text:
Topic: Study Notes: Chapter 8
Romans 8:13 (2)
by Darrel Cline
(darrelcline biblical-thinking.org)
Chapter # 8 Paragraph # 2 Study # 5
August 28, 2007
Lincolnton, N.C.
1769 Translation
13 For if ye live after the flesh, ye shall die: but if ye through the Spirit do mortify the deeds of the body, ye shall live.
1901 ASV Translation
13 for if ye live after the flesh, ye must die; but if by the Spirit ye put to death the deeds of the body, ye shall live.
I. Further questions...
A. Does Paul mean that
unrighteous activity can be "put to death"?
1. The "problem" here is that everyone understands that "habitual" practices are far more difficult to "put to death" than "occasional" actions.
a. It is standard human nature to attempt to make the things that only God can do possible for men by
. By this I mean that it is standard operating procedure to attempt to make the will of God possible to men by reducing the divine requirements down to something men can do. "Putting to death the deeds of the body" means ceasing to engage in the overt actions of... (generally, the "biggies" -- murder, adultery, theft, etc.). This came out in the debate over the "Lordship Salvation" issue when man's responsibility was reduced to "believing" (as if that is something men can do out of their own ability).
b. By the same token, it is standard human nature to simply deny the power of God to any problem outside the realm of human abilities. "Putting to death the deeds of the body" does not mean ceasing to engage in habitual actions that have controlling power over the one doing them. "Don't, " we are told, "expect God to deliver you from your ingrained habits; instead, join a support group."
1) The "problem" here is this: How does God
His principle of reaping what we have sown
salvation from what we have sown?
2) Habitual actions that are evil reveal habitual ways of thinking about what is evil and, for most believers, habitual denial that it is evil.
2. A greater problem is the question of how one applies the Spirit to the problem. If, for instance, I have been a "user" of a given drug that has acclimated my body to itself, how do I go about obtaining the power from the Spirit to stop using? Or, for a different kind of illustration, if I have consistently engaged in a certain type of behavior to "handle" certain types of circumstances so that I have become "habitual" in responding that way to those circumstances, how do I get the Spirit to empower a different way of dealing with those circumstances?
3. There can be no escape from the fact that Paul
to mean every form of unrighteous behavior has a solution in the Spirit. Otherwise, there is only "selective" salvation from the "easier" problems of bondage and that is really no salvation at all.
B. How, then, is the Spirit's power brought into play?
1. First, there is the requirement of deciding which forms of indulgence are "sin". It is not a sin to eat food because the body signals "hunger"; but "gluttony"
a sin. It is not a sin to drink because the body signals "thirst"; but drunkenness
a sin. It is not a sin to work to make money; but covetousness
idolatry and the desire to be wealthy is covetousness. It is not a sin to build friendships; but compromising to keep "friends" is an active evil. It is not a sin to receive glory from men; but it is a sin to pursue the glory of men.
2. Second, there is the requirement of determining to
engage in the identified activity again. It is clear that this determination does not have any "power" in the person to execute the decision, but without the determination, the Spirit sits on the sidelines. I have found that there is no provision of power until there is a deliberate determination before God that "I, by the grace of God, will never do that again".
3. Third, there is the requirement that we "come clean" with God when we do not allow His Spirit to keep us from doing evil. We must "confess our sins" so that we may be "cleansed" and restored to the position of "power" in the Spirit.
C. What about Peter's "stair-step" approach to developing godly character?
1. 2 Peter 1:2-7 indicates a "process", not an "immediate resolution".
a. The "grace and peace" of God is, according to this text, "multiplied" by the
of God and of Jesus our Lord.
b. The divine power of God has granted us all things that pertain to life and godliness through the
of the God Who has called us to glory.
c. We become partakers of the divine nature by means of the
of God.
d. Then there is the process itself...
1) Giving all diligence... [Nowhere in the New Testament do the authors give us the freedom to think that the Christian life, even by the Spirit, is achievable without "diligence".]
2) "Provide nourishment" (the apparent meaning of "add" in the AV text) to...
a) Virtue by faith [
Theological Dictionary of the New Testament
says: "At the time of the New Testament [this] word ...had so many meanings that it gave rise to misunderstandings (Vol. I, p. 457) ...Yet in spite of the ambiguity of the term, we can pick out a single basic meaning...It can refer to mastery in a specific field..." (Ibid. p. 458). This makes Paul's statement in Acts 24:16
important as Paul's effort in a
field, to
the issue. It also makes James' statements in 1:8 ("a double-minded man is unstable in all his ways") and 4:8 ("...purify your hearts ye double-minded")
b) Knowledge by virtue
c) Temperance by knowledge
d) Patience by temperance
e) Godliness by patience
f) Brotherly love by godliness
g) Love by brotherly love
e. The bottom line here is that people grow into Love by growth in true knowledge.
2. This entire "process" approach indicates that Peter does not have an "instantaneous solution" mentality. That makes such a mentality highly unlikely in Paul -- since both are inspired by the same Spirit.
(return to the top of the article)
This is article #336.
If you wish, you may contact Darrel as darrelcline at this site.


text:
Marketing isn't easy for B2B companies, but being aware of the challenges can help your team develop the best solutions.
Peter F. Drucker once said "The aim of marketing is to get customers to know, like, and trust you." The principle remains the same for B2B companies, although they must win over entire corporations rather than individuals with their marketing campaigns. This unique situation brings with it the following marketing challenges.
B2B Marketing Must Engage Potential Buyers
Creating engaging content has been cited as the greatest challenge for B2B enterprise firms and a significant challenge for smaller organizations. This should come as no surprise because it's a challenge faced by marketers across all industries. However, studies suggest B2B buyers have become an increasingly empowered lot who must be engaged to buy.
Ninety percent of B2B purchasers say they don't even want you to market to them. Instead, they claim that when they're ready to buy, they'll find you. That doesn't mean B2B firms should sit back and wait for enquiries to come though. Instead, they must engage potential buyers to ensure they're the company in the front of potential buyers' minds.
Related:The Top 4 Tips for Dealing with Marketing Complexity
Good B2B Marketing Can Be Expensive
In 2013, Content Marketing Institute asked leading B2B marketers about the greatest challenges they faced creating high-impact marketing content. The most popular response was that the task took too much time, followed by a belief that creating such content is too labor intensive. Both these complaints point to one thing: creating good B2B marketing is expensive. With content assets typically taking five weeks to produce and demanding the attention of various staff members over the duration, it's easy to see why B2B marketers feel this way.
Adding to this problem is the belief of 93 percent of marketing leaders think that a lack of return on investment makes it difficult to justify future investment. According to the 2013 B2B Leaders report, an additional 24 percent say a lack of return on investment makes it difficult to choose future activity focuses. Do you persevere with expensive marketing campaigns that could potentially fall flat, or redirect funds into business energy rates and telephone bills? This strategy makes sense in the short term, but could result in less compelling marketing campaigns that don't generate the revenue needed to sustain the B2B firm.
Cultural Conflicts Impact Marketing Vision
B2B companies that blog regularly generate 67 percent more leads than their non-blogging competitors. Active participation on Twitter has also been shown to generate twice as many leads for B2B companies. But despite these compelling statistics, participants at the Digital Cream event in London last year said many B2B managers aren't keeping pace with the technology.
Related:How Business.com and B2B Marketers Use Pinterest Effectively
"B2B senior business managers tend to be older and more traditionally minded, conservative, and set in their ways," explained one of the event's participants. "They have grown up throughout their successful careers with specialist trade magazines, brochures, direct mail, exhibitions, and the sales force making courtesy calls."
This gap between the company's tech-savvy innovators and senior staff members can make delivering marketing solutions that work in the digital age difficult.
B2B Marketing and Sales Must Work Together
A B2B's marketing team doesn't exist in a bubble. While it's easy to become wrapped up in the creativity and content required for a successful marketing campaign, it's important to remember its purpose is to drive sales. Despite this, just 40 percent of B2B companies believe their marketing methods meet the needs of their sales force. The challenge is for marketing and sales departments to work together.
About 34 percent of companies address this by following a traditional model, where marketing employees support the sales team. However, research by business strategy agency Sparks Grove suggests that a more equal arrangement gets the best results.
Related:Bringing Sales and Marketing Together Through Sales Enablement
"For some, it's easy to get caught up in the illusion of stability and merely dabbling in change, which is often a false partnership," Sparks Grove vice president Rob Sherrell cautioned. "Those that talk the talk and walk the walk with the evolution of their marketing function will see long-term success."
Creating such a partnership can be a real challenge for B2B firms, but studies show this is the best business model for success.
Marketing isn't easy for B2B companies, but being aware of the challenges can help your team develop the best solutions.
Author Bio: JT Ripton is a freelance business, marketing and technology writer who occasionally writes for internetserviceproviders.com/search-results.html and you can follow him on Twitter @JTRipton.
(Image via freedigitalphotos.net

subset: commoncrawl


text:
At MCB Consulting, we are more than business and performance management consultants. As trained and experienced interim managers we work effectively inside your organisation to deliver business and performance management solutions that add value to the bottom line.
All of our interim executives have at least 20 years business performance management experience to draw upon. This depth and breadth of business and performance management maturity enables our interims to 'hit the ground running' and solve complex business problems from day one. The career profiles of our interims in business and performance management, are mixed and varied; some started out consulting with the 'big 4' whilst others worked their way through the ranks of industry into prominent senior positions.
MCB is a network based business and performance management organisation offering blue chip and SME clients the knowledge sharing benefits of an established business without the traditional overhead costs. As a small, independent business, all of our interims are known personally to us, which ensures that the interim's focus is always directed at the client's needs. Our tight network of flexible and versatile business and performance management executives means that we can offer the right person for the job for highly competitive fees.
Strategic IT
Project Management
Operational Planning
Process Improvement
Quality Management
Business re-location
Site Closures
Personnel Transfer
Performance Measurement


text:
Catholic Health Initiatives SURGICAL TECH CERTIFIED Surgical Services PRN- No Call Days CHI Health St. Francis in GRAND ISLAND, Nebraska
SURGICAL TECH CERTIFIED Surgical Services PRN- No Call Days CHI Health St. Francis
CHI Health is a regional health network with a unified mission: nurturing the healing ministry of the Church while creating healthier communities. Headquartered in Omaha, the combined organization consists of 15 hospitals, two stand-alone behavioral health facilities and more than 150 employed physician practice locations in Nebraska and southwestern Iowa. More than 12,000 employees comprise the workforce of this network that includes 2,820 licensed beds and serves as the primary teaching partner of Creighton University's health sciences schools. In fiscal year 2014, the organization provided a combined $149.3 million in quantified community benefit including services for the poor, free clinics, education and research. With locations stretching from Kearney, Neb. to Missouri Valley, Iowa, the health network is the largest in Nebraska and serves residents of Nebraska and southwest Iowa. For more information, visit online at CHIhealth.com.
Job Summary:
Under the direction of a registered nurse, performs a variety of duties in an operating room to assist the surgical team. Plans and implements care for patients with a variety of surgical problems. These patients may range in age from neonate, pediatric, adolescent, adult or geriatric at various developmental levels. Patients are from both traditional and non-traditional family structures with a variety of sociocultural and educational backgrounds.
Essential Duties:
Assists surgical team during operative procedure by setting up instrument tables, passing appropriate instruments to surgeons, positioning patients on surgery table and so forth.
Checks surgical equipment to assure that it is in proper working condition for safe use during the patients' operative care.
Selects and prepares the surgical supplies and equipment for operations in accordance with pre-determined lists and surgeons' established preferences and requests. Sterilizes instruments in autoclave according to established procedures.
Prepares the operating room for surgery according to aseptic environment guidelines by checking cleanliness, moving in additional tables and carts and so forth. Sets up the room and sterile tables in adherence to surgeon preferences and departmental guidelines.
Changes into operative clothing, scrubs hands and arms, puts on sterile gown and gloves, and assists others in doing the same.
Greets patient, talks with patient to calm them, and otherwise assists circulating nurse to prepare the patient for surgery. Positions the patient in prescribed position for type of surgery to be performed.
Arranges sterile instrument placement for operation. Counts sponges, needles and instruments with circulator prior to surgery and before incision is closed.
Passes instruments, sponges, and sutures to surgeon and surgical assistants.
Prepares the operative area of the patient. Drapes sterile field. Maintains an aseptic environment by practicing sterile technique throughout the surgical procedure (e.g., reports contamination of sterile field to surgical team).
Completion of an accredited Surgical Technology program
Certification in Surgical Technology
In lieu of attending and completing an accredited Surgical Technology program, must possess 15 years of experience as a Surgical Technologist.
BLS is required upon hire. (Acceptable credentialing bodies and certifications include the following: American Red Cross: CPR/AED for the Professional Rescuer, American Safety and Health Institute: CPR, PRO, must say "Professional Level-with AED", and American Heart Association: Basic Life Support for Healthcare Providers.)
Working Conditions
Patient Care/Surgical environment. Routine and extended periods of standing are required. Manual dexterity required.
Consistently adheres to and demonstrates our Core Values of Reverence, Integrity, Compassion and Excellence.
Catholic Health Initiatives and its organizations are Equal Opportunity Employers.
Job Patient Care Support
Primary Location NEBRASKA-GRAND ISLAND-ST FRANCIS
Daily Schedule PRN/As Needed - No Call
Scheduled Hours per 2-week Pay Period 0
Weekends Required Occasional
Req ID: 2017-R0117734


text:
Suckin', Adventure Time Framed Mini Poster
24mm Matt Black Frame
42.4cm x 52.4cm (17" x 21") Mini Poster with 24mm Matt Black Frame
High quality, framed Suckin', Adventure Time mini poster with a bespoke, 24mm Matt Black frame by our custom framing service.
- High quality, bespoke framing for an exceptional finish
- Each picture is hand framed to order by our expert craftsmen
- All custom framed pictures include free UK delivery
- 100% satisfaction guaranteed - we're so confident you'll love your framed picture, if you are unhappy with your purchase for any reason we will give you a full refund - guaranteed!
StockID: 189131-FRAME2
(approx €75.17 / $86.57)
Out of Stock
Sorry, this product is temporarily out of stock. To be notified when this product is back in stock please email email@example.com


text:
Renting conditions
- 1Guests must pay 40% of their stay in advance by credit card or by bank. The rest will be paid at their arrival at Camping Verneda.
- 2A deposit of 60 € (bungalows, humarau and cabana), 100 € (Bordeta Luxe and Borda Suite) will be paid at your arrival at the Campsite. Before your departure, the accommodation will be checked before your departure and in case to be in bad condition we will charge you a fee of 30 € in concept of cleaning, as well as we will put charges for any damaged or missing objects.
- 3The indicated maximum capacity for each unit can never be surpassed.
- 4Bed and bath linen are not included in the price (except for the luxe bordeta, which does include bed linen), but if required it can be hired at the reception. In winter time, heating is already included in the price. If heating is desired in spring or summer time, the price per day is 10 € (bungalow, humarau, cabana and bordeta luxe) and 15 € (Borda suite).
- 5A dog is allowed (except humarau) but they can't stay all alone in the bungalows and they should always be tied when walking through the campsite. 6 € per night.
- 6In summer the check in time is from 16h and departure before 12am. The rest of the year, check in time depends on the reception hours.
- 7In case of cancellation of the reservation, our policy is as follows:
- Notice 15 days before arrival date: 100% refund.
- Notice given more than 7 days before the arrival date: 50% refund.
- Notice given less than 7 days: 0% refund.
Booking Online
Check the renting conditions and inventory of our accommodation.


text:
Nico Kranjcar
On this day: Steve McClaren reign ends with Croatia home defeatOn this day eight years ago, England fell to a 3-2 defeat at home to Croatia to see their hopes of reaching the following summer's European Championships come to an end.
Nov 21, 06:00
Player Ratings: Hull City 2-1 Queens Park RangersSports Mole rates all the players who took part in Hull City's 2-1 Premier League win over Queens Park Rangers at the KC Stadium.
Feb 21, 18:26
Team News: Two changes for ArsenalQueens Park Rangers make five changes while Arsenal change two for their meeting at the Emirates Stadium.
Dec 26, 16:57
Result: Late goals give Swansea City winSwansea City score twice in the last 15 minutes to earn a 2-0 win over Queens Park Rangers at the Liberty Stadium.
Dec 2, 21:37
Preview: Queens Park Rangers vs. LiverpoolSports Mole previews the Premier League encounter between Queens Park Rangers and Liverpool.
Oct 17, 16:37
Premier League in numbers: Week 5Sports Mole reflects on the fifth weekend of Premier League action with a selection of statistics from each encounter.
Sep 22, 11:01
Sports Mole's Premier League Team of the WeekSports Mole picks out the 11 most impressive players from the fifth round of Premier League encounters.
Sep 22, 10:06
Result: Angel di Maria stars in thumping Manchester United winAngel di Maria stars for Manchester United as the former Premier League champions record a 4-0 win over Queens Park Rangers at Old Trafford.
Sep 14, 17:51
Result: Queens Park Rangers and Burnley share six goals in lively drawQueens Park Rangers and Burnley share six goals in today's early Championship fixture, an emphatic 3-3 draw at Loftus Road.
Feb 1, 14:16
Half-Time Report: Queens Park Rangers leading BurnleyQueens Park Rangers lead Burnley 2-1 at half time in today's early Championship kickoff at Loftus Road.
Feb 1, 13:12
Nico Kranjcar to decide future after seasonNico Kranjcar says that he is in no rush to decide where he will be playing his football next season.
Jan 16, 13:20
Harry Redknapp considers Nico Kranjcar reunion?Queens Park Rangers boss Harry Redknapp considers a bid to sign Dynamo Kiev midfielder Nico Kranjcar for a third time.
Jan 30, 02:42


text:
Castleton State golf tournament
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Learn about Castleton State golf tournament, and registering for elective lectures and seminars. Not all recruiting is done like NCAA Division I teams. Coaches are going to be more drawn to players who display genuine interest in their program throughout the recruitment process. Finally, check with your major department for assistance with prerequisites, tuition payment deadlines, and Castleton State Golf information. Please use the form above to request admissions info for Castleton State.
As a student athlete, you can play college sports competitively at an intercollegiate level, or just for fun via intramurals. Please keep in mind that few students will qualify for athletic scholarships, and that college coaches sward available sports scholarship money judiciously.
Approximately 126,000 student athletes go to college on either a partial or full athletic scholarship, but the vast majority of college athletic teams have open tryouts, and walk-ons may land a position on the team if they are talented enough. If you've been recruited or made it past a walk-on tryout, that's when the real challenge starts. You still have to make it through daily practices, and several rounds of cuts in order to make the team. Students must meet specific eligibility requirements each year to participate in Western University baseball statistics. Beyond consideration for Castleton State golf tournament, you may think about Wabash Valley College AP test scores for complementary electives to your primary course of study.
Certified Personal Trainer
Your Time Fitness
Our Trainers make on average over $25 per hour for paid clients . We provide plenty of pre qualified personal training leads for our trainers.
3 days ago Athletic Trainer
NorthShore University HealthSystem
Athletic Trainer Certification from the National Athletic Trainer's Association Board of Certification.
7 days ago Athletics Work Study Student
Tennessee Board of Regents
Basketball Equipment Manages. Men's and Women's Basketball Managers. The Athletic Department is looking for work study students to work as Baseball Student..
2 days ago Youth Soccer Coach - Part Time Position
Soccer Shots - North Oklahoma City Area
Soccer Shots coaches are committed to doing what is expected of them as the coach and face of Soccer Shots.
6 days ago Part Time Youth Sports Coaching Positions
Kids First Sports Safety, Inc.
Football, Volleyball, Baseball, Basketball, Badminton, Tennis and more! Coaches forecast their schedule around work, college classes, etc..
7 days ago


text:
Help support us by turning off adblock and Enjoy more features.
Download free Dont push from Section: Whatsapp funny images & Category: Free funny wallpapers. Filetype: Funny whatsapp cool images & Size: 72.46 kb
¤ Main Wallpaper menu
¤ Direct download
¤ Most popular Wallpapers
¤ partners
Download hd wallpapers of "Dont push" at your mobile cell phone.
File size : [72.46 kb]
:Download Dont push wallpaper or image for facebook , whatsapp and for your profile pic in Hd format and in high resolution background for desktop and mobile phone..
Similar Downloads


text:
RYS 200, 300, 500 in Rishikesh
For some reason empathy has been heavy on my mind lately. You know, the type of human emotional connection that doesn't allow us to walk past the same homeless man on the corner asking for that one dollar every day. Or the woman on the subway with two babies attached to her hip, bags under her eyes as heavy as the laundry she's also hauling. To you feeling the pain of your close friend mourning a loss in their life as if it were your own loss. Thank goodness we have evolved as species with…Continue
Added by Charity Calloway on October 8, 2013 at 1:30am — 2 Comments
© 2017 Created by Yoga Teacher Training India. Powered by


text:
" Thanks to Tony McCoy for great customer service! I am loving my new car! "
" We are back today for a service appointment second time to the service dept since we have purchased and I must say sale and service dept at this facility bar none is top notch on customer service. Will definitely be a customer for life. "
" After receipt of vehicle, went back by and sales personnel was very attentive and supportive of my questions re certain areas of operation on the vehicle. "
" If it had not of been for our salesman Jason Carroll we probably would not have bought that day. He went above and beyond. "
" The woman who helped me was kind and courteous, and really made me feel at ease about the repairs. The driver who took me to work was a hoot- she's great "
" Wonderful customer service! "
" Nice people. Even helped to try and explain some of the features that the selling dealer didn't. Would go back without question. Service manager was quite nice as well. "
" My experience with Flowers Honda has been excellent from Ernie Wyrick (Salesman) to Regina Cash (Service Advisor). It has been a pleasure dealing with each of them. "
" I am always pleased with the service dept. I like to deal with Regina. She is always very helpful. "
" I left car to be serviced, was picked up and did other errands. Overall service was excellent. "
" Thanks for your wonderful help for us to select this new vehicle. Thanks to you, we made the decision to buy an Honda instead a Toyota. Looking forward to make few more business with you. God bless you Always. "
" This was by far the BEST experience I have ever had with any car dealership! As a matter of fact I had another Honda ready for me to pick up at another dealer. However that dealer was slow to let me know so in the meantime I was looking at other places. So I scheduled a visit within two hours and... View More "
" Flowers Honda was great. It was a nice buying experience. Andrew was my salesperson and he did a fantastic job. He was referred to me by my parents who recently purchased a 2013 NIsssan Pathfinder. I will refer folks to Flowers Honda and Andrew in the future. "
" My sales person was Lance Thompson and he was an excellent help with purchasing my vehicle. I am very pleased with my buy! "
" Excellent... no matter how many times I came by Drew was always willing to help me! "
" This was the second time we dealt with this company, and both times very pleasurable. Buying a car can be a painful experience, but each time was very easy.The sales person wasted no time in fulfilling or needs, and the finance manager was very timely in preparing the never ending paperwork.I feel... View More "
" We have purchased both new and used cars from Flowers over the past few years. Always a good experience. The people and the customer service are the real deal. From service to finance and sales, Customer service is the objective.. "
" Had a wonderful experience! Lance went above and beyond my expectations and I am loving my new Honda Pilot!! "
" Great experience today this is our 4th Honda we are loving our new CR-V Touring it is an awesome riding car. Special thanks to Ernie & all the staff for all they did. The Palmers "
" David Flowers and his team at Flowers Honda really get it. They really do appreciate their customers. Thanks for raising the bar! "


text:
Spring is just around the corner — so be sure to get fit with our gym in Amarillo in time for pool season! We offer a wide variety of group exercise classes to help you find and complete any weight loss programs.
Click here for our update March group exercise schedule!


text:
Hello reader,
so the Micro Millions is over. Haven't become filthy rich. Hehe, it was fun to play in the few events I did play. I was most bummed out for losing in the first round of a $2 HU event.
Cash game went great this week. Ever since I stepped down to NL10 I haven't had a losing day. That feels good, but it wasn't the plan! The great plan was to move up.
And I haven't finished the literature I told myself to read. Still, feel like I've thought about the game a lot and did improve. I read hand discussion forums, but that's such a.. painful way for me to learn. Yet people I respect the most say that's the way they learned.
Hmh, shouldn't expect the same thing to have to work for me.
Okay, I think I'll stop here for today. For some reason I'm struggling with writing in english a bit.
Thanks for stopping by!


text:
The Miracle Started With Free Food!
November 4, 2014
A UBC student was invited to a free campus BBQ. The student had no idea just how much God would satisfy their spiritual hunger.
"When I first came to UBC, I went to the free BBQ. I went because of the free food as I was in Land and Food Systems faculty and free food is always a bonus! I wasn't a Christian nor did I know anything about God, but someone offered to pray for me and that impressed me. After that I came to every Thursday campus worship night I had no idea why I was drawn, but even after long stressful days, I still wanted to come and worship with this awesome community you are leading.
The following year I went to the Winter Retreat (Emerge) and became a Christian. At that time I was healed of my chest pains that I had had for years. It was a miracle and my journey of faith all started with free food at the BBQ and somebody taking the initiative to pray with me. He used YOU to make this community a safe and enjoyable place where I could experience the glorified Lord in ways that are unimaginable to most others." This student was baptized last year!
"Taste and see that the Lord is good. Blessed is the one who takes refuge in Him." Psalm 34:8
Location UBC


text:
'Pale Shallows', Oil on Linen Abstract Painting - unframed
130 x 90cm
Please complete your details and a representative will be in touch as soon as possible.
Thanks! You have successfully sent your message. We will be in touch soon.
Uh-oh. There is an error in your submission, please make sure you have typed everything correctly.


text:
Tibia Mmo Online Role-Playing Game Released For Iphone And Ipod Touch
When we strain to achieve our goal- we build something. When we are in a competitive market, our main goal is to make it so that our customers continue to buy and not pass to our competitors. Our strategy will be our way to achieve these goals.
Google+ is a product of Google itself; no wonder search outcomes for Google+ users are Website on-screen results. This is great because music promotion totally is actually – don't you think it's exposure that artists and bands want? So keep on top and sign up.
Be legit – build a band page of the site. You should create one gone – URL and band name – and have your own musical digital footprint. The right gifts category 'Arts, Entertainment and Sports' and you are therefore all set.
Before – I went along to my customers with Terms blow, and straight in order to them about strategy and practices, I noticed quite early that the client lost me in the term – strategy. Today, when one wants clearly something which usually is important – say might be a 'strategic'. But management has a lot of important damage that is not a strategy. They are simply a question of good government. All of the cellular company are strives to possess the technology infrastructure, future development horizon, current edge desirable devices, demand content services, excellent customer service, brand lights, etc. Much of his time is about these tasks. Important? Without a doubt. Strategic? Not a way!
A buyer who sends more money than you requested in the form of a check is planning to scam your organization. The goal is to demand that you cash the check, send the product, and your own additional extra money. The only problem is that the original check, the overpayment, is an imitation. They hope that a bit more your bank realizes this, you already sent the leftover price. Unfortunately, you are left high and lose moisture. You are without the phone you mailed into the fake buyer and extra money you sent these products.
If black is your favorite color, enjoyment no trouble finding low-cost leather iphone case. Should you desire for some diversity, should search. Red is my personal color, and i love
phone insurance the white interior as aid showcase my choice typically the white colored Iphone.
This model does not possess an LCD screen unlike more advanced generations and model. Its ink pricing is also relatively high, specifically you follow the manufacturer's recommendation. The paper output tray also carries a low tolerance. It also lacks Ethernet and a memory company : card reader. And finally, may well not definitely be a good choice if must make sure a fast printer.
Using methods you you must update your free smartphone apps all of them more usable and all the time more interesting. I hope these tips helped pretty!


text:
LILI Unit: World War II & Vietnam War Memorials
|Essential Question:
What was the United States' involvement in World War II and the Vietnam War?
|Pre-trip lesson: This program introduces students during the course of two pre-trip lessons to two major international conflicts of the 20th century: World War II and the Vietnam War. Students examine the causes of these conflicts and their effects – both in the U.S. and around the world. They apply map skills as they track the involvement and alliances of countries in both wars. In the first lesson, students learn about the events and people that precipitated World War II and led to U.S. involvement – from the violence carried out by Hitler and the Nazis throughout Europe, to Japan's international aggression in the Pacific and ultimate attack on Pearl Harbor. In the second lesson, students are introduced to the Cold War and the broader international tensions that created the Vietnam War. They read and analyze letters from soldiers in Vietnam to help understand why the Vietnam War became so controversial in the U.S. and sparked such heated protests and debates. Students also work with tangrams to develop a conceptual understanding of area.
|Level of Difficulty:
|Trip: At the World War II Memorial, students examine bas reliefs depicting various aspects of World War II. They write captions describing the reliefs, and then share their thoughts with the whole class. At the Vietnam Veterans Memorial, students learn about the design of the wall and why it was chosen as the appropriate design to commemorate those who perished during the Vietnam War.
|Academic Standards:
|Post-trip lesson: As a culminating activity, students create a persuasive poster in the spirit of Vietnam protesters. They express an opinion about a topic through words, symbols and pictures, and try to persuade others to agree with them. Students also test their knowledge of 20th century history as they compete in a collaborative review game and take written assessments.


text:
Syllabus and application forms for all exams can be downloaded from the CLRG website
Latest exam criteria updates click here
TMRF, TCRG and ADCRG exams will be held in Adelaide November 2nd - 5th at University of Adelaide.
Accommodation details - ibis Adelaide booking link - AIDA
The hotel is the Ibis Grenfell. The offer is $156 per night including Buffet Breakfast for 1 person.


text:
Words containing duodenop
Found 1 words containing duodenop. Browse our Scrabble Word Finder, Words With Friends cheat dictionary, and WordHub word solver to find words that contain duodenop. Or use our Unscramble word solver to find your best possible play! Related: Words that start with duodenop
- Scrabble
- Words With Friends
- WordHub
- Crossword


text:
In July I missed granddaughter Maizy's b'day with my usual birthday blog wishes, the first week of August I missed son Alan's b'day and now here it is the 29th of August and I have missed blogging for our dear girl, Kim.
Sheesh... when we were done laughing so hard this morning Sherwin turns to me and says, 'Maybe you should ask Sheila May how she does it." And that started me off all over again. *
August 27 (was the day)
Kim Goerlitz
Birthday Wishes to you, dear girl!!
She is a great mama to Maizy and Lucy... (photo from files of yesteryear!)
Wife to son, Shelby...
Full of fun and laughter...
And my wish for you, dear Kim, at the beginning of your new year is...
"Love is not affectionate feeling,
but a steady wish for the loved person's
ultimate good as far as it can be obtained."
- CS Lewis
*Oh, by the way, if any of you are wondering what Sheila May does that I need to learn? Well, she is my oldest sister and she remembers EVERYONE'S birthday with a card sent on time and maybe even early! My kids have taken to give me the old nudge, nudge about it and I just laugh and shrug my shoulders and promise to do better... (they know I love them to bits!)


text:
- Services
- We strive to provide complete care for our patients. Learn more about all the services we provide.
You are using an outdated browser. Please upgrade your browser to improve your experience.
The very first step in the development of arthritis is articular cartilage (the type of cartilage lining the joint) damage due to the inherited bad biomechanics of an abnormally developed hip joint. Traumatic articular fracture through the joint surface is another way cartilage is damaged. With cartilage damage, lots of degradative enzymes are released into the joint. These enzymes degrade and decrease the synthesis of important constituent molecules that form hyaline cartilage called proteoglycans. This causes the cartilage to lose its thickness and elasticity, which are important in absorbing mechanical loads placed across the joint during movement. Eventually, more debris and enzymes spill into the joint fluid and destroy molecules called glycosaminoglycan and hyaluronate which are important precursors that form the cartilage proteoglycans. The joint's lubrication and ability to block inflammatory cells are lost and the debris-tainted joint fluid loses its ability to properly nourish the cartilage through impairment of nutrient-waste exchange across the joint cartilage cells. The damage then spreads to the synovial membrane lining the joint capsule and more degradative enzymes and inflammatory cells stream into the joint. Full thickness loss of cartilage allows the synovial fluid to contact nerve endings in the subchondral bone, resulting in pain. In an attempt to stabilize the joint to decrease the pain, the animal's body produces new bone at the edges of the joint surface, joint capsule, ligament and muscle attachments (bone spurs). The joint capsule also eventually thickens and the joint's range of motion decreases.
No one can predict when or even if a dysplastic dog will start showing clinical signs of lameness due to pain. There are multiple environmental factors such as caloric intake, level of exercise, and weather that can affect the severity of clinical signs and phenotypic expression (radiographic changes). There is no rhyme or reason to the severity of radiographic changes correlated with the clinical findings. There are a number of dysplastic dogs with severe arthritis that run, jump, and play as if nothing is wrong and some dogs with barely any arthritic radiographic changes that are severely lame.
The hip grades of Excellent, Good and Fair are within normal limits and are given OFA numbers. This information is accepted by AKC on dogs with permanent identification (tattoo, microchip) and is in the public domain. Radiographs of Borderline, Mild, Moderate and Severely dysplastic hip grades are reviewed by the OFA radiologist and a radiographic report is generated documenting the abnormal radiographic findings. Unless the owner has chosen the open database, dysplastic hip grades are not in the public domain.
Excellent: this classification is assigned for superior conformation in comparison to other animals of the same age and breed. There is a deep seated ball (femoral head) which fits tightly into a well-formed socket (acetabulum) with minimal joint space. There is almost complete coverage of the socket over the ball.
Good: slightly less than superior but a well-formed congruent hip joint is visualized. The ball fits well into the socket and good coverage is present.
Fair: Assigned where minor irregularities in the hip joint exist. The hip joint is wider than a good hip phenotype. This is due to the ball slightly slipping out of the socket causing a minor degree of joint incongruency. There may also be slight inward deviation of the weight-bearing surface of the socket (dorsal acetabular rim) causing the socket to appear slightly shallow. This can be a normal finding in some breeds however, such as the Chinese Shar Pei, Chow Chow, and Poodle.
Borderline: there is no clear cut consensus between the radiologists to place the hip into a given category of normal or dysplastic. There is usually more incongruency present than what occurs in the minor amount found in a fair but there are no arthritic changes present that definitively diagnose the hip joint being dysplastic. There also may be a bony projection present on any of the areas of the hip anatomy illustrated above that can not accurately be assessed as being an abnormal arthritic change or as a normal anatomic variant for that individual dog. To increase the accuracy of a correct diagnosis, it is recommended to repeat the radiographs at a later date (usually 6 months). This allows the radiologist to compare the initial film with the most recent film over a given time period and assess for progressive arthritic changes that would be expected if the dog was truly dysplastic. Most dogs with this grade (over 50%) show no change in hip conformation over time and receive a normal hip rating; usually a fair hip phenotype.
Mild Hip Dysplasia: there is significant subluxation present where the ball is partially out of the socket causing an incongruent increased joint space. The socket is usually shallow only partially covering the ball. There are usually no arthritic changes present with this classification and if the dog is young (24 to 30 months of age), there is an option to resubmit an radiograph when the dog is older so it can be reevaluated a second time. Most dogs will remain dysplastic showing progression of the disease with early arthritic changes. Since HD is a chronic, progressive disease, the older the dog, the more accurate the diagnosis of HD (or lack of HD).
Moderate Hip Dysplasia: there is significant subluxation present where the ball is barely seated into a shallow socket causing joint incongruency. There are secondary arthritic bone changes usually along the femoral neck and head (termed remodeling), acetabular rim changes (termed osteophytes or bone spurs) and various degrees of trabecular bone pattern changes called sclerosis. Once arthritis is reported, there is only continued progression of arthritis over time.
Severe Hip Dysplasia: assigned where radiographic evidence of marked dysplasia exists. There is significant subluxation present where the ball is partly or completely out of a shallow socket. Like moderate HD, there are also large amounts of secondary arthritic bone changes along the femoral neck and head, acetabular rim changes and large amounts of abnormal bone pattern changes.
(information from OFA website)
Office Hours
They are great! They fit me in for an emergency appointment same day and are very professional in manner. Dr Rutledge was so gentle with our furbaby pitbull Kilo and the service was phenomenal. Within 20 minutes of blood being drawn we found out he had Lyme. The pricing was very reasonable. I highly recommend taking your pets to this vet. I'm beyond pleased and relieved. Thank you Cherry Ridge Vet.
What can we help you find?


text:
An elegant true-to-life keepsake of your baby's first moments. Beautiful laser-cut crystal with your baby's true 3D image carefully etched inside. LED base lighting emits a glow that highlights every contour of your baby's face. Our high-quality cherry base displays an extra luxurious feel. Our premium size, guaranteed to spark conversation.
Large: Each side is 3.5in (80mm)
Medium: Each side is 2.4in (60mm)
Small: Each side is 2.0in (50mm)
NOTE: After adding this product to your cart, you will be asked to upload or email us your baby's ultrasound image (for example, a JPG or TIFF file).
Want to see more pictures of this product and others? Vist our Facebook page


text:
- 10
The purpose of a resume is to showcase your skills, qualifications and job relevant competencies. If all this is already being done by your resume, then why bother writing a cover letter?
Well, cover letter, as the name suggests, serves to cover your resume. While the resume will talk about your skills, qualifications and competencies your cover letter will write why you are the top candidate for this position.
One of the functions of a cover letter is to highlight the relevance among your skills and the recruiter's requirements. A sample cover letter serving the same function, for the position of junior secretary follows.
Junior Secretary Cover Letter Sample
Sue Gilbert
789, Worthington Road
Westerville, OH 78995
☏ (000) 555-6666
✉ sue.gilbert @ email . com
December 10, 2013
Mr. Gary Ronald, HR Manager
Kelly Associates
89 Twinkle Avenue
Westerville, OH 78995
Dear Mr. Ronald:
I was delighted to hear about your job company's job opening for a junior secretary as I possess all the skills required for the position. The following table gives you a snapshot of how my expertise matches your needs:
You Require
I Offer
|● Ability to handle official correspondence on daily basis
|● Expertise in communication via email, in person and on phone, abreast with professional communicational standards
|● Familiarity with drafting letters, using MS Word
|● Advance level skills in MS Office, exceptionally good at MS word and Excel
|● Time management and task prioritizing skills
|● Immaculate management skills, demonstrated ability to work in an organized manner under high pressure
|● Know-how of event planning and some experience in organizing meetings
|● A track record of planning and executing various high level nation-wide meetings and conferences, arranging stay and travel of guest delegates
In addition, my hands on experience in office assistance, taking minutes, completing legal files and maintaining business correspondence would definitely come in handy for the office at Kelly Associates.
In view of the apparent, flawless match among what you require and the expertise, I would enthusiastically welcome an interview meeting with you. Therefore, I will call upon your office to set up an interview date later this week. Meanwhile, If you need any documents or have any queries, feel free to contact me at (000) 555-6666.
Thank you for your time and consideration.
Sue Gilbert
Encl. Resume


text:
Steam screw ARIEL.* U. S. No. 95740. Of 52 tons gross; 26 tons net. Built at Philadelphia, Pa., in 1883. Home port, Rochester, N.Y. 70.3 x 18.0 x 7.8 Tow service. Crew of 5. Of 175 indicated horse power.
* Formerly Steam screw HARRY ROUSSEL.
Merchant Vessel List, U.S., 1923
Steam screw HARRY ROUSSEL. U. S. No. 95740. Of 52.24 tons gross; 26.12 tons net. Built at Philadelphia, Pa., in 1883. Home port, New York, N.Y. 70.3 x 18.0 x 7.8
Merchant Vessel List, U.S., 1885 [steam vessels]
The Maritime History of the Great Lakes site is managed by Walter Lewis
Since 2005 this site has been the prototype for the digital collection management tools built for the Our Digital World (formerly the OurOntario project of Knowledge Ontario.)
As a prototype it is subject to occasional, unexplained interruptions in service ... because we keep trying new things.
My favourites lets you save items you like, tag them and group them into collections for your own personal use. Viewing "My favourites" will open in a new tab.
Login here or start a My favourites account.


text:
Native Plants
Q. Who is Mr. Smarty Plants?
A: There are those who suspect Wildflower Center volunteers are the culpable and capable culprits. Yet, others think staff members play some, albeit small, role. You can torture us with your plant questions, but we will never reveal the Green Guru's secret identity.
Did you know you can access the Native Plant Information Network with your web-enabled smartphone?
Ask Mr. Smarty Plants is a free service provided by the staff and volunteers at the Lady Bird Johnson Wildflower Center.
rate this answer
Thursday - October 28, 2010
From: Phoenix, AZ
Region: Southwest
Topic: Container Gardens
Title: Looking for a summer through winter blooming container plant, for Phoenix.
Answered by: Leslie Uppinghouse
QUESTION:I'm in Phoenix. I'm looking for a perennial plant that will be planted in a container in a commercial setting, that is under a shaded pergola. She wants it to bloom in the winter and if carried into the summer, great. Currently has Lantana and they look too viney and has no blooms, doesn't want to use them again.
In the Native Plant Information Database on our website we have a neat feature called Recommended Species. You can use this to find native plants in your area with searchable qualifications to help you find just what you are looking for.
If you choose Arizona off of the map displayed, then narrow you search with Perennial, Part Shade and the bloom times you are seeking, you should see about 52 species.
Here are a couple of good choices from that search for you to consider and we encourage you to play with these searches on your own and take a deeper look at the variety of choices the results give you. Not knowing the size of the container you are talking about makes it tough to know exactly what might suit your needs.
The first plant that might be a good option is Asclepias tuberosa (Butterflyweed) This plant is a summer through fall and early winter bloomer. It can get quite big, stays bushy and is literally covered with big bright orange flowers. It does very well in containers and takes little water once established. It can take tough heat but will bloom well with partial shade.
The second choice would be Bouvardia ternifolia (Scarlet bouvardia) Scarlet bouvardia has a more delicate plant shape than the bushy Butterflyweed. The plant has long branches with a clump of bright red tuberous blooms at the end of each stem. This is particulariy nice in a taller container where you can let the branching extend tall and droop over the sides of the container. Again takes little water and blooms summer into late fall and early winter and is happy with partial shade, although it too can take full sun and high heat.
Lastly you might want to take a look at Tecoma stans (Yellow bells) Yellow bells is known for its habit of blooming very late into the season and will sometimes be the only yellow around in early winter. It loves a container as long as it is large. This can be a very large plant, up to 6' when planted in the ground. It has lovely shiny dark green foliage and great big yellow tubular flowers. Its shape is shrub-like and looks best unpruned until you need to cut it back which would be after it has finished blooming for the season.
One thing you might want to consider is using a combination of plants that might fit together in the container. If you plan it out, you can have a variety of species planted together to have color or at least interesting foliage year round. With one species you will always have a couple of months without blooms and many without any foliage at all. If this is an issue and suspecting that it would be, as this is for commercial application, make sure to think about whether or not you need the plant or plants to be evergreen all year round as the examples we have given you are not. Combinations of blooming plants and some evergreen foliage might be just the solution you are looking for.
More Container Gardens Questions
Bluebonnets in pots in New Caney, TX
April 25, 2009 - My mother in New Caney (Texas), would like to plant Bluebonnets in some lovely terra cotta containers on her porch (and will hopefully mail me some dried pressings of my beloved state flower). Other t...
view the full question and answer
Container plants for part shade in Bee Cave TX
June 18, 2013 - Dear Mr Smarty Pants, I am looking for plants that will thrive on my covered porch in 3 tall planters. These are meant to help me block an unattractive view out my living room window, so they must...
view the full question and answer
Native grasses for wood planter box in Houston
August 04, 2011 - Hi, I'm making a long wood planter box/bench for my wood deck. The area gets direct sun only in the late afternoon/evening and the deck serves as a play space for our one-year old son. I'd like to...
view the full question and answer
Native plants for hanging baskets in Abilene
June 10, 2008 - I live in the DRY West Texas heat in Abilene. I'd like to put some hanging plants along my back fence. Preferably something that would attract butterflies. We have a pool in our back yard and almost ...
view the full question and answer
Regulations for transporting plants to Texas from Florida
July 29, 2008 - We are relocating to TX from FL, I have a collection of potted palm trees and quite a few potted tropical plants (none are invasive)that I would like to bring with us, we will be traveling by car and ...
view the full question and answer
|Support the Wildflower Center by Donating Online or Becoming a Member today.


text:
Lg gsa e60l driver
All you have to do is lg gsa e60l driver use your creativity and your new image will be done in few mouse lg gsa e60l driver. Customize protocols which you brock lesnar death clutch book to block. The company's Snapseed can not only lg gsa e60l driver zest or l to images shot therirangum mukile mp3 your iPhone, iPad, or iPod touch camera, but also share it on Flickr, Lg gsa e60l driver, ga Twitter. It was originally developed for our own use. While we easily blew through the first few puzzles, the game made lg gsa e60l driver sweat from the fifth board on. Sponsored 5GB Storage Free.


text:
Malcolm X College clinical pharmacy
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Learn about Malcolm X College clinical pharmacy, and registering for discussion sections. Which college degrees give you the best chances of finding employment after graduation? You can enter nursing with either an associates degree or BSN. As a licensed vocational nurse (LVN), you may provide patient care under the supervision of a registered nurse (RN). Concentrating on Malcolm X College clinical pharmacy, for example, you may gain an advantage in corporate job recruiting on-campus. Check with the pharmacy department for course registration deadlines, and pharmacy technician program requirements. Please use the form above to request admissions info for Malcolm X College.
Typically, clinical trials compare a new pharmaceutical drug or therapy with another that already exists in order to determine if the new drug is more effective. In some studies, participants may be assigned to receive a placebo, usually a sugar pill. In double-blind experimental research trials, the participants are not informed about which medicine is being used. Double-blind studies are specifically designed to prevent both patients and scientists on the research team from influencing results. This ensures more scientifically-conclusive results for pharmaceutical companies.
Most clinical research studies pose the risk of physical discomfort, although some participants experience complications that require medical attention. In rare cases, participants have been seriously injured or have died resulting from their ingestion of experimental pharmaceutical preparations. The specific risks associated with a research protocol are described in detail in the informed consent document. Also, a member of the medical research team must explain the major risks of participating in a pharmacy study. Beyond major requirements within the pharmacy department, you may consider Fort Valley State University clinical pharmacology as a complementary elective to your primary course of study.
Nurse Technician
St. Francis Hospital
Certified Nursing Assistant (CNA). Or currently enrolled in a School of Nursing with completion of the "Fundamentals of Nursing" curriculum..
7 hours ago Hospice RN
Care Initiatives
Registered nursing education. Prefer two years recent clinical experience in medical/surgical, oncology, home health or public health nursing.
5 hours ago Quality Assurance Nurse
VIVA Pediatrics
Keep nursing documentation/paperwork. Pediatric Home Health agency looking for a Quality Assurance Nurse in the Richardson office..
4 hours ago Case Management Travel Nurse (RN) (UR/UM)
Tailored Healthcare Staffing
Graduate from an accredited school of Nursing, BSN preferred. We are one of the nation's fastest-growing travel nursing agencies, for good reason.
5 hours ago PSYCHIATRIST
North East Medical Services
Prescribes psychiatric medications and collaborates with therapist, case management and nursing staff to facilitate appropriate medication monitoring and..
4 hours ago Program Director - Nursing
Bryant & Stratton College
PhD, DNS, EdD, or DNP required in Nursing or related field, Master's degree must be in Nursing. New York State Nursing license is required..
13 hours ago


text:
Stay informed!
With the free Becker Shopping
Newsletter you - as a registered customer – always will be informed one click
earlier than others about exclusive and cutting-edge news.
All advantages in overview:
- Exclusive promotions
- Product recommendations
- Bargains and Discounts
- Exclusive Coupons
- Information about new products and updates
- Convenient online ordering directly over the newsletter with one click
Sign up now and take advantage of our regular Shopping Newsletter.
Only for short time: get a 10,- EURO voucher for your next purchaise.
* only valid for buying purchases in the period of 24.03.2016 till 03.04.2016
After entering your email address in the registration form, you will receive a confirmation of your registration by email. Please confirm this by clicking on the link in the email. In this way we ensure that no unauthorized person can register you for our newsletter (so-called "double opt-in" process).
Enjoy it.
Your Becker Shopping Team
- Your e-mail address has changed? No problem! Your settings can be changed conveniently via this page at any time. Simply enter your old email address and then register with the new email address again.
- Of course you can always easily unsubscribe from our newsletter (with effect for the future). At the end of each newsletter you will find an appropriate unsubscribe link. Or just cancel your registration by unsubscribing your email address on this page.
- Your personal data will be processed in accordance with the Data Protection Act. We reject any transfer of your data to third parties. You always have the opportunity to view and change your stored data. Please send us an e-mail to firstname.lastname@example.com stating your name, surname, address and e-mail address.


text:
1980 Look Out for the Catch
1980 Pardon Me Prime Minister
1980 Time Murderer Please
1981 Laughter in the Dark
1981 There Goes the Bride
We haven't yet been able to locate a programme for this show. If you have one, or any other memorabilia, we'd love to hear from you so please do get in touch!
1981 Tabitha
1982 Cat on the Fiddle
1982 The Proof of the Poison
1982 Not Now Darling
1983 When the Wheel Turns
1983 Don't Utter a Note


text:
Hello Key Biscayne!! ,Happy with my double practice today... ,Doble..
Garbine Muguruza
Hello Key Biscayne!! 🎾🔆
Happy with my double practice today...
Doble sesión de entrenooo...
Miami Open WTA
It would help if you study how Kutznetsova beat Pliskova at Indian Wells; you beat Kutznetsova at Roland Garros, so you can do it and prevail over them at Miami; vamos Dimples...!!!
Hi Garbiñe, the main draw is not prohibitive, but beware the early rounds: they are very insidious. Did you see the risks that Stan raced to reach the Indian Wells final? You temperamentally look a little like him (in my opinion, of course). Anyway: Viva Garbiñe! A big hug from Bologna.
@GarbiMuguruza I was wondering why you had on your ankle supports. What did you say in your video when you were packing? Those are the best videos because you are just being yourself which are far more interesting than "I love this tournament, and the fans". Is there anyway you can close caption those videos? Or do another in English? I mean you are in the US where only 17% of the population speak Spanish. How are the US fans going to get to know you? To your bilingual team or to your fans who already speak Spanish I already know your opinion and I am not interested in it because it dosent solve the problem. Telling me to learn Spanish is like me telling you to learn a language you don't know. It would take longer than Garbiñe's career to learn. Please speak more English on your videos. I beg you.😔🙏🙏🙏🙏🙏🙏🙏🙏
Visit https://www.facebook.com/GarbiMuguruza/videos/806248656190106/
Carla Suárez with Xavier Budó Bartumeu at Miami Open.
👋🏻👋🏻 Miami Open 👋🏻👋🏻 ¡Contenta de estar de vuelta! Happy to be here again!!
Un papà per amico, anzi per supporter
Auguri a tutti i papà!! 😃🎉 Io i miei li ho fatti così: http://www.gazzetta.it/native-adv/kiaservice-longform01-festa-del-papa.shtml?intcmp=kiaservice_bottom3T1A_180317_gazzetta_ss_home
BNP Paribas Open
👍 When you make your first final in Indian Wells...
Congrats, Stan Wawrinka! See you on championship Sunday at the #BNPPO17 🏆


text:
University of New Orleans workforce development
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Think about what career is best suited for you, and where you want to study. Request more information now.
Learn about University of New Orleans workforce development, and registering for elective discussion sections and seminars. Which college degrees give you the best chances of finding employment after graduation? Whether you are considering an associates degree, or a bachelor of business administration degree, your investment may pay off with a higher-paying job, or an in-house promotion. Concentrating on University of New Orleans workforce development, for example, you may gain an advantage in corporate recruiting being done on-campus. Check with the workforce development department for course registration deadlines, and career training program requirements. Please use the form above to request admissions info for University of New Orleans.
Human resources specialists must recruit, screen, and interview job applicants. They often are tasked with other duties such as compensation and benefits, and employee training. To fill a job opening, human resources managers may choose to recruit on-campus at a local university, sponsor a job fair, or simply place job ads online. Each method has advantages in employment screening, and built-in drawbacks regarding issues such as wages and salaries, healthcare, pensions, and union practices.
Potentially, the best candidates may be hired through on-campus recruiting, the resources required may be prohibitive. Online ads would attract a larger applicant pool, but many applicants may lack proper qualifications. Hiring decisions must take into account a limited advertising budget, as well as the necessity of maintaining low employee turnover. With a bachelors degree, the average salary for human resources specialists was $58,350 annually, as of 2017. Beyond major requirements within the workforce development department, you may consider Loyola Marymount University popular classes as a complementary elective to your primary course of study.
Sales and Marketing Analyst
Willing to get involved in ad hoc projects with a can-do attitude. You will work on a number of projects with a varied group and need to be flexible in taking..
3 days ago Vegetation Crewmember
ASRC Federal
ASRC Federal Primus provides federal government agencies a complete spectrum of operations and maintenance, facilities management, logistics and business.
2 days ago Summer Undergrad Intern
Bond Street
Bond Street is transforming small business lending with technology, data and design. Inspired by our mission to help small businesses realize their dreams.
2 days ago Financial Analyst: Planning, Analysis & Product Costing
Supports Finance Director in preparing for Business Review Meetings and other ad hoc analysis. They are job related and consistent with business necessity..
3 days ago Hotel Manager in Training - Food & Beverage
Buffalo Marriott HARBORCENTER
The MIT position will require ability to work flexible shifts in a 24x7 business environment, including weekends and holidays, with ability to travel and..
2 days ago Accounting Finance Manager
Bachelor's Degree in Accounting or Finance and CPA preferred. Zymergen is a fast growing company in search of a Accounting Finance Manager to be an integral..
5 days ago


text:
|Home | About | Journals | Submit | Contact Us | Français
Conceived and designed the experiments: AD FM PC. Performed the experiments: GC AD FM PC JB CC LP CG AV DR. Analyzed the data: AD FM FS JB CC YL JF DR. Contributed reagents/materials/analysis tools: GC FS CC LP YL CG AV DR. Wrote the paper: AD FM YL JF.
Huntington disease (HD) is a fatal neurodegenerative disorder, with no effective treatment. The pathogenic mechanisms underlying HD have not been elucidated, but weight loss, associated with chorea and cognitive decline, is a characteristic feature of the disease that is accessible to investigation. We, therefore, performed a multiparametric study exploring body weight and the mechanisms of its loss in 32 presymptomatic carriers and HD patients in the early stages of the disease, compared to 21 controls. We combined this study with a multivariate statistical analysis of plasma components quantified by proton nuclear magnetic resonance (1H NMR) spectroscopy. We report evidence of an early hypermetabolic state in HD. Weight loss was observed in the HD group even in presymptomatic carriers, although their caloric intake was higher than that of controls. Inflammatory processes and primary hormonal dysfunction were excluded. 1H NMR spectroscopy on plasma did, however, distinguish HD patients at different stages of the disease and presymptomatic carriers from controls. This distinction was attributable to low levels of the branched chain amino acids (BCAA), valine, leucine and isoleucine. BCAA levels were correlated with weight loss and, importantly, with disease progression and abnormal triplet repeat expansion size in the HD1 gene. Levels of IGF1, which is regulated by BCAA, were also significantly lower in the HD group. Therefore, early weight loss in HD is associated with a systemic metabolic defect, and BCAA levels may be used as a biomarker, indicative of disease onset and early progression. The decreased plasma levels of BCAA may correspond to a critical need for Krebs cycle energy substrates in the brain that increased metabolism in the periphery is trying to provide.
Huntington disease (HD) is a neurodegenerative disease with autosomal dominant inheritance. The causal mutation is an abnormally expanded CAG trinucleotide repeat in the first exon of the HD1 gene on chromosome 4p, encoding a polyglutamine stretch in the huntingtin protein. Although transcriptional modifications, excitotoxicity, protein aggregation and loss of normal function of huntingtin, have been hypothesized to be responsible for the symptoms in patients [1], HD remains a devastating disorder with no effective treatment. Access to predictive DNA testing provides an opportunity for early therapeutic intervention in presymptomatic individuals.
Despite the ubiquitous expression of mutated huntingtin, only the pathophysiology of brain-related symptoms, which are relatively inaccessible to investigation, have received attention. However, unlike other neurodegenerative disorders, affected HD patients are known to lose weight [2], despite normal, or even increased, food intake [3], [4]. In a group of 361 HD patients, lower body mass index (BMI) has also been shown not to correlate with dystonia or with chorea [5]. The demonstration that mechanisms underlying weight loss in HD are related to disease onset would indicate that a more systemic, and possibly treatable, defect may be implicated early in the pathophysiology of HD.
Therefore, we conducted a thorough multiparametric investigation exploring the underlying causes of weight loss in a group of patients with no or little signs of the disease, compared to controls. This included the use of a multivariate statistical analysis of plasma components quantified by proton nuclear magnetic resonance (1H NMR) spectroscopy. We observed a systemic metabolic defect involving branched chain amino acids (BCAA) in HD, associated with early weight loss. The role of BCAA in mitochondrial intermediary metabolism may indicate a systemic attempt at compensating for the early energy deficit in HD. These results further support recent data relating altered mitochondrial energy metabolism in HD with defect in the regulation of transcription caused by mutated huntingtin [6].
We included 32 individuals with abnormal CAG repeats expansions (>36) in the HD1 gene (19 women and 13 men, mean age of 42±11 years, ranging from 28 to 80) and 21 controls (13 women and 8 men, mean age of 37±9.5 years, ranging from 27 to 62). In the HD group, 3 subgroups were constituted on the basis of their symptoms determined by the Unified Huntington disease rating scale (UHDRS) score [7]. There were 15 presymptomatic individuals who had previously applied for predictive testing, carriers of the HD1 mutation but without any significant motor or cognitive signs of HD, as defined by UHDRS≤3 (UHDRS 0.7±1.2). Ten HD mutation carriers were very mildly affected, with 4≤UHDRS≤25 (UHDRS 11.9±4.9), and were designated as early HD patients. The remaining 7 HD patients had moderate signs of the disease, with 26≤UHDRS≤70 (UHDRS 44.4±14.1), and were designated as mild HD patients. Since diagnostic and predictive testing in HD is highly confidential, family members were not chosen as a control group, which consisted of healthy volunteers unrelated to HD mutation carriers. All participants were enrolled in a clinical protocol promoted by the Assistance Publique des Hôpitaux de Paris (CRC 05129), and approved by the local ethics committee. Informed consent was obtained for all participants. Motor dysfunction was evaluated with the UHDRS and a total functional capacity score, TFC [8]. We used a simplified validated questionnaire – the patient health questionnaire, PHQ-9 – to evaluate depression [9]. Treatment and smoking habits were recorded. A detailed medical history was obtained for each participant, especially conditions known to affect body weight, such as malabsorption, renal insufficiency, endocrine dysfunction and inflammatory process (auto-immunity, cancer).
Height and weight were recorded the day of the clinical examination. The body mass index (BMI) was obtained by dividing weight (in kilograms) by height (in meters) squared. Bioelectrical impedance (Tanita®) was measured to evaluate the lean mass and fat mass of all participants. Since this was a cross-sectional study, changes in body weight were not evaluated prospectively. Instead, the kinetics of body weight was determined by subtracting current weight from the weight recorded in medical records of each participant 5 years before inclusion in the study.
To determine caloric intake accurately, both opened and closed-ended questionnaires were used. The opened-ended questionnaire consisted of a semi-quantitative recording of the patients' regular food and beverage consumption during the three days preceding the consultation. The accuracy of this questionnaire was verified one month later with a closed-ended questionnaire that was sent to the homes of all participants. A series of diagrams was used, reflecting the amount of each class of food and beverage consumed over a 24-hour period. The same methodology was strictly applied to assess caloric intake in HD patients, presymptomatic carriers and controls. In order to interpret changes in body weight, major changes in eating habits during the past 5 years were also recorded, especially diets intended to gain or lose weight. Mean total calories, proteins, lipids and sugar intake for both the HD and control groups were calculated using an automated system (Diaeta software®).
A standardized protocol was designed to thoroughly evaluate all possible causes of weight loss and to avoid biases related to food intake and circadian fluctuations. It included sequentially: (i) a minimal 12-hour fast the night preceding the examination, (ii) collection of blood and urine at the same time (9 am), (iii) ingestion of a standardized meal (450 calories) over a period of 10 minutes, (iv) collection of a second blood sample to determine ghrelin values 1 hour after eating. Samples were stored on ice for immediate analyses or frozen at −80°C for further analyses.
Routine analyses of blood chemistry, including liver and kidney function, were performed. Serum insulin growth factor type 1 (IGF1) concentrations were measured using a specific immunoradiometric assay (IGF1 RIACT, Cis-Bio International, Gif- sur- Yvette, France). The three main axes involved in the regulation of weight balance were explored: (i) inflammation, by measuring of CRP, ESR, IL1β and IL6 by ELISA (Diaclone, Besançon, France), (ii) endocrine function, by measuring (at 9 am), fasting serum cortisol, insulin, tetraiodothyronine (T4L) and thyroid stimulating hormone (TSH) levels, fasting and fed ghrelin (8089-K, Linco Research, St Louis, USA) levels, and fasting leptin levels (HL-81HK, Linco Research, Paris, France); (iii) intermediary metabolism, by measuring plasma amino acids and acylcarnitines, as well as urinary organic acids [10], [11].
For comparison of means, ANOVA or non-parametric tests were used as appropriate (SPSS® software).
Plasma samples were prepared for 1H NMR spectroscopy with minimal handling as described [12]. For statistical analyses of the whole metabolic profile, spectra were data reduced in numerical format by integrating spectral regions (buckets) every 0.02 ppm (parts per million) and scaled to the total intensity of the spectrum with Amix 3.6.8 software (Bruker Analytische Messtechnik, Germany) from 0.8 to 8.6 ppm; the water peak area was excluded from each spectrum (4.4 to 5.2 ppm). Accordingly, each bucket of the NMR spectrum corresponded to a single X variable. Metabonomic studies, e.g. partial least squares analysis (PLS), consist in multivariate statistical analyses with as many components as variables. PLS (Simca-P® 11.0 software, Umetrics, Sweden) best describe the variation within the NMR spectra according to a priori classification, corresponding to a Y variable, which was the UHDRS score in our study. Therefore, the pair-wise PLS scores were plotted to identify principal components, maximizing the covariance between all X (NMR spectrum) and Y (UHDRS) variables. The greatest dispersion of the spectral profiles is usually observed in the two first components of the analyses. A contribution plot was then analyzed in order to determine the respective weight of variables that contributed most to the difference between groups.
The 3 groups defined according to UHDRS scores showed similar ages at examination (Table 1). Abnormal CAG repeats in the mildly affected group were slightly smaller than in the early group, but the latter were older at examination (Table 1). Early affected HD patients had low chorea subscores (4.8±3.7), and all mildly affected patients were autonomous and were able to live on their own, as shown by mean TFC scores above 10 (Table 1). Depression scores of the HD group were higher than those of controls (7.3±6.6, n=32 versus 0.7±1.6, n=21, p<0.001). Smoking was also more prevalent in the HD group (n=12/32 versus 1/21 in controls, p=0.006).
Retrospective analysis of body weight during the 5 years preceding the study showed a significant weight loss in the HD group compared to controls (p<0.001). The difference remained significant when men (p=0.002) and women (p=0.003) were analyzed separately (Table 2). Mean weight loss in early (−3.1±2.9 Kg) and mild HD patients (−5.0±7.1 Kg) was significantly greater than in presymptomatic carriers (−2.6±3.9 Kg) (p<0.01). Caloric intake recorded over the 3-day period and the 24-hour period was similar, so that the value, an essential determinant of weight balance, was considered to be reliable both in the HD group and in controls. No changes in diet or in conditions affecting body weight were recorded over the 5 years preceding the study either of these groups. Although HD mutation carriers had a higher caloric intake, their BMI was similar. In women, the BMI of the HD group was lower than the average for the French population (BMI=23, in 'Enquête décennale santé', INSEE 2006), which was not reflected by the controls from our study (BMI=21.3). Importantly, in HD men, BMI was significantly lower than in controls, and total caloric intake was inversely correlated with weight (p=0.029) and lean body mass (p=0.004), which clearly indicated a hypermetabolic state. Moreover, in presymptomatic carriers, daily caloric intake was higher than in controls (2195±495 Cal, n=15 versus 1665±305 Cal, n=21, p<0.001), as well as protein intake (85±24 g, n=15 versus 70±14 g, n=21, p=0.025). We found no correlation between depression scores and food intake or between smoking habits and weight loss.
ERS, CRP, serum interleukins IL 1ß (0.96±3.82 pg/ml versus 0.28±0.77 pg/ml) and IL 6 (0.54±2.50 pg/ml versus 0.39±0.89 pg/ml), on the one hand, and serum fasting cortisol (13.4±4.4 µg/100 ml versus 16.7±6.8 µg/100 ml), insulin (5.5±2.2 µU/ml versus 6.0±3.6 µU/ml), T4L (14.7±2.2 pmol/l versus 16.4±1.9 pmol/l) and TSH (1.92±0.90 mUI/l versus 1.80±0.65 mUI/l), on the other hand, were similar in the HD group and controls. Therefore, common causes of hypercatabolic state, i.e. inflammation and classical endocrine dysfunctions, were excluded. There was no glycosuria, and fasting blood glucose levels were in the normal range in the HD group (4.7±0.4 mmol/l).
PLS analyses distinguished HD individuals at different stages of the disease as shown in Figure 1. The difference between presymptomatic carriers and early HD is shown in Figure 1a. Early and mildly affected patients could be distinguished (Figure 1b), as could controls and presymptomatic carriers, despite some overlap (Figure 1c).
Metabolic profiles of plasma from early affected HD patients were then compared to those of presymptomatic carriers, those of mildly affected HD patients to early HD patients. The spectral region that contributed to differences among the HD groups determined from PLS contribution plots is shown in Figure 2. There was a significant (>2SD) decrease along with disease progression in the plasma concentrations of a group of variables from the buckets located between 0.85 to 1.0 ppm on the NMR spectrum. These peaks correspond to the branched chain amino acids (BCAA), valine, leucine and isoleucine. No other significant differences among the groups were detected in the spectra even though very small buckets (0.02 ppm) were analyzed.
To confirm that BCAA are affected in HD, we also measured their concentrations in plasma by ion exchange chromatography. Valine, leucine and isoleucine levels were significantly lower in the HD group compared to controls (209±47 µmol/l versus 245±44 µmol/l, p=0.009; 118±24 µmol/l versus 144±23 µmol/l, p<0.001 and 56±12 µmol/l versus 68±15 µmol/l, p=0.002, respectively). In addition, the levels of each BCAA were correlated with the observed weight loss in the patients (p=0.007, 0.003 and 0.017), and, more importantly, negatively correlated with UHDRS values (p=0.017, <0.0001 and 0.003) in both men (p=0.035, 0.019 and 0.036) and women (p=0.007 for leucine and 0.01 for isoleucine). The number of CAG repeats was also negatively correlated with valine (p=0.015), leucine (p=0.018) and isoleucine (p=0.020). Although the BMI values of women with HD were similar to those of controls, they had significantly lower leucine (109±19 µmol/l versus 134±22 µmol/l, p=0.002) and isoleucine (53±10 µmol/l versus 65±16 µmol/l, p=0.014) levels (Figure 3). Interestingly, the plasma levels of the three BCAA were significantly lower in patients at an early stage of the disease compared to presymptomatic carriers (188±35 µmol/l versus 229±50 µmol/, p=0.042, 105±21 µmol/l versus 130±24 µmol/l, p=0.019 and 49±9 µmol/l versus 62±12 µmol/l, p=0.024). The plasma levels of valine (228±50 µmol/l versus 245±44 µmol/l), leucine (130±24 µmol/l versus 144±23 µmol/l) and isoleucine (62±12 µmol/l versus 68±15 µmol/l) tended to be lower in presymptomatic carriers than controls, although the difference was not significant. There was no correlation between BCAA levels and age or smoking habits.
All other metabolic markers were similar in the HD group and in controls. However, IGF1 levels were significantly lower in the HD group than in controls (175±48 ng/ml versus 210±47 ng/ml, p=0.011) and negatively correlated with UHDRS scores (p=0.004). IGF1 levels were also correlated with leucine (p=0.04) and isoleucine (p=0.02) levels. There was no correlation between IGF1 levels and parameters associated with weight (BMI, lean and fat body mass) or caloric intake.
In men, fasting and postprandial ghrelin levels were higher in the HD group than in controls (1797±719 pg/ml versus 1077±453 pg/ml, p=0.024 and 1365±538 pg/ml versus 860±291 pg/ml, p=0.021 respectively). However, women with HD and controls had similar BMI values. Accordingly, ghrelin levels were negatively correlated with BMI (p=0.008) but not with the UHDRS score. Fasting ghrelin also correlated with caloric intake in men (p=0.029), consonant with its orexigenic activity. Importantly, the ratio between pre- and post-prandial ghrelin levels were strictly identical in the HD group compared to controls (1.35 versus 1.36) indicating that the negative feedback on hypothalamus induced by food intake is functional in HD. Leptin levels, which vary independently but inversely to ghrelin, were lower in men with HD compared to controls (4.4±3.3 ng/ml versus 12.4±11.5 ng/ml, p=0.028), but not in women, and were correlated with weight (p<0.001) and fat body mass (p<0.001), but not with the UHDRS score.
This study is the first comprehensive investigation of the physiopathology of weight loss in HD. We retrospectively confirmed that weight loss begins early in the disease [5], despite higher caloric intake, and is evident even in presymptomatic mutation carriers and those with mild chorea, ruling out the role of hyperactivity. This hypermetabolic state is not explained by common mechanisms like inflammation or altered endocrine functions, both of which have been incriminated in the pathophysiology of HD [13], [14]. High ghrelin levels and low leptin levels in men with HD were reflective of their low BMI compared to controls, and did not evolve with the disease. Thus the ability of the hypothalamus to inhibit ghrelin synthesis after food intake is functional in HD, contrary to a previous report [15]. Therefore, the hypermetabolic state of HD patients seems to be part of the pathological process induced by mutated huntingtin.
Our 1H NMR spectroscopic analyses showed that a systemic metabolic defect is associated with the status of HD carriers, as well as disease progression. A selective decrease in branched chain amino acids plasma concentrations distinguished presymptomatic carriers from patients at an early stage of the disease and patients at an early stage from mildly affected patients. Decreased plasma BCAA levels were previously documented in more severely affected HD patients, but the authors did not evaluate the patients' diet or weight [16], [17]. Recently, a decrease of plasma BCAA was found by mass spectrometry in HD patients at different stages of the disease, in association with various metabolic changes [18]. Our metabolic screening was sufficiently detailed to demonstrate that plasma BCAA are the only metabolites that differ between the HD patients and controls. A significant difference between patients at an early stage of the disease and presymptomatic carriers, was also observed regardless of sex. The difference between presymptomatic carriers and controls, did not reach statistical significance, however, consistent with the partial overlap between the metabolic profiles of plasma observed by 1H NMR spectroscopy. This is most likely due to the heterogeneity of the presymptomatic group in which the estimated time to disease onset varies among individuals, so that the metabolic profiles of some presymptomatic carriers can be similar to those of controls. Interestingly, the decrease in the levels of BCAA correlated with weight loss in HD patients. Most importantly, it varied with HD itself, i.e. with the UHDRS scores of the patients and the number of CAG repeats in their mutations. Therefore, plasma BCAA can be considered as relevant biomarkers of the early stages of HD. For more severely affected patients, further analyses should be performed. It is of note that very few metabonomic studies have led to the identification of biomarkers that can be used routinely for the follow up of patients. This is due to common experimental and analytical biases in humans that include dietary intake, time of sample collection, sample conditioning and chemical shifts due to changes in pH [19], [20]. The rigorous control of these parameters in our study likely explains the accuracy of our NMR findings.
The implication of BCAA in mitochondrial intermediary metabolism, both in brain and peripheral tissues, further supports an important role for energy deficit in HD. A reduction in ATP production was shown in brain of HD mice, including presymptomatic mice [21]. A significant reduction in ATP levels and mitochondrial respiration was also evidenced in striatal cells of HD mice, although the respiratory chain complexes were not impaired [22]. In HD patients, there is strong evidence for hypometabolism in the brain where glucose consumption is reduced, especially in the basal ganglia, even in presymptomatic mutation carriers [23], [24], [25]. The underlying cause of this early energy deficit in HD brain is currently unknown, but impaired glycolysis [26], citric acid cycle [27] and/or oxidative phosphorylation [22] may be involved. Recently, mutated huntingtin was shown to decrease the expression of PGC-1α (peroxisome proliferators-activated receptor gamma coactivator-1α) in the striatum of HD mice and patients, through a CREB-dependent transcriptional inhibition [28]. PGC-1α is a transcriptional coactivator that regulates key energetic metabolic pathways, both in the brain and peripheral tissues [29]. The possible role of PGC-1α in HD was initially suspected from the observation of selective striatal lesions in the PGC-1α knockout mouse [30]. Down-regulation of PGC-1α in HD striatum was then shown to affect mitochondrial energy metabolism, possibly by impairing oxidative phosphorylation [28]. In addition, the inhibition of succinate dehydrogenase, by 3-nitropropionic acid or malonate, mimics HD neuropathology in mice [31], indicating that a lack of substrates for the citric acid cycle and the respiratory chain is implicated in the energy deficit in HD brain. Importantly, mitochondrial oxidation of BCAA leads to the production of acetyl-CoA and succinyl-CoA, two key intermediates of the citric acid cycle. Insufficient caloric or protein intake was excluded in our study, as well as impairment of the BCAA oxidation pathway since organic acid levels in urine were normal. Therefore, the decrease in plasma BCAA observed in the HD group probably results from the activation of a compensatory mechanism to provide energy substrates to the citric acid cycle, as described in various cachexia-producing illnesses [32], [33]. The correlation between decreased BCAA levels and weight loss in our study suggests that excessive mobilization and oxidation of BCAA to produce energy in muscle is associated with weight loss and reduced lean body mass. The observation of weight loss prior to neurocognitive decline suggests that neurological symptoms are exacerbated when substrates from the periphery become insufficient to compensate for the energy deficit in the HD brain. The normal rate of oxygen consumption recently observed after striatal infusion of succinate [34] supports the idea that providing energy through an increase in both systemic and cerebral citric acid cycle intermediates may be a promising therapeutic approach in HD.
BCAT (branched-chain aminotransferase) is the first enzyme involved in BCAA catabolism and is preferentially expressed in muscle. Since altered energy metabolism has been shown in muscle of HD patients [35], it remains to be determined whether the systemic decrease in plasma BCAA also reflects an adaptive response to a peripheral energy deficit in HD [36], in addition to the energy deficit in the brain. As the two key enzymes of BCAA oxidation, BCAT and BCKDH (α-keto acid dehydrogenase), are widely expressed in the brain [37], the decrease in BCAA levels detected in the cerebrospinal fluid of HD patients [16] may indicate that BCAA oxidation is also activated in the brain to compensate for the local energy deficit. Indeed, BCAA play an important role in brain metabolism, accounting for up to 20% of whole-body BCAA metabolism [38]. Leucine, in particular, is a nitrogen donor for the glutamate-glutamine shuttle, with transamination of α-keto-isocaproate to leucine leading to the conversion of glutamate into α-ketoglutarate [39]. Low levels of BCAA in the brain are, therefore, likely to impair the buffering of glutamate, in accordance with previous studies showing altered glutamate-glutamine cycling in HD [40]. Recently, excessive oxidation of BCAA was observed in a BCKDH kinase knockout mouse, emphasizing the importance of BCAA in intermediary metabolism, in both brain and peripheral organs [41]. Indeed, the systemic decrease in BCAA levels was associated not only with weight loss, but also with motor dysfunction in adult mice.
Finally, our study showed that low plasma BCAA levels are associated with reduced IGF1 levels in the HD group despite a higher protein and caloric intake than controls. The tight connection between IGF1 and essential amino acids has been repeatedly demonstrated [42], [43], [44]. Interestingly, huntingtin is a substrate of the serine-threonine Akt pathway, which is activated by IGF1 [45]. Reduced activation of the Akt pathway has been shown to decrease phosphorylation of mutated huntingtin, resulting in increased neuronal toxicity [46]. Low levels of IGF1 in HD patients might contribute to the alteration in Akt activation observed in HD animal models and patients [47].
This study provides the first demonstration of a systemic metabolic defect in HD, associated with early weight loss. Plasma BCAA represent a promising and accessible biomarker that may be useful for the detection of disease onset and for monitoring therapeutic trials in patients at an early stage of the disease. Decreased plasma BCAA levels in HD strongly suggest a critical need in the brain for citric acid cycle substrates provided by peripheral organ metabolism.
The authors gratefully acknowledge Alexis Brice, Merle Ruberg and Charles Roe for their helpful suggestions. They also acknowledge Anne Faudet for her expert technical assistance and Anne Desfarge for her help with the dietary assessment of both the controls and HD patients.
This study was approved by the Committee de Protection des Personnes (CPP) from the Pitié-Salpêtrière Hospital Paris (France) on October 18, 2006 (project n# 17-06).
Competing Interests: The authors have declared that no competing interests exist.
Funding: Dr Mochel was supported by the Fondation pour la Recherche Médicale (France).
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


text:
Full Description
The topical web directory first appeared in the Internet Archive on October 12, 2004. In order to submit a site listing to the directory, it is necessary to first purchase a SEOMA account for $15.00, which includes one submission credit, with discounts on additional credit purchases. Instant placement is promised, with possible modifications made after the site has been published, in order to conform to directory standards.
Approved sites are listed in the most appropriate category, as well as on custom detail page, each with an outbound link. Keywords in the description are highlighted and linked to internal pages within the site.
The top-level categories of the SEOMA directory are Arts, Business, Computers and Internet, Entertainment, Finance, Health, Home, Science, Shopping, and Society.
Website Address


text:
DVD to MP4
- Xilisoft DVD to MP4 Converter for Mac
- Xilisoft DVD to MP4 Converter for Mac provides the best way to rip DVD to MP4 format for iPod, iPhone, PSP, PS3, Archos, iRiver PMP, Creative Zen, and Apple TV. You can also extract audio from DVD movie and convert DVD to MP3, AAC or M4A format with this Mac DVD to MP4 converter.
- Price: $35.95
- Learn more about this>>
- iSkysoft DVD to MP4 Converter for Mac
- iSkysoft DVD to MP4 Converter for Mac is an ideal solution to convert DVD to MP4 files for your Mac and portable players like iPod, iPod touch, iPhone, Apple TV, PSP and so on. It can also extract DVD audio to M4A, AAC for playback on your players.
- Price: $34
- Learn more about this>>
Hot Search
mp4 3gp MTV flv YouTube mpeg4 ipod psp dvd flash Convert DVD to MPEG mov Burn ISO Images vob rmvb Convert YouTube Video to Audio file FLV to MP3 iPod to Mac Convert MKV to Xbox 360 AVI on Mac avi to dvd video to mp4 video editor Convert DVD to SWF video or dvd to ipod Create Ringtones for Mobile video or dvd to psp Convert FLV watch TV on PC remove commercials remove scenes from video edit video Blackberry capture from TV tuner burn video files to DVD DVD Burner apply effects and transitions iPod Video Converter rip DVD split trim video merge video upload video to cell phones Convert WMV to Sony PSP DV to DVD transfer DV to DVD MPEG editor DVD Creator for Mac video to portables DVD cover editor edit make and burn ISO AVI to SWF video montage


text:
Jun 20, 2017 07:35 AM IST | Source: Moneycontrol.com
Indian ADRs: HDFC Bank, Tata Motors, ICICI Bank, Infosys down
Indian ADRs ended lower on Monday. ICICI Bank shed 0.11 percent and Wipro was down 0.08 percent.
Indian ADRs ended lower on Monday. In the IT space, Infosys fell 0.10 percent at USD 15.07 and Wipro was down 0.08 percent at USD 10.06.
In the banking space, ICICI Bank shed 0.11 percent at USD 9.78 and HDFC Bank declined 0.60 percent at USD 88.71.In the other sectors, Tata Motors slipped 0.31 percent at USD 34.81 and Dr Reddy's Laboratories gained 0.33 percent at USD 41.91.


text:
What is the diffrence between inpatient and outpatient Electronic health record (EHR) systems
I am suppose to research two electronic health record (EHR) systems: one that supports a doctor's office or outpatient facility and another for an inpatient acute hospital. Than create a Word table, Excel spreadsheet, or similar document comparing the specifications of the two systems based on the following criteria:
What is the type of system used? Is it cloud-based or client server/desktop based?
What size of practice can the software support (compare the number of physicians or beds the software can support)?
Is the software CCHIT Certified?
What specialties (such as cardiology, radiology internal medicine, neurology, etc.) can the software design to accommodate?
Tutor Answer
Hi, please view the attached file.It has been lovely working with you.Oconnor
Running head: HEALTH AND MEDICAL: ELECTRONIC HEALTH RECORDS
Health and Medical: Electronic Health Record Systems
Student's name:
Course title & number:
Electronic health record system
The outpatient setting covers the entire lifetime of a patient; this is unlike the inpatient
facility that focuses on an episode of care. This difference in perspective, therefore, warrants
a variation in the electronic health record system in the outpatient and inpatient settings.
Below is a summary of the differe...
Brown University
1271 Tutors
California Institute of Technology
2131 Tutors
Carnegie Mellon University
982 Tutors
Columbia University
1256 Tutors
Dartmouth University
2113 Tutors
Emory University
2279 Tutors
Harvard University
599 Tutors
Massachusetts Institute of Technology
2319 Tutors
New York University
1645 Tutors
Notre Dam University
1911 Tutors
Oklahoma University
2122 Tutors
Pennsylvania State University
932 Tutors
Princeton University
1211 Tutors
Stanford University
983 Tutors
University of California
1282 Tutors
Oxford University
123 Tutors
Yale University
2325 Tutors