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Cliffside Cottage
From $375 / night
16 travelers
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Description from the manager
Description from the manager
Bedrooms: 3/
Bathrooms: 3/
Sleeps: 6/
Type: House
Cliffside Cottage is a 3 bedroom, 3 full bathroom home on a bluff at Gleason Beach. Located about 5 miles north of Bodega Bay on the Sonoma coast, the home offers a spectacular ocean view. All 3 bedrooms have a queen size bed and a TV. There is also a TV in the living room. There is a full kitchen, DVD player, a propane fireplace and a hot tub. The outside grill is charcoal; there is also a free standing charcoal grill on the patio. Cable and unlimited phone service in the continental USA are included also. WIFI is a free service provided as a courtesy on an "as available" basis without warranties of any kind, either express or implied, ...Read more
About the manager
About the manager
Coastal Vistas Vacation Rentals
Coastal Vistas Vacation Rentals
- Response rate: 25%
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- Calendar updated: 2 days ago
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Cliffside Cottage is located about 5 miles north of Bodega Bay on the bluff at Gleason Beach on the Sonoma coast.
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tall and austere, this pagoda inspire meditation. it is perfect to combine with the shaanxi museum, the South Gate and the museum of the foreest of stone steles museum
Traveled her with China Odyssey Tours. A nice pagoda that is a must do if you are in the area. Not overly important to see if is out of your way and you have visited other Pagodas. To be fair, we were getting 'Pagoda'ed out' by day 10 of our 2 week China trip, so we can compare it to others that we have seen. It would be one of the best lit Pagodas in China at night time. Day time though is worth a casual walk through, but don't bother if there are long ques. A display inside talks about the end of the Silk Road and shows a map. The Drum and Bell tours are also well described with signs. Entry into the Pagoda building itself is not allowed.
We got here by underground an interesting experience. Overall a pleasant park and some points of interest but not worth busting a gut if you are on a tight schedule.
it is nice. Be careful with the vendors..gees...they really want to sell you something...they are almost aggressive...an old lady (about 101 years old) was after me...a lot of poverty here...
While the area around the pagoda might not be that special the view from the top (quite a walk up if its hot!) is one of the best in Xi'an on a clear day and well worth it.
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subset: commoncrawl


text:
Why Buy from Bold Rugs?
- Free Shipping and No Sales Tax (On Orders Over $99)
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Surya Goa G5037 Area Rug
|Ships Within
|Style: Contemporary , Geometric
|Collection: Surya Goa
|Material: Wool ()
|Weave: Hand Tufted
|Country of Origin: India
|Color(s): White >> Secondary Color(s):Beige,Olive,Gold - Pantone Colors: 13-0907,18-1110,15-0948.
Questions? Click Here or Call 1-888-989-RUGS (7847)
Reviews for Surya Goa G5037 (Total of 0 reviews)(Write Reviews)
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|The Surya Goa G5037 by Surya is sometimes listed with the following brand codes: G5037-23, G5037-3353, G5037-268, G5037-58, G5037-811, G5037-913. Also, the following UPC codes: 764262468380, 764262468359, 764262468342, 764262468366, 764262468373, 764262834550
Additional Rugs from the Surya Goa Rug Collection
- Surya Goa G5119
- Surya Goa G5152
- Surya Goa G5141
- Surya Goa G5153
- Surya Goa G5138
- Surya Goa G5125
- Surya Goa G5076
- Surya Goa G5128
- Surya Goa G5091
- Surya Goa G5036
* Disclaimer: Because of differences in computer monitors we are not responsible for differences in colors shown in rug pictures on your computer screen. Also, we cannot accept orders with pricing errors due to typos or other human errors. Please email us or call us at 1-888-989-7847 if you have any questions about colors, stock availability or any other questions you might have.


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Bernard H. is thirty year old businessman. He is married with two children, who are both in school. He is a small scale manufacturer of tin pepper near the community market. He buys fresh and dry pepper, mills and processes them into canned pepper, and then supplies them to food vendors and restaurant operators. His operation is on a limited scale due to inadequate capital to buy machines for the processing.
Bernard wants to take advantage of the loan opportunity to buy more raw materials and equipment to increase his efficiency and produce in larger quantities. He believes this can help expand his business to produce a larger income to help finance his children's education.
He belongs to the community group called Nyame Boafo ("The helping God") Trust Group. In this group, members guarantee for one another as social collateral and act as peer pressure to repay the loan.
About Ghana
42View loans »
Success!! The loan was 100% repaid
- Repayment Term
- 11 months (Additional Information)
- Repayment Schedule
- Monthly
- Disbursed:
- Jun 7, 2008
- Listed
- May 23, 2008
- Currency Exchange Loss:
- Covered
- Ended:
- Mar 16, 2009


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The Southwest Kansas Bar Association is sponsoring its annual scholarship essay contest for all qualified seniors attending a high school in the 29 county area served by the Association.
Students from 12 Kansas high schools will be honored Wednesday, Feb. 5, by the University of Kansas Alumni Association and KU Endowment.
Life for Debbie Tomlinson was not easy growing up. Her mother died of lung cancer when she was young and she moved to Kansas from California with her abusive, alcoholic father. She was beaten often and at the age of 15 she was kicked out of her house. She bounced around from home to home and eventually wound up married and pregnant at the age of 17. The lack of her home life stability coupled with her pregnancy caused her to drop out of high school, a decision she immediately regretted.
MANHATTAN – More than 3,500 Kansas State University students have earned semester honors for their academic performance in the fall 2013 semester.
Principals Honor Roll (Straight A's or 4.0 GPA): Jaci Guthrie, Collin Hammond, Evan Hammond, Christopher Schenk
Wilson Hall is ringing with voices as Sterling College students prepare for the first show of the semester. "Words and Music from Broadway Today" will take place at 7:30 p.m. on Friday, Jan. 31, and Saturday, Feb. 1, in Cornerstone in the Student Union.
Principal's Honor Roll
All A Honor Roll
Barton Community College has named 239 students to the President's List for the fall 2013 semester. To qualify for this honor, students must have been enrolled in a minimum of 12 credit hours and maintained a grade point average of 4.0 on a 4.0 or "A" letter scale.
Each year the Golden Belt Community Foundation helps students realize their dreams with scholarships made possible through the generosity of caring donors.
Forty-seven Fort Hays State University students have been accepted into the 2014 "Who's Who Among Students in American Universities and Colleges."
Raymond Junior High Honor Roll
Each year, Members of Congress have the opportunity to nominate outstanding young men and women to attend the nation's military service academies. Following in-person interviews with candidates and rigorous evaluation by a board of Kansans, 1st District Congressman Tim Huelskamp announced that he would recommend the following individuals:
NEWTON - Prairie View Inc. will host an Adventure with Youth at Risk workshop Feb. 10-12 on its main campus, 1901 E. First St., Newton. Presenter is Jason Leal, Prairie View's recreation and adventure facilitator.
Page 30 of 64
Local students are among the 400 who completed associate, bachelor's or graduate degrees at Fort Hays State University in the summer 2015 term.
A Kansas State University honorary that helps outstanding freshmen become future campus leaders has selected new members for the 2015-2016 new year.
Sixteen area students were awarded scholarships to Kansas State University totaling $4,300 at the Great Bend Area K-State Alumni Club's alumni/student tailgate ...
Teacher professional development is an enormous sinkhole, sucking billions of dollars every year and producing no measurable results, says a new study by TNTP, a ...
Chicago mother Nyesha Terry wasn't exactly thrilled when she visited her son Lloyd's kindergarten classroom and found him wearing a trash bag, according ...
Four-year-old Zayde Sands does everything with his left hand.
TOPEKA - Successful applicants to the July 2015 Kansas bar examination were sworn in as Kansas attorneys at a ceremony Friday, Sept. 25, at the Topeka ...
CHICAGO — It's 10 a.m., class change time in Cristo Rey Jesuit High School, and students are churning between rooms. The boys in dark ...
At-risk youths who held a summer job may also improve their school test scores this year, a new National Bureau of Economic Research study finds.
Anna Frizell and Caleb Maneth are the recipients of the Carl and Evelyn Miller Memorial 4-H Scholarship. Carl and Evelyn were leaders for the Lakin ...
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Weft & Weave
Tapestry Of Church Of The Creator® Nature Of The Functioning Body Of COTC
Church of the Creator® is comprised of like minded, dedicated representatives serving the Creator, Divine Plan, living the "Family Unification of Mankind - All Aspects Of The Whole" humans through free will choice - "... Dedicate Our Physical Embodiments ..." - Those words from the Sacred Mandate anchor and draw together Spiritually Commissioned, unique individuals, each representative of some aspect of mankind, so that the weft and weave of the tapestry of COTC includes, collectively, representatives of the Whole of humanity.
How do I become a "Member" of the Church?
"Church Membership" is activated when an individual recognizes within themselves that they are a "Member."
The Church already recognizes "...all Thinking Thought Beings In Form" to be "...Members of the Body of the Church."
Membership is self-evident, a God Given right, a foregone conclusion, knowing that the Creator made us all members, of one body. So within TE-TA-MA Truth Foundation-Family Of URI, Inc, and Church Of The Creator®, "Church Membership" is a self-recognition, a claim, left to the conscious choice of the individual. To recognize oneself as a member requires no further action by the Church.
Anyone recognizing as Truth the Mission Statement:
Sacred Mandate
may "...Join in Principle and Witness..." Print the Document, take action, sign your name.
Your action, free will choice, is a claim activating individual Membership within the Church, a contract, a Covenant & Pact with other Members of the Church and God. That self-recognition, in thought, word, deed of your signature is a legal anchor within man's law, your "Membership."
COTC Associate Ministers
Collective Service within Church Of The Creator®
"Associate Ministers are those choosing, commissioned and witnessed to be the Instruments to Mandate and infuse the Higher Truths to this Humanity, to bring forth into manifest state the Sacred Sciences of the Holy Spirit Shekinah - AMEN - AMEN; and in proclaiming these truths shall HERALD, AFFIRM, TEACH, and SANCTIFY in preparation and Celebration of that which is descending unto and through the Redemptive Vehicle of the Bestowal Son Jesus, the Office Of The Christ." Ecclesia Magna Charta - Article IX Ministerial Positions, Section 4, © 1984 All Rights Reserved
Individuals choosing, being chosen, to walk the COTC Path may become a Candidate for Ordination, Commissioned, Ordained, within the Ministerial Position, COTC Associate Minister. It is a spiritual calling, commitment to live a Collective Covenant & Pact as the People of Light, the True Israel, demonstrating by example the Principles and Practices of the Church.
GRIDS Of Consciousness Unification
Authored Co-jointly by the Ministerial Unit Revs. Drs. Grace Marama URI and James Germain URI, 1979-1980, to bring about better understanding of the reciprocal flow of collective energy and living experiences
© 1984 TE-TA-MA Truth Foundation-Family Of URI, Inc. All Rights Reserved.
This publication is intend for use in conjunction with an audio CD. Understanding of the Principles & Practices of the Church are accelerated by experiential demonstration within:
COTC GRIDS Accord Seminar™


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We offer a great range of men's accessories, including ties, hats, wallets and much more.
Results 1-20 of 169
Gamekeeper, 7.5" navy waxed hat
BNWT Screamer size S/M beige unisex trapper hat
Hosana Blue Baseball Cap Size: One Size
Hosana Southsiders Blue Baseball Cap Size: One size
UNK White NBA Baseball Cap Size: One size
Dunn & Co "County" size 7 (57 cm) Harris tweed flat cap
Musto - Size: Small - Brown - Baseball cap
Christys London - Size: 6 5/8 - Brown - Trilby
KuSan - Size: S - Grey Speckle Pompom Wool Beanie
BNWT Green Kids, age 1 - 2 years reversible camper hat
BNWT Green Kids, age 2 - 3 years navy/red reversible camper hat
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© 2015. Oxfam is a registered charity in England and Wales (no 202918) and Scotland (SC039042).
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text: Official game balls for NFL football's Super Bowl XLIX sit in a bin before being laced and inflated at the Wilson Sporting Goods Co. in Ada, Ohio (AP Photo/Rick Osentoski) [ NFL investigation into deflated footballs ongoing By Associated Press January 21, 2015 The NFL says its investigation into whether the New England Patriots used under-inflated footballs in the AFC championship game is ongoing after a report Tuesday night claimed the league found 11 balls were not properly inflated. Read More|Comment Category: News, Sports Tags: 2015 Super Bowl, New England Patriots Send to a friend! Share on Facebook Share on Twitter Pin it! Reddit This! Share on Tumblr!


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Coastal forecaster, weather observer and offshore sailor specializing in the local nuances of Central Oregon Coast weather for residents and visitors.
By: NewportOr , 3:12 PM GMT on August 22, 2014
Friday, August 22nd – Lincoln County
Summary: In the wake of yesterday's mellow weather with partly cloudy skies, light northwest winds and highs in the 60s, the predicted minor weather front and marine layer moved in before midnight. It was totally overcast with accompanying fog and drizzle by about 2:00am. The mercury remained fairly high as temperatures drifted into the mid-50s, and precipitation amounts were just barely recordable. This morning, it was still a touch misty in spots, there were areas of dense fog, the breeze was light out of the south, and the thermometer had risen a few degrees to the upper-50s.
Past 24 Hours High/Low/Rain...
Lincoln City: 69F/52F/<0.01"
Depoe Bay: 66F/51F/0/01"
Newport: 64F/50F/0.01"
Waldport: 63F/49F/0.01"
Yachats: 64F/54F/0.01"
Forecast: Before your spirits are seriously dampened, we should see the gray big-top burn off by late morning and the return of the sun this afternoon. Northwest winds are expected to rise today to 10-15 mph gusting to 20, and high temps will be seasonal at 65F or so. Tonight, on your way to see 'Mary Shelley: Frankenstein Unbound' at the PAC in Newport, partly cloudy skies, a northerly breeze with gusts to 20 mph or a tad higher, and overnight low temps around 55F. Look for mostly sunny skies tomorrow, lighter winds and highs again of 65F or so. Outlook is for sunny days, partly cloudy nights, increasing northwest winds and standard thermometer readings between 55F and 65F next week.
Travel: In the Coast Range today, partly cloudy and 70-80F. Valley destinations will have mostly sunny skies with highs around 80F. For the Cascades, partly cloudy, isolated showers and thunderstorms; the freezing level is at 8,000 feet.
Marine: It's nearly flat this morning. Winds are calm to southerly 5 knots and seas are running 3 feet at 8 seconds. As of 8:00am, Depoe Bay and Yaquina Bay bars are unrestricted. Limited visibility in fog and drizzle should fade as today progresses and we switch back to NW winds 10-15 knots gusting 20 by this afternoon; swells 4 feet with a 3 foot chop on top. Tonight and tomorrow, expect patchy fog, northerlies 10-15 knots gusting 20 and lumpy 4 footers. Outlook is for N winds 15-25 knots and choppy 4-5 foot seas Sunday through Tuesday.
On the Beach... Fog early, partly cloudy later, windy, surf 3-4 feet (low).
For a safe and enjoyable time on the Central Coast, the Oregon Parks & Recreation Department offers these Beach Safety Tips.
08/22 Fri 11:52 AM 6.74 H
08/22 Fri 05:08 PM 2.95 L
08/22 Fri 11:07 PM 8.10 H
08/23 Sat 05:52 AM 0.16 L
In Short: Patchy fog, drizzle, then partly cloudy and breezy.
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Please, Mssrs. Lieberman and Netanyahu, show me one historical example where religious, racial or national loyalty oaths imposed by force have factually created greater loyalty rather than just the opposite? The Spanish Inquisition did not succeed in creating genuine, devoted Catholics of us Jews. Nor will we succeed in developing more "trustworthy" Israeli citizens out of Palestinian Muslims or Christians by compelling them to swear allegiance to the "Jewish democratic" character of their birthright home or forcing them to rubber-stamp their clearly inferior form of "Jewish citizenship." Such colossally benighted efforts will merely spawn more bitterness, enmity and an even stronger desire for Palestinian religious and national revenge. Usurping people's land and minimal power over their daily lives (no matter how desperate or factually motivated our justification) is difficult enough to make emends for. Usurping people's very communal and inner psychological identity begets a form of hatred that may never be appeased by via any mundane means. And we -- far more than anyone -- SHOULD know this! Is such cruel psychic and spiritual usurpation really our best hope of insuring Israel's long-term security in the greater Muslim world, or of cementing our daily more-and-more tenuous bonds with the wider Christian and secular democratic West? Any half-way intelligent and thoughtful observer knows that the current campaign to impose "pro-Jewish" loyal oaths on Israel's ethnic and religious minorities, as well as the Netanyahu government's renewed demands that Palestinians formally attest to Israel's exclusive Jewish status, are nothing but red herrings fabricated by the Israel right to prevent a territorial compromise at almost any cost by unnecessarily and fruitlessly antagonizing Palestinian national sentiment and solidarity. Neither realistically will root out an iota of "Israeli-Arab subversion," nor concretely make Israel much the safer. The Spanish Inquisition did not greatly enhance Jewish loyalty to Christianity. It merely legitimized the construction of a new class of suspect Jewish "religious subversives" whose property, thus, could "justly" be expropriated. It succeeded in unleashing a sea of homeless, bitter Jewish refugees who nurse the memory of their oppression to this day. And it engendered a population of clandestine Jewish Marranos who stubbornly clung to their beloved religion despite the potential mortal cost -- all carved from a Spanish Jewish population who formerly were relatively accommodated to continued, semi-benign Catholic or Moorish-Muslim rule. Our new "Jewish loyalty" Inquisition, just like the ancient Spanish one, will most likely serve to designate a new population of "Palestinian subversives" to likewise be brutally expelled and made homeless, and incite many more generations of wholly avoidable Arab-Jewish bloodshed. The Israeli political and religious right, along with we more moderate Jews both within Israel and abroad, are, however, entirely justified to be skeptical of peace treaties. MERE OATHS -- no matter how august or eloquent their words -- do not make peace. The only means to peace is its courageous, difficult and unrelenting daily practice! And our people's history has given us no time left to tarry!
Aden hotel used by Yemen goverment hit by grenade (Reuters)
from the article: Lieberman is Kahane. And even the right senses it


text:
Possible Answer
It is a central Business Banking Sort Code. Santander, Customer Service Centre, Bootle, Merseyside, L30 4GB. - read more
Jan 25, 2012 · ... branch with the sort code 09-01-35? ... sort code now belongs to Santander ... during 2010 and the bank is now fully incorporated into Santander. - read more
Please vote if the answer you were given helped you or not, thats the best way to improve our algorithm. You can also submit an answer or search documents about santander bank sort code 09 01 35.


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Ebola Epidemic 'Out of Control'
ABC News' Dr. Richard Besser and CDC Director Dr. Tim Frieden on the deadly Ebola outbreak in Africa and urgent transport of two sick Americans.
Ebola: Heightened Alert Across America
Six people in the United States tested for signs of Ebola, Dr. Brantly showing signs of improvement.
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The 2009 Roble was aged for 7 months in seasoned French and American oak. Purple-colored, it gives up a first-class perfume of mineral, Asian spices, violets, and lightly roasted black fruits. This is followed by a succulent, full-flavored, voluminous wine with excellent balance and a long, fruit-filled finish. It is an outstanding value that over-delivers in a big way as well as a sneak preview of just how good the top wines from Ribera del Duero will be when released 2-3 years from now.
The item you have chosen is not in stock in our retail stores or within our main warehouse.
2012 Bodegas Volver "Tarima Hill" Monastrell Alicante
2014 Quinta da Aveleda Loureiro Alvarinho Vinho Verde Regional Minho
Mas Codina Cava Brut Reserva Penedès
2012 Bodegas Castaño "Solanera Viñas Viejas" Yecla
2009 Bodegas Casa Juan Señor de Lesmos Crianza Rioja


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RJR.John Rocha Designer girl's dark orange sequin cardigan
Item No.2320208750
Item No.2320208750
Up to 70% Off - Save up to £14.00
This girl's designer cardigan from RJR.John Rocha is knitted from soft cotton and has a sequin embellished front with jewel button fastenings.
UK Home Delivery Free (UK orders over £30) or £3.49
Delivered within 5 working days
Next or Named Day Delivery
7 days a week between 8am - 6pm
Sunday to Friday - order by 9pm - £3.99
Saturday - order by 6pm - £3.99
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Monday to Sunday - order by Midnight - £6.99
Collect from store the next day - FREE
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Subject to exceptions, Debenhams is happy to exchange or refund your purchase within 28 days of delivery. Please check here for more details on our returns policy and exceptions.


text:
Publisher's Description+
EarthDesk replaces your desktop picture with a high-resolution image of Earth, complete with accurate current lighting conditions (sun, moon, city lights, and real-time clouds). This image will change throughout the day to reflect the movement of the sun, moon, and clouds in real time. Tons of features like city lights at night, zoom capabilities, and political and satellite maps make this a top-notch earth viewer.
What's new in this version:
- Fixes a bug that would prevent EarthDesk from starting up if the "Restore Background" option in the Display Tab was not checked.
- Options in the Shading menu are now renamed so that the same text is displayed in both the Display Tab menu and the menu bar menu.
- Minor performance and stability enhancements.


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I have a huge fear of the dentist. In fact, I tend to avoid the dentist as much as possible, especially when I know I need to have work done. I knew that I needed a few fillings from my prior dentist in texas. I saw 5 star dental on Yelp and gave them a try.
My initial visit was great. Everyone was very nice, and the office is very clean. I didn't have to wait long. I also appreciate that they listened to my conce... view more
Five Star Dental
7800 W Sand Lake Rd,
Orlando, FL 32819
(407) 226-3350
Business Details
in Business
YP Qualified
- Hours:
Regular HoursSat - SunClosed
- General Info:
- There is nothing more beautiful than a healthy smile and here at Five Star Dental we make it our goal to give you that stunningly bright smile. That's why our team will do everything we can to ensure your teeth are their healthiest and that they stay that way.
- Extra Phones:
Fax: (407) 226-3352
- Services/Products:
Take it easy! We offer services to simplify your next visit to our practice, making it even more enjoyable.
Our services for you
- Routine cleaning and check-ups
- X-rays
- Preventive treatment
- Fillings
- Bondings
- Crowns and bridges
- Periodontal treatment
- Teeth whitening
- Root Canals
- Oral hygiene education
- Sealants
- All other aspects of dentistry
Do you have questions about our services?
Simply contact us by phone at 407-226-3350.
- Payment method:
- cash, financing available, all major credit cards, check, insurance
- Location:
- We are conveniently located at the intersection of Sand Lake Rd. and Dr. Phillips Blvd, just a short trip from exit 74A on I-4, behind the Panera Bread. Our office is located on the second floor above the Corona Cigar Company.
- Neighborhood:
- Doctor Phillips
- Amenities:
Dr. Bernard Nash DMD, MS, PA
A 1986 licensed graduate of the University of Florida, College of Dentrisry, Bernard Nash has been practicing Dentistry for the past 24 years. He specializes in General Dentistry and was a past instructor at the University of Florida, College of Dentistry.
- Other Link:
- Category:
- Dentists
I have a huge fear of the dentist. In fact, I tend to avoid the dentist as much as possible, especially when I know I need to have work done. I knew that I needed a few fillings from my prior dentist in texas. I saw 5 star dental on Yelp and gave them a try.
so I skipped my biannual cleaning eight times. Teeth cleaning hurts me and I am not a frequent flosser. I didn't get my cleaning done...more tartar build-up....cavities....more fear....no cleaning....no treatment....This situation continued several years and I ended up with a lot of problems in my mouth. Every day, I thought to myself, "I need to go see a dentist, I need to go...".
I wanted to go to the kindes... view more
In all honesty, if you are looking for the best dentist in the Orlando then you should definitely visit Dr. Nash.
There are many reasons why I felt the need to write a 5 star, personal review for Dr. Nash & his team in Orlando. Before even visiting the office, I took a few minutes to browse the site and was absolutely blown away by the organization and amount of resources offered online. If you have any questions... view more
Best office EVER!!!! I NEVER have to wait, they are ALWAYS on time!!! From the moment I walk in the door they take the time to know my name and offer me a friendly smile which puts me at easy (this is HUGE for a dental office, cause I'm a chicken). The girls in the back took the time to explain all proceduces and allow me to "bother" them with as many questions a I have (and I have alot). Dr. Nash is an... view moreLike this review?Yes|Flag Abuse
Super Caring Dentist !!! Very cordial and caring staff. This Dentist and staff make you feel welcome and a part of the family. Totally painless and professional, with an exceptionally modern facility.Like this review?Yes|Flag Abuse
My wife and I have used this dentist for the past 2 years, and are happy with our treatment. The staff seems professional and the equipment is well-maintained. The dentists are cheerful, and do their best to communicate exactly what you need as far as fillings, gum work, etc., and the reasons for each type of work.Like this review?Yes|Flag Abuse


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Despite being in the ice cream business, John Clopton will be busy this winter.
The owner of Frostbite Gourmet Ice Cream is planning to launch a tricycle-based ice cream delivery service this spring.
"I'm purchasing my first trike this month with the intent of delivering in Lafayette Square and possibly Downtown, to start off," he says.
Until Clopton can get approval from the city of St. Louis for anything more, he'll only be offering residential delivery.
"Unfortunately the city only gives vending allowances for motorized vehicles in vending districts," he says. "The trike doesn't qualify as a food truck, street vendor or sidewalk vendor, so until the ordinance is revised, I won't be able to sell like a food truck."
The exact launch date is weather dependent, and delivery service hours are yet to be determined.
Clopton is having a customized tricycle built specifically for ice cream delivery and anticipates receiving it in early January. Clopton will be the only one manning the pedals at first, but plans to expand his delivery territory, add more trikes, and hire other "drivers" as business picks up.
In support of the new effort, the http://getfrostbite.com/" target="_blank">Frostbite website is being updated to showcase the delivery service and facilitate ordering.
Customers will be able to choose from his line of 12 signature flavors, which includes not only the usual suspects, but more adventurous flavors like Six Row Strong Porter (made with beer from the local brewery), champagne, and mango (in season).
He'll also offer a rotating line of experimental flavors such as spicy hot chocolate, cucumber mint and candied bacon. All Frostbite flavors are made with as many local ingredients as possible, including honey from Missouri and Illinois farms.
In addition to launching the delivery service, Clopton has started working with a commercial kitchen to ramp up production and is negotiating retail deals with several local stores.
Watch our http://www.feaststl.com/online-exclusives/the-feed/" target= "_blank">news feed and Frostbite's site for further developments.


text:
special section
What To Do When The Anger Gets HotWhat makes me angry? That's an interesting question. I don't get angry. If you ask the monks and teachers who were with me in Tibet or India, I'm sort of known for not getting angry. I do get irritated sometimes. Especially being diabetic. If I explain something and people don't understand and then I try my best to talk to them and they still don't get it, then I get a nervousness within me, and I'm thinking, "What is the use of talking? I better shut up." Or physically, I start sweating. Is it a diabetic effect—when the sugar is low—or is this really irritation? More »
Summer 1985The new neighbors were hidden from view by the spruce that covered the rise separating our properties. From behind the trees came the buzzing of saws, and the banging of nails. Through my kitchen window I watched their truck struggling up the steep incline toward the building site, weighted with lumber and gyp rock. Sometimes I watched them walking on the road. A man, a woman, a kid, a dog. More »
7 comments
Shantideva PatienceWhatever wholesome deeds,Such as venerating the Buddhas, and generosity,That have been amassed over a thousand aeonsWill all be destroyed in one moment of anger.There is no evil like hatred,And no fortitude like patience.Thus I should strive in various waysTo meditate on patience.My mind will not experience peaceIf it fosters painful thoughts of hatred.I shall find no joy or happiness,Unable to sleep, I shall feel unsettled.A master who has hatredIs in danger of being killedEven by those who for their wealth and happinessDepend upon his kindness.Hence the enemy, anger,Creates sufferings such as these,But whoever assiduously overcomes itFinds happiness now and hereafter.Therefore I should totally eradicateThe fuel of this enemy;For this enemy has no other functionThan that of causing me harm.Whatever befalls meI shall not disturb my mental joy; More »
Color-Blind FuryI need to find a way to deal with my anger at racism before it overwhelms me. Although I behave in a civilized manner—I don't scream at or beat or kill anyone—anger festers within me, keeping me from being aware of my own power and potential. Buddhism provides concrete methods to deal with anger; however, it is difficult to practice the precepts while under constant attack. I think of the Zen Buddhist story about the traveling monks who were suddenly confronted by assailants. One monk chose to sit and meditate while the others ran off. His screams as he was murdered were heard a great distance away. This is my dilemma, too. The monks' situation is relevant to me: In moments of personal instability and crisis, how is Buddhism practiced? More »
4 comments
The Deluding ForceI sometimes get angry when I feel I've been treated unjustly or when I feel others have been treated that way. I will get angry if I have worked very hard to complete a project, and someone blames me if it doesn't work or assumes I didn't try hard. I try to wait for the feeling to wash through me. As empowering as it can be to feel anger sometimes, I find that I invariably regret acting from that feeling. Anger is an incredibly deluding force. It tends to give one tunnel vision and a very limited sense of options. More »
4 comments
Angry Faces"Man, Jarvis. Are you watching the news?" my new neighbor asked from the next cell one evening. I was relaxing, reading a book about meditation. "I have it on, Omar, but I'm not really watching it," I answered, glancing up at my television. "Why, what's up?" "Ah, man! Check out Channel Seven. They showing a Ku Klux Klan rally in Louisiana. Man, just look at all those Klansmen screaming and shouting all that white supremacy garbage. Get this: all these idiots is talking about how all the Jews and Blacks are destroying this country. Did you hear what they were saying?" "Nah, man. I missed it. I have the volume turned down. I'm just using the light to read by. I did see a bunch of angry faces and racist posters, though." More »


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India's Parliament to Consider Banning Adoption by Same-Sex Couples
August 12, 2014 by HRC staff
After India's federal cabinet voted to prohibit same-sex couples from adopting, Parliament will determine whether or not to ratify this discriminatory law.
The cabinet made its decision Wednesday during its discussion to amend the Juvenile Justice (Care and Protection of Children) Act. The Indian government has already restricted same-sex couples from adopting by requiring letters of recommendation and imposing an age requirement.
The proposed law comes a year after India's Super Court recriminalized same-sex activity, despite decriminalizing it in 2009.
It is unclear if this law will apply to LGBT parents who are single. Many LGBT Indians adopt as single parents because the country does not recognize same-sex relationships, according to Gay Asia News.
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G.G.T. Tibet Inn
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TripAdvisor Reviews G.G.T. Tibet Inn Burlington
Travel Blogs from Burlington
Travel to VT via NH with a stop
... Sun Road but I'm not sure I agree. It was much colder at the top than the bottom of the mountain. It was nice at the summit but we didn't stay too long. We left the gift shop and ended up eating at the Scarecrow Pub and Restaurant. There was no one in the dining room when we got there and several tables came in after us but somehow it took us over an ...
Healing Winds & Finding Joy
... my "getaway from cancer" and it was such good sister fun & bonding time. What a wonderful break and distraction from the post treatment issues and concerns.
Which brings me to an update on my cancer recovery. I am very grateful that I get to be "finished with my treatment." I don't have any discernible signs of cancer now, and I hope we never see it again. Physically, I have been through an awful lot this year and transitioning ...
Burlington Farmer's Market and Shelborne Mus
... Vodka.
There were a couple of goat cheese vendors including one run by friends of
Christine and Derek.
From there we walked down to the waterfront, then back up to
Church Street before returning to the car in the parking garage to go find
lunch. Heading south we opted to stop at
Folino's Pizza for lunch. We ordered our
pizzas while Derek waited in line at the ...
Vermont touring
After an amazing breakfast (all the TripAdvisor reviews rave about the breakfast) we set off for a walk around the town, checked out some galleries, bought a few souvenirs, drove across the bridge into New Hampshire just so we could tick off another state visited (and back into Vermont) and headed north. Just a leisurely drive with time to stop and admire the ...
Johnny New Jersey
... cleaned the cab, unpacked and organized. Jp showed me our route.....Utah, Oregon, Washington, South Dakota, Colorado.... Whenever jp travels he ends up with sunglasses that I call his "Johnny New Jersey" glasses. I particularly love it when he wears them with his cowboy ...


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ECK Worship Services
Eckankar teaches that there is an audible life current known as the ECK, or Holy Spirit, that connects each of us with the heart of God. We start the service with the HU Song, then an ECK Cleric and ECK Speakers share insights into how this life current, the Holy Spirit, helps us live, thrive and love the spiritual life. Group discussion and fellowship follows.
Come and share your experiences with others who view life as a spiritual school. The ECK Worship Service is a place where anyone can come and learn about how their spiritual experiences can help them in their lives. Dress is casual. Discussion is informal. Join us for a spiritual exercise.
All are invited.
Get your free copy of the latest edition of the Spiritual Wisdom Journal at: http://www.spiritualwisdomjournal.org/
We just grab a coffee and speak French. Some people have been coming every week for months... it creates a kind of warmth to the group.
— Rafaël, started French Conversation Group
Meetup members, Log in
By clicking "Sign up" or "Sign up using Facebook", you confirm that you accept our Terms of Service & Privacy Policy


text:
People tend to check in during these times:
Add hours
Bring an iPod. Music is horrible.
Busiest hours 3-9pm. Busiest day: Monday
Hours of Operation: MON-FRI (5am-11pm); SAT (7am-7pm); SUN (7am-5pm).
Be careful during the day when they decide to wash the floors here with what feels like its 100% soap.. Turns the weight room into a skating rink..
Small scale workout center, but has enough and complete equipment for everybody.
If you don't know how to use something properly ask for help.. And your not impressing anyone with 350 on the bench when ur doing 1/4 reps.. Do it right or don't do it at all..
Like how cheap it is here...dislike how unprofessional the employees are.
Hello everyone, after your workout clean off all weights, machines, mats, etc.
No one runs the treadmills the last hour of closing time .
Don't be a creeper!
June is three years Fitness II has been open. I'm an initial member too. $10 month is great for your pocket & your body! Long live exercise.
When you're done with a machine, WIPE IT DOWN. Stop being gross leaving puddles everywhere.
Vacation week, go everyday!
Quit this place to go to 24hr fitness in rt 4 #winning
Cold outside, warm up with a greatcworkout.
Pumping iron rocking to jimi h.
Get in and workout.
I'm looking for the mayor
Downstairs machines mostly used by men, usually easier to access equipment. Great workouts. Where is the mayor?
Keep your mouth shut and get it done.
A guess a tip would be not to eat Wendy's after your workout.. Then that makes you an idiot.
I'm the mayor of this bitch. Place the crown on my head heh
It is mandatory for all of you to rerack and clean your equipment!!!!!
No one re-racks here!!!!!!!!!
Get in and bust a sweat..
Pineapple smoothie w/ scoop of vanilla whey protein. Awesome
Me and Fitness ll have a love-hate relationship.


text:
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OpenSource World Conference & Expo Announced
IDG World Expo announced the launch of OpenSource World Conference & Expo, an event that will include features of LinuxWorld with an emphasis on open source technology.
Scheduled for August 10-13, 2009, at San Francisco's Moscone Center, OpenSource World will include a full conference program and an exhibit floor featuring Linux and open source companies. The event will be co-located with IDG's Next Generation Data Center (NGDC) event, which will offer separate conference tracks but share the expo floor. Whereas LinuxWorld included a three-day expo hall, the new OpenSource World expo will be reduced to two days.
Prior to the new event announcement, LinuxWorld organizers announced a move to Moscone West, a smaller conference hall.
O'Reilly's OSCON event has moved to take place in San Jose three weeks prior to OpenSource World, making the two events head-to-head competitors.
Issue 180/2015
Buy this issue as a PDF
Bugzilla Bug
Bug database has a bug of its own that could allow an intruder to create an unauthorized account.
US Launches New Strategy for Broadband Access
Report focuses federal resources on achieving universal Internet access.
RC4 Finally Gets the Fork
Leading browser makers say "no" to porous encryption algorithm
IBM Says TOR Network a Vehicle for Ransomware
Report from the X-Force group says attackers are using TOR to hide their crimes
Mozilla Announces new Firefox API
Future Firefox extensions will be compatible with Chrome.
Weird Security Flaw Affected Intel Chips for 16 Years
Better read this if you bought your computer before 2011
OpenSSH 7.0 Secure Shell Arrives
Users should upgrade to the new version as soon as possible
Qemu Flaw Lets the Guest Escape
Xen project announces a privilege escalation problem for Qemu host systems
Android Bug Threatens Millions of Users
Attackers can compromise an Android phone just by sending a text message
Lenovo and Canonical Announce Laptop Deal
PC vendor will pre-install Ubuntu on portables in India.


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Pioneer Connect
- September 2, 2012
( 2,648)
When Auto Connect is set to 'ON,' your compatible Android device can be directly connected to any Pioneer in-dash car audio product equipped with a USB port. When connected to a Pioneer in-dash receiver, you can find, browse, select, and listen to music stored on your Android device directly from the Pioneer receiver. NOTE: App compatibility varies by Android device. For more information, please visit http://www.pioneerelectronics.com
DEH-X65BT w/Sam. Galaxy S3 Absolutely USELESS! No updates in a ridiculously long time... Pioneer has failed to both keep up with new device(s), and firmware updates. Some users have been lucky enough to have the app work for them, but most have been using either older Pioneer head units, older phone models, or a combination of both. Luckily it still does charge the S3 via USB (w/o the app) and I can stream the media via bluetooth. Also, software conflicts when app is installed.
A long way to go The only time this works is after a phone restart and hitting the pandora app on the head unit. Avh x3500. Widget fails to load. Auto connect on the app doesn't stay. So you have to re-enable auto connect every time the app is opened. A fairly useless app. Disappointed in Pioneer's commitment to Android devices. Samsung Galaxy S3.
Crap ware from Pioneer? YES Installed, opened, forced closed. Undaunted I pressed on and finally figured out how it works. I have to be in the USB utility screen first, tap connect to PC, plug in cable, tap home, tap pioneer connect app, tap on, then the blue connect signs comes on. Thats TOO MANY TAPS for an app that supposed to help me and it still forced closed randomly. Pioneer, do you know what QC means? DEH-X8500BH and S Galaxy 2S.
Terrible Have to turn auto on every time I open app. Doesn't even pair my phone via bluetooth or Pandora. Useless. Good job pioneer.
Very frustrating, Pioneer is not ready to support Android phones. Bought a Pioneer in dash receiver (DEH-X5600HD), says it works with Android phones to play Pandora via USB connection. It does not work. Tried this app since the description says: "your compatible Android device can be directly connected to any Pioneer in-dash car audio product equipped with a USB port". Called Pioneer, they say you do NOT need this app to make the phone work. I can tell you it did not make my phone work. Still does not work. Pioneer is not ready to run Android phones. The radio connects fine with my old iPhone. Pioneer Customer Service: useless. He told me to try buying a bluetooth connected radio, it will probably work.
Black As much as I love looking at a black screen, I don't need this app to provide one for me. Whenever something did pop up, it always said "not connected", when I definitely was.
USB audio recording and playback finally possible on Android 3.1 or higher!
More from developer
Pioneer ARC (Advanced Remote Control) allows you to access various music sources


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Slideshow: Where to Eat Lunch in Chelsea Market
Pasta at Giovanni Rana
Giovanni Rana Pastificio & Cucina: 212-370-0975; rananyc.com
Meaty Sandwiches at Dickson's Farmstand Meats
Dickson's Farmstand Meats: 212-242-2630; dicksonsfarmstand.com
Crepes at Bar Suzette
Bar Suzette: 917-727-2169; barsuzette.com
Nicer Sit-Down at The Green Table
The Green Table: 212-741-6623; cleaverco.com
Sandwiches at Bowery Kitchen Supplies
Bowery Kitchen Supplies: 212-376-4982; bowerykitchens.com
Meat Pies at Tuck Shop
Tuck Shop: 212-255-2021; tuckshopnyc.com
Sandwiches and Salads at Ronnybrook Dairy
Ronnybrook Dairy: 212-741-6455; ronnybrook.com
Noodles and Curry at Chelsea Thai
Chelsea Thai: 212-924-2999; chelseathai.com
Smoothies and Salads at One Lucky Duck
One Lucky Duck: 212-255-4300; oneluckyduck.com
Sandwiches and Bread at Amy's Bread
If you're up for constructing your own lunch, you can do no better at Chelsea Market than the bread at Amy's. The Semolina with Golden Raisins and Fennel has been a name-maker for Amy's and is wonderful with cheese. For dessert, their carrot cake is our favorite in town.
Amy's Bread: 212-462-4338; amysbread.com
DIY Italian at Buon Italia
Buon Italia: 212-633-9090; buonitalia.com
Fruit and Veggies at Manhattan Fruit Exchange
Manhattan Fruit Exchange: 212-989-2444; www.manhattanfruitex.com


text:
Beautiful and heart touching writing. THANKS
Posted by Zubair Khan
Credit: The Express Tribune via Wasim Sroya:
They scraped his person from his gravestone, because those in the underworld would also object to his being Muslim. ILLUSTRATION: ERUM SHAIKH
They ripped his name out of books
with scissors dipped in venom
so our children wouldn't be poisoned
with a heretic's intellect.
They scraped his person from his
gravestone, because those in the
underworld would also object to his
being Muslim.
They bomb his places of worship,
they don't like them being called
mosques, as if their own belligerence
was a superior form of prayer;
Our flag's white rectangle,
the so-called symbol of the few,
flaps tattered and stained with
the blood of peripheral pariahs
like him.
They banished a man from the annals
of history for a sin so heinous
to be exiled by its own seven sisters.
It's called genius.
While their bodies simmered with
the disgust of imposters and false
prophets, while they vigilantly clicked
the prayer beads like ticking
suicide bombs,
He presented them the Nobel like a
white flag, a fresh white rectangle.
While they thought they brought God
to the world with their self-righteous
calligraphy of hate,
He unveiled the God-particle.
And guess what, he wasn't even 'Muslim'.
The above picture is of ATLAS , one of the four detectors at the Large Hadron Collider.
Beautiful and heart touching writing. THANKS
Dear Zubair Khan Sahib-MASHA ALLAH-A sad but exhilirating veracity,indeed-Jazakula Khairun
"Allah keray zoor e Qalam aur zia ada ho!"
May allah bless you during RAMADHAN particularly & generally for the rest of your beneficial life,amin.
Your EULOGY of DR. Prof. Abdus Salam has touched my heart deeply,indeed!An AHMADIYYA MUSLIM ABDUS SALAM IS THE "MOON" OF ISLAMIC SCIENTISTS SHINNING HIGH ABOVE IN THIS MODERN DIGITAL AGE OF THE PROMISED MESSIAH HADHRAT MIRZA GHULAM AHMAD _UNDER THE PROTECTION OF KHILAFAT E AHMADIYYA LOVINGLY REMEMBERED, PRAISED & HONOURED AROUND THE GLOBE BUT PAKISTANI " MULLAS & THOSE WHO BLINDLY FOLLOW"
The beacon of light SALAM would keep on ENLIGHTENING the WORLD-MAY ALLAH BLESS HIM IN PARADISE WITH A HIGHER STATUS,amin.
Allah will punish all those who tries to harm His people and misuse His religion of Islam and do not respect His sayings and doings. They will definetly go Hell , Insh-Allah.
Thanks, may Allah bless you for writing such a good article, and this is true that if you deny Gods blessings then you will be punished and this is why Muslim ummah is in problems but yet they dont understand. they see killing of hundreds of Muslims but cant do anything because they have refused to the blessings of Allah.
May GOD bless us all.
Love for all and hatred for none.


text:
Stay up to date with new and upcoming programming and events from UWTV.
UWTV @UWTV More ways to watch @UWTV alert! Get our new @RokuPlayer channel: https://t.co/FZFXeRkxAZ http://t.co/BOmrHS1zHW
SeaArtsLectures @SeaArtsLectures RT @SeaArtsLectures: So excited to be with @GilbertLiz at @WellReadTV - can't wait for her talk at @benaroyahall tonight! http://t.co/z4bC…
UWTV @UWTV @UWTV has a new @RokuPlayer channel! Add our channel to your player here: https://t.co/FZFXeRkxAZ http://t.co/gcsWUvNnWP


text:
I like to think of myself as a online fiction reading guru. Over the years, I've learned to sift through the great stories and the not so great stories. I enjoy reviewing, and being reviewed.
I have many aliases, though my main ones are Ren, E.T., and H.J. Soul. You can find me on almost all the big online fiction sights, but other then Wattpad the only ones that I visit regularly are:
Lunaecence, on which I am ElvenTrinity.
Quizilla, on which I am Sillyartist2000.
I'm in the proccess of writing two stories, both of them revolving around mermaids. I've published Something Blue, which is a companion to Waterweaver which I have yet to post.
Joined:5 years ago
Reading Lists
ATaleForASoul's Reading List20 stories
Good Read5 stories
3 Published Works
Featured work.
Something Blue
Social data: 212 reads. 5 votes. 4 comments.
Description: Far beneath the sea, a young Bettadin Merr struggles to submit to the customs of her people, but cheifly her father- who is uncomprimising in his views. Far above the water on the surface, a troubled young man seeks to win the hand of his would...
Other Works by ATaleForASoul.
Her Dance.Completed
Her Dance.
98 1 3
A tragic love story. . . (Wow. It wasnt as dark the first time I wrote it, but Alana deserved more than...
Here kitty, kitty. Yum fishy, fishy. The memoirs of a Goldfish.Completed
Here kitty, kitty. Yum fishy, fishy. The memoirs of a Goldfish.
205 4 6
A short, one page tale of a goldfish that's hopelessly in love. Happy early Valentine's day!
This user has no recent activity.


text:
Quantum Publishing Releases FACE-TO-FACE Self-Help Book
According to a recent New York Times op ed piece, a young boy who spends a considerable amount of time texting lamented, "Someday, someday, but certainly not now, I'd like to learn how to have a conversation." Studies over the last decade have shown that electronic communication, including emails, text messaging, and even cell phones strain business and personal relationships because of the lack of nonverbal clues, the encouragement of egocentric perspective, and a tendency toward isolation.
Yalda T. Uhls and Patricia M. Greenfield of the Children's Digital Media Center Los Angeles in a recent white paper wrote, "Human beings evolved for face-to-face communication. The presence of another person in the flesh triggers important human emotions such as empathy. We may be reducing such emotions in developing human beings by reducing face-to-face communication and augmenting electronic communication".
Prominent lawyers and educators Robert A. Esperti and Renno L. Peterson in their just released book Face-To-Face (Quantum Press, ISBN 978-0-9850456-3-0) agree that electronic communication has adversely affected the art of conversation, but go on to show that without understanding what a conversation means, even those who believe they converse well tend to fall into habits that hinder their relationships. They take a humorous look at common conversational habits, and then offer building blocks and insights that will help everyone, no matter what their age or status in life, build better relationships through better conversational skills.
Lloyd Schermer, past Chairman of the American Newspaper Publishers Association, former Chairman and EEO of Lee Enterprises, the nations' fourth largest newspaper agrees, and states, "If you listen to the wisdom of [Face-To-Face], you and your relationships will be far the better for it."
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A reliable and accurate estimation of liver size by physical examination is an important aspect of the clinical assessment of a patient. The scratch test uses auscultation to detect the lower liver edge by using the difference in sound transmission through the abdominal cavity over solid and hollow organs. The test is thought to be particularly useful if the abdomen is tense, distended, obese, or very tender. Although the sign is often taught to medical students and residents, the value of the technique for detecting the liver edge has become controversial.
The study was performed in two parts. In the first part, 18 patients undergoing upper abdominal ultrasound as outpatients were randomly selected and the scratch test was performed by two raters independently, followed by ultrasound (USG) as the reference standard. In the second part of the study, the two raters independently performed the scratch test on separate randomly selected patients (15 patients by rater 1, and 16 patients by rater 2), followed by USG.
Agreement between raters on the scratch test was very high, with an intra-class correlation coefficient of 0.97. The agreement between the raters and the USG was 0.37 using Spearman's rho. A Bland –Altman plot indicated that, on average, raters underestimated the distance from the right costal margin to the liver edge by only about 2.4 centimeters compared to USG. This translates into 37% and 54% of raters' estimates falling within 2 and 3 cm of USG estimates. Each unit increase in BMI increased the discrepancy between raters and USG by 0.26 cm (p = 0.012).
The scratch test has very high reproducibility and overall agreement between the scratch test and USG was moderate, with a spearman's rho of 0.37. The accuracy may potentially be improved by using the point of initial sound transmission rather than the point of maximal transmission. We conclude that the scratch test deserves further investigation.
Keywords:Scratch test; Hepatomegaly; Auscultation; Liver edge; Liver span
A reliable and accurate estimation of liver size by physical examination is an important aspect of the clinical assessment of a patient. The utility of various examination techniques used to determine liver size has been shown to be somewhat inconsistent, and to lack inter-observer correlation when compared with imaging methods [1-6].
The scratch test is a type of auscultatory percussion usually ascribed to Burton-Opitz in 1925 to identify the cardiac silhouette [7], although references to similar techniques date back to 1840 and have been described for various organs, including the inferior hepatic margin [8]. As applied to the liver, the scratch test uses auscultation to detect the difference in sound transmission through the abdominal cavity over solid and hollow organs. The test usually consists of placing the stethoscope below the xiphoid and lightly but briskly stroking the skin in a direction parallel to the expected liver edge, starting at the right lower quadrant and working slowly up to the right costal margin along the mid clavicular line. When the liver edge is reached, the sound of the scratch is transmitted to the stethoscope [9]. Over the years however, many variations in technique have been described [10] including:
• placement of the stethoscope near the umbilicus, the costal margin, or over the liver
• percussing with finger and pleximeter, finger alone, bristle brush, or corrugated rod
• Stroking in a circular, centripetal, centrifugal, lateral or longitudinal direction
This technique is said to be particularly useful if the abdomen is distended, obese, too tender for palpation, or if abdominal muscles are tense [9,11].
To date, only a few studies have been done to validate the reliability and accuracy of scratch test [2,12,13]. These studies have been hampered by low numbers of patients [12,13] and limited statistical analyses. Overall however, the consensus is that the test has performed poorly and recent recommendations are that the scratch test be abandoned [10,14].
We believe that this dismissal of the scratch test is premature and based on insufficient evidence. We therefore aimed to add to the evidence base by evaluating the reliability and accuracy of the scratch test to determine the lower border of liver, with comparison to ultrasound (USG) as the reference standard.
The study was performed in two parts. In the first part, 18 patients undergoing upper abdominal ultrasound as outpatients for various indications were randomly selected; the scratch test was performed by two raters independently and followed by the ultrasound.
In the second part of the study, the two raters independently performed the scratch test on separate randomly selected outpatients (15 patients by rater 1, and 16 patients by rater 2), followed by upper abdominal ultrasound.
Scratch test procedure
The scratch test was performed by marking a point on the right costal margin at the midclavicular line (point A in Figure 1). This point was used as a reference to take the measurements of liver span below the costal margin. The diaphragm of the stethoscope was placed on the xiphisternum (point C in Figure 1). Light transverse strokes of the skin with a single finger, parallel to the suspected liver edge, were made advancing from the right lower quadrant along the midclavicular line to the costal margin. When the hepatic edge was reached (point B1 in Figure 1), the scratching sound was transmitted through the solid liver with the resultant sudden increase in auscultated sound intensity; the sound intensity continued to increase until it was maximal (point B2) and this point was taken as the best estimate of the liver edge. The distance between this point and point A (distance AB2) was recorded on a data sheet. The sonographers used the same reference point to measure distance to the liver edge (Point A) but were blinded to the value obtained by the clinical raters. The results were recorded in centimeters between the right costal margin (RCM) and the liver edge.
Figure 1. Illustration of the landmarks on the abdomen in relation to the measurements used for scratch test.
The two raters (AD, KG) were senior medical registrars in the department of general medicine. Before the study, 2 calibration sessions with a consultant (JA) were performed to standardise the method, i.e. where to place the stethoscope, where to scratch, whether to listen for the point of the start of sound transmission or the point of maximal sound transmission, etc. The two raters also used the same brand of stethoscope. To ensure that the sound transmission was not purely through the skin, we measured a control point below the xiphisternum using the same stroking technique (point D in Figure 1). This point was the point of maximal sound intensity when stroked with the finger ascending upwards towards the stethoscope from below the umbilicus. The distance CD was measured in centimeters and compared with the distance B2C. If B2C was more than CD, then it was assumed that the transmission of sound heard at point B2 was through liver. AB2 was then measured as liver span below the RCM. However, if B2C was less than or equal to CD, then we assumed that the sound conduction was likely due to skin conduction and that the liver edge did not extend beyond the RCM. No clinical information about the subjects and no other methods of physical examination were performed in the study in order not to bias the interpretation of the scratch test; in particular, palpation of the liver edge was not performed.
Informed, written consent was obtained from all patients and the study was approved by the Hunter New England Area Ethics committee.
Ultrasound procedure
The ultrasound was performed with a Phillips iU22 Ultrasound Machine (Koninklijke Philips Electronics N.V., Netherlands) using a 5-2 MHz curved array transducer with the default abdominal preset. Time Gain Compensation (TGC) curves were adjusted to optimize the image quality if required. A single focal zone was set to the mid liver parenchyma. Harmonics were off. Patients were asked to hold their breath during the ultrasound exam but not during the scratch test in order to mimic usual clinical practice.
Statistical analysis
The co-primary outcomes were agreement between the 2 observers as measured using the intra-class correlation coefficient (ICC) and agreement between each observer and the USG reference standard as measured using Spearman's correlation coefficient (rho), which is the non-parametric equivalent of Pearson's coefficient.
Secondary outcomes included the degree and source of disagreement including:
•Bland-Altman plots comparing the difference between each rater and the USG (on the y-axis) compared to the USG (on the x-axis).
•the proportion of rater values that lie within 1, 2 or 3 cm of the reference value.
•whether the absolute value of the distance or the subject's body mass index (BMI) influenced the degree of error between the clinical observer and the USG using linear regression.
Threshold p-value for significance was taken as <0.05.
A total of 49 patients were included in this study. Eighteen patients were assessed in duplicate but independently by two raters. In the second part of the study 15 patients were separately examined by the Rater 1 and 16 patients were examined by Rater 2. Characteristics of all 3 groups are given in Table 1.
Table 1. Characteristics of the 3 patient groups
Figure 2 shows the agreement between the 2 raters for the 18 subjects examined in duplicate. The ICC was very high at 0.97.
Figure 2. Agreement between the 2 raters on location of liver edge, measured in cm from the right costal margin.
Agreement between the 2 raters and the reference USG is summarized by the Spearman's rho of 0.37 (p-value = 0.0024) which indicates moderate agreement. The agreement between each rater and the USG is captured in a different way using the Bland Altman plot, which graphs the difference between the raters (pooled if in duplicate) and the reference standard USG (on the y-axis) vs the value of the reference standard USG (on the x-axis) (see Figure 3). This figure indicates that, on average, the raters underestimate the distance from the RCM to the liver edge by about 2.4 centimeters compared to USG.
Figure 3. Bland-Altman plot showing difference between raters' values and ultrasound value.
However this difference depends to a large extent on where the liver edge lies; the closer it is to the RCM, the more the observers overestimate the distance and the farther it is from the RCM, the more the observers underestimate the distance. This average "offset" of about 2.4 cm is about the difference between the point of onset of transmission and the point of maximal transmission that was noted anecdotally during the study, i.e. difference between B1 and B2 in Figure 1.
We also calculate the proportion of ratings that are within 1, 2 or 3 cm of the reference value (Table 2, column 1). We note that 37% of ratings fall within 2 cm of the reference value and 53% fall within 3 cm. These proportions are low due partly to the average "offset" noted earlier. We extrapolate that if we used the point where transmission of the scratch started being heard (B1 in Figure 1) rather than the point of maximal transmission (B2 in Figure 1), the "offset" would be removed and these proportions would increase (see Table 2, column 2) to 43% of ratings being within 2 cm of the reference and 76% being within 3 cm.
Table 2. Number and percentage of ratings in each difference range compared to ultrasound (US)
A linear regression indicates that BMI does significantly affect the difference between raters and the USG, with each unit increase in BMI increasing the discrepancy by 0.25cm (p=0.002). Although the most accurate ratings were at BMI of 30–35, once the "offset" of 2.4 cm is taken into account, the least difference between raters and USG is seen at a BMI of ~27. BMIs that were higher or lower than this led to overestimates and underestimates respectively of the liver span relative to the RCM (Figure 4).
Figure 4. Difference between raters and USG as a function of BMI of the subject.
Agreement between raters on the scratch test was very high, with an ICC of 0.97. This is much higher than previous papers; for example Joshi et al. [6] found a kappa of 0.17-0.33, and Tucker et al. [12] found a reliability coefficient of 0.68. This is likely due to the standardization sessions performed between the raters before the data collection. These however were brief (2 × 1 hour) and represent a relatively short "learning curve" compared to other physical exam maneuvers. Previous papers did not describe any standardization attempts or describe the experience of the raters with the scratch test. We speculate that this lack of standardization partly contributed to the previous estimates of poor performance for the scratch test.
We compared the scratch test vs USG for determining location of the liver edge rather than total liver span, because USG is not reliable for detecting the superior liver margin, given that this would have to be ascertained by probing intercostally and that bone interferes with ultrasound conductance. Previous studies have correlated the scratch test with overall liver span [2,12,13] and we believe that uncertainty about the location of the upper liver edge [2], as well as the lack of correlation between overall liver span and distance below the RCM [12] both contributed to poor performance of the scratch test. Furthermore, not all previous studies have made clear whether the landmark of the right costal margin at the mid-clavicular line was marked in common. Naylor et al. [15] have shown that the variation in marking this point can be up to 10 cm, and this added source of measurement error likely also contributed to the poor performance of the scratch test in previous evaluations.
The overall agreement between the scratch test and USG was moderate, with a spearman's rho of 0.37. While this may fall well short of a perfect test (with rho of 1), the question for physical exam maneuvers is not whether they are perfect but whether they are useful enough to provide information. This correlation translates into 37% of ratings falling within 2 cm of the reference value and 53% falling within 3 cm. This is consistent with the results found by Tucker et al. [12] of 45% and 55% respectively, but falls short of the 78% accuracy within 2 cm found by Fuller et al. [13], as well as the values of 54% (within 2 cm) and 74% (within 3 cm) found by Sullivan et al. [2]. We emphasise however that both of these last 2 studies evaluated the scratch test within the context of other maneuvers and that the raters were not blinded to their own results on palpation or other percussion. By contrast, we evaluated the scratch test in isolation, with no knowledge of the history, presumed diagnosis or reason for USG, or results of palpation. While this gives a "cleaner" estimate of the performance of the scratch test, it would tend to underestimate the performance of the test.
The Bland-Altman plot, which has not been graphed by any of the previous studies, indicates an average underestimate of about 2.4 centimeters by the scratch test compared to USG. This was anecdotally the distance between the point at which sound transmission began and the point at which it was maximal (points B1 to B2 in Figure 1). We speculate that the accuracy of the scratch test may be increased by using the point at which transmission of sound begins (B1) rather than using maximal transmission (B2); this would essentially negate the "offset" of 2.4 cm and increase accuracy to 43% (within 2 cm) and 76% (within 3 cm), in line with previous studies mentioned above. This would however need to be tested prospectively.
The Bland-Altman plot also shows that raters tend to overestimate small spans and underestimate large spans. This may indicate that as the liver edge nears the RCM or the right iliac fossa, the scratch test becomes harder to perform accurately, and people estimate larger and smaller values compared to USG respectively. This bias was present despite the performance of a negative control, i.e. checking for skin transmission along the line of the umbilicus. We speculate that the bias would have been greater without this negative control given that a handful of measures (n = 5) were given a value of 0 because the measured liver span below the RCM was ascribed to skin transmission. This bias is not in keeping with previous data showing that accuracy was greater in patients with cirrhosis than in controls [1] but we speculate that this may be due to confounding by body mass index.
Indeed, we find that increasing BMI does increase the discrepancy between raters and USG. This is consistent with the study of Wolfgang et al. [16]; a sonographic survey of 2080 patients found that body mass index (BMI) and height were the most important factors affecting liver measurements at midclavicular line.
Although recent textbooks suggest that the scratch test should be abandoned, we believe that the evidence base is still scanty and not sufficiently robust to rule out the usefulness of this maneuver. We find very good reproducibility between raters as well as sufficient validity compared to USG to make it useful in the physical exam armamentarium. The use of Bland-Altman plots, which has not been done in the past, suggests that the overall tendency to underestimate the distance from RCM to liver edge may be compensated by using the point of initial sound transmission rather than the point of maximal sound transmission as the indication for the liver edge. The use of a negative control by checking for skin transmission between umbilicus and xiphoid may also help increase accuracy. We conclude that the scratch test deserves further investigation.
USG: Ultrasound;RCM: Right costal margin;ICC: Intraclass correlation coefficient;BMI: Body mass index
Competing interests
None of the authors have any conflict of interest.
Authors' contributions
KG, AD, and JA conceived the study. KG, AD and CA acquired the data. JA was responsible for the analysis and interpretation of the data. KG and JA drafted the manuscript. All authors critically reviewed the manuscript and approved the final version.
We would like to thank the staff of the ultrasound department at John Hunter Hospital for their support and patience during this study.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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A simple method for co-segregation analysis to evaluate the pathogenicity of unclassified variants; BRCA1 and BRCA2 as an example
- Equal contributors
1 Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
2 Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
3 Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
4 Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
5 Department of Genetics, University Medical Center, Groningen University, Groningen, The Netherlands
6 Department of Human Genetics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
7 Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
8 Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
9 Family Cancer Clinic, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
10 Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
11 Department of Clinical Genetics, University Medical Center, Maastricht, The Netherlands
12 Department of Genetics and Cell Biology, University Medical Center, Maastricht, The Netherlands
BMC Cancer 2009, 9:211 doi:10.1186/1471-2407-9-211Published: 29 June 2009
Assessment of the clinical significance of unclassified variants (UVs) identified in BRCA1 and BRCA2 is very important for genetic counselling. The analysis of co-segregation of the variant with the disease in families is a powerful tool for the classification of these variants. Statistical methods have been described in literature but these methods are not always easy to apply in a diagnostic setting.
We have developed an easy to use method which calculates the likelihood ratio (LR) of an UV being deleterious, with penetrance as a function of age of onset, thereby avoiding the use of liability classes. The application of this algorithm is publicly available http://www.msbi.nl/cosegregation webcite. It can easily be used in a diagnostic setting since it requires only information on gender, genotype, present age and/or age of onset for breast and/or ovarian cancer.
We have used the algorithm to calculate the likelihood ratio in favour of causality for 3 UVs in BRCA1 (p.M18T, p.S1655F and p.R1699Q) and 5 in BRCA2 (p.E462G p.Y2660D, p.R2784Q, p.R3052W and p.R3052Q). Likelihood ratios varied from 0.097 (BRCA2, p.E462G) to 230.69 (BRCA2, p.Y2660D). Typing distantly related individuals with extreme phenotypes (i.e. very early onset cancer or old healthy individuals) are most informative and give the strongest likelihood ratios for or against causality.
Although co-segregation analysis on itself is in most cases insufficient to prove pathogenicity of an UV, this method simplifies the use of co-segregation as one of the key features in a multifactorial approach considerably.


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