferring hundreds of kids ... [and] all the staff changes that are associated with the school closures," Ms. Hinz said. Tracking homeless students and including them in restructuring plans would be "way too organized" in that context, she added.
Still, Ms. Pringle said other districts should consider Minneapolis' model. "Placing students in a school that is unstable or slated to be closed, is just devastating, not just academically but socially and emotionally," she said.


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Free Fight
Checking in with TUF 17 coach Jon Jones...TUF 17 premieres on FX tonight...
Through 17 wins, including five in championship fights against the best in the business, Jon Jones has seemingly done the impossible: he's made his fights look easy. Of course we know they're not, and that hours upon hours are spent in the gym for the UFC light heavyweight champion to put forth that impression.
But after six weeks as a coach on season 17 of The Ultimate Fighter, which premieres tonight on FX at 8pm, "Bones" found out that being on the other side of the Octagon is no picnic either.
"It's a lot of work," said Jones. "It really made me have more respect for my coaches, to see how much work they really do, and how much work it really is to be a head coach. You deal with people who need attention and there's all types of little stuff. Everyone has their own individual needs and skill sets, and you really have to be everything for everybody. But it was fun."
As fun as you would expect it to be when your opposing coach is the man you will be fighting in April. But if anything, Jones was shocked by the behavior of trash talking genius Chael Sonnen when the two crossed paths in the TUF gym in Las Vegas.
"It was a surprise to me," said the New Yorker. "He started off being polite and it kinda threw me off at first. And I said I wasn't the one who was gonna be the jerk. People expected Chael to be a jerk, so if Chael wanted to be polite, that was easy for me to do."
The 25-year-old Jones says agreeing to do the hit reality series was an easy call for him as well.
"I kinda felt like I owed the UFC and the fans one," he said. "The UFC 151 situation didn't really sit well with me with the way it all played out, and I didn't want the fans to think that I wasn't for them or the company. Last season (TUF 16) wasn't the best season and I wanted to give back to the sport and let the fans know that I was here for them."
Joined by assistant coaches Stonehorse Goeman, Bubba Jenkins, Frank Mir, Ricky Lundell, and John Woods, Jones is in an interesting position for this upcoming season, given the fact that it will be tough to teach anyone what he does in the Octagon. But like he did for himself over the last five years, he made it clear to his team that MMA isn't about replicating someone else's style, but keeping an open mind and creating your own.
"I was trying to tell the guys that we can't do everything for you, so you've got to be on top of your weight and cut your weight and that you owe it to yourself to be confident and believe," he said. "Another thing for me was to not try and change anybody's style. Having six weeks with the athletes isn't really enough time, so what you can do is try to motivate them, inspire them, and give them some mind knowledge and new ways of looking at things."


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Disclaimer: This material is being kept online for historical purposes. Though accurate at the time of publication, it is no longer being updated. The page may contain broken links or outdated information, and parts may not function in current web browsers. Visit https://espo.nasa.gov for information about our current projects.
We present validation studies of MLS version 2.2 upper tropospheric and stratospheric ozone profiles using ozonesonde and lidar data as well as climatological data. Ozone measurements from over 60 ozonesonde stations worldwide and three lidar stations are compared with coincident MLS data. The MLS ozone stratospheric data between 150 and 3 hPa agree well with ozonesonde measurements, within 8% for the global average. MLS values at 215 hPa are biased high compared to ozonesondes by ~20% at middle to high latitude, although there is a lot of variability in this altitude region. Comparisons between MLS and ground-based lidar measurements from Mauna Loa, Hawaii, from the Table Mountain Facility, California, and from the Observatoire de HauteProvence, France, give very good agreement, within ~5%, for the stratospheric values. The comparisons between MLS and the Table Mountain Facility tropospheric ozone lidar show that MLS data are biased high by ~30% at 215 hPa, consistent with that indicated by the ozonesonde data. We obtain better global average agreement between MLS and ozonesonde partial column values down to 215 hPa, although the average MLS values at low to middle latitudes are higher than the ozonesonde values by up to a few percent. MLS


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Please double check for fitment for your application. Please be sure to review the terms and conditions at the bottom of the page before purchasing. Mounting hardware (nuts, bolts, etc), even if shown in the picture is not absolutely guaranteed to come with the part.
BRIEF DESCRIPTION OF THE PART AND/OR NOTICEABLE WEAR. 2 SMALL DENTS ON LOWER FRONT, MINOR SCRATCHES. This is a brief description of the part which could be in better or worse condition. This is the bike the part came off of. Additional notes: VIDEO TAKEN OF BIKE RUNNING, FRONT AND REAR LIGHTS, GAUGES AND DYNO TEST.DYNO TEST PERFORMED TO SHOW THAT TRANSMISSION IS WORKING. ELECTRICAL THAT IS WORKING: HEADLIGHT HIGH AND LOW BEAM, BOTH FRONT SIGNALS, BOTH REAR SIGNALS, TAIL/BRAKE LIGHT AND HORN.
CHARGING SYSTEM IS WORKING AND CHARGING AT 14.16 VOLTS. ADDITIONAL NOTES: ALL LIGHTS AND HORN WORK PROPERLY. ALL RADIO/CASSETTE FUNCTIONS WORKING PROPERLY. BIKE RAN VERY STRONG ON THE DYNO.Based in Massillon, Ohio is a LICENSED motorcycle salvage dealer by the State of Ohio and most states in the country. The company was started in 2005 as a small salvage parts supplier. By respecting our customer's trust and focusing on providing you with quality salvaged parts at a fraction of new or after market prices, we have grown to be the largest indoor salvage powersports dealer in the United States.
Our vehicles and their systems are tested even on a dyno machine and videoed prior to disassembly for you to review. We bring our showroom to you by accurately describing and photographing the honest condition of each unique part. Our staff has access to Microfiche schematics to assist you in cross referencing.
But what does this mean to you? We recognize that the part you need is more than a part. It is the solution to getting you back on the road of freedom.
Because our vehicles are legally obtained, you can expect compliance and integrity. Our parts are warehoused and not exposed to nature's elements which will reduce the part's integrity. Through our dyno testing videos, full disclosure of the part condition, secure warehousing and expedient service, we hope we exceed your expectations. The internet is not the only option. We hope you choose to be a part of the Pinwall family as your bike is a part of yours!
So what is the small print? The parts are removed from salvage vehicles. Age and mileage should be considered in determining "normal wear". We do our utmost to reflect each and every unique part's condition so the description or lack thereof of a used item is a general description of this used part other than normal wear. We do not intentionally hide defects when photographing parts.
We will not assume what you are looking for and we kindly ask not to assume anything about the parts. Some parts, even damaged parts, may not fit your application but are acquired by others for a unique solution. We do our utmost in full disclosure. Because we cannot control if a previous owner modified a bike, we cannot guarantee the OEM cross reference. For our customer's safety, we do not sell used tires.
We recommend replacing wear parts on your items prior to installation. For example, gaskets, fork seals, brake pads, bearings, etc and anything of the like, are not guaranteed by Pinwall Cycle parts, Inc. Frames, engines and major components come with a bill of sale from Pinwall Cycle Parts, Inc. Having the donor vehicle identification number from the vehicle the part came off of.
For security reasons, the bill of sale will be mailed separately from the part. It is illegal to sell a dismantled vehicle frame with a title. In most states, the original vehicle identification number is replaced with a custom or assembled vehicle identification number and registered as an assembled built vehicle. Once your vehicle is assembled and inspected by your state it will no longer be registered as the year, make and model of the frame you are purchasing, but rather a custom built/assembled/special vehicle having the year in which your project was inspected by your state officials.
This is generally how it works, but please check with your local state trooper inspection facility for clarification on their laws. Please understand your local DMV usually does not understand this process. Custom values are accurately listed by law and we cannot change the price.
Quotes are good for 14 days. If not paid by the 7th day, we reserve the right to relist or resell the item. Please do not assume anything about an item. The item "1995-1996 Harley Davidson Touring FLHT/C FLTCU FUEL GAS PETRO TANK CARB'D" is in sale since Wednesday, July 25, 2018. This item is in the category "eBay Motors\Parts & Accessories\Motorcycle Parts\Body & Frame\Gas Tanks".
The seller is "pinwall_cycle_parts" and is located in Massillon, Ohio. This item can be shipped worldwide.


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- Home
- Privacy Statement
Privacy Statement
General – We protect your personal data
AWDC is firmly committed to respecting your privacy and protecting your personal data. This Data Protection Notice explains how we use and protect personal data when you:
- visit one or more of the following websites:
- submit your CV or apply for a job;
- register for our newsletter or events;
- give us your contact details;
- visit our premises or apply to visit the Diamond District; or
- correspond with us.
The processing of information relating to identified or identifiable natural persons (personal data) collected through this website or otherwise received by AWDC, such as through e-mails, business cards, fax, correspondence or registration forms, is subject to EU Regulation 2016/679 (the General Data Protection Regulation) and any national implementing or complementing rules and regulations in Belgium. The Belgian Data Protection Authority supervises compliance with the applicable data protection laws.
Which information do we collect?
AWDC may, through its website, collect certain information relating to users who visit its website and may, solely for internal purposes, track how users make use of its website. The information collected through the website includes the Internet Protocol (IP) addresses, computer and connection information such as browser type and version, operating system, as well as Uniform Resource Locators (URL) click stream to, through, and from our website, including date and time.
In addition, AWDC may collect and process information of persons who contact us (including job applicants) or register for our newsletters and events, through the website, e-mail or internet-based services. This information may include: the contact details and other information on business cards, CVs and in electronic signatures, IP addresses, e-mail addresses, passwords and information provided by the person registering for the event and/or the newsletter, and whether you have read the newsletter. If you visit our premises, we will ask you for an official ID document for security purposes.
In some cases, your information may be complemented or updated with publicly available information to ensure your contact details and professional information are up to date.
How and why do we use your data?
Your personal data are only used to the extent that this is required to pursue the following legitimate interests:
- to ensure the security of the website;
- to improve the website's content and compile statistics on the use of the website;
- public relations, including the administration of our contact database, maintaining press contacts, organising visits of the Antwerp Diamond district and the promotion and defence of interests of AWDC and the Antwerp diamond business;
- for security purposes, to ensure legal compliance, investigate fraud or infringements and establish, defend or exercise legal claims; and/or
- to maintain a contact database of our members and external contacts.
If requested by you, or with your consent, we may also use your personal data (consent may be assumed for existing customers of AWDC):
- to process your queries efficiently;
- to contact you for the purpose of providing information on our sector and our activities and developments (including the sending of newsletters and organising events);
- allow you to manage your "my AWDC-dossier"; and/or
- to process your job application or find job opportunities that suit your profile.
If you have consented to such processing of your personal data, you have the right to withdraw such consent at any time. Please see below for how to withdraw your consent.
To whom can we disclose your data?
AWDC relies on third parties to host and provide technical support for its website and for the delivery of its newsletters. In the context of these services, and only to the extent that this is necessary for the service they provide, these third parties may have access to the personal data processed by AWDC for the aforementioned purposes. In addition, professional advisors and auditors may have access to your personal data. Our service providers abide by appropriate confidentiality and other safeguards protecting your personal data under the same standards as described in this statement.
Under certain circumstances, AWDC may need to disclose personal data to public authorities for the purposes as mentioned above, including to comply with regulatory or legal requirements.
For the delivery of our newsletters, we rely on the services of MailChimp. To learn more about how MailChimp protects your personal data, please consult their privacy policy here. MailChimp is located in the United States of America and has been certified to protect personal data under the EU-US Privacy Shield Framework.
If you visit the Antwerp Diamond District or the AWDC offices, we may disclose your personal data that you provide us to the premises that you intend to visit and to external security firms that ensure security in the Diamond District and the AWDC offices.
Your rights - How can you manage/access/delete your data?
You have the right to access your data, have us update outdated information or correct any errors in your data or, if necessary, delete such data or request that we restrict the use thereof, or subject to conditions set out in the law, to object to any processing of personal data on grounds relating your particular situation. You also have the right to opt out of receiving newsletters or marketing materials from AWDC. With each newsletter, you will have the possibility of unsubscribing or updating your information and preferences.
If you are registered on the www.adjobs.be platform, you have the right to data portability of the data that you have provided to us.
If you attend our events, we may take pictures of you which we use on our website to report on these events. If you wish that we remove your picture from the website, please send an email with proof of your identity to the contact address below.
You can exercise your rights, or withdraw consent by sending an email to firstname.lastname@example.com or by sending a registered letter to the legal department of AWDC, Hoveniersstraat 22, 2018 Antwerp, Belgium. Please note that we may ask for additional information to ascertain your identity before we comply with your request. If we cannot remedy your concern, you can contact the Belgian Data Protection Authority with questions or concerns relating to the protection of your personal data.
Security and confidentiality
On both an organizational and technical level, AWDC has developed and adapted security measures, regarding personal information collected on the Websites, to avert unauthorized destruction, loss, alteration, modification, unauthorized access or accidental communication to third parties, as well as any other unauthorized data processing.
In any event, AWDC cannot be held liable for any direct or indirect damages resulting from the wrongful or unlawful use of your personal data by a third party.
This website may contain links, hyperlinks or references to websites from third parties. AWDC is not responsible for the content and data protection compliance of these websites nor the products or services they offer. AWDC recommends that users read carefully the privacy policy of every website they visit – they may differ from this Data Protection Notice
How long do we keep your data?
Data about your browsing our website will be kept only for the duration of the session. However, cookies may last longer on your device so we can identify you upon your next visit.
Registrations for events or newsletters will be kept until after the event or until you unsubscribe from our newsletters.
Information about visitors at our premises are kept for 30 days or longer if required for security purposes or to investigate an incident.
Other personal data that we have will be retained for the duration that is relevant for the purpose as set out above, in accordance to internal retention periods, taking into account contractual or legal obligations and liability that we may have to keep records of our files.
Governing law and jurisdiction stipulation
This Data Protection Notice shall be governed, interpreted and enforced in accordance with Belgian law, which applies exclusively for any litigation.
Antwerp courts have exclusive jurisdiction to rule on any dispute that may arise from the interpretation or implementation of this Data Protection Notice.
Persons requesting any additional information, comments, complaints or disputes concerning this Data Protection Notice or concerning manner in which AWDC collects your personal data can contact us by email at email@example.com or by sending a registered letter to the legal department of AWDC, Hoveniersstraat 22, 2018 Antwerp, Belgium.


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Sold Out
Fun lightweight mixed material pink tassel earrings:
Sold Out
We are making these to donate to those in need during COVID-19. If you would like to request some to be donated to you please email the address and quantity looking for to firstname.lastname@example.com or email@example.com.
If you would like to purchase a mask for yourself we recommend a donation of $20- all proceeds go to making more masks!
...and very fashionable!
Note: These normally ship in 1-2 days but we apologize in advance if there are any delays due to coronavirus.
Sold Out $ 32.00
Beaded stud heart drop earrings in mint/ light turquoise:
Sold Out
Beaded parrot earrings:


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Godzilla (2014) 2160p BluRay x265 HEVC 10bit HDR AAC 7.1 Tigole [MEGA]
In 1999, the Janjira nuclear plant was mysteriously destroyed with most hands lost including supervisor Joe Brody's colleague and wife, Sandra. Years later, Joe's son, Ford, a US Navy ordnance disposal officer, must go to Japan to help his estranged father who obsessively searches for the truth of the incident. In doing so, father and son discover the disaster's secret cause on the wreck's very grounds. This enables them to witness the reawakening of a terrible threat to all of Humanity, which is made all the worse with a second secret revival elsewhere. Against this cataclysm, the only hope for the world may be Godzilla, but the challenge for the King of the Monsters will be great even as Humanity struggles to understand the destructive ally they have.


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We'll be doing a hammer and tongs, Smoking Mirrors flavored radio transmission this evening. It should be available for download on Monday evening. It makes sense to have a companion mirrors to counterpoint the broadcast.
Dog Poet Transmitting.......
The climate, data tinkering scandal, continues to implode as red-faced, finger pointing, dissembling scientists run out of the burning building, faster that Tiger Woods, in advance of his wife with a 7 iron ...and with bad knees on both accounts.
Once, these august emblems of pure scientific inquiry were wide-eyed children, dreaming of Nobel Prizes, dancing like sugar plums in their heads. Like the long tradition of other lying collectives, which date from the Royal Geographic Society and before; these graft-taking scoundrels have done their industry proud. They found what they were supposed to find and they said what they were told to say by the governments and corporations who provided the grants and salaries, in advance of their complicity in one more gargantuan, public rip-off.
They are joined in spirit by their comrades in the AMA-Pharmaceutical combine with their Tammy Faye flu and toxic vaccines. They are joined by their comrades on Wall Street and the banking world with their toxic mortgages and tungsten-filled gold bars; the accidental Twinkie. They are joined by their comrades in the heroin trade, as the opium flows from the killing fields of >Afghanistan to the sidewalks of Main Street, USA. They are joined by their comrades in the halls of government, as the wars expand across the Middle East.
Yes, these honorable men and women are joined by other soulless husks in suits, from every industry and field of endeavor, whispering as they go, "Me first, you later... maybe." They are attended by a plague of lawyers who swarm like locusts across the looted plains. It's The Treasure of Sierra Madre, with thousands of deranged lunatics grasping at the swirling dust of imaginary gold... trampling their fellows, elbows sweeping to the right and the left as they belly up to the trough, snorting and stamping and sodomizing everything in their path like overcrowded rats... eating their own children, stabbing the household pets with forks and dancing to dissonant symphonies that sound like John Cage on bad acid.
Some unnamed hero dropped a dime. Some pissed off former comrade had finally had enough of those bankrupt, lying swines. Here they are, these men of complex learning and fine reputation. Somebody said, "Hello Sailor" and they went right up the stairs. They took off their clothes and they rolled around on the stained mattresses in the burning shame of their moral incontinence. They got on their knees and they did the job and they took the money. They weren't set up like Randy Cunningham and James Traficant for opposing the juggernaut of Ersatz Israel. They went willingly and laid it on the line for the corporate dime.
Few cities in the world look like Copenhagen at Christmas. It's a wonder to see and all the uptown panhandlers from around the world will be walking around with their hands out; looking for Santa to reach into his bag for their just rewards. They lied their asses off. They sold their souls for a pallet of tungsten filled gold. They want what's coming to them. They earned it. There will be no dissenting voices in Copenhagen. They will all be of one accord. The liars and thieves will toast one another for their tireless efforts on behalf of themselves. The faceless thugs in the black, Kevlar jumpsuits will be at every corner, just looking to break some heads, already half tumescent in anticipation of the crack of batons on available heads. They are damn well going to kick some radical, hippie ass. If they can't fire up the crowd, they'll send their agitators into the midst of them to get the party going.
Fleets of hookers have flown in from Ost Bloc and there will be young boys and girls in the back rooms for discriminating tastes. There will be dominatrixes and red ping pong balls. It will be a three part mini-series called, "Blood and Semen". There will be buggery and skullduggery and animal abuse. There will be Satanists in the shadows and dancing in the streets. There will be talk of money and necessary deaths. There will be crimson-faced martini-drinking, fat men riding on the Heart Attack Express. There will be groping and fumbling in the dark, as the Horned Goat of Mendes rises above the city and smiles on his frolicking children in the bacchanal below.
Obama (rhymes with Osama) will be there, grateful that there are no Russians who won't shake his hand and there will be a raging epidemic of lawyers. There will be lawyers everywhere; in the closets and under the beds, rising out of the cisterns in three piece suits. There will be thousands of pens on automatic pilot, moving across thousands of sheets of paper. There will be sheets in the wind and sheets on the beds, where robot armies of lawyers will copulate with demons and there will be drowning polar bears in the canals. It will be The Devil's Mardi Gras, swept by a wildfire of unbridled greed.
I will not be there and you will not be there. We will receive no golden, tungsten Twinkies. They will speak of us though. They will talk about what to do with us after the fix goes in. I fear that the world is top heavy. When it falls it will crush itself under the weight of the plunder.
\They howled and screamed about Chavez wanting the legal opportunity for a third term. However, in New York, Michael Bloomberg got permission to do it ...and the public didn't even have to vote on it. I guess it depends on who you are. I guess it depends on who you are.
Well, my friends... absurdity piles on to absurdity, like some confection designed by Gaudi. There are no boundaries to contain reality. Reality is running for its life, with thousands of lawyers in pursuit. There is no way to predict just how crazy it might get before critical mass is reached. How does it maintain? How does it continue? I am astonished that it can hold itself together. It is a scientific marvel far beyond the abilities of the global warming guys. This unreal fiction, formerly know as life, is breaking every law of physics. This is far beyond small airliners bringing down enormous skyscrapers at free fall into their own footprints. This is the wonder of the age; this tragi-comic fantasy. Is it held up by invisible wires... force fields... blind faith? "I guess but I just don't know".
Can you imagine being in the position of having to explain this day after day? How do they do it? Well... December brings us into a very different vibration than any we have known before. I won't be commenting on that at this time. Suffice it to say that something entirely new is going to be added to the equation and you will become increasingly aware of it. Certain doors are opening and certain energies are going to be pouring out and... how is that going to affect what is already off the charts?
Strangely enough, I feel good. I don't know why. Things don't look all that good. The world has the appearance of a starving wino with a serious case of delirium tremens. The world looks like George W. Bush trying to ride a six foot unicycle. The world looks like it needs to go into detox before it has a nervous breakdown. The world has got the shakes and it really needs a drink. The world is knotting its tie around its wrist and then tossing the rest of it over the back of its neck. It's pulling the tie with the opposite hand which is pulling the wrist, which is attached to the other hand that is holding the shot glass; necessity is the mother of invention, maybe blind need is too.
The Global Warming Magical Mystery Tour is headed for Copenhagen and I'm headed out to the front of the house to work on my succulents in the various planters. I'll be missing all the parties and the meets and greets. My invitation never arrived so it looks like I won't depart; no complimentary, tungsten filled, gold bars for me.
End Transmission.......
'I Am Alive' is track no. 8 of 12 on Visible's 2007 album 'Almost A Capella'
Lyrics (pops up)
Smoking Mirrors Mirror.


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Major publisher preps for Apple tablet as delay, OLED rumors surface
According to MediaMemo, a digital version of Wired magazine will be ready by the middle of 2010 for Apple's tablet. The publisher reportedly does not even have confirmation that the long-rumored tablet even exists.
"Condé Nast CEO Chuck Townsend says his company is working closely with Hewlett-Packard (HPQ) and that it has also been communicating its plans to Apple," the report said. "But Townsend made a point of saying that Apple executives themselves refuse to acknowledge that theyâre actually planning a tablet: 'Theyâre not talking to anybody openly,' he says."
The publisher has plans to eventually create digital versions of all 18 of its titles through a new publishing form being created by Adobe called AIR. Though the software works on both Mac and PC, it is not currently compatible with the iPhone.
Despite this, the report said that the publisher intends to create magazines much like one that was released Wednesday for the iPhone: a digital copy of the latest issue of GQ magazine, available for $2.99 on the App Store.
In other Apple tablet news, DigiTimes, a Taiwanese trade publication with a hit-and-miss track record on Apple rumors, has reported that the device has been delayed until the second half of 2010. For its part, AppleInsider has been told by reliable sources that the tablet will arrive in the first quarter of 2010, a position maintained since the summer.
The new report claims that Apple plans to postpone the launch because it has decided to switch components, and will launch a second, more expensive model that will sport a 9.7-inch OLED display from LG. In addition, it said that another, 10.6-inch LCD model would be available.
Earlier this year, it was revealed that Apple and LG reached a $500 million deal for the supply of flat panel displays through the year 2013. DigiTimes alleges that the agreement includes the supply of OLED displays.
The report suggests that an OLED-based tablet would cost Apple between $1,500 and $1,700 to build based on current prices, though the cost of supplies is dropping rapidly. It forecasts an OLED model costing about $2,000 at retail, with the LCD option priced between $800 and $1,000.
In August, rumors of two models and an OLED screen first surfaced, though prices were never suggested to be as high as $2,000.


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i hope you're having a great 2015 so far.
today marks the release of my "HOTLINE MIAMI 2 EP". it contains two tracks featured in the forthcoming game from the inimitable Dennaton Games, Hotline Miami 2, and two exclusive tracks.
"Decade Dance" is a different mix from both the game version and the forthcoming 12″ vinyl album compilation version.
"Voyager" is a rework of the bonus track originally seen on the first HM EP, and is the same as the vinyl version, but different from the game version.
"Kill Streak" is exclusive to the EP, and finally "Miami" is a totally new rework of the track from the original HM EP.
i also have an album ready that is nearly complete, containing ten original tracks, that i've been working on over the last couple of years, which is very nearly complete. i'm excited to finally get out there, and hope to release it in the next few months on my bandcamp.
there are also some other musical projects i've been working on that i'd like to release at some point, so it'll be good to get the release schedule moving (and i really should get round to uploading the digital re-releases of my Space Recordings d'n'b vinyl back catalogue one day as the distributor, ST Holdings recently folded, sadly…)
i'm sorry i haven't been around on social media much recently, and that i don't have much to announce on the game front… but it does feel nice to begin the new year by sharing something i have been working on.
i hope you all have a great year, and thankyou all as always for all the words of support over the last few years.
i'd like to also say a big thankyou to my amazing daughter, Aila, who provided the artwork (then aged 4, now aged 5!)


text:
Last night in a cream and floral Gucci jacket, fashion icon Dapper Dan accepted a lifetime achievement award from the Council of Fashion Designers.
DANIEL DAY: I can't tell you enough of how important this is to people of color.
CORNISH: He wasn't always beloved by the mainstream fashion industry back when he used designer logos without permission.
DAY: I used to ride up and down Madison Avenue with my children in the car, pointing at the stores. Yeah, doll. Versace - that's my partner.
DAY: Gucci - that's my partner. I was the greatest silent partner in the world.
CORNISH: He's the first Black designer to receive this honor. So we wanted to revisit the time I met with Daniel Day in 2019 to talk about his memoir "Dapper Dan: Made In Harlem." And, of course, he was dressed to the nines.
DAY: This is fine polka dot Gucci loafers.
CORNISH: Are those gold moths on the back of your shoes?
DAY: Are they? Yes. The cheapest jacket I have inside is 2,700. So the people in my community I know can't afford that, so I make sure I stand outside and engage them every day.
CORNISH: Oh, this is beautiful.
DAY: Isn't it?
CORNISH: So now he's selling jackets for nearly three grand. But when he was a kid here in Harlem, his family didn't have that kind of money. He tells a story in his book about shopping for an Easter suit with his father.
DAY: We went to Ripley's department store. I was going to get my first suit. Now, I think I was in eighth grade, and we went to Ripley department store. I saw chocolate brown suit with pinstripes. I loved it. My father wouldn't give it to me, right? But he was going to get it on credit because we couldn't pay cash. We didn't have the money. And so I said, Daddy, let me see the contract. And I read the contract and figured out the mathematics. And I said, Dad, you're going to end up paying two and a half times what the suit is worth. I said, don't get it there, you know?
And we came one day out the store. And on the way down the steps, my father stopped me. And he said, boy - I got to take my glasses off. He said, boy, don't you know you can read? Boy, you can read, you know? And I'm seeing - I'm looking at my father's face, you know, and the intensity of his face, right? Then it all came back to me because my father only went to the third grade, and he had to teach himself to read. So everything I'd encounter, I know that I could read my way out of it.
CORNISH: Did you ever get your Easter suit?
DAY: My Easter suit - no, I never got it. I never got it. I got a better suit. I got something that suited me for life. So I'm glad. That's one suit I'm glad I didn't get.
CORNISH: Daniel Day is now partners with Gucci. The fashion giant struck a deal with him in 2017. But when he was making clothes in the '80s, he wasn't asking permission to use the Gucci logo. Back then, after he'd been making and selling furs for a few years, he noticed a trend. Designer bags by brands like Gucci and Louis Vuitton were printed with the label's logos all over them. And Dan thought, I can do that but bigger.
DAY: So when I saw the designer bag, I said, wow. Just imagine. If I can have them walking around looking like that bag, I could change the whole game.
CORNISH: He bootlegged the logo prints and made bespoke suits and dresses, even custom upholstery for cars with the material. The actual clothing labels weren't making anything like this. And so Dapper Dan became a favorite designer for rappers and hustlers, Harlem's Black and Latino clientele with money to spend, money the major fashion houses did not welcome. Dapper Dan was the king of hip-hop fashion before the labels shut him down in the '90s.
Oh, my gosh. So where are these photos from?
DAY: Each picture that you see on the wall tells a story.
CORNISH: Now, one photo jumped out at me. It's the rapper Rakim in the legendary Gucci patterned jacket Dapper Dan made for him.
DAY: The black leather jacket, black leather plonge with gold-colored Gucci G's all over and trimmed in metallic gold. That's a historical jacket. That is probably the most important jacket in hip-hop.
CORNISH: It's also, if I'm reading the book correctly, part of the transition from outfitting gangsters in the neighborhood to having more of hip-hop artists come in, right?
DAY: Back then, the rappers wanted to be like the gangsters. They wanted to dress like the gangsters. Today we have the opposite going on. The gangsters want to be like the rappers. And Eric B and Rakim - those were the first ones that really - gangsters really, really liked their style.
CORNISH: When you wanted to get into furs, you studied and learned in the business. When you wanted to get into making custom clothes, you studied and really went around to manufacturers and learned things. And you always call this process sciencing (ph).
DAY: Very challenging.
CORNISH: And you do it over and over again, though.
DAY: Over and over again. And you know what? I find it exciting. Right now my children think I'm crazy because I stay on the internet. They have no clue to how important this is to me. I can press a button and get information that I used to have to go into garbage and get, you know, that wasn't revealed to me. I had to find the factories to sew it, find a way to get in there and talk to the owners, talk to the workers. But I'm glad. In a way, I'm glad because I did work that nobody else was willing to do and nobody else had even thought about. And that's what made it exciting for me - to find out how something is put together.
CORNISH: You said that you now have access to information that you used to have to scrounge around to get. Can we talk about that? Like, what are some of the obstacles that any other person who is opening up a store at that time wouldn't have had to go through? - because you talk in the book about people not selling to you, right? You know, the kinds of furs you got at first were not very good. It just seemed like there was a lot - you could never just get a straightforward contract for something.
DAY: I started by going to trade shows to see what kind of machinery was involved in making a garment. In addition to that, I would go to people who made these machines and people who use these machines to try to pretend I was going to place an order with them so I can see how they work.
And the first thing I do when I go in there to talk to them and tell them what I want to do - I would shake their hand, look in their eyes and look behind them to see what they're reading or see what books are on their desk. I would look for information like that. And I would always try to find a person of color that worked there. If I couldn't get that information, then afterwards, I would, like, pay them, you know, to tell me something. And if that didn't work, then I go through their garbage when they close - all kind of things like that.
CORNISH: So when did you start to think of yourself - and I don't know if you do now - as a designer and think of the business not just business and another kind of hustle but a creative part of yourself?
DAY: See; that's the good word. I like that. The first word you used, designer, I don't like. Last word you used, creative - that's what I do like. That's what I think it is.
CORNISH: Now do you think of yourself as a designer?
DAY: I consider myself one who creates clothes, and fashion is clothes and uses that vehicle to fashion young minds. That's my goal. I want to tell stories that change people's lives. Like, I made clothes that change people's attitude about how they feel about they self. That's it. That's the core of who I am. I tell stories about what I did, how I did it that could change them. I make clothes to make them feel different right away. You understand? Those are the two things I like doing.
CORNISH: Daniel Day, Dapper Dan, thank you so much for speaking with us.
DAY: Oh, thank you. Thank you for coming here and listening to a crazy man from Harlem talk about his life.
CORNISH: That was Dapper Dan in 2019, talking about his memoir "Dapper Dan: Made In Harlem." Transcript provided by NPR, Copyright NPR.


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Label: NIFEDIPINE tablet, film coated, extended release
Contains inactivated NDC Code(s)
NDC Code(s): 50090-2939-2 - Packager: A-S Medication Solutions
- This is a repackaged label.
- Source NDC Code(s): 0093-5173
- Category: HUMAN PRESCRIPTION DRUG LABEL
- DEA Schedule: None
- Marketing Status: Abbreviated New Drug Application
Drug Label Information
Updated February 23, 2018
If you are a consumer or patient please visit this version.
- Download DRUG LABEL INFO: PDF XML
- Official Label (Printer Friendly)
Nifedipine is a drug belonging to a class of pharmacological agents known as the calcium channel blockers. Nifedipine is 3,5-pyridinedicarboxylic acid, 1,4-dihydro-2,6-dimethyl-4-(2-nitrophenyl)-, dimethyl ester, C17H18N2O6, and has the structural formula:
Nifedipine is a yellow crystalline substance, practically insoluble in water but soluble in ethanol. It has a molecular weight of 346.3. Each extended-release tablet is formulated as a once-a-day controlled-release tablet for oral administration designed to deliver 30 or 60 mg of nifedipine.
Inert ingredients in the formulations are: anhydrous lactose, colloidal silicon dioxide, ethylcellulose, hydroxyethyl cellulose, hypromellose, magnesium stearate, methacrylic acid copolymer type A, methacrylic acid copolymer type B, microcrystalline cellulose, polyethylene glycol, red ferric oxide, sodium lauryl sulfate, talc, and titanium dioxide.
Nifedipine Extended-release Tablets meet USP Dissolution Test 3.
Nifedipine is a calcium ion influx inhibitor (slow-channel blocker or calcium ion antagonist) and inhibits the transmembrane influx of calcium ions into cardiac muscle and smooth muscle. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels. Nifedipine selectively inhibits calcium ion influx across the cell membrane of cardiac muscle and vascular smooth muscle without altering serum calcium concentrations.
Mechanism of Action
A) Angina
The precise mechanisms by which inhibition of calcium influx relieves angina has not been fully determined, but includes at least the following two mechanisms:
1) Relaxation and Prevention of Coronary Artery Spasm
Nifedipine dilates the main coronary arteries and coronary arterioles, both in normal and ischemic regions, and is a potent inhibitor of coronary artery spasm, whether spontaneous or ergonovine-induced. This property increases myocardial oxygen delivery in patients with coronary artery spasm, and is responsible for the effectiveness of nifedipine in vasospastic (Prinzmetal's or variant) angina. Whether this effect plays any role in classical angina is not clear, but studies of exercise tolerance have not shown an increase in the maximum exercise rate-pressure product, a widely accepted measure of oxygen utilization. This suggests that, in general, relief of spasm or dilation of coronary arteries is not an important factor in classical angina.
2) Reduction of Oxygen Utilization
Nifedipine regularly reduces arterial pressure at rest and at a given level of exercise by dilating peripheral arterioles and reducing the total peripheral vascular resistance (afterload) against which the heart works. This unloading of the heart reduces myocardial energy consumption and oxygen requirements, and probably accounts for the effectiveness of nifedipine in chronic stable angina.
B) Hypertension
The mechanism by which nifedipine reduces arterial blood pressure involves peripheral arterial vasodilatation and the resulting reduction in peripheral vascular resistance. The increased peripheral vascular resistance that is an underlying cause of hypertension results from an increase in active tension in the vascular smooth muscle. Studies have demonstrated that the increase in active tension reflects an increase in cytosolic free calcium.
Nifedipine is a peripheral arterial vasodilator which acts directly on vascular smooth muscle. The binding of nifedipine to voltage-dependent and possibly receptor-operated channels in vascular smooth muscle results in an inhibition of calcium influx through these channels. Stores of intracellular calcium in vascular smooth muscle are limited and thus dependent upon the influx of extracellular calcium for contraction to occur. The reduction in calcium influx by nifedipine causes arterial vasodilation and decreased peripheral vascular resistance which results in reduced arterial blood pressure.
Pharmacokinetics and Metabolism
Nifedipine is completely absorbed after oral administration. Plasma drug concentrations rise at a gradual, controlled rate after a nifedipine extended-release tablet dose and reach a plateau at approximately six hours after the first dose. For subsequent doses, relatively constant plasma concentrations at this plateau are maintained with minimal fluctuations over the 24-hour dosing interval. About a four-fold higher fluctuation index (ratio of peak to trough plasma concentration) was observed with the conventional immediate-release nifedipine capsule at t.i.d. dosing than with once daily nifedipine extended-release tablet. At steady-state, the bioavailability of the nifedipine extended-release tablet is 86% relative to nifedipine capsules. Administration of the nifedipine extended-release tablet in the presence of food slightly alters the early rate of drug absorption, but does not influence the extent of drug bioavailability. Markedly reduced gastrointestinal retention time over prolonged periods (i.e., short bowel syndrome), however, may influence the pharmacokinetic profile of the drug which could potentially result in lower plasma concentrations. Pharmacokinetics of nifedipine extended-release tablets are linear over the dose range of 30 to 180 mg in that plasma drug concentrations are proportional to dose administered. There was no evidence of dose dumping either in the presence or absence of food for over 150 subjects in pharmacokinetic studies.
Nifedipine is extensively metabolized to highly water-soluble, inactive metabolites, accounting for 60 to 80% of the dose excreted in the urine. The elimination half-life of nifedipine is approximately two hours. Only traces (less than 0.1% of the dose) of unchanged form can be detected in the urine. The remainder is excreted in the feces in metabolized form, most likely as a result of biliary excretion. Thus, the pharmacokinetics of nifedipine are not significantly influenced by the degree of renal impairment. Patients in hemodialysis or chronic ambulatory peritoneal dialysis have not reported significantly altered pharmacokinetics of nifedipine. Since hepatic biotransformation is the predominant route for the disposition of nifedipine, the pharmacokinetics may be altered in patients with chronic liver disease. Patients with hepatic impairment (liver cirrhosis) have a longer disposition half-life and higher bioavailability of nifedipine than healthy volunteers. The degree of serum protein binding of nifedipine is high (92 to 98%). Protein binding may be greatly reduced in patients with renal or hepatic impairment.
Following intravenous administration, clearance of nifedipine was decreased by 33% in elderly healthy subjects relative to young healthy subjects.
Like other slow-channel blockers, nifedipine exerts a negative inotropic effect on isolated myocardial tissue. This is rarely, if ever, seen in intact animals or man, probably because of reflex responses to its vasodilating effects. In man, nifedipine decreases peripheral vascular resistance which leads to a fall in systolic and diastolic pressures, usually minimal in normotensive volunteers (less than 5 to 10 mm Hg systolic), but sometimes larger. With nifedipine extended-release tablets, these decreases in blood pressure are not accompanied by any significant change in heart rate. Hemodynamic studies in patients with normal ventricular function have generally found a small increase in cardiac index without major effects on ejection fraction, left ventricular end diastolic pressure (LVEDP), or volume (LVEDV). In patients with impaired ventricular function, most acute studies have shown some increase in ejection fraction and reduction in left ventricular filling pressure.
Electrophysiologic Effects
Although, like other members of its class, nifedipine causes a slight depression of sinoatrial node function and atrioventricular conduction in isolated myocardial preparations, such effects have not been seen in studies in intact animals or in man. In formal electrophysiologic studies, predominantly in patients with normal conduction systems, nifedipine has had no tendency to prolong atrioventricular conduction or sinus node recovery time, or to slow sinus rate.
I. Vasospastic Angina
Nifedipine extended-release tablets are indicated for the management of vasospastic angina confirmed by any of the following criteria: 1) classical pattern of angina at rest accompanied by ST segment elevation, 2) angina or coronary artery spasm provoked by ergonovine, or 3) angiographically demonstrated coronary artery spasm. In those patients who have had angiography, the presence of significant fixed obstructive disease is not incompatible with the diagnosis of vasospastic angina, provided that the above criteria are satisfied. Nifedipine extended-release tablets may also be used where the clinical presentation suggests a possible vasospastic component, but where vasospasm has not been confirmed, e.g., where pain has a variable threshold on exertion, or in unstable angina where electrocardiographic findings are compatible with intermittent vasospasm, or when angina is refractory to nitrates and/or adequate doses of beta blockers.
II. Chronic Stable Angina (Classical Effort-Associated Angina)
Nifedipine extended-release tablets are indicated for the management of chronic stable angina (effort-associated angina) without evidence of vasospasm in patients who remain symptomatic despite adequate doses of beta blockers and/or organic nitrates or who cannot tolerate those agents.
In chronic stable angina (effort-associated angina), nifedipine has been effective in controlled trials of up to eight weeks duration in reducing angina frequency and increasing exercise tolerance, but confirmation of sustained effectiveness and evaluation of long-term safety in these patients is incomplete.
Controlled studies in small numbers of patients suggest concomitant use of nifedipine and beta-blocking agents may be beneficial in patients with chronic stable angina, but available information is not sufficient to predict with confidence the effects of concurrent treatment, especially in patients with compromised left ventricular function or cardiac conduction abnormalities. When introducing such concomitant therapy, care must be taken to monitor blood pressure closely, since severe hypotension can occur from the combined effects of the drugs (see WARNINGS).
III. Hypertension
Nifedipine extended-release tablets are indicated for the treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including nifedipine extended-release tablets.
Control of high blood pressure should be part of comprehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals. For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Program's Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC).
Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly.
Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to lower blood pressure goal.
Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (e.g., on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy.
Nifedipine extended-release tablets may be used alone or in combination with other antihypertensive agents.
Excessive Hypotension
Although in most angina patients the hypotensive effect of nifedipine is modest and well tolerated, occasional patients have had excessive and poorly tolerated hypotension. These responses have usually occurred during initial titration or at the time of subsequent upward dosage adjustment, and may be more likely in patients on concomitant beta blockers.
Severe hypotension and/or increased fluid volume requirements have been reported in patients receiving nifedipine together with a beta-blocking agent who underwent coronary artery bypass surgery using high-dose fentanyl anesthesia. The interaction with high-dose fentanyl appears to be due to the combination of nifedipine and a beta blocker, but the possibility that it may occur with nifedipine alone, with low doses of fentanyl, in other surgical procedures, or with other narcotic analgesics cannot be ruled out. In nifedipine-treated patients where surgery using high-dose fentanyl anesthesia is contemplated, the physician should be aware of these potential problems and if the patient's condition permits, sufficient time (at least 36 hours) should be allowed for nifedipine to be washed out of the body prior to surgery.
The following information should be taken into account in those patients who are being treated for hypertension as well as angina:
Increased Angina and/or Myocardial Infarction
Rarely, patients, particularly those who have severe obstructive coronary artery disease, have developed well documented increased frequency, duration and/or severity of angina or acute myocardial infarction on starting nifedipine or at the time of dosage increase. The mechanism of this effect is not established.
Beta Blocker Withdrawal
It is important to taper beta blockers if possible, rather than stopping them abruptly before beginning nifedipine. Patients recently withdrawn from beta blockers may develop a withdrawal syndrome with increased angina, probably related to increased sensitivity to catecholamines. Initiation of nifedipine treatment will not prevent this occurrence and on occasion has been reported to increase it.
Congestive Heart Failure
Rarely, patients, usually receiving a beta blocker, have developed heart failure after beginning nifedipine. Patients with tight aortic stenosis may be at greater risk for such an event, as the unloading effect of nifedipine would be expected to be of less benefit, owing to the fixed impedance to flow across the aortic valve in these patients.
Gastrointestinal Obstruction Requiring Surgery
There have been rare reports of obstructive symptoms in patients with known strictures in association with the ingestion of nifedipine extended-release tablets. Bezoars can occur in very rare cases and may require surgical intervention.
Cases of serious gastrointestinal obstruction have been identified in patients with no known gastrointestinal disease, including the need for hospitalization and surgical intervention.
Risk factors for gastrointestinal obstruction identified from post-marketing reports of nifedipine extended-release tablets include alteration in gastrointestinal anatomy (e.g., severe gastrointestinal narrowing, colon cancer, small bowel obstruction, bowel resection, gastric bypass, vertical banded gastroplasty, colostomy, diverticulitis, diverticulosis, and inflammatory bowel disease), hypomotility disorders (e.g., constipation, gastroesophageal reflux disease, ileus, obesity, hypothyroidism, and diabetes) and concomitant medications (e.g., H2-histamine blockers, opiates, nonsteroidal anti-inflammatory drugs, laxatives, anticholinergic agents, levothyroxine, and neuromuscular blocking agents).
Gastrointestinal Ulcers
Cases of tablet adherence to the gastrointestinal wall with ulceration have been reported, some requiring hospitalization and intervention.
General - Hypotension: Because nifedipine decreases peripheral vascular resistance, careful monitoring of blood pressure during the initial administration and titration of nifedipine is suggested. Close observation is especially recommended for patients already taking medications that are known to lower blood pressure (see WARNINGS).
Peripheral Edema: Mild to moderate peripheral edema occurs in a dose dependent manner with an incidence ranging from approximately 10% to about 30% at the highest dose studied (180 mg). It is a localized phenomenon thought to be associated with vasodilation of dependent arterioles and small blood vessels and not due to left ventricular dysfunction or generalized fluid retention. With patients whose angina or hypertension is complicated by congestive heart failure, care should be taken to differentiate this peripheral edema from the effects of increasing left ventricular dysfunction.
Information for Patients: Nifedipine extended-release tablets should be swallowed whole. Do not chew, divide or crush tablets.
Laboratory Tests: Rare, usually transient, but occasionally significant elevations of enzymes such as alkaline phosphatase, CPK, LDH, SGOT and SGPT have been noted. The relationship to nifedipine therapy is uncertain in most cases, but probable in some. These laboratory abnormalities have rarely been associated with clinical symptoms; however, cholestasis with or without jaundice has been reported. A small (5.4%) increase in mean alkaline phosphatase was noted in patients treated with nifedipine extended release tablets. This was an isolated finding not associated with clinical symptoms and it rarely resulted in values which fell outside the normal range. Rare instances of allergic hepatitis have been reported. In controlled studies, nifedipine extended-release tablets did not adversely affect serum uric acid, glucose, or cholesterol. Serum potassium was unchanged in patients receiving nifedipine extended-release tablets in the absence of concomitant diuretic therapy, and slightly decreased in patients receiving concomitant diuretics.
Nifedipine, like other calcium channel blockers, decreases platelet aggregation in vitro. Limited clinical studies have demonstrated a moderate but statistically significant decrease in platelet aggregation and an increase in bleeding time in some nifedipine patients. This is thought to be a function of inhibition of calcium transport across the platelet membrane. No clinical significance for these findings has been demonstrated.
Positive direct Coombs test, with/without hemolytic anemia, has been reported, but a causal relationship between nifedipine administration and positivity of this laboratory test, including hemolysis, could not be determined.
Although nifedipine has been used safely in patients with renal dysfunction and has been reported to exert a beneficial effect in certain cases, rare, reversible elevations in BUN and serum creatinine have been reported in patients with preexisting chronic renal insufficiency. The relationship to nifedipine therapy is uncertain in most cases but probable in some.
Drug Interactions: Beta-adrenergic blocking agents: (see INDICATIONS AND USAGE and WARNINGS). Experience in over 1400 patients with nifedipine capsules in a noncomparative clinical trial has shown that concomitant administration of nifedipine and beta-blocking agents is usually well tolerated, but there have been occasional literature reports suggesting that the combination may increase the likelihood of congestive heart failure, severe hypotension, or exacerbation of angina.
Long-acting Nitrates: Nifedipine may be safely co-administered with nitrates, but there have been no controlled studies to evaluate the antianginal effectiveness of this combination.
Digitalis: Administration of nifedipine with digoxin increased digoxin levels in nine of twelve normal volunteers. The average increase was 45%. Another investigator found no increase in digoxin levels in thirteen patients with coronary artery disease. In an uncontrolled study of over two hundred patients with congestive heart failure during which digoxin blood levels were not measured, digitalis toxicity was not observed. Since there have been isolated reports of patients with elevated digoxin levels, it is recommended that digoxin levels be monitored when initiating, adjusting, and discontinuing nifedipine to avoid possible over- or under-digitalization.
Coumarin Anticoagulants: There have been rare reports of increased prothrombin time in patients taking coumarin anticoagulants to whom nifedipine was administered. However, the relationship to nifedipine therapy is uncertain.
Cimetidine: A study in six healthy volunteers has shown a significant increase in peak nifedipine plasma levels (80%) and area-under-the-curve (74%), after a one-week course of cimetidine at 1000 mg per day and nifedipine at 40 mg per day. Ranitidine produced smaller, non-significant increases. The effect may be mediated by the known inhibition of cimetidine on hepatic cytochrome P-450, the enzyme system probably responsible for the first-pass metabolism of nifedipine. If nifedipine therapy is initiated in a patient currently receiving cimetidine, cautious titration is advised.
Nifedipine is metabolized by CYP3A4. Co-administration of nifedipine with phenytoin, an inducer of CYP3A4, lowers the systemic exposure to nifedipine by approximately 70%. Avoid co-administration of nifedipine with phenytoin or any known CYP3A4 inducer or consider an alternative antihypertensive therapy.
CYP3A inhibitors such as fluconazole, itraconazole, clarithromycin, erythromycin, nefazodone, fluoxetine, saquinavir, indinavir, and nelfinavir may result in increased exposure to nifedipine when co-administered. Careful monitoring and dose adjustment may be necessary; consider initiating nifedipine at the lowest dose available if given concomitantly with these medications.
Other Interactions:
Grapefruit Juice: Co-administration of nifedipine with grapefruit juice resulted in approximately a doubling in nifedipine AUC and Cmax with no change in half-life. The increased plasma concentrations most likely result from inhibition of CYP 3A4 related first-pass metabolism. Avoid ingestion of grapefruit and grapefruit juice should be avoided while taking nifedipine.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Nifedipine was administered orally to rats for two years and was not shown to be carcinogenic. When given to rats prior to mating, nifedipine caused reduced fertility at a dose approximately 5 times the maximum recommended human dose. There is a literature report of reversible reduction in the ability of human sperm obtained from a limited number of infertile men taking recommended doses of nifedipine to bind to and fertilize an ovum in vitro. In vivo mutagenicity studies were negative.
Pregnancy: Pregnancy Category C: Nifedipine has been shown to produce teratogenic findings in rats and rabbits, including digital anomalies similar to those reported to phenytoin. Digital anomalies have been reported to occur with other members of the dihydropyridine class and are possibly a result of compromised uterine blood flow. Nifedipine administration was associated with a variety of embryotoxic, placentotoxic, and fetotoxic effects, including stunted fetuses (rats, mice, rabbits), rib deformities (mice), cleft palate (mice), small placentas and underdeveloped chorionic villi (monkeys), embryonic and fetal deaths (rats, mice, rabbits), and prolonged pregnancy/decreased neonatal survival (rats: not evaluated in other species). On a mg/kg basis, all of the doses associated with the teratogenic, embryotoxic or fetotoxic effects in animals were higher (5 to 50 times) than the maximum recommended human dose of 120 mg/day. On a mg/m2 basis, some doses were higher and some were lower than the maximum recommended human dose, but all are within an order of magnitude of it. The doses associated with placentotoxic effects in monkeys were equivalent to or lower than the maximum recommended human dose on a mg/m2 basis.
There are no adequate and well-controlled studies in pregnant women. Nifedipine extended-release tablets should be used during pregnancy only if the potential benefit justifies the potential risk.
Lactation: Nifedipine is transferred through breast milk. Nifedipine extended-release tablets should be used during breast-feeding only if the potential benefit justifies the potential risk.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Geriatric Use: Age appears to have a significant effect on the pharmacokinetics of nifedipine. The clearance is decreased resulting in a higher AUC in the elderly. These changes are not due to changes in renal function (see CLINICAL PHARMACOLOGY, Pharmacokinetics).
Over 1000 patients from both controlled and open trials with nifedipine extended-release tablets in hypertension and angina were included in the evaluation of adverse experiences. All side effects reported during nifedipine extended-release tablet therapy were tabulated independent of the causal relation to medication. The most common side effect reported with nifedipine extended-release tablet was edema which was dose related and ranged in frequency from approximately 10% to about 30% at the highest dose studied (180 mg). Other common adverse experiences reported in placebo-controlled trials include:
Of these, only edema and headache were more common in nifedipine extended-release tablets patients than placebo patients.
The following adverse reactions occurred with an incidence of less than 3.0%. With the exception of leg cramps, the incidence of these side effects was similar to that of placebo alone.
Body as a Whole/Systemic: asthenia, flushing, pain
Cardiovascular: palpitations
Central Nervous System: insomnia, nervousness, paresthesia, somnolence
Dermatologic: pruritus, rash
Gastrointestinal: abdominal pain, diarrhea, dry mouth, dyspepsia, flatulence
Musculoskeletal: arthralgia, leg cramps
Respiratory: chest pain (nonspecific), dyspnea
Urogenital: impotence, polyuria
Other adverse reactions were reported sporadically with an incidence of 1.0% or less. These include:Body as a Whole/Systemic: face edema, fever, hot flashes, malaise, periorbital edema, rigors
Cardiovascular: arrhythmia, hypotension, increased angina, tachycardia, syncope
Central Nervous System: anxiety, ataxia, decreased libido, depression, hypertonia, hypoesthesia, migraine, paroniria, tremor, vertigo
Dermatologic: alopecia, increased sweating, urticaria, purpura
Gastrointestinal: eructation, gastroesophageal reflux, gum hyperplasia, melena, vomiting, weight increase
Musculoskeletal: back pain, gout, myalgias
Respiratory: coughing, epistaxis, upper respiratory tract infection, respiratory disorder, sinusitis
Special Senses: abnormal lacrimation, abnormal vision, taste perversion, tinnitus
Urogenital/Reproductive: breast pain, dysuria, hematuria, nocturia
Adverse experiences which occurred in less than 1 in 1000 patients cannot be distinguished from concurrent disease states or medications.
The following adverse experiences, reported in less than 1% of patients, occurred under conditions (e.g., open trials, marketing experience) where a causal relationship is uncertain: gastrointestinal irritation, gastrointestinal bleeding, gynecomastia.
Gastrointestinal obstruction resulting in hospitalization and surgery, including the need for bezoar removal, has occurred in association with nifedipine extended-release tablets, even in patients with no prior history of gastrointestinal disease (See WARNINGS).
Cases of tablet adherence to the gastrointestinal wall with ulceration have been reported, some requiring hospitalization and intervention.
In multiple-dose U.S. and foreign controlled studies with nifedipine capsules in which adverse reactions were reported spontaneously, adverse effects were frequent but generally not serious and rarely required discontinuation of therapy or dosage adjustment. Most were expected consequences of the vasodilator effects of nifedipine.
(n=235)Dizziness/lightheadedness giddiness
Flushing/heat sensation
Nausea, heartburn
Muscle cramps, tremor
Peripheral Edema
Nervousness, mood changes
Dyspnea, cough, wheezing
Nasal congestion, sore throat
There is also a large uncontrolled experience in over 2100 patients in the United States. Most of the patients had vasospastic or resistant angina pectoris, and about half had concomitant treatment with beta-adrenergic blocking agents. The relatively common adverse events were similar in nature to those seen with nifedipine extended-release tablets.
In addition, more serious adverse events were observed, not readily distinguishable from the natural history of the disease in these patients. It remains possible, however, that some or many of these events were drug related. Myocardial infarction occurred in about 4% of patients and congestive heart failure or pulmonary edema in about 2%. Ventricular arrhythmias or conduction disturbances each occurred in fewer than 0.5% of patients.
In a subgroup of over 1000 patients receiving nifedipine with concomitant beta blocker therapy, the pattern and incidence of adverse experiences was not different from that of the entire group of nifedipine-treated patients (see PRECAUTIONS).
In a subgroup of approximately 250 patients with a diagnosis of congestive heart failure as well as angina, dizziness or lightheadedness, peripheral edema, headache, or flushing each occurred in one in eight patients. Hypotension occurred in about one in 20 patients. Syncope occurred in approximately one patient in 250. Myocardial infarction or symptoms of congestive heart failure each occurred in about one patient in 15. Atrial or ventricular dysrhythmias each occurred in about one patient in 150.
In post-marketing experience, there have been rare reports of exfoliative dermatitis caused by nifedipine. There have been rare reports of exfoliative or bullous skin adverse events (such as erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis) and photosensitivity reactions. Acute generalized exanthematous pustulosis also has been reported.
To report SUSPECTED ADVERSE REACTIONS, contact Valeant Pharmaceuticals North America LLC at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gove/medwatch.
Experience with nifedipine overdosage is limited. Generally, overdosage with nifedipine leading to pronounced hypotension calls for active cardiovascular support, including monitoring of cardiovascular and respiratory function, elevation of extremities, judicious use of calcium infusion, pressor agents and fluids. Clearance of nifedipine would be expected to be prolonged in patients with impaired liver function. Since nifedipine is highly protein-bound, dialysis is not likely to be of any benefit.
There has been one reported case of massive overdosage with nifedipine extended-release tablets. The main effects of ingestion of approximately 4800 mg of nifedipine extended-release tablets in a young man attempting suicide as a result of cocaine-induced depression was initial dizziness, palpitations, flushing, and nervousness. Within several hours of ingestion, nausea, vomiting, and generalized edema developed. No significant hypotension was apparent at presentation, 18 hours post-ingestion. Electrolyte abnormalities consisted of a mild, transient elevation of serum creatinine, and modest elevations of LDH and CPK, but normal SGOT. Vital signs remained stable, no electrocardiographic abnormalities were noted, and renal function returned to normal within 24 to 48 hours with routine supportive measures alone. No prolonged sequelae were observed.
The effect of a single 900 mg ingestion of nifedipine capsules in a depressed anginal patient also on tricyclic antidepressants was loss of consciousness within 30 minutes of ingestion, and profound hypotension, which responded to calcium infusion, pressor agents, and fluid replacement. A variety of ECG abnormalities were seen in this patient with a history of bundle branch block, including sinus bradycardia and varying degrees of AV block. These dictated the prophylactic placement of a temporary ventricular pacemaker, but otherwise resolved spontaneously. Significant hyperglycemia was seen initially in this patient, but plasma glucose levels rapidly normalized without further treatment.
A young hypertensive patient with advanced renal failure ingested 280 mg of nifedipine capsules at one time, with resulting marked hypotension responding to calcium infusion and fluids. No AV conduction abnormalities, arrhythmias, or pronounced changes in heart rate were noted, nor was there any further deterioration in renal function.
Dosage must be adjusted according to each patient's needs. Therapy for either hypertension or angina should be initiated with 30 or 60 mg once daily. Nifedipine extended-release tablets should be swallowed whole and should not be bitten or divided. In general, titration should proceed over a 7 - 14 day period so that the physician can fully assess the response to each dose level and monitor blood pressure before proceeding to higher doses. Since steady-state plasma levels are achieved on the second day of dosing, titration may proceed more rapidly, if symptoms so warrant, provided the patient is assessed frequently. Titration to doses above 120 mg are not recommended.
Angina patients controlled on nifedipine capsules alone or in combination with other antianginal medications may be safely switched to nifedipine extended-release tablets at the nearest equivalent total daily dose. Subsequent titration to higher or lower doses may be necessary and should be initiated as clinically warranted. Experience with doses greater than 90 mg in patients with angina is limited. Therefore, doses greater than 90 mg should be used with caution and only when clinically warranted.
Avoid co-administration of nifedipine with grapefruit juice (see CLINICAL PHARMACOLOGY and PRECAUTIONS: Other Interactions).
No "rebound effect" has been observed upon discontinuation of nifedipine extended-release tablets. However, if discontinuation of nifedipine is necessary, sound clinical practice suggests that the dosage should be decreased gradually with close physician supervision.
Care should be taken when dispensing nifedipine extended-release tablets to assure that the extended-release dosage form has been prescribed.
Co-administration with Other Antianginal Drugs
Sublingual nitroglycerin may be taken as required for the control of acute manifestations of angina, particularly during nifedipine titration. See PRECAUTIONS, Drug Interactions, for information on co-administration of nifedipine with beta blockers or long-acting nitrates.
- nifedipine
nifedipine tablet, film coated, extended releaseProduct Information Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:50090-2939(NDC:0093-5173) Route of Administration ORAL Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength NIFEDIPINE (UNII: I9ZF7L6G2L) (NIFEDIPINE - UNII:I9ZF7L6G2L) NIFEDIPINE 60 mg Inactive Ingredients Ingredient Name Strength ANHYDROUS LACTOSE (UNII: 3SY5LH9PMK) SILICON DIOXIDE (UNII: ETJ7Z6XBU4) ETHYLCELLULOSE, UNSPECIFIED (UNII: 7Z8S9VYZ4B) HYDROXYETHYL CELLULOSE (2000 MPA.S AT 1%) (UNII: S38J6RZN16) HYPROMELLOSE, UNSPECIFIED (UNII: 3NXW29V3WO) MAGNESIUM STEARATE (UNII: 70097M6I30) METHACRYLIC ACID - METHYL METHACRYLATE COPOLYMER (1:1) (UNII: 74G4R6TH13) METHACRYLIC ACID - METHYL METHACRYLATE COPOLYMER (1:2) (UNII: 5KY68S2577) MICROCRYSTALLINE CELLULOSE (UNII: OP1R32D61U) POLYETHYLENE GLYCOL, UNSPECIFIED (UNII: 3WJQ0SDW1A) FERRIC OXIDE RED (UNII: 1K09F3G675) SODIUM LAURYL SULFATE (UNII: 368GB5141J) TALC (UNII: 7SEV7J4R1U) TITANIUM DIOXIDE (UNII: 15FIX9V2JP) Product Characteristics Color RED (reddish brown) Score no score Shape ROUND Size 9mm Flavor Imprint Code B;60 Contains Packaging # Item Code Package Description Marketing Start Date Marketing End Date 1 NDC:50090-2939-2 90 in 1 BOTTLE; Type 0: Not a Combination Product 03/29/2017 Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date ANDA ANDA075289 12/11/2000 Labeler - A-S Medication Solutions (830016429) Establishment Name Address ID/FEI Business Operations A-S Medication Solutions 830016429 RELABEL(50090-2939) , REPACK(50090-2939)


text:
It was more of a strategy than an epiphany.
Last week I got into the nitty-gritty of a SEAC paper I'm writing with David G. Anderson (University of Tennessee). We're using various large datasets to try to describe and interpret patterns of change in archaeological remains that could be related to changes in the size, structure, and distribution of human populations in the Eastern Woodland during the Late Pleistocene and Early Holocene.
As I started pulling together information (from PIDBA, DINAA, and my ongoing radiocarbon compilation) and thinking about how to organize it, I realized that keeping the databases separate was both a logistical hassle and an analytical problem. I invested in dumping all the information into a single relational database that we can use for this paper and that I'll continue to update in the future. I've been calling it "Megabase" in my head. So that's what it is until it gets a better name.
Here is an illustration that I'll briefly discuss:
- DINAA is a compilation of state-curated site data, one entry per Smithsonian Trinomial;
- PIDBA has county-by-county counts of various kinds of Paleoindian projectile points;
- EWHADP is a compilation of prehistoric structure data (keyed to both county and Smithsonian Trinomial);
- The Kirk Project is point-by-point attribute data, with most entries having county-level provenience;
- Most of the entries in the radiocarbon compilation have a Smithsonian Trinomial.
The Megabase of Today will be fine for the SEAC paper and for the near future. It will be able to do a lot. Ideally, however, the Megabase of the Future will have DINAA serving as both a "router" for data that is attached to a Smithsonian Trinomial and an analytical tool in its own right. One issue is that not all states are currently participating (and therefore not all Smithsonian Trinomials -- the "addresses" for sites -- are in the system). Another issue is that the site forms (and therefore the site information that is collected and stored) differ by state. To reach its full potential, DINAA data will have to be supplemented by additional data about the materials recovered from sites, how sites were recorded, etc. Ensuring that we're making "apples to apples" comparisons will be a significant chore -- DINAA currently has information on somewhere in the neighborhood of half a million sites. You can't just sit on your couch and cross-check all that.
I know enough to be dangerous with a computer, but I'm not sufficiently sophisticated to know the nuts-and-bolts options for building the Megabase of the Future. In 2015 we did a sort of "proof" of concept to demonstrate that the EWHADP and DINAA could be linked together. I'm not sure if that is they way to go or not. Perhaps there's something that can be done with blockchain technology -- it sure sounds cool.
Anyway, I'm going to get the Megabase of Today functional in time to do the analysis for the SEAC paper we'll give in a month. If you're interested in talking about the Megabase of the Future, please let me know.