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Dallas Beeler threw 7 shutout innings while striking out 5 batters. Logan Watkins went 2-4 with a 2B & triple.
Alcantara had another big night going 4-5 and is now batting .306 on the year. Rob Whitenack is showing that not everyone comes back from TJ without any issues as he scuffled again last night giving up 8 hits, 3 walks and 5 ER in 2.1 IP last night.
Javier Baez hit HR # 6 yesterday and is now slugging .508. He also committed a pair of errors in the field. Michael Jensen had a decent start working 5 IP while allowing 1 ER and striking out 3.
Shawon Dunston Jr had a PH triple last night and Trey Martin picked up 3 hits as well. The pitching was awful though. So far only Tayler Scott has really stood out among the Boise staff.


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Cleveland, OH (SportsNetwork.com) - Kyrie Irving continued his recent dominance of the Knicks, tallying 37 points and 11 assists in the Cleveland Cavaliers' 109-94 win over New York from Quicken Loans Arena.
Irving, who entered the tilt averaging 27.4 points per game in his last five against New York, shot 14-of-23 from the floor and 4-of-7 from the arc as Cleveland won for the fourth time in five games.
Jarrett Jack added 17 points off the bench for Cleveland, while Tristan Thompson and C.J. Miles went for 12 and 10 points, respectively, in the triumph.
"The first thing we wanted to try to clean up here and take care of was the defensive end of the floor," said Cleveland head coach Mike Brown. "We wanted to try to establish a certain culture here."
Carmelo Anthony poured in 29 points for New York, which lost its second consecutive game. Amar'e Stoudemire scored 15 points, J.R. Smith chipped in 14 and Pablo Prigioni dished out a season-high nine assists in extended minutes off the bench.
"This is all new to me. I've never started a season this way, 5-15," said Stoudemire. "The only way for me to deal with it is to continue to get better, stay positive, keep working hard and see what happens."
Two days after finding themselves in a 25-3 hole against Boston, the Knicks trailed 27-9 early in the contest Tuesday.
New York's bench fueled a second quarter charge that made it 48-45 at halftime in favor of the Cavs, but Cleveland pulled away in the third after Irving outscored the entire Knicks' starting unit, 12-11, in the frame.
Thompson and Alonzo Gee added eight points apiece and the Cavs led 81-65 heading into the fourth.
Jack scored five straight early in the fourth to end New York's comeback hopes.
Cleveland snapped a three-game losing streak against the Knicks ...The Cavs
won the rebounding margin, 38-31 ... Andrea Bargnani scored 11 points for New
York on 5-of-17 shooting ... The Knicks will host Chicago on Wednesday.
Cleveland will visit Orlando on Friday.

subset: commoncrawl


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Practice Philosophy
As a patient of Dr. Cole, you will receive the highest in patient care, surgical excellence and staff competence. Before your surgery, you will be provided with all the information you will need to be comfortable in deciding if plastic surgery is right for you. The accredited surgical facility provides a setting of unparalleled comfort and, most importantly, privacy for elective cosmetic procedures as well as reconstructive surgeries. Following the surgery, Dr. Cole and her staff are committed to you long after you are healed and recovered.
Location & Office Hours
Ste C 215
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Anchorage, AK 99508
View Map
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Complainant, below please find the official complaint form of the Board of Examiners for Land Surveyors. Before you file with our office, the Board requests that you read the following information which explains its function, responsibilities and powers :
If the board votes to hold a formal hearing, you may be subpoenaed to testify.
You may mail your complaint information to:
State of Tennessee Board of Examiners for Land Surveyors
500 James Robertson Pkwy
Nashville, TN 37243-1146
Phone: 615-741-3611
If you have any questions or concerns please do not hesitate to contact our office Monday through Friday, between the hours of 8:00 A.M. and 4:30 P.M. CST, at (615) 741-3611.
Donna Moulder Administrative Director
Print Complaint Form [pdf]


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Edward welcomes nearly 4,000 babies into the world each year, among the highest number in Illinois. There are many reasons why so many expectant parents choose Edward's maternity services and have made Edward the most preferred hospital for obstetrics in Chicago's west and southwest suburbs.
Experienced, caring nurses and comforts of homeA nurse is assigned one-on-one to you during active labor. Edward is a Magnet Hospital for nursing excellence which puts our OB nurses in elite company.
All-private newly remodeled rooms provide every patient comfort such as a comfortable sleeper sofa and a flat screen TV with inputs for your camera and camcorder. You'll also enjoy our family lounges and a remodeled nursery with a baby spa for infant massages and baths. We encourage skin-to-skin contact with your newborn for bonding during that first important hour. We offer daily neck and shoulder massage for mom from our own massage therapist.
Expert care for high-risk pregnancies, multiplesMany women have no problems with pregnancy other than the normal discomforts. Others experience more serious complications that need immediate attention. Learn about our renowned Maternal Fetal Medicine Clinic and the highest level of care provided in our Level III Newborn Intensive Care Unit for those newborns who need critical care.
We provide outstanding resources for parents of multiples as Edward delivers more multiples than nearly every hospital in Illinois.
We are here to to help as soon as you decide to have a baby until well after your child is born. Edward offers a variety of classes to help prepare for pregnancy, childbirth and caring for your newborn, as well as a special series of classes and information for those expecting multiples. Our Cradle Talk support group is one our most popular as new moms gather to share stories and learn valuable parenting information. A Breastfeeding Center provides education and support in your efforts to nurture your newborn. During your pregnancy, you should get regular prenatal checkups, eat a well-balanced nutritious diet, and get plenty of appropriate exercise.
Edward helps you at all phases of pregnancy:
See info about birth certificates, length of stay, classes, social security numbers, and visiting hours in our frequently asked questions. Prepare for the big day – link here for Labor and Delivery tips, including mapping your route to the hospital and information for visitors.
Nationally Certified Excellence
Joint Commission accredited organizations can earn certification for programs devoted to chronic diseases and conditions. Edward Hospital has received Joint Commission Disease-Specific Certification for Pre-Term Labor.
Edward is one of the first hospitals in the nation to participate in a collaborative of perinatal quality improvement advocates with state health departments, academic health centers, and March of Dimes chapters. Read more.
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text: Conference Presentation | 10 May 2015 Building a Competitive Jerusalem Michael E. Porter and Christian H.M. Ketels Jerusalem 2020 is a five-year growth plan for Jerusalem's economic development based on Professor Michael E. Porter's theory of competitive advantage. The plan was presented to Israeli Prime Minister Benjamin Netanyahu with the goal of significant investment by the Israeli government in Jerusalem. Keywords: economics; Israel; Economics; Israel; Citation:Porter, Michael E., and Christian H.M. Ketels. "Building a Competitive Jerusalem." Paper presented at the Jerusalem 2020, Jerusalem, Israel, May 10, 2015. View Details CiteView Details Read Now Related


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If you can dream it, you can do it. -Walt Disney
Quality is a great business plan. -John Lasseter
Let's make some funny pictures. -Tex Avery
I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend. -Howard Zinn
When critics sit in judgment it is hard to tell where justice leaves off and vengeance begins. -Chuck Jones
And what do you benefit if you gain the whole world but lose your own soul? -Jesus
A man should never neglect his family for business. -Walt Disney
What's most important in animation is the emotions and the ideas being portrayed. -Ralph Bakshi
Once you have heard a strange audience burst into laughter at a film you directed, you realize what the word joy is all about. -Chuck Jones
Before enlightenment: chop wood, carry water. After enlightenment: chop wood, carry water. -Buddhist Proverb
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Automatic Rotoscoping
Showcase your drawings, illustrations, video and media.
5 posts • Page 1 of 1
Re: Automatic Rotoscoping
Wow that's an amazing effect! Thanks for posting the video. What's the plan? Is this available for purchase?
Daily Z
Re: Automatic Rotoscoping
An impressive effect. But I find the use for animation for too real
Re: Automatic Rotoscoping
Thanks for your reply. Sorry it has taken so long for me to reply.
I will be releasing it soon. I have been putting it off until now because I wanted to make sure it was exactly as I wanted it, rather than rush it out only to have to keep updating it.
I have now put together a more comprehensive video that shows its full functionality. It is about 22 minutes long and 364MB. You can download it from:
It's in a Microsoft codec so should play on any Windows PC using Windows Media Player.
Re: Automatic Rotoscoping
Looks interesting. Let us know when you release it. (I'm into mixing some different ways of "cartooning/cloning" characters.)
Composer of music for movies and animations
5 posts • Page 1 of 1


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Octopus Serving Pedestal
- Overview
From fruits de mer to fruit salad, this platter turns summertime foods into centerpieces.
- 16.25" wide x 11" deep x 6.25" high
- Cast aluminum with an antique finish.
- Molded glass.
- Glass is dishwasher-safe.
- Read more on our blog about the inspiration behind this product.
- Dimensions & Care
- Overall: 16.25" wide x 11" deep x 6.25" high
- Glass: 13.5" diameter
- Glass is dishwasher-safe.
- Wipe with a soft dry cloth.
- Shipping Info
This is a general shipping item.
View our Shipping Information
Customer Service - Shipping Information
Return Policy
At Pottery Barn, we take great pride in the quality and craftsmanship of our products. Attention to design, materials, safety and construction is our priority. We carefully inspect your order prior to shipment. Upon receipt, please inspect your purchase and notify us of any damage; we will arrange for a prompt replacement. If, within 7 days for Quick Ship upholstery and 30 days for all other products, you are dissatisfied for any reason, you may return your purchase for a refund of the merchandise value.
We cannot accept returns on monogrammed, personalized, special-order items, or on items damaged through normal wear and tear. We also cannot accept returns of final-sale items which are identified by a price which ends in .99.
For returns of items purchased from your Pottery Barn registry, we will gladly provide a refund or exchange for the merchandise within 90 days of your event or within 90 days of purchase, whichever date is later.
You may return merchandise through the mail for a refund or replacement. For detailed procedures for returning items through the mail, please contact Customer Service at 1.888.779.5176, 7 days a week, 5:00am - 9:00pm (PT).


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May 31st, 2010
We recently had the pleasure of writing/directing/producing a television spot for Clearly Contacts' (a Coastal Contacts brand). What made it more special was that the star of the commercial was [Vancouver icon] Trevor Linden.
The approach to the spot was grown up and informational with limited reference to Trevor's hockey career. But, we also wanted to find a way to let Trevor have some fun and to leave some Easter eggs online for his adoring BC fans. With that in mind, we wrote a series of "behind the scenes" spots designed to poke fun at bad, pun-filled athlete endorsements.
The campaign helped spread the word about the simple fact that we all pay too much for eyewear, but it also allowed Clearly Contacts to flex their humour muscle and remind us why they were named in BC Business' Top 20 Innovative Companies.
The "director" (who was being directed by Leah Nelson, as was the television spot) was played by Graeme Duffy, local improv actor. Not only is he hilarious, but his diminutive size next to Trevor made him perfect. What we didn't expect was that Trevor would go toe-to-toe with Graeme in the improv ring, one-upping our scripted lines as he went. In fact, his acting was so good that Graham had to break character on a few occasions to see if Trevor was actually as uncomfortable as he seemed. Of course he wasn't—he was just so "in character" that he had us all fooled, causing Leah to stop the filming and say "Ok stop. Who is acting right now?". So, there you have it; Trevor Linden can act. What's more, he was probably the most pleasant actor we've every had the opportunity to work with.
Stay tuned for more behind the scenes action in the Clearly Contacts YouTube stream, or on Twitter.


text: Comments on: The Hill: GOP Protecting Talk Radio 'Profits"? http://www.thelandofthefree.net/conservativeopinion/2007/10/07/the-hill-gop-protecting-talk-radio-profits/ The Land of the Free presents articles and news about the world and the United States from a conservative, libertarian and classical liberal point of view. Wed, 06 Mar 2013 00:51:05 +0000 hourly 1 http://wordpress.org/?v=3.6 how to payoff a payday loan


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KDE 4.2 Beta 1 has been released and packages are available for Kubuntu 8.10, the Intrepid Ibex. Through unexpected hospital visits and endless waves of turkey & other merriments, the Kubuntu packaging ninjas always prevail. (Even if they are a week and a half late) These packages install to their normal locations and will upgrade your current KDE 4.1.x installation.
KDE 4.2 Beta 2 has been released and packages are available for Kubuntu 8.10 "Intrepid" and 9.04 "Jaunty". Read more for details.
The second alpha release for Kubuntu Jaunty is available now for early testers. See the release notes for more information or download it directly.


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Tiger Woods has a vision of greatness - and, for nearly a decade now, has used that vision to reach legendary heights of glory! Entitled "Vision", this spectacular poster celebrates the legendary superstar's amazing foresight - and eyesight - with brilliant photography and a sharp black-bordered design. Featuring a Tiger drive in his traditional Sunday red, and a background shot of his classic deep stare, this is a beautiful piece of photographic art for your wall. And, as with all the posters in Upper Deck's Tiger Woods poster series, the poster includes a huge facsimilie autograph from the man himself! Perfect for the wall of any fan, and a great collector's item for years to come.
Product Specifications:


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ComicsAlliance Vs. AvX Round Twelve: Final Fight
This is the twelfth and final installment of ComicsAlliance Vs. AvX, our unofficial scorecard for Marvel's big summer publishing event, Avengers Vs. X-Men. Jason Aaron is your writer, Adam Kubert is your penciller, and I am your humble score-keeper, one last time.
Round twelve! From the shores of Subt


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Forget Hartline's TD numbers... look at the tape. The guy has serious quality in a position where we're almost totally devoid. He has some of the best feet in the NFL.
I hope they find a way to bring him back. He's Ireland's only successful WR draft pick and he's ours. Keep him.
Sent from my GT-I9300 using Tapatalk 2


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After the mysterious brutal death of an old friend, a group of teenagers find themselves in possession of "Stay Alive", a next generation horror survival videogame based on the spine-chilling true story of a 17th century noblewoman known as "The Blood Countess." The gamers don't know anything about the game other than they're not supposed to have it…and they're dying to play it. Not able to resist temptation, the group begins to play the grisly game and soon a chilling connection is made – they are each being murdered one-by-one in the same method as the character they played in the game. As the line between the game world and the real world disappears, the group must find a way to defeat the vicious and merciless Blood Countess, all the while trying to…STAY ALIVE.
The cast includes Jon Foster, Samaire Armstrong, Frankie Muniz, Sophia Bush, Adam Goldberg, Jimmi Simpson, Milo Ventimiglia and Rio Hackford.


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Click Here To Watch This Video at Club Amateur Usa
Original, high-quality, digital MPEG movies featuring straight, bi-curious, bisexual, and gay amateur men baring it all for the camera.
Description: ClubAmateurUSA Bi Stud Tate sits back with his feet in the air... he loves getting his cock jacked hard as his ass gets pounded with a slippery dildo!
Permanent link to this video:
Code to embed player in blogs and forums, etc:
Post this video in the JUB Forums with this code:
Simply copy the above code into your JUB forum post and the movie will appear.


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Discontinued Product
Entertainment To-Go
Mobile Phone with QWERTY Keyboard, Music Player, and 2.0 MP Camera
LG EnV2 (VX9100 Maroon)
- 2.0 Megapixel Camera and Camcorder
- Bluetooth® Stereo Capable
- Compact QWERTY Keyboard
- Large External Keys for Easy Dialing
Mobile Phone with QWERTY Keyboard, Music Player, and 2.0 MP Camera
VX9100 Maroon
SHOW HIDE Technical SpecificationsBack to Top
- Technology
- Carrier
- Form Factor
- Camera
- Music Player
- Qwerty
- Speaker Phone
- Bluetooth
- Web
- Frequency
- DataTransmission
- Dimensions
- Weight
- Display
- Verizon
- Flip
- 2.0 Megapixel Camera and Camcorder
- Music Player for MP3, WMA, AAC, & AAC+
- Full, Compact QWERTY Keyboard for Fast Messaging
- One-Touch Speakerphone
- Version: 1.2
- Mobile Web 2.0*
- Hearing Aid Compatible (M3/T3-Rating)
- 1.9 GHz CDMA PCS, 800 MHz CDMA (Digital Dual-Band)
- High-Speed EVDO†
- 4.00" (H) x 2.13" (W) x 0.65" (D)
- 4.23 oz.
- Internal LCD: 260K Color TFT, 320 x 240 Pixels, 2.40" External LCD: 260K Color TFT, 160 x 64 Pixels, 1.45"
Rated 4.4 out of 5 by 30 reviewers.
Rated 4 out of 5 by ladonna63 Good Value, Reliable, Basic I've had this simple phone for 4 or 5 years, working off the original battery. No problems. Battery life is exhausted rapidly when used with car speaker phone system. Otherwise, it needs to be charged every day or two. Texting feature is easy. After 3 years of use, some keys started to stick ... "sstttticcckk". Annoying, but not enough to buy a new one. I don't use other features much. If you're not a tech-y and don't have to have the latest greatest device, this phone will serve you well at a relatively low cost. October 20, 2013
Rated 4 out of 5 by hdavis27 A Great Cell Phone This phone is great, its a great messaging phone, and for the price, it was a great value. Phone is very reliable and a great performer. If you are in need of a great high end simple messaging phone, this is a great pick. June 3, 2013
Rated 2 out of 5 by Zeppo Power problems I got a reconditioned phone in March 2012, but it wouldn't stay charged for very long. So I got a new battery, but even the new battery couldn't keep the phone charged for more than a day. So I exchanged the phone for a new one, yet I'm still having trouble keeping the phone charged for more than a couple days. I'm trying to think if I'm doing anything wrong. This is my first QWERTY keyboard phone; my last two were flip phones and my first was a chocolate-bar phone, which held a charge up to 2 weeks! Two days for this phone seems like too little. April 25, 2012
Rated 5 out of 5 by lilbit My most Favorite phone EVER!!! I have had many different phones, but this one beats every one of them! and, I have also had smart phones, don't even compair to this one! I love that it has the 2 viewing windows! I cannot find another phone with this feature! May 14, 2012
Rated 5 out of 5 by (: amazazingg i had this phone for like 2 and a half years it was really good for the most part haha great if you text all the time like mee toward the end of the contract some of the keys get a little weird and started doing weird things but overall i loveee it<3 March 4, 2012
Rated 5 out of 5 by sustahl So happy I got this phone I bought this phone over two years ago. It was the first phone that I never had to turn in for warranty repairs. It also stays charged for the longest of the phones I have ever owned. The QWERTY keyboard wasn't a slide keyboard, but you had to open the phone which was so much simpler to use. September 27, 2011
Rated 5 out of 5 by LuckyCat Easy Texting I text a lot and this phone has made it super easy for me to do so. October 9, 2011
Rated 5 out of 5 by J eNv2 VX9100 I have had my LQ enV2 cellphone for over two years and love it! It was easy to use even without reading all of the manual. Cool! The flip is great with a large alpha-numeric keypad large enough that my fingernails don't hit the wrong keys! For a cellphone it takes great pictures, and short videos. Even though I usual have a case over my phone to protect it, I am amazes it with stands an occassional drop to tile floors and even concrete sidewalks! Verizon says the two year contract is up, but I really DON'T WANT TO UPGRADE because I love my enV2. But I my consider another new LQ! May 12, 2011
Small and sleek, the LG enV²makes calling and texting a breeze. Taking pics and flicks is super-easy with the neatly integrated 2.0 megapixel camera. And, last but not least, its got a built-in music player, so even if you're on-the-go, you'll never be at a loss for entertainment.
Design, features and specifications subject to change without notice. Screen images simulated and/or dramatized. Some features in videos may not be available on all models. Please refer to the TECHNICAL SPECIFICATIONS tab for a complete list of features by model.
Design, features and specifications subject to change without notice.


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Looking for new cars for sale? Westlake, OH residents prefer the selection at Ganley Honda. Browse our wide selection of new 2015 Honda vehicles in North Olmsted. Ganley Honda's inventory is competitively priced and our sales staff is friendly, professional and ready to answer your questions. Come take a look at the all new Civic, Fit, Accord, Crosstour, Pilot, Odyssey, Ridgeline, CR-V models in the Cleveland area! If you can't find the exact new car you want, fill out our Carfinder form and we'll track it down for you!
Residents throughout Cleveland, Parma, Westlake, Lorain, Lakewood, Cuyahoga County, and Northeast Ohio can visit Ganley Honda today to test drive their dream car. Whether you're looking to buy or lease a coupe, sedan, truck, van, convertible, SUV, or hatchback,Ganley Honda has what you are looking for. Visit our dealership for more information on our newest cars for sale. North Olmsted dealer, Ganley Honda, is willing to go above and beyond for our customers. Let us treat you to free carwashes and superior customer service.
Sales Hotline 888-699-3824 or Text Us 440-540-5364


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Rancid is an American punk rock band formed in Berkeley, California in 1991. Founded by 80s punk veterans Tim Armstrong and Matt Freeman, both of whom previously played in the highly influential ska punk band Operation Ivy, Rancid is creditedâ[][]along with Green Day and The Offspringâ[][]for reviving mainstream interest in punk rock in the United States during the mid-1990s. Unlike Green Day and The Offspring however, Rancid remained signed to an independent record label and retained much of its original fan-base, most of which was connected to its underground roots. Rancid's songs reflect its advocacy for populist radical politics, near-religious practice of DIY ethics, and discontent with punk elitism. Rancid includes Armstrong on guitar and vocals, Freeman on bass and vocals, Lars Frederiksen on guitar and vocals, and Branden Steineckert on drums. The band was formed by Armstrong, Freeman, and former drummer Brett Reed, who left the band in 2006 and was replaced by Steineckert. Frederiksen joined Rancid in 1993 when the band was searching for a second guitar player.
This area is intended for discussion only. If you have a question about your order, or require customer service you can get in touch via our Customer Service Area. Comments enquiring about existing orders, including personal details, or with questions will be deleted.


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Enter Member ExchangeLogin
... just one more benefit of your IIA membership
As much as The Institute of Internal Auditors is about ideas and products, more than anything it's about people. To help you connect with your colleagues, The IIA is pleased to offer you an exciting new networking tool - Member Exchange (ME). This service, available exclusively to IIA members, helps facilitate connections between all members of our community.
What Can I do With Member Exchange?
- Certification — Discuss test preparation suggestions for the CIA®, CFSA, CCSA and CGAP examinations
- Career Ladder — Network with other members to obtain training and professional development suggestions to assist you in your career growth.
- Connect with Other Members — Attend a local chapter meeting when you travel.
- "Day-to-day" Problem Solving — Get answers from industry professionals on common audit issues affecting you today.
- Best Practices — Obtain best practice advice from industry professionals.
How Does Member Exchange Work?
Upon logging in, you will be asked to review your profile, answer a series of questions, and complete an interactive menu that allows you to rank interests and words to describe yourself. You will then be plugged into a searchable, sortable universe of your IIA peers. You can match up with colleagues who share your interests, challenges or concerns. Using an intuitive "push-pin" interface, Member Exchange allows you to instantly visually identify fellow IIA members and how your common interests and needs coincide with theirs. You can send messages, upload documents, and begin making connections in a matter of minutes!
What Makes Member Exchange Different?
In our tech-savvy society, programs and Web sites similar to Member Exchange are becoming increasingly popular. Member Exchange, however, is one of the few sites that allows you to connect dynamically with other members of the internal audit community. Rather than joining static groups and making connections to others by initiating a link, Member Exchange gives you an instant visual of how members of the community relate to and intersect with your professional interests. The push-pin screen shows how other members' similarities and dfferences intersect by placing their "pins" closer or further away from your own. From this screen, you can narrow the results yet further. Want to find a chapter leader who is interested in taking the CIA, lives in Chicago, and speaks French as their primary language to form a CIA study group with? It's possible on Member Exchange!
The definition of networking hasn't changed, but how we do it has. Member Exchange, the no-cost online global networking tool, is ready to help you take your IIA experience even further. Just another way The IIA is enhancing your membership experience.
Flash is required to use Member Exchange. Please click here to download Adobe Flash Player.


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Free jewelry clutch with online purchases above €120*LOGIN
Approximate size: 5.8 x 1.7 x 5.7 x 13 cm
Unfortunately this product is currently not available.To the Boutique Finder
A square and strong design, ideal for every occasion. The Swanflower® motif is enriched by little pearls and crystal pavé, adding a touch of elegance and sophistication. Frame and temples in injected material, lenses in nylon 6 base, sun protection: high (category 2/3).
Article no.: 5003128


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IMLS Press Contacts
Jeannine Mjoseth, firstname.lastname@example.com
Mamie Bittner, firstname.lastname@example.com
New Technology Services Draw Record Numbers to Libraries:
Government Study Documents Ten Years of Steadily Increasing Public Use
Washington, DC—The Institute of Museum and Library Services (IMLS) announces the release of a new research brief, Service Trends in U.S. Public Libraries, 1997-2007. The brief identifies important changes public libraries have made to address patron needs in an increasingly Internet-centric environment and explores service differences in urban and rural communities. A comparison of more than 11 years of Public Library Survey data suggests that service changes in U.S. public libraries are having an impact on visitation and circulation, as record numbers of people now use public libraries nationwide. Several findings from the survey include:
Future research from the Office of Policy, Planning, Research and Communication will examine library services in a variety of different contexts from small towns and remote rural areas to central cities and suburbs. This type of place-based analysis can provide important insight into the impact libraries have on their communities, while building a stronger, evidence-based platform for planning library services to meet local needs.
To read the research brief please go to: http://www.imls.gov/pdf/Brief2010_01.pdf
About the Institute of Museum and Library Services
The Institute of Museum and Library Services is the primary source of federal support for the nation's 123,000 libraries and 17,500 museums. The Institute's mission is to create strong libraries and museums that connect people to information and ideas. The Institute works at the national level and in coordination with state and local organizations to sustain heritage, culture, and knowledge; enhance learning and innovation; and support professional development. To learn more about the Institute, please visit www.imls.gov.


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The parabolic Asian cooking(dumpling) strainer is the perfect candidate for this project.
I was able to pick up 20 more access points in the city and connect to a network a few blocks away!
This is BY-FAR the most simple of all Wifi extensions!
Image 2:
_best paint'job EVER!_ - This is the general Idea behind the parabolic dish.
- it should bounce all waves from the dish into the focalpoint (wifi thumbstick).
~*~ My Personal Webpage ~*~ --- More cool stuff!
Step 1: GO GET STUFF!!!
a) Cooking strainer from Asian food market.
- Needs to be PARABOLIC
-The wooden handle on mine made it easy to work with.
-Cost $7.00
-Mesh should be similar "tightness" as pictured. (Don't get the loose mesh)
b) USB Wireless Thumb Drive (g or b/g)
c) USB extension. -- The longer the better.(but get as much as you need.)
@ sokamiwohali
What you say IS true. At first glance, one might think "consent of the owner" would mean that one would have to receive explicit permission from the owner in order to use his or her wi-fi network.
The fact that the network was unsecured, however, changes the game a little. Although it is illegal to break into, say, an "unsecured" (unlocked) car or house, the physical realm is much different than the digital realm. I have never received explicit permission to access this website, or google, or any other website for that matter. An unsecured wi-fi network is conceptually no different than an unsecured website. The protocols and hardware used are very similar as well.
TL;DR: In the real world, the power is held within the hands of the owner(s). On the internet, if it isn't secured, than by default it is public.
Now for the reply...lol
you confirmed that my comment is correct in the information i gave good sir. If a network is unsecured, the owner of the network is giving non-verbal consent to ANYONE who wants to use it...think about Starbucks or Mickey-D's...*MINUS THE TERMS OF USE PAGE* if you were to accesss their wifi, since it is unsecured, its free game.
As far as your accessing this, or any other website...your true to a point...you can access this website [or the others], BUT if you want to enjoy the fruits of your and everyone elses labor (ie: your having to join to even comment on this post (not trying to be a butthead btw. plz dont take it that way), e-books, etc.) you need to be a member (and throw in the pro membership as well for the downloads). HOWEVER do not let the statement i just said lead one astray...NOT EVERY website requires one to have a membership to enjoy the site fully.
Very true on your last statement tho...thats why i secure my WIFI. i know how it is with accessing unsecured WIFI...when i was in college i didnt pay one red cent for the internet i used...and i accessed from my room...haha...good ol days!!
man.. it seems u know nothing about lebanon!
these countries u're talking about are like "saudi arabia, and "morocco" and these so arab islamic countries.. (anyway i dont think they still do that)
lebanon is located in the Middle East.. near cyprus, and limited by syria from the east and israel from the south..
actually i dnt like to say that lebanon is an arabic country..
we do speak arabic.. but education systems are english and french thought.. (schools teach in english and french, in majority, all scientific subjects and literature .. and some of them teach it in arabic..)
and btw.. the Lebanese Republic's President is always Christian!..
u better do a research about lebanon to know more..
actually i was just kidding, but i don't think they'll get you if u hacked a wifi connection or a personal email address!
they may only get you if u did something really illegal like cyber-criming or anything like that..
USB wifi adapter.
(Sorry bad english, cos I'am Indonesian Not a Colony of england)
You free dumplings with it as well.
Is it legal to use someone's Wi-Fi connection to browse the Web if they haven't put a password on it?
Nobody really knows. "It's a totally open question in the law," says Neal Katyal, a professor of criminal law at Georgetown University. "There are arguments on both sides."
In analogy; I do not have a padlock (password) on my fridge (wifi), so is it therefore legal for anyone to walk into my house and eat my food (internet) without my knowledge because I failed to secure adequately?
I park my car (wifi) at the mall and forget to lock it (password), so is it therefore legal for anyone to walk up and take it for a joyride (use my internet) without my knowledge?


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The Amelia rug's alluring patterns will entice unsuspecting admirers into a room, but its supple texture is what will keep them there. Made from 100% polyester, it has the durability of microfiber—promising good looks and luxurious comfort for years to come.
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"If we want to know the Scriptures, to the study of Greek and Hebrew we must go..."
- J. Gresham Machen
Degrees & Programs
Westminster Seminary California offers an excellent Master of Divinity (M.Div.) program. 70% of enrolled students are pursuing an M.Div. degree. In addition to this degree, WSC offers three Master of Arts (M.A.) programs for men and women who do not plan to serve in ordained ministry. Built off of the M.Div., the M.A. programs allow students to focus on a particular area: Biblical Studies, Theological Studies, or Historical Theology. Individuals interested in taking classes for credit or audit should consider some of the Non-Degree Program study options WSC offers.


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Too Much of a Good Thing
With American political polarization at historical highs, Peter Orszag argues the United States needs ways around its politicians.
See more in Congresses, Parliaments, National Legislatures; Tax Policy; United States
Adjunct Senior Fellow
Economics, macroeconomics; U.S. budgetary policy, tax policy; health care.
Peter R. Orszag is Vice Chairman of Corporate and Investment Banking and Chairman of the Financial Strategy and Solutions Group at Citigroup, Inc. He is also a Contributing Columnist at Bloomberg View, a Distinguished Scholar at the NYU School of Law, and an Adjunct Senior Fellow at the Council on Foreign Relations.
Prior to joining Citigroup in January 2011, Dr. Orszag served as a Distinguished Visiting Fellow at the Council on Foreign Relations and a Contributing Columnist at the New York Times. He previously served as the Director of the Office of Management and Budget in the Obama Administration, a Cabinet-level position, from January 2009 until July 2010. From January 2007 to December 2008, Dr. Orszag was the Director of the Congressional Budget Office (CBO). Under his leadership, the agency significantly expanded its focus on areas such as health care and climate change.
Prior to CBO, Dr. Orszag was the Joseph A. Pechman Senior Fellow and Deputy Director of Economic Studies at the Brookings Institution. While at Brookings, he also served as Director of The Hamilton Project, Director of the Retirement Security Project, and Co-Director of the Tax Policy Center. During the Clinton Administration, he was a Special Assistant to the President for Economic Policy and before that a staff economist and then Senior Advisor and Senior Economist at the President's Council of Economic Advisers. Orszag has also founded and subsequently sold an economics consulting firm.
Dr. Orszag graduated summa cum laude in economics from Princeton University and obtained a Ph.D. in economics from the London School of Economics, which he attended as a Marshall Scholar. He has coauthored or coedited a number of books, including Protecting the Homeland (2006), Aging Gracefully: Ideas to Improve Retirement Security in America (2006), Saving Social Security: A Balanced Approach (2004), and American Economic Policy in the 1990s (2002).
Dr. Orszag serves on the Board of Directors of the Peterson Institute for International Economics, the Mt. Sinai Medical Center in New York, the Robert Wood Johnson Foundation, ideas42, and the Partnership for Public Service. He is also a member of the Institute of Medicine of the National Academies of Sciences, the Trilateral Commission, the Hamilton Project Advisory Council, and the Marshall Scholarship Alumni Advisory Board, and holds an honorary doctorate from Rensselaer Polytechnic Institute.
With American political polarization at historical highs, Peter Orszag argues the United States needs ways around its politicians.
See more in Congresses, Parliaments, National Legislatures; Tax Policy; United States
The United States' fiscal future depends on whether the country can limit health-care costs.
See more in United States; Health Policy and Initiatives
Peter Orszag writes that surprising growth of the nonprofit sector should prompt a closer examination of its tax exemption's budgetary impact.
See more in United States; Tax Policy; Corporate Regulation
Peter Orszag writes that economists' theories to explain the gap between jobs open and jobs filled have diverging implications for the speed of the labor market's recovery.
See more in North America; Economics; Society and Culture
Peter Orszag wants regulators to watch out for excessive consolidation in local hospital markets as Medicare's shift to value-based payments puts pressure on health care providers to merge and raise fees for private insurers.
See more in United States; Competitiveness; Corporate Regulation; Health; Society and Culture
As more college-educated workers fill low-skilled jobs, Peter Orszag explains that declining demand for highly skilled labor and falling wages are to blame.
See more in United States; Education; Labor
Peter Orzag and John Bridgeland suspect that scarcity will increasingly impact Washington's fiscal policy.
See more in United States; Budget, Debt, and Deficits; Financial Crises
Peter Orszag writes that cities installing traffic cameras to curb speeding and impose fines may also be tempted to monetize the data that those cameras collect.
See more in United States; Intelligence; Privacy
Peter Orszag explains that employment, in and of itself, may provide health benefits in the form of decreased rates of depression, increased mobility, and improved life expectancy as compared to those who are unemployed or retired.
See more in United States; Labor; Aging
Peter Orszag examines the puzzling demographic finding that the U.S. mortality rate falls by 0.3 percentage points for every one percentage-point increase in the unemployment rate.
See more in United States; Labor
Peter Orszag writes that Americans report feeling like they switch jobs and move to new states more often now than in the past, but data show that the rates of job changes and interstate migration have actually declined.
See more in United States; Labor
Peter Orszag writes that making cities more resilient to the challenges of stormwater runoff is a wise investment to minimize climate change-related damage.
See more in United States; Infrastructure; Climate Change
Peter Orszag argues that giving health-care providers a fixed payment for each Medicare beneficiary could provide a path forward between competing views of health care reform offered by Republicans and Democrats.
See more in United States; Health Policy and Initiatives
Peter Orszag examines how cities could foster more public-private partnerships in infrastructure construction with revenue-based auctions.
See more in United States; Infrastructure
Peter Orszag argues that switching to the chained consumer price index for calculating Social Security cost-of-living adjustments will not make as much of a difference as many seem to think.
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Peter Orszag argues that low interest rates and high unemployment make today an ideal time to repair deteriorating U.S. infrastructure.
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Peter Orszag writes that, although health care costs have been rising more slowly, recent data suggest Medicare spending growth may have sped up slightly in the past few months.
See more in United States; Budget, Debt, and Deficits; Health Policy and Initiatives
Peter Orszag highlights research findings that reinforce the usefulness of test scores in evaluating teacher performance.
See more in Education; Children; United States
Peter Orszag argues that widening gaps in college completion rates between rich and poor students not only undermines the American ideal of equal opportunity, but also misses an economic opportunity to boost productivity.
See more in Education; Poverty; United States
Peter Orszag argues that reforming medical malpractice law to include "safe harbors" that protect doctors who follow evidence-based medical guidelines could bring down health-care costs without reducing the quality of care.
See more in Health Policy and Initiatives; Budget, Debt, and Deficits; United States
Peter Orszag finds good news about health care costs in the latest budgetary and economic projections released by the CBO, but he cautions that the outlook for unemployment and federal spending is still gloomy.
See more in Budget, Debt, and Deficits; Health Policy and Initiatives; United States
Because a financial crisis can inflict lasting damage to productivity growth, Peter Orszag argues that the failure of U.S. policymakers to enact a "barbell" fiscal policy now could yield more economic troubles down the road.
See more in Financial Crises; International Finance; Global
This meeting is on the record.
This meeting is on the record.
This meeting is on the record.
This meeting is on the record.
This meeting is on the record.
Peter Orszag contributes his favorite chart of the year to the Washington Post's Wonkblog.
Peter Orszag joins Bloomberg TV's Margaret Brennan to talk about the eurozone crisis and the debate over deficit reduction in the United States.
Peter Orszag appears on Squawk Box to discuss the road to economic recovery.
In remarks prepared for a postponed Senate Committee on Finance hearing, Peter Orszag argues that the U.S. must address both the weak labor market and an unsustainable fiscal path over the medium and long term.
Peter Orszag says Congress won't raise the debt ceiling without a push from the financial markets.
Peter Orszag joins Maria Bartiromo on CNBC's Wall Street Journal Report to talk about the Obama administration's economic policies.
Peter Orszag appears on Charlie Rose.
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Peter Orszag joins Bloomberg TV's Margaret Brennan to talk about the eurozone crisis and the debate over deficit reduction in the United States.
Peter Orszag appears on Squawk Box to discuss the road to economic recovery.
Peter Orszag joins Maria Bartiromo on CNBC's Wall Street Journal Report to talk about the Obama administration's economic policies.
For more information on the David Rockefeller Studies Program, contact:
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2013 Wall of Fame Nomination & ScholarshipsPosted Feb. 4, 2013
The East Liverpool Campus Wall of Fame Committee is pleased to announce that the annual campus Wall of Fame Awards Dinner will be held on Friday, May 3.
Attached is a nomination form that will allow faculty, staff, students, and community members to nominate individuals for either the Friend of the Campus or Lifetime Achievement Awards. The Lifetime Achievement Award recognizes former students and alumni for their professional accomplishments, civic involvement and community leadership. The Friend of Kent State University at East Liverpool Award recognizes a community member for their efforts to strengthen our campus. Bethany Zirillo can provide a more detailed description if you have questions. Please note that the nomination deadline is February 26.
The committee is pleased to announce that the following awards and scholarships will also be made available again in 2013:
- STUDENT CAMPUS SERVICE AWARD- current student employee or current student volunteer who has had a significantly impacted Kent State University at East Liverpool
- STUDENT COMMUNITY SERVICE AWARD -current student who engages in community service requirements beyond program or academic requirements
- DR. JOAN D. GAILEY SCHOLARSHIP-$500 scholarship for a students pursuing a degree in business or business related field.
- FACULTY AND STAFF WALL OF FAME SCHOLARSHIP- Scholarship(s) funded through the generous support of KSU East Liverpool faculty and staff
*The nomination deadline for these awards is February 26, 2013.*
The committee is also pleased to share that we are able to continue the tradition of presenting the Faculty and Staff Wall of Fame scholarship Wall of Fame dinner. If you would like to contribute to this scholarship fund, you can provide a gift on-line by visiting https://www.givetokent.org/Main.aspx (please indicate account 11301/ East Liverpool Wall of Fame) or contact me at email@example.com to request a pledge card. Additional information about how you can contribute to this scholarship will be forwarded in the near future.
The Wall of Fame Committee looks forward to your participation at this year's awards program. Please save the evening of May 3 on your calendar to help recognize the contributions and academic achievement of Kent State at East Liverpool's students. If you have any questions, or would like to join the Wall of Fame Committee please feel free to contact me at firstname.lastname@example.com.
2013 Dr. Joan D. Gailey Wall of Fame Scholarship Application
2013 Wall of Fame Lifetime Achievement & Friend of Campus Nomination Form
2013 Wall of Fame Awards Student Campus Service and Community Service Nomination Form


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LGBT Welcoming Accommodation Chicago, United States of America - Compare, review, book cheap and discounted LGBT Welcoming hotels in Chicago at Hotels.com. Using Hotels.com you can book your LGBT Welcoming Hotel in Chicago online with ease with our fast online search facility you are able too:
- Find, compare and review different LGBT Welcoming accommodation in Chicago by star rating, amenities, theme, location, neighborhood or brand
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- Securely book your hotel room online today!
- Receive email and text confirmations with reservation details of your online hotel booking
- Join Hotels.com welcome rewards program for free – Stay 10 nights and receive 1 night free*


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I have come to the point (as of October 2014) where quality in tea is more important than quantity. Especially because I'm a seasonal tea drinker where hot tea is concerned, and a SLOW one to boot. I generally don't resteep only because I'd be here all day if I did, though I do break out a gaiwan from time to time.
I adore French teas in practically every iteration, Japanese Sencha (specifically from the Uji region, as they offer the most seaweed flavor), and Dan Cong oolongs. I am trying to focus on plain teas and so companies like Verdant, Upton, and Butiki are on my favorites list.
When it comes to tea, I feel like the 10th Doctor says it best:
"Tea! That's all I needed! Good cup of tea! Super-heated infusion of free-radicals and tannin, just the thing for healing the synapses. "
Medford, OR


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LONDON — Agent of Joe Cocker says British singer has died of lung cancer at age 70.
Dave Granlund cartoon on Santa.
International donors have so far failed to deliver billions of dollars in aid money that was promised to rebuild the war-battered Gaza Strip, a Palestinian official said Monday, saying the rift between rival Palestinian factions is deterring foreign...
TLC is highlighting yet another subculture with its upcoming special,�My Husband's Not Gay.The one-hour program, which airs�Sunday, Jan 11�at 10/9c, follows a group of Mormon men who are happily married to women — but are...
Friday's Amazing Race finale was pretty sweet. Food scientists and PhD students
As the United States and Cuba move toward normal relations, Americans are getting closer to one day freely visiting the island and sipping tall rum cocktails by the sea.
The ex-girlfriend of Sammy Davis Jr. is the latest woman to come forward with sexual assault claims against�
Dear Dave,
- Events Calendar


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Nb: infants must be under the age of 2 and
children must be under the age of 12 at the time of
A car-free resort with a warm welcome
Direct access on skis
In the heart of Paradiski ski area
The residence comprises 2 buildings made of timber, stone and slate, located 50 m from the ski lifts, shops and services.
Living room with 2 single beds
Sleeping area with 2 single beds.Other Information: SUNDAY ARRIVAL.
Living room with 3 single beds. Bedroom with 2 single beds. Other Information: SUNDAY ARRIVAL.
Living room with 3 single beds
Sleeping area with 1 single folding bed. Bedroom or mezzanine with 2 single beds or double bed.Other Information: NB: ground floor apartments, duplex or mezzanine
Located in the Béryl building
Living room with 3 single beds. Bedroom (or Mezzanine) with 2 single beds
Bedroom with 2 single beds. Bathroom: Additional shower room. Other Information: Please note: Description applies to majority of apartments but some exceptions apply.
(located in the Béryl building)
Living room.
Two bedrooms.3 single beds.1 double bed.
2 bunk beds.Other Information: SUNDAY ARRIVAL.
Iglu acts as a travel agent for disclosed principals/tour operators, further details
of which will be made available at the time of booking. Your holiday contract will
be bound by the tour operators terms and conditions.
Prices are shown for a basic room or unit, can be subject to change and are indicative
until time of booking. Please call on 020 8544 7114 for prices for other travel
and room options for this property.
The price shown includes 7 nights accommodation,
on an accommodation only basis.
Prices shown are per person per week based on maximum occupancy. Descriptions and
quality ratings are provided by the Tour Operator (or one of the Tour Operators
where similar holidays are offered by more than one supplier). We reserve the right
to make minor adjustments to the description or rating based on staff and customer
feedback. For payments by credit card, a 2.5% credit card charge (4% for AMEX) will
be added to your invoice. If you pay by a UK issued debit card, there is no charge.
All bookings are subject to a £5 per person Passenger Admin Fee charged by Iglu.com.


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Syleena Johnson (née Thompson born September 2, 1976 in Harvey, Illinois) is a Grammy award-nominated American R&B and soul singer-songwriter and actress.
This area is intended for discussion only. If you have a question about your order, or require customer service you can get in touch via our Customer Service Area. Comments enquiring about existing orders, including personal details, or with questions will be deleted.


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The stepfather of Michael Brown has apologized for angry comments he made after the grand jury decided not to indict the police officer who killed his stepson, but said his remarks had nothing to do with the arson and looting that ravaged Ferguson and the surrounding area.
Three decades after lethal gas swept through Bhopal, the central Indian city remains haunted by memories of the world's worst industrial disaster.
I�ve lived most of my life in very white places. My hometown, population 200 at the time, was totally white. One black family lived in our small school district in a neighboring town. I got to know a handful of black people in college, but not many,...
In 1998, recording artist Marshall Mathers � better known as Eminem � wrote a song about killing his ex-wife Kim.
A defiant Takata Corp. told a U.S. safety agency that its demand for a nationwide air bag recall isn't supported by evidence, and the government doesn't have authority to tell a parts maker to do a recall.
The crush of obligatory gift-giving is upon us, when you want to do something thoughtful for the neighbor, the sister-in-law, the boss, but you have no idea what to give beyond the usual. Maybe this year, it can be more like a game, like a treasure...
[WARNING: The following story contains spoilers from Tuesdays' penultimate episode of�Sons of Anarchy. Read at your own risk.]Although�
- Events Calendar


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Sunday, February 3, 2013, 17:46Somerville man burned in fire possibly caused by his smoking while using oxygen
Listen to audio from the incident:
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Monday, May 16, 2011, 12:38
A link to my resume is located in the Links section in the sidebar to the right.
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Monday, March 23, 2009, 07:35On this site, you will find information for monitoring emergency services, public safety, and law enforcement agencies in Somerset County, New Jersey and select surrounding cities / boroughs / townships outside its borders. Gaining functionality to this service is easy: either just stay on the page and listen to the player embedded in it OR download the ProScan Client!
The difference between using your internet browser and using ProScan is that with ProScan, you can view in real-time the channels that are talking, as opposed to just hearing plain audio with a lag.
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Freedom 335
33' Dual Console
" Our family enjoys cruising in the new Freedom 335, our third Grady-White. We love cooking out on the grill, and everything we need is stored right below in the built in refrigerator. The helm and cabin air conditioning along with the diesel generator make all of the amenities we have dockside, available anywhere we go. Touring the Grady-White plant while our Freedom 335 was in production also allowed us to see the craftsmanship that goes into implementing some of these features that are difficult to find in any other saltwater boat. We've owned many runabouts, sportfish and motoryachts and would place Grady White as a whole at the top of the list! "
–Dr. Kent and Judy Webb, Wilmington, NC
Freedom 335 owners


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Brian Shaw
5 Pump Up Songs Athletes Use, And You Should Too (Part 2)
In our first list, we took a look at the pump up songs used by athletes Jason Hammel, Zach Johnson, T.Y. Hilton, Saul "Canelo" Alvarez and Swin Cash. In this installment, we'll deepen our search […]
Brian Shaw In Mix, But Jason Kidd Owns Buzz In Nets' Coaching Decision
Kidd met with general manager Billy King on Monday and Shaw is expected to meet with the team Wednesday.
Report: Nets Contact Hall Of Famer Larry Brown As Search For Coach Continues
The Nets are continuing to search for their next head coach, and it's no secret that owner Mikhail Prokhorov likes big names. Cue Larry Brown, the current head men's basketball coach at Southern Methodist University.


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"Customer service is priority #1 at Rocky Mountain ATV/MC. We value our customers and strive to be the best shopping experience- when you buy from us, you are buying lifetime service."
-Dan Thomas, CEO and Founder
We take pride in offering no hassle returns. In the event of a return, please call, email or chat with us to receive a solution to the problem. For apparel that doesn't fit quite right, Click here to see our Fit Guaranteed Program.
We will stand behind all products we sell with regards to manufacturing defects in workmanship and material. Most products are limited to the manufacturer's warranty. However, we will do everything in our power to take care of the problem.
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Call us: 1 800 336-5437
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Each review submitted enters you into a $100 gift card monthly drawing, and a $500 gift card quarterly drawing!
Comments On Jul 29, 2015:Seems to be good grease.
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Comments On Jan 07, 2014:The Pro Circuit Seal/O-Ring Grease is an amazing lubricant for installing your oil seals as well as any O-ring. I little bit will go a long way and it does not wash off like other lesser quality greases on the market. I highly recommend if you service your own forks that you keep a jar of this in your toolbox!
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Comments On Nov 12, 2013:If you work on your bikes, and who can afford not to, this is like chain lube, loctite, wrenches, etc. Simply a must-have.
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Comments On Jul 26, 2013:I have noticed that "not all" Honda OE Seals come lubed. I have used this several times with excellent luck. I will continue to use it.
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Comments On Nov 12, 2012:Super slick and does what you would expect. It's a lot cleaner than wheel bearing grease.
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Comments On Nov 09, 2010:When you replace rubber o-rings or seals you really need to use seal grease. It will help prevent tearing and chaffing on installation and makes the seals much easier to remove and replace the next time. You could pay more for another brand but there's really no need to. This stuff works.
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Comments On Nov 06, 2009:This Stuff is Excellent. Best Grease I Have Come Across. Is Worth The 10 Dollar Price Tag...
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Comments On Aug 28, 2009:Used this a couple times on fork rebuilds. Works like a champ.
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Comments On Oct 24, 2007:i have used this product for shock & fork re-assembly with excellent results. i also apply a generous coating inside the fork seal wiper during assembly & after cleaning out dirt & mud between rides.
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Theater Schedules
Explore worlds unknown, discover fascinating science all around you and spark your imagination in the theaters of the Orlando Science Center! Giant Screen Films will amaze you with images of extraordinary clarity and depth that expand beyond your peripheral vision in the Dr. Phillips CineDome. And experience Educational and Hollywood Movies in stunning, immersive 3D and ultra high definition 4K resolution in the Digital Adventure Theater: A National Geographic Experience.
Show schedules and content are subject to change.
Please call 407.514.2000 before you visit to confirm times and schedule.
Date: Saturday, August 16, 2014 - 3:15 pm
General Audience
Prepare to "see" the invisible! Too small, too fast, too slow or just plain invisible to the naked eye...Mysteries of the Unseen World will show you the magic and majesty of the objects, events, processes and creatures that exist literally all around you, but that you have never seen until now. Your world will never be the same!


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Topic Contents
- General Information
- Background Information About Childhood Craniopharyngioma
- Histopathologic Classification of Childhood Craniopharyngioma
- Diagnostic Evaluation of Childhood Craniopharyngioma
- Stage Information
- Treatment Options for Newly Diagnosed Childhood Craniopharyngioma
- Treatment Options for Recurrent Childhood Craniopharyngioma
- Late Effects in Patients Treated for Childhood Craniopharyngioma
- Changes to This Summary (08 / 12 / 2014)
- About This PDQ Summary
- Get More Information From NCI
Childhood Craniopharyngioma Treatment (PDQ®): Treatment - Health Professional Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Childhood Craniopharyngioma Treatment
General Information
The PDQ childhood brain tumor treatment summaries are organized primarily according to the World Health Organization classification of nervous system tumors.[1,2] For a full description of the classification of nervous system tumors and a link to the corresponding treatment summary for each type of brain tumor, refer to the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.
Dramatic improvements in survival have been achieved for children and adolescents with cancer. Between 1975 and 2010, childhood cancer mortality has decreased by more than 50%.[3] Childhood and adolescent cancer survivors require close follow-up because cancer therapy side effects may persist or develop months or years after treatment. (Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors.)
Primary brain tumors are a diverse group of diseases that together constitute the most common solid tumor of childhood. Brain tumors are classified according to histology, but tumor location and extent of spread are important factors that affect treatment and prognosis. Immunohistochemical analysis, cytogenetic and molecular genetic findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification.
- Louis DN, Ohgaki H, Wiestler OD, et al., eds.: WHO Classification of Tumours of the Central Nervous System. 4th ed. Lyon, France: IARC Press, 2007.
- Louis DN, Ohgaki H, Wiestler OD, et al.: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114 (2): 97-109, 2007.
- Smith MA, Altekruse SF, Adamson PC, et al.: Declining childhood and adolescent cancer mortality. Cancer 120 (16): 2497-506, 2014.
Background Information About Childhood Craniopharyngioma
Incidence and Presentation
Craniopharyngiomas are relatively rare pediatric tumors, accounting for about 6% of all intracranial tumors in children.[1,2,3] They are believed to be congenital in origin, arising from ectodermal remnants, Rathke cleft, or other embryonal epithelium in the sellar and/or parasellar area. No predisposing factors have been identified.
Because craniopharyngiomas occur in the region of the pituitary gland, endocrine function and growth may be affected. Additionally, the close proximity of the tumor to the optic nerves and chiasm may result in vision problems. Some patients present with obstructive hydrocephalus due to tumor obstruction of the third ventricle. Extremely rarely, the tumor may predominate in the posterior fossa with presenting symptoms of headache, diplopia, ataxia, and hearing loss.[4]
Regardless of the treatment modality, long-term survival is approximately 85% in children [2,3] with 5- and 10-year overall survival rates greater than 90%.[5,6,7,8]
- Bunin GR, Surawicz TS, Witman PA, et al.: The descriptive epidemiology of craniopharyngioma. J Neurosurg 89 (4): 547-51, 1998.
- Karavitaki N, Wass JA: Craniopharyngiomas. Endocrinol Metab Clin North Am 37 (1): 173-93, ix-x, 2008.
- Garnett MR, Puget S, Grill J, et al.: Craniopharyngioma. Orphanet J Rare Dis 2: 18, 2007.
- Zhou L, Luo L, Xu J, et al.: Craniopharyngiomas in the posterior fossa: a rare subgroup, diagnosis, management and outcomes. J Neurol Neurosurg Psychiatry 80 (10): 1150-4, 2009.
- Muller HL: Childhood craniopharyngioma. Recent advances in diagnosis, treatment and follow-up. Horm Res 69 (4): 193-202, 2008.
- Müller HL: Childhood craniopharyngioma--current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol 6 (11): 609-18, 2010.
- Sanford RA, Muhlbauer MS: Craniopharyngioma in children. Neurol Clin 9 (2): 453-65, 1991.
- Zacharia BE, Bruce SS, Goldstein H, et al.: Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro Oncol 14 (8): 1070-8, 2012.
Histopathologic Classification of Childhood Craniopharyngioma
Craniopharyngiomas are histologically benign and do not metastasize to remote brain locations or to areas outside the sellar region except by direct extension. They may be invasive, however, and may recur locally. They may be classified as adamantinomatous or squamous papillary, with the former being the predominant form in children.[1] They are typically composed of both a solid portion with an abundance of calcification, and a cystic component which is filled with a dark, oily fluid. Recent evidence suggests that adamantinomatous craniopharyngiomas are locally more aggressive with a significantly higher rate of recurrence compared with the squamous papillary subtype.[2]
The molecular basis for craniopharyngioma differs by histologic subtype. Activating beta-catenin gene mutations are found in virtually all adamantinomatous tumors.[3,4] Conversely, BRAF V600E mutations are observed in nearly all squamous papillary craniopharyngiomas.[4]
- Karavitaki N, Wass JA: Craniopharyngiomas. Endocrinol Metab Clin North Am 37 (1): 173-93, ix-x, 2008.
- Pekmezci M, Louie J, Gupta N, et al.: Clinicopathological characteristics of adamantinomatous and papillary craniopharyngiomas: University of California, San Francisco experience 1985-2005. Neurosurgery 67 (5): 1341-9; discussion 1349, 2010.
- Sekine S, Shibata T, Kokubu A, et al.: Craniopharyngiomas of adamantinomatous type harbor beta-catenin gene mutations. Am J Pathol 161 (6): 1997-2001, 2002.
- Brastianos PK, Taylor-Weiner A, Manley PE, et al.: Exome sequencing identifies BRAF mutations in papillary craniopharyngiomas. Nat Genet 46 (2): 161-5, 2014.
Diagnostic Evaluation of Childhood Craniopharyngioma
The results of imaging studies (computerized tomography scans and magnetic resonance imaging [MRI] scans) are often diagnostic for childhood craniopharyngiomas, with most demonstrating intratumoral calcifications and a solid and cystic component. The most common location is suprasellar, with an intrasellar portion. Craniopharyngiomas without calcification may be confused with other tumor types, such as germinoma or hypothalamic/chiasmatic astrocytoma, and biopsy may be required.[1] MRI of the spinal axis is not routinely performed.
Apart from imaging, patients often undergo formal visual examination including visual field evaluation and endocrine testing.
- Rossi A, Cama A, Consales A, et al.: Neuroimaging of pediatric craniopharyngiomas: a pictorial essay. J Pediatr Endocrinol Metab 19 (Suppl 1): 299-319, 2006.
Stage Information
There is no generally applied staging system for childhood craniopharyngiomas. For treatment purposes, patients are classified as having newly diagnosed or recurrent disease.
Treatment Options for Newly Diagnosed Childhood Craniopharyngioma
There is no consensus as to the optimal treatment of newly diagnosed craniopharyngioma, in part due to the lack of prospective randomized trials comparing different treatment options. A systematic review of 109 reports that described extent of resection found that subtotal resection plus radiation therapy was associated with similar rates of tumor control as gross total resection and that both approaches were associated with higher progression-free survival (PFS) rates than subtotal resection alone.[1][Level of evidence: 3iiiDiii] Treatment is individualized based on factors such as the size, location, and extension of the tumor and potential short-term and long-term toxicity.
Radical Surgery
Because these tumors are histologically benign, it may be possible to remove all the visible tumor resulting in long-term disease control.[2][Level of evidence: 3iA]; [3][Level of evidence: 3iiiB]; [4][Level of evidence: 3iiiC] A 5-year PFS rate of about 65% has been reported.[5] Many surgical approaches have been described, and the route should be determined by the size, location, and extension of the tumor. A transsphenoidal approach may be possible in some small tumors located entirely within the sella,[6][Level of evidence: 3iiiC] but this is not usually possible in children, in which case a craniotomy is usually required.
Gross total resection is technically challenging because the tumor is surrounded by vital structures, including the optic nerves and chiasm, the carotid artery and its branches, the hypothalamus, and the third cranial nerve. The tumor may be adherent to these structures, which may cause complications, and may limit the ability to remove the entire tumor. The surgeon often has limited visibility in the region of the hypothalamus and in the sella, and portions of the mass may be left in these areas, accounting for some recurrences. Almost all craniopharyngiomas have an attachment to the pituitary stalk, and of the patients who undergo radical surgery, virtually all will require life-long pituitary hormone replacement with multiple medications.[3,7]
Complications of radical surgery include the need for hormone replacement, obesity (which can be life threatening),[8] severe behavioral problems,[9] blindness, seizures, spinal fluid leak, false aneurysms, and difficulty with eye movements. Rare complications include death from intraoperative hemorrhage, hypothalamic damage, or stroke. Hypothalamic-sparing surgical techniques may show a decrease in severe postoperative obesity without an increase in tumor recurrence.[10][Level of evidence: 3iiDi]
If the surgeon feels that tumor remains, or if postoperative imaging reveals residual craniopharyngioma that was not resected, radiation therapy may be recommended to prevent early progression.[11][Level of evidence: 3iiiDiii] It can be difficult to determine whether a tumor is progressive; carbon-11 methionine positron emission tomography is being evaluated for its use in these cases.[12] Periodic surveillance magnetic resonance imaging is performed for several years after radical surgery because of the possibility of tumor recurrence.
Surgery with Cyst Drainage
For large cystic craniopharyngiomas, particularly in children younger than 3 years and in those with recurrent cystic tumor after initial surgery, stereotactic or open implantation of an intracystic catheter with a subcutaneous reservoir may be a valuable alternative treatment option. The benefits of this procedure include temporary relief of fluid pressure by serial drainage, and in some cases, for intracystic instillation of sclerosing agents as a means to prolong the interval to or obviate the need for radiation. This procedure may also be helpful in allowing the surgeon to perform a two-staged approach, whereby first the cyst is drained by the implanted catheter to relieve pressure and complicating symptoms, followed by tumor resection.[13]
Limited Surgery and Radiation Therapy
The goal of limited surgery is to establish a diagnosis, drain any cysts, and decompress the optic nerves. No attempt is made to remove tumor from the pituitary stalk or hypothalamus in an effort to minimize certain late effects associated with radical surgery.[10] The surgical procedure is followed by radiation therapy, with a 5-year PFS rate of about 70% to 90% [5,14]; [15][Level of evidence: 3iDiii] and 10-year overall survival rates higher than 90%.[16][Level of evidence: 3iiA]; [1][Level of evidence: 3iiiDiii] Transient cyst enlargement may be noted soon after radiation therapy but generally resolves without further intervention.[17][Level of evidence: 3iDiv] Conventional radiation is fractionated external-beam radiation with a recommended dose of 54 Gy to 55 Gy in 1.8 Gy fractions.[18] Surgical complications are less likely than with radical surgery. Complications of radiation include loss of pituitary hormonal function, cognitive dysfunction, development of late strokes and vascular malformations, delayed blindness, development of second tumors, and, rarely, malignant transformation of the primary tumor within the radiation field.[19,20] Newer radiation technologies such as intensity-modulated proton therapy may reduce scatter whole-brain and whole-body irradiation and result in the sparing of normal tissues. It is unknown whether such technologies result in decreased late effects from irradiation.[15,21,22] Tumor progression remains a possibility, and it is usually not possible to repeat the radiation dose. In selected cases, stereotactic radiation therapy can be delivered as a single large dose of radiation to a very small field.[23][Level of evidence: 3iC] Proximity of the craniopharyngioma to vital structures, particularly the optic nerves, limits this to very small tumors that are in the sella.[24][Level of evidence: 3iiiDiii]
Intracavitary Radiation Therapy and/or Chemotherapy
Some craniopharyngiomas with a large cystic component may be treated by stereotaxic delivery of P-32 or other radioactive compounds.[25,26]; [27][Level of evidence: 2A]; [28][Level of evidence: 3iiiDiii] Nonradioactive agents such as bleomycin and interferon-alpha have also been used.[29,30,31]; [32][Level of evidence: 2C] These strategies have been found to be useful in certain cases and are with low reported risk of complications. However, none have shown efficacy against solid portions of the tumor.
- Clark AJ, Cage TA, Aranda D, et al.: A systematic review of the results of surgery and radiotherapy on tumor control for pediatric craniopharyngioma. Childs Nerv Syst 29 (2): 231-8, 2013.
- Mortini P, Losa M, Pozzobon G, et al.: Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. J Neurosurg 114 (5): 1350-9, 2011.
- Elliott RE, Hsieh K, Hochm T, et al.: Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children. J Neurosurg Pediatr 5 (1): 30-48, 2010.
- Zhang YQ, Ma ZY, Wu ZB, et al.: Radical resection of 202 pediatric craniopharyngiomas with special reference to the surgical approaches and hypothalamic protection. Pediatr Neurosurg 44 (6): 435-43, 2008.
- Yang I, Sughrue ME, Rutkowski MJ, et al.: Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28 (4): E5, 2010.
- Locatelli D, Massimi L, Rigante M, et al.: Endoscopic endonasal transsphenoidal surgery for sellar tumors in children. Int J Pediatr Otorhinolaryngol 74 (11): 1298-302, 2010.
- Sands SA, Milner JS, Goldberg J, et al.: Quality of life and behavioral follow-up study of pediatric survivors of craniopharyngioma. J Neurosurg 103 (4 Suppl): 302-11, 2005.
- Müller HL, Gebhardt U, Teske C, et al.: Post-operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow-up. Eur J Endocrinol 165 (1): 17-24, 2011.
- Clark AJ, Cage TA, Aranda D, et al.: Treatment-related morbidity and the management of pediatric craniopharyngioma: a systematic review. J Neurosurg Pediatr 10 (4): 293-301, 2012.
- Elowe-Gruau E, Beltrand J, Brauner R, et al.: Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity. J Clin Endocrinol Metab 98 (6): 2376-82, 2013.
- Lin LL, El Naqa I, Leonard JR, et al.: Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1 (2): 126-30, 2008.
- Laser BS, Merchant TE, Indelicato DJ, et al.: Evaluation of children with craniopharyngioma using carbon-11 methionine PET prior to proton therapy. Neuro Oncol 15 (4): 506-10, 2013.
- Schubert T, Trippel M, Tacke U, et al.: Neurosurgical treatment strategies in childhood craniopharyngiomas: is less more? Childs Nerv Syst 25 (11): 1419-27, 2009.
- Winkfield KM, Tsai HK, Yao X, et al.: Long-term clinical outcomes following treatment of childhood craniopharyngioma. Pediatr Blood Cancer 56 (7): 1120-6, 2011.
- Merchant TE, Kun LE, Hua CH, et al.: Disease control after reduced volume conformal and intensity modulated radiation therapy for childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 85 (4): e187-92, 2013.
- Schoenfeld A, Pekmezci M, Barnes MJ, et al.: The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neurooncol 108 (1): 133-9, 2012.
- Shi Z, Esiashvili N, Janss AJ, et al.: Transient enlargement of craniopharyngioma after radiation therapy: pattern of magnetic resonance imaging response following radiation. J Neurooncol 109 (2): 349-55, 2012.
- Kiehna EN, Merchant TE: Radiation therapy for pediatric craniopharyngioma. Neurosurg Focus 28 (4): E10, 2010.
- Ishida M, Hotta M, Tsukamura A, et al.: Malignant transformation in craniopharyngioma after radiation therapy: a case report and review of the literature. Clin Neuropathol 29 (1): 2-8, 2010 Jan-Feb.
- Aquilina K, Merchant TE, Rodriguez-Galindo C, et al.: Malignant transformation of irradiated craniopharyngioma in children: report of 2 cases. J Neurosurg Pediatr 5 (2): 155-61, 2010.
- Beltran C, Roca M, Merchant TE: On the benefits and risks of proton therapy in pediatric craniopharyngioma. Int J Radiat Oncol Biol Phys 82 (2): e281-7, 2012.
- Boehling NS, Grosshans DR, Bluett JB, et al.: Dosimetric comparison of three-dimensional conformal proton radiotherapy, intensity-modulated proton therapy, and intensity-modulated radiotherapy for treatment of pediatric craniopharyngiomas. Int J Radiat Oncol Biol Phys 82 (2): 643-52, 2012.
- Kobayashi T: Long-term results of gamma knife radiosurgery for 100 consecutive cases of craniopharyngioma and a treatment strategy. Prog Neurol Surg 22: 63-76, 2009.
- Hasegawa T, Kobayashi T, Kida Y: Tolerance of the optic apparatus in single-fraction irradiation using stereotactic radiosurgery: evaluation in 100 patients with craniopharyngioma. Neurosurgery 66 (4): 688-94; discussion 694-5, 2010.
- Julow J, Backlund EO, Lányi F, et al.: Long-term results and late complications after intracavitary yttrium-90 colloid irradiation of recurrent cystic craniopharyngiomas. Neurosurgery 61 (2): 288-95; discussion 295-6, 2007.
- Barriger RB, Chang A, Lo SS, et al.: Phosphorus-32 therapy for cystic craniopharyngiomas. Radiother Oncol 98 (2): 207-12, 2011.
- Kickingereder P, Maarouf M, El Majdoub F, et al.: Intracavitary brachytherapy using stereotactically applied phosphorus-32 colloid for treatment of cystic craniopharyngiomas in 53 patients. J Neurooncol 109 (2): 365-74, 2012.
- Zhao R, Deng J, Liang X, et al.: Treatment of cystic craniopharyngioma with phosphorus-32 intracavitary irradiation. Childs Nerv Syst 26 (5): 669-74, 2010.
- Ierardi DF, Fernandes MJ, Silva IR, et al.: Apoptosis in alpha interferon (IFN-alpha) intratumoral chemotherapy for cystic craniopharyngiomas. Childs Nerv Syst 23 (9): 1041-6, 2007.
- Linnert M, Gehl J: Bleomycin treatment of brain tumors: an evaluation. Anticancer Drugs 20 (3): 157-64, 2009.
- Steinbok P, Hukin J: Intracystic treatments for craniopharyngioma. Neurosurg Focus 28 (4): E13, 2010.
- Cavalheiro S, Di Rocco C, Valenzuela S, et al.: Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus 28 (4): E12, 2010.
Treatment Options for Recurrent Childhood Craniopharyngioma
Recurrence of craniopharyngioma occurs in approximately 35% of patients regardless of primary therapy.[1] Management is determined in large part by prior therapy. Repeat attempts at gross total resection are difficult and long-term disease control is less often achieved.[2][Level of evidence: 3iiiDi] Complications are more frequent than with initial surgery.[3][Level of evidence: 3iiiDi] External-beam radiation therapy is an option if this has not been previously employed, including consideration of radiosurgery in selected circumstances.[4][Level of evidence: 3iiiDiii] Cystic recurrences may be treated with intracavitary instillation of radioactive P-32, bleomycin,[5][Level of evidence: 3iiiDiii] or interferon-alpha,[6][Level of evidence: 3iiiB] and a reservoir may be placed to permit intermittent outpatient aspiration. Although systemic therapy is generally not utilized, a small series has shown that the use of subcutaneous pegylated interferon alpha-2b to manage cystic recurrences can result in durable responses.[7][Level of evidence: 3iiiDiii]
Treatment Options Under Clinical Evaluation
The following is an example of a national and/or institutional clinical trial that is currently being conducted. Information about ongoing clinical trials is available from the NCI Web site.
- PBTC-039 (NCT01964300) (Peginterferon Alfa-2b in Treating Younger Patients With Craniopharyngioma That is Recurrent or Cannot Be Removed By Surgery): This is a phase II clinical trial evaluating how well peginterferon alfa-2b works in treating children with craniopharyngioma that is recurrent or cannot be removed by surgery. This trial follows a small (N = 5) single-institution experience with peginterferon alfa-2b, in which prolonged complete responses were observed in some patients.[7]
- Yang I, Sughrue ME, Rutkowski MJ, et al.: Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28 (4): E5, 2010.
- Vinchon M, Dhellemmes P: Craniopharyngiomas in children: recurrence, reoperation and outcome. Childs Nerv Syst 24 (2): 211-7, 2008.
- Jang WY, Lee KS, Son BC, et al.: Repeat operations in pediatric patients with recurrent craniopharyngiomas. Pediatr Neurosurg 45 (6): 451-5, 2009.
- Xu Z, Yen CP, Schlesinger D, et al.: Outcomes of Gamma Knife surgery for craniopharyngiomas. J Neurooncol 104 (1): 305-13, 2011.
- Hukin J, Steinbok P, Lafay-Cousin L, et al.: Intracystic bleomycin therapy for craniopharyngioma in children: the Canadian experience. Cancer 109 (10): 2124-31, 2007.
- Cavalheiro S, Di Rocco C, Valenzuela S, et al.: Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus 28 (4): E12, 2010.
- Yeung JT, Pollack IF, Panigrahy A, et al.: Pegylated interferon-α-2b for children with recurrent craniopharyngioma. J Neurosurg Pediatr 10 (6): 498-503, 2012.
Late Effects in Patients Treated for Childhood Craniopharyngioma
Quality-of-life issues are important in this group of patients and are difficult to generalize due to various treatment modalities. Whereas intelligence quotient is usually maintained, behavioral issues and memory deficits attributed to the frontal lobe and hypothalamus are common.[1] Patients with hypothalamic involvement showed impairment in memory and executive functioning.[2] Other common problems include visual loss, obesity (which can be life threatening),[3] and the almost universal need for life-long endocrine replacement with multiple pituitary hormones.[4,5,6][Level of evidence: 3iiiC] Vasculopathies and secondary tumors may also result from local irradiation.[7] A recent report indicated that adults on long-term growth hormone replacement secondary to childhood craniopharyngioma involving the hypothalamus were at increased cardiovascular risk.[8]
Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for specific information about the incidence, type, and monitoring of late effects in childhood and adolescent cancer survivors.
- Winkfield KM, Tsai HK, Yao X, et al.: Long-term clinical outcomes following treatment of childhood craniopharyngioma. Pediatr Blood Cancer 56 (7): 1120-6, 2011.
- Özyurt J, Thiel CM, Lorenzen A, et al.: Neuropsychological outcome in patients with childhood craniopharyngioma and hypothalamic involvement. J Pediatr 164 (4): 876-881.e4, 2014.
- Elowe-Gruau E, Beltrand J, Brauner R, et al.: Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity. J Clin Endocrinol Metab 98 (6): 2376-82, 2013.
- Vinchon M, Weill J, Delestret I, et al.: Craniopharyngioma and hypothalamic obesity in children. Childs Nerv Syst 25 (3): 347-52, 2009.
- Dolson EP, Conklin HM, Li C, et al.: Predicting behavioral problems in craniopharyngioma survivors after conformal radiation therapy. Pediatr Blood Cancer 52 (7): 860-4, 2009.
- Kawamata T, Amano K, Aihara Y, et al.: Optimal treatment strategy for craniopharyngiomas based on long-term functional outcomes of recent and past treatment modalities. Neurosurg Rev 33 (1): 71-81, 2010.
- Kiehna EN, Merchant TE: Radiation therapy for pediatric craniopharyngioma. Neurosurg Focus 28 (4): E10, 2010.
- Holmer H, Ekman B, Björk J, et al.: Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy. Eur J Endocrinol 161 (5): 671-9, 2009.
Changes to This Summary (08 / 12 / 2014)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
General Information
Revised text to state that between 1975 and 2010, childhood cancer mortality has decreased by more than 50% (cited Smith et al. as reference 3).
Stage Information
Revised text to state that for treatment purposes, patients are classified as having newly diagnosed or recurrent disease.
Treatment Options for Newly Diagnosed Childhood Craniopharyngioma
Revised text to state that there is no consensus as to the optimal treatment of newly diagnosed craniopharyngioma, in part due to the lack of prospective randomized trials comparing different treatment options. Also added text to state that a systematic review of 109 reports that described extent of resection found that subtotal resection plus radiation therapy was associated with similar rates of tumor control as gross total resection and that both approaches were associated with higher progression-free survival rates than subtotal resection; treatment is individualized based on factors such as the size, location, and extension of the tumor and potential short-term and long-term toxicity.
Late Effects in Patients Treated for Childhood Craniopharyngioma
Added text to state that patients with hypothalamic involvement showed impairment in memory and executive functioning (cited Özyurt et al. as reference 2).
This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
About This PDQ Summary
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of childhood craniopharyngioma. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
- be discussed at a meeting,
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Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Childhood Craniopharyngioma Treatment are:
- Kenneth J. Cohen, MD, MBA (Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital)
- Karen J Marcus, MD (Dana-Farber Cancer Institute/Boston Children's Hospital)
- Roger J. Packer, MD (Children's National Medical Center)
- Malcolm A. Smith, MD, PhD (National Cancer Institute)
Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Pediatric Treatment Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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The preferred citation for this PDQ summary is:
National Cancer Institute: PDQ® Childhood Craniopharyngioma Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/child-cranio/healthprofessional. Accessed <MM/DD/YYYY>.
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Texas Governor Rick Perry defended his policy of allowing illegal immigrants to obtain in-state tuition for Texas state colleges in the Fox News/Google debate September 22.
Perry faced withering criticism from former Massachusetts Governor Mitt Romney, who said of the Perry-backed Texas policy of granting in-state tuition to illegal immigrants:
It's an argument I just can't follow. I've got be honest with you, I don't see how it is that a state like Texas — to go to the University of Texas, if you're an illegal alien, you get an in-state tuition discount. You know how much that is? That's $22,000 a year. Four years of college, almost $100,000 discount if you are an illegal alien go to the University of Texas. If you are a United States citizen from any one of the other 49 states, you have to pay $100,000 more. That doesn't make sense to me. That kind of magnet draws people into this country to get that education, to get the $100,000 break. It makes no sense.... We have to turn off the magnet of extraordinary government benefits like a $100,000 tax credit — or, excuse me, discount for going to the University of Texas. That shouldn't be allowed. It makes no sense at all.
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Photo: Texas Gov. Rick Perry makes a statement during the Republican presidential debate on Sept. 22, 2011 in Orlando, Fla: AP Images