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Allen leads resurgent Arkansas passing attack
FAYETTEVILLE, Ark. (AP) Bret Bielema left little doubt about the foreseeable future when he said returning starter Brandon Allen had pulled away from the rest of the Arkansas quarterbacks following a scrimmage last week.
The Arkansas coach had good reason for his declaration, both for Allen and the rest of the Razorbacks.
Despite an injury-plagued and disappointing season a year ago in his first as the starter, Allen has been at the forefront of a surge in optimism surrounding the passing game at Arkansas this spring.
Whether the newfound comfort level will translate to an improvement in the Southeastern Conference's worst aerial attack from a year ago won't be known until the fall.
Until then, the pressure is squarely on Allen's shoulders to show how far Arkansas has come since bottoming out in Bielema's first season – a 3-9 debacle that saw the Razorbacks go winless in the SEC for the first time since joining the league in 1992.
By all accounts, and based on a pair of open scrimmages, the early results this spring have shown that Allen no longer resembles a first-year starter struggling to pick up offensive coordinator Jim Chaney's offense.
This is the junior's team, for better or worse, and he wouldn't have it any other way leading into next week's spring game.
"I think last year at this time a lot of people weren't on the same page at all," Allen said. "… Right now, (the offense) is pretty much honed. I think the older guys have done a good job of teaching it to the younger guys. We're definitely a lot better schemed right now."
Arkansas spent last spring practicing in Bielema's system for the first time. The pace and setup of practice, along with the passing routes and play calls, were all vastly different than under former coaches Bobby Petrino and John L. Smith.
The results were nothing short of disastrous in the passing game, where the Razorbacks finished last in the SEC with an average of 148.5 yards passing.
Allen, in his first season as the starter, didn't fare much better while working his way through an early season shoulder injury for much of the year. The Fayetteville native and son of a former Arkansas assistant coach had the worst passer rating of any SEC starter, completing 128 of 258 passes (49.6 percent) while throwing 13 touchdowns and 10 interceptions.
The lack of success through the air was difficult for many in the state to watch, particularly after the school had become accustomed to fielding one of the top passing offenses in the country under Petrino.
The criticism, particularly of the injured Allen, was even more difficult to read and hear for the quarterback's family – including Arkansas backup quarterback Austin Allen, the younger brother of the starter.
"It's tough when you see Twitter and all that stuff and you see what people say about him," Allen said. "But we both have tough skin; that's just how my parents raised us."
With last season's struggles behind him, and his shoulder completely healed, Brandon Allen returned to the practice field this spring with the intention on proving – to his teammates and himself – that he was the unquestioned starter for the Razorbacks.
He's done just that so far, completing 26 of 35 passes (74.3 percent) for three touchdowns and one interception through two open scrimmages.
The latest performance was what caused Bielema to say Allen has "separated himself" from his younger brother and any other challengers, a vote of confidence Allen said showed Bielema "has the trust in me to lead this offense and do good things for us."
Bielema's confidence in Allen is also shared by Chaney, the former Tennessee offensive coordinator who has praised the progress of both the quarterback and the offense overall. Chaney said he's been able to call plays this spring without last year's learning curve, and Allen has played a large role in that.
All that's left is to carry forward this spring's progress into next season, something Chaney has little doubt is on deck for Allen and the rest of the offense.
"I don't think Brandon's scratched the surface yet on the type of player he can be, and I look forward to watching him become that," Chaney said.


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From the most basic portfolio building blocks to specialized funds that give investors access to niche markets, ETFs cover them all, and with the constant launches and filings of new ETFs it is easy to forget about some "older" funds on the market. Although there are numerous new funds already in the pipeline, taking a step back and looking at the performance of ETFs that have been on the market for a while paints a vivid picture of just how far the industry has come [see also 5 Worst ETF Strategies Of The Last 5 Years].
This month marks the one-year anniversary of three offerings from issuers Global X, Direxion and RBS. Since December 2011, these ETPs have weathered poor market conditions and proved that their strategies are here to stay. Combined, these four funds have accumulated over $38 million and counting in total assets over the last year [see The 5 Most Important Chart Patterns For ETF Traders].
Below we check on the one-year performance of these ETFs:
FTSE Greece 20 ETF ( GREK)
As Greece continues to struggle through economic recovery efforts and increasing supervision from other European nations, GREK allowed ETF investors to see just how volatile the country is. The index this ETF tracks offers unparalleled exposure, as it is comprised of the top 20 companies that are domiciled in, principally traded in, or whose revenues are primarily from Greece.
As far as first years go, GREK's performance was a roller coaster ride, with a 200-day moving average of nearly 50%. Despite this, Global X's fund managed to end the the year with a 11% return. Investors who saw an opportunity to invest in June are having the best six months by far, with a 76% return since the fund bottomed out this summer [see also Get Rid Of Your Emerging Market Volatility Once And For All].
All Cap & Large Cap Insider Sentiment Shares ( KNOW, INSD)
Direxion launched two new ETFs at the end of last year, both of which select 100 different stocks from either the S&P 500 or the S&P 1500 by Sabrient Systems. KNOW allows investors to isolate stocks in the S&P that Sabrient considers favorable based on corporate insider action instead of traditional cap weighting, while INSD takes this method a step further to limit any small or micro-cap companies from its list.
These funds have followed the total market trend pretty closely since inception, with KNOW exaggerating every gain and loss in the market while INSD reacts more slowly and has had lower returns than the S&P 500. Both ETFs have a heavy tilt towards financial services, but while KNOW focuses on technology and healthcare, INSD may feature less volatility by instead picking industrial and consumer defensive firms [see High Tech ETFdb Portfolio ].
NASDAQ-100 Trendpilot ETN ( TNDQ)
RBS introduced its own "Trendpilot" product to the ETP universe, which tracks either the NASDAQ-100 Total Return Index or the yield on a hypothetical notional investment in three-month U.S. Treasury bills, depending on the relative performance of the underlying equity index. When the NASDAQ-100 Total Return Index is at or above its 100-day simple moving average, TNDQ goes long the underlying securities. However, if the same index closes below its 100-day simple moving average for five consecutive sessions, TNDQ automatically shifts exposure into short-term U.S. Treasuries [see also 101 High Yielding ETFs For Every Dividend Investor].
Until June, TNDQ did follow the NASDAQ 100, but as the index fell TNDQ switched to flat returning three-month U.S. Treasury bills, and subsequently missed the momentum regained in August. The trendpilot strategy cut the year-end return in half, but TNDQ will still return 8.66% for its long-term investors on its one-year anniversary.
[For more ETF analysis, make sure to sign up for our free ETF newsletter or try a free seven day trial to ETFdb Pro]
Disclosure: No positions at time of writing.
Click here to read the original article on ETFdb.com.
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subset: commoncrawl


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N.Y. first state to tighten gun laws after Newtown
New York Gov. Cuomo signed a bill into law Tuesday, to restrict gun sales and require reporting of threats by mentally ill. (Jan. 15) AP
Parts of the new law take effect immediately.
ALBANY, N.Y. — New York Gov. Andrew Cuomo signed a package of tougher gun measures Tuesday, soon after the state Assembly voted to bolster the state's ban on assault weapons and high-capacity magazines.
The Democrat-dominated Assembly passed the provision Tuesday by a 104-43 vote after the state Senate approved it by a wide margin late Monday.
STORY: N.Y. law allows gun data to stay private
STORY: States reworking gun laws
The signing makes New York the first state to enact tighter restrictions on guns after the Dec. 14 massacre in Newtown, Conn., in which 28 people died including 20 children.
"I am proud to be a New Yorker today," Cuomo said shortly before signing the bill. "I am proud to be part of this government, not just because New York has the first bill, but because New York has the best bill."
The gun-control package makes changes and additions to a broad swath of state law, ranging from requiring universal background checks for all gun and ammunition sales, boosting the state's power to confiscate firearms from the mentally ill and increasing penalties for gun-related crime.
"We proceeded, one month after the tragedy of Sandy Hook, to say to the nation: It's not acceptable to ignore the common-sense things governments can do to stem gun violence," said Senate Democratic Leader Andrea Stewart-Cousins of Yonkers.
The new laws provide for an immediate ban on semi-automatic rifles, shotguns and pistols with a "military-style feature," such as a flash suppressor or a bayonet mount. Guns that had been legal but are being banned would be grandfathered in, but their owners must register their firearms with the state or sell them out of state within one year.
Magazines are limited to a maximum capacity of seven bullets, down from the current 10.
The legislation includes a "Webster provision," a life-without-parole sentence for anyone convicted of killing a first responder. The provision is a reference to the Christmas Eve shooting in a Rochester, N.Y., suburb where two firefighters were shot and killed.
An additional provision permits gun licensees to opt out of having their personal information available to the public under the state's Freedom of Information law. It was inserted in response to a controversy that erupted after The (Westchester, N.Y.) Journal News published an interactive map with names and addresses of handgun-permit holders in two suburban New York counties.
For the first 120 days of the new law, no information on gun licenses will be available to the public, then the opt-out provision will take effect. People who already have licenses will be able to fill out a form at their county clerks' offices to opt out.
Criticism from gun rights advocates and a number of Republicans in the state Legislature was swift.
The National Rifle Association, which had previously labeled Cuomo as "America's most-anti-gun governor," expressed "outrage" at the "draconian gun-control bill that was rushed through the process."
"Gov. Andrew Cuomo and the New York State Legislature orchestrated a secretive end-run around the legislative and democratic process and passed sweeping anti-gun measures with no committee hearings and no public input," the lobbying group wrote in a statement.
The Assembly's debate on the package stretched for more than 4 1/2 hours Tuesday. Various Republicans expressed dissatisfaction with it and with Cuomo's decision to allow a vote without the mandatory three-day aging period. Cuomo issued a "message of necessity," which allows lawmakers to vote on a bill immediately after it is introduced.
New York came one step closer to enacting tougher gun laws on Monday, with the state Senate approving a set of broad changes in a late-night Monday vote and the Assembly expected to act early Tuesday.
Assemblyman Steve Katz, a Republican from the New York City suburb of Yorktown, said the bill — known as the New York Secure Ammunition and Firearms Enforcement Act, or NY SAFE — is based on Cuomo's "misguided, egotistic notion that this will advance his presidential aspirations."
"Why are we being bullied into voting on this bill without proper, responsible due diligence?" Katz asked.
Others have accused Cuomo of trying to seize headlines by rushing a bill through the Legislature to become the first state to act after Newtown.
"Cuomo seized the opportunity to exploit tragedy and put his own personal politics ahead of sound public policy," the NRA wrote in an alert sent to its members.
Cuomo defended his decision to rush the legislation to a vote, which he said was in part to prevent a run on sales of soon-to-be-banned assault weapons.
"As soon as people found out that I was proposing a specific law that was going to ban the sale of assault weapons, we were afraid it would actually cause a rush on the market on people who wanted to buy assault weapons," Cuomo told reporters.
The new gun laws received praise from New York City Michael Bloomberg, a staunch gun-control advocate whose Mayors Against Illegal Guns initiative has aired television advertisements pushing for tougher laws.
"The responsible and comprehensive gun reform bills the governor signed into law today will help keep guns away from criminals and others who are already prohibited from purchasing them," Bloomberg said in a statement.
Contributing: Joseph Spector and Jessica Bakeman, Gannett Albany Bureau


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An organic mountain farm uses indigenous breeds to produce high-quality meat, while preserving the local environment and genetic resources.
Projects & Practice
The future-proof peat meadow polder 'Lange Weide', is unique bottom-up initiative and the largest submerged drainage project in the Netherlands.
Adjustments to water management and remedial measures help to preserve protected areas and conserve the landscape of the Western Langstraat.
A farm employing people with special needs set up a process line and an experimental kitchen, where non-commercial agricultural produce can be turned into new products.
The project made an Ekso Bionics Exoskeleton available to patients in rural areas. This enables community rehabilitation of patients recovering from spinal injuries, strokes and brain injuries.
A land consolidation project helped restore the functionality of vineyard terraces and thus maintained a landscape which is a habitat of rare species.
A community project in which young people actively participated in shaping their environment and strengthened the cohesion of their community.
A leading manufacturer of conserves and jams used RDP support to increase its winter water storage capacity for use during the summer dry months.
The project supported the construction of a water supply network in the village of Reka, ensuring that all inhabitants have adequate access to water.
A project that supports the integration of young immigrants into Swedish society and is organised by young immigrants themselves.


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Halfway between the famed Dunn's River Falls of Ocho Rios and the historic town of Falmouth you'll find Runaway Bay, Jamaica, a lush tropical paradise. Whether you are planning a quiet and romantic getaway, or just fun, sun, and adventure, you'll love the gorgeous views, white sand beaches, sunny weather, and easy, laid-back attitude. Enjoy an intimate trip for two in a beautiful rental home, or a quality family holiday in a beachfront house. There are many activities from water sports, to golf, to spas, restaurants, and more. A Runaway Bay holiday rental is a beautiful, quiet, and exotic Caribbean getaway.
Snorkeling is really fun and colorful off the coast of Runaway Bay, as the reefs are close to shore and the waters are full of tropical fish. Canyon Wall is a must-see spot for divers, as well as a number of other protected dive sites with sunken boats. Awesome beach and snorkel is just a few sandy footsteps from your villa rental.
Explore the Green Grotto Cave Complex, play a great round of golf at the Breezes Runaway Bay Golf Club, or go horseback riding at Chukka Caribbean Adventures.
In neighboring Ocho Rios, climb the guided Dunn's River Falls waterfall walk. The falls are a slow climb and lots of fun, but you should be in good walking shape as you'll be covering some slippery stones under the water. Be sure to bring sneakers or good water shoes, and your swimsuit.
Take a day trip to nearby, historic Falmouth for a unique and relaxing way to spend the afternoon. Take a bamboo raft down the river and sail by the unique, local river and fishing life. When in town, enjoy shopping for local crafts and the colonial architecture. On your way back to your holiday rental stop off at a local jerk chicken vendor so that you can enjoy the flavor and aroma all the way home. From your Runaway Bay holiday rental, relax in the Caribbean sun with quiet coves, endless peaceful sun-kissed beaches and shady hammocks. The combination of white sands and sapphire waters will make you want to stay in Jamaica forever.
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Change address
Unless you use Premium for Family, you don't need to register your address with Spotify.
You can travel the globe and take Spotify with you without needing to change anything on your account. Find out more about your country settings.
Got Premium for Family?
It's not possible to change the address registered on an existing Premium for Family plan.
If you move, or enter the wrong details, you need to create a new account (make sure you cancel the plan on your old account and sign out everywhere beforehand), then subscribe to Premium for Family on that new account.


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Unless you're one of those impermeable-to-pain wonderbabes who can wear 4-inch heels all day long without ever flinching (we know you, and we salute you), you've probably spent some time searching for comfortable, stylish pumps. Truth be told, this is one of our loftiest goals — to finally find a pair of heels that don't feel like a pair of heels.
While flats and wedges are perfectly acceptable in our style book, sometimes you just need that leg-lengthening, confidence-enhancing boost that a great pair of heels provides. And so, here you go: a handy guide to the most stylish, work-friendly footwear hitting shelves for spring. With walkable heels and sturdy-meets-comfy designs, these are the options you'll reach for every morning. Just call us heelhunters, if you like.


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How to Use the Images
Photos 1 & 2
Photos 1 & 2
Lincoln practiced arithmetic problems in a sum book made of folded paper and stitched in the middle. Historians believe that Lincoln practiced these problems in 1824 when he was 15 years old.
Note the verse in the lower left corner:
Questions for Illustrations 1 & 2
In Illustration 2, Lincoln assigned himself the problem of multiplying 342,435 by 342. Attempt to solve this problem. Once you have your answer, you can check it just like Abraham checked his. He used a technique called the "Rules of Nines." Follow the directions below.
1. First draw a sizeable X on your paper and put an "A" on the right side of the X, a "B" on the left side, a "C" on top, and a "D" on bottom.
2. What do you get when you add together all the numerals in the multiplicand? Add the numerals in 342,435 or: 3 + 4 + 2 + 4 + 3 + 5.
3. Add together the numerals that make up the multiplier of 342 (3 + 4 + 2).
4. Finally, add up the numerals in your product (the answer you got when you multiplied 342,435 by 342. That's ___ + ___ + ___ + ___ + ___ + ___ + ___ + ____ + ___.
5. What was the number you got when you added up the numerals in the multiplicand? (Your answer for #1) Divide this number by 9. Put your remainder in the big "X" below, right next to the letter A.
6. What did you get when you added up the numerals in the multiplier? (Your answer for #2) Divide that number by 9 and put the remainder in the "X" by the letter B.
7. Now do the same thing with the number you got once you added the numerals in the product. Put the remainder in the top of the "X", next to the letter C.
8. Here are the last three steps. Multiply together the number you put next to A with the number you put next to B. Divide by 9 one last time and put your remainder next to D, in the bottom of the "X."
9. Is the number you put in the top of the "X" (near the C) the same as the number in the bottom of the "X" (near D)? Then your multiplication is correct! Did you get an X that looks like the one by Lincoln?
* The images on this screen have a resolution of 72 dots per inch (dpi), and therefore will print poorly. You can obtain a larger version of Illustration 1 and Illustration 2, but be aware that each file will take as much as 60 seconds to load with a 28.8K modem.


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This Flashback was prompted by a recent gathering in Hamilton of digital designers, who were asked to re-imagine Jackson Square , especially it's underwhelming front entrance. These shots from the Spec Archives show a what the area looked like before construction.
One thought on "Flashback: Jackson Square"
Thanks for publishing the picture of skaters. It was my idea as CKOC broadcaster to make use of the empty lot for a natural ice rink. We ran a promotion and filled the space with winter fun. Forecourt of City Hall would have been a good location after the reno.
Bob Bratina
Comments are closed.


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Hello and welcome to the XTS Talen Merchant Mod V1 This mod adds a Female merchant to the Imperial City Market district. She has some very usefull spells fora certaion point in the game when u may need them. As well as much more. She can Buy certain items at full price, Sells new Spell powers, Rechanges Magicle items, Repairs Magicle items, Shs is a master or Illusion and can Train. To install 1 - Drop the XTSTalenTheMerchantV1.esp into C:\Program Files\Bethesda Softworks\Oblivion\Data 2 - Dubble click the Oblivion short cut and instead of clicking Play click Data Files 3 - Click the XTSTalenTheMerchantV1.esp so it has A in the box 4 - Click ok and then Play. You MUST Donnload this mod from = Downloads / TES Modding / Oblivion Made by Xtreme Team Studios, enjoy the mod !
Only registered members can share their thoughts. So come on! Join the community today (totally free - or sign in with your social account on the right) and join in the conversation.


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"Slithering", the new video from Portuguese extreme progressive metallers MALEVOLENCE, will make its online debut on Friday, November 2. The track comes off the band's upcoming third full-length album, "Antithetical", which was written and produced by Carlos Cariano, recorded by Paulo Pereira at 20m2sea Studio (Portugal), and mixed and mastered at Woodshed Studio (Germany) by V. Santura (TRIPTYKON, OBSCURA, PESTILENCE).
Commented Carlos: "[For the 'Slithering' video], we worked with 4therecords, a young company producing mainly short films and commercials. 'Slithering' is their boldest achievement to date and we are truly pleased with the visual quality of our first cooperation with this entity. The support of 4therecords was central and decisive to attain the professional final results."
The follow-up to 1999's "Martyrialized", "Antithetical" features the lineup that recorded "Martyrialized", including core members Carlos Cariano (vocals, guitar), Aires Pereira (bass), Fred Noel (guitar), Paulo Pereira (keyboards) alongside session drummer extraordinaire Dirk Verbeuren (SOILWORK, THE DEVIN TOWNSEND PROJECT, JEFF LOOMIS).
The main theme of "Antithetical" illustrates a razor-sharp concept inspired from Ancient Greek Etymology (1580s, from Gk. Antithetikos) that reflects the diametrical opposition to a number of propositions consisting in the revelation of a divergent thought. Pertaining to "Antithetical", the Anti (against) + Thesis (position), as a figure of speech (mainly used by the authors of the Baroque period; style of the epoch known as the art of conflict) acknowledge opposition towards the relative thesis expressed.


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Biopsy(redirected from sternal biopsy)
Also found in: Dictionary, Thesaurus, Encyclopedia.
removal and examination, usually microscopic, of tissue from the living body, often to determine whether a tumor is malignant or benign; biopsies are also done for diagnosis of disease processes such as infections.
aspiration biopsy one in which tissue is obtained by application of suction through a needle attached to a syringe.
brush biopsy one in which the sample is obtained by a brush with stiff bristles introduced through an endoscope, such as for a tissue sample from an inaccessible place such as the renal pelvis or bronchus.
chorionic villus biopsy chorionic villus sampling.
cone biopsy one in which an inverted cone of tissue is excised, as from the uterine cervix.
endoscopic biopsy removal of tissue by instruments inserted through an endoscope.
excisional biopsy removal of biopsy tissue by surgical cutting, such as a lumpectomy.
fine-needle aspiration biopsy aspiration biopsy using a fine needle. For superficial tissue such as the thyroid, breast, or prostate the needle is unguided, but for deep tissue it must be guided radiologically.
incisional biopsy biopsy of a selected portion of a lesion.
needle biopsy (percutaneous biopsy) one in which tissue is obtained by insertion through the skin of a special type of needle (see biopsy needle).
punch biopsy one in which tissue is obtained by a punch-type instrument.
sentinel node biopsy biopsy of a sentinel node (the first lymph node to receive lymphatic drainage from a malignant tumor). It is identified as follows: a dye and a radioactive substance are injected into the body, which causes certain nodes to "light up" like a sentinel, indicating that they are the most appropriate ones for examination. They are detected by both the light created by the dye and the radioactive substance that is monitored by a gamma camera. If the sentinel nodes do not contain malignant cells, this usually eliminates the need for removal of more distal nodes. Called also intraoperative lymphatic mapping.
shave biopsy biopsy of a skin lesion by excising it with a cut parallel to the surface of the surrounding skin.
stereotactic biopsy biopsy of the brain using a stereotactic technique to locate the biopsy site. This can be done as a minimally invasive surgery technique. The patient's head is held in a special rigid frame so that a probe can be directed into the brain through a small hole in the skull.
sternal biopsy biopsy of bone marrow of the sternum removed by puncture or trephining; see also sternal puncture.
bi·op·sy (Bx),(bī'op-sē),
1. Process of removing tissue from patients for diagnostic examination.
2. A specimen obtained by biopsy.
[bio- + G. opsis, vision]
biopsy/bi·op·sy/ (bi´op-se) removal and examination, usually microscopic, of tissue from the living body, performed to establish precise diagnosis.
aspiration biopsy biopsy in which tissue is obtained by application of suction through a needle attached to a syringe.
brush biopsy biopsy in which cells or tissue are obtained by manipulating tiny brushes against the tissue or lesion in question (e.g., through a bronchoscope) at the desired site.
cone biopsy biopsy in which an inverted cone of tissue is excised, as from the uterine cervix.
core biopsy , core needle biopsy needle biopsy with a large hollow needle that extracts a core of tissue.
endoscopic biopsy removal of tissue by appropriate instruments through an endoscope.
excisional biopsy biopsy of tissue removed by surgical cutting.
incisional biopsy biopsy of a selected portion of a lesion.
needle biopsy biopsy in which tissue is obtained by puncture of a tumor, the tissue within the lumen of the needle being detached by rotation, and the needle withdrawn. Called also percutaneous b.
percutaneous biopsy needle b.
punch biopsy biopsy in which tissue is obtained by a punch.
shave biopsy biopsy of a skin lesion in which the sample is excised using a cut parallel to the surface of the surrounding skin.
stereotactic biopsy biopsy of the brain using stereotactic surgery to locate the biopsy site.
sternal biopsy biopsy of bone marrow of the sternum removed by puncture or trephining.
n. pl. biop·sies
1. The removal and examination of a sample of tissue from a living body for diagnostic purposes.
2. A sample so obtained.
tr.v. biop·sied, biop·sying, biop·sies
To remove (tissue) from a living body for diagnostic purposes.
bi·op′sic (bī-ŏp′sĭk), bi·op′tic (-tĭk) adj.
Etymology: Gk, bios + opsis, view
1 the removal of a small piece of living tissue from an organ or other part of the body for microscopic examination to confirm or establish a diagnosis, estimate prognosis, or follow the course of a disease.
2 the tissue excised for examination.
Usage notes: (informal)to excise tissue for examination. Kinds of biopsy include aspiration biopsy, needle biopsy, punch biopsy, and surface biopsy. bioptic [bī·op′tik] , adj.
biopsy(1) A surgical procedure in which a small piece of tissue is removed from a patient.
(2) The tissue itself; the histological changes seen in the biopsy are interpreted by a pathologist, usually under a microscope, who renders a diagnosis based on relatively standard morphologic criteria.
Many biopsies are performed in an ambulatory ("outpatient") setting and can be obtained by direct visualisation, or during an endoscopic procedures of the GI tract and elsewhere; when a suspicious lesion is detected, a small pincer is inserted through a fiberoptic endoscope, and a small portion removed for microscopic evaluation; usually, the tissue is fixed, processed in various solvents, embedded in paraffin, stained and examined by light microscopy. Less commonly, other techniques—e.g., immunofluorescence and electron microscopy—may be required to establish a diagnosis. While an experienced pathologist can readily evaluate most biopsy specimens, there are instances in which the tissue diagnosis cannot be made; in these cases, the specimen is sent to expert consultants for further evaluation.
Reasons for performing biopsy
(1) Diagnosis disease;
(2) Determine extent of disease—e.g., metastasis in cancer;
(3) Determine adequacy of surgical removal—e.g., tumours.
biopsynoun A term for
1. A surgical procedure in which a small piece of tissue is removed from a Pt.
2. The tissue itself; the changes in the biopsy are interpreted by a pathologist, usually under a microscope, who renders a diagnosis based on relatively standard morphologic criteria. See Abdominal wall fat pad biopsy, Agonal biopsy, Aspiration biopsy, Biochemical biopsy, Blastocyst biopsy, Blind biopsy, Bone marrow aspiration & biopsy, Breast biopsy, Cervical biopsy, Chorionic villus biopsy, Cleavage stage biopsy, Cold cone biopsy, Cone biopsy, Core biopsy, Endobronchial biopsy, Endometrial biopsy, Endomyocardial biopsy, Endoscopic biopsy, Excisional biopsy, Fine needle aspiration biopsy, Guided wire open biopsy, Heart biopsy, Incisional biopsy, Jumbo biopsy, Metabolic biopsy, Microbiopsy, Mirror image biopsy, Muscle biopsy, Needle biopsy, Nerve biopsy, Open biopsy, Open lung biopsy, Pleural biopsy, Polar body biopsy, Prostate biopsy, Punch biopsy, Renal biopsy, Salivary gland biopsy, Saucerization biopsy, Sentinel lymph node biopsy, Sextant biopsy, Shave biopsy, Skin biopsy, Skinny biopsy, Skinny needle biopsy, Small intestinal biopsy, Stereotactic biopsy, Stereotactic needle biopsy, Transbronchial needle biopsy, Transbronchial biopsy, Wedge biopsy, Wire-guide excisional biopsy.
1. Process of removing tissue from living patients for macroscopic diagnostic examination.
2. A specimen obtained by brush or needle and syringe aspiration for biopsy.
[bio- + G. opsis, vision]
biopsy(bi'op?se) [ bio- + -opsy],
A tissue sample removed from the body for microscopic examination, usually to establish a diagnosis. The tissue can be obtained surgically or by aspiration. The procedure can be guided by computed tomography, ultrasonography, magnetic resonance imaging, or radiography, or it can be performed without imaging, i.e., "blindly".
aspiration biopsyNeedle biopsy.
blind biopsy
A biopsy taken without radiographic guidance or strong evidence of localized disease.
brush biopsy
The removal of cells from an organ by rubbing them loose.
cone biopsy
Removal of a cone shaped piece of tissue from the uterine cervix to diagnose or treat cervical diseases. The procedure may be performed with a scalpel, carbon dioxide (CO2) laser, or Loop Electrosurgical Excision Procedure (LEEP).
endometrial biopsy
The removal of a sample of uterine endometrium for microscopic study. The procedure is commonly used in fertility assessment to confirm ovulation and to determine the cause of dysfunctional or postmenopausal bleeding.
fine needle aspiration biopsyAbbreviation: FNA biopsy
The removal of cells or tissue through a long, narrow-gauge needle with or without radiological guidance.See: illustration
fine-needle nonaspiration biopsyFine-needle capillary sampling.
liver biopsy
1. The percutaneous removal of tissue from the liver with a large-bore needle that captures a core of tissue.
2. A wedge of the liver obtained during laparotomy or laparoscopy.
muscle biopsy
The removal of muscle tissue for microscopic examination and chemical analysis.
needle biopsy
The withdrawal of fluid or tissue by means of negative pressure applied with needle and syringe.Synonym: aspiration biopsy
percutaneous breast biopsy
Use of a directional, high-speed, rotating cutter attached to a vacuum source to gather multiple contiguous core samples of breast tissue through a single point of insertion. This minimally invasive procedure is usually performed under local anesthesia, using stereotactic imaging or real-time ultrasonography.
percutaneous renal biopsy
Obtaining renal tissue for analysis with a needle inserted through the skin, usually done after the kidney has been localized by ultrasound, computed tomography, or angiography. This technique is used to establish a diagnosis of renal dysfunction, determine prognosis in patients with renal disease, evaluate the extent of renal injury, and determine appropriate therapy. The most common complication is urinary bleeding, which tends to clear gradually over several days.
percutaneous transthoracic needle aspiration biopsy
Use of a radiographically guided aspiration needle to obtain a sample of tissue in cases of suspected pulmonary malignancies or other unknown lesions. Because of the risk of pneumothorax, the procedure is usually contraindicated in patients receiving mechanical ventilation.
punch biopsy
The removal of a small piece of tissue (usually of the skin) with a hollow, round cutting tool.
sentinel node biopsy
A technique for identifying the initial site of cancer metastasis. After injection of a radioactive tracer directly into the tumor mass, the tissue is massaged to encourage uptake of tracer by lymphatic vessels. A negative biopsy of the first node infiltrated by the tracer suggests that the malignancy has not yet spread to neighboring regional lymph nodes.
shave biopsy
Removal of a shallow layer of skin with a cutting instrument, e.g., a scalpel, sawing parallel to the skin surface. A shave biopsy may leave a small depression in the skin.
CAUTION!It should not be used to remove lesions suspected for melanoma or lesions that seem to have significant depth.
suction biopsy
A technique for obtaining tissue by aspiration, e.g., to obtain tissue from the mucosa of the stomach and intestines.
vacuum-assisted biopsy
A biopsy technique in which a hypodermic probe is placed through the skin into an organ of the body (such as the breast), and negative pressure is used to draw one or more samples into a chamber, where they are captured and removed for analysis under a microscope.
biopsyA small sample of tissue, taken for microscopic examination, so that the nature of a disease process can be determined. Breast biopsies are commonly done to investigate suspicious lumps. Suspicious skin growths are normally biopsied, and in the course of surgery under general anaesthesia, it is common for biopsies to be taken. The tissue obtained is soaked in molten paraffin wax and allowed to harden into a block. Very thin slices are then cut and mounted on glass slides for staining and examination by a histopathologist.
biopsythe surgical removal of small amounts of tissue for examination to aid a diagnosis.
Removal of a small piece of tissue for microscopic examination. This is done under local anesthesia and removed by either using a scalpel or a punch, which removes a small cylindrical portion of tissue.
Mentioned in: Abdominal Ultrasound, Actinomycosis, Acute Lymphangitis, Anal Cancer, Balantidiasis, Bladder Cancer, Blastomycosis, Bone Biopsy, Brain Abscess, Breast Cancer, Budd-Chiari Syndrome, Cervical Cancer, Cervical Conization, Choriocarcinoma, Colonoscopy, Colposcopy, Cryptococcosis, Endometrial Biopsy, Erythema Nodosum, Fibroadenoma, Head and Neck Cancer, Hepatitis, Autoimmune, Histiocytosis X, Hypogonadism, Immune Complex Test, Kidney Biopsy, Kidney Cancer, Laparoscopy, Leukemias, Chronic, Leukocytosis, Liver Biopsy, Liver Disease, Malabsorption Syndrome, Malignant Lymphomas, Mycetoma, Myelofibrosis, Neuroblastoma, Otitis Externa, Pancreatic Cancer, Endocrine, Pancreatic Cancer, Exocrine, Photosensitivity, Pneumocystis Pneumonia, Polycystic Kidney Disease, Primary Biliary Cirrhosis, Prostate Biopsy, Prostate-Specific Antigen Test, Rabies, Salivary Gland Tumors, Sigmoidoscopy, Stomach Cancer, Temporal Arteritis, Testicular Surgery, Thyroid Biopsy, Thyroid Cancer, Tumor Markers, Vulvar Cancer, Waldenström's Macroglobulinemia, Wilms' Tumor, Wilson Disease
1. Process of removing tissue from patients for diagnostic examination.
2. A specimen obtained by biopsy.
[bio- + G. opsis, vision]
removal and examination, usually microscopic, of tissue from the living body. Biopsies are usually done to determine whether a tumor is malignant or benign; however, a biopsy may be a useful diagnostic aid in other disease processes such as infections.
aspiration biopsy
biopsy in which tissue is obtained by application of suction through a needle attached to a syringe.
bite biopsy
instrumental removal of a fragment of tissue.
bone marrow biopsy
brush biopsy
removal of cells and tissue fragments using a brush with stiff bristles (introduced through an endoscope). Effective in obtaining tissue samples from inaccessible places such as the renal pelvis.
closed biopsy
one carried out without access through an open incision such as a laparotomy. An example is a percutaneous, fine needle aspirate.
cone biopsy
biopsy in which an inverted cone of tissue is excised, as from the uterine cervix.
cytological biopsy
obtaining specimens of cells by various methods including irrigation of a hollow tube.
biopsy dart
an alternative to immobilization of large and wild animals; a dart which cuts a skin bipsy, then falls out. Limited to use for superficial lesions.
endoscopic biopsy
removal of tissue by appropriate instruments through an endoscope.
excisional biopsy
biopsy of tissue removed from the body by surgical cutting.
exploratory biopsy
a combination of exploratory surgery to determine size and location of a lesion and the taking of a biopsy.
fine needle biopsy
see needle biopsy (below).
hepatic biopsy
may be by transperitoneal incision, more commonly by percutaneous needle or trocar and cannula technique.
incisional biopsy
biopsy of a selected portion of a lesion.
needle biopsy
biopsy in which tissue is obtained by puncture of a tumor, the tissue within the lumen of the needle being detached by rotation, and the needle withdrawn.
punch biopsy
see punch biopsy.
Robson-Heggers biopsy
a procedure for the collection of a piece of tissue from an infected wound in order to determine the extent and the nature of the infection.
sternal biopsy
biopsy of bone marrow of the sternum removed by puncture or trephining (see also sternal puncture).
surface biopsy
sample of cells scraped from the surface of a lesion or obtained by impression smears.
surgical biopsy
one obtained during a surgical procedure.
synovial biopsy
by a needle biopsy technique or through an arthrotomy incision using special forceps for a bite biopsy.
total biopsy
obtained by removal of the entire lesion. May be for therapeutic as well as diagnostic purposes.
ultrasound-guided biopsy
use of ultrasonography to guide the passage of a needle or biopsy instrument into an internal organ or lesion.
Patient discussion about Biopsy
Q. I have seen that there are many types of biopsy done for a breast cancer patient…….. I have seen that there are many types of biopsy done for a breast cancer patient…….. On what basis they decide the mode of treatment?
A. on what stage of development the cancer is, did it spread over to lymph nodes, the type of the breast cancer, estrogen-receptor levels, the aggressiveness of the tumor and even the woman's age...
Q. What are side effects after you have had a temporal arteritis biopsy?
A. like every biopsy- when there are anatomical variations you might cause damage. but that is fairly rare...from what i remember it's a very safe procedure.
Q. I had a breast biopsy and I am wondering what could be the chances for me to have breast cancer? I am 23 years female and new to this site. Last week I had a breast biopsy and I am wondering what could be the chances for me to have breast cancer? Any idea……More discussions about Biopsy


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imagineinternet needed a new web page design and created a contest on 99designs.
A winner was selected from 37 designs submitted by 13 freelance designers.
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Accepted File Formats:
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There are so many "worsts" about the tragic auto accident in Longmont that resulted in a 27-year-old woman losing her unborn baby that it's hard to know where to begin.
But we'll start with the rap sheet of the accused, 52-year-old Gary Sheats. This is his sixth DUI charge, according to a story from the Longmont Times-Call. Sixth. The first one was in 1980, with the others scattered through the ensuing decades.
We can't ignore his blood alcohol level, which was an astonishing .292, several times the legal limit. Another "worst."
And he is accused of leaving the scene of the accident, which caused serious injury to pregnant Heather Surovik, who subsequently lost her baby boy and Surovik's mother, a passenger in the car. How do you drive away from something like that? We suppose it's possible that someone with a .292 BAC could be so drunk that he didn't know he was involved in a wreck. Another "worst."
Our thoughts are with Heather Surovik and her family.


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INDIO >> Every year the nouveau circus troupe Lucent Dossier Experience fascinates Coachella Valley Music and Arts Festival-goers with their elaborate moves and show-stopping costumes.
Dream Rockwell, founder of the performance group, wants attendees heading to the three-day festival to think of this year's theme as "fairy pranksters," adding "we always a get a little grimy."
This year marks the 10th year — nine under the name Lucent Dossier Experience — the troupe has taken the stage on the Do LaB.
"The rule at Coachella has been that an act can not preform two years in a row," she said.To celebrate the occasion, the troupe has been asked to headline the Gobi stage Sunday night at 11 — it will be their first time performing outside of the Do LaB while at Coachella. In years past, the performers would take the stage about two to three times a day, she said.
"Being the final act of the weekend is pretty exciting for us," she said.
In keeping with tradition, they will start their festival experience at the The Do LaB stage, Friday at 7 p.m. with a completely different show. Since the beginning, Rockwell said she has noticed a loyal following from festival-goers, which she attributes as the reason they have been asked to return year-after-year.
"I've heard from people who would show me their schedule and tell me they stayed in the Do LaB the whole time instead," she said. "It feels good to know that your hard work is appreciated.
The Do LaB, which is their main stage and designed specifically for the troupe which means the sets for both stages will be completely different. For the Gobi tent, Rockwell said they are going to use high-powered LED lights, normally used in submarines, to replace the fire element often used in their shows.
"We're definitely excited and taking the show to a whole new level," she said.


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Getting High Quality Medical Care in a Changing Healthcare Landscape
When searching for good medical care, it used to be that the hunt focused on whether the physician was the best in his or her profession, had a good bedside manner, was conveniently located and referred patients to the hospital with the most up-to-date equipment.
But nowadays, rules imposed by insurers for scheduling and receiving care can sometimes place roadblocks between you and the physicians and hospitals you prefer.
For people with diabetes, this new healthcare environment can be especially disconcerting. In an effort to save money on the spiraling cost of medical treatment, employers can decide to switch healthcare insurance options they offer employees — and all of a sudden you may discover that visits to your family doctor or diabetes doctor are no longer covered, and you need to seek out a new physician or physicians to provide your medical care. For people with diabetes, this can mean learning new philosophies and methods of care which may differ from lifelong established systems that the patient has successfully used to manage the disease.
So, what do you do in this new healthcare world?
Here's some general guidelines to follow:
- Understand what's going on in healthcare these days, so you can better understand and work with the changing roles of healthcare providers, and the different pressures they are facing.
- Be knowledgeable about your own diabetes so you can ask questions and pinpoint areas where you and your primary care physician need to focus extra attention — and perhaps get additional help from a specialist — to keep your diabetes on track.
- Be your own advocate. Know what preventive care and screening the American Diabetes Association recommends, and ask your physician when it is time to have these various aspects of your care provided. Try to find an insurer that supports (i.e. pays for) getting these preventive measures done. Don't hesitate to call or write your health insurer and provide them with a clear and compelling argument as to why you need them to pay for some aspect of your healthcare that they don't cover — a referral, or an educational program for example. Include in your arguments any research that supports your need for the referral, and be sure to note that the insurance company will benefit if a needed referral will decrease your risks of developing more costly medical problems down the road.
- Choose your primary care physician wisely. Look for someone who is both knowledgeable about diabetes and who seems interested in working cooperatively with you.
- Make sure your primary care physician will, and more importantly can refer you periodically to a quality diabetes or other specialist, or to education programs for help with hard to manage problems.
- If possible, be prepared to pay for some things out of pocket, particularly diabetes education, and an occasional second opinion from a physician who may not be covered by your insurance.
- When possible, choose the health plan that enables you the greatest freedom to see different physicians and pays for the care you need.
- Don't hesitate to express concern if you have questions about the quality of your care.
The changing roles of physicians
Today's world of medicine is very specialized, yet efforts to contain costs are placing increasing burdens on primary care physicians — the traditional family physician — to provide as much medical care to patients as possible, because their care is the least costly. Yet, in caring for your diabetes, it is likely that your medical needs will require both a primary care physician and a team of healthcare professionals who can back your primary care physician up when needed. "If at all possible, you should find a medical setting where your diabetes is cared for by a team of professionals, each an expert in a particular aspect of your total care," notes Dr. Richard S. Beaser of Joslin Diabetes Center. This team should include the primary care physician, a diabetes expert who is usually an endocrinologist, a dietitian, nurse educator, exercise physiologist and someone who will provide psychological counseling and support when needed. Other team members may be added as needed to treat or prevent complications.
Your desire to have your diabetes treated by a team of specialists — and your insurer's desire, in many cases, to have as much care as possible provided by a primary care physician — may seem to be at odds. "Some believe that those two needs are in conflict," notes Kenneth E. Quickel Jr., M.D., president emeritus of Joslin in Boston. "But in fact, the best, most cost-effective care in the long run will occur for people with diabetes when the primary care physician and the specialty care team work in collaboration with each other."
Physician as traffic cop
Your primary care physician is trained to care for you as a total person and treat a wide range of medical problems, from colds and the flu, to checking your cholesterol levels and checking your diabetes care. This person serves as a traffic cop, in many ways, coordinating your overall medical treatment.
But in addition to acting like a traffic cop, this physician also serves in many health insurance settings as a gatekeeper, managing day-to-day health needs and regulating the flow of patients to more costly forms of care. In essence your primary care physician works on your behalf and the insurer's behalf to be sure that you are receiving care for your medical needs in the most cost-effective way possible. Frequently, payments to primary care physicians from insurers are tied to how effectively they can reduce the use of expensive tests and services — and the physician may be penalized for a perceived overuse of specialists and expensive tests.
"Back in 1916 Elliott P. Joslin wrote that 'the number of cases of diabetes is so great that it at once becomes evident that their care must rest in the hands of the general practitioner. It is ridiculous to expect that the treatment of diabetics should all be under the supervision of a specialist,'" notes Dr. Quickel. "So, while this role of 'gatekeeper' is just a fact of life today, in fact it has always been important for the primary care physician to work with the diabetes specialist. Picking an excellent primary care physician is as important for people with diabetes these days as it is to pick an excellent diabetologist or endocrinologist, and being certain that they can work together is essential.
Diabetes specialists as primary care physicians
In some health insurance programs diabetes specialists are registering as primary care physicians, as well as diabetes specialists, to enable patients to pick a diabetes expert to serve as their primary care physician. This is due, in part, to the fact that most diabetologists are first trained in general internal medicine or pediatrics before they receive additional training in diabetes and endocrinology. But they are also doing this because the line where primary care ends and diabetes care begins can be very blurred. In the Boston market, some of Joslin's diabetologists are enrolled as primary care physicians in some health plans for this very reason. "Joslin physicians have frequently served as primary care physicians for patients over the past 50 years or more, because diabetes is a lifelong disease that affects so many aspects of a person's health, " notes Dr. Quickel.
Other insurers don't allow diabetes specialists — even though they are certified to practice general internal medicine — to enroll as primary care physicians. In some cases, they may even insist that specialists associated with a medical school be classified as 'tertiary care physicians,' which severely limits your ability to be referred to them. The insurers do this because the insurance company perceives these specialists and the institutions they hospitalize patients in as exceptionally high priced. So the same Joslin physician may be enrolled as a primary care physician in one health plan, and a tertiary care specialist in another.
"In the perfect world, our preferred role is to serve as the diabetes expert, and to leave the primary care to the primary care physicians," notes Dr. Richard Jackson, a senior physician at Joslin. "But because patients sometimes want and need more from us than insurers will allow them to get if we enroll in these health plans as specialists only, we do in some cases enroll as primary care physicians."
The ideal
The ideal scenario is that you identify a primary care physician who is knowledgeable about diabetes, has an interest in the disease — and knows his or her limitations and will refer you for additional care when needed, irrespective of any disincentives insurers may place on making the referral. "Most physicians aren't going to let the insurers get in the way of making a referral for a patient who really needs it simply because of some small financial incentive," notes Dr. Quickel. "But a primary care physician has to know a lot about a mind-boggling number of different diseases and conditions. He or she may not be as immediately up-to-date on new thoughts in diabetes care as a diabetes specialist, whose role is to know a lot about one disease or group of diseases and their complications. What this means is that the primary care physician can manage most of your medical issues — including many of those surrounding your diabetes. But at a certain point, the primary care physician may need to seek a specialist's advice if things aren't going as well as they need to."
"What we're really advocating is a holistic approach, focused on preventing problems," notes Dr. Jackson. "By focusing on preventing problems rather than acting upon them when they occur, we can actually lower the cost of healthcare by limiting the amount of money patients need to spend on specialists to treat costly complications like artery disease, a heart attack, stroke or other problems."
Be knowledgeable about your disease
How can you as the patient know if the diabetes portion of your medical care is going as it should? "By being a knowledgeable patient," says Hill, who is director of educational services at Joslin.
Below are some key questions you should know the answer to in assessing both how your diabetes is going and how your primary care physician and diabetes healthcare team's combined management of your disease is fairing. "If you don't know the answers to these questions, ask the person who provides the bulk of your diabetes care (whether that is a primary care physician, a Joslin specialist, a nurse practitioner, or a diabetes specialist elsewhere) the answers to these questions at your next visit," Hill says.
These are also good questions to discuss with a new primary care physician or diabetes specialist that you may be switching to as a result of a change in health plans, notes Jackson.
Be your own advocate
If you don't know the answers to all of these questions, discuss them with the clinician most involved in your diabetes care over the next couple of visits. Then ask yourself how you felt while you were asking your physician some or all of these questions. If you felt increasingly comfortable as the conversation continued, this may suggest that the physician was a good listener, and didn't send out "bad vibes" suggesting that he/she didn't like being questioned about his medical practices. If, on the other hand, you felt that you needed to stop asking questions fairly quickly, was that because the physician — either overtly or covertly — was sending you signals that he/she didn't like being questioned about his knowledge of your disease? Or was it just your own discomfort with questioning a traditional authority figure?
"You're paying for your health insurance — get what you need and are paying for," says Dr. Jackson.
What to do if you are uncomfortable
Many people will find it difficult to discuss these questions with their physician. "Many of us have been raised to believe that we can't question the parish priest or the doctor, that they will take care of us and it's just as well not to ask too much," says Hill. "But as research like the Diabetes Control and Complications Trial (DCCT) increasingly shows us, the results of careful blood sugar control will reduce complications risk. It becomes increasingly important to make sure that all the members of your healthcare team know what they are doing — and that includes you. You, the patient, are the most important member of the team managing your disease. You have every right, as a result, to know that the other members of the team are working with you, and have the skills to make your life with diabetes as manageable and risk-free as possible."
What do you do if you are genuinely uncomfortable with your healthcare provider, and your choices are limited to the physicians enrolled as provider for your insurance company?
"Ask around," recommends Hill. "Go to meetings of the local diabetes association, and try to find other people with diabetes who have found good primary care physicians and/or good diabetes specialists-primary care physicians who may be covered under your insurance. Check out the primary care physicians of friends who don't have diabetes, but who say their physician is approachable and seems knowledgeable about whatever medical conditions they have. Perhaps such a physician will also be knowledgeable about diabetes — or perhaps if he/she isn't, at least he/she will be willing to refer you to someone who is for your diabetes care, and continue to provide your overall non-diabetes medical care."
Can your employer help?
You may also want to consider letting your employer's human resources or benefits department know if you are uncomfortable with the quality of the care you are receiving under your health plan, particularly if the health coverage has been recently changed and you feel your healthcare is suffering because of it. While insurance companies, on average, will have an individual as a subscriber for three years or so before the subscriber either switches insurers or switches jobs, statistics show that your employer will, in all likelihood, have you as an employee for much longer. Poor healthcare can result in poorer performance on the job, lost work days and lost productivity, not to mention higher insurance costs in the long run if you develop complications. Your employer is likely to be very interested in knowing if you are concerned about the quality of your medical care as a result of a change in health coverage. And the insurance carrier may be more likely to listen to the voice of an employer who is paying for insurance for hundreds or thousands of workers, rather than listening to you, who is the voice of only one.
Perhaps even more importantly, your employer may be interested in knowing of ways that they can continue to offer a lower cost health plan that meets the needs of most of their employees, while offering some additional work-site programs to help meet the needs of their workers with diabetes, or others with problems such as obesity, high blood pressure, high blood fat levels, etc. Perhaps you can talk with your employee benefits department about providing on-site nutrition counseling free of charge to people with these kinds of problems; or perhaps offering a fitness benefit or weight loss program in addition to the basic health plan, which might enable you to develop an exercise or weight loss program at lower cost to help manage your diabetes; or perhaps a stress management program free at work to help lower blood pressure.
Be prepared to pay out-of-pocket
People need to recognize that increasingly, having health insurance does not automatically entitle you to have all your medical care for free. People with diabetes have long had to pay for diabetes education out-of-pocket — and in some cases have balked at doing so. "Part of being an educated consumer is having a good diabetes education," notes Hill. "While insurers are increasingly covering some diabetes education, you may still have to pay something for that."
In addition, a change in health insurance coverage and a resulting change in healthcare providers may leave you longing for your former diabetes healthcare team. You may find that advocating for yourself to get the referral you want to see your former team just isn't working. Or the effort of managing your diabetes and all the other things going on in your life may leave you without the emotional energy you may need to do all the spade work required to get that referral. Or, admit it, some people just feel too uncomfortable to complain on their own behalf. Or the environment at your workplace may make you feel uncomfortable about calling attention to your medical issues with your employer's benefits department.
If any of these situations is the case for you, then perhaps, if possible, you should simply plan to spend out of pocket once a year for a good diabetes-specific medical evaluation (doctor visit, lab tests, diabetes education, eye exam) with your former diabetes specialists, even if they aren't covered under your health plan. See it as augmenting the care you are receiving and getting covered by your insurer. "After all, to make sure your car is running smoothly you would spend $500-$1000 a year on tune-ups, oil changes and other things which are over and above your warranty," says Dr. Jackson. "Why not do the same thing for your body?"
This can serve two useful purposes — first, it can help reassure you that your diabetes care is on track, and provide you information about how you can improve your overall diabetes care. Second, if problems with your existing medical care are uncovered, you can use this information to go back to your own physician and health plan and seek improvements. Or perhaps you can parlay the information into an out-of-plan referral to the physician team you wanted to see in the first place, or some additional action (i.e. specialty referrals) within the plan to physicians who may be categorized as super specialists, only to be referred to in the most dire of circumstances.
How do you choose your insurance wisely?
Despite changes in the market place most people covered by insurance at work still find that they have some choice in health coverage. What should you look for when the annual opportunity to make your health plan selection comes along? What should you look for in health insurance coverage if you are going to change jobs and someone in your family has diabetes? How do you minimize upheaval in your healthcare team coverage? Here's some questions to make sure you know the answer to when considering health plans:
Are the physicians I currently see covered under the insurance plan?
If they are, how easy or difficult is it to gain access to these specialists I am seeing? How easy, in general, is it to get a referral?
Just seeing the name of your physicians on a list of providers may suggest that you'll be able to see them whenever you wanted, just as in the past. This may not be the case, however. Some plans, for example, list certain physicians as part of their health network. But they are as tertiary care providers, which means that you can only be seen by one of these physicians if your primary care physician recommends it and the medical director of the health plan OKs it. "Getting this approval is a long process and your request will often be rejected. Instead, the plan will offer to cover you seeing a specialists in the local area — an endocrinologist in the community not associated with the physician you want to see, even though the physician you want to see may be in your local community."
So, before signing up with a new health plan, don't just check with the health plan's provider book to see if your specialists are covered under the plan. Also check with your specialists themselves to see how difficult it is to get a referral under the health plan you are considering.
Other questions to know the answers to include:
- What co-pays and deductibles are required in the health plan I am considering? How do these differ with physicians I may see who are "out-of-network?"
- Does the insurance plan cover such things as diabetes education? Weight loss programs? Fitness programs? One-on-one counseling with dietitians, certified diabetes educators, etc.? Can the costs of these services be included in your deductible? Does the insurance plan cover costs associated with these programs at any institution, or only at certain places?
- What coverage is provided for medical supplies such as blood sugar monitoring equipment and supplies? What does the drug benefit include? Are insulin and syringes covered?
- What is the mental health benefit? Will it cover such things as a diabetes-related support group or one-on-one counseling? How difficult or easy is it to get a referral to such a program through your health plan?
- If the person with diabetes to be covered under the health plan has a diabetes complication, what rules governing preexisting conditions may limit how much money your insurance will cover to pay for those complications? Or for diabetes care itself?
- Is the person to be covered under the plan who has diabetes planning on becoming pregnant? If so, will the health plan cover the more frequent testing and doctor visits required? Who are the specialists in diabetes and pregnancy covered under the plan? Where will the baby be delivered and what are the neonatology services available?
Keep in mind that each insurance plan has numerous different sub-plans that it sells to employer groups. The only way you will know for sure if your care at Joslin is covered, for example, is to check with your insurance carrier.
"Getting healthcare just isn't what it used to be," notes Hill. "People just have to be prepared to be more aggressive consumers to get the care they used to simply get by paying their health insurance premiums and their doctor bills. It takes a lot of work. But now, more than ever, an informed, intelligent consumer who is willing to be a little aggressive will get the best healthcare."
Find more information about diabetes in What You Need to Know about Diabetes – A Short Guide available from the Joslin Online Store.
Page last updated: September 15, 2019


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Weight Training and Conditioning
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Individualized conditioning programs to improve muscle strength, flexibility, and endurance. Cardiopulmonary endurance will be developed through exercises. Two class hours per week.
Home - General Information - Student Services -
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Undergraduate Degrees - Academic Graduate Regulations -
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Appendix A - Appendix B - Appendix C - Appendix D


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It's just about last call for Kentucky Derby contenders this weekend with preps in Arkansas and Kentucky.
The Arkansas Derby and Blue Grass Stakes highlight a schedule that also finds several Breeders' Cup champs back in action -- including Horse of the Year and Breeders' Cup Mile winner Wise Dan and Classic winner Fort Larned, who will try again to get his season started after dumping his rider last time out.
Overseas, Black Caviar is set to go again, provided the rain doesn't make too much of a mess of the Randwick course, and Nakayama Racecourse in Japan hosts the first leg of that nation's Triple Crown. And the Audemars Piguet QE II coming over the horizon in Hong Kong is shaping up as quite the international tussle.
Look quickly because they'll be running fast!
Derby preps
This is it, for all intents and purposes, for 3-year-olds hoping to make it to the Kentucky Derby. Those without enough points to crack the Churchill Downs starting gate on May 4 need to put in a good showing Saturday in either the $1 million, Grade I Arkansas Derby at Oaklawn Park or the $750,000, Grade I Toyota Blue Grass at Keeneland -- or lower their sights.
Only one of the 11 entrants for the Arkansas Derby -- the D. Wayne Lukas-trained Oxbow -- already has enough qualifying points to be sure of a Derby slot. California trainer Bob Baffert, who has suffered a series of setbacks on the Triple Crown trail, has two in this field who need more points -- Den's Legacy, who languishes at 19th on the list and probably needs a third-place finish or better, and late-developing War Academy, who likely needs a top-two finish to make it to Louisville. The race looks like a tossup with at least half the field having credentials that could support a win bet. Among those are Falling Sky, Overanalyze and Frac Daddy, all of whom already have earned Derby points. Despite his lack of experience, War Academy was installed as the 2-1 morning-line favorite for this 9-furlong test.
Fifteen are entered for the Blue Grass, which also has a lot of horses "on the bubble" for the Kentucky Derby -- with the added wrinkle that the race is run over Keeneland's all-weather surface. In this bunch, Uncaptured is No. 15 on the Kentucky Derby priority list and Java's War is No. 17. Java's War, who finished a late-closing second behind Derby favorite Verazzano in the Grade II Tampa Bay Derby last month, has shown an affinity for the surface by running third in the Grade I Dixiana Breeders' Futurity last fall. West Hills Giant was second to Vyjack in the Grade III Gotham Stakes back in March. Uncaptured won four straight on the Woodbine all-weather track last fall and was second to Black Onyx last month in the Grade III Spiral Stakes on the Turfway Park all-weather. He was installed as the morning-line favorite. Charming Kitten has been good on the dirt but ran poorly in his only race at Keeneland. Balance the Books won the Grade III Bourbon Stakes over the course last fall. Rydilluc has won three in a row on the turf in Florida, including the Grade III Palm Beach Stakes in his last outing.
After these races, only the Lexington Stakes at Keeneland on April 20 and the Derby Trial at Churchill Downs the following weekend offer Derby qualifying points -- and minor points, at that. So most of the field for the Run for the Roses should be set by Saturday night.
Kentucky Oaks preps
Rose to Gold joined a list of impressive fillies likely for the Kentucky Oaks when she overcame a sloppy track to take Wednesday's $400,000, Grade III Fantasy Stakes at Oaklawn Park by 4 1/2 lengths. Manuka Honey was second and Marathon Lady finished third. Rose to Gold, a Friends Lake filly, ran 1 1/16 miles in 1:45.8 with Calvin Borel up. Rose to Gold now has five wins and one second from seven starts with her only disappointing performance coming over the Keeneland all-weather last fall. Rose to Gold is tied with Beholder for the No. 1 spot on the Kentucky Oaks preference list with 164 points. "She's proven she wants to go there and we're going to give her every opportunity to get there," said winning trainer Sal Santoro. "I'm extremely proud of her. If my daughter had just won the Nobel Prize, that's how proud of her I am."
A field of 10 or 11 is expected for Sunday's $150,000, Grade II Beaumont Stakes at Keeneland, going 7 furlongs over the all-weather track. The race offers just 20 points to the winner but could help settle the bottom of the listings for the May 3 Kentucky Oaks.
The older males
Fort Larned, the 2012 Breeders' Cup Classic winner, headlines Saturday's $600,000, Grade II Oaklawn Handicap at the Hot Springs oval. This is his second try to start his 5-year-old season. The first ended when he stumbled out of the gate in the Grade II Gulfstream Park Handicap a month ago, fell on his nose and dumped jockey Brian Hernandez Jr. to the dirt. Both avoided serious injury and Fort Larned should be a handful again Saturday going 9 furlongs -- if he can keep Hernandez aboard. Trainer D. Wayne Lukas has Optimizer set, hoping to rebound from a bad outing last time in New Orleans. Cyber Secret jumped out of the allowance ranks to win the Grade III Razorback for track owner Charles Cella in his last race and returns. Unstoppable U has been improving and won the Maxxam Gold Cup at Sam Houston in his last race. Alternation won this race last year but is struggling this season.
The ladies
Tiz Miz Sue won the Grade III Azeri Stakes at Oaklawn Park last year, then finished third in the Grade I Apple Blossom. She won this year's renewal of the Azeri, too, and hopes to improve in Friday's $600,000 renewal of the Apple Blossom where she is scheduled to meet a tough field of six others. Those rivals include proven graded stakes performers Grace Hall, Summer Applause and She's All In. On Fire Baby returns to action for the first time since finishing fourth in the Grade I Acorn last June.
Justin Philip, fifth in last fall's Breeders' Cup Sprint, moved to Oaklawn Park late last month and promptly won an allowance event by 4 1/2 lengths. He moves back into graded stakes company in Saturday's $250,000, Grade III Count Fleet Sprint Handicap at 6 furlongs against seven rivals. Among them, Laurie's Rocket stands out on the basis of a two-race win skein over the track.
Gantry ran second to Delaunay in both his stakes tries at Fair Grounds this winter, now takes on a different type of field in Saturday's $175,000, Grade III Commonwealth Stakes at Keeneland. Only six signed on for the 7-furlong sprint on the all-weather track. An interesting prospect -- or perhaps project -- is Handsome Mike, who has been oh-so-promising at longer distances but, aside from the Grade II Pennsylvania Derby last year, hasn't delivered. Now he goes short for trainer Doug O'Neill.
At Aqueduct, filly and mare sprinters get their chance in Saturday's $200,000, Grade II Distaff Handicap at 6 furlongs. Spectacular Sky is the 119-pound highweight off a second-place finish in the Grade II Inside Information Stakes at Gulfstream Park in her last start. The other six are looking for some "black type" in a very soft spot. Cluster of Stars has won all four of her career starts but all have been on the Big A's inner track. Action now has shifted to the main track, which often makes a big difference.
Eleven fillies and mares signed on to tackle 7 furlongs on the Keeneland all-weather track in Saturday's $300,000, Grade I Madison Stakes. Holiday for Kitten won the Grade II Thoroughbred Club of America Stakes the last time she set hoof on the Keeneland plastic. But that was in October of 2011 and she hasn't shown much in occasional appearances since. Byrama is in from California with a solid record but few wins. Shumoos has given a good account of herself in England and California, finishing second against males in last fall's Breeders' Cup Juvenile Sprint. Fantasy of Flight was second in the Grade III Hurricane Bertie at Gulfstream in her last race.
On the grass
Horse of the Year and Breeders' Cup Mile champ Wise Dan makes his seasonal debut Friday in the $300,000, Grade I Maker's 46 Mile over the Keeneland turf. The 6-year-old Wiseman's Ferry gelding has been working steadily at the Lexington oval for trainer Charles LoPresti and faces just four rivals in Friday's race. He has won seven of his last eight starts -- all graded stakes. Data Link, last year's winner, is back for another try and has won his last two starts in California and Florida. Silentio has been running well in California, just missing by a nose to Suggestive Boy in the Frank E. Kilroe Mile at Santa Anita in his last start.
A really nice field of fillies and mares tackles 1 1/16 miles on the grass at Keeneland in Saturday's $300,000, Grade I Jenny Wiley Stakes. Centre Court has not been out of the exacta in any of her last nine races against top company. Old Tune has won six straight, in South America and in Florida. Better Lucky won the Grade I Matriarch at Hollywood Park in her last start but has been idle since November. Quiet Oasis has been on the board in six of her last seven starts. Samitar won the Grade I Garden City Stakes at Belmont last year and finished second in her seasonal debut in Florida. Abaco took nine tries to break her maiden for patient trainer Shug McGaughey but then reeled off four straight wins and a second in the Grade III Suwanee River in her last outing. Daisy Devine has been first or second in nine of her last 10 starts. Hard Not to Like was second in last year's Grade II Ashland Stakes over the Keeneland all-weather track. Solving this puzzle should produce a nice payday.
Saturday's $100,000, Grade III Shakertown Stakes is for the turf sprinter specialists -- 5 1/2 furlongs on the lawn. Regally Ready won the 2011 Breeders' Cup Turf Sprint but then saw his career derailed after an unproductive trip to Dubai last spring. The More Than Ready gelding makes his seasonal debut against eight rivals. Among them, Perfect Officer won this event last year but hasn't raced since last August.
A half dozen filly and mare turf sprinters take to the Santa Anita lawn Saturday in the $100,000, Grade III Las Cienegas Stakes at 6 1/2 furlongs. Mizdirection won the Breeders' Cup Turf Sprint last year and also took her two intervening starts. She also won this race last year and overall shows nine wins from 14 starts and earnings just north of $1 million. The others all have something to prove against a horse of Mizdirection's caliber.
Black Caviar, bidding for her 25th win without a loss, drew the inside position in a field of 11 for Saturday's AUS-Group 1 T J Smith Stakes at Randwick. Also in the field is Hay List, the only Australian rival who has been able to extend the champion mare. But Hay List is coming off a series of injuries and was entered only after a satisfactory midweek work made up for subpar effort last weekend. Black Caviar, meanwhile, will not start if the course is too wet, said trainer Peter Moody. Moody was particularly concerned that the T J Smith was moved to be the last of nine races on the card and eight preceding races could compromise the footing for his star.
The Satsuki So, or Japanese 2,000 Guineas, drew 21 entrants for Saturday's renewal at Nakayama Racecourse. The race is the first leg of the Japanese Triple Crown and, at 2,000 meters, also the shortest. The early favorites include Camino Tassajara, winner of the Jpn-Group 2 Hochi Hai Yayoi Sho, over the course and distance, over two other strong contenders for Saturday's race -- Codino and Epiphaneia. Last year's top 2-year-old, Logotype, also is looking to step forward here and rides a three-race winning streak dating back to last year.
Hong Kong
The April 28 Audemars Piguet QE II is shaping up as a crackerjack event, with successful runners from Dubai World Cup night set to clash with a quartet of top local stars. Two-time Hong Kong Horse of the Year Ambitious Dragon, rising stars Akeed Mofeed and Military Attack and the brilliant California Memory are the embattled locals and, should they all go in the 2,000-meters event over the Sha Tin turf, their rivalry would be a headliner on its own. However, they also may have to contend with the likes of Sheik Mohammed's feisty mare Sajjhaa, who won the $5 million, Group 1 Dubai Duty Free on World Cup night; South African star Igugu, who finished fifth in the Duty Free; and Treasure Beach, who got home eighth in the $10 million World Cup but is always dangerous. All three are on the list of selected runners two weeks out. Also listed are solid local performers Thumbs Up and Irian. In Addition, Group 1 winner Eishin Flash is listed to represent Japan in the event. "This year's race has again attracted some of the world's highest caliber racehorses and it will be intriguing to see how they match up against what is an outstanding home team," said Bill Nader, executive director of racing for the Hong Kong Jockey Club.


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Bulldog Ennis to join NRL's Sharks in 2015
Canterbury skipper Michael Ennis is set to end his NRL career at Cronulla after agreeing terms with the club from next season.
The 30-year-old former NSW Origin hooker on Wednesday agreed to a two-year deal with the Sharks, with an option for a third in 2017.
The signing is a coup for the embattled Sharks, who have been searching for a new hooker with incumbent John Morris expected to retire and back-up Isaac De Gois recently departed to Parramatta as cover for injured star Nathan Peats.
Ennis reportedly turned down an offer from Canberra last month.
"Michael is a quality player and one who will definitely complement the roster we have here at the Sharks at present," Sharks chief executive Steve Noyce said in a statement.
"He has shown he can play 80 minutes which changes up the way we can do things with the interchange bench, has experience at the highest level and is a tough competitor with great leadership qualities.
"It is exciting to have him on board."
Cronulla captain Paul Gallen said he was thrilled to have his former Origin teammate join him at the club, who sit second last on the NRL ladder with just two wins from 12 games this season.
"Not only is he amongst the best hookers in the game, but Mick is just the sort of player you love to play alongside," Gallen said.
"His attitude is infectious to those around him in that he competes on every play and has a real will to win."
Ennis joined the Bulldogs in 2009 and has since played more than 120 games for the club.
"The Bulldogs are disappointed that we weren't able to come to an agreement with Michael for the future and we thank Michael for the enormous contribution he has made during his six years here," Canterbury chief executive Raelene Castle said.
"Everyone here holds him in high regard and supports his decision, which is ultimately in the best interests of his family and their future."
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Demi Lovato returning as 'X Factor' judge
NEW YORK (AP) — Fox network says Demi Lovato is returning as a judge of "The X Factor."
The singer-songwriter will be back alongside series creator Simon Cowell when the singing competition begins its third season this fall.
Although calling Lovato "really, really annoying," Cowell said he enjoys working with her. She joined the panel of judges last year.
Thursday's announcement comes as the panel is being revamped. Britney Spears and record producer Antonio "L.A." Reid departed after Season 2.


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Hi all,
Just wondering where the license information for the Patguard 2 software is stored?
Is it in a certain reg key or is there a specific license transfer program that can be used to accomplish this?
Basically what I need is an easy way to transfer the license from one machine to another as we don't want to violate our license terms if we need to use it on different sites with different equipment.
Thank you.