text:
By Martin Crutsinger
AP Economics Writer
WASHINGTON (AP) -- The economy we've got today is more or less the economy we've got for the rest of the year.
That's the message from the Federal Reserve, which has sharply reduced its forecast for U.S. growth. It sees unemployment barely budging in the rest of 2012.
The Fed also says the economy is under threat from Europe's debt crisis and from the prospect of sharp spending cuts and tax increases that will kick in at year's end unless Congress acts.
None of which is comforting for companies, job seekers or President Barack Obama, whose re-election hinges in part on whether the economy improves between now and November.
Until recently, many economists were hopeful that the economy would strengthen in the second half of the year. But optimism is fading as hiring and growth have slowed for a third straight spring.
To prod businesses and consumers to borrow and spend more, the Fed said at the end of a two-day policy meeting Wednesday that it would extend a program designed to drive down long-term interest rates. It also reiterated plans to keep short-term rates at record lows until at least late 2014. And it said it's ready to do more to jolt the economy if necessary.
"If we're not seeing a sustained improvement in the labor market, that would require additional action," Bernanke said in his quarterly news conference.
Here's how a weak economy for the rest of the year could affect some categories of Americans:
-- Job seekers
People looking for work aren't expected to enjoy much better opportunities in the rest of 2012. The Fed thinks the unemployment rate will fall no lower than 8 percent by year's end. It's now 8.2 percent.
American employers have become wary of hiring. They added just 69,000 jobs in May. Since averaging a healthy 252,000 a month from December through February, job growth has slowed to a lackluster 96,000 a month. And Fed officials and other economists don't think hiring will accelerate in coming months.
-- Retirees and savers
The Fed's continued plan to keep short-term rates super-low through 2014 isn't happy news for people who depend on investment income. When the Fed keeps the rates it controls at record lows, rates throughout the economy generally stay low, too. That's why money market funds are paying rates barely above zero -- well below inflation.
Anyone willing to lend money to the U.S. government over the next 10 years stands to receive about 1.6 percent interest. That's just about what the consumer inflation rate has been for the past 12 months. In exchange for buying long-term U.S. Treasurys, these investors will manage merely to run in place.
-- President Barack Obama
Obama's re-election bid is getting no help from the economy -- the core issue in the presidential campaign. The president's political team has been hoping the unemployment rate would drop by Election Day well below the roughly 8 percent level where the Fed thinks it will be at year's end. With job growth slumping, the president must make the tough case that it would improve in a second Obama term.
Still, unemployment might not be quite the threat to Obama that it appears. Unemployment rates in seven of the 10 battleground states that will likely determine the election are lower than the national average. That trend could blunt Republican candidate Mitt Romney's effort to capitalize on weak job growth to defeat Obama.
-- Borrowers
The one group of Americans who are big winners in the Fed's low-interest-rate campaign are borrowers. They are, that is, if they meet tightened credit standards for consumer and business loans.
The average national rate nationally on a fixed-rate 30-year mortgage is just 3.71 percent. That's scarcely above the 3.67 percent average earlier this month -- the lowest since long-term U.S. mortgages were introduced in the 1950s.
Mortgage rates have been sinking because they tend to track the yield on the 10-year Treasury note. Anxiety about Europe's debt crisis has led many investors to buy U.S. Treasurys, which are considered ultra-safe despite their puny yields. When demand rises for Treasurys, their yields fall.
On Wednesday, the Fed said it thinks the economy will grow between 1.9 percent and 2.4 percent this year, sharply less than in its previous estimate in April. And it's roughly the annual pace at which most economists think the economy is growing now.
"All economists have shaved down their forecasts for this year," said Sung Won Sohn, an economics professor at the Martin Smith School of Business at California State University.
Sohn said his own forecast was in line with the Fed's. He said he was surprised the Fed didn't downgrade its unemployment outlook even more based on its forecast for economic growth.
Even so, "If the Fed's forecast unfolds, that would be bad news for incumbent politicians," Sohn said. "If I were President Obama, I would be worried."
Some political strategists expect the picture the Fed sketched of the economy to play into Romney's hands.
"If I'm Mitt Romney, I immediately use Bernanke's comments to make the case that what I've been saying is right: Barack Obama isn't working, the stimulus has failed and the only way to take us out of this is to make a change in the White House," said Joe Brettell, a Republican strategist.
He said Romney's message is simple: "I'm the guy who can fix the problem."
Most people think the biggest problem is unemployment. Brian Bethune, an economics professor at Gordon College in Massachusetts, said he thinks the unemployment rate will end the year at 8.1 percent or 8.2 percent.
Bethune thinks the Fed might decide by early fall that the economy needs some aggressive new step, such as another bond buying program. The Fed has completed two such programs. It bought more than $2 trillion in Treasurys and mortgage-backed securities.
If such a program were launched and helped boost the economy, it could end up benefiting job seekers and perhaps Obama's re-election chances.
"If we are still seeing these terrible employment numbers," Bethune said, "then the Fed is going to have to consider another move. The economy can't just flop along at this level."
Bethune said the problem for incumbents like Obama is that perceptions about the economy tend to freeze about six months before an election -- even if the economy improves after that.
Even so, economists note that continued declines in oil and gas prices could spur growth by giving consumers more spending power.
On Wednesday, the Fed said it will continue a program called Operation Twist through year's end. Under the program, the Fed has been selling $400 billion in short-term Treasurys since September and buying longer-term Treasurys. The Fed said it will extend Operation Twist using $267 billion in securities.
But it might not provide much benefit. Businesses and consumers who aren't borrowing now at historically low rates aren't likely to do so just because rates dipped a little more.
David Jones, chief economist at DMJ Advisors, estimates that extending Operation Twist will lower long-term rates by only about one-tenth of a percentage point.
Associated Press writers Paul Wiseman, Christopher S. Rugaber and Philip Elliott contributed to this report.
Published: Fri, Jun 22, 2012


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Widescreen cockpit.
The instrument display provides previously unknown options for driver information. This is a digital instrument cluster that, together with the multimedia system display, forms the Widescreen Cockpit. All information is presented in high resolution and in colour on the 31.2 cm (12.3-inch) instrument display. The driver can choose between the 3 display styles "Classic", "Sporty" and "Progressive". The digital display allows a more variable presentation of the content and brings vehicle functions – such as assistance systems –. (Widescreen cockpit is optional)
Burmester Surround Sound System.
15 high-performance speakers, a 10-channel DSP amplifier with a total output power of 590 W and also amplifier/speaker systems configured specifically for the vehicle make for the first-class Burmester sound. Alongside outstanding sound, the high-quality stainless steel bezels underscore the exclusive interior. If required, this impressive listening experience can be upgraded even further. The surround function generates a virtual all-round sound for maximum spatial impact. (Burmester Surround Sound System is optional)
The G-Class is over 12 cm wider and 5 cm longer. The expanded interior offers substantially more comfort on campaigns of conquest around the world. This includes 150 mm more legroom in the rear.
Driving Assistance.
This package brings together some of our most advanced safety systems to help you avoid accidents and enjoy a more relaxing driving experience. These intelligent technologies not only warn you of impending danger, but also actively intervene if required. Semi-automated driving on motorways, country roads and even in town, autonomous braking in critical situations when needed, and active support during evasive manoeuvres – these are just some of the functions of the Driving Assistance package. The aim: more comfort and less stress by relieving the driver's workload, thereby improving safety for all road users.
Parking package with 360 camera.
When driving off-road, the new G-Class parks where it wants. In the city, there are two optional equipment packages which can assist with parking. The Parking package with reversing camera makes it easier to both find a parking space and to enter and leave parallel or end-on parking spaces. It consists of a reversing camera and Active Parking Assist with PARKTRONIC. The Parking package with 360° camera, meanwhile, allows parking and manoeuvring with a realistic all-round view provided by four networked cameras and even gets the new G-Class into tight spaces with ease. (Parking package is optional)
The MULTIBEAM LED headlamps enable high beam to be left on without dazzling other road users. Individually controllable LEDs direct the light precisely so as to blank out other vehicles whilst illuminating the surroundings with almost daytime levels of brightness.
The light pattern is directed precisely where it is required via 84 individually controllable LEDs. A total of four control units calculate the ideal light pattern 100 times per second using information from a camera located behind the windscreen.
G 63: AMG-specific grille.
The AMG radiator trim impresses with vertical louvres and a central star in high-gloss chrome. As such, the Mercedes-AMG G 63 differs significantly from the entry-level model in that the dynamic character of the vehicle is brought to the fore.
The light-alloy wheels have striking, powerful design with wheel sizes from 18" up to 22". There are a wide new range of standard and optional wheels available.
Sliding sunroof.
The power sliding sunroof provides pleasant ventilation in the interior. As it is made of glass, it also gives the interior of the vehicle a brighter feel. A movable headlining affords protection against the sun. If the system detects rain, the open roof moves to the tilt position.

subset: commoncrawl


text:
IMLS Press Contact
Mamie Bittner, email@example.com
Washington, DC—The Institute of Museum and Library Services (IMLS) today announced nine 21st Century Museum Professionals grants totaling $1,968,346. The recipients are matching their grants with a total of $2,277,018 in non-federal funds. IMLS received 68 applications requesting $11,630,873.
"These grants help museum professionals acquire, improve, and maintain their knowledge and skills," said IMLS Director Susan Hildreth. "The projects we're funding have impact and public value well beyond the nine grantees and their service areas."
Click here to view the list of funded projects.
For more information about the 21st Century Museum Professionals grant program, please visit http://www.imls.gov/applicants/21mp.aspx.
Use the IMLS grants search tool to view our archive of grants awarded by the Institute. Search grants by grant name, institution, or project type.
About the Institute of Museum and Library Services
The Institute of Museum and Library Services is the primary source of federal support for the nation's 123,000 libraries and 17,500 museums. Through grant making, policy development, and research, we help communities and individuals thrive through broad public access to knowledge, cultural heritage, and lifelong learning. To learn more about IMLS, please visit www.imls.gov.


text: "I'm Just Chin-Chillin" Wooden Sign by Functional Rustic is the perfect gift!. Measurements: 19 in x 3.5 in x 5/8 in. The sign is made from a salvaged wooden shipping pallet and hand painted with oil paint. Twine is used to hang the sign. Each Functional Rustic sign is handmade to order and will look similar to what is picture but may not be the actual sign displayed.


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Then and NowThe author of Teen People of the Bible reminds today's teenager he or she is not alone Monthly
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Your Daily PrayerA devotional prayer and inspirational image delivered to you every weekday morning to start your day in conversation with God.Daily


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Jessica and Justin
March 18, 2006
Congratulations! Looking foward to seeing the photos.ReplyDelete
Jessica! you look so beautiful! I really really wish I could have come to your wedding! My mom said it was pretty.ReplyDelete
Congratulations! May you both have more years of happiness than you could ever count :-)ReplyDelete
Here's a post from a guy! : )
Jessica, the wedding was an awesome testament to yours and Justin's faith. It was a really neat experience, that has definitely left a lasting impression on me and my life. What the two of you has done is what I am aiming for, and it was amazing for me to watch the whole thing--courting and all--happen.
God bless you both!
Irish Marriage Blessing
May God be with you and bless you,
May you see your children's children.
May you be poor in misfortunes and rich in blessings.
May you know nothing but happiness
from this day forward.
Congratulations Jessica!
Wow! You look great and so does your new husband.
I know we only know each other through sewing blogs. I have read all the steps along the way in the making of your wedding dress. It turned out beautiful.
Congratulations to you and may you continue to be blessed.
Congratulations! I can't wait to see more pics!ReplyDelete
Jessica or Ruth,
I cant find my thing from the wedding, can you please send me Jess and Justins addy?
love ya!!


text:
Tagged: Ryan Webb
Padres' Secret Unveiled
All season long I've been asking myself: how does a team that cannot score runs continue to win as much as the Padres in 2010?
I thought the answer was excellent pitching.
If Ryan Webb is hangin' with Yoda, then it's a good bet that Mat Latos is hangin' with Obi-wan… and Heath Bell is chillin' with… Vader.
Hate me 'cuz I can spin the double-bladed saber, just don't hate me 'cuz I"m right.
(Image courtesy of the AP)


text:
This library contains research reports produced by the Building America program and other building science resources used to support this Solution Center. The materials cover both new construction and existing homes. Use the search box and/or the filters to explore hundreds of residential building resources. Access to some references not produced by Building America may require purchase from the publisher. Documents are listed alphabetically. While we continually update our database, links may have changed since posting. Please contact our webmaster if you find broken links.
Report evaluating the relative effectiveness of various control and distribution strategies to improve hydronic space heating performance in existing low-rise multifamily buildings


text:
With well over 7,000 students, enrollment is at its second-highest point since 1983.
Data reported to the State Budget Office on Wednesday, Sept. 7, show total enrollment at 7,031, a 1 percent increase over fall 2010's official figure of 6,976.
Female enrollment is up for the sixth straight year to an all-time high of 1,837, or 26.1 percent of the student body.
Graduate enrollment increased approximately 5 percent, with a record 1,303 students seeking master's and PhD degrees, up from 1,256 in fall 2010. "We broke through 1,300 for the first time and processed 3,000 applications, another record number," said Jacqueline Huntoon, dean of the Graduate School. "Graduate enrollment continues to increase in accordance with our strategic-plan goal of having 3,000 grad students by 2035."
"Of our on-campus enrollment, growth is strongest among international students, and we are very pleased that students are drawn here from all over the world to pursue a graduate degree," she said. Many are self-supporting or are supported by their employers or home countries, she noted. "They provide an economic boost both to the University and to the local community."
Another area of growth is distance learning. The number of students seeking a graduate degree online is up markedly, from 58 to 106.
Undergraduate enrollment is up as well, with 5,728 students compared to last year's 5,720. The number of new first-year students grew from 1,115 to 1,161, an increase of approximately 4 percent. The freshman class will also include more women: 288 as compared to 273 in 2010.
In addition, the academic credentials of the entering freshman class are up for the sixth straight year, with a record-setting average ACT composite score of 26.4, compared to last year's 26.1.
"Smart, adventurous students want to study with other smart, adventurous students," explained John Lehman, assistant vice president of enrollment services.
The enrollment count also reflects the fact that more students are staying at the University. The retention rate from undergraduates' first to second year of study has risen to 83.3 percent, approximately 2.5 percent higher than 2010's 80.9 percent.
The COMPASS program employs a variety of strategies to improve student retention. "Our orientation program helps new students acclimate to the community and learn about the resources that can make them successful," said Director Susan Liebau. The office offers special services for transfer and commuter students, along with the ExSEL program, which combines leadership development with tips for improving academic performance.
In addition, the University tracks first-year students' mid-term grades and has stepped up efforts to reach out to those who are struggling. "That's been one of our most effective efforts to ensure the success of students," Liebau said.
Published in Tech Today
by Marcia Goodrich, senior writer


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Kinross-Tasiast has been a hot topic in the mining community for at least two years, since the take-over of Red Back mining in September 2010, stirring much speculation among stock market traders as well as anticipation from unemployed Mauritanian graduates. Yet it remains an impenetrable mystery. The precious ore is extracted far from prying eyes hoping to catch a glimpse of the truth, to confirm their unanswered questions and suspicions. Despite its many problems, the mine is claimed to have achieved something in the order of US$2.5 billion annual revenue, under an agreement where Mauritania receives only 3%. With traders losing faith in the promised gold, and the jobless Mauritanians still looking for work, the big question is: "where is the money?"
Tasiast was touted as the second largest gold deposit in Africa, making it irresistible to international companies lured to Mauritania by the promise of massive returns. By April 2012, the Executive Board of Kinross Gold was cloistered for two days in the Canary Islands at the Las Palmas regional headquarters of the Canadian gold mining giant. They were urgently discussing a major capital optimization study for its mines in Ghana and Mauritania. The meeting came at a critical juncture for Kinross Gold, facing massive cost escalation on its development projects, after already announcing delays to the Ghanaian Lobo-Marte and Fruta del Norte projects to focus on Tasiast.
A series of negative events triggered a sharp fall in share price in January 2012m when US$3.1 billion – about 21% of its value – was wiped out after announcing a $2.49 billion write off – part of the US$4.6 billion "goodwill" included in the US$7.1 billion cost of the Red Back purchase, and a 6-9 months' delay before Tasiast gold production would come on-stream, at which time it would fail to meet previous output estimates.
Then in March, the company was hit with a $4-billion class action lawsuit related to the troubles at Tasiast, filed by Canadian firm Koskie Minsky LLP. "Based on our investigation, we are prepared to pursue litigation to preserve the company and the value of Kinross Gold stock for all shareholders, including seeking removal of certain officers and directors and monetary payments," said shareholder rights attorney Willie Briscoe. The complaint charged that Kinross Gold's financial statements were not fairly presented in conformity with International Financial Reporting Standards and were materially false and misleading.
This was the second such suit in less than a month, after a similar claim was filed in the United States in February. Both lawsuits relate to Kinross Gold's disclosure around Tasiast: that the miner made misrepresentations relating to the quality and quantity of gold ore.
With the write-off, plus punitive damages in the offing, cost-cutting would be at the top of the agenda in Las Palmas. They would also need to decide how to respond to an unexpected tax demand for several million dollars from Mauritania.
The meeting would also be an ideal opportunity to discuss the creation of a plan, since, despite allocating a budget of $US800 million for Tasiast this year, and being way behind schedule, they don't have one.
Speaking as a programme manager, this would be the most disturbing fact about Kinross Gold I have uncovered, were it not for the fatal plane crash in July which claimed seven lives, all Mauritanians, and to which Kinross reacted with condolences for the deceased and their families, but also saw fit to mention that no Kinross staff were killed, no gold was on board, and that the tragedy would not impact mining operations. It certainly made a difference to the loved ones of the seven people who died. The pilot's sister is still struggling to cope with her grief.
Top-down de-staffing
Despite offical denials, removal of "certain officers and directors" did happen, although it is not clear whether this was solely in response to the lawsuits. People who were formerly described in glowing terms as "integral" to the growth of the company, and especially the flagship Tasiast project, disappeared. Calls to their numbers via the Kinross switchboard went unanswered, and the receptionist said they had left the company.
Based on press releases, it is apparent some of them found new jobs:
- TIMOTHY C. BAKER– Executive Vice-President and Chief Operating Officer, when the due diligence was being done on the Red Back transaction.
- THOMAS M. BOEHLERT– Executive Vice-President and Chief Financial Officer. He left soon after the Red Back transaction.
- KENNETH G. THOMAS– Senior Vice-President, Projects. This was the man responsible for the Tasiast expansion project.
- ROBERT D. HENDERSON– Senior Vice-President, Technical Services. He signed off as a "Qualified Person" on most of the Kinross Gold mines' reporting.
- MARK E. ISTO– Senior Vice-President, Project Development. Coordinated work with engineering consultants for Tasiast.
- MARK D. SEDORE—Vice-President, Technical Services. He signed off as a "Qualified Person" on Tasiast.
For a while it seemed as though the one man who has profited most from Kinross, CEO Tye Burt, who was awarded total compensation of US$50-60-million since 2005 in the form of cash, share and option-based awards and pension value, would never leave, but he finally got canned in August after a drop in Q2 profits.
Whoever was still around in April would have had to discuss the Tasiast mine expansion project in their meeting. This is a project which had previously been considered impracticable by independent and separate expert studies. However, Ken Thomas, who joined Kinross Gold from Hatch in 2010, seemingly had his heart set on engaging the company in what later proved a costly and reckless adventure. The expansion project, which included two processing plants with a complex infrastructure, would have to be cancelled or curtailed. But Kinross had already outsourced to a host of foreign sub-contractors. If the board decided to surrender the project indefinitely, the subcontractors would not relinquish their claims without some form of compensation.
Subcontractor perks
Some subcontracted companies based in Mauritania enjoy(improperly) the same dispensations and benefits as Kinross-Tasiast. This situation has come about either by contrivance, or through the ignorance of the Mauritanian authorities which carved out the Tasiast deal. The primary subcontractor was Hatch, a Canadian consulting firm whose mission was the study and monitoring of the expansion project.
The key expansion project subcontractor is Consolidated Contractors Company [CCC], an Arabian construction company, owned by a Palestinian from Lebanon, and based in Greece. CCC was in charge of Civil Engineering works to build the expansion project plant at a cost of US$1 billion.
The project being mothballed, CCC has been thrown some million-dollar bones to chew on while waiting for the return of better times, but they are all projects which were originally slated to be awarded to Mauritanian companies. CCC now supports construction of the airport at Tasiast; an asphalt road linking the site to the road between Nouakchott and Nouadhibou – and related works; and a pipeline project to supply fresh water. To do this, it employs 110 expatriates and not a single Mauritanian.
In those situations where local people are employed, the recruitment practices reflect the grace-and-favour cronyism that is endemic in Mauritanian society. "Kinross employs about 300 Mauritanian workers, strictly for manual labour, and 5 in 6 of them almost exclusively have the same tribal affiliation," says one worker.
Second in line is DORCE, a Turkish company based in Ankara, tasked with construction of a workforce camp of about 7,000 rooms, for a total of US$100 million. It employs 500 expatriates and 600 locals, but 80% of the Mauritanians are small traders.
Next is the turn of Friedlander (ORTEC Group), a French company specializing in plumbing, whose mission is limited to the construction of a pipeline feeding the plant with seawater to clean extracted ore. It employs 50 expatriates, as well as a workforce of labourers, of which 70% are from sub-Saharan Africa.
Fourth most important is CIS, an international catering company with headquarters in France, operating in Mauritania as NAC, and responsible for a catering contract worth US$11 million. CIS, or NAC, employs 30 expatriates and more than 400 Mauritanian staff. The indigenous employees are hired without permanent employment contracts, working 12 hours a day for a measly 70,000 Ouguiyas (about US$230) at the end of the month, and no entitlement to overtime. No wonder the company has no operations in France other than an office: the EU labour laws forbid such treatment.
According to one worker, "There are of course other, less visible foreign companies operating behind the scenes, seemingly unknown to the Mauritanian tax man, but appearing on the list of companies associated with Kinross-Tasiast."
"The 'Mauritanisation' of workers obviously does not apply to these companies," one worker voices. "Here, they conspire with the authorities, with the compliance of the labour inspector, to keep almost everything in the dark," concludes a team leader. "Cheating is endemic here," reveals a Mauritanian civil rights activist. "For example, salaries of expatriate workers of these various companies are kept under wraps. Expats working in that area of Kinross-Tasiast which they call "operations" are managed from the regional office in Las Palmas."
Another indignant Mauritanian engineer adds, "Kinross-Tasiast is just a big scam."
"Regardless of the level of commitment from the government in wanting to impose real transparency on these vested interests," adds a technician, "it will never happen."
Related articles
- Kinross CFO exits company
- Kinross dumps CEO (mining.com)
- Kinross-Tasiast: L'or est de silence (rmibiladi.com)
- Kinross to Announce Q3 Financial Results on November 7, 2012 (sys-con.com)
- Mauritania: Troubles for Kinross at the Tasiast Gold Mine (sahelblog.wordpress.com)


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OLYMPIA—Starting this month, most Washington drivers renewing their licenses will have an additional year until their next visit to the Department of Licensing as the state transitions from a five-year driver license renewal cycle to a six-year cycle.
By extending the renewal cycle to six years, drivers in our state won't have to visit DOL offices as often. Over time, this change also will reduce the number of drivers and ID card holders visiting DOL offices each year. This will help keep wait times as low as possible for all our customers.
The cost of a basic driver license or ID card will remain at $9 per year, but most customers will be paying for an additional year, so the total renewal cost will change from $45 for five years to $54 for six years.
Moving to a six-year driver license is expected to reduce the average number of annual renewals by more than 100,000. In order to evenly distribute all of our state's licensed drivers into six years of roughly equal and lower renewal volumes, some drivers will be selected to receive a license extension for less than six years.
Beginning August 10, approximately 20 percent of drivers with licenses expiring in October will be selected at random by DOL's license issuance system to receive a five-year license. The remaining 80 percent will receive a six-year license.
DOL will continue this gradual transition for the next five years by selecting 20 percent of drivers each year to receive licenses valid for less than six years. During the second year of this process, 20 percent of drivers will get a license valid for four years. In the third year, 20 percent will get a license valid for three years. In the fourth year, 20 percent will get a two-year license. In the final year, 20 percent will receive a one-year license.
Drivers randomly selected to receiving shorter renewal periods will only pay for the number of years their license is valid and will be eligible to renew online.
Click here for more info on DOL's website.


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Still catching up...here is a great early morning session with a fun family!!
Thanks for the morning fun, K Family!! Donuts weren't bad either!!
I want my photography to highlight this red thread – this connection between people, who at one time or another, in one circumstance or another, have met. It may be children, grown-ups, friends, families, parents with their kids, lovers, even newborn babies. The red thread is there and its strength and flexibility are amazing.
My approach to photographing your wedding, family or children is to capture the connections and relationships in a photojournalistic style. Catching your family and friends in real-life settings, creating images that evoke love and laughter, and provide photographs that can be treasured by all who are, and will be, connected to you.


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Dr. Jean Dausset dies at 92; scientist's discovery made tissue typing for transplants possible
Dr. Jean Dausset, the French Nobel laureate who discovered the human leukocyte antigen, or HLA, system on human tissue that made tissue typing for transplants possible, died June 6 in Mallorca, Spain. He was 92.
The HLA antigens are molecules on the surface of cells that allow an individual's immune system to distinguish between its own tissues, which it ignores, and foreign tissues, which are vigorously attacked by disease-fighting antibodies. There are six major HLA groups, but hundreds of variations within them, so it is virtually impossible to produce a perfect match in transplants. That is why immune-suppressing drugs must also be used to prevent rejection even with the best matches.
In other animals, these antigens are called histocompatibility ("histo" meaning tissue) antigens. These were first discovered in mice by Dr. George Snell of the Jackson Laboratory in Bar Harbor, Maine, who shared the 1980 Nobel Prize in Medicine with Dausset and Dr. Baruj Benacerraf of the Harvard Medical School.
Dausset discovered the histocompatibility antigens in humans, gave them the name HLA, and demonstrated with experimental skin grafts that incompatibility of antigens led to rejection of transplants. He and his colleagues collected blood samples from people from 54 racial and ethnic groups from all corners of the world and demonstrated that the HLA complex was not unique to any particular group, but was universal.
He then showed that the genes that serve as the blueprints for the antigens reside in a section of chromosome 6 known as the major histocompatibility complex. He also demonstrated that many of the genes were linked to specific human diseases.
With his Nobel Prize money and a substantial grant from French television, he established the Centre d'Etude du Polymorphisme Humain, or CEPH, for the study of the human genome. The center collected DNA from 61 large families and made it available to researchers around the world who made a map of DNA markers that played a crucial role in deciphering the human genome.
Jean Baptiste Gabriel Joachim Dausset was born Oct. 19, 1916, in Toulouse, France, the son of a physician who moved the family to Paris when Jean was 11. He earned a bachelor's degree at the Lycee Michelet in Paris and enrolled in medical school at the University of Paris, but was drafted into the French army in 1939.
After France fell to German troops in 1940, he made his way to the Free French Forces in North Africa, after first giving up his identity papers to help save a Jewish colleague. During the Allies' Tunisian campaign, he performed transfusions, triggering a lifelong interest in hematology that led directly to his Nobel.
After Paris' liberation in 1944, he returned to the city and was placed in charge of blood collection for the regional transfusion center. He completed his medical studies in 1945. After a postdoctoral fellowship in Boston at Children's Hospital he returned to the regional blood center, where he began transferring the techniques developed for matching red blood cells to the study of white blood cells.
While continuing his research, he collaborated with Dr. Robert Dubré to institute radical reforms in the hospitals and universities where medicine was taught, emphasizing the need for professors of the basic sciences and laying the foundation for further French advances in biology.
He also founded France Transplants and France Bone Marrow Grafts, organizations dedicated to delivering donor organs and bone marrow to needy recipients quickly and efficiently.
In 1993, CEPH became the Foundation Jean Dausset-CEPH. Dausset retired as president in 2003 but remained honorary president until his death.
Dausset had a lifelong interest in what he called "plastic art" and at one time was owner of an Impressionist gallery, Le Gallerie du Dragon.
In 1963, he married Rose Mayoral from Madrid and they had two children, Henri and Irene. He is survived by all three.
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https://www.newscientist.com/article/mg ... te-colony/
Not particularly impressed with most of it, but I thought the folks here would like this paragraph:
I don't think people realise how incredibly brittle the technology that we depend on is. If the internet goes down today, we'd be in a world of chaos. I'm worried about the first 48 hours, about people just going berserk if they don't have the internet. They are not going to have TV, they are not going to have radio stations probably, their cellphones will fail. They are going to be plunged into electronic darkness and scared out of their wits. After all, they have just been plunged back into the 19th century, and frankly they don't have the skills to cope.


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Monday, 9 May 2011
Pre-order DANCE WITH DRAGONS and get PRINCE OF THORNS for free
An interesting promotion. Prince of Thorns is next up on the review pile after the second Hunger Games novel, so I'll let you all know what I make of it.
18 comments:
what a great deal! i was all ready to place my order until i saw it was exclusive to the UK.
- 9 May 2011 at 16:53:00 GMT
Good to hear you're reviewing Prince of Thorns soon. Looking forward to your take on it.
- 9 May 2011 at 16:58:00 GMT
- ediFanoB said...
That's a cool offer ..... for people living in UK. But I'm not envious. I ordered A Dance with Dragons in advance a long, long, long time ago.
I got an ARC of Prince of Thorns. And I'm reading Prinz der Dunkelheit which is the German edition of Prince of Thorns ....
- 9 May 2011 at 17:29:00 GMT
I preordered from them about a month ago. Wonder if they'll let me pick up the free book? In town tomorrow so I guess I'll go and ask them.
Thanks for the heads-up Wert
- 9 May 2011 at 17:39:00 GMT
- Mark Lawrence said...
As I understand it you have to pre-order in store - the offer isn't retrospective - and you're getting an ARC essentially, a paperback uncorrected proof. And it lasts until the 3,000 copies are used up (or GRRM's book comes out and there's no longer such a thing as pre-ordering it).
Not my dream-child or rules, but it does seem like a bargain.
- 9 May 2011 at 18:17:00 GMT
Very tempting if the in-store price is the same one as the one on the website, but I doubt it.
- 9 May 2011 at 19:42:00 GMT
Is this a shop only offer? I couldn't see it on the website (book is half price thouh). If ADWD is discounted and prince of thorns (which is on my to buy list) is free then it;s worth pre-ordering at shop.
- 10 May 2011 at 09:07:00 GMT
They did indeed back-date the offer for me. Hooray for them! So far (4 chapters in) it's shaping up nicely as well
- 10 May 2011 at 13:02:00 GMT
Thanks for the details Mark. Seems a pretty good bargain and a nice way to get hold of your book in advance.
I'll try my luck on the way home tonight, otherwise there seems to be some decent deals on your hardback edition later on.
- 10 May 2011 at 13:23:00 GMT
- Justin said...
Sad to say that with the difference between the dollar and the pound right now even a free book doesn't off-set the difference. Sigh.
- 10 May 2011 at 13:42:00 GMT
- Alex said...
My pre order of Dance with Dragons was made before my 4 year old son was born. Don't think I'm paying Amazon more than a tenner for the hardback :)
- 10 May 2011 at 15:21:00 GMT
Your son could be a teenager before the next one materialises. - Ian
- 11 May 2011 at 01:41:00 GMT
Managed to grab a copy :)
Absolute bargain, thanks for the heads up, wert and Mark as the bookseller wasn't even aware of the promotion.
- 11 May 2011 at 07:31:00 GMT
My Waterstones didn't get them in yet, despite having one of those ads for the offer.
- 11 May 2011 at 17:23:00 GMT
I ordered a copy of DWD by GRRM in my local Waterstones store today and you receive an ARC of Prince. I managed to bag the last copy.
- 11 May 2011 at 18:01:00 GMT
In that case did you reserve your reserve gift, anon?
- 11 May 2011 at 20:57:00 GMT
No, since the only reason I would buy it from them is the promotion, and I might miss it if they sold out before I went to pick it up.
- 12 May 2011 at 00:04:00 GMT
- Joe said...
I pre ordered with Waterstones, the HB is £12.50 and you get the free book. So better than amazon. Best to do it in store and they ask for a £3 deposit.
- 15 May 2011 at 14:23:00 GMT


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Frequently asked questions about Medicare Part B
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text:
Monoprice Glass Panel Pro review: Affordable alternative to Apple display
Today's Best Tech Deals
Picked by Macworld's Editors
Top Deals On Great Products
Picked by Techconnect's Editors
Monoprice 27" IPS-Glass Panel Pro LED Monitor
The 27-inch IPS-Glass Panel Pro LED Monitor isn't the first Monoprice IPS monitor that I've looked at, but it's the first that doesn't feel like a compromise between price and features.
The screen itself has never been the issue. Monoprice uses high quality IPS panels from LG along with efficient LED backlights. The first display I looked at, Monoprice's 27-inch IPS LED CrystalPro Monitor, had a wobbly stand, inexpensive-looking case design, and two of the seven menu buttons on the display didn't do anything. The second Monoprice display, the 27-inch IPS Zero-G Slim, had a better stand, but the buttons were on the back of the display with no labels on the front. Using the menus required me to crane my head around the back to locate the proper button then come back to the front to see the onscreen menus and then back to the rear to find the up or down button. More concerning, the Zero-G Slim only offered dual-link DVI and VGA connections.
The 27-inch IPS-Glass Panel Pro LED Monitor, however, has clearly marked buttons (that all work!) conveniently located on the bottom edge of the case. The Pro LED monitor's stand lets you easily swivel the screen left to right and allows for a few degrees of tilt, but it does not offer height adjustment and the ability to pivot into portrait mode. The display provides DisplayPort and HDMI connections in addition to dual-link DVI and VGA connections. While some newer monitors are beginning to support DisplayPort 1.2's daisy-chaining capabilities, the Monoprice does not.
The Pro LED Monitor includes decent sounding speakers, though a pair of inexpensive desktop speakers would probably sound better.
The Pro LED Monitor has the same 2560 by 1440 pixel resolution as the Apple 27-inch Thunderbolt Display. It features a glossy screen, like the Thunderbolt Display, but with less reflection—more in-line with the new iMac's glossy screen. The Monoprice's IPS display ensures wide viewing angles with no harsh color shifts as you move from left to right, or up and down from the center of the screen. I looked at a series of test screens and found no problems with light leakage and no stuck or dead pixels.
Side by side with the Apple Thunderbolt Display, the Pro LED Monitor image quality was a bit warmer. Unlike the Apple display, the Pro LED Monitor offers color controls to allow for calibrating the display to your liking. Grays appeared neutral, though blacks were not quite as deep as on the Apple display. There is a high contrast mode available on the Pro LED Monitor, but I much preferred the images the monitor displayed with this feature off. Photographic images looked very good on the screen with natural looking skin tones and I found no uniformity issues.
Bottom line
The 27-inch IPS Glass Panel Pro LED monitor offers similar onscreen performance to the much more expensive Apple's Thunderbolt Display. It lacks the fit, finish, and Thunderbolt port of Apple's offering, but if you care more about the images displayed than the case in the display is housed, the Monoprice display is great bargain with enough nice-to-have features to avoid feeling like a compromise.
Monoprice 27" IPS-Glass Panel Pro LED Monitor
It's not as full-featured as some others, but this display has the basics, and it produces a great-looking image.
- Wide viewing angles
- Multiple input types
- No height adjustment or pivoting capabilities
- No USB hub
- No DisplayPort 1.2 daisy chaining support


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Published On:20 May 2012
Posted by Indian Muslim Observer
Saudi Arabia, Women, and Judicial Reform
By Isobel Coleman
While I was visiting Saudi Arabia last week, King Abdullah fired one of the most popular Islamic leaders in the Kingdom from his government position. Sheikh Abdel Mohsen Obeikan was an advisor to the royal court until last week when, in a single line, the king ordered that the sheikh resign from his post. The reaction was swift. In newspapers, on Facebook, and on Twitter, Obeikan's supporters and detractors speculated, gloated over, and lamented the sheikh's inglorious fall. While it is still not clear what happened, it is safe to say that this is yet another episode in Saudi Arabia's internal struggle to define the role of women in society.
I met Sheikh Obeikan some years ago when my colleague Rachel Bronson and I interviewed him at his palatial home in Riyadh. (The Obeikan family owns an empire of printing, packaging, publishing, and education companies.) At one point during our interview, our translator stopped translating and embarked on an animated conversation with Obeikan. When we pulled him back to the task at hand, the translator apologized, saying he was just so excited to have an opportunity to speak with the great sheikh. At the time, Obeikan waxed eloquently about the need for gradual change in Saudi Arabia, but it seems he's been singing a different tune more recently. In the two weeks preceding his dismissal, Obeikan made several statements on his radio show "Fatawakum," or "Your Fatwas," about proposed reforms to the Saudi judicial system and specifically, the role of women. (The title of the radio show was "The Meaning of Women in the Courts.") He complained (Arabic) about plans to Westernize society and "the Saudi woman" and to replace Sharia courts with man-made laws. He stressed his opposition to women mixing with men during court proceedings and complained that neither the minister of justice nor the head of the court paid his objection any heed. During the hour long interview, he praised King Abdullah for founding Princess Nora University for women, the largest all-female university in the world with 50,000 students. But he inveighed against gender mixing of male and female students at other universities–calling it deviant. Although he didn't name names, he was likely objecting to gender mixing at King Abdullah University for Science and Technology (KAUST), one of the King's favored projects. When KAUST opened in September of 2009, another senior cleric, Sheikh Saad al-Shethry, also publicly criticized the new university for gender mixing, and King Abdullah fired him too.
On the topic of judicial reform, Sheikh Obeikan warned of a conspiracy by influential people to corrupt Muslim society by implementing man-made laws. The prominent newspaper Dar Al Hayat published a critical response (Arabic) to this claim, accusing Obeikan of resurrecting the incendiary term "man-made laws" to disgrace and distort discussions about potential judicial reforms. The article notes that the state issues many "man-made laws" such as traffic regulations, pointing out sensibly that "There is no Sharia text that requires people to stop at a red light or to wear a seat belt for example." After he was fired, Obeikan's supporters rallied to his cause. One post on his Facebook wall reads, "May God give you victory. Yes, it is urgent that the ulema take a firm stand to stop the corruption and destruction that are eating away at the unification of the country." A supporter on Twitter refers to "the arrogant liberal schemes in our country" and promised not to forget Sheikh Obeikan's warning about "their conspiracies for the judiciary and women."
Of course, this brouhaha is about much more than Sheikh Obeikan's fate, or even women mixing with men and Saudi's legal system. It's a skirmish in the larger battle over whether Saudi Arabia will cling to its medieval ways or gradually adopt a more modern perspective. In this instance, King Abdullah has come down on the side of modernity. But dissent over women's status in society will remain at the heart of competing visions for the country for a long time to come. As facts on the ground evolve–with women making up the majority of college graduates, young generations connected in an unprecedented fashion to the internet and social media, and the need for a more competitive economy to support its burgeoning population–it will become increasingly untenable for Saudi Arabia to straddle both the 7th century and the 21st century.
(Courtesy: Council on Foreign Relations)


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The Tenth Commandment
Sometimes it can be hard to differentiate covetousness from legitimate desire. But there are things for which we can be on the lookout. Envy of another's position likely indicates that one is coveting it. Obsession with a particular good to ...Read More
Speaking the Truth
Matthew Henry writes, "Truth is a debt we owe to one another; and, if we love one another, we shall not deceive one another." Christians must be known for their love of the truth and the trustworthiness of their speech. ...Read More
The Ninth Commandment
There are a number of different ways in which we can break this rule against false witness. If we teach or proclaim wrong things about God's character, we are bearing false witness. If we gossip and backbite to destroy how ...Read More
God's Work Ethic
God's people are called to be generous, not foolish. We want to provide real help to widows, orphans, and others who are in true need, first in our churches and then in the world. As we seek to help others, ...Read More
False Balances and Just Weights
In a just economic system, the wealthy still pay more than those of lesser means in terms of the actual dollar amount. Yet, they do not pay a greater percentage of their income in taxes than those who are not ...Read More
The Eighth Commandment
As we will see tomorrow, there are a multitude of ways we can steal from others. Many of these are government-sanctioned, which is why it is important for us to understand what God's Word says about theft. If we follow ...Read More
Lustful Intent
Positively, question and answer 109 of the Heidelberg Catechism note, the seventh commandment encourages the maintenance and promotion of chastity in marriage and singleness. We should be doing all that we can to prevent a climate in the church and ...Read More
The Seventh Commandment
Just as idolatry led to destructive consequences for the ancient Israelites, the analogous sin of adultery leads to destruction on an earthly level (2 Kings 17:6–23; Matt. 19:1–12). This should be enough to cause us to flee adultery, but knowing ...Read More
Dealing With Anger
We can avoid expressing our anger sinfully if we stop to think about how we are being treated and the relative importance of the situation. Often, we are so quick to show our ire that we forget that others may ...Read More
When Anger Destroys
Uncontrolled anger is not merely a vice that can be overlooked. Instead, it can destroy lives, and we all know people who have impacted their futures for ill because they could not control their tempers. Sin always creates damage in ...Read More


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This cute illustrated astronaut otter card will sure make anyone's day!
• Card size is 4.25 x 5.5 inches (A2 Folded) printed with high quality paper & ink.
• Blank inside for your personal message
• Printed on premium recycled card stock and includes a matching envelope
• Each card is protected with a sleeve for safe keeping.


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Spectro Broadband LED Series Is Most Powerful Ever
Ushio releases the world's most powerful Broadband LED series OUDE MEER, THE NETHERLANDS – Ushio Europe are proud to announce the
Ushio releases the world's most powerful Broadband LED series OUDE MEER, THE NETHERLANDS – Ushio Europe are proud to announce the
Oude Meer, the Netherlands (September 2020) – Ushio is proud to announce its inclusion in FORTUNE's annual Change the World list
Ushio Inc. (Head office: Tokyo, President and CEO: Koji Naito, hereinafter "Ushio") hereby announces that Jiro Ushio, Director and Corporate Advisor,
Please note: this article is also available in French, and can be accessed here. Approaching a full year since Ushio Europe
Epitex LEDs comprise the largest available collection of light emitting diodes on the market. Spanning violet (UV), visible, and infrared (IR) wavelengths,
Oude Meer, the Netherlands (September 2020) — Dr. Hiroki Ohge, Professor, Department of Infectious Diseases, Hiroshima University Hospital, and a group
Ushio Inc. (Japan) has announced the release of two new violet laser diodes (LDs), HL40113MG and HL40115MG, emitting a wavelength of
Oude Meer, the Netherlands (August 2020) — Ushio Inc. (TYO: 6925; headquarters in Tokyo, Japan) and a research group led by Dr.
Ushio, Inc. has begun the mass production of HL67191MG and HL67192MG, offering two new red laser diodes (LDs) for operation at
Ushio has commenced production of its latest high-powered short-wavelength infrared (SWIR) LEDs, the Epitex D-Series. Following the prior success of the
A report on the latest viral inactivation experiment conducted by Columbia University using Ushio's Care222® has been published in ScienceDaily, a


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The Basics of Election Law and Litigation
Resources for Judges, Lawyers, Journalists, and Others Interested in Our Electoral Process
In the past ten years, we have seen a dramatic increase in election-related litigation in the United States. Legal challenges to election results are now a common part of our democratic process. All too often, judges lack the resources to hear these complicated cases, which must be decided quickly and resolutely given their impact on our political process.
The purpose of this resource is to enhance state court judges' understanding of the basics of election law and election-related litigation. These materials are targeted to judges who are called upon to resolve these disputes, as well as lawyers, journalists, and others interested in our electoral process.
You will find in this website a variety of resources to help you better understand the basics of election-related litigation, including an election law manual, a video lecture series, and samples of our innovative "war game" approach that tests state election statutes and demonstrates for judges the unique nature of election litigation.
For any questions regarding content within this resource, please contact us.


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Serviços Personalizados
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SAMJ: South African Medical Journal
versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.98 no.8 Cape Town Ago. 2008
Emergence of extensive drug resistance (XDR) among Gram-negative bacilli in South Africa looms nearer
Adrian Brink; Charles Feldman; Guy Richards; Johan Moolman; Marthinus Senekal
Department of Clinical Microbiology, Ampath National Laboratory Services, Milpark Hospital, Johannesburg; the Division of Pulmonology, Department of Medicine, Johannesburg Hospital and University of the Witwatersrand, Johannesburg; the Department of Intensive Care, Johannesburg Hospital and University of the Witwatersrand, Johannesburg; Lancet Laboratories, Pretoria; and Pathcare, Cape Town
Until recently, the term 'extensive drug resistance' (XDR) was held to be applicable to Mycobacterium tuberculosis only. It is now clear that Gram-negative bacilli are moving a step closer towards acquiring similar resistance. The emergence of multi-(MDR) and pan-drug resistant (PDR) Gram-negative health care-associated pathogens has been confined to non-fermenters such as Pseudomonas aeruginosa and Acinetobacter baumannii. However, increasing reports of infections due to XDR fermentative Enterobacteriaceae such as Klebsiella pneumoniae, Escherichia coli, Enterobacter spp. and even Salmonella spp. support the notion that '... MDR, XDR and PDR Gram-negative fermenters might become our worst nightmare'.1-5
The proposed definitions are as follows:
MDR: resistance to 3 or more of the following 8 classes:
- anti-pseudomonal cephalosporins (ceftazidime and cefepime)
- carbapenems (ertapenem, imipenem and meropenem)
- beta-lactam/β-lactamase inhibitor combination (piperacillin/tazobactam)
- fluoroquinolones (ciprofloxacin or levofloxacin)
- aminoglycosides (amikacin, gentamicin and tobramycin)
- aztreonam
- polymyxin E
- tigecycline (Wyeth, filed for registration in South Africa).
XDR: susceptibility to 2 or less classes.
PDR: diminished susceptibility to all classes (no options for treatment).
The National Antibiotic Surveillance Forum (NASF) has previously reported extremely high rates of antibiotic resistance among selected pathogens isolated from blood cultures in private institutions in South Africa.6 This report documents these new developments, particularly with regard to susceptibilities of invasive strains of the fermentative Gram-negatives, K. pneumoniae, E. coli and Enterobacter species, isolated from patients in all private institutions in seven major centres in South Africa.
Methods and results
The methods employed were similar to those described previously.6 The study was conducted from 1 July 2007 to 31 December 2007. Over this period, a total of 1 241 blood culture isolates were tested; E. coli (N=503), K. pneumoniae (N=548) and Enterobacter spp. (N=190). The resistance profiles of these strains are depicted in Table I.
The study highlights the following:
- The high levels of resistance to key 'workhorse' Gram-negative antibiotics used in the hospitals studied
- The significant prevalence of broad-spectrum antibiotic-inactivating enzymes, in particular extended-spectrum β-lactamases (ESBLs) in some centres, and other resistance mechanisms affecting fluoroquinolones and aminoglycosides in strains of invasive Enterobacteriaceae
- The considerable differences in the prevalence of resistance and ESBL production between the various centres. This emphasises the need for routine antimicrobial surveillance at least at regional level, and preferably at each hospital or even each unit. The concept of 'know your bugs' has never been as crucial to guiding and optimising empirical treatment for bacteraemic infections as it is now.
Extensive drug resistance among these species can be conferred by several resistance mechanisms:
- Carbapenemases (KPC) are β-lactamase enzymes that inactivate the carbapenems (ertapenem, imipenem and meropenem). Those that were recently described during outbreaks in New York were resistant to all β-lactams including piperacillin-tazobactam, and most were resistant to aminoglycosides and fluoroquinolones.3
- Zinc-containing enzymes called metallo-β-lactamases (MBLs) were initially thought to be specific to P. aeruginosa and found only in Japan. However, the emergence of this enzyme among fermentative Gram-negatives in Europe (in 1997 in Italy and 1998 in Portugal) has dispelled this theory. Once such strains emerge in an intensive care unit, ward or hospital, endemicity is inevitable. This was evident from an ongoing hospital outbreak in Madrid of MBL-producing XDR Enterobacteriaceae involving 4 species: K. pneumoniae, E. cloacae, E. coli and K. oxytoca.7 A recent publication from Greece has also reported an ongoing epidemic of MBL-producing K. pneumoniae in several hospitals, involving more than 50% of blood culture isolates, effectively prohibiting the use of carbapenems.8 There are no commercially available MBL inhibitors.
- In vivo development of ertapenem resistance in an XDR strain of K. pneumoniae, due to both ESBL production and porin deficiency (which elevated imipenem and meropenem minimum inhibitory concentrations (MICs) 4 - 7-fold, respectively) in a private hospital in Cape Town, was recently described.1 Two subsequent case reports by Segal et al. described a similar phenomenon at Groote Schuur Hospital (also in Cape Town), in which imipenem and meropenem MICs increased 4- and 8-fold respectively, during meropenem therapy.2 Six other clinical strains from private hospitals in Cape Town have confirmed that hyper-production of an ESBL in association with porin deficiency is one mechanism by which these pathogens may become XDR (Pathcare, unpublished data).
- Several XDR strains of K. pneumoniae have now also been isolated from patients in two private hospitals in Johannesburg (Ampath, unpublished data). The underlying mechanism(s) of resistance is under investigation.
Attributable morbidity and mortality of increasingly resistant organisms is often difficult to quantify. However, apart from the considerable impact on financial resources, clinical outcome in bacteraemic infections caused by ESBL-producing K. pneumoniae appears to be worse than that of patients with non-ESBL-producing isolates.9 Tumbarello et al. documented the 21-day mortality rate in an ESBL group to be 52% (25/48), whereas that in the non-ESBL group was 29% (29/99) (p<0.007, odds ratio (OR) 2.62).10 These results have been confirmed in a recent meta-analysis of bacteraemia caused by ESBL-producing Enterobacteriaceae by Schwaber et al. which also demonstrated an increased risk for delay in effective therapy (pooled risk ratio (RR) 5.36; 95% confidence interval (CI) 2.73 - 10.53).11 In the Spanish outbreak mentioned above, the overall mortality rate among patients infected with an MBL-harbouring organism was also very high (45%), and it was estimated that 67% of these deaths were attributable to the presence of the resistant organism.7 Reasons for the increased mortality include the increased likelihood that initial therapy would be inappropriate and that, whereas MBL- and KPC-producing organisms may appear to be susceptible to carbapenems, clinical response may be poor.12
These reports are extremely disturbing; the occurrence of all such cases or outbreaks must be monitored closely. Whether salvage therapy with polymyxin E (colistin sulphate - an antibiotic emanating from the 1950s) will be an effective therapeutic option for such XDR infections, and for how long this may be so, remains to be determined. As such, not all strains of Proteus spp., Serratia spp., Morganella morganii and Providentia spp. are uniformly susceptible to polymyxin. In contrast to the relative abundance of therapeutic options for resistant Gram-positive infections (such as those caused by methicillin-resistant Staphylococcus aureus), there are no new antibiotics in development other than tigecycline for these Gram-negative infections (Table II).13,14
As recommended before,15,16 limitation of the development and spread of resistant pathogens in our institutions requires a multi-disciplinary approach, preferably involving a hospital committee to dictate:
- rigorous infection control practices
- infectious disease and clinical microbiology consultation
- active surveillance and application of molecular methods to detect epidemiological trends in mechanisms of resistance and clonal spread of such bacteria
- adequate source control
- meticulous attention to the appropriate use of antibiotics, including choice, dosage and duration of therapy
- de-escalation to narrower-spectrum antibiotics according to susceptibility.
The fact that overall antibiotic management (including prolonged duration, utilisation of multiple inappropriate or unnecessary agents, and a virtual absence of de-escalation) is suboptimal in clinical practice is evident from the nationwide results of a recent survey in academic, public and private institutions (S Bhagwanjee, personal communication) in which all of these practices were rife. In previous studies, prior exposure to antibiotics had been a common risk factor for ESBL-producing bacteria and, in this regard, the role of cephalosporins and fluoroquinolones is widely recognised (often referred to as 'collateral damage'). However, recent evidence suggests that prior use of carbapenems may also be a significant risk factor for ESBL-producing Gram-negatives in patients with bacteraemia.17 Ironically, in the NASF surveillance presented here, the carbapenems were the most active antibiotics in the majority of centres. Therefore, a formal strategic programme of sustained reduction in antibiotic consumption of all classes over the long term in hospitals nationwide, such as occurs in Sweden, is urgently warranted.18
As private institutions in South Africa do not employ the doctors who provide services in their hospitals, they are not able to influence prescribing habits. The fact that the antibiotic-prescribing fraternity has not yet accepted stewardship of the emerging problem of XDR Gram-negative bacilli has given rise to an ethical dilemma both in South Africa and internationally.19 To delay the imminent end of the antibiotic era, it may well be time now to challenge the right of doctors to prescribe whichever antibiotic they wish, including the dosage and duration.
Although restriction of established prescribing habits is a controversial matter, it is certain that this practice would reduce resistance levels in the community and hospitals. Similarly, punitive measures should also be instituted in an attempt to install and ingrain basic infection control practices such as hand disinfection in health care workers. Finally, ongoing training of pre- and postgraduate doctors (and nursing staff) in appropriate aspects of clinical microbiology, infection control and the principles of anti-infective use, must be mandatory.
'The die', as Julius Caesar said on crossing the Rubicon, 'is cast'. However, such is the desperate nature of the present situation that every attempt should be made to at least delay the onset of this modern plague.
Conflict of interests declaration: AB has received recent research funding from Merck and Sanofi-Aventis, served on the advisory board of MSD and Pfizer and on speakers' bureaux for AstraZeneca, Abbott Laboratories, Bayer, GlaxoSmithKline, Merck, Pfizer, Sanofi-Aventis and Wyeth pharmaceuticals. CF has received research funding from Abbott Laboratories and Sanofi-Aventis, acted on the advisory board of MSD, Abbott Laboratories and Pfizer, served as a speaker for MSD, Bayer, Abbott Laboratories, GlaxoSmithKline, AstraZeneca and Sanofi-Aventis and received funding for congress travel from Abbott Laboratories and Sanofi-Aventis. GR has served on advisory boards of MSD, Pfizer, Abbott Laboratories, Fresenius Kabi and Roche. He has received research funding from Bristol-Myers Squibb, and has served on speakers' bureaux for Merck, Sanofi-Aventis, Roche, AstraZeneca, Pfizer, Bayer, GlaxoSmithKline, Wyeth, Boehringer and Fresenius Kabi. JM served as a speaker Bayer and GlaxoSmithKline. MS has served on advisory boards of MSD, Roche and Sanofi-Aventis. He has served on speakers' bureaux for MSD, Sanofi-Aventis, Roche, AstraZeneca, Pfizer, Bayer-Schering, GlaxoSmithKline, Wyeth and Bristol-Myers Squibb.
The contributions of the following NASF members from private pathology practices are acknowledged: L Badenhorst, F Botha, M Botha, S Breuning, S Budavari, J Coetzee, M Cruz da Silva, G Elliott, M Henning, N Janse van Rensburg, S Kahn, R Loxton, L Marcus, M Mennen, N Miller, A K Peer, X Poswa, K Pillay, B Prinsloo, P Schoeman, M Senekal, J Smit, P Smith, W Swart, J van Greune, G van Greunen, C van Rensburg, M van Rensburg, O van Rensburg, J van Wyk, G Weldhagen and I Zietsman.
The NASF is supported by an unrestricted educational grant from Aspen Pharmacare, Abbott Laboratories, AstraZeneca, Bayer, Bristol-Myers Squibb, GlaxoSmithKline, MSD, Pfizer, Roche, Sanofi-Aventis and Wyeth.
1. Elliott E, Brink A, van Greune J, et al. In-vivo development of ertapenem resistance in a patient with pneumonia caused by Klebsiella pneumoniae with extended-spectrum β-lactamase. Clin Infect Dis 2006; 42: e95-98.
2. Segal H, Elisha BG. Resistance to p-lactams, and reduced susceptibility to carbapenems, in clinical isolates of Klebsiella pneumoniae due to interplay between CTX-M 15 and altered outer membrane permeability. S Afr J Epidemiol Infect 2006; 21: 41-44. [ Links ]
3. Bratu S, Brooks S, Burney S, et al. Detection and spread of Escherichia coli possessing the plasmid-borne carbapenemases KPC-2 in Brooklyn, New York. Clin Infect Dis 2007; 44: 972-975. [ Links ]
4. Miriagou V, Tzouvelekis LS, Rossiter S, et al. Imipenem resistance in a Salmonella clinical strain due to plasmid-mediated class A carbapenemase KPC-2. Antimicrob Agents Chemother 2003; 47: 1297-1300. [ Links ]
5. Hossain A, Ferraro MJ, Pino RM, et al. Plasmid-mediated carbapenem-hydrolyzing enzyme KPC-2 in an Enterobacter sp. Antimicrob Agents Chemother 2004; 48: 4438-4440. [ Links ]
6. Brink AJ, Moolman J, Cruz da Silva M, et al. Antimicrobial susceptibility profile of selected bacteraemic pathogens from private institutions in South Africa. S Afr Med J 2006; 97: 30-36. [ Links ]
7. Tato M, Coque TM, Ruiz-Garbajoza P, et al. Complex clonal and plasmid epidemiology in the first outbreak of Enterobacteriaceae infection involving VIM-1 metallo-β-lactamase in Spain: Towards endemicity. Clin Infect Dis 2007; 45: 1171-1178.
8. Psichogiou M, Tassios PT, Avlamis A, et al. Ongoing epidemic of blaViM-1_positive Klebsiella pneumoniae in Athens, Greece: a prospective survey. J Antimicrob Chemother 2008; 61: 59-63. [ Links ]
9. Giske CG, Monnet DL, Cars O, et al. Minireview: Clinical and economic impact of common multidrug-resistant Gram-negative bacilli. Antimicrob Agents Chemother 2008; 52: 813-821. [ Links ]
10. Tumbarello M, Spanu T, Sanguinetti M, et al. Bloodstream infections caused by extended-spectrum -lactamase-producing Klebsiella pneumoniae: Risk factors, molecular epidemiology, and clinical outcome. Antimicrob Agents Chemother 2006; 50: 498 - 504. [ Links ]
11. Schwaber MJ, Carmeli Y. Mortality and delay in effective therapy associated with extended-spectrum Ê-lactamase (ESBL)-production in Enterobacteriaceae bacteraemia: a systematic review and meta-analysis. J Antimicrob Chemother 2007; 60: 913-920. [ Links ]
12. Cornaglia G, Akova M, Amicosante G, et al. Metallo-p-lactamases as emerging resistance determinants in Gram-negative pathogens: open issues. Int J Antimicrob Agents 2007; 29: 380-388. [ Links ]
13. Chopra I, Schofield C, Everett M, et al. Treatment of health-care-associated infections caused by Gram-negative bacteria: a consensus statement. Lancet Infect Dis 2008; 8: 133-139. [ Links ]
14. Talbot GH, Bradley J, Gilbert D, et al. Bad bugs need drugs: An update on the development pipeline from the antimicrobial availability task force of the Infectious Diseases Society of America. Clin Infect Dis 2006; 42: 657-668. [ Links ]
15. Brink AJ. Multidrug-resistant (MDR) Gram-negative fermentors: 'Our worst nightmare?' Editorial. S Afr J Epidemiol Infect 2007; 22: 2-4. [ Links ]
16. Richards GA. The therapeutic challenge of Gram-negative sepsis: Prolonging the lifespan of a scarce resource. Clin Microbiol Infect 2005; 11(S6): 18-25. [ Links ]
17. Martinez JA, Aguilar J, Almela M, et al. Prior use of carbapenems may be a significant risk factor for extended-spectrum p-lactamase producing Escherichia coli or Klebsiella pneumoniae in patients with bacteraemia. J Antimicrob Chemother 2006; 58: 1082-1085. [ Links ]
18. Molstad S, Erntell M, Melander E, et al. Sustained reduction of antibiotic use and low bacterial resistance: 10-year follow-up of the Swedish Strama programme. Lancet Infect Dis 2008; 8: 125-132. [ Links ]
19. Delitt TH, Owens RC, McGowen JE, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007; 44: 159-176. [ Links ]
A Brink


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From Rodney in Denver:
I've been thinking of ways to get more people to use mass transit. I thought making transit passes tax deductible would be a good idea… I'm curious what your thoughts are on this idea?
Well Rodney, having just finished my own taxes, I think it's a pretty darn good one. There's a deduction for people who buy hybrids; there's mileage credit for folks who drive for business purposes; there's even a sales tax deduction for major purchases (like cars and boats). Why no love for transit types?
I think the trick is in the implementation. A deduction for buying a transit pass wouldn't be very substantial (given that the cost of passes isn't very substantial) and therefore wouldn't provide much of an incentive to buy one. If the deduction was much more than the cost of the pass (in other words, closer to the social benefit of driving less), we'd have to require folks to prove that they actually rode.
Soon, most transit systems will have the technology to measure actual transit usage, and we'll be able to reward (through tax breaks and other fabulous prizes) frequent riders. Until then, I'll take the transit-pass deduction. And the free food at transit fests.


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Regional Leaders Tell DR Congo Rebels to 'Stop War'إقرأ هذا الخبر بالعربية
Regional leaders called on DR Congo rebel group M23 Saturday to end hostilities and leave a key eastern town they seized in a rampant advance that has sparked fears of a wider conflict.
The meeting of east African heads of state went forward without a key player -- Rwandan President Paul Kagame, whose country the United Nations accuses of backing the rebels -- and wrapped up after less than an hour.
In their closing statement, the leaders called on the rebels to "stop all war activities" and "stop talk of overthrowing an elected government".
Kagame, whose country denies backing the M23, had been expected to attend the meeting in the Ugandan capital.
But a Ugandan foreign ministry official told AFP shortly before the summit that the president was not coming and would instead be represented by his foreign minister, Louise Mushikiwabo. No reason was provided for the absence.
A Ugandan official had earlier said that both Kagame and DR Congo President Joseph Kabila would attend, and that without them the summit would be "meaningless".
The international community has voiced alarm over the lightning advance by the M23 in DR Congo's mineral-rich but underdeveloped eastern Kivu region, where the insurgents seized the regional capital of Goma and another key town nearby in less than a week.
The advance has displaced tens of thousands of civilians, sparked warnings of a humanitarian disaster, and raised fears that a wider conflict could again erupt in the area, the cradle of back-to-back wars that shook DR Congo from 1996 to 2002.
DR Congo leader Kabila flew in for Saturday's summit in Kampala, which also included the presidents of Uganda, Kenya and Tanzania.
An M23 delegation was also in Kampala, but not at the summit, which is officially reserved for the nations of the 11-member International Conference on the Great Lakes Regions.
M23's political leader Jean-Marie Runiga Lugerero expects to hold separate talks with Ugandan President Yoweri Museveni later in the day.
"There has not been a meeting yet. We are still waiting," said Rene Abandi, head of external relations for M23's political wing.
The rebels captured Goma, the capital of North Kivu province, on Tuesday after less than a week of fighting, before taking the key town of Sake 20 kilometers (12 miles) to the west the next day.
Reports on Saturday said the situation was calm but tense in both towns.
DR Congo's Kabila had met with the leaders of Rwanda and Uganda immediately following the fall of Goma and the three leaders issued a joint statement urging the rebels to pull out of the city.
The M23 has refused to withdraw unless Kabila agrees to direct peace talks with the group.
The United Nations has also accused Uganda of backing the M23 rebels, charges that it, like Rwanda, denies.
Rwanda's president Kagame was due to hold talks with his counterpart from the Republic of Congo, Denis Sassou Nguesso, later Saturday, according to sources in both capitals.
Members of Sassou's delegation had already arrived Friday in the Rwandan capital.
In DR Congo's capital Kinshasa, the interior ministry temporarily banned peace protests Saturday, blocking students from holding a planned rally.
"The interior ministry said demonstrations were banned to give diplomacy a chance," student leader Dieumerci Bebeto told AFP.
An interior ministry source confirmed the ban on condition of anonymity.
"Not all demonstrations are banned. There are certain demonstrations that are liable to lead to destruction and violence, and those are temporarily suspended," the source said.
The move came after several thousand women, including Justice Minister Wivine Mumba Matipa and several lawmakers, marched Friday against the violence.
Protesters have staged demonstrations in several DR Congo cities since the rebels seized Goma, sometimes turning violent and throwing stones. Three people died at a protest in Kisangani, the capital of the eastern province of Orientale, according to U.N.-sponsored broadcaster Radio Okapi.
The U.N. has come in for criticism at the rallies, where protesters have accused its peacekeepers of not doing enough to stop the rebels.
The M23 was launched by former fighters in an ethnic Tutsi rebel group that was integrated into the military under a 2009 peace deal whose terms the mutineers say were never fully implemented.
The two DR Congo wars of 1996-2002 both started in the volatile Kivu region in the east of the country.


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I can't help but notice the songspeak site has had some banner ads for the McCain/Palin campaign lately. I can only imagine this is because we've had a few McCain and Palin related posts recently, but rest assured that we here at Songspeak in no way, shape, or form support the McCain/Palin ticket.
So it bothers me that ads for them are popping up on the site. Why should it look like we're promoting someone that we don't support, nor agree with? Worse yet, the ad looks like some sort of satire, repeating the "maverick" catchphrase over and over. This whole maverick idea is one of the most ridiculous things I've seen in politics, and reeks of pandering to the lowest common denominator. "Hey, Joe Six-Pack! We're mavericks! We're gonna shoot up Washington with change…YEE-HAAAWWWWWW!" The whole thing seems like one big (sad) joke. But it's for real. Frightening. (Never mind that I don't understand how a candidate like McCain that has served in the senate for 22 years can pretend that he'd be "change").
Everyone knows that the ORIGINAL mavericks are the Ford Maverick, James Garner (who played Maverick in the TV series that ran from 1957 to 1962), Tom Cruise (who played Maverick in the 1986 hit movie Top Gun), and Mel Gibson (who played Maverick in the 1994 movie version of the TV series). And even though one is a car, and two of them are total whackjobs now, I'm confident that ANY of them would make a better Vice President (or President) than Sarah Palin. Especially the car.