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Sunday, January 31, 2010
Green Peritoneal Dialysis Fluid
Saturday, January 30, 2010
AJKD Bundling Editorials
This will all likely change in the coming months as the PPS nears finalization. A single lump-sum payment will be charged which will taken into account not only the dialysis procedure but also all medications and laboratories provided during the dialysis procedure. Proponents of the PPS would argue that the ESRD Program already soaks up a large chunk of the Medicare budget (5.8% of the overall budget, despite affecting less than 1% of Medicare beneficiaries), and the "bundling" strategy will encourage nephrologists to use tests and medications (particuarly EPO) more judiciously, resulting in lesser overall costs.
However, there are several controversies with the PPS alluded to in many of these editorials. For instance: in the new plan, all labs ordered during dialysis would be included in the bunding plan. For instance, patients who need to have their INR monitored frequently can have their bloods drawn during dialysis, a practice which is probably both humane and having practical sense from a standpoint of preserving the vasculature for future fistula use. However, many are concerned that dialysis units will be resistant to provide this service for patients, as they will no longer be reimbursed for drawing these labs. Some point out that decreased lab work provided during dialysis will also have a negative effect on completing kidney transplant evaluations in a timely manner. Still others are concerned that many ESRD-specific oral medications (e.g., phosphate binders, cinacalcet) will also fall into the bundled payment: for nephrologists who are responsible not only for the health of their patients but also the health of their dialysis unit, might this not put nephrologists in the unenviable position of having to "ration" expensive oral drugs only to the patients deemed to deserve them the most? Finally, there is also concern that only the largest dialysis corporations will be able to compete with the new regulations, leading to the closure of several smaller and non-profit dialysis centers.
The final PPS is apparently still being tinkered with, so we don't know the exact details quite yet. However in reading these editorials it is clear that there remains some trepidation about how the bundling will change the dialysis landscape.
Friday, January 29, 2010
Rituximab in Refractory Lupus Nephritis
What's the evidence for using Rituximab in refractory Lupus Nephritis?
To date, there is published data from over 20 studies, comprising 300 patients, of cases of refractory lupus or lupus nephritis treated with rituximab, with reported response rates of around 75%. However, positive reporting bias is a real concern, and no randomized trials in renal disease exist.
She continues to have very active serology; what does this mean?
Autoantibody levels in lupus and vasculitis do not predict relapse very well in general. The published studies report that responders will typically demonstrate a fall in anti–double-stranded DNA antibodies, and a correction of complement depletion. So, they appear to have more of a role in predicting response to treatment
This patient has now been in remission for over 1 year. However, I'm concerned about the possibility of an impending relapse. Relapses are reported as occurring after an average of 10 to 13 months, although some patients maintain remission for several years. Also, her peripheral B cells (CD19+ or CD20+ lymphocytes) have recently recovered. Patients who fail to achieve depletion tend to have poor or no clinical response, whereas prolonged B cell depletion is associated with a prolonged clinical response. Protocol re-treatment at 4- or 6-mo intervals is under evaluation, so for now there is no good answer to this question.
Thursday, January 28, 2010
A Divided Consensus on Health Care Reform
Wednesday, January 27, 2010
Glomerular Density and Predicting Progression in IgA Nephropathy
IgA nephropathy (IgAN) is an unpredictable beast, and identifying patients who will go on to develop progressive disease can be challenging. The classic predictors of progression, namely heavy proteinuria, CKD, glomerular sclerosis and tubulointerstitial fibrosis, are themselves just markers of advanced disease. There is a real need for better early histopathologic predictors of renal prognosis.
One promising prospect is glomerular density (GD), i.e. the number of nonsclerotic glomeruli per mm2, which was the focus of this recent study from Japan. The investigators performed a retrospective analysis of almost 100 IgAN cases with preserved renal function at the time of biopsy (average GFR 90 ml/min). Interestingly, they found that the GD varied hugely between patients, from 1 to 8 glomeruli per mm2. In multivariate analysis, only GD, and the presence of a cellular/fibrocellular crescent, were found to be significant predictors of progression. Patients with a low GD experienced more rapid decline in renal function, and this enhanced risk for progression was increased if a cellular/fibrocellular crescent was also present. Interestingly, the classic predictors of progression listed above did not predict prognosis, presumably due to the early stage of disease.
Of course, these findings will need to be replicated in other ethnic groups. Nonetheless, when a case of IgAN next appears at your biopsy conference, you should pipe up "what's the GD?". Just try not to look too smug when you do it.
Tuesday, January 26, 2010
Potential Use of Rituxan in Membranous Nephropathy
Monday, January 25, 2010
The Business of Dialysis
Also included in the figure (not shown here) is the "revenue per treatment"--that is, how much profit each company obtains from the average patient's dialysis run. For example, Fresenius reported a revenue per treatment of $348 for the 3rd quarter of 2009. I'm not sure how they arrive at these numbers, but you can do a quick calculation to figure out how much a single patient dialyzing on the standard 3x/week schedule is worth to the company on a yearly basis: $348/treatment x 3 treatments/week x 52 weeks/year = $54,288.00/year. Like it or not, dialysis is also a business.
Saturday, January 23, 2010
ASN's New Logo
The logo replaces the traditional ASN logo, which is fairly simple:
You can learn more about the new ASN logo on the ASN homepage (just click on Mr. Kidney), but briefly the new logo is intended to go along with the ASN's new tagline, "Leading the Fight Against Kidney Disease," and is supposed to place greater emphasis on ASN's leading role in patient care and important kidney-relevant policies.
Friday, January 22, 2010
Interferon effects on the kidney
A variety of mechanisms of injury have been reported, though most attention has focused on the ability of interferon therapy to cause proteinuria and nephrotic syndrome. This has been noted most commonly with interferon-alpha therapy, though in many of the patients with hepatitis B or C it may be difficult to be certain whether or not the development of nephrotic syndrome comes from the interferon therapy or a direct hepatitis-mediated renal injury such as MPGN. There have also been some recent case reports suggesting that interferon-beta can also cause a minimal change nephrotic syndrome in patients treated for multiple sclerosis and malignant melanoma.
Other mechanisms of renal injury reported with interferon use include acute tubular necrosis, acute interstitial nephritis, and even hemolytic-uremic syndrome. Occasionally, tubuloreticular structures as seen on electron microscopy of a kidney biopsy can be a clue as to the diagnosis of interferon-induced renal injury; these may also be seen in HIV-associated nephropathy.
Thursday, January 21, 2010
Gadolinium Beliefs
Wednesday, January 20, 2010
Bortezomib in Myeloma Cast Nephropathy
Bortezomib is a proteosome inhibitor used primarily in the treatment of relapsed myeloma. However, it is increasingly being used in the management of myeloma cast nephropathy (MCN).
Bortezomib binds to, and inhibits the function of, the 26S proteosome in plasma cells. This proteosome ordinarily performs a housekeeping function, degrading ubiquitinylated proteins, and hence clearing the cell of abnormal or misfolded proteins. Inhibition prevents degradation of pro-apoptotic factors and results in programmed cell death. The secretory nature of myeloma cells makes them particularly susceptible to agents which interfere with the ubiquitin pathway. Bortezomib has additional effects on other intracellular signaling systems, such as the NF Kappa B pathway, which may attenuate proximal tubular damage from nephrotoxic monoclonal light chains.
There are now several small case series suggesting bortezomib is efficacious in MCN. One of these reports on 20 patients with relapsed MM and creatinine > 2mg/dL. Renal failure was reversed in 40% in under 3 weeks. Additionally, 50% of patients had a 50% improvement in serum creatinine over the course of one month. Toxicity did not appear to be increased.
Bortezomib is given intravenously and does not require dose reduction in renal impairment. For these reasons, bortezomib is likely to have a particularly important role in the future management of patients with monoclonal Ig-mediated kidney disease.
(Image taken from NEJM June 26 2003 Volume 348; 2597-2598)
Tuesday, January 19, 2010
Cool New Cell Paper Demonstrates Molecular Basis for Thyroxic Hypokalemic Periodic Paralysis
Although thyrotoxicosis is a predisposing factor to this disease, there was also a clue that genetics was involved: Latin American and Asian populations appeared especially susceptible to TPP. The investigators identified a novel inward-rectifying potassium channel, Kir2.6 (interestingly, a gene which had escaped detection in all versions of the human genome thus far!), and sequenced this gene in affected individuals. In 33% of the unrelated patients in their sample, they identified mutations in Kir2.6 which appear to alter the function of this potassium channel and lead to an altered skeletal muscle excitability. Interestingly, the transcription of Kir2.6 was found to be altered by thyroid hormone, providing an explanation as to why the disease manifests itself most commonly during episodes of thyrotoxicosis.
Monday, January 18, 2010
The Undocumented ESRD Population
This is a complex issue, and one which will doubtlessly need to be addressed in a more comprehensive manner in the future.
Friday, January 15, 2010
Pre-Op Cardiovascular Testing for Kidney Transplant Recipients
The situation is even more confusing when you realize that patients with ESRD have an exceptionally high rate of coronary artery disease. This study by Ohtake et al performed screening cardiac caths on 30 patients with ESRD--and found that a full 53% of the sample had "angiographically significant CAD", including an even greater percentage (83%) in the subset of patients with ESRD and diabetes! Although it is controversial whether all of these patients would benefit from revascularization therapy, it makes the case that performing a "screening test" (such as ECHO or stress tests) is ESRD is not really worthwhile--you should just go ahead and cath everybody.
That being said, the more common approach to a cardiac workup in a patient being evaluated for kidney transplant is to use such a screening test. The two most popular are probably dobutamine stress echocardiography (which according to this recent AJKD review by Lentine et al has sensititives and specificities ranging from 37% - 95% and 71% - 95%, respectively) and myocardial perfusion studies (sensititives and specificities from 37% - 90% and 40% - 90%, respectively). As you can tell from the wide range of values reported above, the positive and negative predictive values of these tests are worse in the ESRD population than in the general population, making interpretation somewhat tricky. Electron beam CT scan, which determines a "calcium score" within coronary arteries to provide a risk assessment for CAD, has not been rigorously evaluated in the ESRD population.
The KDOQI Guidelines state that dialysis patients on the kidney transplant waiting list should undergo annual performance of non-invasive stress tests, such as those above, if they are considered "high risk"--which they define as having diabetes, known CAD, or having more than 2 traditional risk factors.
Thursday, January 14, 2010
Up To Date: The Nephrology Textbook of Today?
New poll starts tonight.
Wednesday, January 13, 2010
Polycystic Kidney Disease, mTOR and Sirolimus
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the gradual enlargement of multiple fluid filled cysts in both kidneys, which compress and destroy normal adjacent nephrons, typically resulting in ESRD by the fifth decade of life. Management has traditionally been limited to the treatment of the complications of hypertension and renal failure; however, several promising new therapies are on the horizon, such as nonpeptide vasopressin 2 receptor antagonists, inhibitors of the receptors for EGF and vascular endothelial growth factor (VEGF), and inhibitors of cmyc expression. All of which have been shown to inhibit disease progression in experimental models of PKD.
The mTOR inhibitor Sirolimus (Rapamycin) is another promising potential therapy, having also been shown to slow cyst development in rat models. Interestingly, it also slows the increase in size of native polycystic kidneys in human renal transplant recipients. It is currently the subject of three clinical trails underway in the US and Europe. Mechanistically, the cytoplasmic tail of wild-type Polycystin 1 normally interacts with, and inhibits, mTOR; loss of function of Polycystin 1, as seen in ADPKD, results in marked activation of mTOR within the epithelial cells of renal cysts. Sirolimus is believed to exert its effect via this mechanism. As mutations in PKD1, which encodes PC1, account for 85% of cases of ADPKD, Sirolimus has the potential to ameriorate the condition of the vast majority of APCKD patients.
Tuesday, January 12, 2010
Differential Diagnosis of Granulomatous Kidney Disease
Monday, January 11, 2010
Carotid Endarterectomy for CKD Patients
In patients without CKD or ESRD, either carotid endarterectomy or carotid stenting are commonly used strategies; however, many surgeons are reluctant to advise such procedures in patients with kidney problems. For one, definitive diagnosis often relies on imaging that involves injection of either iv contrast dye or gadolinium, which have well-documented complications in patients with CKD. Furthermore, patients with CKD/ESRD are more likely to suffer surgical complications than those without.
Interestingly, however, a new paper in this month's JASN by Mathew et al (with an accompanying editorial) describes a subgroup analysis of CKD patients within the North American Symptomatic Carotid Endarterectomy Trial (NASCET), a large randomized trial of carotid endarterectomy versus medical management in which creatinine levels were routinely available. They found that individuals with a GFR less than 30 ml/min and symptomatic high-grade carotid stenosis (defined as greater than or equal to 70% stenosis) who do NOT undergo carotid stenosis have exceedingly poor outcomes. Although the study requires the usual caveats associated with subgroup analysis such as the presence of unforeseen confounders, these data will likely provide a stimulus to consider carotid endarterectomy more routinely in individuals with kidney disease.
Sunday, January 10, 2010
Hydrothorax in periteonal dialysis patients
Patients diagnosed with a hydrothorax should be advised to temporarily cease PD. If necessary, patients can be transiently converted to hemodialysis while waiting for resolution of the hydrothorax. A trial of re-introducing low pressure PD (e.g. small volume) can then be attempted. If this strategy fails, switching to hemodialysis is a viable option. Video-assisted talc pleurodesis or operative repair are other alternatives available to patients who wish to continue PD.
Saturday, January 9, 2010
Hypercalcemia of Malignancy
1. PTHrP (PTH-related peptide): this is the most common cause of hypercalcemia of malignancy, and is sometimes referred to as "humoral hypercalcemia of malignancy." The PTHrP essentially mimics the effects of PTH by virtue of its interaction with the PTH receptor, though since PTHrP is not detected by standard PTH assays the measured PTH level is typically very low. Sending a PTHrP level may be helpful, though in my experience it often takes several days to come back. PTHrP is most commonly secreted by solid tumors, such as breast cancer.
2. osteolytic metastases: this is the 2nd most common mechanism of hypercalcemia of malignancy, and is due to osteoclast-mediated bone breakdown. It occurs in characteristic tumor types, which can be recalled by this nifty mnemonic, "BLT with a Kosher Pickle, Mustard & Mayo":
B = breast cancer
L = lymphoma, lung cancer
T = thyroid cancer
K = kidney cancer
P = prostate cancer
M & M = multiple myeloma
3. tumor production of calcitrol: the mechanism is here is similar to that of granulomatous disease: tumor cells provide enzymatic synthesis of 1,25 OH-vitamin D, the active form of vitamin D, leading to unregulated GI uptake of calcium. It is most commonly seen in Hodgkin's lymphoma and some cases of NHL as well. It can be diagnosed by finding an elevated 1,25 OH vitamin D level in the presence of malignancy.
Very, very rarely one can observe ectopic PTH secretion as a mechanism for hypercalcemia of malignancy.
Thursday, January 7, 2010
Favorite Renal Consult Topics
Check out the new poll question in the right margin.
Wednesday, January 6, 2010
SGK1, Hypertension and the Metabolic Syndrome
Tuesday, January 5, 2010
Differential Diagnosis of Hypomagnesemia
Monday, January 4, 2010
Familial juvenile hyperuricemic nephropathy
Originally described by Duncan and Dixon in 1960, FJHN is an autosomal dominant disease characterized by hyperuricemia, gout, and progressive renal failure. It was only recently discovered that FJHN was caused by mutations in the UMOD gene encoding the protein uromodulin, an 85 kDa glycoprotein involved in renal stone formation, the modulation of immune responses, and urothelial cytoprotection. These mutations lead to reduced renal excretion of urate. In vitro animal models of the disease suggest that the mutant forms of uromodulin cause the protein to be retained in endoplasmic reticulum, which inhibits normal trafficking to and expression at the cell surface. Patients often present in early adulthood with hyperuricemia or gout and normal blood pressure. The fractional excretion of urate is generally low. Renal dysfunction in these patients develops between ages 15-40 and is progressive, usually leading to ESRD in 10-20 years. On biopsy, patients are found to have chronic interstitial nephritis as well as thickening and splitting of the tubular basement membrane.
The optimal treatment strategy for FJHN is not clear at this time. Treatment with allopurinol to prevent gout has been recommended, though it remains uncertain as to whether or not allopurinol offers any significant benefit to preventing progression of renal disease.
Saturday, January 2, 2010
Basics of PD prescription writing
1. What kind of PD does the patient use: for the most part, we distinguish between CAPD (continuous ambulatory peritoneal dialysis, in which the individual manually performs fluid exchanges, often several times throughout the course of a day) versus CCPD (continuous cycling peritoneal dialysis, in which a PD "cycler" machine is used to perform automated exchanges, usually at night), though often components of both are part of the prescription.
2. How much fluid volume per bag? Usually either 2 Liter or 2.5 Liter bags are used.
3. What percentage of dextrose solution is used? I've included in a previous post the common color-coding scheme PD patients use to specify which solution they use; this is often invaluable because patients often know only what color bag they use, not the numerical value of how much dextrose is in their PD fluid. The higher the % of dextrose, the greater the amount of UF is generally achieved.
4. How many exchanges per day? For CAPD, this may be as simple as saying that a patient gets 4 exchanges a day. However, the answer may be more complicated for patients who use a cycler.
For example: a typical CAPD script might look like this: 2 Liters x 2.5% x 4 exchanges per day.
Another common dilemma encountered by renal fellows is what to do with CCPD patients who are admitted to the hospital, since cyclers are rarely available for inpatient use and patients do not always bring their own into the hospital. Generally, cycler regimens can be converted to CAPD regimens by calculating their total daily infusion volume and then dividing this by 4 exchanges per day.
Other details of the PD prescription worth mentioning: often one needs to distinguish between "low calcium" and "regular calcium" dialysates; some patients will regularly use heparin with each fill; and icodextrin is being increasingly used for individuals who fall into the "high transporter" category of PD patients.
Any questions? Your best bet is usually just to call the PD nurse on call--in my experience, they tend to know their individual patients extremely well, and can troubleshoot most technical issues relatively rapidly.
Friday, January 1, 2010
History of Cystoscopy
A free article on the Development of the Modern Cystoscope via Medscape can be found here. The French instrument described above was not the first attempt at endoscopy, but was apparently one of the earliest. It is described as a "long metal channel through which a mirror reflected light from a petroleum-fueled lamp," and could be used to demonstrate the presence of gallstones and kidney stones in some situations. However, one of its major limitations was that the metal heated up pretty quickly and caused significant patient discomfort. I can't imagine being one of the first patient subjects trying out the new, experimental cystoscope...


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Afghan policeman opens fire on troops; No deaths
(CBS/AP) KABUL, Afghanistan - An Afghan policeman opened fire on NATO forces and Afghan soldiers Monday morning in the fifth apparent attack in a week by Afghan security forces on their international partners. The U.S.-led military coalition says none of its service members were killed.
A Taliban spokesman claimed responsibility for the shooting, which took place in the eastern province of Nangarhar, saying the attacker was a police officer who had been in contact with insurgents before the assault.
A recent rash of "green-on-blue" attacks, in which Afghan security forces or attackers wearing their uniforms turn their guns on the coalition troops training them, has raised worries about a deterioration of trust between the two sides as well as the quality of the Afghan police and soldiers who will take over full security responsibility for fighting the Taliban when most international troops leave by the end of 2014. It also raises renewed worry that insurgents may be infiltrating the Afghan army and police despite heightened screening.
The coalition has recorded 27 so-called green-on-blue attacks so far this year, resulting in 38 deaths - a dramatic rise from previous years.
NATO spokesman Charlie Stadtlander says an initial investigation indicates the attacker was an Afghan police officer, though the man was wearing civilian clothes. He says the shooter escaped.
He would not say if any international service members were wounded in the attack, citing coalition policy.
Taliban spokesman Zabiullah Mujahid issued a statement Monday afternoon praising the shooting. He said the police attacker had been "waiting for such an opportunity to attack" international forces.
Mujahid said three Americans died in Monday's shooting, though the insurgents often exaggerate their assaults' success.
The Taliban traditionally steps up attacks in August, but the militant group's claimed success in recruiting rogue forces from the ranks of the Afghan army and police to turn on their Western allies, with whom they work and live very closely as ISAF ramps up its planned transition of security to Afghan forces, has fostered a lack of trust.
At least seven American service members have been killed in the past week by either their Afghan counterparts or attackers wearing their uniforms.
Coalition officials say a few rogue policemen and soldiers should not taint the overall integrity of the Afghan security forces and that the attacks have not impeded plans to hand over security to Afghan forces, which will be 352,000 strong in a few months. But there is growing unease between international troops and their Afghan partners and that's something Taliban insurgents are happy to exploit.
While the Taliban often claim they have infiltrated the Afghan security forces and are carrying out these attacks, CBS News reporter John Bentley reported in July that a U.S. Defense Department report maintains the attacks are not carried out by insurgents.
"Investigations have determined that a large majority of green-on-blue attacks are not attributable to insurgent infiltration of the ANSF (Afghan National Security Forces), but are due to isolated personal grievances against coalition personnel," the report said.
The Afghan security forces have established an eight-point vetting process. ISAF spokesman Brig. Gen. Gunter Katz explained that recruits require two letters from local elders as a character reference as well as biometric, medical and drugs checks, but ISAF is still working with the Afghan forces to improve this process.
Nonetheless, early in 2012, top U.S. commander Gen. John Allen ordered American units to select a "guardian angel" to watch over fellow troops, even as they sleep, at joint U.S.-Afghan bases and on joint operations involving live fire - a direct response to the mounting green-on-blue attacks.
Last year, a U.S. Army team led by a behavioral scientist produced a 70-page survey that revealed both Afghan and American soldiers hold disturbingly negative perceptions of the other.
According to the survey, many Afghan security personnel found U.S. troops "extremely arrogant, bullying and unwilling to listen to their advice" and sometimes lacking concern about Afghans' safety in combat. They accused the Americans of ignoring female privacy and using denigrating names for Afghans.
American troops, in turn, often accused Afghan troops and police of "pervasive illicit drug use, massive thievery, personal instability, dishonesty, no integrity," the survey said.
U.S. military officials have downplayed that survey.

subset: commoncrawl


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Hey folks! At this Sunday's nation-wide End the Fed protest, we had a great march in Nashville (here's a quick clip I filmed of it) and as it turns out, I got my picture in Tennessee's newspaper of record, the Tennessean. You can read the full article here:
The crowd listened to speakers for a half-hour before walking from the Federal Reserve building on Rosa L. Parks Boulevard to Broadway and then toward the Cumberland River. The group was greeted with shouts of encouragement, thumbs up and lots of horn honking.
PS: the sign in that picture says "Inflation is a Tax!" It's one of the very worst and most steeply regressive (hitting the poor harder than the rich) taxes we pay. Here are 76 Reasons to Audit and End the Fed.
Then yesterday, I was invited on Eric Dondero's Libertarian Politics show along with a panel of other bloggers to discuss current events. Listen to the show using the embedded player below and you'll get my take on indefinite detainment, Rand Paul's U.S. Senate campaign, Sarah Palin, 2010 elections I'm watching, and the health care monstrosity in the Senate:


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SourceKey.Com Testimonial [Sponsor Commercial]
Our newest sponsor "Source Key" releases a testimonial commerical. Source Key reports: "Source Key travels to meet up with Kareem and Chris. Check out two of our successful members who joined SourceKey.com and are willing to publicly talk about their experiences". Shout out to Source Key for helping pay them bills
Please click the "Report" button below if the video on this page is not working properly.
Comments will only be displayed by verified emails. No Spamming or Racism.


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Delivering on service level guarantees can be challenging. With CA Workload Automation iDash (CA WA iDash), you can apply advanced workload analytics in real time to create an efficient and finely tuned CA Workload Automation AE and /or CA Workload Automation CA7® Edition environments. Streamline SLAs and automate tasks to focus on improving the workload environment, maintain higher levels of availability and reduce the time and effort required to diagnose and resolve performance issues. Visualize complex relationships, proactively monitor thresholds and alerts, and execute recovery actions when thresholds are at risk of being missed.
Implementation services offer a comprehensive, proven approach and reduce project complexity with a carefully managed and phased implementation.
Control, visibility and costs are common challenges for workload management. Continual infrastructure changes, advances in technology and shifting business demands require managing increasingly complex environments, but the lack of integration can reduce responsiveness. Many organizations are implementing new processes to reduce business impact from lost productivity and wasted resources.
Organizations are challenged to:
CA Workload Automation iDash enables organizations to streamline management of business-critical SLAs and automate repetitive tasks so you can focus on improving your workload environment to maintain higher levels of availability. CA WA iDash provides at-a-glance workload analytics to help your team reduce the time and effort required to identify, diagnose and resolve performance issues. CA WA iDash also includes robust reporting to store and report on historical workload data across the entire environment.
CA Workload Automation iDash foundation services are designed to implement and configure the base functionality. The foundation services and capabilities supported are underpinned by the following components:
Acceleration services enable you to add functionality to a foundation implementation that can extend the value of your solution. CA Workload Automation iDash is an add-on to CA Workload Automation AE (formerly CA AutoSys®) and/or CA Workload Automation CA7® Edition; therefore, no additional Acceleration Services are available for this offering.


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France's attempt to ban the planting of a Monsanto strain of genetically modified maize was rejected by the EU's food safety body on Monday.
In response to scientific evidence submitted by France backing its bid to ban the GM maize, the European Food Safety Authority ruled that "there is no specific scientific evidence, in terms of risk to human and animal health or the environment" to support a ban.
In 2008, France banned the the strain MON 810 following public protests against the GM maize, but this was overturned by a French court in 2011. However, in March the French government reinstated the ban, with the then agricultural minister Bruno Le Maire saying the move was "to protect the environment".
The Monsanto-owned strain, marketed as YieldGard by the US company, is an insect-resistant strain of maize that was introduced in 1997.
In its verdict on Monday, Efsa said that much of the scientific evidence in France's new submission in January had already been included in a previous 2008 submission to the agency, which concluded at the time "that no specific scientific evidence, in terms of risk to human and animal health or the environment, was provided that would justify the invocation of a safeguard clause [ban]". It added that no new scientific work had been submitted that suggested there was risk to the environment, either.
A spokesman for Europe's health commissioner, John Dalli, told the AFP news agency that the EU executive "will consider how to follow up on this ruling, though technically we could ask France to raise its ban [on the Monsanto strain]".
The ruling follows a renewed focus on GM food in the UK, with researchers making a plea to anti-GM activists not to rip up a test site of GM wheat. On Sunday, Hector Christie, an old Etonian farmer, was arrested for breaking into the Rothamsted Research site where the wheat is being grown and cutting the top off several plants.


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We've seen so much footage and promotional material from The Amazing Spider-Man 2 that at this point it would be naive to believe you're going to get many surprises or twists in this second chapter of the untold story of Peter Parker. Rhino (Paul Giamatti), Electro (Jamie Foxx) and Harry Osborn's Green Goblin (Dane DeHaan) will all be battling Spidey in the film, with the fate of Peter's missing parents and Harry's ailing father serving as the overarching frame of the story.
Beyond that, we know that the next installment of the series, The Amazing Spider-Man 3, will likely see the Web-Head battling up to half a dozen foes (The Sinister Six), allowing director Marc Webb to finish his trilogy arc in spectacular fashion (pun). So, all that's really left for the present time is sitting back to see if Amazing Spider-Man 2 will truly be an improvement on the (barely passable) first film.
While many fans probably think that this "Final Trailer" promotion is but the cherry on an ice cream sundae of overexposure, there are some merits to it; namely, the improved visual effects rendering, which look less like a video game and more like what you want to see in blockbuster Spider-Man flick. The initial trailers for ASM2 indeed looked like cut scenes from a video game whenever Spidey and Electro were going at it, but this latest string of previews has a darker, more tactile feel to its CGI, which makes all the difference in the world.
The filmmakers also seem to be done with trying to sell fans on the idea that Jamie Foxx's Electro is the crux of the story. Electro was always a questionable choice for a main villain arc, and the more we began to scrutinize and examine Dane DeHaan's role as Harry Osborn, the clearer it seemed to become that this movie was going to be more about fathers and sons and legacy than it was about a goofy janitor who gets electrical powers and runs amok.
In these latest trailers, the attempts at misdirection seem to be done, and the filmmakers seem to be embracing the richness of the Peter/Harry conflict as a primary hook of their movie. Wise move, in my humble opinion…
Though it may give away even more great moments or hints of what's in store, this is the version of Amazing Spider-Man 2 that has me excited about the prospect of grabbing a theater seat and a pair of 3D glasses and enjoying a good time with one of my favorite superheroes.
…Now stop giving things away and just show us the movie, already!
Kofi Outlaw blogs at Screen Rant.


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Miss Spice needed a new logo design and created a contest on 99designs.
A winner was selected from 42 designs submitted by 12 freelance designers.
Looking for a modern logo for labels for packaged spices using Indian or Moroccan style patterns to give an exotic edge..
The name "spice&spice" should be in a circular shape with a geometric indian or morroccan pattern in either the middle or around the edge. This is the basic idea except the words "spice&spice" would be where the words "cranberry body butter" are on this link.
I like this pattern
And this idea
I am happy to change my packaging idea and consider some square or rectangular shapes.
- spice&spice or Spice&Spice or SPICE&SPICE
- spiceandspice.com
- some gold on either the lettering and/or pattern- Indian or morroccan inspired pattern either in the centre or around edge or both
- simple or elegant font
- very fancy or exotic font - needs to be modern
- not too folksy. ie too much pattern with curly writing
Find out how a design contest works or learn more about our logo design services.


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Build your own or buy?
Posted 04 July 2005 - 11:35 PM
Posted 28 September 2012 - 10:29 AM
- You have done so before, have a nice case and reusable parts and want to upgrade.
- You are building a high end game machine and want to control all the inputs carefully.
- You want to run Linux and not buy Windows as part of the package.
- You want to have fun and learn something about computers by building one.
Edited by raymac46, 28 September 2012 - 10:30 AM.
Posted 28 September 2012 - 06:37 PM
That being said, CompUSA (Tiger Direct) has quite a few really nice package deals for desktops lately.
Support Slackware: https://paypal.me/volkerdi, also Patreon/Slackware
Posted 30 September 2012 - 09:16 PM
Building your own is fun and rewarding.
For the things we have to learn before we can do them, we learn by doing them.
Posted 01 October 2012 - 12:11 AM
Like everyone else, build for home PC. I do prefer to buy laptops (most vendors allow sufficient customization to get what you want) as well as buy desktops and servers for work.
Aryeh Goretsky
Aryeh Goretsky
Microsoft MVP 2004.1-2018.6 [Cloud and Datacenter Management]
(previously Networking, Windows, Windows for Devices and IT)
Facebook • Google+ • personal blog • personal website • Twitter • work blog
Posted 01 October 2012 - 12:29 PM
AKA Fran
My Public Key for Email :: BambisMusings Blog :: Fran's Computer Services Blog :: MyPassionIsBooks Blog :: 5BuckReview :: CNIRadio
"The Net interprets censorship as damage and routes around it." ~John Gilmore (Time Magazine, Dec 6, 1993)
Posted 01 October 2012 - 03:34 PM
For my needs, I would prefer to build.
Posted 01 October 2012 - 06:10 PM
Posted 02 October 2012 - 03:39 PM
he builds to the same specs as a dell, hp or ibm, but claims he saves about 50% of the cost...
my theory is, are the hard drives, ram, mobo, power supply, etc as durable?
Posted 02 October 2012 - 03:55 PM
Posted 30 August 2013 - 10:37 AM
The real surprise is that it was free shipping and came from Hong Kong. Took 7 days. What's the deal with that? Half way around the world and only 7 days. So now I get to open my case and add a new toy and hopefully clear up some clutter.
Posted 30 August 2013 - 10:53 AM
AKA Fran
My Public Key for Email :: BambisMusings Blog :: Fran's Computer Services Blog :: MyPassionIsBooks Blog :: 5BuckReview :: CNIRadio
"The Net interprets censorship as damage and routes around it." ~John Gilmore (Time Magazine, Dec 6, 1993)
Posted 18 November 2013 - 09:28 AM
- You'll likely only need to replace the CPU box when you upgrade. The speakers and monitors last a long time and if you have DVI or HDMI on the monitor you are good to go.
- If you buy, go for a business grade unit. You'll get a nicer case with better cable management and a decent mobo/CPU combination. My Acer Veriton even has an upgraded cooler for the CPU, and also features Windows 7 Pro. A lot less crapware as well.
- That said a commercially available unit will have some compromises. In my instance it was a wimpy power supply and poor integrated video - fine for business but no good for gaming. I had to pay extra to replace the PS and add a video card. Cooling was also inadequate so I had to put in a case fan. I also added some RAM so at the end of the day it probably would have been cheaper to spec and build the machine as I now have it.
- If you are going to get a new machine for Linux, there's no question that you should build it yourself. You can make sure your hardware is Linux friendly, and you don't have to buy Windows or remove it from the PC. You also don't have to worry about the UEFI/Secure Boot nonsense either if Windows 8 was never installed.
- Bottom line - if you are upgrading a desktop system it still makes a lot of sense to DIY even if the economics are about the same.
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BBC News
- Supreme Court: Parliament suspension case 'a difficult question of law'
- 'Country stands behind Stokes' in Sun story row
- Jodie Chesney: Teenager 'murdered in drug turf war'
- Gatwick to use facial recognition tech at departures
- Wirral falling branch killed pregnant driver's baby
- Neyland Marina: Firefighter dies in boat crash
- Girl, 11, throws loaf of bread at armed robber
- Lib Dems: Being a woman is not a weakness, says Swinson
- Universities 'failing' victims of sexual misconduct
- Labour would 'carry out' further referendum result, Corbyn pledges
- Soot pollution particles 'cross the placenta'
- Rob Howley: Wales backs coach sent home from World Cup over alleged betting breach
- No-deal Brexit: 10 ways it could affect you
- In full: Boris Johnson interview from Luxembourg with BBC's Laura Kuenssberg
- Prorogation: How can the government suspend Parliament?
- Sea views: Capturing British maritime life
- No charge for 91-year-old's boiler 'under any circumstances'
- Digging for Victory: Stories from wartime gardens
- Does fat shaming help people lose weight?
- The Face: Is 2019 the time to launch a new magazine?
- County lines: Wales 'drowning in drugs with worse to come'
- Is a clean-break Brexit possible?
- What can restaurants do to help customers with allergies?
- Fuel prices: A really simple guide to why they go up and down
- Supreme Court: What happened with Brexit on Tuesday?
- Jo Swinson: 'We must stop Brexit'
- How one pilot survived WW2's biggest airborne operation
- Boris Johnson insists UK will leave EU on 31 October
- Brexit press conference goes on without Johnson
- Inside the Supreme Court
- The Papers: PM's 'warning' to judges and diabetes 'epidemic'
- Riley Siswick murder police 'not given information by council'
- Inquiry into safety and wellbeing concerns at two hospitals
- Environment strategy consultation launched in Northern Ireland
- Betsi Cadwaladr nurses' rota changes risks 'loss of goodwill'
- Sam Walker: Prisoner posted YouTube videos of life behind bars
Local Pubs in LEALANDS:
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TheGoodPubGuide.co.uk search for pubs in LEALANDS


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I have wanted to do the cross country ski to Glacier Point in the winter every since I heard about it a couple years ago. Despite being eager to go last winter, it never materialized due to lack of snow. This year would be different. After several feet of snow fell in the second half of December conditions were prime and the weather looked great over New Years Eve and Day. The Glacier Point winter trip starts at the family ski area at Badger Pass. Snowhoes and xc skis (both classic and skating) can be rented at the Badger Pass nordic center starting at 8:30 am (to be returned by 4 pm for single day rates). The route to Glacier Point and back from Badger Pass is 22.5 miles by my GPS watch and posted on Strava (the actual Glacier Point is a short walk from the end of the groomed track at the ski hut). We decided to go fast and light and make it a day trip. Despite my lack of experience with skate skiing, I was able to pick up the motions enough to make decent progress and even allow for some time to relax and enjoy the view at Glacier Pint. Total moving ski time around 4:08 and round trip in 5:40. Complete photo album here.
After driving the snowy road to Badger Pass, I arrived at the door step of the nordic center at 8:30 am on the nose (just as they were opening) and I soon had rented the skis for the day. The day was sunny but cold, but skate skiing is an intense physical activity so I warmed up nicely. The track had just been groomed and was in pristine condition as I was among the first to ski today. This was only my second time skate skiing and my form left much to be desired at the beginning expending much more energy than necessary. Despite this, we made decent progress up the long hill to the pass near Illilouette Ridge with occasional magnificent views of the Clark Range. From the pass it was largely downhill with a thrilling decent into Glacier Point as the jaw-dropping view of Half Dome suddenly appears. Glacier Point is spectacular in the winter and this was a magical day with clear, crisp conditions and relatively fresh snow coating everything. We marveled at the views and the beauty that is Yosemite. On the way back we stopped at Washburn Point for more stellar views. The way back was a bit of slog with the uphill portions at the end, but my form was improving making it relatively easier. Working against me was the fact that cross country is about as taxing as running on uphills. It felt pretty good to cover 22.5 miles on only my second time on skate skis. It seemed as if not many people make the trek to Glacier Point and back in a single day, instead opting to stay at the pricey ski hut (where meals and water are provided) or snow camp somewhere in the vicinity of Glacier Point. If you are opting for the day trip, skate skiing is definitely the way to go. The Glacier Point winter trip was a great experience and I look forward to doing it again! Complete photo album here.


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The Botanic Gardens and Parks Authority (BGPA or Authority) manages Kings Park and Botanic Garden and Bold Park in Perth, Western Australia. The Authority sits within the Western Australian State Government portfolio of the Minister for the Environment. The strategic direction of the Authority is largely dictated by the Botanic Gardens and Parks Authority Act 1998 and Regulations 1999.
Authority Structure
Botanic Gardens and Parks Authority board members are appointed by the Minister for Environment. The Chief Executive Officer oversees staff in the three directorates of Business and Visitor Services, Science, and Horticulture and Conservation.
Plans and Policies
Policy and planning documents assist in the ongoing care and maintenance of designated lands: Kings Park and Botanic Garden, and Bold Park. Public comment is sought on key documents, such as Park Management Plans.
Rules and Regulations
The Botanic Gardens and Park Authority manage Kings Park and Botanic Garden and Bold Park under the Botanic Gardens and Parks Authority Act 1998 and associated Botanic Gardens and Parks Authority Regulations 1999.
The Authority is required to issue infringements for breaches to the Regulations and penalties may apply. Actions that may attract infringements include illegal parking; speeding; littering; damage to plants or wildlife; or, dogs off leads.
Funding and Stakeholders
The Botanic Garden and Parks Authority receives its funding primarily from the State Government of Western Australia. Significant revenue is also generated through various events, activities, leases and licenses in place.
Publications and Reports
The Botanic Gardens and Parks Authority publishes a range of information including books, brochures, scientific papers, strategic policy documents and annual reports.


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Dream Theater Reveal Cover Art + Track List for Upcoming Self-Titled Album
At the beginning of June, Dream Theater revealed that their new disc will be self-titled with a release date set for Sept. 24.
Now the band is offering up even more on their very first self-titled release throughout the span of their 28-year career, including the cover art seen here on the left and the full track listing below.
Marking the band's 12th studio album, guitarist John Petrucci comments on the writing process. "I see every new album as an opportunity to start over," he explains. "To either build or improve upon a direction that has been evolving over time or to completely break new ground."
'Dream Theater' the album will include nine tracks that encompass everything Dream Theater the band is all about "from the epic and intense to the atmospheric and cinematic," according to Petrucci. It was recorded at Cove City Studio in Glen Cove, N.Y. with Petrucci producing and Richard Chycki handling the engineering and mixing duties.
Pre-orders for the new disc will get under way later in July with a variety of versions available from LP to limited edition box set. Visit the Roadrunner Records webstore for all the latest details.
'Dream Theater' Track Listing:
1. False Awakening Suite
i. Sleep Paralysis
ii. Night Terrors
iii. Lucid Dream
2. The Enemy Inside
3. The Looking Glass
4. Enigma Machine
5. The Bigger Picture
6. Behind the Veil
7. Surrender to Reason
8. Along for the Ride
9. Illumination Theory
i. Paradoxe de la Lumière Noire
ii. Live, Die, Kill
iii. The Embracing Circle
iv. The Pursuit of Truth
v. Surrender, Trust & Passion


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Itching is one of the most unpleasant sensations imaginable – and a cat's or dog's never-ending scratching, biting, and licking can seem nearly as aggravating. Watching your pet suffer with a chronic itch is an all-too-common experience facing pet parents these days. If your pet is constantly shaking their head, or scratching, rubbing, chewing or licking some area of skin, you can bet that there's likely some agonizing itching going on. Left untreated, areas of itchy skin
become vulnerable to damage from your pet's scratching or licking, to hot spots (areas of oozing, dry or inflamed skin), and even to secondary infections from bacteria. What may be causing the itch, and what can you do about it?
We've compiled a list of the top ten itch-causing factors and some suggestions on what you can do to help your pet escape from that irritating itch. Before your pet is tearing up their skin, pulling out their fur, or forced to wear a cone-shaped (Elizabethan) collar, consider these common causes of itchiness in pets and work with your vet to get your pet some relief:
1. Poor Quality Diet – We're not talking about food allergies here (more on that shortly). A surprising factor underlying a vast number of allergic itch reactions is simply a poor quality diet that inadequately nourishes a cat or dog. As we always say, a good diet is the foundation of good health. Even the best medication won't eliminate allergic skin reactions when your pet's immune system is unable to function properly due to lack of nutrients. If you're still feeding a grocery store, veterinarian prescribed or commercial chain pet store food, we urge you to read our article, "What You Need to Know About Your Pet's Food," check the label on your companion's food package, and find a natural food for your cat or dog. A good daily multivitamin is a great way to enhance the nutrient levels your pet gets
each day as well.
2. Airborne Allergens – Most cases of itchy skin are caused by the same things that cause human allergies (dust, grasses, pollen, etc.). While humans sneeze and have other respiratory symptoms, pets usually develop atopic dermatitis, showing their allergic reaction through their skin. While this is a major cause of pets' itching, airborne allergies are tough to diagnose, and other causes usually need to be ruled out first. Remember that just like humans, pets can be allergic to both natural allergens like pollen and chemical irritants like pesticide residue and household cleaning products. Often, these allergies can be controlled but not completely eliminated; allergy support products and essential fatty acid supplements can be of help to many pets with airborne allergies.
3. Food Allergies – While making up only about 10% of diagnosed allergies, food allergies are considered by many holistic vets to be the primary cause of about 30% of allergy cases in pets. This is due to how allergies activate your pet's immune system. Pets sensitive to one food allergen (commonly grain-based proteins called glutens) can become hyper-reactive to other allergens like dust or pollen. Fortunately, food allergies can be resolved with diligent detective work, eliminating all common allergens from the diet (beef, chicken, eggs, corn, wheat, soy, and milk), then reintroducing one at a time to see which ones cause an allergic reaction. Strict avoidance of irritants can resolve most cases of pure food allergy. Grain-free and novel protein foods as well as raw food diets can do much to alleviate food-based allergies for many animal companions. Our articles, "All About Raw Food," "Is Grain-Free Food Right for Your Companion?" and "The Role of Protein in Good Nutrition," provide further details on this important topic.
4. Contact Dermatitis – Some cases of itchy skin in pets is caused by direct skin contact with irritating substances. Common causes of contact dermatitis include flea collars and topical flea and tick preparations, grooming products, and household cleaners that pets contact through their skin – especially through the pads of their feet. Consider natural insect control products and grooming products for your pet, use natural cleaners in your home, and remember that sensitive pets can be allergic to product ingredients generally considered safe. As with food allergies, removing suspect products from any contact with your pet's skin can help determine what's causing the itch.
5. Fleas, Mites and Insect Bites – The most common allergy that causes itchy skin in pets (usually around the base of the tail and hindquarters) is flea bite dermatitis, an allergic reaction to flea saliva that can be triggered by only one flea bite! This can be frustrating for pet parents because a single flea bite can cause a severe reaction, yet you may never see a full blown flea infestation. If you live in an area where fleas are present, always keep in mind that one flea can cause some furious itching in your pet. Your vet can help you determine what degree of flea protection you need to keep your pet safe and healthy, but remember that natural solutions for insect control are the safest way to go and are well worth a try if you live in an area known for flea problems. We also offer aids for flea & insect bites.
Most mites are nearly invisible, and are commonly found in and around pets' ears and head. Severe mite infestations known as mange can be diagnosed through skin scrapings taken by your vet. Even mosquito bites can cause severe itching in sensitive pets, so keep a natural insect repellent handy during bug season to help your pet stay bite-free. For more information, please read our articles, "The Natural Approach to Flea Control," and "Ask the Vet: Natural Treatment for Demodectic Mange."
6. Skin Infections – Three main types of skin infections can cause itching in pets. Bacterial infection, known as Pyoderma, is often a secondary problem created by a cat or dog scratching, licking or biting an already irritated area of skin. These skin infections can be painful as well as increasing the itch factor. Ringworm, a fungal infection, is not uncommon – and it's contagious to humans! Ringworm commonly appears as areas of broken or crusty skin, with hair loss, usually around the head, face, or extremities. A vet can test your pet if ringworm is suspected. Another fungus problem is due to a yeast infection on the skin, known as Malessezia Dermatitis. This chronic itch problem commonly occurs on the paws or in the ears. Please see our articles, "Chronic Ear Infections," for more details. Minor skin infections and hot spots may respond well to natural healing products we offer.
7. Genetic Factors & Breed Predisposition – Unfortunately, some breeds of cats and dogs are more prone to sensitive skin, or are more likely to develop allergic itching due to skin folds and ear shapes. Siamese cats, and many breeds of dogs including Labrador and Golden Retrievers, Boxers, Shih Tzus, and many Terrier breeds are more prone to allergies that cause itching skin. Dogs with skin folds and floppy ears are more likely to develop itching from yeast or bacterial infections due to the ideal environment their anatomical features offer to these opportunistic microbes. Another related factor is temperament, with sensitive, high-strung breeds being more prone to reactive health conditions like allergies. The mind-body connection operates in pets as well as humans! If yours is a sensitive breed, please check out our Anxiety and Stress articles in our Holistic Healthcare Library for tips on reducing your pet's stress, and consider a holistic anxiety remedy to help ease your pet's emotional reactivity.
8. Vaccine Reactions – Although still controversial and not uniformly acknowledged by all pet health professionals, incidences of over-vaccination, and even single dose vaccine reactions are becoming more recognized and well-documented in pets. Vaccines are designed to cause a reaction in the immune system, and for some pets, the protein base of the vaccine serum can cause pets to develop allergies. In other cases, multiple vaccines administered together can overwhelm the immune system, resulting in "vaccinosis," a condition commonly known to trigger allergic symptoms like itchy skin. Please read our article, "The Truth About Pet Vaccinations," for more details on this important health issue. The homeopathic remedy, Thuja can be helpful for pets that may have vaccine-related issues.
9. Glandular/Hormonal Imbalances – Several glandular imbalances can cause skin problems that contribute to itching in some pets. Two of the most common are related to thyroid and adrenal gland functioning. Hypothyroidism (low thyroid function) is more common in dogs than in cats, but cases are found in both species. Hypothyroidism can cause the skin to become greasy, foul smelling, and in some cases very itchy. Cushing's Disease (more correctly called Hyperadrenocorticism) is caused by adrenal gland overactivity, and commonly occurs in older dogs, where numerous skin problems that can cause itching may occur. These are serious health issues that require vet treatment, so always check with your vet when unusual skin issues or other symptoms arise. Our article, "Thyroid Disorders in Cats and Dogs," provides additional information.
10. Detoxification Effects – The skin is an important organ of elimination, and one of the ways that pets may remove toxic residues from their systems is through their skin. If your pet has a temporary bout of itching, it may be a simple healing process as the body rids itself of residues its been storing up. This is a very common phenomenon when pets change from pharmaceutical to holistic remedies, or when their food is upgraded. Typically, a period of itchy skin, change in stool odor, consistency and volume, and/or runny nose can occur as part of a healing crisis when pets are going through a natural and healthy detoxification process. These periods generally don't last long, and should resolved within 1-4 weeks, depending on the state of health your companion. We carry an excellent homeopathic detoxification aid, Newton Homeopathics Detoxifier, which may be of benefit to pets eliminating toxins in conjunction with changes in diet or medications. Please see our articles, "Sixteen Steps to Detox Your Pet," and "When Is It Time to See the Vet?" for more information.
While our Top Ten Causes of Itching is not an exhaustive list, it does give you a place to start with the most common causes of itchy skin. We encourage you to review our other articles on Allergies and Itching in our Holistic Healthcare Library that may be helpful, including:
Ask the Vet: Seasonal Allergies & Itching
Itchy Skin and Allergies
Alleviating Your Pet's Itchy Skin
Ask the Vet: Food Allergies & Diarrhea


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Scenario 1
From UA Libraries Digital Services Planning and Documentation
In this disaster scenario, we lose our delivery software (or its functionality).
An example might be if a hacker broke in and mucked up the works, or deleted key files. Another example might be if the server hard drive is failing, and a chunk of code is corrupt.
The proposal under consideration is to back up a copy of our software at least weekly, and store it on an different server an/or an external hard drive which can be kept off-site for greater security.
Then the task would be to restore the software from the latest backup available; if the OIT backups are inaccessible or destroyed, we would have our own separate backup that would not be more than a week old.


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RWJ Barnabas Health - Somerset
Robert Wood Johnson University Hospital is a 965-bed hospital with campuses in New Brunswick and Somerville, offering Central New Jersey residents expanded access to the highest quality medical services and a wider array of innovative therapies available at only a small number of elite academic medical centers nationwide.
RWJUH's New Brunswick and Somerset campuses now serve as the flagship hospital of Robert Wood Johnson Health System, New Jersey's premier health system of choice which currently has $1.5 billion dollars in revenue, more than 10,100 employees, 3,250 medical staff members and 1,733 beds.
- Video
- Slideshow


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New charges lodged in 'man cave' probe
State workers indicted; allegedly used hideaway to party, sell drugs on job
ALBANY — It was the "man cave" that never closed.
That's the image a prosecutor painted Thursday as two suspended state workers were arraigned a slew of new crimes — including allegations their work shifts in a downtown Albany maintenance garage were rife with drug use, sleeping on the job and all-night parties that attracted other state employees.
Louis Marciano, 50, of Rensselaer, a supervisor at the state Office of General Services, and Gary Pivoda, 48, of Latham, a janitor at the agency, now face a 22-count indictment based on secret video surveillance and allegedly phony time sheets.
A prosecutor for state Attorney General Andrew Cuomo left little to the imagination about the cave as the men were arraigned before Judge Stephen Herrick in Albany County Court.
"Watching TV, sleeping, using marijuana, weighing, packaging and selling marijuana," Assistant Deputy Attorney General John Prizzia told the judge as he began describing the allegations against Pivoda. "Using cocaine, weighing, packaging and selling cocaine. And literally hosting parties where others — some of whom were state employees, some of whom were not — were invited onto state property, into the enclosure where they used cocaine and marijuana throughout the night."
Despite the videotaped evidence of others allegedly involved, no further charges are immediately expected, authorities said.
Moving onto Marciano, the prosecutor told Herrick investigators have "substantial and compelling video evidence" showing the supervisor holed-up in the hangout. He said Marciano not only slept there while being paid to work, but used marijuana and cocaine and hosted the parties.
Marciano was not accused of selling drugs. But Prizzia added, "This defendant was a supervisor who literally sat by and watched as his co-defendant, who was supervising, ran a business of selling marijuana and cocaine. And this defendant literally slept alongside of him and then certified the time records as true and accurate."
The indictment comes three months after state Inspector General Joseph Fisch's office raided the reputed party den — located inside a maintenance area of the East Garage off Phillip Street.
Both workers are charged with grand larceny, defrauding the government, official misconduct, criminal nuisance, cocaine and marijuana possession, using drug paraphernalia and filing a false instrument for allegedly turning in phony time sheets.
Pivoda faces additional charges he sold cocaine July 2 and peddled marijuana on six other occasions, the indictment said.
Both men face 2 1/3 to 7 years in prison if convicted of grand larceny. The false filing charge, meanwhile, carries a 1 1/3- to 4-year sentence. The additional cocaine selling charge facing Pivoda carries up to 9 years behind bars.
The men, both of whom surrendered to police Thursday morning, pleaded not guilty.
The salt-and-pepper-haired Pivoda, a slim man with glasses and a mustache, was released on $10,000 bail. Marciano, a stocky man with glasses and a graying beard and mustache, was released on $5,000 bail.
"Lou Marciano and I are shocked that he would actually be prosecuted for this," said his attorney, Lee Kindlon, "when there was actually a more publicized and egregious waste of tax money last spring as our state Senate sat around proud doing nothing while Rome burned."
Brian Donohue, the attorney for Pivoda, questioned what work was not accomplished while the men were at work. And he said he was unaware of any drugs being seized or lab work done to verify drugs were involved, he said he expected to get several of the counts against his client dismissed.
"I don't know how they got an indictment on the drug charges," he said. The indictment covers the period from Feb. 17 to July 14, the day of the raid on East Garage.
Three days later, Fisch's office announced that the men had been suspended. He alleged they regularly clocked in to work around 4 p.m., got high and snoozed while other workers cleaned Pivoda's section in the garage. He said the duo not only set up couches, a television, DVDs and scales to weigh marijuana inside the hangout, but Pivoda used his OGS truck to make drug shipments to electricians, plumbers and other state employees.
At the time, the office announced that Pivoda had been arrested and charged with misdemeanor use of drug paraphernalia and unlawful possession of marijuana. Those charges were later dismissed in City Court when no prosecuting agency filed paperwork to support the appearance tickets issued by State Police.
Marciano was not charged until Thursday. He has 31 years of state experience, Pivoda nine.
Both men have prior law entanglements.
Prizzia noted Pivoda has prior convictions that include possession of stolen property in 1977, unauthorized use of a vehicle in 1979, petit larceny in 1980, attempted burglary in 1982, misdemeanor assault in 1988 and burglary in 1992.
Prizzia said Marciano was convicted of attempted first-degree criminal contempt in 1997 after being arrested for felony criminal contempt and misdemeanor assault.
Pivoda was paroled for burglary by the time he was hired by the state in 2000. An OGS spokesman said in July that background checks were not mandatory until 2001 and could not say if Pivoda disclosed the conviction when he applied. Marciano served probation for his offense.
The Times Union reported in July that despite the allegations, both Marciano and Pivoda had racked up $28,400 in overtime over the past five years.
Marciano made $23,738 for 919 hours of overtime since July 2004, while Pivoda made $4,732 for under 250 hours in overtime, data from state Comptroller Thomas DiNapoli's office showed.
In July, Kindlon, defended Marciano earning the overtime, saying his crew worked long hours, adding "They had a break room ... Any allegations of wrongdoing, I think, are far overblown."
Reach Robert Gavin at 434-2403 or firstname.lastname@example.com.


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An Alabama man faces a possible life sentence after he was found guilty of the attempted premeditated murder of his ex-wife in September 2010.
An Alabama man faces a possible life sentence after he was found guilty of the attempted premeditated murder of his ex-wife in September 2010.
Michael L. Crump, 55, was convicted Dec. 21 of attempted premeditated murder with a weapon, burglary of a dwelling with a firearm and shooting into a building. He also pleaded no contestto violation of an injunction and possession of a firearm when subject to an injunction.
Crump faces a minimum of 20 years in prison, according to the state attorney�s office.
Crump, of Jasper, Ala., was arrested in July 2010 after he went to his ex-wife�s home near Niceville and repeatedly struck and kicked her.
Crump told her after the assault that if she called law enforcement he would kill her.
He was arrested in August after an arrest warrant was issued, and he post bond.
On Sept. 20, 2010, Crump entered his ex-wife�s backyard carrying a shotgun. The woman told officials she saw the gun aimed at her and ran to an upstairs room, where she was able to escape through a window and get to a neighbor�s home.
Crump fired at the woman at least three times and reloaded the gun before going upstairs in the woman�s home. When he was not able to find her he left the scene and fled from Okaloosa County sheriff's deputies.
Crump ditched his shotgun, but deputies found it later in Choctawhatchee Bay. The Florida Department of Law Enforcement positively identified it as the gun that was fired into the woman�s home.
Circuit Judge John T. Brown is scheduled to sentence Crump on Feb. 12.


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Here we are at Block #14 of the Virtual Quilting Bee! Wow. Only 2 more blocks and then we start putting them together. Which means, I need to get my rear in gear because (confession time) I am a few blocks behind. (I share so that no one feels quilt-guilt. We're all in this together.)
Today's tutorial is by the talented and very funny, Emily Herrick. You are probably familiar with Emily because of her fabulous fabric collections for Michael Miler such as Going Coastal and her latest, Technicolor. Have fun visiting Emily!


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VVS Kick Off Concert "ABC's and Do-Re-Mi's" Helps Give Illiteracy the Boot
VERONA- VVS High School chorus, band and orchestra held their annual Kick Off-Concert. This year, students are showing off more than their musical talent by showcasing their contributions to the worlds of music and literature.
Unlike previous years, this year's kick off concert has a theme: literacy.
"Our kick off concert usually just the first concert of the year," said High School Chorus Instructor Brandie Collins. "This year is special, because our kids were invited to be part of a worldwide consortium."
Thanks to help from the VVS Music Boosters, the chorus helped fund a new choral piece written by Eric Whitacre. The group presented the piece months before its public release in February, a privilege reserved for groups that are part of the consortium.
The song featured lyrics taken from a Margaret Wise Brown story titled "Goodnight Moon". Whitacre's new song is the first piece of music that has been allowed to take content from the story. Whitacre is known by some as the "rockstar of the choir world" according to Collins.
"We chose to have the concert tie in with literacy," Collins said.
The band opened up the show with a piece from the phantom of the opera and a piece title "The Heart of Madness," which was inspired by works of Edgar Allen Poe. After the band the orchestra played "Barber of Seville" and a piece called "Home Free" from the 1966 film "Born Free," which is based on a book with the same title.
After a brief presentation of students and faculty members sharing the connection between music and literacy, the VVS music boosters donated $500 worth of music themed books to the elementary schools. "Goodnight Moon," along with biographies of the Beatles and Mozart were among some of the donations. Altogether, the boosters have given around $2500 to this year's program.
After the donation was finalized, the guys of the choir opened up with "Down by the Sally Gardens," which was arranged by Douglas E. Wagner and based on a William Butler Yeats poem. Hannah Schuldt, a VVS eleventh grader played the piano accompaniment. The girls then presented "Sigh No More" Accompanied by ninth grader Matt Selby. "Sigh No More" was arranged by Ruth Morris Gray using words from Shakespeare's "Much Ado About Nothing." The night was closed with the exclusive presentation of "Good Night Moon" by the whole chorus.
As if to help the kids along, Taylor Swift gave a live video conference earlier in the school day for the kids. Swift answered student's questions about the importance of reading.
"I think it's really cool that we get to do the first presentation of "Good Night Moon"," said VVS junior and chorus member Taylor Peck. "This is a really good cause, and the song choices help people actually connect music and literacy."


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The city of College Park has received two development awards recognizing outstanding land use and construction for its Gateway Center, the public-private development surrounding the Georgia International Convention Center (GICC).
The Gateway Center, College Park's $230 million mixed-use development consists of the 403-room Marriott Headquarters Hotel, the 147-room SpringHill Suites and a class A office building.
"The Gateway Center Project is, in my opinion, the cornerstone of South Fulton and North Clayton counties," said College Park Mayor Jack Longino.
College Park was presented the awards by the Urban Land Institute (ULI) and the Atlanta Regional Commission (ARC). The organizations recognize exceptional real estate development and land use that lead to sustainable, thriving communities.
"It was a tremendous honor to be recognized by ULI for the Gateway Center project," said College Park's Economic Development Director Barbra Coffee. "ULI members take very seriously their role and responsibility in awarding projects that make substantial contributions to sustainable and green building practices. Our Gateway Center office and hotel developments exemplify these standards."
The construction was part of a master plan adjacent to the 400,000 square foot GICC and the AtlSkyTrain light rail station, which opened in 2009. Located less than a mile from Hartsfield-Jackson Atlanta International Airport, the Gateway Center rail stop connects the airport with the consolidated car rental facility.
"The GICC is the only convention center in the U.S. connected to a major airport by light rail," Longino added. "It is a fantastic project and development model. It demonstrates how entities working together create sustainability through responsible land use which strengthens our communities."
The Atlanta Regional Commission recognized College Park's Gateway Center as one of the recipients of the 2012 Developments of Excellence awards. The Gateway Center was selected for the Exceptional Merit for Public-Private Partnership award.
"This confirms our city's mission of working together to achieve a collective goal that benefits the larger portion of our population," said Longino.


text:
Top Items:
Vanity Fair:
Exclusive: Monica Lewinsky Writes About Her Affair with President Clinton — Monica Lewinsky writes in Vanity Fair for the first time about her affair with President Clinton: "It's time to burn the beret and bury the blue dress." She also says: "I, myself, deeply regret what happened between me and President Clinton.
Discussion: Wall Street Journal, Talking Points Memo, Yahoo! News, CNN, Guardian, The Political Insider, OnPolitics, CBS DC, Rush Limbaugh, Fox News, Mediaite, Hinterland Gazette, Conservative Intelligence …, The Other McCain, Hot Air, Taylor Marsh, ABC News, Daily Mail, Business Insider, Le·gal In·sur·rec· tion, Althouse, FishbowlDC, The Week, The Daily Caller, KOIN-TV and The Huffington Post
Caitlin MacNeal / Talking Points Memo: Lewinsky: My 'Global Humiliation Was Driven By The Internet'
Jessica Valenti / Guardian: Monica Lewinsky's return to public life is brave. Are we brave enough for her?
Catalina Camia / OnPolitics: Monica Lewinsky: Affair with Bill Clinton was 'consensual'
Dan Morrison / CBS DC: Hillary Clinton: Gun Culture 'Way Out Of Balance'
Noah Rothman / Mediaite: CNN's Banfield: Lewinksy Interview's 'Uncanny' Timing Coincides with Likely Hillary Run
Janet Shan / Hinterland Gazette: Bill Clinton's Ex-Jump-Off Monica Lewinsky Ready to Bury the Infamous "Blue Dress"
David Freddoso / Conservative Intelligence Briefing: Vanity Fair revisits Bill Clinton's 'war on that woman'
Robert Stacy McCain / The Other McCain: A. Ejaculating on a Fat Girl
Ed Morrissey / Hot Air: Lewinsky emerges: "My boss took advantage of me"
Meghan Keneally / Daily Mail: How I was left suicidal, turned down $10million in offers and was made a scapegoat to save Bill …
Brett LoGiurato / Business Insider: Monica Lewinsky Is Breaking Her Silence About Her Affair With Bill Clinton
William A. Jacobson / Le·gal In·sur·rec· tion: Monica Lewinsky: "Sure, my boss took advantage of me"
Nick Massella / FishbowlDC: Monica Lewinsky Opens Up in June Issue of Vanity Fair
Scott Meslow / The Week: Monica Lewinsky breaks 10 years of silence on affair with President Clinton
Taylor Bigler / The Daily Caller: Monica Lewinsky Requests Correction From Beyoncé
Paige Lavender / The Huffington Post: Monica Lewinsky Breaks Her Silence On Her Affair With Bill Clinton
Lucy McCalmont / Politico:
Monica Lewinsky in Vanity Fair: Time to burn beret — Monica Lewinsky is taking to the pages of Vanity Fair to address her affair with former President Bill Clinton, writing that she avoided the spotlight for fear of becoming an issue during Hillary Clinton's 2008 campaign …
Discussion: Outside the Beltway, Mediaite, CBS DC, Towleroad News #gay and The Huffington Post
Doug Mataconis / Outside the Beltway: Monica Lewinsky Speaks
Andy Towle / Towleroad News #gay: Monica Lewinsky Says She Empathized with Tyler Clementi Over Public Online Humiliation
Katie Glueck / Politico:
Hillary Clinton pushes gun control, Obamacare
Hillary Clinton pushes gun control, Obamacare
Discussion: CNN and Washington Free Beacon
Alexander Bolton / The Hill:
Republican senators turning against their own in 2016 — Fearful of a third successive Democratic triumph, concerned Senate Republicans are turning against 2016 presidential bids by upstart hopefuls within their own ranks. — In forceful comments to The Hill, GOP senators made it plain …
Discussion: Washington Monthly, The Moderate Voice, Booman Tribune and Prairie Weather
Ron Beasley / The Moderate Voice: Head Them Off At The Pass
Prairie Weather: With Congressional ratings in the tank, Republicans look to Republican governors for 2016 candidates
Paul Steinhauser / CNN:
Jeb Bush edges up, Hillary Clinton slightly slides, in CNN 2016 poll — Washington (CNN) - She's still the overwhelming front runner in the race for the 2016 Democratic presidential nomination, but according to a new national poll Hillary Clinton's support has slightly deteriorated since the beginning of the year.
Discussion: Washington Post, Politico and Shakesville
Jonathan Topaz / Politico: Poll: Rand Paul, Jeb Bush lead GOP field
Melissa McEwan / Shakesville: In the News — Here is some stuff in the news today...
Dylan Scott / Talking Points Memo:
Rand Paul Wants Hillary Clinton Subpoenaed By Benghazi Committee (VIDEO)
Rand Paul Wants Hillary Clinton Subpoenaed By Benghazi Committee (VIDEO)
Discussion: Liberaland and susiemadrak.com
Justin Gillis / New York Times:
Wide Impact of Climate Change Already Seen in U.S., Study Says — The effects of human-induced climate change are being felt in every corner of the United States, scientists reported Tuesday, with water growing scarcer in dry regions, torrential rains increasing in wet regions …
Discussion: Los Angeles Times, Taegan Goddard's Wonk Wire, Re/code, Poynter, Mediaite, Politico and Althouse
Taegan Goddard / Taegan Goddard's Wonk Wire: Climate Change is Already Hurting Us
James Temple / Re/code: Caltech Raises Millions to Tackle the "Most Fundamental Issue Facing Mankind"
Andrew Beaujon / Poynter: Obama reaches out to forecasters on climate report
Darren Goode / Politico: Obama tries weather outreach on climate
Ann Althouse / Althouse: There is... no return. No... mediation. It's very brutal. …
Climate change is here and action needed now, new White House report says
Climate change is here and action needed now, new White House report says
Discussion: ThinkProgress, The Verge, The Agonist, KFOR-TV and EcoWatchEcoWatch
Kwame Opam / The Verge: Report shows global warming's economic, infrastructural impact is 'unavoidable'
Sahil Kapur / Talking Points Memo:
White House Hopes Report Will Change GOP Minds On Climate Change
White House Hopes Report Will Change GOP Minds On Climate Change
Discussion: PoliticusUSA
White House climate change report unveils dire warning, calls for action
White House climate change report unveils dire warning, calls for action
Discussion: The Federalist, Mediaite, Shakesville, National Review and Mashable
Noah Rothman / Mediaite: Obama's Climate Gambit Insults Your Intelligence
Melissa McEwan / Shakesville: White House Releases Climate Change Report
Andrew Freedman / Mashable: Obama Taps TV Meteorologists to Roll Out New Climate Report
New York Times:
A Defeat for Religious Neutrality — The American values of pluralism and inclusion are central to the First Amendment, which forbids government from favoring or aligning itself with any particular religion or believers over nonbelievers. — In a lamentable ruling on Monday …
Discussion: Daily Kos and The Reaction
Georgia Logothetis / Daily Kos: Abbreviated pundit roundup: Supreme Court decision on public prayer, Robin Hood tax and more
Michael J.W. Stickings / The Reaction: In public prayer case, the Supreme Court strikes another blow against American democracy
Dahlia Lithwick / Slate:
The Supreme Court gives its blessing for prayer at town meetings. Get ready for a lot more Jesus in your life.
The Supreme Court gives its blessing for prayer at town meetings. Get ready for a lot more Jesus in your life.
Discussion: Washington Monthly, msnbc.com, law.cornell.edu, American Prospect, The Dish, Bloomberg View, Talking Points Memo and Hot Air
Ed Kilgore / Washington Monthly: Get Prayer Out of the Churches and Back in the Public Square Where It Belongs!
Adam Serwer / msnbc.com: Supreme Court blesses prayer at town meetings
Scott Lemieux / American Prospect: Supreme Court: Tear Down This Wall!
Andrew Sullivan / The Dish: A Ruling At The Corner Of Church And State
Noah Feldman / Bloomberg View: Say a Prayer for Justice Kennedy
Caitlin MacNeal / Talking Points Memo: Alabama Chief Justice: The First Amendment Protects Only Christians
Garrett Epps / The Atlantic Online:
With the Supreme Court's Help, Religion Creeps Toward the State
With the Supreme Court's Help, Religion Creeps Toward the State
Discussion: Washington Post, ThinkProgress, ACS Blog and New York Times
ThinkProgress: The Supreme Court Just Blew A Gaping Hole In The Wall Of Separation Between Church And State
Lyle Denniston / SCOTUSblog:
Opinion analysis: Prayers get a new blessing
Opinion analysis: Prayers get a new blessing
Sarah Posner / Religion Dispatches: Supreme Court Rules Sectarian Legislative Prayer Constitutional - Post by SARAH POSNER
Peter Montgomery / Right Wing Watch: Religious Right Sees Opportunity In Supreme Court Prayer Ruling
Ruthann Robson / Constitutional Law Prof Blog: Divided Supreme Court Finds Town Board Prayer Does Not Violate Establishment Clause
Jennifer Rubin / Washington Post: A hope and a prayer from the Supreme Court
Sahil Kapur / Talking Points Memo: Kagan Accuses Conservative Justices Of 'Blindness' To Secular Values
Doug Mataconis / Outside the Beltway: Once Again, The Supreme Court Upholds Legislative Prayer
Richard Wolf / USA Today: Supreme Court upholds prayer at government meetings
Melissa Pamer / KTLA 5:
Rialto Assignment Asking Students to Question Holocaust to Be Revised — The Rialto school district planned to revise an eighth-grade assignment that raised red flags by asking students to consider arguments about whether the Holocaust — the systematic killing by the Nazis of some 6 million Jews …
Ed Morrissey / Hot Air: Great moments in education: CA school asks students to ponder whether Holocaust story …
Erick Erickson / RedState: The Common Core — Common Core seems like a good idea.
Patterico's Pontifications: Wait Until You See What the L.A. Times Thinks "Multiple Credible Sources" Are
Harold Maass / The Week: 10 things you need to know today: May 6, 2014
Eric Owens / The Daily Caller: California School District Promises To Revise CRAZY Eighth-Grade Lesson Promoting Holocaust Denial
Travis Gettys / The Raw Story: CA schools back off assignment asking whether Jews made up Holocaust for money
Bryan Preston / The PJ Tatler: Holocaust Denial Comes to Common Core
Veronica Rocha / Los Angeles Times: Rialto schools revise assignment asking whether Holocaust occurred
Beau Yarbrough / sbsun.com:
EXCLUSIVE: Rialto Unified defends writing assignment on confirming or denying Holocaust
EXCLUSIVE: Rialto Unified defends writing assignment on confirming or denying Holocaust
Discussion: Talking Points Memo, Hit & Run, National Review, TheBlaze.com, The Week and Pamela Geller, Atlas Shrugs
Catherine Thompson / Talking Points Memo: School District Revises Assignment Questioning Whether Holocaust Was 'Actual Event'
Scott Shackford / Hit & Run: Let's Have Middle-Schoolers Debate Whether the Holocaust Happened!
Jonah Goldberg / National Review: Rot In Common Core
Benjamin Weingarten / TheBlaze.com: The one book that explains how the existence of the Holocaust became an 8th grade 'critical thinking' exercise
Catherine Garcia / The Week: California school district is revising an assignment that questioned the existence of the Holocaust
Cornelius Swart / KGW-TV:
Gov. Kitzhaber helps save woman's life — PORTLAND — Oregon's governor performed CPR on an unconscious woman in downtown Portland Monday, providing her medical assistance and helping to keep her alive until paramedics could arrive. — Gov. John Kitzhaber was traveling by car through downtown Portland …
Discussion: Talking Points Memo, Washington Post, OnPolitics and Fox News Insider
Niraj Chokshi / Washington Post: Oregon Gov. Kitzhaber may have saved a life on his way to dinner last night
John Kitzhaber / Fox News Insider: Oregon Governor Stops to Perform CPR on Unconscious Woman
Gov. John Kitzhaber / Oregonian:
Gov. John Kitzhaber performs CPR on woman lying unconscious on Portland street
Gov. John Kitzhaber performs CPR on woman lying unconscious on Portland street
Discussion: PoliticusUSA, The Daily Caller, CNN and Mediaite
Keith Brekhus / PoliticusUSA: Democratic Oregon Governor Performs Life-Saving CPR On Unconscious Woman
Melodi Smith / CNN: Oregon governor performs CPR on woman
Evan McMurry / Mediaite: Oregon Gov. Performs CPR on Woman Dying in the Street
Sabrina Tavernise / New York Times:
Mortality Drop Seen to Follow '06 Health Law — BOSTON — The death rate in Massachusetts dropped significantly after it adopted mandatory health care coverage in 2006, a study released Monday found, offering evidence that the country's first experiment with universal coverage …
Harold Pollack / healthinsurance.org: Could Obamacare save 24,000 lives a year?
Jason Linkins / The Huffington Post: Harvard Study Suggests Health Insurance Saves Lives. The Hill Wonders If That's A Good Thing.
Peter Suderman / Hit & Run: Obamacare and the Uninsured
Andrew Sullivan / The Dish: The Best Of The Dish Today
Joan McCarter / Daily Kos: Obamacare's future in saving lives
Ferdous Al-Faruque / The Hill: New RomneyCare study gives glimpse of ObamaCare costs
Josh Marshall / Talking Points Memo: Yes, It Saves Lives
ACP Journal Club:
Changes in Mortality After Massachusetts Health Care Reform: A Quasi-experimental Study — Benjamin D. Sommers, MD, PhD; Sharon K. Long, PhD; and Katherine Baicker, PhD — Ann Intern Med. 2014;160(9):585-593. doi:10.7326/M13-2275 — Background: The Massachusetts 2006 health care reform …
Megan McArdle / Bloomberg View: Obamacare Might Help You Live Longer
Michael F. Cannon / Forbes: New Study Suggests RomneyCare Saved Lives, But At A Very High Cost
Peter Suderman / Hit & Run: Did RomneyCare Saves Lives?
Sarah Hurtubise / The Daily Caller: Harvard Romneycare Study Warns Of Massive Obamacare Costs
Dylan Scott / Talking Points Memo: Study: RomneyCare Seems To Have Saved Lives, And Obamacare Could Too
Adrianna McIntyre / The Incidental Economist: Health insurance saves lives. That means it improves health, too.
Brett LoGiurato / Business Insider: A New Study Says Romneycare Has Saved Thousands Of Lives
Tara Culp-Ressler / ThinkProgress: New Study Confirms That Health Reform Can Save Lives
Ramesh Ponnuru / National Review: The Health in Health Insurance — In the latest issue of NR …
Jim Romenesko:
Survey: Most say journalism is headed in the wrong direction — Profs at the Indiana University School of Journalism surveyed 1,080 journalists and found: — * Six in ten say their newsrooms have shrunk during the past year, while only 13.2% report newsroom growth.
Discussion: Firedoglake, The Dish and The Huffington Post
Andrew Sullivan / The Dish: How Journalists See Journalism
Katherine Fung / The Huffington Post: Majority Of Journalists Say Journalism Is Going In Wrong Direction
Chris Cillizza / Washington Post:
Just 7 percent of journalists are Republicans. That's far fewer than even a decade ago.
Just 7 percent of journalists are Republicans. That's far fewer than even a decade ago.
Discussion: Mediaite and National Review
Noah Rothman / Mediaite: Number of Reporters Identifying as GOP Collapses to 7%
Andrew Johnson / National Review: Study: Just 7 Percent of Journalists Are Republicans
Juan Williams / The Hill:
House GOP walking into a trap — What happens to the House Republican caucus if Speaker John Boehner (Ohio) forces a vote on immigration reform? — Here are three predictions: — 1. The bill passes. An overwhelming majority of Republicans vote for it.
Sean Trende / Real Clear Politics:
The Tea Party, Revisited
The Tea Party, Revisited
Discussion: Washington Monthly, Fox News, Weekly Standard, Instapundit and Politico
Mark Hemingway / Weekly Standard: Super PAC with McConnell Ties Attacking Nebraska Tea Party Candidate Ben Sasse
Elizabeth Price Foley / Instapundit: THE TEA PARTY, REVISITED: Sean Trende's interesting take over at RealClearPolitics.
Manu Raju / Politico: May primaries to test GOP establishment clout
Emily Schultheis / Politico:
House candidate: I'd 'rather see' terror attack than TSA screening — A candidate for Congress in Georgia said earlier this year that he'd rather see another terrorist attack on the United States than have Transportation Security Agency screenings at airports.
Discussion: Business Insider, Political Insider blog, Mediaite and The Week
Brett LoGiurato / Business Insider: House Candidate Says He'd 'Rather See Another Terrorist Attack' Than Go Through TSA Screening
Daniel Malloy / Political Insider blog: Video: U.S. House hopeful Bob Johnson says "I'd rather see another terrorist attack" than deal with TSA
Jake Sherman / Politico:
Nancy Pelosi calls for split Benghazi panel — House Minority Leader Nancy Pelosi said the select committee probing the attack in Benghazi should be split equally between Democrats and Republicans. — "If this review is to be fair, it must be truly bipartisan," Pelosi said in a Tuesday morning statement.
Discussion: Washington Examiner, Power Line and Hot Air
Byron York / Washington Examiner: Nancy Pelosi wants even split on new Benghazi committee — unlike committee she picked when Speaker
John Hinderaker / Power Line: Pelosi Wants Even Split on Benghazi Committee
Ed Morrissey / Hot Air: Pelosi demands equal split on Benghazi select panel
Sahil Kapur / Talking Points Memo:
Pelosi Calls For Equal Ratio Of Dem, GOP Members On Benghazi Panel
Pelosi Calls For Equal Ratio Of Dem, GOP Members On Benghazi Panel
Discussion: The Daily Caller and Daily Kos
Catherine Thompson / Talking Points Memo:
Lawmaker Who Compared Obamacare To Holocaust: You're Missing My Point — The Tennessee lawmaker who compared Obamacare's individual mandate to Nazis deporting Jews to concentration camps thinks his critics missed the point. — State Sen. Stacey Campfield (R) caused a stir Monday morning …
Discussion: Mediaite, The Raw Story, No More Mister Nice Blog, Liberal Values and Camp4u
Evan McMurry / Mediaite: State Sen. Who Likened Obamacare to Nazi Death Trains Thinks You Just 'Missed His Point'
David Ferguson / The Raw Story: TN Republican who compared Obamacare to Nazi death camps says we missed his point
Ron Chusid / Liberal Values: Percentage of Uninsured Continues To Decrease-Tennessee Republican Compares Obamacare To The Holocaust
The Sen / Camp4u:
Here you go. — I regret that some people miss the point of my post.
Here you go. — I regret that some people miss the point of my post.
Discussion: Washington Monthly, Washington Post, The Huffington Post and Mediaite
Niraj Chokshi / Washington Post: Tennessee state senator: Critics 'miss the point' of blog post comparing Democrats, Nazis
Igor Bobic / The Huffington Post: GOP Lawmaker Who Compared Obamacare To Nazi 'Train Rides': It's All Just A Misunderstanding
Andrew Kirell / Mediaite: GOP State Sen.: Obamacare Sign-Ups Are Like Nazi Death Trains
Roque Planas / The Huffington Post:
MSNBC Celebrates Cinco De Mayo In Worst Possible Way — MSNBC tried its hand at cultural commentary on Monday with a Cinco de Mayo segment featuring a stereotypical portrayal of a stumbling Mexican by a reporter pretending to guzzle tequila straight from the bottle.
Discussion: Talking Points Memo, Hugo Balta, Politico, BuzzFeed, Mediaite and NewsBusters
Caitlin MacNeal / Talking Points Memo: MSNBC Apologizes For 'Ill-Advised' Cinco De Mayo Segment (VIDEO)
Adrian Carrasquillo / BuzzFeed: MSNBC To Apologize On-Air For Cringeworthy Cinco De Mayo Segment
Andrew Kirell / Mediaite: MSNBC Apologizes for Insensitive Segment on Cinco de Mayo
Mark Finkelstein / NewsBusters: What If Fox News Instead of MSNBC Had Pulled This Cinco de Mayo Stunt?
Adrian Carrasquillo / BuzzFeed:
Here's A Cringeworthy Video Of What MSNBC Thinks Cinco De Mayo Is About
Here's A Cringeworthy Video Of What MSNBC Thinks Cinco De Mayo Is About
Discussion: The Daily Caller, The Huffington Post and Poynter
Brendan Bordelon / The Daily Caller: MSNBC To Apologize For 'Racist' Cinco De Mayo Segment [VIDEO]
Roque Planas / The Huffington Post: Hispanic Journalists Demand MSNBC Apologize For Cinco De Mayo Segment
Andrew Beaujon / Poynter: MSNBC apologizes for Cinco de Mayo segment
Paul Roderick Gregory / Forbes:
Putin's 'Human Rights Council' Accidentally Posts Real Crimean Election Results — The website of the "President of Russia's Council on Civil Society and Human Rights" posted a blog that was quickly taken down as if it were toxic radioactive waste. According to the Council's report …
Discussion: Washington Post, Little Green Footballs, Business Insider, RedState and The PJ Tatler
Ilya Somin / Washington Post: Russian government agency reveals fraudulent nature of the Crimean referendum results
Paul Roderick Gregory / Little Green Footballs: Kremlin Accidentally Posted the Real Crimean Annexation Vote Results on their Site
Michael Kelley / Business Insider: Putin's Own Human Rights Council Published A Report Slamming The 'Discredited' Crimea Referendum
Eli Lake / The Daily Beast:
So Many Jihadists Are Flocking to Libya, It's Becoming 'Scumbag Woodstock' — Leaders from at least three of al Qaeda's most virulent affiliates are now in Libya. What are they planning there? — In the nearly 20 months since the September 11, 2012 Benghazi attacks …
Discussion: The PJ Tatler, Washington Post, Yahoo! News and Hit & Run
Rick Moran / The PJ Tatler: Libya Has Turned Into a 'Scumbag Woodstock'
Jennifer Rubin / Washington Post: Clinton's real problem isn't Benghazi, it's al-Qaeda
Nick Gillespie / Hit & Run: Forget Benghazi! "Libya is Now 'Scumbag Woodstock'"!
Globe and Mail:
Ford turns back from United States — After announcing he was taking time off to go to rehab, Toronto Mayor Rob Ford boarded a plane to Chicago last Thursday, landed, but then turned around before officially entering the United States. — "He voluntarily withdrew his application to enter the USA …
Discussion: Talking Points Memo, Guardian, Daily Mail and The Week
Tom Kludt / Talking Points Memo: Where's Rob Ford? Mayor Mysteriously Turns Plane Around After Touching Down In Chicago
Amanda Holpuch / Guardian: Toronto mayor Rob Ford reportedly denied entry to US
Ashley Collman / Daily Mail: Where's Rob Ford? Toronto mayor was turned away at the U.S. border after he announced leave of absence to enter rehab
Jordan Valinsky / The Week: Report: Rob Ford turned back from entering United States


text:
Dec 26th '14, 20:44
Dec 26th '14, 22:00
Dec 26th '14, 22:08
Dec 31st '14, 15:57
Atom95 wrote:Awesome. Thanks General! This will vastly improve my race gametype.
$lave wrote:Damnit bridgit, you are forgetting how fucking serious business the internet is.
Jan 1st '15, 23:16
Tycho X wrote:That sounds like a lot of fun!
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The Ultimate RPG MAKER for Windows! Introducing RPG MAKER™ XP, the latest Windows entry in the RPG MAKER series that gives you the power to create your own original role-playing games. Its popular and highly user-friendly editor interface has been carried over from RPG MAKER 2000, and its graphic capabilities, battle screen layout, and data packaging features are better than ever. By popular demand, this latest installment also boasts a brand-new Scripting function. RPG MAKER XP is bound to satisfy beginners and experts alike.
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Vintage Holiday Centerpiece
Light up the holiday table in classic style! Our noble fir and Western red cedar centerpiece arrangement is full of festive touches like berries, pinecones and a red taper candle to top it off. Set in a vintage tin planter with a charming poinsettia design, this is one gift sure to have family, friends and party guests feeling very merry!