text:
- Research
- Open Access
Soluble urokinase plasminogen activator receptor predicts mortality in exacerbated COPD
© The Author(s). 2018
- Received: 23 February 2018
- Accepted: 2 May 2018
- Published: 21 May 2018
The inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) is elevated in severe acute and chronic medical conditions and has been associated with short-term mortality. The role of suPAR in predicting risk of death following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has never been studied. We hypothesized that increased suPAR is an independent predictor of short-term mortality in patients admitted to hospital with COPD or acute respiratory failure.
This retrospective cohort study from a university hospital in the Capital Region of Denmark included 2838 acutely admitted medical patients with COPD as primary (AECOPD) or secondary diagnosis, who had plasma suPAR measured at the time of admission between November 18th, 2013 to September 30th, 2015 and followed until December 31st, 2015. Primary outcomes were 30- and 90-days all-cause mortality. Association of suPAR and mortality was investigated by Cox regression analyses adjusted for age, sex, CRP values and Charlson comorbidity index.
For patients with AECOPD or underlying COPD, median suPAR levels were significantly higher among patients who died within 30 days compared with those who survived (5.7 ng/ml (IQR 3.8–8.1) vs. 3.6 ng/ml (2.7–5.1), P < 0.0001). Increasing suPAR levels independently predicted 30-day mortality in patients with COPD with a hazard ratio of 2.0 (95% CI 1.7–2.4) but not respiratory failure.
In this large group of acutely admitted patients with COPD, elevated suPAR levels were associated with increased risk of mortality. The study supports the value of suPAR as a marker of poor prognosis.
- COPD exacerbation
- Mortality
- Biomarker
- Hospitalisation
Chronic obstructive pulmonary disease (COPD) is worldwide a leading cause of morbidity and mortality, posing a considerable socioeconomic burden to society [1]. COPD is a highly complex disease with symptoms not only related to the respiratory system. In many patients with COPD, the course of the disease will be progressive with a gradual decline in health status and increasing frequency and severity of acute exacerbations (AECOPD). This progressive course of the disease is associated with a substantial increase in all-cause mortality. In the clinical assessment of the severity of the disease, the GOLD classification is often applied [1]. However, improved risk prediction in patients with COPD would be of great value, in particular if it additionally would facilitate identification of terminal ill patients in need of enhanced preventive efforts, palliative care or other interventions.
Several biomarkers have, in studies of stable COPD, been associated with disease severity and mortality risk [2]. A history of frequent exacerbations of COPD is per se a marker of poor prognosis [3]. However, diagnostic and/or prognostic markers in unstable disease have so far provided variable results. In the ECLIPSE cohort, previous exacerbations, older age, high white blood cell count, emphysema, severe airflow limitation and poor health status were associated with increased risk of future hospitalizations [4]. A meta-analysis of routine blood-tests in AECOPD found that anaemia, hypoalbuminemia and elevated levels of the cardiac biomarkers pro-BNP and troponin-T, but not high-sensitivity C-reactive protein (hs-CRP) predicted mortality from COPD [5]. By contrast, a recent systematic review found CRP to be the only robust biomarker showing consistently elevated levels in AECOPD compared with control groups [6]. Recently, a readmission and mortality risk prediction score, comprising previous admissions, extended dyspnoea grade, age and heart failure but no biomarkers, has been proposed [7].
Previous studies have shown that the urokinase plasminogen activator receptor (uPAR) is involved in the pathogenesis (both small airway fibrosis and emphysema) of COPD through complex molecular pathways and gene expression patterns [8–10]. Soluble urokinase plasminogen activator receptor (suPAR) is the soluble form of the uPAR receptor and can be measured in blood/plasma. suPAR is considered an inflammatory biomarkerand is elevated in both acute and chronic illness. It is a non-specific risk marker with a diagnostic cut-off value of approximately 3 ng/ml [11]. However, little is known about suPAR in relation to disease status and mortality in COPD. suPAR has previously in a small study been found to be superior to CRP and fibrinogen in the prediction of AECOPD and in monitoring treatment of exacerbation [12]. Furthermore, suPAR levels are increased in stable COPD compared to healthy controls [13]. Finally, suPAR has been shown to predict a range of chronic conditions and mortality in the general population as well as being associated with risk of readmission and mortality in a large group of acutely admitted medical patients, with AECOPD constituting a subgroup of these [14, 15].
In this study, we aimed to investigate the value of suPAR levels in plasma upon hospital admission as a prognostic biomarker for short-term mortality in COPD patients based on a large, unselected population of acutely admitted medical patients.
Study design and population
This retrospective, registry-based cohort study was carried out in the Acute Medical Unit (AMU), Copenhagen University Hospital Hvidovre, Denmark, and included acute medical patients admitted from November 18th, 2013, until September 30th, 2015. The patients were followed in national registries for up to 90 days. The AMU receives unselected, adult internal medical patients within all specialties, except medical gastroenterology and patients requiring isolation due to infections or suspected acute myocardial infarction in need of PCI. Upon hospitalization, all patients routinely have a set of standard blood tests analysed, including blood cell count, electrolytes, analyses of kidney- and liver function, and CRP. Since November 18, 2013, suPAR has been included in this biomarker panel as a routine analysis. All patients, who were admitted to the AMU throughout the described period and had suPAR measured as part of the admission blood samples, were included in the present study.
- 1.
Patients admitted with acute exacerbation of COPD as the primary diagnosis during the index admission (AECOPD)
- 2.
Patients admitted with a diagnosis of COPD registered as the primary diagnosis before or during the index admission (any COPD)
- 3.
Patients admitted with respiratory failure as the primary diagnosis during the index admission and with a registration of COPD as secondary or any other order of diagnosis during the index admission (Respiratory failure)
Thus, patients belonging to the groups AECOPD and Respiratory failure are also included in any COPD. However, no patient appeared more than once in the analyses, i.e. readmissions were not included in the study.
Outcomes and covariates
The primary outcomes were death from any cause within 30 or 90 days after admission, respectively. Secondary outcome was analysis of the interaction between levels of suPAR and CRP.
Covariates included in the adjusted analyses were age, sex, Charlson comorbidity index (Charlson score), and CRP.
The Charlson score was calculated for each patient as a measure of the patients' comorbid conditions using a SAS macro, [18] and using the updated weights defined by Quan et al. [19] Assessment of the Charlson score was calculated from diagnoses registered in the NPR up to 2 years prior to the index admission.
Plasma suPAR levels were measured using the suPARnostic AUTO Flex ELISA kit (ViroGates A/S, Birkerød, Denmark) as described in detail previously [15]. The suPARnostic® ELISA measures the full length suPAR molecule (D1D2D3) as well as the cleaved suPAR molecule (D2D3).CRP was measured using a COBAS 6000 analyser (Roche Diagnostics, Mannheim, Germany).
Statistical analysis
Continuous variables are presented as median and interquartile range (IQR) and categorical variables are presented as numbers (n) and percentages (%).
We used both univariate and adjusted Cox regression analyses to estimate the effect of suPAR on time to death. Results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). The adjusted analyses were controlled for age, sex, Charlson score, and CRP. For the Cox regression analyses, suPAR was log2-transformed or stratified in quartiles.
Survival for suPAR- or CRP quartiles is presented in Kaplan-Meier plots for each of the three COPD groups.
Finally, we performed ROC curve analyses for 90-days mortality in the three groups using DeLongs test for two correlated ROC curves (with and without suPAR).
SAS Enterprise Guide 7.11 (SAS Institute) and R 3.2.3 (The R Foundation for Statistical Computing) were used for statistical analysis. R 3.2.3 was used to create the figures. A P < 0.05 was considered to be statistically significant.
Patient demographics and covariates at the index admission in patients with COPD as primary diagnosis, underlying COPD and respiratory failure due to COPD
any COPD
Respiratory failure
717 (20.2)
2573 (72.4)
265 (7.4)
311 (43.4)
1142 (44.4)
109 (41.1)
406 (56.6)
1431 (55.6)
156 (58.9)
Age (years)
72.8 (64.0–79.9)
73.4 (63.6–81.3)
73.4 (65.9–78.0)
Charlson score
1.0 (0–11)
1.0 (0–11)
1.0 (0–11)
Length of stay (days)
3.2 (0.8–7.8)
2.2 (0.7–6.8)
5.9 (1.8–12.0)
CRP (mg/L)
24.0 (6.0–75.0)
15.0 (4.0–65.0)
26.0 (7.0–86.0)
suPAR (ng/mL)
3.5 (2.6–5.0)
3.8 (2.8–5.4)
3.8 (2.8–5.3)
High suPAR and CRP are associated with increased risk of mortality
Mortality rates in patients with AECOPD, any COPD, or Respiratory failure due to COPD, respectively, stratified according to suPAR and CRP quartilesa
any COPD
Respiratory failure
30-day mortality
671 (93.6%)
46 (6.4%)
2338 (90.1%)
235 (9.1%)
210 (79.3%)
55 (20.7%)
suPAR (ng/ml), median (IQR)
3.5 (2.6–4.9)
4.5 (3.5–5.8)
3.6 (2.7–5.1)
5.7 (3.8–8.1)
< 0.0001
3.8 (2.8–5.1)
4.1 (3.0–6.3)
CRP (mg/L), median (IQR)
21 (5–75)
46 (15–86)
13 (4–57)
71 (20–160)
< 0.0001
21.5 (6–80)
43 (8.5–115)
suPAR quartile 1
176 (97.2%)
5 (2.8%)
594 (97.2%)
17 (2.8%)
58 (82.9%)
12 (17.1%)
suPAR quartile 2
176 (95.6%)
8 (4.4%)
634 (94.6%)
36 (5.4%)
51 (79.7%)
13 (20.3%)
suPAR quartile 3
165 (91.2%)
16 (8.8%)
583 (91.2%)
56 (8.8%)
54 (81.8%)
12 (18.2%)
suPAR quartile 4
154 (90.1%)
17 (9.9%)
527 (80.7%)
126 (19.3%)
< 0.0001b
47 (72.3%)
18 (27.7%)
CRP quartile 1
186 (96.9%)
6 (3.1%)
622 (96.4%)
23 (3.6%)
57 (80.3%)
14 (19.7%)
CRP quartile 2
166 (94.3%)
10 (5.7%)
619 (95.5%)
29 (4.5%)
54 (85.7%)
9 (14.3%)
CRP quartile 3
154 (90.1%)
17 (9.9%)
577 (89.6%)
67 (10.4%)
51 (77.3%)
15 (22.7%)
CRP quartile 4
165 (92.7%)
13 (7.3%)
520 (81.8%)
116 (18.2%)
< 0.0001b
48 (73.8%)
17 (26.2%)
90-day mortality
621 (86.6%)
96 (13.4%)
2203 (85.6)
370 (14.4%)
194 (73.2%)
71 (26.8%)
suPAR (ng/ml), median (IQR)
3.3 (2.6–4.6)
4.7 (3.7–6.2)
< 0.0001
3.6 (2.7–5.0)
5.4 (3.8–7.5)
< 0.0001
3.7 (2.8–5.0)
4.2 (3.0–6.3)
CRP (mg/L), median (IQR)
20 (5–75.5)
41 (13–73)
12 (3–54)
61 (16–130)
< 0.0001
19 (6–82)
43 (7–110)
suPAR quartile 1
174 (96.1%)
7 (3.9%)
583 (95.4%)
28 (4.6%)
55 (78.6%)
15 (21.4%)
suPAR quartile 2
169 (91.9%)
15 (8.1%)
614 (91.6%)
56 (8.4%)
49 (76.6%)
15 (23.4%)
suPAR quartile 3
149 (82.3%)
32 (17.7%)
540 (84.5%)
99 (15.5%)
49 (74.2%)
17 (25.8%)
suPAR quartile 4
129 (75.4%)
42 (24.6%)
< 0.0001b
466 (71.4%)
187 (28.6%)
< 0.0001b
41 (63.1%)
24 (36.9%)
CRP quartile 1
178 (92.7%)
14 (7.3%)
605 (93.8%)
40 (6.2%)
52 (73.2%)
19 (26.8%)
CRP quartile 2
155 (88.1%)
21 (11.9%)
593 (91.5%)
55 (8.5%)
51 (81.0%)
12 (19.0%)
CRP quartile 3
133 (77.8%)
38 (22.2%)
537 (83.4%)
107 (16.6%)
46 (69.7%)
20 (30.3%)
CRP quartile 4
155 (87.1%)
23 (12.9%)
468 (73.6%)
168 (26.4%)
< 0.0001b
45 (69.2%)
20 (30.8%)
suPAR levels independently predict mortality risk
Thirty- and 90-day mortality risk, expressed as hazard ratios, by suPAR levels, entered as either continuous (log-transformed) or in quartiles, at index admission in patients with AE COPD, any COPD and Respiratory failure due to COPD
AECOPD (n = 717)
any COPD (n = 2573)
Respiratory failure (n = 265)
30-day mortalityb
2.2 (1.5–3.2)
< 0.0001
2.5 (2.1–2.9)
< 0.0001
1.5 (1.0–2.1)
1.6 (0.5–4.9)
2.0 (1.1–3.5)
1.2 (0.6–2.7)
3.3 (1.2–9.0)
3.3 (1.9–5.6)
< 0.0001
1.1 (0.5–2.4)
3.7 (1.4–10.1)
7.6 (4.6–12-6)
< 0.0001
1.8 (0.9–3.7)
1.8 (1.2–2.8)
2.0 (1.7–2.4)
< 0.0001
1.3 (0.8–2.0)
1.2 (0.4–3.8)
1.5 (0.8–2.6)
1.2 (0.5–2.7)
2.3 (0.8–6.6)
1.8 (1.1–3.2)
0.8 (0.4–1.9)
2.0 (0.7–5.7)
3.4 (2.0–5.9)
< 0.0001
1.3 (0.6–2.8)
90-day mortalityc
2.5 (2.0–3.3)
< 0.0001
2.3 (2.1–2.6)
< 0.0001
1.5 (1.1–2.2)
2.1 (0.9–5.3)
1.9 (1.2–2.9)
1.1 (0.6–2.4)
4.9 (2.2–11-1)
3.6 (2.4–5.4)
< 0.0001
1.0 (0.5–2.1)
7.1 (3.2–15.8)
< 0.0001
7.3 (4.9–10.8)
< 0.0001
1.6 (0.8–3.1)
2.2 (1.6–2.9)
< 0.0001
2.3 (2.1–2.6)
< 0.0001
1.4 (1.0–2.1)
1.8 (0.7–4.5)
1.5 (0.8–2.6)
1.1 (0.6–2.4)
3.9 (1.7–8.9)
1.8 (1.1–3.2)
1.0 (0.5–2.1)
4.3 (1.9–9.9)
3.4 (2.0–5.9)
< 0.0001
1.6 (0.8–3.1)
The ROC curve analyses confirmed that there were significant differences for the AUC, when suPAR was added to age, sex, Charlson score and CRP in the two COPD groups but not for Respiratory failure (not shown).Calculations of the sensitivity and specificity of log-transformed suPAR yielded values of 0.78 and 0.49, respectively, for 30- days mortality in the largest patient group (Additional file 1: Table S1).
Interaction between CRP and suPAR
To assess whether the association between suPAR levels and mortality was mediated through a concomitant increase in CRP, we performed interaction analyses with CRP as a linear, continuous variable and suPAR as either a continuous variable or log-transformed in separate analyses for all three groups and for both 30- and 90-day mortality. There was no significant interaction between the two biomarkers except for 90-day mortality in the largest group when entering suPAR as a continuous variable (p = 0.04) (data not shown).
This retrospective cohort study in a population of patients admitted to a University hospital with AECOPD or any acute medical condition with underlying COPD showed that the inflammatory biomarker suPAR was independently associated with all-cause mortality. Furthermore, we showed that median suPAR levels were higher among those who died within 90 days of admission compared with those who survived in all three groups of respiratory patients. Interaction analyses showed that these effects were not mediated through concomitantly elevated CRP, although this biomarker was also independently associated with mortality, but less consistently compared to suPAR. This is consistent with previous findings and the value of CRP in combination with other biomarkers as indicators of poor prognosis in COPD has also recently been confirmed in a study comprising patients from the COPDGene- and the ECLIPSE cohorts [6, 20].
To our knowledge, this is the first large-scale study investigating the relationship between this recently introduced prognostic biomarker and COPD. The mortality rate in the present study did not differ from other studies of mortality in relation to severe AECOPD [21]. The magnitude of the association corresponds well with other studies that specifically have addressed the role of suPAR as prognostic indicator of mortality in acutely ill patients [15, 22, 23]. However, the vast majority of previous studies have investigated suPAR in cohorts of patients with systemic inflammatory response syndrome (SIRS) or sepsis in an intensive care unit setting, which makes comparisons of the present study with previous findings challenging. The sensitivity and specificity of suPAR regarding mortality in the present study is comparable with pooled values from a recent systematic review of suPAR and bacterial infections [24]. A very recent study of chronic heart failure (CHF), a condition which has the chronic, systemic inflammation in common with COPD, found that elevated suPAR levels approximately doubled the risk of subsequent mortality during 3 years of follow-up [25]. This was, however, stable patients in an outpatient setting. A Danish study of 449 patients consecutively admitted to hospital with chest pain and followed for up to 6.6 years found that suPAR was associated with increased all-cause mortality independent of other variables reflecting myocardial ischaemia (HR 1.93) [26]. Only one small cross-sectional study comprising 43 patients has measured suPAR upon hospitalisation with AECOPD and found it to be higher than in healthy controls [12] and also that suPAR correlated negatively with level of FEV1. Furthermore, suPAR levels decreased after 7 days, but whether this was a treatment effect or occurred spontaneously remains unknown. Two other small studies of stable COPD patients matched with healthy control subjects found opposite effects regarding suPAR levels [13, 27]. Thus, the value of adding suPAR to routine blood samples in hospitalised AECOPD for subsequent risk prediction has so far been largely unexplored. It has previously been demonstrated that the cell-bound form of suPAR (uPAR) is highly expressed in the small airway epithelia of patients with COPD compared with normal controls and that increased uPAR expression in the small airway epithelium of patients with COPD participates in an active epithelial-mesenchymal transition process [8, 9]. Assuming that increased uPAR expression results in increased uPAR cleavage and suPAR generation, the observations by Wang and co-workers are supported by our observation of increased suPAR and worse prognosis in COPD.
Given the pathophysiological mechanisms of most cases of AECOPD, namely a flare-up in acute local and systemic inflammatory mediators and airway bacterial or viral infection, [28] a high level of an unspecific inflammatory biomarker such as suPAR is expected. As suPAR is a very stable biomarker, it may be less affected by the exacerbation and more reflective of the underlying chronic condition, which may explain its high prognostic power in AECOPD.
In AECOPD no single biomarker or clinical test, apart from sustained respiratory acidosis measured in an arterial puncture, can accurately predict the immediate or short-term (less than 3 months) outcome [29]. Previous studies have proposed either a panel of biomarkers, a composite measure of clinical features and blood tests e.g. as a "prediction score tool" or simply an assessment of demographic variables for determining the risk for hospital readmission or death from COPD [2–7]. In terms of novel biomarkers of prognosis in COPD, the study by Stolz et al. [2] found that simultaneously elevated plasma levels of the three biomarkers adrenomedullin, arginine vasopressin and atrial natriuretic peptide were associated with increased mortality risk during a 5-year follow-up in patients with stable COPD. An assessment of adrenomedullin alone or in combination with composite measures such as age, grade of dyspnea and degree of airflow obstruction conveyed an increased mortality risk comparable to the observations in the present study [30]. However, the patients in this study were derived from several cohorts of patients who also had stable disease. Furthermore, a number of the scoring tools that have been developed for predicting future risk of readmission or death from AECOPD are quite complex or include measures of cardiovascular comorbidity, which may not be readily accessible in the acute setting [7, 31]. None of the scoring systems seem to agree upon, which few key parameters are considered superior in the prediction of severe and/or fatal incidents of AECOPD. The latest publication proposes an 8-item scoring tool for predicting 1-year mortality after a first hospitalization for AECOPD [32]. The variables associated with increased risk included older age, male sex, having a severe exacerbation, longer duration of the disease and hospital stay, prior hospital admissions, a diagnosis of cancer and a higher Charlson score. A number of these were already predefined as important confounders and included as covariates in the present study [15]. Interestingly, a study aimed at predicting 12-month mortality in elderly patients presenting to the emergency ward, by asking the attending physicians the so-called "surprise question" ("Would you be surprised whether this patient died in the next 12 months?") suggested a fair sensitivity but poor specificity [33]. When combined with other determinants of unfavourable outcome, although not including any blood-based biomarkers, results remained unchanged.
For admission with respiratory failure and COPD as secondary diagnosis we found no statistical significant relationship between suPAR and mortality, although there was a tendency when entering suPAR as a continuous variable for death by 90 days (p = 0.06, Table 3). This may in part be due to the small numbers, especially when analysis is performed by suPAR quartiles. Nevertheless, this finding is somewhat unexpected and needs further investigation. Patients with acute, hypercapnic respiratory failure have an even higher risk of in-hospital or short-term mortality than patients belonging to either of the other groups, [29] which is why a stronger relationship would be anticipated in this group. The 30- and 90 days mortality rates were approximately doubled in the Respiratory failure group compared with the other groups, indicating that the negative results from the survival analyses represent a statistical lack of power rather than a true association.
Limitations of the present study include lack of data on smoking status as suPAR is confounded by smoking [34]. The Danish patient registries are validated and diagnoses are registered upon hospital discharge or in-hospital death but some inaccuracy may occur, although misclassification of the diagnoses in question is normally not a major source of bias [35]. Furthermore, this study did not discriminate the patients by other indicators of increased mortality risk such as number of previous exacerbations, need for non-invasive ventilation or referral to intensive care unit, level of FEV1, dyspnoea grade, BMI or socioeconomic status. However, regarding FEV1, the new GOLD guidelines recognize that a hospitalisation for COPD is more predictive of worsened prognosis than lung function [1]. Nevertheless we cannot rule out that patients with high levels of suPAR also had lower FEV1. Also, measurement of blood-eosinophils was only available in a minority of the patients. Another limitation is that suPAR values were only measured at hospital admission, and thus it was not possible to assess whether this biomarker changed according to therapy or disease course in general. In future studies of AECOPD it would also be useful to analyse how suPAR can contribute to already existing prediction scores for readmission and/or death.
We have shown that suPAR levels are elevated in patients admitted to a large university hospital with COPD as primary or secondary diagnosis, who died within 30- or 90 days of follow-up compared with patients, who survived. The risk of death within 30- or 90 days after admission was doubled with increasing levels of suPAR for patients with AECOPD or any medical condition and underlying COPD, which is consistent with other studies. suPAR seems to be independent of- and better than CRP in discriminating an adverse outcome. It is therefore suggested that measurement of suPAR can be used as an indicator of poor prognosis in patients with more severe acute exacerbation of COPD.
Availability of data and materials
The data that support the findings of this study are available from the Clinical Research Centre, Amager and Hvidovre Hospital but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the Clinical Research Centre, Amager and Hvidovre Hospital.
Authors' contributions
NSG, DVJ, KM and CSU contributed to designing the study, interpreting data, drafting the manuscript and approving the final version. OA and JE-O contributed to designing the study, acquisition of and interpreting data and approving the final version of the manuscript. LJHR contributed to designing the study, analyzing and interpreting data, drafting the manuscript, and approving the final version.
Ethics approval and consent to participate
The study was approved by the Danish Health and Medicines Authority (ref. no. 3–3013-1061/1) and by the Danish Data Protection Agency (ref.no. HVH-2014-018, 02767).
Competing interests
NSG, DVJ, KM, CSU and LJHR have nothing to declare. JE-O and OA have invented patents on suPAR and prognosis. The patents are owned by Amager and Hvidovre Hospital, Denmark and licensed to ViroGates A/S. JE-O is co-founder, shareholder and CSO of ViroGates A/S.
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- Rasmussen LJH, Ladelund S, Haupt TH, Ellekilde G, Poulsen JH, Iversen K, et al. Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study. Emerg Med J. 2016;33:769–75.View ArticlePubMedPubMed CentralGoogle Scholar
- Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Scand J Public Health. 2011;39:30–3.View ArticlePubMedGoogle Scholar
- Pedersen CB. The Danish civil registration system. Scand J Public Health. 2011;39:22–5.View ArticlePubMedGoogle Scholar
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- Uusitalo-Seppälä R, Huttunen R, Tarkka M, Aittoniemi J, Koskinen P, Leino A, et al. Soluble urokinase-type plasminogen activator receptor in patients with suspected infection in the emergency room: a prospective cohort study. J Intern Med. 2012;272:247–56.View ArticlePubMedGoogle Scholar
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- Haupt TH, Kallemose T, Ladelund S, Rasmussen LJ, Thorball CW, Andersen O, et al. Risk factors associated with serum levels of the inflammatory biomarker soluble urokinase plasminogen activator receptor in a general population. Biomark Insights. 2014;9:91–100.View ArticlePubMedPubMed CentralGoogle Scholar
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text:
Tuesday, 24 January 2012
Leave The Damn Thing
20:50 | Posted by Imaginary | | Edit Post
I really don't know what to write in this post.
But I do know this, it's time that people woke up.
Right know people are in chains, and they have every ability to remove these chains but they choose not to, I would ask why but I already know the answer.
It's fear.
Fear is the only roadblock between you and eternal freedom, it's the only thing that's keeping you lying to yourself waiting for a supreme being to bestow his divine blessings upon you, the thing that keeps you saying "someday I'll be free.. someday".
No, not someday, now, that is where freedom exists, reality.
I don't blame you though, you've been programmed to think in a certain, destructive way, and you don't know how to decode the program.
Why is it that you became a slave to thought? Aren't you sick and tired from running around all day and night just for a sense of approval? A sense of self worth? Hasn't that tired you out enough? Why have you surrendered to beliefs of what should or shouldn't be? What is and isn't?
The prison of humanity has a door which is wide open, but humanity just gets so close to the door and runs back shivering from fear. They are so afraid from the punishment they might receive from actually crossing the door, they'd be labeled as different, weird, crazy, they're afraid that they'll be unwanted after they're free.
But once you're free it won't matter to you, at all, it will be actually natural, you won't need to keep up that false image anymore, so it wouldn't matter what people think of you, who would they be judging? You? Who?
Whoever says that you are good or bad, right or wrong, fat or thin, cute or ugly, is just judging you based on what has been accepted as the "norm", it's what has been blindly accepted but not verified, whoever that person is, he doesn't really know you, he never knew you.
That's the thing, nobody really knows you, and at the same time you really don't know anybody, so what's approval gonna bring you anyway, what is it that's being approved? The lie?
The lie that's been injected into your brain? the lie that has no ground in reality whatsoever? the false story?
Think for yourself, leave all that bullshit behind, you don't need approval, you don't need to increase your self worth, because that's all a false expression anyway, it's all false, get it? It's a joke, there's no you, never was, and never will be.
You don't need to defend, you don't "need" to do anything, just life being.
Life is infinite, because this moment is infinite, it never ended and never began, you will only be able to see that once you are able to see truth, not fallacy, and you do that by taking the mask off and denying everything you thought of as true.
Deny everything and everyone, I'm talking about everything here, everything you believe in, everything you've been taught as true in school, what your parents told you what your friends told you, every single thing.
Just throw it all away and take that chance, throw all that false bullshit behind and just move on and never look back, whenever you're feeling afraid, ask yourself what are you afraid of, this is truth we're talking about and you'll never get there if you're sitting in a corner biting your nails.
Once that's done, once the lie's been seen as it is, then the mask disintegrates, and what's beneath is what is true. That nothingness.
Seeing the non-existence of the self and the actual existence of life is the most freeing experience.
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SCARBOROUGH — The board of education will meet Thursday, June 21 in executive session to discuss Superintendent Julie Kukenberger's contract.
The board will meet at 7 p.m. at the municipal building on Route 1. According to the agenda, a motion will be taken to go into executive session "for discussions concerning the Superintendent's contract/evaluation, not to return to public session."
The board must hold a public meeting to vote on issues discussed during an executive session.
Kukenberger was hired by the district in 2016, but there has been a recent vocal contingent in town seeking to oust the superintendent based on criticism of her leadership, focusing on the forced resignation of Scarborough High School Principal David Creech and changing school start times.
Three board of education members, Jodi Shea, Donna Beeley, and Cari Lyford, were recalled in May, accused of incompetence, and following the vote, Kukenberger was called on to resign by supporters of that movement.


text:
The rain is coming down in sheets as I stare out the window at the bike that sits atop the roof rack of my car in the office parking lot. I had planned on riding today at lunch but am nursing a bruised motivation to ride for some reason. I usually jump at the chance to ride in the rain, but today something just doesn't feel right. Maybe it's the onset of the holiday blues or perhaps just the aftereffects of a tough ride this past Sunday, but for whatever reason here I sit forlornly surfing the internet on my lunch break searching for answers to questions I can't quite accurately pose instead of pedaling away my office-induced frustration. Although Google returns 17000 results in 0.59 sec for "why am I watching water drip from my bike handlebars instead of listening to the hiss of tires on pavement", I still can't seem to find a solution. So much for the information age.
Luckily I happened upon a Dirt Rag Interview with Keith Bontrager in which I think I've discovered the key to happiness:
"When I'm home my days often go like this: Wake up, yell at the cats, drink very strong coffee, feed the livestock, water the garden, eat something, do my email, fiddle with bikes, go for a ride or run in the hills, check email, harvest, cook and eat dinner (with a beer), yell at the cats, go to bed. It's a pretty basic life."
Amen to that. Now how do I get there from here?


text:
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Buds: Lavender Conditioner
*Ingredients from Organic Farming 99.4% of the total ingredients are from Natural Origin 10.1% of the total ingredients are from Organic Farming 99.9% of the plant ingredients are from Organic Farming Natural and Organic Cosmetic certified by ECOCERT GREENLIFE according to ECOCERT Standard available at http://cosmetics.ecocert.comHow To Use : After rinsing out Shampoo completely, fill your palm with a dollop of conditioner and spread it through your hair evenly. Take your time and work it in nicely. Make sure you´ve turned out the water while you are doing this. Once that is done properly, you can brush your teeth to give the conditioner time to really pamper your hair. Then turn on your water again and you can rinse your hair and gargle.
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text:
About the Race for Refugees:
The Race for Refugees brings awareness and much needed funding for the support of Syrian refugees and other refugees from around the world. Directed by Paoli Presbyterian Church, in Paoli, Pennsylvania, the event includes a 5K . Kiddie K and Family Fun Day with live music, food, and activities for the whole family.
What is the Refugee Crisis?
Over 60 million children and families have been forcibly displaced from their homes by conflict and strife, collapse of infrastructure, and serious danger to their lives. These are the largest numbers of refugees and displaced people since World War II. Refugees are people who have fled their home country due to war, violence, or persecution, according to the UN Refugee Agency. Refugees are different from immigrants because refugees cannot go home, or are afraid that it is not safe to return. Displaced people have had to leave their homes for the same reason as a refugee, but they are still living within their home country. More than half of all the world's refugees are children under the age of 18.
World Vision: Going to the Ends where no one else goes:
Started in the 19050's World Vision is a global Christian humanitarian organization. WV goes where humanitarian and development needs are high. If estimates hold true, by 2030, around eighty percent of the world's extreme poor will live in fragile states. What's more alarming is that extreme poverty has a child's face: the majority of people in fragile contexts are young. As a child-focused organization, WV has a clear call to help the most vulnerable children — those who live in fragile states and who are increasingly forced to flee instability within and across borders as refugees. World Vision partners with churches, donor governments, corporations, and individual supporters across the globe, in addition to local communities, faith bodies, civil society, and public institutions where they work. Ultimately, WV's successful programs empower refugees and displaced people and cultivate ingenuity and resilience, so that communities have the know-how, the confidence, and the ability to help themselves and care for their children.


text:
Hide Forgot
Description of problem:
Dragging a nautilus folder icon to the panel will create a launcher to
open the folder. However if the name of the folder has non-ascii
chars in it the launcher doesn't work, since the folder name vfs URI
get's quoted.
Version-Release number of selected component (if applicable):
How reproducible:
Steps to Reproduce:
1. Create folder with non-ascii (eg. "ø") in the name
2. Drag nautilus folder icon to panel
3. Try to open the folder from the panel
Actual results:
Folder doesn't open, insted error dialog is shown:
Couldn't find "/home/bongo/Desktop/C3B8"
Expected results:
Folder should open.
Additional info:
Hmm, the problem is that the panel apparently interprets %f etc in the
commandline. One possible fix would be to escape the % in the uri to %%.
Another solution would be to instead of creating an Application
lauchcher with cmdline nautilus -- 'uri', create a Link launcher with
just the given uri.
As of gnome-panel-2.8.1-2, I can no longer reproduce the bug. Closing.


text:
I had been feeling an urge to see the sea so I decided to take the plunge (no, not actually IN the sea, I'm talking about the East coast of Britain here) and book somewhere to stay with the girls for the first weekend of the Easter holidays. Last summer we took quite a few trips together, mostly to see friends, but it has been a while since we travelled anywhere together and although the thought made me a little nervous, I really wanted to do it.
Well, I am so glad we did. I found a converted farm property at Boggle Hole, which is close to Robin Hood's Bay, that had availability (www.southhousefarm.co.uk). My Mum said she'd like to join us for most of the stay, and my sister said she'd come up for a day too. Whilst getting ready for even a three day trip was something like preparing to climb Mount Everest (or so I imagine, clearly this is not something I have ever done) once we were on the road I felt a sense of achievement and excitement at the thought of taking a nearly three year old and a five year old to the seaside. Children this age love the sea - or at least I have never met one that doesn't.
Admittedly there were a few moments on the journey when I began to think that I had, in fact, momentarily lost the last remaining dregs of my sanity. Particularly as the girls have rather different music taste and were expressing this in a very vocal manner. This particular argument was definitely fuelled by my rash decision earlier in the week to buy some cheesy music for five year old to sing along to in the form of Abba Gold. Why oh why I did that I will never really understand. Yes she loves it, but only if you play Dancing Queen followed by Mamma Mia followed by Dancing Queen followed by... you get the picture. And it seems I had forgotten just how bad that music really is (apologies to Abba fans if you're reading, it's just not my thing). Two year old on the other hand wanted a lullaby that's on a CD produced by two members of Tindersticks and sung by Robert Forster - I'd like to say her taste is already more sophisticated but I fear that smacks of favouritism and I don't mean it that way. Anyway I seem to have been sidetracked by my meanderings about our journey when I really wanted to write about our lovely weekend.
We arrived at the house: "Mummy, it's a topsy-turvy house! The bedrooms are downstairs and the kitchen is upstairs." I then had about 15 minutes of sheer panic as I misplaced my car keys and therefore couldn't get anything out of the boot (they were on the dashboard by the way): "Mummy when can we go to the beach? Mummy, can we go to the beach yet? Mummy, why can't we go to the beach yet?" Aaaarrrggghhh. But once I'd found them and grabbed a towel and changes of clothes - oh yes, and buckets and spades, and wellies of course (I'll remind you this is the East coast of Britain), we set off down the hill.
Part of the beauty of Boggle Hole is that it is completely devoid of external attractions. By that I mean it simply is a sheltered pebbly bay at the bottom of a road. No crazy golf, no slot machines, no fairground rides and - dare I say it - not even any ice cream for sale. The girls loved it. We paddled and froze our feet. We collected shells, pebbles and seaweed. We searched for crabs. We smiled. In such a setting there is no need to try and entertain children in the way that we seem to do constantly in our society, they can simply be, exploring and discovering for themselves.
Later my Mum arrived, which brought more excitement, and the next day was spent with her and my sister's family. We even had sun. Perfect.
Two days later I was driving home - girls asleep, one clutching a peanut butter sandwich, the other a bucket of 'treasures' - and I was moved to streams of tears. Don't think by this that I felt bad, my sadness was a complicated one but it has its root in a deep sense of how fortunate I am right now. I was internally thanking my Dad, who died in 2002, for teaching me about the pleasure that the simplest things can bring. I will always be happiest in the open air, in simple and uncluttered surroundings, and whilst at that point the memory of Dad brought tears and a sense of loss for those few moments, I know that something of him stays with me. And I also know that there is something of him in my two wonderfully funny, charismatic and adventurous little girls.


text:
Rohl farmhouse sink – Ceramic rohl farmhouse sink is from of natural minerals. Include various clay that is pre fired and coated with a waterproofing solution. The high temperatures produce a luxurious glaze to clay basin and provide a powerful, durable surface. Since ceramics are highly resistant to scratches, it is not likely Rohl ceramic sink will deeply scratch. If you get a surface scratch in Rohl sink, can arise from frequently washing utensils and metal dishware in the sink, you can repair it with a pumice stone.
To fix scratched ceramic rohl farmhouse sink, things you need are: pumice, Waste water soap (optional) and soft cloth (optional). Starting with replace the drain plug in ceramic rohl farmhouse sink and fill it with about 1/2 inch, or just enough to cover the bottom. Wet pumice completely in the water.
Buff scratches on the sides of rohl sink with pumice. Rub the stone over the scratch and go in the direction of the scratch. To remove the scratch, keep polishing moving back and forth. Pull the drain plug. Drain the water from the sink. Removing scratches the ceramic rohl farmhouse sink. Remember to keep wet of pumice stone. Remember. Avoid washing your metal utensils, pots, pans and dishes in Rohl ceramic sink. And also clean rohl sink daily with dishwashing soap and a soft cloth.More reader came from this term:rohl farm sinks,rohl farmhouse sink,rohl faucets repair,ceramic farmhouse sink


text: A heavier thrusting weapon that targets the entire body. All hits must be with the tip and not the sides of the blade. Touches hit by the side of the blade do not halt the action. Unlike foil and sabre, Épée does not use right of way, and allows simultaneous hits by both fencers. However, if the score is tied at the last point and a double touch is scored, nobody is awarded the point.


text:
Maybe you simply want to change the color of a metal door, or maybe the existing paint is peeling off. Whatever the case, you can paint a metal door and make it look like new again. Although the task is easy, it can also be time-consuming. The worse shape your door is in, the more preparation time you'll need for the project. Once you're finished, however, you'll be proud of your work and realize how much your prep time paid off.
Step 1
Remove all hardware, including locks, knobs, kickplates, and knockers with a screwdriver. If possible, also remove weatherstripping. Place the hardware, along with screws, together in a container to ensure they don't get lost.
Step 2
Remove any small areas of loose paint with a paint scraper. If the majority of paint is in bad shape, use paint remover to strip the metal door. Follow the manufacturer's instructions for best results. Apply the remover with a brush and wipe off the dissolved paint after the designated amount of time noted on the instructions.
Step 3
Use denatured alcohol and a cloth to clean the metal door to make sure it is free of oil, grease, and other contaminants. This step ensures the paint will adhere properly to the surface.
Step 4
Cover glass or screen sections in the metal door with newspaper and painter's tape. Block off any weatherstripping that's still attached before you begin to paint.
Step 5
Apply a metal primer to the door with a brush, if you previously stripped the paint—or if there are bare spots exposing the metal. If you use a different type of paint than the existing finish, you'll also need to apply primer to ensure the new paint sticks properly. Always follow the directions on the container, and allow the primer to dry before you proceed.
Step 6
Paint the metal door by using a short nap roller and a paint pan. Not only will using a roller make your job quicker, but it also won't leave brush marks. If there are indentations in the metal, use a small 4-inch roller so you can reach them. After the first coat of pain has dried, apply a second coat, if necessary.


text:
By Jay Leon Guerrero
The Islandwide Junior Varsity Basketball Tournament hosted by the Guam Basketball Confederation (GBC) tipped off Monday afternoon with nine teams participating at the Okkodo Gym.
GBC held the tournament after the IIAAG season to determine a champion. This is the fourth year of the tournament hosted by GBC, the highest governing board for basketball in the region. Action started in the afternoon and carried into the early evening as teams started the double elimination format.
JFK, Tiyan and both Okkodo teams (Okkodo A and Okkodo B) advanced to the winners bracket. Basketball will resume on Wednesday at Okkodo due to the semi-final games played on Tuesday evening.
Game results:
Okkodo B 71, ND Royals 31
The Okkodo Bulldogs B team defeated the visiting ND Royals 71-31. Jan Gozum led a balanced Okkodo scoring attack with 14 points. Lenard Baul and Nick Panganiban each scored 10 points for the Bulldogs. Shayden Attao led the Royals with a game high 21 points.
The JFK Islanders were on fire from down town, draining 12 three-pointers to send the GW Geckos to the losers bracket. Jobi Saimon hit four 3-pointers for JFK as they defeated the GW Geckos 68-30. Edmund Palacios led the Geckos with 11 points. Ralf Manalac led all scorers with 13 points for JFK.
Okkodo B 54, FD 39
The Okkodo B team avenged a regular season loss against the Friars and defeated the bigger team 54-39. Nicolas Panganiban and Jon Michael Lorena led the offense in the second and third quarter as the Bulldogs maintained a double digit lead.
"We are going to do our best to win this tournament. It helps that we play (the first day) in our home court, we practice here and it is an advantage," said Panganiban. "We learned from our loss against FD in the regular season and came into this game with a better mentality," said Lorena. Lorena forced turnovers in the paint, handing the Friars the worst loss of the year. Raymond Castro led FD with 12 points.
Tiyan 59, Guam High 34
"Our defense will help us win this tournament," said Tiyan's Ian Asuncion. The Titans held the Guam High Panthers to just two points in the first six minutes of regulation to get the win.
Laurence Decano said everyone contributed to the win and he looks forward to challenging other teams in the tournament.
"We look to get better as the season continues with good teamwork."
Decano scored seven points in the second half to help his team secure the victory. Asuncion had a team high 12 points to lead the Titans. Dillen Dela Cruz scored a game high 17 points for the Panthers.
Okkodo A 38, Sanchez 33
Alvin Aromin and Tristan Valdez each scored eight points to lead the Bulldogs offensively. The Bulldogs led 30-21 after three quarters before the Sharks made a comeback in the final period.
Sanchez had a shot to tie the game with 30 seconds left in regulation but a moving screen (offensive foul) gave possession back to the Bulldogs and they made all their free throws down the stretch to advance to the winners bracket. Julio Devera scored 11 points to lead the Sharks, Ivan Perez chipped in eight points.
Elimination Game:
GW's Edmund Palacios scored 20 points in the second half to help the Geckos win a come from behind victory over the ND Royals. The Royals were eliminated after the loss.
The Geckos trailed by six points in the final five minutes of regulation but managed to take the lead late in the game. The Royals had two attempts in the final seconds of the game to win but came up short.
Palacios had 22 points total, 20 in the second half to keep GW 's season alive. Nolan Sablan scored 20 points for the Royals.
Wednesdays games at Okkodo:
Guam High vs Sanchez @ 5pm
FD vs GW @ 615pm
JFK vs Okkodo B @ 730pm


text: Our range of our selection of bathroom mirrors only the 3rd generation silver mirror with other all of timesaving fea energy efficient and dimmable led bulbs and style to large led mirrors encore led bathroom mirrors to enhance your space and traditional bathrooms. Bathroom with this stylish and sophistication this timeless contemporary other fixtures. Led bathroom mirrors style, shipping on our range of illuminated and get ready while seeing clearly when preparing for your facial features such as well as bringing an accent as a touch of bathroom glow the business day from. All products come with the 3rd generation silver.Tag: led bathroom mirrors style


text:
Halderson arrived in the NHL when Detroit purchased the Victoria Cougars during the 1926-27 season. He played for the Detroit Cougars in 19 games and the Toronto Pats and Leafs in 25 more, having been traded by Detroit for Pete Bellefeuille. He then spent two seasons in the Canadian-American Hockey League before moving on to the American Hockey Association, where he played until 1937.
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text:
And . . . action! As the uproarious trio returns, sensitive Sean takes the spotlight — scripting a low-low-budget film while fielding unexpected female fans.
Coop is cooking up another sure-misfire scheme (big surprise), and this time the comedy plays out from Sean's point of view. What's the new master plan? Making a cheapo horror movie guaranteed to make Coop, Sean, and Matt filthy rich! It's a terrible idea, and Sean knows it. But he actually is desperate for cash — and for a way to wipe that big fat L off his girlfriend-less forehead. But when he agrees to write a script about the attack of zombie-vampire humanzees, he has no idea just how powerful a chick magnet this movie will be. Suddenly Sean is juggling not one but three interested ladies. There's his accidental-girlfriend-turned-psychotic-stalker, Evelyn. There's the wicked hot actress from drama class, Leyna, who seems willing to do anything to land the starring role. And even his twin sister's gothed-out best friend, Nessa, is looking at Sean in a whole new way. Will any of them wind up as Sean's true leading lady? Will Sean stop being a doormat and finally start calling the shots?
Book Trailer
Kirkus Reviews
August 1, 2012
It's nice guy Sean's turn to shine in this hilarious follow-up to Swim the Fly (2009) and Beat the Band (2010).
Sean isn't initially swayed by his crazy friend Coop's idea to make himself, Sean and their third amigo Matt into millionaires by shooting a low-budget horror film. But after his parents announce that they are having another baby and there is no money for a bigger house, Sean decides to sign on as screenwriter to avoid moving into his mean twin sister's room. However, writing the movie is the least of his problems. Sean also finds himself embroiled in a terrifying romantic four-way with his new, Swiss-cheese–smelling, stalker girlfriend Evelyn, his drama crush Leyna and his sister's best friend, the enigmatic Nessa. Sean's well-intentioned attempts to juggle his relationships, school and the movie shoot result in the kind of outrageous mishaps that fans have come to expect from author Calame, who once again does not disappoint with grade-A gross-outs that include a colossal bird-crap bombing and a chorizo-and-chili projectile-vomiting incident.
Fearlessly foul, this consistently comical series should be required reading for all teenage boys and anyone else with a strong stomach and highly sensitive funny bone. (Fiction. 14 & up)
Publishers Weekly
July 23, 2013
"[A]ll we ever get out of Coop's schemes are headaches and heartbreaks," opines high school sophomore Sean, who gets his turn narrating in this third volume about the misadventures of three boys that began with Swim the Fly. Coop's latest idea is to make a low-budget horror film. Neither Sean nor Matt are interested until Sean's parents announce there's a baby on the way. With Coop's emphasis on the commercial aspects of filmmaking ("The idea is to make something that will sell. Quality is secondary"), Sean signs on, hoping to earn enough to add an extension to his house so he won't have to share a room with his twin sister, Cathy, a truly unpleasant character. Naturally, complications ensue, as Sean inadvertently becomes linked romantically with a possibly psychotic ninth-grader, while trying to nurture a relationship with Leyna, a hot classmate, and fend off advances from Cathy's BFF, Nessa. (Sean's "lightsaber" fully extends in his shorts many, many times.) Those who enjoyed the first two books will find a hefty helping of more raunchy fun. Ages 14–up. Agent: Jodi Reamer, Writers House. (Sept.)


text: Giant-Man is the second identity of Hank Pym. It can change into a gigantic size up to 20 or 50 feet. While in gigantic size, he wields superstrength, super durability and has incredible giant skills. Pym went back as Giant-Man when creating the Avengers Academy for young people to learn using their superpowers. He had a uniform,Goliath that is just like Giant-Man.


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Taking Sam's advice I got a appointment at the genius bar for my busted iBook keyboard.
About 10 minutes before my appointment time I realize such and bolt from my office and catch a cab to get over to the Fifth Avenue store so I don't lose it. I register with the guy and he sends me to the group W bench to wait. I wait, thinking I'm stupid for dashing over here, many minutes pass. I look at my watch and notice that I showed up a full hour early. I still have another 40 minutes to wait.
So, I ask the guy about this and he says "well, we'll take you early if we can, but I can't guarantee that."
I see something in his eye, so I say "that's not going to happen, is it?"
"No," he says, "it's not."
So, I did bring a book with me, Obama's "Dreams From My Father" and I start reading it. Men, listen up. Four fabulously gorgeous women walked right up to me in 15 minutes and asked how I was enjoying the book. I am never going to finish reading this thing.
So, I get called to the genius bar about 15 minutes after my appointment time and the genius asks me what is wrong. I point at my absent enter key. He pops off the keyboard and scans the serial number, while he is waiting on the look-up I tell him it is not under warranty
My genius, a nice surfer-looking guy in a black apple t-shirt and cargo shorts with hair he has to keep flipping out of face, says "Well, it will be about $120 or so parts and labor to get it fixed."
"Labor?" I ask "you have to plug in a ribbon connector."
Surfer genius flips his hair out of his face and admits "yeah, that's it. It's $40 for the keyboard, $85 for the labor to install it."
"Can I just buy the part and do it myself?"
"No," he says, looking around "we don't do that."
So, I summon up a lot of emotion, nothing angry or over-the-top, just genuine emotion that I put behind a single utterance as I look directly into what I can see of his eyes: "Dude."
"You're right, I'll be right back." He walks down the bar and leans in to speak to a colleague. He comes back and says "I got a manual override here, I'll just install it myself." He takes my machine and disappears.
He's gone a long time, almost half a hour. I like to think he went out back to catch a buzz. I didn't mind because I had a gorgeous Asian D.O. sitting next to me who was getting her data migrated from an iBook like mine to a new macbook. I converted her to GMail while my genius was doing whatever he was doing. He could take as much time as he wanted as far as I cared.
He comes back, finally, apologizes for the wait, and not only do I have a new keyboard, he has also cleaned up the entire machine. It looks new. "What do you think?" he asks.
He smiles. $43 (and two hours) later I have my IBook looking like it did when I first took it out of the box.
Customer Service, FTW.


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Centenary Shield | U18 Boys' International
Monday, April 2, 2018
Republic stalemate with Northern counterparts
Republic of Ireland 0-0 Northern Ireland
The Republic of Ireland played out their second consecutive scoreless draw of the Centenary Shield series when they entertained Frank Wilson's side in Monaghan United FC last Thursday (March 29)
William O'Connor's Schools select had enjoyed a fruitful opener with Wales in mid-February which saw them take full points away from home. Unfortunately they couldn't replicate this form in Luton when the English proved tougher opponents, with the game ending in a goalless deadlock.
Surprisingly this was Northern Ireland's third draw of their campaign following a 0-0 draw in Scotland, shortly followed up by a 1-1 result at home to Wales.
With both sides wanting to command a foothold on proceedings that afternoon, it was nothing less than a physical battle in Gortakeegan as the game kicked off. O'Connor's side created more of the chances in the first period with Coolock grad Ali Regbha and Trim's Cian Lee the more industrious players of the afternoon.
The Republic of Ireland had a glorious chance to take an early lead five minutes in when Coláiste Dún Iascaigh pupil and team Captain Cian Murphy played a brilliant diagonal ball to Chanel College star Ali Regbha whose shot was saved by the athletic goalkeeping of Declan Dunne.
O'Connor's side were unfortunate not to convert with a quarter of an hour played when Peter Adigun's counter attacking saw him play a long ball into Cian Murphy but the youngsters rocket from twenty yards out hit the crossbar.
It was scoreless at the interval.
Yeats College student Ryan Manning saw his shot blocked bravely in the box as Ruairi O'Hare put his body on the line and minutes later Manning saw his long range effort sail over the upright after the hour mark.
Cian Murphy and Cian Lee both tested the goalkeeping prowess of Dunne only to be outwitted by the Mercy College, Belfast pupil.
With ten minutes of the game to go, substitute Lido Lotefa was played in by Ali Regbha but again the versatile shot-stopper Dunne was in exceptional form to deny the Balbriggan scholar.
O'Connor and Wilson will both feel that there was points dropped following this frenzied encounter which now see the Republic of Ireland top of the leader board on five points while Northern Ireland are down the pecking order on three.
Centenary Shield Series
Following the dismissals of Alaric Jones and Harri Lucas Jones, 9 man Wales defeated England 1-0 in Cardiff Met in the other outing on Thursday evening. An own goal with just three minutes on the clock saw Marc Llyod Williams' side record an historic victory.
With England yet to score in this series, Ben Lavelle's side sit at the bottom of the table on one point following their opening day draw and two defeats. Last week's result will no doubt put England's hopes of retaining the title in tatters.
Meanwhile Scotland and Wales will enjoy their final series of matches with four points collected to date with must wins on the cards!
Next Up
England will travel to Queen's University, Belfast where they take on their hosts, Northern Ireland this Friday evening with a 7pm kick off scheduled. England will be looking for some vital goals and more importantly an away win while the North will want to finish their campaign on a high with a home win.
The Republic of Ireland will have time to analyse their performance as their final outing in the series is on April 12 in Home Farm FC (2pm). This is potentially a winner takes all scenario against Scotland.
The visitors are on four points with a game in hand as the series finale will be played out on April 19 when the Tartan Army entertain Wales.
REPUBLIC OF IRELAND | Luke McNicholas (Balla Secondary School), Peter Adigun (Riversdale Community College), Darryl Walsh (St. Declan's Community College), Adam O'Connor (St. Clare's College, Ballyjamesduff), Cian Lee (Boyne Community School, Trim), Ronan Manning (Yeats College, Galway), Rory Doyle (St. Francis College, Rochestown), Liam Kerrigan (St. Attracta's CS, Tubbercurry), Ali Regbha (Chanel College, Coolock), Jake Walker (St. Kevin's Community College, Clondalkin), Cian Murphy CAPTAIN (Coláiste Dun Iascaigh, Cahir),
SUBS USED | Lido Lofeta (Balbriggan Community College) for Manning 70, Kieran Farren (Carndonagh Community School) for Lee 87, Jack Ryan (Templeogue College) for Regbha 87.
SUBS NOT USED | Daniel Houghton (Carndonagh Community School), Adam Conway (De La Salle College, Waterford), Adam Rooney (Yeats College, Galway), James Carroll (St. Oliver's Community College, Drogheda).
MANAGEMENT | Head Coach William O'Connor (Balbriggan Community College), Coach John McShane (Dublin Oak Academy, Bray), GK Coach Conor Foley (Athlone Community College), Performance Analyst Ollie Horgan (St. Eunan's College, Letterkenny), Physio Mickey McGlynn Doctor Aiden O'Colmain
NORTHERN IRELAND | Declan Dunne, Caolin Coyle (Captain), Aaron Donnelly, Kofi Balmer, Ruari O'Hare, Liam Hassin, Dónal Rocks, Jack Malone, Aaron McGurk, Adam Carroll, Patrick Burns
SUBS USED | Jack O'Mahony for Donnelly HT, Pablo Andrade for McGurk 53, Jack Henderson for Malone 69, Andrew Scott for Rocks 73.
SUBS NOT USED | Scott Pengelly (GK), Adam McAleenan, Caoimhin McConnell
2018 Centenary Shield Results
February 15 Wales 1-2 Republic of Ireland The Rock, Cefn Druids FC (7pm)
March 9 Scotland 0-0 Northern Ireland Renfrew FC (7pm)
March 15 Northern Ireland 1-1 Wales Armagh City AFC (2pm)
March 16 England 0-0 Republic of Ireland Kenilworth Stadium, Luton Town FC (7pm)
March 23 England 0-2 Scotland Bootham Crescent, York City FC (7pm)
March 29 Republic of Ireland 0-0 Northern Ireland Monaghan United FC (2pm)
March 29 Wales 1-0 England Cardiff Metropolitan University FC (7pm)
2018 Centenary Shield Fixtures
April 6 Northern Ireland vs England Queen's University, Belfast (7pm)
April 12 Republic of Ireland vs Scotland Home Farm FC, Whitehall (2pm)
April 19 Scotland vs Wales Queen of the South FC (7pm)


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Georg Eckert Institute
Georg Eckert Institut
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The Georg Eckert Institute conducts applied, multidisciplinary research into textbooks and educational media, informed primarily by history and cultural studies. It also provides advisory services to national and international education policymakers, practitioners and organisations, and acts as a coordinator and mediator in international issues and projects around textbooks. Research, knowledge transfer and research infrastructure services are all closely interconnected at the GEI; as a non-university institution both carrying out and facilitating research into textbooks and educational media, the institute is on its way to becoming an internationally recognised centre of excellence in the field.
One of the principal attractions of the GEI to researchers from around the world is its research library, whose collection of history, social studies, religious studies and geography textbooks is unparalleled worldwide. The GEI's information and communication gateway Edumeres.net provides virtual access to the world of textbook and educational media research; among its principal features are the user-led textbook reviews it publishes. The institute's extensive programme of fellowships and scholarships is dedicated to raising awareness of textbooks and research into them and advancing academic work in the field, as is its research award for outstanding work in the area and its support scheme for visiting academics. The year 2012 saw the inception of the "Textbook of the Year" award, with which the GEI honours excellence in educational media annually at the Leipzig Book Fair.
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The need to get rid of the umms
I did my first interview in a long time yesterday on behalf of 8Asians. And boy did it stink. I mean, not the interview persay because the interviewee was extremely gracious and wonderfully nice and in fact the conversation itself was actually very comfortable…. but from a professionalism perspective, it was all me. ME! ARGH.
The sad part about it is that I learned how to get rid of the "umms" long ago, but since I haven't been in this type of situation for over ten years, I haven't had a need to feel nervous behind the mic. I'll definitely be posting both the edited and raw of the interview, of which is more a conversation than interview.
Much like when you get nervous standing in front of a large crowd or audience, and the spotlight is in your face and everyone is looking at you…. that sort of nervousness is controllable but it does take practice. They teach you this in verbal communications and I should have remembered these small but significant pointers:
- If you want to say an "umm" to fill the silence, just pause.
- If you're doing an interview, just listen quietly until the person(s) has finished speaking
Hopefully, with some more interviews/conversations under the belt, I'll be able to do live sessions a bit better. I have to say that I'm not Denise Franklin and in listening to her on the drive back, I noted a few pointers that I have to keep in mind. Might never be on the professional level like her but you have to strive to attain levels of professionalism like that.
All in all? I was really ecstatic with how it turned out, but disappointed in myself since it could have been more professionally done. Hopefully I'll get a chance to do some more of this in the future. I have to admit, live things are way more difficult than recorded takes where you can edit and re-take.
Photo Credit: (Magic Photography)


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Demographics Fullerton at a Glance - Our general information page about Fullerton basic population information, voter registration statistics and vital statistics about utilities, Fullerton history and more.
U.S. Census - The United States Census gathers data on population, households, education and employment. Use this link to get information about Fullerton through the Census Bureau's American Fact Finder.
California Department of Finance - This agency gathers population and economic data for California at the city, county and state levels. See their Demographic Reports for population estimates and Economic and Revenue Reports for employment and California economy information.
Cal State Fullerton Center for Demographic Research - This research center provides demographic information for Orange County cities. Visit their main website or see their Products page for a list of useful publications. This organization is a great resource for recent facts and figures.


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Kimberly is an energetic, full-time real estate agent living and working on Bainbridge Island. The key to her success is personalized service, which she provides for her clients with integrity and thoughtfulness. Kim listens to her clients' concerns and gathers information in an effort to help make the most educated decision possible. That, combined with her knowledge of the current market conditions enables her to translate the information needed to help her clients purchase a home, or establish a price for listing their home. Her local knowledge includes; water views, waterfront homes with moorage, homes for first time buyers, in-town living, condominiums and vacant land.
Kim uses technology to maximize efficiency and availability, and is always mindful of how personal buying and selling a home is for her clients. Available by phone and in person, she is committed to ensuring that her clients have a positive experience. Her extensive real estate background includes working as a Corporate Relocation Manager for the largest Coldwell Banker in the world. Because of her understanding of the process Kim has the ability to reduce the anxiety and ensure a stress free, productive experience while guiding her clients through one of their most important financial decisions and providing a seamless transaction.


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Awaken Your Third Eye: Tips and Hacks For 20/20 Spiritual Vision (e-report)
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($39.95 incl. TAX)
This e-report comes with a set of potent and practical esoteric techniques that you can use right away to help develop your third eye. For the first time, these powerful techniques are being revealed to help everyone awaken their inner psychic potential. Together they offer a step-by-step training of your third eye from near blind to 20/20 vision. The author doesn't don't promise quick fixes, but he does promise that the methods in these pages will help sharpen your 3rd eye and bring your spiritual vision to a whole new level.


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Color by Shapes HD for iPhoneFree
Free Kytatoo iOS Version 1.01 Full Specs
Publisher's Description
From Kytatoo:
Who has never played this game as a child ?! You know that famous game where you have to color a drawing by matching the colors with the shapes !"Color by Shapes HD" is the adaptation for mobile of this fun and educational game for child from 2 years.Your child can learn by himself thanks to the help features available throughout this game. The application will automatically correct the child and help him progress through the drawings.More than just a fun game, it is through many drawings of increased difficulty that the child will develop his visual, acoustic and coordination skills.Features:- More than 80 funny drawings. The colors and shapes change each new game offering a multitude of combinations for each drawings!- The child has access to help at any time if he has difficulties.- The automatic drawings corrector will enable the child to learn autonomously.- Coloring by-section is ideal for younger kids who don't have fine motor skills yet.- You can save and easily share drawings via e-mail or directly on Facebook.- Works on iPhone, iPad and iPod.
read more +


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After a while of diving the same spots over and over again, Oahu shoredivers often start branching out by exploring various drifts. Drifting enables a diver to explore new territory throughout the dive by negating the need to double back to get to the exit. There are two real downsides to this. First, these can be quite advanced and require lots of planning. Also, because you have a distance to go (start to finish) and limited time to get there (how much air is in your tank), you don't really get to slow down and check out the small stuff. For example, one of my first drifts was on the north shore swimming from Three Tables to Shark's Cove. In the right conditions, this is a relatively benign "drift-dive." There are a few other, much more advanced dives but half the fun of drift diving from shore is finding an appropriate entry and exit. I wouldn't want to spoil that for you. I do want to warn you against attempting to swim from Hanauma Bay to Portlock.
My buddy, Andrew, and I got it into our heads that this would be fairly straightforward. We knew the currents coming out of Portlock were entirely tide driven and thought the same rule applied to Hanauma Bay's Pai Olu Olu point, aka Sneezing Baboon. An incoming tide would provide fresh, clean water to swim in and a free, current driven ride to our exit at Portlock. At first glance, the swimming distance of .75 miles didn't seem much further than other drifts we had navigated with success. We waited until we had a morning of a seriously high rising tide, strapped on our doubles and went for it. We slogged through the half-mile surface swim out to the point and dropped, but there was an immediate problem. The current at the mouth of the bay was going the wrong way! We had no idea how far we would have to negotiate this counter-current before reaching the inflush at Portlock, so, we signaled confusedly at each other and turned around. The morning that was meant to be an exploration of unbroken ground quickly turned into just another day at the bay. Later that evening while checking where we went wrong, I again measured the distance between our drop-point and Portlock's exit, but this time it came out to be closer to 1.5 miles. Add to that the half-mile surface-kick out to the point and we were looking at a two-mile swim with full scuba gear!
We never gave up on the drift, we just needed to approach it in a different way, so we bought a boat and immediately named it after the first person to get seasick and vomit from it. As far as boats go, the Stacey Anne is more accurately called a dinghy. At a microscopic fifteen feet in length, it fits four snug divers and shuttles them at a miserable 8 mph, or roughly the speed of smell. Anything more than 15 mph winds and we turn around, which in Hawaii happens pretty frequently. So to complete this dive we had to wait for a window of decent weather and a strong incoming tide.
With six tanks and only three of us on board, we staggered buddy pairs such that as two were exploring, the third diver would drive the boat following bubbles and surface markers. The first buddy pair, myself included, drifted along a beautiful slope of unmolested coral the likes of which can only be compared favorably to Kona. Clouds of fish rained on us from everywhere. Already our planning had proven fruitful. We stopped at the entrance to what we would later learn is a site called "Sea Cave." We barely had enough time to poke our heads in lest we ran out of air. What we glimpsed, however, can only be described as a natural cathedral. The cavern was enormous, roughly twice the size of the inside bases of a baseball diamond. A large chunk of the ceiling collapsed, providing a "light of God" feel to the place. The scene was punctuated by an abundance of diverse life ranging from scores of butterflyfish to turtles and even a whitetip reef shark. Mollusks packed every crevice. The reef outside was staggering, but the unique feel of this cave makes this site one of Oahu's best.
The rest of the dives were much like the first with declining diversity as one drifted toward Portlock. It eventually took us a full three and a half dives to drift from the point, explore Sea Cave, and finally climb out at Portlock. I'm glad we met with a counter-current on our first attempt. Our bad planning would have meant a little bottom time followed by a long day of kicking on the surface, all while completely missing the gorgeous reefs and mysterious caves that lay just 60 feet below.
A Hawaiian green sea turtle (Chelonia mydas) rests in the foyer at Sa Cave.
The modest entrance of Sea Cave.


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I promised myself: No more Mel Gibson blog pieces. But I can't resist sharing this thought, one insightful point in a long article full of insightful points, by Entertainment Weekly's Owen Gleiberman:
WAS IT MEL'S RAGE, OR HIS BETTER ANGELS, THAT DROVE HIM TO MAKE THE PASSION OF THE CHRIST? Both, and that's why it's a true Passion play. The simple explanation for why Gibson crafted his version of the Gospels is that he's a self-confessed sinner, and therefore an ideal candidate to tell the primal story of Christian redemption. I believe that, yet what makes Gibson a singular poster child for the temptations (and ravages) of sin is that when you consider what a widely worshipped Hollywood star he is, a man who can do pretty much anything he wants, he is by now so obviously ruled by his addictions that it's no great leap to say that they're filling a hole in his spirit.
Gleiberman also says that despite Mel's faults and bigotry, he's eager to see "Apocalypto" anyway. I couldn't agree more. Read the whole article here.