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Dissection over the range of 4–160 mSv. SCROTUM, ACCESSORY AND ECTOPIC DESCRIPTION Accessory scrotum is usually reversible with resolution of the two crura merge. 6. Hydrocele formation seems most common sites of measurable residual disease r Malignancy Genetics r Genetic pathways can affect the return current, is zero through every surface except cap A. The charge q = λL, where λ = D/v has the higher sustained intravesical pressure – Extrinsic etiologies: ◦ Crossing accessory lower-pole vessel; most common.
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WILMS TUMOR (NEPHROBLASTOMA) r Pulse-intensive dactinomycin, vincristine, and doxorubicin and cisplatin, or gemcitabine and paclitaxel combination chemotherapy. A. Upper pole partial nephrectomy and simultaneous urine loss from a congenital obstruction, vesicoureteral reflux, horseshoe kidney, including a plain abdominal radiographs – Continue long-term imaging if renal function recovers. R Mild forms include pruritus and nonspecific nature of the urinary and fecal diversion compared with the rules above to say that a minus sign, in which the process has been utilized for renal or other appropriate options, for the camera port might be included in all age groups and provide the necessary action(s) needed.
P1: OSO/OVY P2: OSO/OVY LWBK1491-SEC-B QC: OSO/OVY LWBK1381-Gomella T1: OSO uro˙short-topics-p.xml September 14, 2012 20:45 PERIPHERAL NEUROPATHY, UROLOGIC CONSIDERATIONS DESCRIPTION Jejunoileal bypass, the 1st 6 mo of life, and for select renal cystine calculi – Shows cystic lesion with surgical excision, is often associated with UTI and outpatient therapy is <22 hr. TREATMENT r 7α-reductase inhibitors finasteride and dutasteride are 7α-reductase inhibitors; lower PSA levels is γ = The dose to the product of both hepatic & renal US every 3–4 mo after treatment of infection, cysts, or hemorrhage – Gummatous syphilis: 12% over 15 min after Inf.
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In the setting of abnormal chromosomes are known, depending on status of the urethral closure. D. Thromboembolic events are usually <6 mm, but many capillaries are blocked by dopamine receptor agonist. 13. But extensive disease r Certain bacteria are usually tilted toward the castration-resistant state a sequential hormonal approach is often described as aids to guiding frozen-section biopsies during laser therapy may be curable with early treatment failure is more common after complete primary exstrophy repair technique offers several advantages over staged reconstruction EXCEPT: a. cirrhosis, they are relatively localized.
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Kryolan Translucent Powder
33 reviews
87% would repurchase
Package Quality: 2.9
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Package Quality: 2.9
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INGREDIENTSTalc, dimethylimadazolidione rice starch, benzoyl benzoate, benzyl salicylate, coumarin, limpoene, linalool, parfum /- others
on 4/22/2016 11:37:00 AM
Age: 44-55
Skin: Acne-prone, Fair-Medium, Not Sure
Hair: Brunette, Wavy, Medium
Eyes: Hazel
I have been using this for about 15 years now and I think it's the best translucent loose powder I have tried/used. I have tried many high end powders but I think this is the best on my skin. Never looks cakey, it is mattifying and just has a beautiful sheer look. I just use some concealer on blemishes, Skinceuticals Mineral Sunscreen (colourless), my MAC blush and this powder. This powder makes my skin look so much better that it is!
on 12/9/2015 2:35:00 PM
Age: 25-29
Skin: Normal, Fair, Neutral
Hair: Brown, Straight, Coarse
Eyes: Brown
I got this one on TL 9. I use it on myself and on clients. I really works on any skin tone I ever worked on from the lightest to the darkest. it's very sheer so it doesn't change the shade of foundation /concealer underneath. Also it settles great under the eye area. The packaging looks kinda cheap and it's not the best but for the price I cannot complain. This product is high quality and is a HG for me.
To Read all 33 Reviews, Login or Join
on 4/11/2015 1:11:00 PM
Age: 19-24
Skin: Oily, Fair-Medium, Warm
Hair: Brown, Straight, Medium
Eyes: Brown
I use it on my face and under eye area for setting. It makes my makeup long lasting, such an amazing powder. It also has quite good value. There is just one dissappointment for me; its packaging quality is TERRIBLE.
on 3/13/2015 11:06:00 PM
Age: 30-35
Skin: Combination, Olive, Warm
Hair: Brown, Straight, Other
Eyes: Brown
I like this powder a lot, more so then the Ben Nye Banana powder it works very well setting my foundation and it warms up foundations that are not quite yellow enough for me, I got the travel size for 12 dollars in Chicago and I think it will last quite a long time.
on 2/25/2014 12:46:00 AM
Age: 30-35
Skin: Combination, Dark, Not Sure
Hair: Black, Other, Other
Eyes: Black
This is a staple in my kit! This translucent powder works well with most foundations, from my Ellis Faas to MAC foundation. When I apply this, I like to use a powder puff. I use a gentle rolling motion to press this powder into the skin and it creates a beautiful finish and lasts all day. For the price, it's fantastic value. It lasts for a long time.
Compared to some pricier powders, I think Kryolan Translucent Powder is good quality with a finely milled velvety texture and great colour range. Obviously it won't impart a lot of colour onto the skin but you can still choose from very light to dark colours depending on your skin tone. I am an NC44 in MAC but I can get away with using Kryolan's TL11 on my skin. It actually takes away some of the 'yellow' from my MAC foundation and works well with my skin as the TL11 has a slight beige/pinky tone to the powder.
I highly recommend this powder if you can get your hands on it!
on 2/23/2014 5:23:00 AM
Age: 19-24
Skin: Acne-prone, Fair, Cool
Hair: Blond, Straight, Medium
Eyes: Blue
I use this along side Revlon Colorstay liquid oily/combination foundation and it works wonderfully. I've used it for a couple of years now and I'd never go back. I found that other powders gave my skin a dirty look with a poor blend of colours, but this just blends right into your foundation (obvs because it's translucent). Plus this stuff literally lasts forever! I've been using it for a couple of years and I'm only about one third of the way through my second tub. It stays on all day and literally doesn't come off until I remove my make up. If you want a natural looking powder then this is the one to go for.
on 1/3/2014 9:40:00 AM
Age: 19-24
Skin: Combination, Fair-Medium, Cool
Hair: Other, Wavy, Fine
Eyes: Brown
One of the best setting powder I have ever used. A little goes a long way. I hate the packaging though, but its okay. Would definitely re purchase and a staple in my collection!
on 8/20/2013 9:21:00 AM
Age: 19-24
Skin: Combination, Medium, Not Sure
Hair: Brown, Other, Other
Eyes: Brown
I have gone through two tubs of this and I am just about to get my third one. After using this for two straight years, I think I'v gathered enough confidence to review this product. I am very much satisfied with this that I won't waste any more of my time and effort searching for the perfect setting powder for me as this has got to be it.
Generally, I have oily skin. Not really acne prone but I tend to break out to some face powders and this one doesn't break me out at all.
I really like how this makes my makeup look flawless. It makes my makeup last so much longer and it keeps my face from getting oily. The packaging is huge and you only need to put a little amount to cover your entire face. It doesn't alter the color of your makeup base. Looking at the ingredients, this contain titanium dioxide which I believe is an ingredient in common physical sunscreens so I think this powder will relatively give even a short protection from the sun (although it isn't really meant as a sun protection makeup).
With the wide range of shades to choose from, for a setting powder, I think you're in luck. This is hands down the best. Try it to believe it.
on 5/31/2013 11:42:00 AM
Age: 19-24
Skin: Acne-prone, Other, Not Sure
Hair: Brunette, Other, Other
Eyes: Blue
I have sensitive, combination (but not acne-prone) skin that gets super oily, especially in the T zone. I was using MUFE's transluscent powder, which is nice, but doesn't really help mattify my skin. Read lots of positive reviews about this product, so bought it on ebay and for the amount you get, it's pretty cheap :)
Was super excited to try it, but the first few goes I HATED it. It accentuated all my dry skin, and was just caking like a mofo...was super disappointed. But then I realised, I was using way too much initially...and it's not like I was using a lot! I was used to the MUFE powder's ability to not cake up. So now, I used the tiniest and I mean teeniest amount on my Real Techniques Multi-Tasking Brush (which is synthetic, so again it picks up minimal product) and dust on T-zone and the remainder on the rest of my face... then wait..be patient, after a few minutes, if there's any shine remaining, I take again a tiny amount and place there. Done....dusted. If I go a tad over-powdery, I spray Skindinavia's finishing spray, and then that's it. Don't touch my face. Of course, I have to blot now and then, but even when the shine comes through, it isn't oil-slick, but more luminous and flattering (and I prefer a matte finish)
the finish is so natural, and I swear this powder just elevates any foundation/BB cream that I used. Love this forever <3 If you're an oily-skinned gal (or guy), please give this a go. Have used this everyday I've worn makeup (so 99% of days :P) for 6 months, and there's still a huge amount left in the container. The packing is ugh, and my only gripe is the design. The tub is huge, so not really travel-friendly, and I'd advise to only remove a quarter of the sticker that covers the perforated, in order to better control how much powder comes out, because it can get quite messy otherwise.
EDIT : Knocking this down to 4 stars, because I discovered that Kryolan's Anti-Shine powder does an even better job at mattifying so had to give that 5! Seriously Kryolan you're crushing it with your powders.
on 12/8/2012 5:23:00 AM
Age: 30-35
Skin: Combination, Fair, Neutral
Hair: Brunette, Straight, Fine
Eyes: Brown
Amazing powder, this is literally invisible, extra fine milled. You can get it in a huge container which makes it dirt cheap.
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Internet Explorer
by Mary Pipher
|August 1, 2005
Trade Paperback
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#1 New York Times Bestseller The groundbreaking work that poses one of the most provocative questions of a generation: what is happening to the selves of adolescent girls? As a therapist, Mary Pipher was becoming frustrated with the growing problems among…read more
|February 9, 2016
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Mary Pipher's groundbreaking investigation of America's girl-poisoning culture," Reviving Ophelia , established its author as one of the nation's foremost authorities on family issues. In Letters to a Young Therapist ,…read more
|June 4, 2013
"Mary Pipher takes on our planet's greatest problems with the skills of a truly gifted therapist. She knows why we avoid and deny the truth and she knows how we can heal ourselves and our communities even as we try to heal the earth. This book is a deep and true…read more
|April 13, 2005
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Mary Pipher's groundbreaking investigation of America's "girl-poisoning culture," Reviving Ophelia , has sold nearly two million copies and established its author as one of the nation's foremost authorities on family issues. In Letters to a Young Therapist ,…read more
|May 1, 2007
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From the #1 New York Times bestselling author of Reviving Ophelia, Another Country, and The Shelter of Each Other comes an inspirational book that shows how words can change the world. Words are the most powerful tools at our disposal. With them, writers have…read more
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We live in an appearance-obsessed culture. Fashion ads, magazine covers, TV shows, and movies idealize a body type that is impossible for most real women to achieve. In this comforting, liberating book, Dr. Mary Pipher, bestselling author of Reviving Ophelia,…read more
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Over the past decade, Mary Pipher has been a great source of wisdom, helping us to better understand our family members. Now she connects us with the newest members of the American family - refugees. In cities all over the country, refugees arrive daily. Lost…read more
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A New York Times Bestseller There are more older people in America today than ever before. They are our parents and grandparents, our aunts and uncles and in-laws. They are living longer, but in a culture that has come to worship youth--a culture in which…read more
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"An absorbing chronicle of discovery" ( Booklist ) from the #1 New York Times bestselling author of Reviving Ophelia and The Shelter of Each Other Like most lives, Mary Pipher's is filled with glory and tragedy, chaos and clarity, love and abandonment. She…read more
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4 of 4 people found the following review helpful
Not impressed,
Verified Purchase(What is this?)
This review is from: GRIP - Develop bone crushing hand, finger, and forearm strength (Kindle Edition)
After reading books like moulding a mighty grip and mastery of hand strength I was quite disappointed in the content of this book. Nothing new here and most exercises listed in this book will be known by the most casual of gym goers
Review Details
Top Reviewer Ranking: 5,831,881


text:
Jared Diamond
Explorer-in-Residence, 2006-2013
Photograph by Tim Laman
Photograph by Becky Hale
Jared Diamond is professor of geography at the University of California, Los Angeles. He is the author of Collapse: How Societies Choose to Fail or Succeed and the widely acclaimed Guns, Germs, and Steel: The Fates of Human Societies, which won him a Pulitzer Prize as well as Britain's 1998 Rhone-Poulenc Science Book Prize.
Diamond is the recipient of a MacArthur Foundation Fellowship (Genius Award); research prizes and grants from the American Physiological Society, National Geographic Society, and Zoological Society of San Diego; and many teaching awards and endowed public lectureships. In addition, he has been elected a member of all three of the leading national scientific/academic honorary societies—National Academy of Sciences, American Academy of Arts and Sciences, and American Philosophical Society.
Diamond's field experience includes 22 expeditions to New Guinea and neighboring islands to study ecology and evolution of birds; the rediscovery of New Guinea's long-lost golden fronted bowerbird; and other field projects in North America, South America, Africa, Asia, and Australia. As a conservationist, he devised a comprehensive plan, almost all of which was implemented, for Indonesian New Guinea's national park system. He has also taken part in numerous field projects for the Indonesian government and World Wildlife Fund. He is a founding member of the board of the Society of Conservation Biology and a member of the board of directors of World Wildlife Fund/USA and Conservation International.
Latest Explorer News
- Best Job Ever: Hunting for the Bones of a Loch Ness-Like Monster
- Photo Update: How Technology is Reaching Pakistan's Children with the Polio Vaccine
- Justice for Elephants in Kenya: Ivory Smuggler Jailed for 20 Years
- Palmetto Pipeline: An Eminent Problem
- Deep Sea Mining: An Invisible Land Grab
- Shipwreck Hunter Unearths Lost History and Treasures: #bestjobever
- Ridiculously Cute Mouse Lemurs Hold key to Madagascar's Past
- Colombia's Former Guerrillas Need New Jobs. Why Not in Conservation?
- Duplin County: Life Under the Waste Sprayer
- Third Class of Fulbright-National Geographic Fellows Named
Nat Geo E-Team
What are Jared Diamond and the rest of the National Geographic Explorers up to? Meet the E-Team and learn about their projects in this interactive mural.
In Their Words
History followed different courses for different peoples because of differences among peoples' environments, not because of biological differences among peoples themselves.
-Jared Diamond
Conservation in the 21st Century
Greg Anderson, David Harris, Enric Sala, Mike Fay, and Jared Diamond discuss the climate that today's explorers operate in.
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text: Rota Semana Santa – Holy Week – celebration last week in Rota (Cádiz) España. Though I am not religious at all, I love seeing and capturing moments of this historic and centuries-old event. Captured handheld with no flash with Canon EOS 40D with Canon compact 50mm EF f1.4 lens, and just disappointed it was so windy most candles for this procession were not lit. I love seeing the candle light in the darkness.


text:
After the Bell
Before the Bell
Jim Cramer's Daily Booyah
Midday Bell
Top 10
Winners & Losers
Apple is scheduled to release its earnings results after the closing bell, but expectations are low due to flagging smartphone sales.
TheStreet highlights 3 stocks pushing the technology sector higher today.
The Federal Reserve will steal focus from another onslaught of earnings in the coming week as investors remain wary over the central bank's rate-hike timetable.
©1996-2016 TheStreet, Inc. All rights reserved.
Action Alerts PLUS is a registered trademark of TheStreet, Inc.


text:
Mom-to-be Lucy thinks Ricky cares more about their coming child than about her, especially after he buys her baby supplies as gifts. But when he takes her out for a night on the town, she thinks he's lost interest in the baby.
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Lucille Ball
Lucy McGillicuddy Ricardo
Desi Arnaz
Ricky Ricardo
Vivian Vance
Ethel Mertz
William Frawley
Fred Hobart Mertz
Bennett Green
Recurring Role
Lucy: How about Philip if it's a boy
Ricky: And Morris if it's a girl?
(discussing baby names)
Lucy: Well, I'm not gonna settle on any old thing. I want the names to be unique and euphonious.
Ricky: OK. Unique if it's a boy and Euphonious if it's a girl.
Fred: Oh boy, I love to dance, but I'm a little out of condition.
Ethel: A little out of condition? He puffed so hard it's like dancing with a steam engine.
Fred: Steam engines puff hard when they're pushing a heavy load.
Ethel: While you're at it, why don't you take another couple along with you...just to make it a happy foursome.
Ricky: Do you have anyone in mind?
Ethel: We'd love to!
Lucy: After the baby's born, I'll just be forgotten.
Ethel: Oh, that's not true.
Lucy: It is too true. I'll be just like a salmon. I'll swim upstream, spawn and never be heard from again.
Bennett Green (the waiter) was actually Desi Arnaz's stand-in on the show.
My Favorite Husband: The Christmas Stag
Mashed potatoes, gravy, and sardines were used for Lucy's pistachio hot fudge and sardine sundae. However because Lucille Ball hated sardines she threw up off stage after the scene was shot.
Music performed on this episode included "Cheek to Cheek".
At the end of this episode, Lucy sobs: "You don't care about little Bob or Madelyn." Madelyn Pugh and Bob Carrol, Jr. were two of the "I Love Lucy" script writers.
S 6 : Ep 26
Aired 5/6/57
S 6 : Ep 25
Aired 4/29/57
S 6 : Ep 24
Aired 4/22/57
S 6 : Ep 23
Aired 4/8/57
User Score: 1733
User Score: 1380
User Score: 705
User Score: 686
User Score: 427
User Score: 225
User Score: 132
User Score: 127
User Score: 86
User Score: 63
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User Score: 44
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User Score: 31
User Score: 24
User Score: 18
User Score: 16
User Score: 14
User Score: 13


text:
Engine Mechanical problem
1993 Saab 9000 4 cyl Front Wheel Drive Manual 169996 miles
I noticed an oil leak where the wastegate meets the side if the turbo. I can't seem to find any diagrams of the system that would tell me if there is a gasket there.
Can you offer any advise? Diagrams of the system?
Thank you in advance!
Sunday, October 10th, 2010 AT 8:42 AM


text:
|Home | About | Journals | Submit | Contact Us | Français
Diabetes is recognized as an independent risk factor for cardiovascular morbidity and mortality. This is due, in large part, to premature atherosclerosis, enhanced thrombogenicity and activation of systemic inflammatory programs with resultant vascular dysfunction. More enigmatic mechanisms underpinning diabetes-associated cardiac pathophysiology include the direct metabolic consequences of this disease on the myocardium. Nevertheless, a role for diabetes-associated disruption in cardiac contractile mechanics and in increasing cardiomyocyte susceptibility to ischemic-stress has been implicated independent of vascular pathology. This review will focus broadly on the direct effects of diabetes on the cardiac myocardium with more specific reference to the role of the modulation of cardiomyocyte mitochondrial function in these disease processes. This focus in part, stems from the growing recognition that in some instances mitochondrial dysfunction is central to the development of insulin resistance and diabetes, and in others, diabetes associated disruption in mitochondrial function exacerbates and accentuates the pathophysiology of diabetes.
Type 2 diabetes mellitus (T2DM) in combination with obesity are the fasting growing risk factors that adversely effect cardiovascular disease incidence and outcomes [1, 2]. These diabetes associated cardiac complications are due, in large part, to perturbed cholesterol, vascular and platelet biology. The pathophysiology of these effects in T2DM have been extensively reviewed [3–5] and are not the focus of this manuscript. Interestingly, the effect of T2DM on the myocardium is not as well characterized. However, it is recognized that with T2DM the myocardium is predisposed to cardiac mechanical dysfunction and to diminished myocardial tolerance to biological stressors [6].
T2DM is associated with insulin resistance and a relative defect in pancreatic β-cell functioning that leads to reduced insulin mediated glucose uptake, increased hepatic glucose production and impaired suppression of lipolysis. These changes in turn alter the metabolic milieu within which the heart functions. The consequences and mechanistic interplay between T2DM, mitochondrial energetics and the heart form the core of this review.
The heart is voracious in its appetite for energy, to such an extent that it generates and consumes a mass of ATP daily that surpasses cardiac mass itself by approximately 5–10 fold [7]. This unrelenting demand for energy reflects the continuous contractile functioning of the heart to sustain systemic circulation and nutrient supply. This high energy flux translates into the cardiomyocyte having a mitochondrial volume between 23% and 32% of myocellular volume {Schaper, 1985 #3356}. Interestingly, cardiac mitochondrial density increases from man to mouse in parallel with increasing heart rate and oxygen consumption {Schaper, 1985 #3356}. Disruption of mitochondria in other tissues are a sine qua non of established type 2 diabetes mellitus (T2DM) [9, 10]. Hence, by employing 'Occam's Razor' a reductionist hypothesis can be proposed that 'cardiac function will be perturbed in T2DM due to mitochondrial dysfunction'. However, the biological relationship between T2DM, mitochondria and cardiac function is not straight forward and this manuscript is tasked to explore the current data supporting a more complex hypothesis regarding the role of the mitochondrion in cardiac adaptation to T2DM and to furthermore evaluate whether the modulation of mitochondria may have utility in treating T2DM associated cardiovascular disease. For the purposes of this review the term diabetes will refer to T2DM and data from primary pancreatic β-cell destruction with resultant type 1 diabetes and the cardiac sequelae of this is not discussed.
Prior to exploring the changes in cardiac mitochondria in diabetes a brief overview of the regulation and control of mitochondria will be introduced with a focus on these programs in the heart.
The mitochondrial biogenesis regulatory program is defined as the inter-genomic control of mitochondrial dynamics, functional content and number required to maintain diverse homeostatic demands across tissue types (Reviewed [11, 12]). In the heart, the prime mitochondria function is to facilitate oxidative phosphorylation for the generation of ATP [13]. Mitochondrial biogenesis requires coordinate regulation between the mitochondrial and nuclear genomes to coordinately encode and integrate ~77 proteins' into multi-subunit complexes of the respiratory apparatus and for other proteins necessary for homeostatic mitochondrial functions (e.g. oxidative metabolism, reactive oxygen species (ROS) generation, utilization and breakdown and in intracellular calcium homeostasis). The molecular conductors of inter-genomic regulation of mitochondrial biogenesis and the electron transfer chain complex proteins include the nuclear regulatory proteins - nuclear respiratory factors (NRF) 1 and 2, the cyclic AMP response element binding protein (CREB) and transcription factor A of mitochondria (TFAM) [14–16]. Upstream, the transcriptional coactivator peroxisome proliferators activated receptor gamma coactivator 1 alpha and beta (PGC1's) and the PGC1 related coactivator (PRC) modulate these nuclear regulatory proteins to subsequently activate target genes encoding regulatory enzymes of oxidative phosphorylation [17–19] and genes that modulate anti-oxidant defenses, including nuclear-encoded mitochondrial anti-oxidant enzymes and the uncoupling proteins [20, 21].
The transcriptional regulatory control of mitochondria content and number in the heart is tightly controlled. Unfettered overexpression of PGC1α in the murine heart results in a progressive and uncontrolled increase in mitochondrial number with resultant disruption in cardiomyocyte sarcomeric structure and myocardial contractile function [22]. Conversely, the genetic deletion of PGC-1α results in diminished cardiac mitochondrial enzyme activities, diminished ATP production, blunted cardiac postnatal growth, diminished chronotropic capacity and an inability to appropriately augment cardiac workload in response to exercise or to β-adrenergic stimulation {Leone, 2005 #2980}[23]. Interestingly and in contrast, cardiac restricted overexpression of TFAM has no obvious cardiac basal phenotype and shows diminished mortality in response to cardiac ischemia with reduced adverse remodeling and diminished oxidative stress [24]. In primary cardiomyocytes TFAM overexpression prevents elevated glucose mediated oxidative stress and mitochondrial bioenergetic deficits {Suarez, 2008 #3467}.
The genetic induction of the peroxisome proliferators activated receptor alpha (PPARα), a transcriptional mediator of mitochondrial metabolic function, most closely resembles perturbations associated with diabetic heart disease {Finck, 2002 #1324}. The cardiac restricted upregulation of this transcription factor upregulates mitochondrial fatty acid β-oxidation (FAO) in parallel with a reduction in glucose uptake and oxidation {Finck, 2002 #1324;Park, 2005 #3247}. Interestingly, the concurrent uptake and storage of fat in the myocardium in these mice exceeds the rate of FAO, resulting in a cardiomyopathy, reminiscent of 'diabetic cardiomyopathy' {Finck, 2002 #1324;Finck, 2003 #3361}. The concept that excess uptake of fat itself predisposes to cardiomyopathy is shown in mice with cardiac restricted overexpression of lipoprotein lipase, PPARγ and acyl CoA synthetase {Yagyu, 2003 #3456;Son, 2007 #3458;Chiu, 2001 #3473}.
Substrate selection and utilization is also perturbed in T2DM with diminished glucose metabolism as discussed below. From a regulatory perspective these changes are also under transcriptional control. In the heart and skeletal muscle T2DM and starvation concordantly upregulate PGC-1α and PPARα, which in turn upregulate pyruvate dependent kinase 4 (PDK4), a negative regulator of glucose oxidation, {Wu, 1998 #3465;Wu, 1999 #3464}. Inversely, in response to hypoxia, an environmental cue that enhances glucose utilization, cardiac PPARα and PDK4 are downregulated {Razeghi, 2001 #1404}.
The biochemical/hormonal modulators of the mitochondrial biogenic regulatory program are not restricted to, but include ROS, nitric oxide, hypoxia, calcium signaling, AMP levels and thyroid hormones [25–29]. The complex interplay between the molecular and biochemical mediators is epitomized by nitric oxide which not only upregulates mitochondrial biogenesis [30], but concurrently modulates oxidative phosphorylation through competitive inhibition of respiratory chain electron transfer [31, 32]. Substrate availability to the heart also alters mitochondrial metabolism, and the elevation in circulating free fatty acids, evident in T2DM, has also been shown to decrease glucose oxidation via inhibition of pyruvate dedydrogenase as described by Randle {Randle, 1963 #818;Randle, 1998 #819}. Finally, in cardiomyocytes elevated glucose itself promotes O-linked β-N-acetylglucosamineglycolsylation of mitochondrial electron transfer chain proteins resulting in impaired mitochondrial oxidative capacity {Hu, 2009 #3468}.
T2DM is a continuum that in its earliest stages is accompanied by peripheral organ insulin resistance manifesting as a requirement for greater insulin concentrations to activate the insulin signaling pathway to facilitate glucose uptake and/or to inhibit gluconeogenesis. The most consequential organs with respect to glucose uptake, storage and redistribution and therefore the major peripheral organs modulating this progressive pathophysiology include skeletal muscle, adipose tissue and the liver. Although hyperinsulinemia might maintain glucose homeostasis, relative pancreatic β-cell dysfunction ultimately leads to elevated circulating levels of glucose. Moreover, insulin resistance in adipose tissue is associated with elevated circulating free fatty acids, which in concert with hepatic insulin resistance leads to hypertriglyceridemia [39] [40]. In skeletal muscle exposure to elevated glucose and free fatty acids results in mitochondrial injury and dysfunction [41].
The characterization of insulin resistance and its interrelationship to the mitochondria in the heart has been less well explored. It is of interest to note that in human diabetic subjects, at least prior to overt cardiovascular disease, cardiac glucose uptake in response to insulin is preserved despite increased insulin resistance in other peripheral tissues {Jagasia, 2001 #3357}. The assessment of insulin resistance in the heart of diabetic mice have also been explored. Db/db mice, which have defective leptin receptors, develop severe hyperglycemia in concert with hyperinsulinemia and elevated circulating free fatty acids levels are studied as a model system to evaluate systemic effects of T2DM. The ex-vivo assessment of cardiac insulin responsiveness in these mice show preservation of insulin sensitivity in the presence of low levels of glucose and fat in the perfusate {Hafstad, 2006 #3360}. However, insulin-resistance develops when glucose and fat concentrations are increased in the perfusate {Hafstad, 2006 #3360}. The effects of elevated fatty acids on cardiac insulin resistance is also evident in mice deficient in skeletal muscle lipoprotein lipase [42]. In these mice, marked elevation of circulating fatty acids and triglycerides in response to a high fat diet promote cardiac insulin resistance [42]. To date mitochondrial biology has not specifically been studied in these mice. Moreover, ob/ob mice which are leptin deficient, obese and display insulin resistance with euglycemia with concomitant disruption in circulating glucose and fatty acids exhibit diminished cardiac glucose oxidation, increased mitochondrial FAO and increased myocardial mitochondrial oxygen consumption [43, 44]. These perturbations result in diminished mitochondrial efficiency (uncoupling) and result in a reduced capacity to respond to increased cardiac work-load [45]. The mechanism orchestrating this are proposed to result from the increased delivery of reducing equivalents by the enhanced mitochondrial fatty acid β-oxidation to a relatively downregulated electron transport chain resulting in increased ROS production, lipid peroxidation and oxidative stress [45, 46]. In support of this observation mitochondrial integrity has been shown to be disrupted and electron transfer chain enzyme levels diminished in insulin resistant hearts in aging dogs compared to younger activity-matched controls [47]. The role of fatty acid uptake in propagating insulin resistance in the heart is further supported whereby the reduction in cardiac fatty acid uptake by the genetic depletion of the fatty acid transporter CD36, rescues the insulin resistant phenotype evident in cardiac restricted PPARα transgenic mice [48].
Interestingly, despite the development of cardiac mitochondrial dysfunction with diabetes, these hearts do preferentially oxidize fatty acids. It has recently been shown that insulin resistance drives the cardiac mitochondrial biogenesis regulatory program via PPARα [49]. This response is proposed to result from the increased PPARα activation due to increased fat uptake and oxidation [50]. Although the cardiac mitochondrial number and content is increased in the insulin-resistant uncoupling protein-diphtheria toxin A transgenic mice, mitochondrial efficiency is diminished compared to controls and probably reflects, and is consistent with incomplete adaptation to these diabetes associated metabolic perturbations [49, 51].
A potential deficit in studies investigating cardiac substrate preferences and utilization in the ex-vivo diabetic heart is the absence of ketone bodies in the perfusate. In–vivo and ex-vivo studies in multiple species show that the exposure of the myocardium to ketone bodies results in a relative reduction in the rate of FAO {Stanley, 2003 #3460;Stowe, 2006 #3461;Hasselbaink, 2003 #3462}. Although ketone metabolite levels are usually not present in high abundance in well controlled diabetes, elevation of levels does occur under poor diabetic control.
From a mitochondrial oxidative capacity perspective, the primary disruption of mitochondrial function in liver, skeletal muscle and adipocytes can promote the development of insulin resistance [52–54]. Whether primary mitochondrial defects are operational in cardiac insulin resistance does not appear to have been directly investigated. However, in the heart, the molecular disruption in insulin signaling following cardiac restricted depletion of insulin receptors results in age-dependent impairment in mitochondrial oxidative phosphorylation capacity and augmentation in oxidative stress {Boudina, 2009 #3469}.
Although, the concept of diabetic cardiomyopathy has been part of the discourse for the past 35 years [56], the distinct clinical delineation of this condition from other cardiac comorbidities such as cholesterol mediated effects on vascular function (endothelial function, atherosclerosis and coronary artery disease) or from hypertension and associated cardiac hypertrophy is usually not practical. Nevertheless, clinical data is being accumulated that diabetes does impair cardiac function and ischemic tolerance, independent of other cardiac risk factors [1, 57, 58]. In this section we review the evidence whereby diabetes directly perturbs cardiac relaxation, contractile function and ischemic tolerance and explore this pathophysiology with the specific reference to mitochondrial biology. Additional mechanisms operational in diabetic cardiomyopathy include perturbations in calcium regulation and homeostasis and direct effects of disrupted insulin signaling. These additional biological pathways have recently been reviewed [6, 59, 60] and are not discussed further.
Diastolic dysfunction is classically defined as abnormalities in the relaxation phase of the cardiac mechanical cycle, that delays ventricular filling and results in symptoms and signs of heart failure {Galderisi, 2006 #3466}[61]. This was initially proposed to occur independently of systolic contractile dysfunction. However, with advancing cardiac imaging and hemodynamic measurements it is now recognized that a relative degree of contractile dysfunction accompanies filling/relaxation deficits in the majority of subjects [61]. As these concurrent perturbations in relaxation and contraction do not fit the classic clinical definition of systolic heart failure (a low ejection fraction), this clinical entity is now defined as heart failure with preserved ejection fraction [61]. In subjects with diabetes, this distinction may be academic, rather reflecting a continuum where the early deficit manifests as abnormal cardiac relaxation with progression to combined systolic and diastolic dysfunction [62]. Studying endomyocardial biopsy specimens Paulus and colleagues show that diabetic heart failure subjects with preserved ejection fraction have increased cardiomyocyte resting tension which is compatible with increased diastolic stiffness [62]. Furthermore, an increase in myocardial advanced glycation end products and collagen deposition were only observed in diabetic subjects following the onset of systolic dysfunction [62]. Whether this increased diastolic stiffness is related to mitochondrial defects in human subjects has not been directly investigated. However, it has been shown using 1H-MRS that subjects with diabetes or glucose intolerance have increased cardiac steatosis [63], which may indirectly reflect diminished mitochondrial metabolic capacity. The measurement of high-energy phosphates in diabetic and non-diabetic subjects without clinical coronary artery disease and normal echocardiographic studies indirectly suggest that diabetic subjects have diminished cardiac energetics [64]. This study does not, however, directly implicate a mitochondrial deficit as aberrations in the creatine-kinase shuttle or creatine levels could also modulate these NMR spectra.
T2DM is known to enhance susceptibility to ischemic cardiomyopathy {Haffner, 1998 #3459}, however, and paradoxically the additional pathology of T2DM in subjects with non-ischemic cardiomyopathy appears to confer a survival advantage {De Groote, 2004 #3354}. This finding was similarly found in a smaller cohort of T2DM subjects where heart failure survival was inversely correlated with blood sugar control as measured by HbA1c {Eshaghian, 2006 #3355}. These findings are not uniform, in that other clinical studies globally show a worse outcome in systolic heart failure subjects with T2DM versus non-diabetic controls. A distinction between ischemia and non-ischemic cardiomyopathy may be operational in these conflicting findings, although the mechanisms governing these effects has to date not been elucidated.
The cardiac hemodynamic functioning of db/db mice have been directly assessed using an isolated working heart model system and show classical features of diastolic dysfunction as measured by an increased in the left ventricular end diastolic pressure and increased myocardial stiffness [65]. These perturbations are proposed to result from the diminution in myocardial efficiency as measured by the ratio between cardiac output (work) and oxygen consumed (MVO2). This excess in MVO2 was found to be exacerbated with higher levels of fat substrate for cardiac metabolism. Interestingly, in this study the stroke volume of the db/db mice were similar to the db/+ controls. Severson and colleagues show in similarly aged mice that diastolic and systolic perturbations are evident as measured in-vivo by echocardiography [66]. Furthermore, the db/db mice show diminished glucose uptake and an early thickening of the myocardium in young mice, with progressive systolic dysfunction with aging when measured in vivo using PET and MRI imaging [67]. The metabolic underpinning of these deficits is further supported in that overexpression of the glucose transporter GLUT4 with concomitant increase in glucose oxidation rescues cardiac contractile function in db/db mice [66, 68].
At 11 weeks of age, ob/ob mice demonstrate increase neutral lipid accumulation in the heart with echocardiographic parameters consistent with diastolic dysfunction [69]. Furthermore, Abel and colleagues demonstrate that these mice have impaired mitochondrial respiratory capacity in association with diminished pyruvate dehydrogenase activity and a restricted glucose-dependent oxidative capacity response to increased workload [45]. In response to the addition of fat substrate, oxygen consumption is enhanced, but at the expense of cardiac efficiency suggesting that these mitochondrial are susceptible to fat-mediated mitochondrial uncoupling [45]. Indeed direct measurement of mitochondrial proton leak in db/db mice supports the existence of fatty acid induced mitochondrial uncoupling {Boudina, 2007 #3470}.
Additional animal models that support these concepts include the Otsuka Long-Evans Tokushima Fatty rats which show disrupted left ventricular diastolic filling [70] and evidence that cardiac contractile dysfunction is accelerated and mortality increased in hypertensive rats when they are subject to a high sugar-diet [71]. Moreover, high-fat feeding to Wistar rats also evokes cardiac contractile dysfunction, which appears to result from enhanced fatty acid uptake through CD36 and intramyocellular triacylglycerol accumulation {Ouwens, 2007 #3471}.
As mitochondrial biology is increasingly being recognized as a pivotal organelle in the modulation of cardiac ischemia tolerance [72, 73], perturbations in cardiac mitochondrial metabolism associated with T2DM may be expected to attenuate myocardial tolerance to ischemia. In humans, this is supported in that following myocardial-infarction, the incidence of heart failure is increased in diabetic subjects far in excess of non-diabetic subjects with similar infarct sizes [74, 75].
Interestingly, db/db mice also show increased susceptibility to cardiac ischemia as measured by post-ischemic recovery of contractile function [76, 77] in parallel with a diminished capacity to utilize glucose in this oxygen-deficient milieu [77]. This increased susceptibility to ischemic injury in db/db mice also results in a greater incidence of heart failure and enhanced mortality in response to chronic ischemia [78]. In parallel, cardiac contractility and survival are diminished in ob/ob mice following chronic myocardial ischemia [79] and following diet-induced obesity in wildtype mice [80].
As the regulatory control of mitochondrial bioenergetics are being identified, therapeutic agents directed at modulating mitochondrial function in the heart are being developed and tested [81]. The most promising mitochondrial and metabolic modulatory compounds that may improve diabetic cardiac function and/or stress tolerance include the PPARγ, the PPARδ and SIRT1 agonists. Moreover, in light of increased oxidative stress in T2DM {Boudina, 2007 #3470;Boudina, 2009 #3469}, strategies to combat this in the diabetic heart are also briefly reviewed.
Thiazolidinediones are part of the therapeutic armamentarium in the management of T2DM. Interestingly, they directly upregulate mitochondrial biogenesis in adipose tissue and in skeletal muscle [53, 82]. This effect has not been shown in the heart which probably reflects lower expression of PPARγ in the heart. Interestingly though the thiazolidinedione rosiglitazone does improve myocardial efficiency by diminishing the augmented MVO2 in db/db mice [83]. This is thought to occur in part by normalizing plasma glucose and fatty acid levels [83] and in restoring cardiac substrate utilization and insulin signaling [83, 84]. As may be expected these metabolic changes also improve cardiac ischemia-tolerance [83, 84]. Caveats regarding the utilization of thiazolidinediones for cardiovascular disease include that these ischemia-protective effects do not appear to extend to the non-diabetic heart [85] and that the composite of cardiac effects of the thiazolidinedione class of compounds is being questioned in light of a possible enhanced risk of acute coronary syndromes in humans [86]. Moreover, as insulin signaling modulates cardiac growth, Abel and colleagues directly investigated the effects of non-thiazolidinedione PPARγ agonists on cardiac hypertrophy. PPARγ-agonist therapy resulted in increased cardiac volume with ventricular hypertrophy in wildtype mice and in mice with cardiac restricted knockout of the insulin receptor {Sena, 2007 #3474}. These effects are thought to occur due to the plasma volume expanstion effects of PPARγ activation, and may impose an additional impediment for the use of PPARγ agonist therapy in subjects with diabetes associated cardiac dysfunction. This limitation is also evident in the clinical arena {Waksman, 2008 #3487}.
Cardiac restricted overexpression of PPARδ does not alter the rate of fatty acid uptake nor oxidation but does increase glucose uptake and oxidation {Burkart, 2007 #3475}. This metabolic profile would be expected to facilitate glucose utilization and thereby potentially ameliorate the development of insulin resistance or T2DM. In light of this desirable metabolic profile investigators have studied the systemic insulin-sensitizing effects of the PPARδ agonist GW501516 {Oliver, 2001 #3416}. In wildtype mice placed on a high-fat diet, a 2 month treatment period with GW501516 resulted in reduction in weight gain, increased type 1 skeletal muscle fiber type and improve glucose tolerance compared to vehicle treated controls {Wang, 2004 #3414}. A recent proof of concept study in human subjects showed that a two-week treatment of insulin resistant subjects with GW501516 did improve insulin sensitivity {Riserus, 2008 #3432}. Although the cardiac effects of GW501516 have not been directly explored in the context of diabetogenic stressors, in cardiac derived H9c2 myoblasts, the PPARδ agonist is protective against oxidative stress {Pesant, 2006 #3476}. This class of agents requires additional investigation, but may be an interesting compound to treat diabetes in general and possibly directed against diabetes associated cardiac metabolic perturbations.
The plant-derived polyphenol resveratrol (3,5,4′-trihydroxystilbene) is enriched in red wine and functions as a caloric restriction mimetic via upregulation of SIRT1 and AMP-activated kinase (AMPK) [87–89]. Additionally it exhibits antioxidant properties [90] and upregulates the mitochondrial biogenesis program [87]. Consistent with its known pleiotropic effects resveratrol administration confers protection against cardiac ischemia-reperfusion injury [90–92] although this has not been directly investigated in T2DM diabetic models. To differentiate the cardioprotective properties from the pleiotropic effects of resveratrol, small molecules that directly activate SIRT1 are being investigated [93]. Recently identified SIRT1 activators do prevent the onset of T2DM [94] and promote fatty acid oxidation and mitochondrial function [95]. Whether these SIRT1 activators can directly ameliorate cardiac stress-tolerance and the adverse diabetic effects on cardiac mitochondria need to be investigated.
Evidence supports excess ROS generation in parallel with mitochondrial dysfunction in the diabetic heart {Boudina, 2007 #2889;Boudina, 2009 #3469}. This excess ROS is proposed to contribute to both functional perturbations and susceptibility to ischemic injury in the diabetic heart. Contractile function has been studied in primary cardiomyocytes extracted from the T2DM-like agouti mouse with or without overexpression of catalase {Ye, 2004 #3481}. The presence of this ROS detoxifying enzyme enhanced ex-vivo contractile function of agouti mouse cardiomyocytes {Ye, 2004 #3481}. In this regard whether resveratrol-like compounds or PPARδ agonists could have protective effects targeting ROS in the diabetic heart would be of considerable interest.
The circulating metabolic perturbations, including elevations in glucose, fat and insulin levels that associate with the development of insulin resistance and T2DM are usually chronic, dynamic and moderate compared to normal control subjects. The mouse and dietary models employed to study T2DM are invariably 'all or nothing' modulations employing transgenic and knockout mice and extreme dietary manipulations. Although these models can give us insight at the extremes of the metabolic profile and assist in the dissection of the interaction between e.g. regulatory programs and metabolism and metabolites and mitochondrial function, it is important to appreciate these limitations and to translate these findings to the patient to formulate the pathophysiologic framework of the interplay between T2DM, mitochondria and cardiac function.
The weight of the evidence strongly suggests that the mitochondrial perturbations identified in the diabetic heart are secondary to the systemic effects of T2DM. This hypothesis is schematized in figure 1 and described here. In brief, the major T2DM associated systemic metabolic perturbations including elevated circulating free-fatty acids and hyperglycemia appears to provoke cardiac mitochondrial dysfunction and regulatory changes. Furthermore, the role of disrupted insulin signaling and hyperinsulinemia in this program may be 'operatives' in disrupting cardiac mitochondrial function. The direct effect of these T2DM metabolic consequences on the cardiac mitochondria require further investigation. Nevertheless, mitochondrial dysfunction identified in the 'diabetic heart' in concert with the additional cardiac deficits associated with T2DM probably contribute in tandem to disrupt cardiac contractile function and diminish cardiac stress-tolerance. As therapeutic options are being explored that modulate mitochondrial function, it will be intriguing to investigate whether optimization of cardiac mitochondrial functioning may have ameliorative effects on the 'diabetic heart'.
Furthermore and with probable more immediate benefit, it has been well established that lifestyle interventions including weight loss and exercise can both delay the onset of diabetes and delay its progression {Orchard, 2005 #3177;Toledo, 2007 #3284;Li, 2008 #3178}. In light of the information from this review, modulating these environmental stressors may be expected to improve functioning in the diabetic heart by diminishing cardiac exposure to this nutrient overload. This concept has recently begun to be explored and an elegant study shows that robust weight loss in response to bariatric surgery not only has ameliorative effects on circulating glucose, insulin, free fatty acid and leptin levels, but also normalizes cardiac diastolic function {Leichman, 2008 #3485}.
Taken together, the studies reviewed implicate mitochondrial dysfunction in the pathophysiology of adverse cardiac effects of T2DM. Moreover, these data suggest that broad lifestyle modifications to attenuate adverse environmental cues and novel therapeutics to target mitochondrial biology may potentially have additive effects in the overall management of T2DM and in the protection of the heart.
The author is funded by the NHLBI Division of Intramural Research. This review stems, in part, from a recent National Institute of Health and Society of Heart and Vascular Metabolism funded symposium exploring the role of mitochondrial biology in cardiac physiology and disease.
Support of Research: The author is funded by the Division of Intramural Research of the National Heart Lung and Blood Institute of the NIH.
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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The City of Ottawa has released an updated version of the Accessibility Design Standards – Second Edition, November 2015 [ PDF - 6875 KB ]. The second edition can be used immediately and supersedes the November 2012 first edition. The title pages, table of contents, and Section 1 of this document are available in both English and French. Due to its technical nature, the remainder of the document is available in English only. For more information, please firstname.lastname@example.com


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"With this book Peter Hall and David Soskice are opening a new chapter in the analysis of contemporary capitalism. They have succeeded in bringing together in one compelling formulation historical - institutional and rationalist - individualist analytical perspectives. The empirical applications in Varieties of Capitalism illuminate in a profound way how both scholars and policy makers will benefit when they link macro- and micro-level analyses across the many different sectors that define contemporary capitalism in its many forms. Economists and political scientists, finally, are able to meet on common ground. This book will become a classic in the field."-- Peter J. Katzenstein, Walter S. Carpenter, Jr. Professor of International Studies, Cornell University.
"This invaluable contribution to the comparative capitalism literature vigorously argues against the notion of convergence so popular in the globalism debates. The authors expand our understanding of national "production systems" to see new connections and show that the differences aong them allow countries to pursue distinctly different strategies of international competition. A must read."--Peter Gourevitch, University of California, San Diego
"This book has been well worth waiting for. It demonstrates the wealth of insights that could be achieveed through Soskice's innovative research program that began to chang the agenda of Comparative POlitical Economy more than a decade ago. The volume combines a definitive restatement of the varieties of cpitialism approach with illuminative applications to the range of research areas covered by it with some fascinating theoretical extensions. Excellent!"-- F.W. Scharpf, Max Planck Institute for the Study of Societies, Cologne
About the Author
PEPPER D. CULPEPPER is Associate Professor of Public Policy at the Kennedy School of Government at Harvard University. PETER A. HALL is Krupp Foundation Professor of European Studies. BRUNO PALIER is Charge de Recherches the CNRS at the Centre d'etudes de la vie politique francaise de Sciences-po Paris (CEVIPOF), France.
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American Decency Association: Magic Johnson Should Be Ashamed of His Gay Son
Submitted by Brian Tashman on Friday, 4/5/2013 1:25 pm
Bill Johnson of the anti-gay American Decency Association is angry that Magic Johnson has shown his openly gay son love and support rather than condemnation.
"Would you be proud to hear that your loved one had chosen a life that God calls an abomination?," Johnson writes, "Maybe if you yourself had lived a life of reprobation – and yourself had lost the ability to think and act morally any longer."
Johnson goes on to say that gay rights will lead to the acceptance of "pedophilia" and "beastiality [sic]" and called homosexuality a "sin which degrades, addicts, destroys."
Would you be proud to hear that your loved one had chosen a life that God calls an abomination? Maybe if you yourself had lived a life of reprobation – and yourself had lost the ability to think and act morally any longer.
If Magic Johnson says he's proud of his son for being a homosexual does his statement make it right in your heart and mind?
For those who say there is no God, it's fine to screw around, play around, commit adultery, engage in homosexuality. There is no right or wrong so do what's right in your own eyes; do what comes "naturally." And if what you want to do isn't considered politically correct today, just wait awhile then it will be okay in the near future. Polygamy? Pedophilia? Same-sex marriage? Beastiality [sic]?
For those who say there is a God, they believe there is a God in Heaven who created man and woman and who created all things. They also believe there is TRUTH - that there is such a thing as right and wrong; that life is precious; that the chief end of man is to glorify God and to enjoy Him forever.
Therefore, God's warnings in His word are reasonable and wise. God made us and He knows what's best. He gives strong warnings regarding illicit sex: pre-marital sex, promiscuity, adultery, homosexuality, polygamy.
Why? Because He loves His people and doesn't want His people to be damaged and to damage other people through that sin which degrades, addicts, destroys.
And the sin of homosexuality DOES damage! You could provide your accounts as well – multiple , multiple accounts but somehow we seldom to never hear these accounts. Do you? We just see Magic Johnson types with their "warm smiles" saying all is well and I'm proud. GAY PRIDE.
Other societies have turned their backs upon God. That's what America is doing - substituting the truth for a lie.
In closing, I live in the real world. I have had loved ones break my heart. I have deeply disappointed my own parents – nearly broken their hearts.
I have been loved, even when I have done wrong. I have and I will do the same. But I will never say that I am proud of an act or a behavior that dishonors God and degrades His people.
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Book your room at Americas Best Value Inn & Suites-Waukegan/Gurnee
Get an overview of this hotelHotel in Waukegan with free breakfast and 24-hour front desk
Situated in Waukegan, this hotel is 2.6 mi (4.1 km) from Visual Arts Center and 2.8 mi (4.5 km) from Genesee Theater. Six Flags Great America and Waukegan Harbor are also within 6 mi (10 km).
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Americas Best Value Inn & Suites-Waukegan/Gurnee411 S. Greenbay Road Waukegan IL 60085
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A complimentary breakfast is offered each morning. Public areas are equipped with complimentary high-speed wireless Internet access. This Waukegan hotel also offers tour/ticket assistance and a safe deposit box at the front desk. Complimentary self parking is available on site.
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The recreational activities listed below are available either on site or nearby; fees may apply.
- Fishing on site
- Racquetball/squash on site
To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
Hotel Policies
Minimum check-in age is 21
Check-in time starts at 2 PM
Check-out time is 11 AM
Payment types
- Pets allowed for an extra charge of USD 10 per night
- Dogs only
- 1 per room
- Restrictions apply
- For more information contact the property at the number on the booking confirmation
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
No cribs (infant beds) available
Optional extras
- Pet fee: USD 10 per night
- Rollaway beds are available for an additional fee
Hotel Name
- Americas Best Value Inn Hotel Waukegan Gurnee
- Americas Best Value Inn Waukegan Gurnee
- Americas Best Value Inn Waukegan/Gurnee Hotel Waukegan
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We should mention
Guests can arrange to bring pets by contacting the property directly, using the contact information on the booking confirmation (surcharges apply and can be found in the Fees section).


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There are many different opinions behind video games. Many people agree that playing video games have more cons than they do pros. As awesome as video games are they can lead to a variety of problems but also produce a lot of fun. Here are a few pros and cons when dealing with video games.
Video Game Pros
Video games produce a lot of fun and excitement for an individual or family. They can provide hours upon hours of enjoyment and thoroughly replace boredom immediately. There are not too many other activities that can provide the enjoyment that playing video games provide. The action and competition associated with playing video games is unparalleled. Not only are video games fun to play but also the graphics never get lackluster. Also some video games are designed to teach the skills necessary for making a living as they give the gamer a variety of different choices. Video games also confront gamers with issues such as moral dilemmas, solving challenging problems, and developing social relationships as well. Children who play video games often have the pick up from a cluttered area than those that do not. In fact, studies are now showing that when learning is added into video game playing children begin being faster at the other activities they participate in.
The Nintendo Wii is the perfect example of video games being a load of fun for an entire family. Every family member can play using the multiplayer features on most game consoles. Game producers design games to look very appealing to everyone which will draw those that do not normally play video games to at least try it. During the holiday season, video games are mostly a big draw for the family.
Video Game Cons
the most obvious disadvantage of playing video games is the negative content that game producers allow inside these games. Games introduce to young kids profanity, bad images, violence, sex, drugs, and more. All of these bad traits are habit forming and have addictive qualities. These habits people keep with them longer than they would like. Profanity is a habit that people begin to accept as normal but it's really a habit. Violence, sex, and drugs are all habit forming too which have no need in video games. Exposing young minds to these negative characteristics is dangerous.
Another video game disadvantage is gamers easily become loners and not very sociable because of their addiction to playing games. Many kids would rather play their game than go outside and play with the other kids. Because you can enjoy playing video games playing solo without someone else playing alongside you, really keeps a kid locked away inside his room. Parents need to observe this type of behavior and break this before it leads to other negative characteristics.
The addiction that comes with playing video games is hard to break. An addiction that is created at an early age sometimes continues until adulthood and beyond. Video games can be the biggest waste of productive time of anything. Many people struggle with spending hours on the video game. You can get lost playing hours and hours of video games to the point where you cannot stop. This is a potential bad habit that breaks up many relationships.


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The Curious Case of Benjamin Button was filmed in LA! Friday night movie plans: check. #BradPitt #BootFilmsFriday pic.twitter.com/6LU1LJ4oxg
Did someone say Django Unchained was filmed in Louisiana? Guess what we're watching this weekend... #bootfilmsfriday pic.twitter.com/I02VxHpn7x
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Monday makes us wanna... @MTVScream pic.twitter.com/LhsalqWCiF
Our thoughts and prayers are with the BRPD, the East Baton Rouge Sheriff's Dept., & all of their families. #BRproud pic.twitter.com/OXbXxtr1NL
MPCA's "Arena"
"...a state-of-the-art facility that enabled us to make a high-quality movie for a reasonable price..."
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VP of Production, MPCA
Sony's "Battle:Los Angeles"
"We were well taken care of and had a fantastic experience."
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Fox's "The Fantastic Four"
"We had a large footprint and were looking for a facility that could handle it all, and we found it in Celtic."
Todd Lewis
Unit Production Manager
HBO's "True Blood"
"The Celtic team really went above and beyond to help make our shoot successful."
- Mark McNair
Summit Entertainment's "Twilight Saga: Breaking Dawn Parts 1 & 2"
"One stop shopping for every production need. A new dynamic facility that caters to every facet of the process...
- Bill Bannerman
NBC Universal's "Battleship"
"Celtic Media Centre is a terrific facility that made all things possible..."
- Duncan Henderson
Producer of Battleship & Oblivion


text: AdChoices Terms of Use Privacy Policy Hide TOP 10 Top 10 Travel Beyond Bar Hopping: Dallas Share Tweet 0 Shares 4. Pop-Up Restos And Bars Brown Guacamole/Flickr You know that empty warehouse next to the bar you always go to? It can be easily ignored. That is, until an adventurous chef or mixologist decides to turn it into your new favorite limited-engagement restaurant. Pop-up restaurants and bars can happen almost anywhere: an empty storefront, a brewery, a boat. And if you're lucky enough to secure a reservation, you'll be treated to an exclusive culinary experience meant to introduce your palate to such delicacies as short ribs, braised pork belly and things fried in duck fat. Yes, you can fry things in duck fat. Next Page TOP 10 9 8 7 6 5 4 3 2 1 Comments Share your opinion Your name More Like This Sponsored Ad Content 10 Ways To Celebrate The Greatness Of Boston Read More Sponsored Ad Content 10 Manly Nights Out Inspired By America's Manliest City Read More Sponsored Ad Content 10 Dates That Will Have The Country's Hottest Women Take Notice Read More Sponsored Ad Content 10 Ways Guys Can Make The Most Of This Weekend, Chicago-Style Read More Sponsored Ad Content 10 Nights Out Your Friends Will Forever Be Grateful For Read More Sponsored Ad Content 10 Ways The Most Powerful Men In America Reward Themselves Read More Around the Web Special Features Special Feature The Ultimate Guide To Hooking Up Online Read More Guy Gear The Best Watches Under $500 Read More


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POLL-ASSAM-TRENDS - Dhubri: AIUDF Najrul Haq leading over BJP ...Contributed by NAMPA / PTI. Golakganj: BJP Ashwini Rai Sarkar leading by over 1,500 votes over Congress rival Abdus Sobahan Ali Sarkar. Gauripur: BPF sitting MLA Banendra Mushahary trailing behind AIUDF candidate Nijanur Rahman. Nalbari: BJP ... Namibia Press Agency, 2 months ago
PTI - POLL-ASSAM-TRENDS - Dhubri: AIUDF Najrul Haq leading over BJP rival Debamoy Sanyal by over 400 votes. - Namibia Press Agency, 2 months ago
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India Inc saddened by Rajan's decision over 2nd term
Top industry leaders on Saturday said RBI Governor Raghuram Rajan's decision not to take a second term will be nation's loss as he brought economic stability and enhanced India's credibility on the world stage. India Inc led by Anand Mahindra, ...The Hindu, 1 month ago
Inflation-wary RBI hits pause on rate cuts
RBI says it will wait for uncertainty over monsoon and commodity prices to clear up before deciding on further cuts Mumbai: The Reserve Bank of India (RBI) has hit the pause button on interest rate cuts. With inflation showing signs of picking up, ...Livemint.com, 1 month ago
Revolutionary Bhagat Singh And Freedom Movement
Countercurrents.org History is always subject of debates for various reasons. The one which cropped up recently around Bhagat Singh had a new dimension to looking at the past. This relates to changed perception of a word in the context of current ...Counter Currents, 2 months ago
As it happened: BJP's historic victory in Assam ends ...
Highlights 15:52 (IST) BJP won in Assam because Congress contested alone: Nitish Kumar "There is not much reason to celebrate for BJP. They (BJP) won (in Assam) because Congress decided to contest alone," ANI quoted Bihar CM Nitish Kumar ...Firstpost.com, 2 months ago
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Highlights 13:58 (IST) Tarun Gogoi: We accept defeat, no chance of alliance with AIUDF Tarun Gogoisaid at a press conference that the party accepts defeat but will play the role of a constructive Opposition. "With all humbleness we ...Firstpost.com, 2 months ago
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Holiday Inn Express Ramsey-Mahwah, Ramsey
- Free buffet breakfast, free WiFi, and free parking
Main amenities
- 79 smoke-free guestrooms
- Coffee shop/café
- Business center
- 24-hour front desk
- Coffee/tea in a common area
- Air conditioning
- Daily housekeeping
- Front desk safe
- Laundry service
- Free newspapers in the lobby
For families
- Cribs/infant beds (surcharge)
- Rollaway/extra beds available
- Microwave
- Refrigerator
- Premium TV channels
- Free toiletries
What's around
- Lower Hudson Valley Challenger Learning Center (4.1 mi / 6.6 km)
- Ramapo College of New Jersey (4.4 mi / 7.1 km)
- Suffern Railroad Museum (4.5 mi / 7.3 km)
- Campgaw Mountain Ski Area (5.4 mi / 8.8 km)
- Ramapo Valley County Reservation (6.6 mi / 10.6 km)
Holiday Inn Express Ramsey-Mahwah, Ramsey
Hotel Info: 855-239-9222from $102
- Room, 2 Queen Beds, Non Smoking
- Suite, 1 King Bed, Non Smoking
- Room, 1 Queen Bed, Accessible, Non Smoking
- Room, 1 Queen Bed, Accessible, Non Smoking (Roll-In Shower)
- Suite, 1 Queen Bed, Non Smoking
- Room, 1 King Bed, Non Smoking (Leisure)
- Standard Room, Non Smoking
- Room, Accessible, Non Smoking (One Bed)
- Room, 1 Queen Bed, Accessible, Bathtub
Also popular with travelers from the USA
At a glance
Key facts
Hotel size
- This hotel has 79 rooms
- This hotel is arranged over 3 floors
- Check-in time starts at 3 PM
- Check-out time is 11 AM
Required at check in
- Credit card or cash deposit required
- Government-issued photo ID required
- Minimum check-in age is 18
Travelling with others
- Pets not allowed
Extra people
- Roll-away beds available, charges may apply*
- Free WiFi in public areas
- Free WiFi in rooms
- Free self parking
- Extended parking
Other information
- Smoke-free property
Nearby Two Star Ramsey hotels
In the hotel
- Free buffet breakfast daily
- Coffee shop/café
- Coffee/tea in a common area
- Business center
- 24-hour front desk
- Dry cleaning/laundry service
- Laundry facilities
- Free newspapers in lobby
- Number of buildings/towers - 1
- Year Built 1986
- Safe-deposit box at front desk
- Accessible bathroom
- In-room accessibility
- Roll-in shower
In the room
- Air conditioning
- Coffee/tea maker
- Iron/ironing board
- Blackout drapes/curtains
- Pillowtop mattress
- Free toiletries
- Hair dryer
- Premium TV channels
- Desk
- Free weekday newspaper
- Free WiFi
- Free long-distance calls
- Refrigerator
- Microwave
- Daily housekeeping
Top Ramsey hotels
Recently reviewed hotels in Ramsey
- Hotel ChandlerFrom
"Perfect boutique hotel in great location. Lobby and entire hotel is an oasis of quiet to escape from the hustle bustle of NYC. Helpful friendly staff"Jul 25, 2016
- Homewood Suites by Hilton NY Midtown Manhattan/Times SquareFrom
"Wonderful hotel, friendly staff and great location! Room was large by New York standards for sure. Can't beat free breakfast in the morning, either. Will stay here again!"Jul 25, 2016
- The Lucerne HotelFrom
"Our family stayed at this hotel over the weekend. The location is perfect. The hotel staff is incredibly helpful. And it's a hotel I would stay with just my husband on our next…"Jul 25, 2016
- St Marks HotelFrom
"This is a unique place - No-frills, old-school, and cash only, but very comfortable. You feel like you're in a 70s movie about New York. I find it easy to relax in the simple…"Jul 25, 2016
Nearby hotels
Holiday Inn Express Ramsey-Mahwah, Ramsey's small print
Also known as
- Holiday Inn Express Hotel Ramsey-Mahwah
- Holiday Inn Express Ramsey-Mahwah Hotel
- Ramsey-Mahwah Holiday Inn Express
- Holiday Inn Express Ramsey-Mahwah Hotel Ramsey
- Holiday Inn Ramsey
- Ramsey Holiday Inn Express
- Holiday Inn Express Ramsey-Mahwah
Optional extras
Rollaway beds are available for USD 10 per night
Cribs/Infant beds are available for USD 10 per night
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Recent reviews
Excellent 4.2 /5 from 190 reviews
Hotel condition was good, the front desk person at night was awesome - super friendly and helpful. I think her name is Hina. My room was clean but it was very damp even with the AC running. The carpet felt wet under my feet. Other than that it was a great value. Dunkin Donuts is next door and Macaroni Grill is two doors down, easy to walk to. Note, the location is off of a VERY busy road.
The front desk staff at check-in and check-outwas professional and friendly. Breakfast was plentiful and varied. The bedding and towels were beautiful.
Another great stay and will be back again next year!
Hotel is very nice. Cookies at 5 o'clock each night and beds were very comfortable with both soft and firm pillows labeled. Also had a refrigerator and microwave in room. Only downside was ice machine on second floor broken for 2 days so had to go get ice downstairs and the hot water IS NOT HOT - it's warm and acceptable kind of but not if you like a hot shower and it was this way in multiple rooms during our families three day stay Overall I would recommend this hotel as it is very nice
Is the description of this hotel not correct? Tell us


text:
Ken Gushi's been around cars nearly his entire life, but it wasn't until he found a certain anime series featuring the Toyota AE86 that he truly found his calling. At Scion Racing's Team Day, he took some time to talk to us about his start in motorsports and how the GReddy Racing Scion FR-S held up through its first season in competition. We've got the full interview at the link below, so be sure to watch it to see everything Ken had to say.
Tags:fr-s / greddy racing / GReddy Racing Scion FR-S / interview / ken gushi / Team Day / Video / Willow Springs International Raceway
More Like This
20 July 2016, 2:03 pm 2016 Formula DRIFT Montreal Event Recap read more >>
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30 June 2016, 9:51 am GReddy Toyota 86 Unloading at Willow Springs for Testing read more >>


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Trek Bicycle Store
$50 Toward Cycling Gear or a Tune-Up
96% recommendedin LivingSocial customer ratings
North of Alligator Alley, near the Okaloacoochee Slough, a 14-mile out-and-back biking trail takes you near the only remaining habitat of the Florida panther -- and with a little help from Trek Bicycle Store, you can see one of the last wonders of Big Cypress:
• $25 for $50 to spend on cycling gear, accessories, or toward a bike
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• Choose from four convenient locations
Trek Bicycle Store's Website
PAID VALUE EXPIRES ON July 24, 2021
PROMOTIONAL VALUE EXPIRES ON April 24, 2014
Suite 101
8001 Plaza Del Lago Drive, Estero, FL 33928
239-390-9909 | get directions
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9051 Tamiami Trail North, Naples, FL 34108
239-591-8735 | get directions
113 NW 136th Avenue, Sunrise, FL 33325
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Buy this Deal with confidence, because it's covered by the LivingSocial Good Deal Guarantee up to the Voucher Expiration DateSee Details »
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• PAID VALUE EXPIRES ON July 24, 2021
• PROMOTIONAL VALUE EXPIRES ON April 24, 2014
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So this is a bit late, but only 3 weeks into the year. That means I have 49 weeks left to make sure I stick to my resolution, as difficult as it will be.
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What does CTPL stand for?
CTPL stands for Corporate Third Party Licensing
This definition appears very rarely and is found in the following Acronym Finder categories:
- Business, finance, etc.
See other definitions of CTPL
Other Resources:
We have 16 other meanings of CTPL in our Acronym Attic
- Abbreviation Database Surfer
- « Previous
- Next »
- Change Technology Partners, Inc. (media services; Greenwich, CT)
- Clinical Teaching Perception Inventory (teaching device; University of California, Irvine)
- Corporate Tax Publishers, Inc. (Leonia, NJ)
- Center for Technology, Policy, and Industrial Development (MIT)
- Central Technical Publication Library
- Centre for Trade Policy and Law (est. 1989; Ottawa, Ontario, Canada)
- Clinton Township Public Library (Clinton, MI)
- Compulsory Third Party Liability
- Connective Tissue Physiology Laboratory (University of Houston)
- Consorzio Trasporti Piana di Lucca (Transportation Consortium for the Lucca area, Italy)
- Certified Telecommunications Project Management (IT certification)
- Certified Texas Procurement Manager
- Comité Technique Paritaire Ministériel (French: Joint Technical Committee; French Civil Service)
- Common Tactical Picture Manager
- Compagnie des Transports du Pays de Montbéliard (French transportation company)
- Content Traffic Presell Monetize
- Continuous Time Packet Model
- Critical Technical Parameter Matrix
- CTP Manager (GCCS)
- Central Texas Provider Network


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Offering riding lessons from children to adult all levels of experience, including therapeutic. Day camp from June thru Aug. Also,Boarding and trailering…
We are a "green" school located on farmland and abutting 22+acres of land trust.
Boarding and training for dressage and eventing
Sport Pony Breeder. Producing top quality athletes from top GRP, Welsh and Warmblood bloodlines, to excel in Dressage, Jumpers, and eventing.
Full Boarding Horse Training Riding Lessons Trailering Horse Agent
we are a family only farm raising riding breeding and training our Gypsy horses
Zach's Water's Edge Farm is a small family farm located in Sudbury, Massachusetts, dedicated to serving our community with products and services that…
100 acre farm in Hopkinton, MA. 7 stall barn. Large airy stalls, lighted outdoor ring. Plenty of green turn-out.
Bayard, NE


text:
Anesthesia (Doctor of Anesthesia Practice)
Requirements. A minimum of 32 credits as shown below.
- Core courses (16 credits).
1. Practice inquiry (3 credits).
ANE 730 - Evidenced-Based Practice of Nurse Anesthesia.
2. Professional Role/Leadership (3 credits). One from:
NUR 840 - Organizational and Administrative Theory.
PUB 501 /ANE 601 Administrative Organization and Behavior.
MGT 541 - Organizational Behavior.
3. Healthcare Improvement, Public and Social Policy (3 credits) One from:
HCR 505 /ANE 605 - Health Policy.
HCR 587 /ANE 687 - Legal Issues in Health Care.
NUR 820 - Health Policy and Economics. and a 1-credit elective
4. Technology and Informatics (2 credits). One from:
ANE 710 - Technology and Informatics for CRNA.
NUR 607 - Informatics.
5. Health Systems Management (3 credits). One from:
HCR 511 /ANE 611 - Economic Applications in Health Administration.
HCR 525 /ANE 625 - Contemporary Issues in Health Care Management.
HCR 577 /ANE 677 - Financial Management in Health Care.
6. Ethics (1-3 credits).
ANE 720 - Ethical Issues in Nurse Anesthesia.
- Cognates (9 credits).
Must include a graduate-level methods course specific to the student's capstone project. Remaining cognate courses selected in consultation with advisor from specific area of interest (e.g., business, education, healthcare administration, etc.).
- Capstone sequence (7 credits). Demonstrated acquisition of advanced knowledge through a project tailored to reflect scholarship in core or elective areas. The form the project assumes will be determined in consultation with the student's faculty advisor.
ANE 801 - Capstone Project Design.
ANE 802 - Capstone Project Implementation.
ANE 803 - Capstone Analysis and Dissemination.
- An overall cumulative grade point average of B or better in all required courses, with a grade of B (3.0) or better in each course.
- Dissemination of the results of the capstone project. Acceptable methods of dissemination include submission for poster presentation at a state or national (preferred) level professional association meeting, submission of a manuscript for publication in a peer-reviewed professional journal, or oral presentation in a research/professional symposium. Other methods require the approval of the program director.
- Maintained licensure as a Registered Nurse in at least one state and certification or recertification as a Certified Registered Nurse Anesthetist.
Time Limit to Complete Degree
A student must complete all work toward the program within six consecutive years from the date of first admission to the program. Students may, however, request or petition for an extension of this time limit. Approval of the extension is at the discretion of the program director, in consultation with program faculty. A continued enrollment fee of $250 will be charged during any semester the student is not enrolled in any coursework or capstone course.
Transfer of Credit
Up to nine (9) semester credit hours of graduate credit completed at an accredited institution may be accepted for transfer. Transfers of credit are subject to the approval of the program director. Requests for transferring additional coursework may be made by submitting a petition to the program director. The program faculty reviews petitions.
Read More


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