text:
The star-crossed career of Washington receiver James Johnson is over. He is retiring due to a lingering wrist injury suffered last fall, the school announced Thursday.
Johnson showed great promise when he caught 39 passes as a true freshmen in 2009 -- including the first touchdown of Steve Sarkisian's tenure against LSU. That proved to be a career high as injuries derailed two of his past three seasons. In total, he played in 30 games at the UW, catching 68 passes for 791 yards and seven touchdowns.
Johnson, who would have been a fifth-year senior this fall, will remain on athletic scholarship until he completes his degree.
Washington is fairly solid at receiver. It's top-six pass catchers from 2012 are returning this fall, though tight end Austin Seferian-Jenkins is presently suspended due to a DUI arrest and two of those six were tailbacks.
The school also announced that four players have requested and been granted their release: WR Jamaal Jones, DB Darien Washington, TB Erich Wilson II and LB Evan Zeger. None were in the starting mix.
In fact, the Huskies needed some roster attrition to fall under the 85 scholarship limit this fall, so these sorts of moves were expected.


text:
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subset: commoncrawl


text:
The Demand for Disaggregated Food-Away-from-Home Products
Food away from home (FAFH) is an important component of the demand for food and hence, the nutritional intake of adults and children in the United States. Hence, policies designed to influence nutritional outcomes should address the role of FAFH. However, most studies of the response of demand for food to policy changes have ignored the role of FAFH, which means the estimates must be biased, while those studies that have included FAFH have treated it as a single good, giving rise to potential aggregation biases. In this study we estimate a demand system including a FAFH and alcoholic beverages composite (i.e., the aggregate of the three products modeled in the second stage), along with nine food at home (FAH) products (cereals and bakery products, dairy, red meat, poultry, fish, eggs, fruits and vegetables, other foods, and nonalcoholic beverages), and a nonfood composite. We also model allocations within the FAFH and alcoholic beverages composite, treating it as the second stage of a two-stage budgeting process. We estimate the demand for two FAFH products: food from full-service restaurants and other FAFH (including food from limited-service restaurants, vending services, and employee and school cafeterias) and alcoholic beverages as a weakly separable group. Using both the first- and second-stage estimates, we approximate elasticities of demand for disaggregated FAFH products conditional on total expenditure for nonfood. We find that the demands for the two FAFH products respond differently to changes in their own-product prices, other product prices and total expenditure for all goods.
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text:
List contains actors like Dennis Quaid and Ben Foster.
If you want to answer the questions, "Who starred in the movie Pandorum?" and "What is the full cast list of Pandorum?" then this page has got you covered.
This cast list of who was in Pandorum includes both lead and minor roles. (25 items)
- 1
Dennis Quaid Stripes, Any Given Sunday, The Day After Tomorrow
- 2
Ben Foster X-Men: The Last Stand, Lone Survivor, 30 Days of Night
- 3
Norman Reedus Blade II, American Gangster, The Boondock Saints
- 4
Cam Gigandet Twilight, The Twilight Saga: New Moon, The Twilight Saga: Breaking Dawn - ...
- 5
André Hennicke Downfall, Pandorum, A Dangerous Method
- 6
Jon Foster Terminator 3: Rise of the Machines, Pandorum, Thirteen Days
- 7
Cung Le Pandorum, The Man with the Iron Fists, Fighting
- 8
Yangzom Brauen Pandorum, Æon Flux, Cargo
- 9
Antje Traue Man of Steel, Pandorum, Seventh Son
- 10
Eddie Rouse American Gangster, Pineapple Express, Pandorum
- 11
Wotan Wilke Möhring Pandorum, The Experiment, Soul Kitchen
- 12
Friederike Kempter Pandorum, Oh Boy, Eight Miles High
- 13
Neelesha Barthel Pandorum, Samsara, Everyday
- 14
Niels Bruno Schmidt Pandorum, The Baader Meinhof Complex, School's Out
- 15
Jeff Burrell Pandorum, Must Love Death, Tarzan
- 16
Delphine Chuillot Pandorum, Pola X, Parc
- 17
Domenico D'Ambrosio Pandorum, Case 39, Curiosity & the Cat
- 18
David P. Johnson Pandorum, Betrayed at 17, Plaguers
- 19
Asia Luna Mohmand Pandorum, 8:28 am, Princess Painting
- 20
Don Jeanes Transformers: Dark of the Moon, Pandorum
- 21
Albrecht Marco The Girl with the Dragon Tattoo, Pandorum
- 22
Virginia Welch Pandorum
- 23
Dawid Szatarski Pandorum
- 24
Julian Rappe Pandorum
- 25
Nico Marquardt Pandorum


text:
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|21st January 2014 07:52
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|13th May 2016 09:01
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Posts: 2856
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Posts: 1603
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AndrewB said:
This will play out much like the breakup of the EU. It just might take a long time. Think of Texas like Germany, and think of California and New York like Greece and Spain, and it's a pretty good analogy.
Posts: 4440
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Posts: 5437
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MajorRawne said:
In a way, this reminds me of Scotland wanting to secede from the UK. What the hell are Scotland and these states going to do on their own? Will they require lots of money and assistance from the union they are seceding from, as I presume they will? It's all very interesting but are they simply signing their own death warrants?
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AAC encoder/decoder for Flash
- Status Closed
- Budget N/A
- Total Bids 1
Project Description
We need to encode/decode AAC audio inside Flash.
The project is very similar to Ogg Vorbis encoder/decoder already written for Flash, available on Adobe Alchemy Labs
- see [url removed, login to view]:Libraries
Maximal length of input audio is 15 seconds. Encoding process should be as fast as possible, or delegated into pseudo-thread (broken down into multiple frames).
Please read the project first and write the word "Understood". Also write your steps and suggestions to complete the project with a short description of what you understood.Get free quotes for a project like this
Skills Required
Looking to make some money?
- Set your budget and the timeframe
- Outline your proposal
- Get paid for your work
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- Forbes
- The New York Times
- Time
- Wall Street Journal
- Times Online


text:
Summary | Excerpt | Reviews | Beyond the book | Readalikes | Genres & Themes | Author Bio
Jim Praley is not quite sure what to make of Tulsa, the city where he grew up, and went to high school; the city he was a little too eager to leave behind when he finally left for college. At the start of Benjamin Lytal's soulful debut, A Map of Tulsa, Jim has finished his first year of college and is back home in Tulsa for the summer. Already the prodigal son act is one marked with defeat Jim only returns home because he didn't get a summer job with the campus newspaper. Never mind, he tells himself, he will set a systematic course of study over the summer, one that will leave him amply prepared to choose a major, come sophomore year. "I came back to Tulsa that summer for different reasons. To prove that it was empty. And in hopes that it was not," Jim says.
As he finds out over the course of that intense summer, "empty" Tulsa is not. It still isn't the dynamic city...
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text:
DucLe Photographer
Belen CorsoModel Female Pomona, California, US
My MM URL: http://www.modelmayhem.com/belencorso
Mayhem # 2673942
About MeHello to you! >Argentinian model here :D
Yes I do trade work!
I am feeling very creative, I am looking to work with any photographer who's been in need to explore their inconclusive side...where that lexical gap resides..That corner of your mind that dawns a sui generis every night while you suffer from insomnia. If you have new concepts, new ideas and most specially someone who isn't afraid to work with surrealism,lets be a team together and make it real.
I found myself immersed in love for surrealism, but I also enjoy shooting anything that requires me to pose without a bare ass. Anything that you can imagine me doing I can take into consideration, I am very open minded and I love it when photographers play with lights and shadows during shots.
I am a singer on the wait for a good recording with the band, but for now I am staying busy with promotional modeling, if you have any opportunities available for promotional I will gladly take them, bilingual, on time, communicative, and always have endless amounts of energy.
For my future there are plans to improve our society,
one of them is to start my own non-profit organization for special children, one that will provide kids with their required supplies to start being an artist.
Music is my life, maybe I will end up being a classical music composer:D
Writing is also one of my daily passions, I will push towards an awakening.
I love humans, though sometimes they are scary, trying to hide their truths,
your defect calls your name, I can see it in your face, be you, don't reflect, emit.
Have you worked with Belen Corso? Add Credits for Belen Corso! >>
Susan Frick Cowles Photography
"Experienced Model. So easy to work with and a very hard worker. A real trooper when it comes to the shoot going over the expected time."
See Sample Worked together 2-10 times; Most recent: August 2015
DucLe Photographer
mjwolfe2012 Model
trianbampol Photographer
Rico Angelo Photography Photographer
Adam Ayash Official Model
Norma Saballos Photographer
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text:
eBay Store html
This project received 4 bids from talented freelancers with an average bid price of $153 USD.Get free quotes for a project like this
Project BudgetN/A
Total Bids4
Project Description
The candidate we are looking for must have the knowledge of eBay store design and html template coding/installation.
This project include installing html custom design of eBay Store, custom designed html listing template and FTP hosting.
Candidates must bid with references of the stores that they have previously worked on or still working on. Your feedback should also show that you have the knowledge.
This is long term work.
Here is an example of a store that you can see what we are talking about: [url removed, login to view]
If you have viewed that store and you know that you can't do it. Don't waste your time to bid.
Skills Required
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- Set your budget and the timeframe
- Outline your proposal
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text:
Samsung Begins Producing Industry's First Four Gigabit LPDDR3 Mobile DRAM
According to Samsung, the major upside with these mobile chips is that they offer comparable performance to standard DRAM found in desktop and laptop computers. The speedy chips transmit data at up to 2,133 megabits per second (Mbps) per pin, which is more than double the performance 800Mbps LPDDR2. Samsung says it's possible to transmit three Full HD videos totaling 17GB (collectively) in just one second over the new chip embedded in a mobile device.
"By providing the most efficient next-generation mobile memory with a very large data capacity, we are now enabling OEMs to introduce even more innovative designs in the marketplace," said Young-Hyun Jun, executive vice president, memory sales & marketing, Samsung Electronics. "Our 20nm-class four gigabit mobile DRAM provides another example of our ability to deliver well-differentiated, high-performance, high-density memory to customers in a timely manner."
Compared to 30nm-class LPDDR3 DRAM, Samsung says devices that use the new 20nm-class chips offer a 30 percent improvement in performance and 20 percent savings in power consumption. At the same time, Samsung says OEMs can have a 2GB package that includes four of Samsung's new chips in a single package that meets the memory package height of 0.8mm, so the chips won't affect the size of upcoming devices.


text:
Clinical aspects and cytokine response in severe H1N1 influenza A virus infection
DOI: 10.1186/cc9324
© Hagau et al.; licensee BioMed Central Ltd. 2010
Received: 2 September 2010
Accepted: 9 November 2010
Published: 9 November 2010
The immune responses in patients with novel A(H1N1) virus infection (nvA(H1N1)) are incompletely characterized. We investigated the profile of Th1 and Th17 mediators and interferon-inducible protein-10 (IP-10) in groups with severe and mild nvA(H1N1) disease and correlated them with clinical aspects.
Thirty-two patients hospitalized with confirmed nvA(H1N1) infection were enrolled in the study: 21 patients with nvA(H1N1)-acute respiratory distress syndrome (ARDS) and 11 patients with mild disease. One group of 20 patients with bacterial sepsis-ARDS and another group of 15 healthy volunteers were added to compare their cytokine levels with pandemic influenza groups. In the nvA(H1N1)-ARDS group, the serum cytokine samples were obtained on admission and 3 days later. The clinical aspects were recorded prospectively.
In the nvA(H1N1)-ARDS group, obesity and lymphocytopenia were more common and IP-10, interleukin (IL)-12, IL-15, tumor necrosis factor (TNF)α, IL-6, IL-8 and IL-9 were significantly increased versus control. When comparing mild with severe nvA(H1N1) groups, IL-6, IL-8, IL-15 and TNFα were significantly higher in the severe group. In nonsurvivors versus survivors, IL-6 and IL-15 were increased on admission and remained higher 3 days later. A positive correlation of IL-6, IL-8 and IL-15 levels with C-reactive protein and with > 5-day interval between symptom onset and admission, and a negative correlation with the PaO2:FiO2 ratio, were found in nvA(H1N1) groups. In obese patients with influenza disease, a significant increased level of IL-8 was found. When comparing viral ARDS with bacterial ARDS, the level of IL-8, IL-17 and TNFα was significantly higher in bacterial ARDS and IL-12 was increased only in viral ARDS.
In our critically ill patients with novel influenza A(H1N1) virus infection, the hallmarks of the severity of disease were IL-6, IL-15, IL-8 and TNFα. These cytokines, except TNFα, had a positive correlation with the admission delay and C-reactive protein, and a negative correlation with the PaO2:FiO2 ratio. Obese patients with nvA(H1N1) disease have a significant level of IL-8. There are significant differences in the level of cytokines when comparing viral ARDS with bacterial ARDS.
Originating from Mexico and spreading initially in the United States and Canada, a novel influenza A(H1N1) virus infection (nvA(H1N1)) of swine origin spread globally during spring 2009 to mid-February 2010. Rates of hospitalization and death have varied widely according to country [1].Among hospitalized patients 9 to 31% have been admitted to intensive care units (ICUs) where the rate of death was 14 to 46%[2–6].
In Romania the pandemic wave lasted from September 2009 to February 2010, reaching a peak in December. The Romanian Ministry of Health reported 7,008 confirmed cases of nvA(H1N1) influenza, the death rate being 1.9%.
Primary influenza pneumonia had a high mortality rate during pandemics not only in immune-compromised individuals and patients with underlying co-morbid conditions, but also in young healthy adults [7].
During nvA(H1N1) virus infection, experimental and clinical studies have identified dysregulated systemic inflammation as an important pathogenetic mechanism correlating with severity and progression of the disease [8, 9]. The role of most immune responses in controlling and clearance of H1N1 influenza A or its contribution to severe respiratory compromise is not well known.
To and colleagues found higher plasma levels of proinflammatory cytokines and chemokine in the group of patients with acute respiratory distress syndrome (ARDS) caused by viral A(H1N1) influenza, throughout the initial 10 days after symptom onset [8]. Bermejo-Martin and colleagues found that mediators involved in the development of Th17 cells (IL-6, IL-8, IL-9, IL-17), Th1 cells (TNFα, IL-15, IL-12p70) and type II interferon (IFNγ) had high systemic levels in hospitalized patients with nvA(H1N1) influenza [9]. The detrimental or beneficial role of these cytokines in severe illness is not known.
The aim of our study was to further investigate the profile of Th1 and Th17 mediators and interferon-inductible protein-10 (IP-10), an innate-immunity mediator, as early host response in a group of critical and noncritical hospitalized patients with nvA(H1N1) from Cluj-Napoca, Romania, and to correlate them with the clinical aspects.
Materials and methods
Patients and controls
The study was performed between October 2009 and February 2010 in the ICUs of the Emergency County Clinical Hospital and of the Teaching Hospital of Infectious Diseases, Cluj-Napoca, Romania.
Thirty-two patients hospitalized with nvA(H1N1) infection were enrolled in the study: 21 patients with nvA(H1N1)-ARDS, and 11 patients with nvA(H1N1)-mild disease. Additionally, 20 patients with bacterial sepsis-ARDS were included and served to compare the cytokine levels between the nvA(H1N1)-ARDS group and the bacterial sepsis-ARDS group.
The study protocol was approved by the Ethics Committee for Clinical Research of the University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj Napoca and the hospital authority. Informed consent was obtained from each patient or their legal representative.
The inclusion criteria were age > 16 years, symptoms compatible with influenza and confirmed nvA(H1N1) virus, bacterial severe sepsis with ARDS, and informed consent. The exclusion criteria were age < 16 years, known infection by human immunodeficiency virus, patients with other respiratory viral infections, bacterial sepsis without ARDS-syndrome, and refusal to consent.
The control group included 15 healthy volunteers without chronic or acute disease.
Data were recorded prospectively by investigators at each hospital. The following data were recorded: age, sex, pregnancy, underlying diseases (chronic obstructive pulmonary disease, asthma, diabetes, chronic heart failure, chronic renal failure, cirrhosis, immunosuppression), obesity defined as body mass index > 30, and the time in days from symptom onset to hospital admission. Hematological, biochemical and microbiological results were included in the database. The extension of lung infiltrates on chest X-ray scan was registered as the number of quadrants involved. The severity and prognosis of the illness was assessed in adults using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sepsis-related Organ Failure Assessment (SOFA) score. ARDS was defined using the 1994 American-European Consensus Conference definitions [10]. The pulmonary dysfunction score was based on the PaO2:FiO2 ratio, ranging from 0 to 3 where grade 0 represented a ratio less or equal to 250; grade 1, a ratio ranging from 250 to 175; grade 2, a ratio ranging from 100 to 175; and grade 3, a ratio less or equal to 100[11].
A(H1N1) influenza virus presence was confirmed by testing nasopharyngeal swabs or bronchoalveolar lavage specimens with real-time PCR (commercial kits: Full Velocity SYBR Green QRT-PCR/SuperScript III Platinum One-Step Quantitative RT-PCR Taqman; Invitrogen Corporation, Carlsbad, California, USA) at The National Influenza Centre of Cantacuzino Institute, Bucharest, Romania.
Cytokine and chemokine quantification
In patients with nvA(H1N1)-mild disease, the serum samples were taken on hospital admission. In patients with nvA(H1N1)-ARDS infection, the serum samples were taken on admission to the ICU and 3 days later to determine cytokine kinetics. The installation of ARDS, either viral or bacterial, in the course of the disease determined the time of admission to the ICU. In patients with bacterial sepsis-related ARDS, the serum samples were taken on admission to the ICU.
The enrolled patients and the healthy volunteers gave whole blood, which was clotted for 30 minutes at 37°C and stored at -70°C until use. The resulting serum was used for cytokine determination.
Seven different serum cytokines (IL-6, IL-8, IL-12p70, IL-15, IL-17, TNFα and IFN-γ) were measured with Luminex 200 (Luminex Corporation, Austin, TX, USA) using a multiplex cytokine kit along with the assay performed in accordance with the manufacturer's instructions (R&D Systems, Minneapolis, MN, USA). Additionally, we used ELISA kits for quantitative determination of the two cytokines IL-9 and IP-10 (Quantikine; R&D Systems).
Statistical analysis
Subjects were stratified into three groups: 11 patients with nvA(H1N1)-mild disease, 21 patients with nvA(H1N1)-ARDS, and 20 patients with bacterial sepsis-ARDS.
Descriptive statistics included means and standard deviations or medians and interquartile ranges for continuous variables of normal and non-normal distributions. Clinical and biochemical characteristics and cytokine levels were compared. The Fisher exact test and the chi-square test were used for categorical variables. The Mann-Whitney U test was used for nonparametric variables. The Wilcoxon test (nonparametric test) was used to compare two paired groups. The association between nonparametric variables was determined by the Spearman correlation coefficient (r). Any value of P < 0.05 was considered statistically significant. GraphPad Prism version 5.03 Software for Windows (GraphPad Software, La Jolla, California, USA) was used.
Demographic, co-morbidities and clinical characteristics of the patients
Characteristics of patients
All patients with nvA(H1N1) infection (n= 32)
nvA(H1N1)-ARDS group (n= 21)
nvA(H1N1)-mild disease group (n= 11)
P valuea
ARDS bacterial sepsis group (n= 20)
P valueb
Age (years)
37 (30.7 to 52)
42 (33.5 to 55.5)
33 (18 to 35)
57 (38.5 to 66)
Sex ratio (male/female)
Underlying disease
Cardiovascular disease
8 (25%)
10 (31.25%)
Obesity (BMI > 30)
13 (40.6%)
Type 1 or 2 diabetes
2 (6.3%)
3 (9.3%)
3 (9.3%)
3 (9.3%)
Interval between symptom onset and hospital admission (days)
4.5 (2 to 7)
6 (3.5 to 8.5)
2 (2 to 3)
2 (0 to 3)
Presenting symptoms
Fever > 38°C
28 (87.5%)
32 (100%)
25 (78%)
24 (75%)
SOFA score
6.1 (± 3.29)
7.2 (± 4.2)
APACHE II score
12.6 (± 6.62)
15.14 (± 6.36)
16.3 (± 6.03)
Respiratory condition
SaO2 < 94%
23 (71.8%)
PaO2:FiO2 ratio
1.96 (± 0.83)
1.72 (± 0.68)
Mechanical ventilation
11 (34.3%)
Non-invasive ventilation
10 (31.3%)
Initial chest X-ray scan
Extensive bilateral multilobar infiltrates
21 (65.6%)
Secondary bacterial pneumonia
3 (9.4%)
3 (9.4%)
1 (3.1%)
Acute renal failure requiring renal replacement therapy
4 (12.5%)
Length of hospital stay (days)
10 (7 to 12.7)
11 (10 to 14)
6 (6 to 9)
< 0.001
18 (13 to 41)
ICU length of stay (days)
4.5 (1 to 7.5)
7 (5 to 9)
16.5 (1 to 33)
In-hospital death
7 (21.8%)
Among 21 patients with nvA(H1N1)-ARDS, four developed acute renal failure requiring renal replacement therapy, two developed secondary bacterial pneumonia and three developed pneumothorax (Table 1). Ten patients from the nvA(H1N1)-ARDS group received non-invasive ventilation and 11 patients received mechanical ventilation.
Pregnancy was another risk factor for nvA(H1N1)-ARDS infection and ICU admission (3/21 cases; Table 1). Two pregnant women were in the third trimester and one was in the second trimester. No underlying disease was noted. The range interval after symptom onset and ICU admission was 3 to 7 days. Caesarean delivery was necessary in two cases. All pregnant women required respiratory support (two invasive and one non-invasive) during hospitalization and all survived.
Seven patients died in the nvH1N1-ARDS group. Histopathological changes were similar in all cases: tracheitis, bronchitis with focal squamous metaplasia, necrotizing bronchiolitis, emphysema, extensive diffuse alveolar damage associated with alveolar hemorrhage and marked hyaline membrane formation, fibrosis and granulocyte pulmonary infiltrates. Pulmonary thromboemboli with focal infarcts were observed in three cases.
Laboratory characteristics of the patients
Laboratory characteristic
All patients with nvA(H1N1) infection (n= 32)
nvA(H1N1)-ARDS group (n= 21)
nvA(H1N1)-mild disease group (n= 11)
P valuea
ARDS bacterial sepsis group (n= 20)
P valueb
Leukocyte count (x103/μl)
9.8 (7.5 to 11.8)
9.7 (8 to 12.3)
9.9 (6 to 10.5)
14.2 (8.2 to 20.5)
Lymphocyte count (x103/μl)
1.05 (0.7 to 1.87)
0.9 (0.6 to 1.3)
1.6 (0.9 to 2.5)
1.38 (1.12 to 2.9)
Platelet count (x103/μl)
218 (180 to 270)
218 (169 to 288)
218 (180 to 270)
241 (142.8 to 298)
C-reactive protein (mg/dl)
4.8 (1.2 to 9.6)
5.35 (4 to 10.2)
1.2 (0.6 to 4.4)
9.8 (5.75 to 22)
Procalcitonin (ng/ml)
0.23 (0.05 to 0.85)
0.39 (0.11 to 1.12)
0.06 (0.05 to 0.06)
6.3 (4.6 to 11.5)
< 0.001
LDH (IU/l)
698 (360 to 980)
890 (618 to 1134)
360 (250 to 400)
< 0.001
547 (408 to 812)
ALT (IU/l)
30.5 (17 to 80.75)
43 (21 to 92.5)
22 (15 to 30)
25 (13.5 to 50.75)
AST (IU/l)
42 (20 to 98)
95 (32.5 to 164)
17 (16 to 28)
< 0.001
25 (20 to 656)
Total protein level (mg/dl)
6.75 (6 to 7.55)
6.2 (5.8 to 7)
8 (7 to 8)
< 0.001
5.4 (4.8 to 6.4)
Creatinine level (mg/dl)
0.96 (0.6 to 1.17)
1.1 (0.9 to 1.25)
0.6 (0.5 to 0.8)
< 0.001
1.55 (1 to 2.37)
Twenty patients with bacterial sepsis-ARDS were included to compare the cytokine levels in viral and bacterial ARDS. Immune suppression (six patients with cancer) was more common in the bacterial sepsis-ARDS group (P = 0.044). The mean (standard deviation) APACHE II score, SOFA score and PaO2:FiO2 ratio were similar in both groups (Table 1). The leukocyte count, C-reactive protein and procalcitonin levels were higher in the bacterial ARDS group than in the nvA(H1N1)-ARDS group (P = 0.047, P = 0.05 and P < 0.001, respectively) (Table 2).
Cytokine levels according to interval between symptom onset and admission in 32 hospitalized nvA(H1N1) patients
Cytokine (pg/ml)
1 to 5 days
6 to 14 days
P value a
9.8 (7.1 to 14.65)
18 (13.76 to 84.47)
16.63 (9.4 to 41.12)
39.89 (20.62 to 79.84)
9.9 (9.1 to 13.1)
11.5 (8.55 to 12.85)
10.67 (7.11 to 17.8)
10.67 (8.89 to 17.8)
3.9 (3.6 to 5)
6 (4.15 to 11.15)
0.56 (0.323 to 0.98)
0.323 (0.323 to 3.68)
66.85 (21.6 to 166)
60 (15.21 to 163.7)
3.4 (2.965 to 3.4)
3.822 (3.4 to 5.625)
4.15 (0.596 to 6.964)
4.15 (0.59 to 9.5)
Serum cytokine levels over time in the nvA(H1N1)-ARDS group (21 patients)
P valuec
18 (10.41 to 64.88)
11 (8.09 to 23.77)
40.14 (20.62 to 66.7)
24.47 (16.52 to 61.6)
11.3 (9.05 to 14.25)
11.3 (9.65 to 14)
10.67 (8.89 to 16.02)
14.24 (10.34 to 14.24)
5.1 (4.15 to 8.35)
5 (3.9 to 7.7)
0.98 (0.323 to 2.66)
0.323 (0.323 to 1.25)
61.42 (20.5 to 274.5)
31.23 (9.19 to 49.19)
4.15 (2.37 to 6.96)
0.596 (0.596 to 2.11)
3.4 (3.18 to 5.43)
3.4 (2.96 to 3.82)
Serum cytokine levels over time in nvA(H1N1)-ARDS survivors (14 patients)
Cytokine (pg/ml)
P valuec
14.76 (9.69 to 21.54)
8.73 (7.9 to 11.25)
36.95 (16.75 to 41.49)
22.84 (14.6 to 46.86)
10.6 (8.95 to 12.33)
11.3 (8.97 to 12.53)
10.67 (7.11 to 14.24)
14.24 (9.78 to 15.13)
4.55 (4.025 to 5.575)
4.7 (3.6 to 5.325)
0.98 (0.323 to 1.146)
0.323 (0.323 to 0.323)
57.26 (21.05 to 380.7)
29.67 (9.56 to 42.87)
4.15 (3.26 to 6.96)
0.596 (0.596 to 1.485)
3.4 (2.965 to 3.92)
3.4 (2.965 to 3.925)
Serum cytokine levels at admission and 3 days later in nvA(H1N1)-ARDS group survivors versus nonsurvivors
Cytokine (pg/ml)
P value c
P value c
14.76 (9.69 to 21.54)
64.76 (23.17 to 197.4)
8.73 (7.91 to 11.25)
26.9 (12 to 51.36)
36.95 (16.75 to 41.49)
75.41 (36 to 148.3)
22.84 (14.6 to 46.86)
61 (17.44 to 89.8)
10.6 (8.95 to 12.33)
13 (10.4 to 24.7)
11.3 (8.97 to 12.53)
14.5 (10.1 to 16.8)
10.67 (7.11 to 14.24)
14.24 (10.67 to 17.8)
14.24 (9.78 to 15.13)
10.67 (10 to 14.24)
4.55 (4.025 to 5.575)
10.6 (6.18 to 14.3)
4.7 (3.6 to 5.325)
10.4 (5.3 to 18.4)
0.98 (0.323 to 1.146)
0.323 (0.323 to 4.373)
0.323 (0.323 to 0.323)
1.2 (0.323 to 1.645)
57.26 (21.05 to 380.7)
99.87 (8.055 to 199.6)
29.67 (9.56 to 42.87)
40.2 (6.6 to 93.71)
4.15 (3.262 to 6.964)
4.15 (0.596 to 11.89)
0.596 (0.596 to 1.485)
0.596 (0.596 to 2.12)
3.4 (2.965 to 3.925)
5.43 (3.4 to 5.819)
3.4 (2.965 to 3.925)
3.7 (3 to 3.82)
Correlation between cytokine levels and clinical or laboratory characteristics in patients with confirmed nvA(H1N1) infection was determined by Spearman correlation coefficient. We found significant correlation of IL-6, IL-8 and IL-15 levels with C-reactive protein (r = 0.67, P < 0.001; r = 0.5, P = 0.003; and r = 0.48, P = 0.005, respectively), with PaO2:FiO2 ratio (r = -0.556, P = 0.001; r = -0.574, P < 0.001; and r = -0.614, P < 0.001, respectively) and with interval between symptom onset and hospital admission (r = 0.51, P = 0.002; r = 0.41, P = 0.019; and r = 0.48, P = 0.004, respectively).
IL-8 was significantly higher (P = 0.013) in obese versus nonobese patients with nvA(H1N1) infection.
In this study we presented the cytokine profiles following nvA(H1N1) infection in 32 hospitalized patients (11 mild and 21 severe disease) and the cytokine profiles found in 20 cases of bacterial sepsis.
The patients with severe nvA(H1N1) disease were younger than the patients with bacterial sepsis (no statistical significance). Similarly to other study groups, we found that obesity was more common in the nvA(H1N1) ARDS group, suggesting it may be a risk factor for complications and admission to the ICU[2, 5, 6]. Laboratory findings in the same group of patients include lymphocytopenia and elevation in levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase and creatinine - as in other patient groups with novel influenza virus infection [4, 6]. In contrast, the bacterial-ARDS group presented no lymphocytopenia, lower elevation in serum liver enzymes and higher levels of C-reactive protein and procalcitonin. No significant differences were found between bacterial and viral ARDS groups in SOFA and APACHE II scores at admission. The pulmonary histopathological findings in nvA(H1N1)-ARDS nonsurvivors were similar to other fatal cases of nvA(H1N1) virus infection [12, 13].
Installation of ARDS in the course of the disease was the moment of blood sampling for cytokine measurements. There was a difference regarding the time of symptom onset and hospital admission between the severe and mild groups of nvA(H1N1) disease that could affect the comparison of cytokine levels between the two groups. For this reason we not only compared the cytokine levels between mild and severe disease, but also mixed the patients with nvA(H1N1)-mild and severe disease and compared the level of cytokines according to the interval between symptom onset and admission (first interval 1 to 5 days, second interval 6 to 14 days). We found that not all cytokines had the same behavior against the time of symptom onset and admission.
The pattern of immune response in patients with nvA(H1N1) virus infection is incompletely characterized. CD4+ T cells are known to play an important role in the initiation of immune responses by providing help to other cells. T-helper cells could be divided into subsets: Th1, Th2 and Th17.
Th1 cells mainly develop following infections by intracellular bacteria and some viruses [14]. The mediators involved in the development of Th1 are IL-12, IFNγ, IL-15, IL-18 and TNFα.
IL-12 bridges the early nonspecific innate immunity and the subsequent antigen-specific adaptative immunity [15]. IL-12 was shown to inhibit apoptosis of T cells [16] and of dendritic cells [17]. Alveolar macrophages have a functional IL-12 receptor, and virus-infected macrophages in the presence of IL-12 might be protected from apoptosis limiting viral clearance [18]. Apoptosis of virus-infected cells was shown to be an effective mechanism for viral clearance [19]. Bermejo-Martin and colleagues reported more significant IL-12 results in the critical A(H1N1) group of patients [9]. In our study, IL-12 is significantly higher in the nvA(H1N1)-mild disease group and in the nvA(H1N1)-ARDS group versus the control group and is not significantly higher in the bacterial ARDS group.
IL-15 plays a critical role in protecting CD8+ T cells from apoptosis during the contraction phase following microbial infection [20, 21]. The CD8+ T cells surviving in the presence of IL-15 might be pathogenic in lung injury following highly pathogenic influenza A virus infection [22]. IL-15 activates the effector function of memory phenotype CD8+ cells [23]. In our study, IL-15 is significantly higher in the nvA(H1N1)-ARDS group versus the nvA(H1N1)-mild disease group, but without significant difference in the nvA(H1N1)-ARDS versus bacterial-ARDS groups. Similar to our results, IL-15 was a hallmark of critical illness in the Hong Kong and Spanish nvA(H1N1) cytokine studies [8, 9]. IL-15 is significantly higher at admission (P1) and 3 days later (P2) in the nvA(H1N1)-ARDS group for nonsurvivors versus survivors, so it might be pathogenic in lung injury influenza A virus infection. Similarly, To and colleagues found IL-15 significantly higher in critical A(H1N1) patients and very significant in the A(H1N1)-ARDS death group [8].
IFNγ is a cytokine of innate and adaptative immunity. Its major functions are activation of macrophages, differentiation of Th1 from T cells, inhibition of the Th17 pathway and control of intracellular pathogens [24]. Bermejo-Martin and colleagues found high systemic levels of IFNγ in hospitalized patients with nvA(H1N1) [9]. In contrast, in the present study there were no differences between the control and study groups. The IFNγ level over time in the nvA(H1N1) ARDS group was higher at admission than 3 days later, without significant difference between survivors versus nonsurvivors.
TNFα is a cytokine of innate immunity. The principal cellular targets and biologic effects include activation of endothelial cells, neutrophil activation, fever, liver synthesis of acute phase proteins, muscle and fat catabolism, and apoptosis of many cell types. In our study, we found highly increased TNFα levels in the nvA(H1N1)-mild disease, nvA(H1N1)-ARDS and bacterial ARDS groups compared to the control group. TNFα is significantly higher in nvA(H1N1)-ARDS versus nvA(H1N1)-mild disease, with similar results being found by To and colleagues and Bermejo-Martin and colleagues [8, 9]. This cytokine is also significantly increased in bacterial-ARDS versus nvA(H1N1)-ARDS.
For the groups of patients with nvA(H1N1), according to the time interval between symptom onset and hospital admission, there were no significant differences found for IL-12 and TNFα levels, but there were significant differences for IL-15 and IFNγ, levels being higher when the time interval was between 6 and 14 days. None of our patients were on oseltamivir medication between symptom onset and admission.
Th17 cells are effective in host defense against certain pathogens and tissue inflammation. Th17 mediators for the development of Th17 cells are IL-6, transforming growth factor beta, IL-8, IL-9, IL-17, IL-1 and IL-23.
IL-6 is a cytokine of innate immunity, its principal targets being the liver cells, the β cells and the naïve T cells [25]. Despite the apparently beneficial role that macrophages play in controlling early viral replication, several reports have demonstrated a more deleterious effect of these cells in influenza A viral infections by excessive inflammation in the lung attributed to IL-6 and TNFα [26]. In our study, IL-6 is increased in nvA(H1N1)-ARDS versus nvA(H1N1)-mild disease. Similarly, IL-6 and IL-15 constituted a hallmark of critical illness in the Hong Kong and Spanish nvA(H1N1) cytokine studies [8, 9]. In the nvA(H1N1)-ARDS group, the IL-6 serum level is significantly higher at admission than 3 days later. In the same group, IL-6 is significantly higher in nonsurvivors versus survivors at admission and 3 days later, which seems to further contribute to pulmonary damage and death. We found positive correlations between IL-6, IL-15 and IL-8 levels and a longer than 5 days interval between symptom onset and admission, as well as with C-reactive protein, but a negative correlation with the PaO2:FiO2 ratio, indicating the severity of the disease.
IL-8 is a chemokine of innate immunity. The chemokine's principal biologic effect is chemotaxis, being a major chemokine for neutrophil activation, and migration into tissues [24]. In our study, IL-8 is highly significant in the nvA(H1N1)-ARDS and ARDS bacterial groups versus the control group, but is not significant in mild disease. In contrast, IL-8 was increased in both critical and noncritical nvA(H1N1) hospitalized patients in the Spanish and Hong Kong studies. In our study, IL-8 is higher in nvA(H1N1)-ARDS versus nvA(H1N1)-mild disease and in bacterial ARDS versus nvA(H1N1)-ARDS. The obese patients with nvA(H1N1) disease had a significant level of IL-8. Plasma IL-8 levels are increased in normoglycemic obese subjects, related to fat mass and the TNFα system [27].
IP-10 is a chemokine of innate immunity, and macrophages and dendritic cells are the principal cell source. We found a higher level of IP-10 in nvA(H1N1)-mild disease, nvA(H1N1)-ARDS and bacterial-ARDS groups versus the control group, and no other differences between groups. In the nvA(H1N1)-ARDS group, the IP-10 level is higher at admission than 3 days after admission because of the survivors' cytokine profile. An increased level of IP-10 was found in the Spanish group as early response to nvA(H1N1) infection in both hospitalized and mild patient disease, as in the present study, while in the Hong Kong group IP-10 was significantly higher in critical patients only. In our study, IP-10 levels in nvA(H1N1)-ARDS nonsurvivors remained higher at admission and 3 days later, being not significantly correlated with the clinical outcome. Emphysema was one of our hystopathological findings and thus it might be speculated that a high level of IP-10 in nonsurvivors could be correlated with emphysema. IP-10 released by lung CD41 and CD81 T cells stimulates alveolar macrophage production of matrix metalloproteinase-12, which digests lung elastin [28, 29].
IL-17 is a cytokine of adaptative immunity. Principal cellular targets include endothelial cells with increased chemokine production and macrophages with increased chemokine and cytokine production. This cytokine's principal biologic effect is proinflammatory [24, 25]. In the present study IL-17 is significantly higher in the bacterial ARDS group versus the control group and is higher in the bacterial ARDS group versus the nvA(H1N1)-ARDS group. No significant differences between nvA(H1N1)-mild disease versus controls and between nvA(H1N1)-ARDS versus controls were found. In the nvA(H1N1)-ARDS group, IL-17 was higher at admission and lower 3 days later. In the Spanish study the IL-17 level was increased in hospitalized noncritical patients, and in the Hong Kong study no differences between groups were found, similar to the present study.
IL-9, like IL-6, is a Th2 cytokine that induces differentiation of Th17 cells and has anti-inflammatory properties. IL-9 is a cytokine of current interest associated with allergic Th2 responses and is a key modulator of antiviral immunity [30]. In our study IL-9 is significantly higher in the H1N1-ARDS group versus the control group, and is not significantly increased in mild disease - in contrast to the Spanish study, where IL-9 was increased in both critical and noncritical hospitalized patients.
Regarding the behavior of Th17 mediators in nvA(H1N1) groups of patients according to the time interval between symptom onset and admission, there were no differences for IL-9, IL-17 and IP-10 and there were significant differences for IL-6 and IL-8, the levels being higher when the interval was between 6 and 14 days. All our patients with ARDS disease were on corticosteroid treatment, because deficient corticosteroid-mediated downregulation of inflammatory cytokine transcription in ARDS patients is associated with disease progression and mortality. Many studies reported that prolonged corticosteroid treatment was associated with a significant reduction in markers of systemic inflammation [31, 32]. In the present study the blood samples for cytokine measurements were taken at admission for the bacterial-ARDS group of patients, and at admission and 3 days later for the nvA(H1N1) group of patients - for this reason, corticosteroid could not significantly affect cytokine levels.
The small number of patients enrolled in the mild disease group is one of our study limitations. Among hospitalized patients with mild flu-like syndrome, only those with risk of severe complications and of secondary outbreaks in the exposed population were sampled for real-time PCR. On the contrary, the laboratory of the National Influenza Centre of Cantacuzino Institute, Bucharest was overwhelmed, being the only centre for influenza PCR diagnosis. Another limitation is the exclusion of children, an important group with nvA(H1N1) virus infection.
In our critically ill patients with nvA(H1N1) virus infection we found increased levels of some cytokines: IP-10, TNFα, IL-15, IL-12, IL-6, IL-8 and IL-9. The hallmarks for the severity of the disease were IL-6, IL-15, IL-8 and TNFα. We found a positive correlation of IL-6, IL-15 and IL-8 with the admission delay and C-reactive protein and a negative correlation with the PaO2:FiO2 ratio. The obese patients with nvA(H1N1) disease had a significant level of IL-8. There were significant differences in the level of cytokines when comparing viral ARDS with bacterial ARDS.
Key messages
In the influenza-related ARDS group, the levels of IL-6, IL-8, IL-9, IL-12, IL-15, IP-10 and TNFα are significantly increased versus the control group. In the bacterial sepsis-ARDS group, levels of IL-6, IL-8, IL-9, IL-15, IL-17, IP-10 and TNFα are also increased versus the control group. When comparing these two groups, the levels of IL-8, IL-17 and TNFα are significantly higher in bacterial ARDS versus viral ARDS, and IL-12 is increased only in viral ARDS whereas IL-17 is increased only in bacterial ARDS. When comparing the mild nvA(H1N1) and critical ARDS influenza A groups, IL-6, IL-8, IL-15 and TNFα are significantly higher in critical ARDS patients being hallmarks of disease severity.
The serum levels of IL-15, IL-6, IL-8 and IFNγ according to the interval between symptom onset and admission in hospitalized nvA(H1N1) patients are significantly higher when this interval is longer than 5 days.
In nonsurvivors versus survivors from the nvA(H1N1)-ARDS group, IL-6 and IL-15 are increased at admission and stay higher 3 days later - which seems to further contribute to pulmonary damage and death.
There is a positive correlation of IL-6, IL-8 and IL-15 levels with C-reactive protein and with > 5-day interval between symptom onset and hospital admission, and a negative correlation with the PaO2:FiO2 ratio.
The obese patients versus nonobese patients with nvA(H1N1) infection have a significant level of IL-8.
Acute Physiology and Chronic Health Evaluation
acute respiratory distress syndrome
enzyme-linked immunosorbent assay
intensive care unit
interferon-inductible protein-10
- nvA(H1N1):
novel A(H1N1) virus
- PaO2/FiO2:
pressure of oxygen in arterial blood/fraction of inspired oxygen
polymerase chain reaction
Sepsis-related Organ Failure Assessment
- Th:
T-helper type
tumor necrosis factor.
The present work was possible thanks to the financial support for reagent and kit acquisition, obtained from the University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj-Napoca, Romania. The authors would like to thank to all of the nurses, residents and attendings for their special care to the patients with nvA(H1N1) influenza virus infection.
Authors' Affiliations
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Bulgarian Industrial Association – Union of the Bulgarian Business, in cooperation with Enterprise Europe Network invites you to participate in a brokerage event with pre-arranged face2face meetings INDUSTRYMATCHMAKING - IMM2014, B2B AND TECHNOLOGY TRANSFER MEETINGS.
Why participate?
In 2013 - 64 participants from 11 countries with following partnership agreements.
Event target audience: Representatives of companies worldwide working in the following sectors: machine building industry; metallurgy, foundry and tools; automation, robotics, mechatronics, electronic & electrotechnics, industrial electronics industries, components, measurement, telecommunications, services; plastic and rubber industry.
The face2face meetings will be held within the following specialized international exhibitions:
Language: English
If you are looking for partners in the field of green technologies, energy efficiency and renewable sources, waste management and recycling, please register for our event "Go Green to Environment" - 7 March 2014, Friday, Inter Expo Centre, Sofia.
Dates for your agenda
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Infiltration into Israel was reduced by more than 54 percent in June, according to figures by the Interior Ministry's Population and Immigration Authority, cited Monday morning by the Yisrael Hayom daily, which says 928 infiltrators were registered on the Egyptian border, compared to 2,031 during the month of May. Since the beginning of the year, 9,572 infiltrators have been recorded.
Most of those registered in June were from Eritrea and Sudan. Almost no residents of South Sudan were among those recorded.
Tags:Sudan, South Sudan, Interior Ministry, Population and Immigration Authority, infiltration, Eritrea, Egyptian border


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About UsGet the scoop on our dry cleaner and great team ready to serve you. Mirkin's Dry Cleaning is the Springfield areas earth friendly cleaner. The cities first dry cleaner to make the switch from "Perc" to Hydro Carbon contributing to a healthier community and a healthier work environment. Member: The Drycleaning and Laundry Institute (DLI)The Drycleaning
Our HoursLongmeadow Store now open Sunday's 9am-3pm. Same Day Service Monday–Friday All Locations Main Plant 583 State Street Longmeadow Location 149 Longmeadow Street Enfield Location 190 Enfield Street
Our ServicesOur services and products are trusted solutions to fill your needs. Add a touch of cleanliness to your life with help from the experts at Mirkin's Dry Cleaning Service in Springfield, Massachusetts.Our Dry Cleaning company offers a wide variety of Dry Cleaning services.
You can turn to us for Dry Cleaning, Shirt laundering, Wet Cleaning, Suede Leather cleaning, and Ugg boot cleaning.On time Dry Cleaning Service Mirkin's Dry Cleaning Service is a Dry Cleaning company that specializes in Dry Cleaning and related services.When you need something cleaned in a timely and efficient manner turn to mirkins dry cleaners for help.We always get the job done right the first time.
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Local Delivery ServicesMake your life easier let the cleaner come to you !! We gladly offer local delivery services to any location in our service area at no additional cost.Including both pick-up @ homes and businesses. Call today to arrange our delivery services with your next cleaning project.Get in touch with our cleaning company to arrange our specialized cleaning services.


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Uncertain Journey
Stories of immigrants pursuing the so-called American dream and earning a fortune grace the annals of libraries, but rags-to-riches tales are actually rare, a reality driven... Read More
Stories of immigrants pursuing the so-called American dream and earning a fortune grace the annals of libraries, but rags-to-riches tales are actually rare, a reality driven... Read More
John and Delta Turner and their three children live in a shotgun house in a low-income neighborhood in New Orleans. By working two jobs and quietly enduring the bigotry he... Read More
Stephen Cline teaches writing and literature in Hawaii. He drew on his interest in sailing, expertise in music, and knowledge of Celtic history and literature to write Echoes... Read More
"When she woke, she was red. Not flushed, not sunburned, but the solid, declarative red of a stop sign." In Hillary Jordan's dystopian novel When She Woke, Hannah Payne is... Read More
Although a decade has passed since Sunetra Gupta's last novel, this lucid and mesmerizing masterpiece shows she has used every minute of that time wisely. Told in memories and... Read More
An ancestral home that is both haven and cage becomes the focal point for this searching exploration of adultery's place in marital landscapes. Echoing Ethan Frome, Vinegar... Read More
Magdalena Tulli's new literary novel reads like poetry, replete with metaphor, unique syntax, and intriguing images. The author's inventive and graceful language lends this... Read More
Hollywood has handed us an American West of cowboys, cattle, train whistles, and Indian wars, but Terese Svoboda offers a different glimpse of history, from the perspective of a... Read More
Suzanne Kamata's collection of stories The Beautiful One Has Come explores the tension, and sometimes beauty, of straddling two very different cultures. In some cases this... Read More
My Sisters Made of Light is the riveting story of Ujala, a Pakistani schoolteacher imprisoned in Adiala Prison, a women's penitentiary that holds the lives of hundreds of... Read More
Timeless, Nicholas Tchkotoua's fine novel of the passion and fidelity that shaped the lives of a Georgian prince and the young Russian woman to whom he gave his heart, is to... Read More
This intriguing novel, set against the backdrop of pre- and post-World War II, centers around two German Jewish immigrants. Louisa, Rolf, and Rolf's cousin Otto were childhood... Read More


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T1D occurs in genetically predisposed individuals as a consequence of the progressive, selective destruction of pancreatic beta-cells which is primarily mediated by autoreactive T-cells. The disease process results in loss of insulin secretion and life-long insulin-dependence. At present there is no treatment that fully interdicts islet autoimmunity. Our long-range scientific goals are to understand the natural history of T1D and its molecular basis and implement clinical trials evaluating new strategies to prevent or ameliorate this disease. The objectives of this proposal are twofold: 1) to remain an active participant in the research network. Type 1 Diabetes TrialNet, involved in the design and implementation of new intervention strategies;and 2) to propose a novel intervention strategy with alefacept in individuals with recent onset T1D. Our central hypothesis is that alefacept will have therapeutic value in T1D, and temper the perpetuation of the destructive autoimmune process resulting in T1D, preserving beta-cells and their insulin-secreting capacity. There is a solid rationale for attempting new trials to target memory T cells in T1D: growing evidence links memory T cells with diabetes development, and alefacept specifically targets these cells. It is FDA-approved for the treatment of adult patients with moderate to severe chronic plaque psoriasis, which is also an immune-mediated disease. Importantly, alefacept has an excellent safety profile without the typical side effects of other immunosuppressive agents, which makes it ideally suited for potential chronic treatment of immune-mediated diseases. We propose a phase l/ll double-masked, randomized, placebo-controlled trial to test the hypothesis that alefacept will preserve C-peptide secretion in patients with recent onset T1D. Importantly, there is growing evidence for a role of memory T cells in T1D, and the memory compartment is likely to be enriched in islet-specific autoreactive T cells. We propose two treatment courses during a 1-year period and follow-up for an additional year. The primary metabolic outcome will be stimulated insulin secretion as assessed by C-peptide levels after the mixed meal tolerance test. The primary immunological outcome will be a 50-60% reduction in the frequency of memory T cells during the treatment phases.
Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells, resulting in loss of insulin secretion and life-long insulin dependence, and unfortunately often affects children and adolescents. Previous clinical trials have shown that it is possible to interfere with this autoimmune destructive process. If treatment with alefacept safely stops or slows this destructive process, it would be a major advance toward the prevention of a lifelong disease associated with significant morbid complications.
|Orban, Tihamer; Beam, Craig A; Xu, Ping et al. (2014) Reduction in CD4 central memory T-cell subset in costimulation modulator abatacept-treated patients with recent-onset type 1 diabetes is associated with slower C-peptide decline. Diabetes 63:3449-57
|Orban, Tihamer; Bundy, Brian; Becker, Dorothy J et al. (2014) Costimulation modulation with abatacept in patients with recent-onset type 1 diabetes: follow-up 1 year after cessation of treatment. Diabetes Care 37:1069-75
|Pugliese, Alberto (2014) Advances in the etiology and mechanisms of type 1 diabetes. Discov Med 18:141-50
|Arif, Sefina; Leete, Pia; Nguyen, Vy et al. (2014) Blood and islet phenotypes indicate immunological heterogeneity in type 1 diabetes. Diabetes 63:3835-45
|Beam, Craig A; Gitelman, Stephen E; Palmer, Jerry P et al. (2014) Recommendations for the definition of clinical responder in insulin preservation studies. Diabetes 63:3120-7
|Pescovitz, Mark D; Greenbaum, Carla J; Bundy, Brian et al. (2014) B-lymphocyte depletion with rituximab and *-cell function: two-year results. Diabetes Care 37:453-9
|Kroll, Jing Lu; Beam, Craig; Li, Shaobing et al. (2013) Reactivation of latent viruses in individuals receiving rituximab for new onset type 1 diabetes. J Clin Virol 57:115-9
|Krischer, Jeffrey P; Type 1 Diabetes TrialNet Study Group (2013) The use of intermediate endpoints in the design of type 1 diabetes prevention trials. Diabetologia 56:1919-24
|Loechelt, Brett J; Boulware, David; Green, Michael et al. (2013) Epstein-Barr and other herpesvirus infections in patients with early onset type 1 diabetes treated with daclizumab and mycophenolate mofetil. Clin Infect Dis 56:248-54
|Sosenko, Jay M; Skyler, Jay S; Palmer, Jerry P et al. (2013) The prediction of type 1 diabetes by multiple autoantibody levels and their incorporation into an autoantibody risk score in relatives of type 1 diabetic patients. Diabetes Care 36:2615-20
Showing the most recent 10 out of 16 publications


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I give this a 5 star rating as it sounds so yummy!! Am on holidays now and don't have all the ingredients and tools to do this but look so forward to come home to some nice home made treats! Thanks for the great recipe :))
Don't get too much material here in St. Lucia but we managed to get by. Not as many fruits and vegetables we looked forward to, and not easy to get your hands on raw cocoa. Everything gets roasted before pressed into cocoa sticks.
Much more varieties on fruits and veggies in Mexico or some other islands. Strange thing here, people don't plant much of what they could. Anyway, we've had a great time, lovely island, wonderful and friendly people.
Thanks again for this yummy recipe, I'm craving it already :))


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Whether you're packing for an autumn mini-break, business trip or extended holiday, you're faced with the difficult decision of what to take and what to leave out. The usual response is to "smash and grab" your way through your possessions in a frenzied panic. The result, of course, is a haphazardly rammed suitcase, bursting with mismatching clothes. So what can you do?
Strategize your choices. You should select items that can be easily layered that aren't bulky, such as V-necks, light cardigans, jackets — and trousers or skirts, which can be worn as both day and evening wear. If you do need a heavy coat, then wear it to the airport to save space in your suitcase. Mohair is a great fabric for the transition between autumn and summer because it's both breathable and warm.
Embrace the roll. When you pack, don't fold; rather, roll. It's a space saver and prevents your clothes from becoming wrinkled. Shoes should be put inside plastic sleeves to avoid dirtying your apparel. The same rule applies to your toiletry kit.


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This is our studio site. Among other things, we run two businesses:
Field Notes Brand and The Deck Network. Visit them please.
Fresh Signals
Related to the last, so you know, Dan Jenkins' Ten Stages of Drunkeness, from his book, Baja Oklahoma.
1. Witty & Charming
2. Rich and Powerful
3. Benevolent
4. Clairvoyant
5. Fuck Dinner
6. Patriotic
7. Crank up the Enola Gay
8. Witty & Charming, Part II
9. Invisible
10. Bulletproof -jc.05.23.14 #
A post from the daily flow of linkage called Fresh Signals, at Coudal.com.


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Insurance Clerk Salary
Women make up the vast majority of Insurance Clerks in the United States. The average pay in this industry is approximately $13.10 per hour. Health benefits are not enjoyed by everyone in this line of work, and more than a third lack any coverage at all. Medical benefits are reported by the greater part and dental coverage is claimed by more than two-fifths. For the most part, Insurance Clerks enjoy their work and report high levels of job satisfaction. Figures cited in this summary are based on replies to PayScale's salary questionnaire.
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Job Description for Insurance Clerk
Insurance clerks process applications for reinstatement of, changes to, and cancellation of insurance policies for individuals or companies. They work closely with insurance agents to provide paperwork and other necessary items to process a client's insurance policy, and must have thorough knowledge of federal, state, and local insurance policy regulations.Read More...
Insurance clerks must have excellent communication skills and good attention to detail in order to accurately complete clients' insurance policies, and familiarity with mathematics and computer programs is essential. Accurate typing skills, good customer service, and professional phone demeanor are also important. They must be able to work well with other team members, as well as follow instructions from supervisors and/or insurance agents.
The duties of an insurance clerk include compiling data on insurance claims, reviewing insurance applications to ensure all the appropriate questions have been answered, collecting initial premiums, issuing receipts, changing insurance policy records to adhere to the party's specifications, and cancelling insurance policies as requested by agents. Writing professional e-mails and correspondence is frequently required, as well.
Most insurance clerks have a college degree, and many employers prefer that their clerks have at least an undergraduate degree in accounting, business, or a related field, though this is not always a strict requirement. Prior experience in insurance is highly beneficial.
Insurance clerks usually work in an office of an insurance company during normal business hours, and their co-workers include other team members, insurance agents, and supervisors. Insurance clerks may also interact with clients on the phone or in-person.
Insurance Clerk Tasks
- Maintain, update, and file records for health, life, car, rental, or home insurance policies.
- Prepare and file statistical data reports for regulatory agencies.
- Oversee insurance payments, renew policies, and collect overdue payments from individuals or insurance companies.
Insurance Clerk Job Listings
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Pay by Experience Level for Insurance Clerk
Median of all compensation (including tips, bonus, and overtime) by years of experience.
For Insurance Clerks, level of experience appears to be a somewhat less important part of the salary calculation — more experience does not correlate to noticeably higher pay. Relatively untried employees who have less than five years' experience make $26K, but folks with five to 10 years under their belts enjoy an appreciably larger median of $28K. Insurance Clerks who work for 10 to 20 years in their occupation tend to earn about $31K. Insurance Clerks who have stuck around for more than two decades see earnings that are no higher than those of folks who have worked for 10 to 20 years.
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Key Stats for Insurance Clerk
Job Satisfaction
|Extremely satisfied
Rated 5 out of 5
based on 12 votes.


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New Delhi: Pakistan's fast bowlers should be credited for making all the difference between the two teams in the ongoing ODI series, feels captain Misbah-ul Haq.
Talking to newspersons on the eve of the third and final one-dayer on Sunday, Misbah said: "We have not been successful because of just any one department. I feel that our team has done really well in all three departments…
"That's why we are leading the series 2-0. But the biggest difference between the sides has been our fast bowling. Our spinners have always been good, but in this series the way the fast bowlers bowled has been the key," said a smiling Pak captain.
Asked about the changes to be made in the team for the final ODI, Misbah said: "If we make any changes, it will be only to strengthen the team not just for the sake of it. We are leading 2-0 and would definitely like to make it 3-0 in the end."
Misbah didn't put any emphasis on playing in the cold conditions. "It will be a little different for our players after playing in Chennai and Calcutta but before coming here we practised in Lahore and the conditions there were pretty similar to Delhi."
Advising the Indians to work hard to return to form, Misbah said: Our preparations have been exemplary. We have practised in conditions that we expect to find wherever we go to play. We have prepared very well and the results are there for all to see.
"All that I can say about the Indians that they should work hard. There is no short cut, there is no alternative. In our case, all we need to do is to stick to the basics. That's the only way to get the desired results," he said.
Expecting a tall-scoring contest in Delhi, Misbah said: "This pitch looks better than the two previous ones. In the last three-four days before the matches in Chennai and Calcutta, there was no sunshine to dry up the surfaces but I think this will be better for batting because there is not much moisture. I don't think there is any advantage in winning the toss or any disadvantage in losing it here."
Asked how much help the team received from former skipper Inzamam-ul Haq, who interacted with the Pakistan team before they came to India, Misbah said: "He was of great help.
"He is such a great player who has a lot of experience of playing against India and producing big performances against them. He knows of the pressures of playing against India, and how to handle those pressures as a batsman."
Misbah advises Indians to work hardThe Telegraph – Sun 6 Jan, 2013 10:11 AM IST
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|Steak sauce
|1⁄4 Cup (4 tbs)
|Chicken bouillon cubes
|1 Teaspoon
|1⁄2 Teaspoon
|1 Teaspoon
|Hot water
|1⁄2 Cup (8 tbs)
|Chicken thighs
|3 Pound
|Stewing beef
|1 Pound, cut into 1 1/2 inch cubes
|1 Medium, chopped
|2 Medium, peeled and cubed
|2 Medium, pared and thinly sliced
|Canned stewed tomatoes
|16 Ounce
|1⁄4 Cup (4 tbs)
Combine steak sauce, bouillon cubes, salt, pepper, sugar and hot water in crock pot; stir well.
Add remaining ingredients except flour; mix carefully.
Cover and cook on low setting for 8 to 10 hours (on high setting for 4 hours).
Before serving, remove chicken, bone and return meat to crock pot; stir well.
To thicken gravy, make a smooth paste of flour and 1/4 cup juices from stew.
Stir into crock pot.
Cover and cook on high setting until thickened.
Rate It
Nutrition Rank
Nutrition Facts
Serving size: Complete recipe
Calories 2951 Calories from Fat 697
% Daily Value*
Total Fat 79 g121.9%
Saturated Fat 24 g120%
Trans Fat 1.4 g
Cholesterol 1369.6 mg456.5%
Sodium 7810.6 mg325.4%
Total Carbohydrates 171 g57.1%
Dietary Fiber 20 g80%
Sugars 52.3 g
Protein 369 g738.5%
Vitamin A 441.1% Vitamin C 210.7%
Calcium 42.9% Iron 161.9%
*Based on a 2000 Calorie diet


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Most bad managers don't realize how awful they are -- so if you're worried about your leadership skills, you're probably doing fine, writes Steve Tobak. Still, it's worth keeping an eye out for early-warning signs such as sudden silences when you walk into a room, an inability to make speedy decisions and a lack of support from former allies.
Full Story:BNET


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MBA Thesis Sports Marketing
This project was awarded to katudeni for $440 USD.Get free quotes for a project like this
Project Budget$250 - $750 USD
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Project Description
Freelance Writer wanted for MBA thesis in Marketing. The subject is "Marketing Strategies of a Soccer Team" and the language is English (preferably mother tongue). Content: [url removed, login to view] words. As this is a MBA thesis the writer should be familiar with academic research. Only bids with proven work experience will be considered. Please attach previous sample work.
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Dr. Abbuhl is a Penn Medicine employed physician.
There is no publicly available rating for this medical professional for one of the following reasons:
Emergency medicine
A facility of the Hospital of the University of Pennsylvania
Medical School: University of Rochester School of Medicine
Residency: Hospital of the University of Pennsylvania
Emergency department operations, administration and access; Women Faculty Development; Women's careers in medicine and biomedical research
Choo EK, Kass D, Westergaard M, Watts SH, Berwald N, Regan L, Promes SB, Clem KJ, Schneider SM, Kuhn GJ, Abbuhl S, Nobay F: The development of best practice recommendations to support the hiring, recruitment and advancement of women physicians in emergency medicine Academic Emergency Medicine Epub ahead of print (doi:10.1111/acem.13028): 2016.
Westring AF, Speck RM, Sammel MD, Scott P, Conant EF, Tuton LW, Abbuhl SB, Grisso JA.: Culture matters: the pivotal role of culture for women's careers in academic medicine. Academic Medicine 89 (4): 658-663,2014.
Pati S, Reum J, Conant EF, Tuton, LW, Scott P, Abbuhl S, Grisso JA: Tradition meets innovation: transforming academic medical culture at the University of Pennsylvania's Perelman School of Medicine. Academic Medicine 88 (4): 2013.
Westring A, Speck RM, Sammel MD; Scott P, Tuton LW, Grisso JA, Abbuhl S.: "A culture conducive to women's academic success: development of a measure" Academic Medicine 87 (11): 1622-31,2012.
Speck R, Sammel MD, Troxel AB, Cappola AR, Williams-Smith CT, Chittams J, Scott P, Tuton LW, Abbuhl SB: Factors impacting the departure rate of junior medical school faculty: evidence from a longitudinal analysis at a research-intensive medical school Journal of Women's Health 21 (10): 1059-65,2012.
Mills AM, Shofer FS, Boulis AK, Holena DN, Abbuhl SB: Racial disparity in analgesic treatment for emergency department patients with abdominal and back pain American Journal of Emergency Medicine 29 (7): 752-756,2011.
Mills AM, Edwards JM, Shofer FS, Holena DN, Abbuhl SB: Analgesia for older adults with abdominal or back pain in the Emergency Department. West J Emerg Med 12 (1): 43-50,2011.
Pines J, Shofer F, Isserman J, Abbuhl SB, Mills AM: The effect of emergency department crowding on analgesia in patients with back pain in two hospitals Academic Emergency Medicine 17 (3): 276 - 283,2010.
Shah D, Volpe NJ, Abbuhl SB, Pietrobon R, Shah A: Gender characteristics among academic ophthalmology leadership, faculty, and residents: results from a cross-sectional survey Ophthalmic Epidemiology 17 (1): 1-6,2010.
Abbuhl S, Bristol MN, Ashfaq H, Scott P, Tuton L, Cappola AR, Sonnad SS: Examining faculty awards for gender equity and evolving values Journal of General Internal Medicine 25 (1): 57-60,2010.
Academic Profile
HUP Emergency Medicine website
Congratulations to the 184 Penn physicians listed below who were included in Philadelphia Magazine's Top Doctors 2016.
Penn Medicine is one of the world's leading academic medical centers.
A clinical trial is a research study involving patient volunteers that are conducted to find safe and effective treatments for a variety of health conditions.


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|Spider Helicopter Rotorhead - AutoCad 3D.
Our Spider helicopter design is aimed at those who have a little more time, skill and money to be rewarded with a higher performance machine.
NOTE: We currently have our high performance single seat helicopter design on hold. We do not have an expected release time or date for this design. We will be revisiting this design at a later stage as funds permit.
Please feel free to make a donation to Redback Aviation as all contributions are used directly for the running of our website and for the research and development of affordable helicopter designs to be released as plans.
|Typical styled helicopter swash plate control system.
Our vision is to provide a lively and powerful helicopter with a cruise speed of around 95kts. The Spider helicopter will have a welded 4130 chromoly steel airframe (sub-frame) with a streamlined composite cabin.
It will be powered by a converted diesel auto engine driving a clutchable V-belt reduction with automatic engage, similar to the R22 helicopter, to a conventional right angle gearbox (auto part conversion).
We plan to use composite main rotor blades which contribute to its high performance.
Further details will be released on this website as design development and testing progresses.
Please note that this description relates to our prototype currently in development and may change with the final design when released to the public.
We have no plans to design or sell a two seat helicopter at any stage due to increased complexity and expense in developing such a craft.
It's been a long time coming but here is a sneek peak of a previous prototype in it's earlier stages of construction. Since this design we have changed a few things and as with all prototypes, it has since been evolved further into a more refined design.
This version of the Spider was constructed of aircraft grade 4130 chromoly steel tube. It was medium weight and strong with the airframe based on tringulated construction.
The engine was our own version of a Raven Rotor Suzuki G13 BB conversion with Garrett GT2554R ball bearing turbo (way too much power).
Reduction drive was a simple clutchable v-belt reduction system as with most modern light helicopters while using Gates Quad Power belts.
Main rotor gearbox was a modified late model Honda Goldwing rear wheel drive unit. While it performed well, we were not overly sure of it's life expectancy in a helicopter situation with differing loads and forces than it's original motorcycle configuration. An oil cooler was also necessary as heat built up quickly under load. There were many changes required to get it to run in the vertical position reliably.
|Engine horsepower
|Engine rpm
|3800 - 4200
|Main rotor blades
|All composite asymmetric
|Main rotor diameter
|21 ft 6 inch - 6.553 m
|Main rotor rpm
|520 - 530
|Tail rotor diameter
|3 ft 8 inch
|Tail rotor chord
|3.5 inch
|Tail Rotor rpm
|Fuel capacity
|15 US gallons (90 lbs)
|Fuel consumption
|Empty weight
|520 lbs
|Gross weight
|860 lbs
|Rate of climb
|Cruise speed
|105 mph - 168 km/h - 90 kts
|Maximum speed
|115 mph - 185 km/h - 100 kts
|125 mph - 200 km/h - 108 kts
|Service ceiling
|6 ft 8 inch - 2.032 m
The tail rotor was shaft driven with a commercial type industrial right angle gearbox which performed flawlessly. We reduced weight and improved corrosion resistance by changing the shafts to titanium saving more than 30% weight on those components.
The main rotor head was similar to the Mini 500 kit helicopter but basically of our own design.
The main rotor blade was intended to be of composite construction but at around $10,000 ex-factory for a prototype, we chose to stick to standard aluminium construction blades which were sufficient. The helicopter only gained minimal hover time before we decided to once again move with the times and technology to build a more advanced helicopter. Currently we have gone back to the drawing board and are researching drive gearboxes and engines again in persuit of a workable design.