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LONDON, July 29 (UPI)–Hollywood film star Johnny Depp says he is considering retiring from acting in the near future.
"Are there quieter things I wouldn't mind doing? Yes, I wouldn't mind that. I wouldn't say I am dropping out any second, but I would say it's not too far away," the 50-year-old actor told the BBC.
Depp has starred in "The Lone Ranger," "Dark Shadows," "The Pirates of the Caribbean" franchise, "Chocolat," "Edward Scissorhands," "Ed Wood," "What's Eating Gilbert Grape?," "A Nightmare on Elm Street" and the TV series "21 Jump Street."


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Hard work, experience and connections are the keys to success in the rapidly expanding field of international commercial and investment arbitration. If you are prepared to work hard, the ISDE Master in International Commercial & Investment Arbitration offers a unique opportunity to obtain the experience and connections to help you build, consolidate and accelerate a successful career.
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subset: commoncrawl


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A number of GED testing sites throughout the Chicago area have run out of slots for some people who had hoped to take the exam before it switches to a computerized, costlier version next year.
The shortages in Cook, Kane, McHenry and Will counties affect first-time test takers who had planned to take a paper version of the GED exam. Although their official deadline to finish the series of tests on paper isn't until Nov. 16, officials said the demand is simply too high — even with the addition of extra testing sessions.


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Charlotte Addams (Co-Creator, Co-Host, Co-Producer, Current AAS Lip Sync Battle Champion, 2016 Audio Verse Award Nominee for Best Writing): Charlotte was born and raised on the Northern California coast, where made her radio debut in the early nineties in a performance most notable by the fact that she continued to suck her thumb throughout. Encouraged by this inauspicious debut, Charlotte continued to hone her radio skills on a plastic Playskool tape recorder. In the late aughts Charlotte migrated east, and now can be found most often in the walk-in cooler of a downtown Manhattan grocery store, performing her food-based humor for coworkers who are by turns mortified and entertained. To date, she is most proud of writing the following line: "Two pints of Sam Adams and I'm working on brie!" Condolences accepted.
Sarah Smithton (Co-Creator, Co-Host, Co-Producer, Editor, double 2016 Audio Verse Award Nominee for Best Leading Actress and Best Writing): Sarah is a textbook Pisces born and raised in the Mission district of San Francisco. She acts and sings and (occasionally) dances for a living, but you can learn more about that on this website. Sarah's first radio experience came in 2003 while doing promotions for the Mountain Play Association's production of Annie. The interview went very well, and if anyone would like to hear it, she has a copy on cassette tape somewhere. In her free time, she brews her own kombucha and tries to be upside down as much as possible on any aerial apparatus.


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North Shore News Hour
- Monday 12-1pm
- Monday 5-6pm
- Tuesday 12-1pm
- Tuesday 5-6pm
- Wednesday 12-1pm
- Wednesday 5-6pm
- Thursday 12-1pm
- Thursday 5-6pm
- Friday 12-1pm
The North Shore News Hour includes up-to-the minute weather, North Shore happenings in local news, sports and entertainment, as well as a variety of features from WTIP staff and volunteers. If you miss the North Shore News Hour at noon, tune in for a replay Monday through Thursday beginning at 5:00 p.m.
West End News: An interview with Bill Hansen and Clare Shirley-
Bill Hansen has been the voice of the West End News for the past 5 years. Bill's daughter, Clare, will be taking over this weekly report, and Jay Andersen recently spoke with both Bill and Clare about this transition.
School News from Sawtooth Mountain Elementary: December 20-
Landon, Talon, and McCoy report the latest school news.
Click here for archived editions of school news.
School News from Great Expectations: December 17-
Noah and Wren report the latest school news.
Wildersmith on the Gunflint: December 16Fred Smith-
Excitement is building as the birthday of all birthdays nears. Our holiday season is officially in the books for 2016 as the lonesome pine sentinel along the Trail has been lit for yet another year.
What a joy it is coming around the curve and down the hill beside Birch Lake to be greeted by the towering spruce all aglow with hundreds of twinkling bobbles to break up the darkest of darkness. Thanks to those folks on Birch for lighting up our wilderness lives.
Another kick-off for our season's greetings is recognized with the annual Borealis Holiday Concert of last weekend. A number of our Gunflint Trail neighbors lent their voices and instrumental talents to this "joy to the world" spectacle. Congrats to all participants and organizers.
Add to these humankind happenings, the arrival of the full Ojibwe "little spirit moon" within the last few days, and one could not ask for a brighter time in the final stanza of the year.
Conditions for winter time fanciers have been given a boost over the past seven with our first extended cold spell, better late than never. While new snow accumulations to date have been minimal, what's on the landscape currently has been secured by Arctic cold.
How cold was it? Not too terrible compared to days of old, but enough to get one's attention when stepping out the door enroute to the woodshed for an armload of fire wood. An expectation of more sub-nothing temps by this scoop's air time might make our Wildersmith low temp of -12 last Sunday morning pale in frigidity.
The arrival of zero and below temps finds the yet to be frozen Gunflint Lake a steamy cauldron. While waters are warm in comparison to the air above, this yearly occurrence has ghostly plumes drifting ashore from this warm/cold interaction. Accordingly, every appendage up into the shoreline forest is coated in delicate crystal frosting.
The magnificence of this nature-made artistry is almost beyond comprehension. The frosted elegance is the subject of which Hallmark cards are made. The only stopping of this "Jack Frost" decorating show will occur when the winds calm, allowing the Gunflint Gal to put on her winter coat.
Meanwhile, our winter advance is peaceful and quiet. With exception of chattering critters and snapping tree bark, our snowy landscape is still, in and of itself. Flakes are profoundly quiet as they accumulate, but once on the ground, the buildup can become somewhat vocal, as we humans disturb the covering by stepping in it.
Such has become evident with the decline in temperatures during recent days. I find walking through the marshmallow mass to be fascinating, as each step meets the crystal surface compressing our fluff. Perhaps listeners, too, have noted a difference in tonal quality from warm soft snow to the crispy dry cold stuff.
Whereas, our earlier precipitation descended barely in a solid state and landed on warm earth, trekking in such happened in mere quiet, then to a slight "squoosh." Over the past few days, a discernible change is noted while tromping in the drier crystal add-ons. As temps declined, it might be said each step caused the snow to mildly "bark" back at me. As the temp neared zero, each imprint then seemed to "squeak," and on Sunday morning, when it was well below zero, the squeaking became a deeper, hollow resonance.
I've read of such tonal exchanges while walking in the snow from a weather observer in Iowa, and sure enough, he seems to be right on. So, if you ever see me walking down the road on a winter day, seemingly talking to myself, I might be just visiting with the white majesty beneath my boots.
On another subject, as this territory is in the flyway for many migratory birds, I came upon an informative article in the December/January Nature Conservancy publication. If such interests you, I'd recommend finding a copy and looking at the scribing, "Safe Flight—100 Years Of Protecting Birds." The content is interesting commentary for digesting on a cold winter night.
For a final note, since this is also bear country, another thought provoking article appears in the recent Sierra magazine for January/February of '17. Although this reading is focused on brown bears of the Northern Rockies, it has relevance to those of us who live in black bear territory. "The Return Of The Grizzly" by Aaron Teasdale relates to human/bear interactions, much like we experience here in border country. Again, if listeners can get a copy, the author relates an insightful look at how we should be living in close proximity with Ursine.
For WTIP, this is Fred Smith, on the Trail, at Wildersmith, where every day is great, in a superbly natural way.
(Photo courtesy of Tom on Flickr)
Superior National Forest Update: December 16-
Hi. This is Renee Frahm, visitor information and administrative support specialist, with this week's National Forest Update - information on conditions affecting travel and recreation on the east end of the Superior National Forest. For December 16, here's what's going on in the Forest.
Only about a week to get out and get a Christmas tree for this year! Tags are five dollars, but if you have a fourth grader in the 'Every Kid In A Park' program, they can get a free tree tag! When you are looking for a tree, keep an eye out also for the dense clusters of branches often called witch's brooms. While witch's brooms might seem to relate more to Halloween than the current season, they are caused by Eastern Dwarf Mistletoe. Mistletoe has long been considered a mystical plant, and the tradition of kissing under it was once considered a promise of marriage. Peace treaties were also signed under mistletoe, and warring couples could kiss and make up beneath a ball of mistletoe. So, depending on who you are tree hunting with, you may choose to steer them under, or take them far away from any mistletoe you find!
There's a lot of winter though before summer travels begin. We've lost over six hours of daylight since June 21st, so if you think it has been dark, you are absolutely right. We are close to the longest night of the year, the winter solstice on December 21st, but after that low point, our days will start to lengthen again. The average temperature lags behind day length though, so it won't be until much later that we start seeing increases in average temperatures. Since you can't do much about our long cold nights, you may as well get out and enjoy them. Winter is one the best times to go stargazing. The cold air is still and dry and gives a better view of stars than the warm wet summer air. Long nights mean you don't have to stay up late to see the stars, there are no mosquitoes, and there's better chances of seeing the aurora as well.
We finally have some snow on the ground, and our trail partners have been working on grooming cross country ski and snowmobile trails. Most ski trails are in the process of being groomed. Pincushion and Sugarloaf ski areas are compacted, but not groomed, although that information could already be out of date. Similarly, bogs in the Flathorn-Gegoka ski area were insufficiently frozen for grooming, but with our recent cold spell, that may have changed. Check our website for links to the grooming organizations, which will give you more up to the minute information on trail conditions. Snowmobiles need a bit more snow that skis, so most of the snowmobile trails are still not groomed, and many are closed.
While you're out checking out trails, you may find some log hauling going on. On Gunflint, hauling is taking place on Greenwood Road, Firebox Road, Trestle Pine Road, Rice Lake Road, Clara Lake Road, and Honeymoon Trail. Portions of Firebox Road and Trestle Pine Road are also designated snowmobile trails, so snowmobilers need to be extra cautious and aware that hauling may be taking place on these roads. In Tofte, you'll have logging traffic on the Grade and Trapper's Lake Road. Please use caution when driving or recreating in these areas.
There will be no update next week, so happy holidays to everyone from the Superior National Forest! Enjoy the woods, watch out for mistletoe, and until next time, this has been Renee Frahm with the National Forest Update.
An interview with Nocka, the elf-
This is a busy time of year for Santa's elves – and WTIP's Sherrie Lindskog was lucky enough to be able to talk with an elf.
North Woods Naturalist: Varied weather and otters-
Cold weather swings and not-the-usual suspects at the bird feeder. WTIP's Jay Andersen talks with naturalist Chel Anderson about the winter so far.
(Photo by Amit Patel on Flickr)
School News from Birch Grove: December 16-
Tucker and Sophia report the latest school news.
West End News: December 15Bill Hansen-
I was very happy to hear the news that the effort to build rental housing in Lutsen that is targeted toward people who live and work in the West End took a big step forward this week. A $325,000 grant was awarded by the Minnesota Department of Trade and Economic Development to the Cook County/Grand Marais Economic Development Authority. This is a key piece of financing for a 2.7 million dollar plan to build 16 market-rate rental apartments in Lutsen.
The housing shortage in all of Cook County is severe, so this project, along with one planned for Grand Marais and one for Tofte, will be a big step toward easing the shortage. One Roof Community Housing, based in Duluth, is bringing their vast experience as a key partner, hopefully to all three projects. This is not the complete solution to the problem, but is a giant step in the right direction. We owe a debt of gratitude to the many people who have been working on this for so long.
Speaking of good news, I recently saw a report from Visit Cook County, the group that markets Cook County as a tourist destination, that tourism dollars county-wide are up 25% in the last five years. This is significant because it was a little over five years ago that the four parts of Cook County -- Grand Portage, Grand Marais, the Gunflint Trail and the West End -- decided to pool their marketing budgets and promote the county as a whole. Elaborate financial safeguards were put in place to make sure that each area was treated fairly, but even so, it was hard to build trust among the parts of the county that had been in competition with each other for so many years.
In the ten years before Visit Cook County was created, tourism was declining each year, leading up to the recession, which really took a toll. It is now crystal clear that the decision to work together has paid off handsomely for all. In fact, in the last year, Grand Marais has shown the most growth, which is obvious if you spend any time at all in town.
Our local marketing expertise is getting better all the time and the tools available for targeted marketing are also improving fast, so barring any unforeseen disaster, we should see robust growth for at least a few more years, especially in the slow seasons. Congratulations to the hard working staff of Visit Cook County for their success.
Word is out that ice skating has begun on inland lakes. It's not ideal, as there is some snow on the ice, but if you're willing to skate through the snow or do a little shoveling, there is good lake skating to be had.
Be careful - and I speak from personal experience - to always check the ice depth before you skate. Never skate alone and always carry ice picks to pull yourself out if you do fall through. You should also have dry clothing in a waterproof backpack or at least have access to dry clothing and a warm car nearby.
With some wistfulness, I would like to announce that this will be the last time you will hear me as the regular voice of the West End News. I am delighted to report that my very capable daughter, Clare Shirley, will be taking over this commentary, just as I took it over from my dad many years ago. I may be substituting occasionally for Clare when she is busy or out of town, so I may get a chance again to talk about the bloodmobile or the Birch Grove Carnival in the future, which makes me happy.
Even though I'm now officially a "townie," my heart will always be in the warm and wonderful West End.
For WTIP, this is Bill Hansen with the West End News.
Workshops offered to improve "walkability" of Grand Marais-
The Cook County Chamber and Moving Matters are hosting two "Walkabout" workshops to explore the things that might be done to improve the "walkability" of Grand Marais. WTIP's Jay Andersen spoke with Jay Walljasper, who'll be leading the workshops.


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Avoiding Fall Weight Gain – Parvati Magazine
Fitness: Avoiding Fall Weight Gain, by Sandra O'Brien
It seems as though overnight the evenings have already turned cooler here in Oakville, signifying the return of Fall. Fall has always been my favorite time of year. There is something about the leaves changing colour, shorter days, a need for boots and a sweater, that gives me a feeling of peace and homecoming. I am sure it goes back to my childhood and return to school, with the opportunity to see friends who were absent over the summer due to travel, family obligations, work and the multitude of activities that occur in July and August. Read the rest of the article here


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A new carbon capture process to make fuel at an industrial plant brings the cost down to between $94 and $232 per ton compared to previous estimates of $600 per ton. The technology could help drive a market for low-carbon synthetic fuels. Led by Harvard professor of applied physics David … Read more »
Carbon Capture
Sustainability expert Josh Prigge discusses the emerging corporate net positive movement, and shares examples of regenerative practices in action.
The budget bill signed by President Trump last week includes a significant expansion of tax incentives for carbon capture. The tax credit, known as 45Q, allows for a credit of
Organizations in the agriculture industry may have a new reason for going organic: a new study indicates that soils on organic farms store away "appreciably" larger amounts of carbons, and for longer periods, than typical agricultural soils. The study is proof that not only do organic agricultural practices help fight … Read more »
De Beers, the diamond unit of Anglo American, will attempt to capture carbon within the rock from which diamonds are extracted in order to offset its harmful emissions and reduce a tax it might have to pay on carbon emissions at its South Africa mines. De Beers plans to pilot … Read more »
Agricultural processors and food ingredient provider Archer Daniels Midland Company is embarking on a project to capture and store carbon from its Decatur corn processing facility. This is the second carbon capture and storage project that ADM has helped to lead. Previously, the company removed and stored approximately a million tons of … Read more »
In a deal that aims to reduce industrial emissions and convert CO2 into new products for reuse, Veolia and Carbon Clean Solutions (CCSL) have partnered for the large-scale rollout of CCSL's carbon dioxide separation technology.
FuelCell Energy has signed a contract with investment firm Alberta Innovates for an engineering study on fuel cell carbon capture at a Husky Energy-owned heavy oil thermal facility near Lloydminster, Saskatchewan, Canada. The engineering study is part of a multi-phase project to show how commercial-scale fuel cells carbon capture can … Read more »
Carbon is not the enemy and can be used as a resource and in circular economy systems "safely, productively and profitably," according to architect William McDonough, co-founder of the sustainable design Cradle to Cradle methodology.
Toshiba has shipped a 25-megawatt turbine that will be used in the world's first supercritical oxy-combustion CO2 power cycle generation system that will capture and sequester CO2.
Oil and gas giants including Shell, BP, Statoil and Total today said they will invest $1 billion in low-emissions technologies including carbon capture over the next 10 years.
FuelCell Energy and ExxonMobil will test their carbon capture technology at a coal and gas-fired power plant operated by Southern Company subsidiary Alabama Power.


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Trump has reportedly picked a new White House Communications Director, Mike Dubke:
A White House official has confirmed to NBC News that Mike Dubke has been selected to be its communications director https://t.co/byuMDj73jV pic.twitter.com/CTOtMGi2eK
— NBC News (@NBCNews) February 17, 2017
ADMIN MOVES: Per @jpaceDC, Trump expected to name GOP consultant Mike Dubke as White House communications director. pic.twitter.com/1qaMucvB3q
— Meg Kinnard (@MegKinnardAP) February 17, 2017
It's interesting because he founded Crossroads Media, which you've heard about because of Karl Rove who co-founded American Crossroads, their parent group. According to Wikipedia, "Crossroads Media is a media services company that serves American Crossroads."
Breitbart is puzzled by the move:
The decision to bring in Dubke is puzzling, as he is not just any Rove confidante. In 2001, he actually founded one of Rove's main firms, Crossroads Media, LLC—a media firm that provides services to Rove's American Crossroads. He is still listed on the Rove firm's website as a founder of the outfit.
President Trump is very suspicious of Rove and his acolytes and has made that point clear for years now. In an interview with Breitbart News back in April 2016, the now-President of the United States said that Rove is a "is such a dishonorable guy" that he "shouldn't be allowed to write for the Wall Street Journal."
Whatever the reason Trump is choosing Dubke, whether it be from pressure by Priebus and Spicer or simply because Trump likes to show how magnanimous he is by reaching out to people who didn't like him, I'm sure he'll get along just fine with Trump because the White House is apparently where everyone likes to be these days, no matter how they felt during the campaign.


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Sheriffs Court, Glasgow
Following a recent refurbishment and redesign I have been commissioned to produce a large watercolour elevation of the classical face of what used to be the Sheriffs' Court in Glasgow. The image shows the sample section that was presented to all parties with a vested interest, the Architects, (who commissioned me), the Design Group who are producing the sales and letting literature, the Property Developer who is financing the project, and ultimately Glasgow City Council who are overseeing the scheme.
The watercolour artwork will be important as it will be used across the promotion and marketing literature as well as showing how the building will ultimately look, once the scaffolding is removed.
All seem to be happy with the style and technique shown in the sample and so it is full steam ahead with the full piece.
Watch this space!


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This is the complaint I registered with the BBC, as soon as the programme finished:
The programme was completely biased, with nothing but attacks on Corbyn and scepticism and disbelief from the presenter regarding Corbyn's electability. Many 'authority figures' were brought in to deride and attack Corbyn, but no authority figures were brought in to defend him. Only his supporters from the general public were allowed on the programme to praise or support him. In the absence of any big-name authority figures on his side, this made his supporters seem deluded, as if those 'in the know' all supposedly 'knew' he was a bad choice.
The tone of the programme was completely one-sided; all anti- Corbyn. It was nothing but an establishment attack against a politician who is rocking the boat and daring to challenge the status quo.
The BBC can no longer claim to be neutral, it has shown itself to be nothing but an establishment mouthpiece; an ideological tool, spouting lies and propaganda.
I am disgusted and livid. I can't believe I have ever defended the BBC, it may as well be Fox news, as it now seems nothing but a mouthpiece for Murdoch and other corporate elites.


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Every donation matters
London Transport Museum uses the story of transport to encourage, enrich and inspire all Londoners and those who love this city to get the most out of London.
London Transport Museum uses the story of transport to encourage, enrich and inspire all Londoners and those who love this city to get the most out of London.
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Why donate?
London Transport Museum is a heritage and education charity. We need to generate over three quarters of our income from scratch each year. We rely on the support of our visitors, customers, companies, trusts, foundations and crucially individuals to care for our collection of over 470,000 objects, deliver special exhibitions, restoration projects and innovative learning programmes.
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Articles by Lorenzo E. Ferri
Other Publications (38)
- Annals of Surgery
- Critical Care Medicine
- Annals of Surgery
- The Journal of Trauma
- Surgery
- Critical Care Medicine
- World Journal of Surgery
- Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie
- Annals of Surgical Oncology
- Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
- The Annals of Thoracic Surgery
- The Annals of Thoracic Surgery
- Surgical Endoscopy
- The Annals of Thoracic Surgery
- Surgery
- International Journal of Cancer. Journal International Du Cancer
- Thoracic Surgery Clinics
- The Annals of Thoracic Surgery
- Surgical Endoscopy
- Cancer Research
- Journal of the American College of Surgeons
- Surgery
- Molecular and Cellular Biology
- Cancer Research
- Surgery
- Canadian Journal of Surgery. Journal Canadien De Chirurgie
- The Annals of Thoracic Surgery
- Current Oncology (Toronto, Ont.)
- Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
- Journal of the American College of Surgeons
- Surgery
- Annals of Surgical Oncology
- Science Signaling
- International Journal of Cancer. Journal International Du Cancer
- Annals of Surgical Oncology
- World Journal of Surgery
- The Journal of Surgical Research
- Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Articles by Lorenzo E. Ferri in JoVE
Simplificado Humanos neutrófilos extracelular Trampas (TNE) Aislamiento y manipulación Sara Najmeh*1, Jonathan Cools-Lartigue*1, Betty Giannias1, Jonathan Spicer1, Lorenzo E. Ferri1 1LD MacLean Surgical Research Laboratories, Department of Surgery, McGill University En el siguiente protocolo, se describe una manera muy simple para aislar las trampas de neutrófilos extracelular (TNE) a partir de sangre humana entera utilizando reactivos fácilmente disponibles. A continuación, demostramos cómo las redes aisladas se pueden utilizar en un ensayo de adhesión in vitro con células cancerosas.
Other articles by Lorenzo E. Ferri on PubMed
Alteration of Chemoattractant Receptor Expression Regulates Human Neutrophil Chemotaxis in Vivo Annals of Surgery. Apr, 2002 | Pubmed ID: 11923612 To elucidate the mechanisms that regulate human neutrophil delivery in vivo, as well as the mechanisms that lead to observed reduction in polymorphonuclear (PMN) delivery to remote sites in septic patients.
Soluble L-selectin Attenuates Tumor Necrosis Factor-alpha-mediated Leukocyte Adherence and Vascular Permeability: a Protective Role for Elevated Soluble L-selectin in Sepsis Critical Care Medicine. Aug, 2002 | Pubmed ID: 12163803 We have previously demonstrated that leukocyte delivery to remote sites is decreased in sepsis and that increased concentrations of soluble L-selectin are, in part, responsible for this finding. Given that leukocytes have been implicated in the pathogenesis of vascular leakage, we hypothesized that the elevated soluble L-selectin concentrations in sepsis may translate into decreased inflammation-mediated leukocyte-endothelial cell interactions and vascular leakage at these sites.
Hypertonic Saline Resuscitation of Hemorrhagic Shock Diminishes Neutrophil Rolling and Adherence to Endothelium and Reduces in Vivo Vascular Leakage Annals of Surgery. Nov, 2002 | Pubmed ID: 12409670 To evaluate the in vivo effects of hypertonic saline (HTS) resuscitation on the interactions of endothelial cells (ECs) and polymorphonuclear neutrophils (PMNs) and vascular permeability after hemorrhagic shock.
Hypertonic Saline Resuscitation Attenuates Neutrophil Lung Sequestration and Transmigration by Diminishing Leukocyte-endothelial Interactions in a Two-hit Model of Hemorrhagic Shock and Infection The Journal of Trauma. Jan, 2003 | Pubmed ID: 12544907 Hypertonic saline (HTS) attenuates polymorphonuclear neutrophil (PMN)-mediated tissue injury after hemorrhagic shock. We hypothesized that HTS resuscitation reduces early in vivo endothelial cell (EC)-PMN interactions and late lung PMN sequestration in a two-hit model of hemorrhagic shock followed by mimicked infection.
Intra-abdominal Sepsis Attenuates Local Inflammation-mediated Increases in Microvascular Permeability at Remote Sites in Mice in Vivo Surgery. Feb, 2004 | Pubmed ID: 14739854 Given that leukocyte delivery to remote sites is diminished in states of systemic inflammation, such as sepsis, and activated leukocytes may be responsible for endothelial injury leading to vascular leakage, we hypothesized that intra-abdominal sepsis would diminish microvascular leakage at remote sites by altering leukocyte-endothelial interactions.
The Use of Stereotactic Excisional Biopsy in the Management of Invasive Breast Cancer World Journal of Surgery. Nov, 2005 | Pubmed ID: 16240063 Stereotactic breast biopsy techniques minimize the surgical trauma associated with conventional wire-guided open breast biopsy for non-palpable breast lesions (NPBLs). Advanced breast biopsy instrumentation (ABBI) allows for a 2-cm core of breast tissue to be excised under stereotactic guidance in an outpatient setting. We report our initial experience with ABBI. Hospital charts from 89 ABBI procedures between 10/1996 and 07/2002 were retrospectively reviewed for patient characteristics, ABBI parameters, radiographic appearance, pathology, complications, and clinical follow-up. Data are presented as percentage/median (range). Median age was 59 years (range: 39-80 years), mammographic lesions were classified as calcifications 49% (44/89), soft tissue 39% (35/89), or mixed 11% (10/89). Median radiographic size was 7 mm (1-60 mm). Final pathology revealed ductal carcinoma in situ (DCIS) in 7% (6/89) and invasive cancer in 22% (20/89). Microscopically clear margins were obtained in 55% (11/20) of patients with invasive cancer. Of these, 82% (9/11) chose not to undergo further local surgical therapy. Eight patients remain disease free at 56 months (range: 41-95 months) follow-up. The ninth patient was deceased at 6 months from an unrelated cause. The overall complication rate was 3% (3/89). A definitive diagnosis was obtained in 100% of malignant and 87% of benign cases. Median waiting time was 19 days (range: 0-90 days). Our experience demonstrates that ABBI is an effective diagnostic tool for NPBLs. It is associated with minimal complications, and provides negative margins in over half of malignant cases. In selected patients with invasive cancer and negative margins, ABBI may obviate the need for further local surgical treatment. ABBI merits additional investigation as a therapeutic modality for early breast cancer.
Has the Introduction of Laparoscopic Heller Myotomy Altered the Treatment Paradigm of Achalasia? Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. Oct, 2005 | Pubmed ID: 16247525 Although surgical myotomy is well established as the most effective and durable treatment for achalasia, wide acceptance of this procedure as a first-line treatment has been hampered by perceived invasiveness and morbidity. Laparoscopic myotomy has significantly reduced surgical trauma and morbidity while maintaining effectiveness. The effect of laparoscopic myotomy on the treatment pattern for achalasia is not currently known. All patients undergoing surgical myotomy in Quebec from 1997 to 2002 were identified from the Régie de l'assurance maladie du Québec billing database; previous endoscopic treatment was documented from 1990 to the time of surgery. Patients were divided into two groups (prelaparoscopy and postlaparoscopy) defined by the approximate date when laparoscopic myotomy became generally available in Quebec. A questionnaire examining treatment preference for achalasia was sent to all Quebec gastroenterologists. The number of myotomies performed in Quebec remained stable (prelaparoscopy = 28.7/year; postlaparoscopy = 33/year), but were performed on an older population. The rate of preoperative endoscopic treatment did not differ from prelaparoscopy (29.2%) to postlaparoscopy (23.3%). However, the time interval between the last endoscopy and myotomy diminished significantly. Questionnaire response rate was 41% (60 of 147). Although myotomy was recognized as the most effective treatment (54 of 60), only 22 of 60 gastroenterologists would refer a healthy patient for myotomy as initial treatment. Other choices included dilation (33 of 60), Botulinum toxin (two of 60) or calcium channel blockade (three of 60). Despite a decrease in time interval between endoscopic treatment and surgery, no decrease in the rate of existing endoscopic therapies occurred after laparoscopic myotomy became widely available. The benefits and minimal risks associated with laparoscopic myotomy need to be more effectively communicated by referring physicians.
The Influence of Technical Complications on Postoperative Outcome and Survival After Esophagectomy Annals of Surgical Oncology. Apr, 2006 | Pubmed ID: 16485146 The dismal survival associated with esophagectomy for cancer has led to the search for potentially correctable factors responsible for this poor prognosis. Although it is intuitive that technical complications could increase postoperative mortality, the effect on long-term survival is controversial.
Patient Perception of a Clinical Pathway for Laparoscopic Foregut Surgery Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. Jun, 2006 | Pubmed ID: 16769545 Clinical pathways have been implemented for a number of surgical procedures, yet few data are available that explore the patients' perception of these changes in clinical practice. A clinical pathway was developed for laparoscopic fundoplication, Heller myotomy, and paraesophageal hernia repair. Data collected from a cohort of patients undergoing surgery with the pathway over a 12-month period was compared with a group of patients operated on in the 12 months prior to pathway implementation. A questionnaire examining patient-based outcomes and perceptions was completed 6 weeks after surgery. From November 2001 through November 2003, 49 patients underwent primary laparoscopic foregut surgery, 27 before and 22 after pathway implementation. There were no differences in age, gender, procedure, or ASA Class. Parenteral opioid use diminished significantly without compromising the patients' perceived pain control. The number of patients undergoing postoperative investigations diminished, as did length of stay. Of the 20 post-pathway patients completing satisfaction questionnaires, 95% were satisfied or very satisfied with their care during admission. Pathway implementation resulted in a significant reduction in direct postoperative hospital costs. A clinical pathway for laparoscopic foregut surgery was successfully implemented in a single-payer system, resulting in decreased utilization of hospital resources while maintaining high patient satisfaction.
Posterior Mediastinal Chondromatous Hamartoma The Annals of Thoracic Surgery. Apr, 2007 | Pubmed ID: 17383376 A posterior mediastinal mass was found incidentally in a 70-year-old woman during a work-up for an early breast cancer. Computed tomography of the chest showed a well-circumscribed mass near the left subclavian artery and proximal descending aorta. A left video assisted thorascopic excision of the posterior mediastinal mass was performed. Pathologic examination showed it to be a chondromatous hamartoma, representing a very unusual location for this type of tumor.
Esophageal-left Atrial Fistula: Intraoperative Diagnosis and Management The Annals of Thoracic Surgery. Aug, 2007 | Pubmed ID: 17643654 Nontraumatic esophageal-atrial fistulas are usually fatal and are diagnosed postmortem. We report a rare case of intraoperative diagnosis and successful surgical management of an esophageal-left atrial fistula in a 70-year-old woman with a history of brachytherapy, radiotherapy, and chemotherapy for esophageal cancer who presented with progressive dysphagia and hematemesis.
Comparison of Patient-centered Outcomes After Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease or Paraesophageal Hernia Surgical Endoscopy. Feb, 2008 | Pubmed ID: 18027047 Patients undergoing laparoscopic Nissen fundoplication (LNF) with paraesophageal hernias (PEH) are not only older and less healthy than those with gastroesophageal reflux disease (GERD), but in addition the repair is more complicated. We evaluated whether outcomes relating to GERD symptoms and quality of life (QOL) were impacted by the presence of PEH.
The Current Status of Traumatic Diaphragmatic Injury: Lessons Learned from 105 Patients over 13 Years The Annals of Thoracic Surgery. Mar, 2008 | Pubmed ID: 18291194 Our understanding of traumatic diaphragmatic injury (TDI) is based primarily on outdated retrospective series. We sought to reexamine present day patterns of diagnosis, associated injuries, predictors of mortality, and long-term outcomes of this condition.
L-selectin Shedding in Sepsis Limits Leukocyte Mediated Microvascular Injury at Remote Sites Surgery. Apr, 2009 | Pubmed ID: 19303986 Increased soluble L-selectin levels have been shown to attenuate local inflammation-mediated microvascular leakage, and failure to generate high levels has been associated with increased risk of acute respiratory distress syndrome in septic patients. We hypothesized that failure to shed L-selectin in systemic inflammation would result in increased local inflammation-induced leukocyte adherence and microvascular leakage.
Systemic Inflammation Increases Cancer Cell Adhesion to Hepatic Sinusoids by Neutrophil Mediated Mechanisms International Journal of Cancer. Journal International Du Cancer. Sep, 2009 | Pubmed ID: 19431213 Interactions between endothelial selectins and selectin ligands expressed on tumor cells have been implicated in the binding of circulating metastatic cancer cells to the vascular endothelium during extravasation. Moreover, there is mounting evidence that inflammatory environments can accelerate the progression of metastasis by neutrophil mediated mechanisms. In this study, a physiologically relevant in vivo model of early metastasis coupled with intravital microscopy was used to visualize the trafficking of tumor cells within the liver vasculature in real time. Using GFP-labeled Lewis lung carcinoma subline H-59 cells, we show here that disrupting the interactions between endothelial selectins and tumor cell selectin ligands diminished tumor cell recruitment to the liver. Furthermore, systemic inflammation induced by intravenous injection of lipopolysaccharide significantly enhanced the metastatic potential of these lung carcinoma cells by increasing their propensity to adhere to the liver sinusoidal endothelium. Confocal microscopy revealed frequent colocalization of cancer cells with neutrophils and neutrophil depletion in vivo significantly attenuated the lipopolysaccharide-induced increase in H-59 cell adhesion. Although direct selectin-selectin ligand interactions contributed significantly to tumor cell adhesion to sinusoidal endothelial cells, we show here that in addition, interactions between adherent neutrophils within the inflamed sinusoids and circulating tumor cells may further increase tumor cell arrest in the liver.
Acute Traumatic Diaphragmatic Injury Thoracic Surgery Clinics. Nov, 2009 | Pubmed ID: 20112631 Acute diaphragmatic hernia is a result of diaphragmatic injury that accompanies severe blunt or penetrating thoracoabdominal trauma. It is frequently diagnosed early on the trauma bay chest radiograph or CT scan of the chest. However, in the absence of a hernia, it may be difficult to identify traumatic diaphragmatic injury on conventional imaging. A midline laparotomy is the advocated approach for repair of acute diaphragmatic trauma because it offers the possibility of diagnosing and repairing frequently associated intraabdominal injuries. In hemodynamically stable patients with penetrating left thoracoabdominal trauma, the incidence of injury to the diaphragm is very high, and thoracoscopy or laparoscopy is recommended for the diagnosis and repair of a missed diaphragmatic injury. Repair with nonabsorbable simple sutures is adequate in most cases, and the use of mesh should be reserved for chronic and large defects. Outcomes of acute diaphragmatic hernia repair are largely dictated by the severity of concomitant injuries, with the Injury Severity Score being the most widely recognized predictor of mortality.
Pulmonary Inflammatory Myofibroblastic Tumor Invading the Gastroesophageal Junction The Annals of Thoracic Surgery. May, 2010 | Pubmed ID: 20417808 Pulmonary inflammatory myofibroblastic tumors are rare neoplasms of intermediate malignant potential. Most patients are asymptomatic and present with incidental findings on imaging. Dysphagia due to direct invasion into the esophagus is an extremely rare presentation of this uncommon tumor. The diagnosis is difficult to make preoperatively. Complete surgical resection offers the best chance of cure. We describe a 27-year-old man who presented with progressive dysphagia and the diagnosis was only revealed after en bloc resection of the esophagus, cardia, and left lower lobe.
Defining the Learning Curve in Laparoscopic Paraesophageal Hernia Repair: a CUSUM Analysis Surgical Endoscopy. Apr, 2011 | Pubmed ID: 20835725 There are numerous reports in the literature documenting high recurrence rates after laparoscopic paraesophageal hernia repair. The purpose of this study was to determine the learning curve for this procedure using the Cumulative Summation (CUSUM) technique.
LPS-induced TLR4 Signaling in Human Colorectal Cancer Cells Increases Beta1 Integrin-mediated Cell Adhesion and Liver Metastasis Cancer Research. Mar, 2011 | Pubmed ID: 21363926 Infectious complications resulting from resection of colorectal cancer (CRC) elevates the risk of cancer recurrence and metastasis, but the reason for this risk relationship is unknown. Defining the mechanisms responsible may offer opportunities to improve outcomes in a majority of patients whose tumors are resected as part of their therapy. The complex formed between Toll receptor TLR4 and myeloid differentiation factor MD2 defines a major cell surface receptor for lipopolysaccharide (LPS), a gram-negative bacterial antigen that has been implicated in infectious complications after CRC resection. As the TLR4/MD2 complex is expressed on CRC cells, we hypothesized that LPS may promote liver metastasis in CRC by stimulating TLR4 signaling. In support of this hypothesis, we report here that LPS enhances liver metastasis of human CRC cells that express TLR4/MD2 after intrasplenic graft of immunocompromised nude mice. Compared with TLR4 nonexpressing, nonmetastatic CRC cells, we observed increased in vitro adherence to different extracellular matrices and human umbilical vein endothelial cells (HUVEC). Furthermore, we observed an increased likelihood of in vivo capture within hepatic sinusoids after LPS treatment. No differences were apparent in phosphorylation of p38 and MAPK isoforms, but in metastatic CRC cells expressing surface TLR4 treatment with LPS increased Ser473 phosphorylation of AKT kinase. We showed that enhanced adherence elicited by LPS in these cells could be blocked at three different levels, using Eritoran (TLR4 small molecule antagonist), PI-103 (PI3K inhibitor), or anti-β1 integrin blocking antibodies. Taken together, the results indicate that stimulation of the TLR4/MD2 complex by LPS activates PI3K/AKT signaling and promotes downstream β1 integrin function, thereby increasing the adhesiveness and metastatic capacity of CRC cells. Our findings suggest that inhibiting LPS-induced TLR4 signaling could improve therapeutic outcomes by preventing cancer metastasis during the perioperative period of CRC resection.
Estimating the Risk of Prolonged Air Leak After Pulmonary Resection Using a Simple Scoring System Journal of the American College of Surgeons. Jun, 2011 | Pubmed ID: 21489831 The high rate of prolonged air leak (PAL) after pulmonary resection has prompted interest in surgical adjuncts designed to prevent this complication. However, these adjuncts are costly and might not be beneficial if used routinely. Identification of patients at highest risk might allow for more effective use of these adjuncts. Therefore, we sought to develop a simple scoring system to predict PAL.
Reconstruction After Major Chest Wall Resection: Can Rigid Fixation Be Avoided? Surgery. Oct, 2011 | Pubmed ID: 22000169 Rigid fixation is advocated as the best method to achieve good respiratory outcomes after chest wall resection at the expense of a high complication rate. The following study aims to examine the role of myocutaneous pedicled flaps, with or without soft prosthesis, in the reconstruction of small and large chest wall defects.
Claudin-2 Promotes Breast Cancer Liver Metastasis by Facilitating Tumor Cell Interactions with Hepatocytes Molecular and Cellular Biology. Aug, 2012 | Pubmed ID: 22645303 We previously identified claudin-2 as a functional mediator of breast cancer liver metastasis. We now confirm that claudin-2 levels are elevated in liver metastases, but not in skin metastases, compared to levels in their matched primary tumors in patients with breast cancer. Moreover, claudin-2 is specifically expressed in liver-metastatic breast cancer cells compared to populations derived from bone or lung metastases. The increased liver tropism exhibited by claudin-2-expressing breast cancer cells requires claudin-2-mediated interactions between breast cancer cells and primary hepatocytes. Furthermore, the reduction of the claudin-2 expression level, either in cancer cells or in primary hepatocytes, diminishes these heterotypic cell-cell interactions. Finally, we demonstrate that the first claudin-2 extracellular loop is essential for mediating tumor cell-hepatocyte interactions and the ability of breast cancer cells to form liver metastases in vivo. Thus, during breast cancer liver metastasis, claudin-2 shifts from acting within tight-junctional complexes to functioning as an adhesion molecule between breast cancer cells and hepatocytes.
Neutrophils Promote Liver Metastasis Via Mac-1-mediated Interactions with Circulating Tumor Cells Cancer Research. Aug, 2012 | Pubmed ID: 22751466 Although circulating neutrophils are associated with distant metastasis and poor outcome in a number of epithelial malignancies, it remains unclear whether neutrophils play an active causal role in the metastatic cascade. Using in vivo models of metastasis, we found that neutrophils promote cancer cell adhesion within liver sinusoids and, thereby, influence metastasis. Neutrophil depletion before cancer cell inoculation resulted in a decreased number of gross metastases in an intrasplenic model of liver metastasis. This effect was reversed when inflamed neutrophils were co-inoculated with cancer cells. In addition, early adhesion within liver sinusoids was inhibited in the absence of neutrophils and partially restored with a short perfusion of isolated activated neutrophils. Intravital microscopy showed that cancer cells adhered directly on top of arrested neutrophils, indicating that neutrophils may act as a bridge to facilitate interactions between cancer cells and the liver parenchyma. The adhesion of lipopolysaccharide-activated neutrophils to cancer cells was mediated by neutrophil Mac-1/ICAM-1. Our findings, therefore, show a novel role for neutrophils in the early adhesive steps of liver metastasis.
An Enhanced Recovery Pathway Decreases Duration of Stay After Esophagectomy Surgery. Oct, 2012 | Pubmed ID: 22943844 Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, and readmissions after esophagectomy.
The Impact of Incidental Gastrointestinal Stromal Tumours on Patients Undergoing Resection of Upper Gastrointestinal Neoplasms Canadian Journal of Surgery. Journal Canadien De Chirurgie. Dec, 2012 | Pubmed ID: 22992402 Emerging data suggest asymptomatic gastrointestinal stromal tumours (GISTs) of the upper gastrointestinal (UGI) tract are not uncommon. We sought to determine their incidence in patients undergoing resection for UGI neoplasms and their impact on surgical and adjuvant treatment.
Transoral Endoscopic Resection of Esophageal Liposarcoma The Annals of Thoracic Surgery. Nov, 2012 | Pubmed ID: 23098986 A 63-year-old man presented with a 1-month history of dysphagia. Endoscopy showed the patient had a mass in the cervical esophagus. Multiple biopsy specimens were taken, which were inconclusive for a diagnosis. A positron-emission tomography scan showed a hypermetabolic lesion. A transoral endoscopic approach was used to resect the tumor. Final histologic examination revealed a completely resected low-grade liposarcoma.
Influence of Postoperative Infectious Complications on Long-term Survival of Lung Cancer Patients: a Population-based Cohort Study Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer. May, 2013 | Pubmed ID: 23459402 Surgery is essential to any curative plan for lung cancer, but is associated with a high complication rate. We sought to determine the impact of complications on long-term survival after a curative surgery for lung cancer, independent of the effect on early postoperative mortality.
Predicting Lymph Node Metastases in Early Esophageal Adenocarcinoma Using a Simple Scoring System Journal of the American College of Surgeons. Aug, 2013 | Pubmed ID: 23659947 Endoscopic resection is an organ-sparing option for early esophageal adenocarcinoma, but should be used only in patients with a negligible risk of lymph node metastases (LNM). The objective was to develop a simple scoring system to predict LNM in T1 esophageal adenocarcinoma.
Lipopolysaccharide-induced Toll-like Receptor 4 Signaling Enhances the Migratory Ability of Human Esophageal Cancer Cells in a Selectin-dependent Manner Surgery. Jul, 2013 | Pubmed ID: 23809486 Esophageal cancer is an aggressive malignancy, and emerging data suggest that postoperative infections may promote cancer progression. Systemic exposure to lipopolysaccharide (LPS), a Gram-negative bacterial antigen involved in such infections, has been shown to increase cancer cell adhesion to the hepatic sinusoids in vivo. We investigated the direct impact of LPS on the migratory ability of esophageal cancer cells via the LPS receptor toll-like receptor 4 (TLR4).
Cost-effectiveness of Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer Annals of Surgical Oncology. Nov, 2013 | Pubmed ID: 23838923 A recent randomized trial comparing minimally invasive (MIE) and open esophagectomy for esophageal cancer reported improved short-term outcomes. However, MIE has increased operative costs, and it is unclear whether the short-term benefits of MIE outweigh the increased operative costs. Therefore, the objective of this study was to determine the cost-effectiveness of MIE compared to open esophagectomy for esophageal cancer.
Dynamic Reprogramming of Signaling Upon Met Inhibition Reveals a Mechanism of Drug Resistance in Gastric Cancer Science Signaling. Apr, 2014 | Pubmed ID: 24757178 The Met receptor tyrosine kinase is activated or genetically amplified in some gastric cancers, but resistance to small-molecule inhibitors of Met often emerges in patients. We found that Met abundance correlated with a proliferation marker in patient gastric tumor sections, and gastric cancer cell lines that have MET amplifications depended on Met for proliferation and anchorage-independent growth in culture. Inhibition of Met induced temporal changes in gene expression in the cell lines, initiated by a rapid decrease in the expression of genes encoding transcription factors, followed by those encoding proteins involved in epithelial-mesenchymal transition, and finally those encoding cell cycle-related proteins. In the gastric cancer cell lines, microarray and chromatin immunoprecipitation analysis revealed considerable overlap between genes regulated in response to Met stimulation and those regulated by signal transducer and activator of transcription 3 (STAT3). The activity of STAT3, extracellular signal-regulated kinase (ERK), and the kinase Akt was decreased by Met inhibition, but only inhibitors of STAT3 were as effective as the Met inhibitor in decreasing tumor cell proliferation in culture and in xenografts, suggesting that STAT3 mediates the pro-proliferative program induced by Met. However, the phosphorylation of ERK increased after prolonged Met inhibition in culture, correlating with decreased abundance of the phosphatases DUSP4 and DUSP6, which inhibit ERK. Combined inhibition of Met and the mitogen-activated protein kinase kinase (MEK)-ERK pathway induced greater cell death in cultured gastric cancer cells than did either inhibitor alone. These findings indicate combination therapies that may counteract resistance to Met inhibitors.
Gram Negative Bacteria Increase Non-small Cell Lung Cancer Metastasis Via Toll-like Receptor 4 Activation and Mitogen-activated Protein Kinase Phosphorylation International Journal of Cancer. Journal International Du Cancer. Mar, 2015 | Pubmed ID: 25082668 Surgery is required for the curative treatment of lung cancer but is associated with high rates of postoperative pneumonias predominantly caused by gram negative bacteria. Recent evidence suggests that these severe infectious complications may decrease long term survival after hospital discharge via cancer recurrence, but the mechanism is unclear. Lung cancer cells have recently been demonstrated to express Toll-like receptors (TLR) that mediate pathogen recognition. We hypothesized that incubation of non-small cell lung cancer (NSCLC) cells with heat-inactivated Escherichia coli can augment cancer cell adhesion, migration and metastasis via TLR4 signaling. Incubation of murine and human NSCLC cells with E. coli increased in vitro cell adhesion to collagen I, collagen IV and fibronectin, and enhanced in vitro migration. Using hepatic intravital microscopy, we demonstrated that NSCLC cells have increased in vivo adhesion to hepatic sinusoids after coincubation with gram negative bacteria. These enhanced cell adhesion and migration phenotypes following incubation with E. coli were attenuated at three levels: inhibition of TLR4 (Eritoran), p38 MAPK (BIRB0796) and ERK1/2 phosphorylation (PD184352). Incubation of murine NSCLC cells in vitro with E. coli prior to intrasplenic injection significantly augmented formation of in vivo hepatic metastases 2 weeks later. This increase was abrogated by NSCLC TLR4 blockade using Eritoran. TLR4 represents a potential therapeutic target to help prevent severe postoperative infection driven cancer metastasis.
Functional Outcomes and Quality of Life After Proximal Gastrectomy with Esophagogastrostomy Using a Narrow Gastric Conduit Annals of Surgical Oncology. Mar, 2015 | Pubmed ID: 25212836 The best surgical approach for tumors of the proximal stomach remains controversial. For proximal gastrectomy (PG), the evidence regarding quality of life (QoL) and functional outcomes is controversial. Moreover, there are limited data from non-Asian settings.
Validity of the EuroQol-5 Dimensions As a Measure of Recovery After Pulmonary Resection The Journal of Surgical Research. Mar, 2015 | Pubmed ID: 25499985 Surgical innovations advocated to improve patient recovery are often costly. Economic evaluation requires preference-based measures that reflect the construct of patient recovery. We investigated the responsiveness and construct validity of the EuroQol-5 dimensions (EQ-5D) as a measure of postoperative recovery after planned pulmonary resection for suspected malignant tumors.
Current Status of Management of Malignant Disease: Current Management of Esophageal Cancer Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract. Feb, 2015 | Pubmed ID: 25650163 The objective of this study is to outline the evidence regarding the surgical management of esophageal cancer and provide a single institutional outline regarding its implementation.


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Sioux Falls Scientists
Evolution and Global Warming are facts, not theories!
Science and Reason, use them to guide your life.
131 Evolution News Articles
10-31-17 Asteroid impact plunged dinosaurs into catastrophic 'winter'
10-31-17 Alzheimer's may be able to spread through blood transfusions
10-31-17 Hybrids reveal the barriers to successful mating between species
10-30-17 Donor organs created by dissolving and rebuilding pig livers
10-30-17 Zika hasn't been in the news much, but that doesn't mean it's gone
The numbers have also dropped in the United States and its territories. In Puerto Rico, Zika cases hit nearly 35,000 in 2016, the U.S. Centers for Disease Control and Prevention reports. But this year, less than 500 cases have been tallied as of mid-October. In the 50 states, the CDC counted about 5,100 cases in 2016. Most were in travelers who had been to places where Zika was active, although 224 were locally acquired in Florida and Texas. So far in 2017, only about 300 cases have been reported as of mid-October, mostly from travelers. Local transmission seems to have come to a standstill, with one suspected case in Texas and one case confirmed in Florida.
10-30-17 Hunting sea monsters in Kansas
10-26-17 Whether psychology research is improving depends on whom you ask
10-28-17 Can boredom be a good thing?
10-27-17 Space changes how your brain thinks and it starts right away
10-27-17 The first ancestors of giant pandas probably lived in Europe
10-27-17 How genes affect pigmentation
10-27-17 A growing oral HPV epidemic
10-27-17 The power of 'bromances'
10-27-17 Longevity secrets revealed
10-27-17 Want to think outside of the box? Try sniffing a placebo
10-26-17 Ban on weedkiller glyphosate won't save anyone from cancer
10-26-17 Brain-zap therapy may throw people with depression into a rage
10-26-17 Gaming addiction probably isn't a real condition, study suggests
10-26-17 Dinosaur sported 'bandit mask'
10-26-17 New dinosaur sported a curious set of chompers
10-26-17 Early menopause is more likely if you've ever been underweight
10-26-17 Ancient skull 'oldest tsunami victim'
10-25-17 We've evolved an even more powerful form of CRISPR gene editing
10-25-17 New CRISPR gene editors can fix RNA and DNA one typo at a time
10-25-17 'Incredible' editing of life's building blocks
10-25-17 T. rex's silly-looking arms were built for slashing
10-25-17 Ichthyosaur fossil discovered for first time in India
10-25-17 The science behind your terrible life choices
10-25-17 C-sections lead to heftier mouse pups, but the implications for people aren't clear
10-25-17 Nanoscale glitches let flowers make a blue blur that bees can see
10-24-17 The IQ test has a dark history
10-24-17 What the controversial 'human' teeth fossils really tell us
10-24-17 How glow worms get their glow on
10-23-17 Your autopilot mode is real – now we know how the brain does it
10-23-17 Chronic back pain stem cell treatment could cut need for opioids
10-23-17 Inbreeding hurts the next generation's reproductive success
10-23-17 Mating with Neandertals reintroduced 'lost' DNA into modern humans
10-23-17 Geese-like birds seem to have survived the dinosaur extinction
10-23-17 Narcissists aren't very conservative but believe in inequality
10-23-17 How bird feeders may be changing great tits' beaks
10-21-17 The dangers of 'knowing thyself'
10-20-17 A home test kit may let you diagnose endometriosis years earlier
10-20-17 Scientists battle over whether violence has declined over time
10-20-17 This is your brain on cellphones
10-20-17 America's obesity epidemic has reached a new peak
10-20-17 Potassium protects the heart
10-20-17 Another way sugar can kill
10-20-17 Neanderthal genes' influence
10-20-17 Resurrecting extinct species raises ethical questions
10-19-17 Laws to protect athletes' brains do reduce concussions — eventually
10-19-17 The next wave of bird flu could be worse than ever
10-19-17 Doubling up on 'junk DNA' helps make us human
10-19-17 Stonehenge builders 'ate food from Scotland'
10-19-17 The mass extinction that might never have happened
10-18-17 This ancient clock rules our lives — and determines our health
10-18-17 Hunger-blocking injection lets fat monkeys quickly lose weight
10-18-17 Getting on cancer's nerves: A surprising way to thwart tumours
10-18-17 A common herbal medicine may cause liver cancer mutations
10-18-17 The science behind why sweet and salty foods taste so good together
10-18-17 Moms tweak the timbre of their voice when talking to their babies
10-17-17 Four brain genes help explain obsessive compulsive disorder
10-17-17 How volcanoes may have ended the dynasty of Ptolemy and Cleopatra
10-17-17 A universal flu vaccine may be nearing reality
10-16-17 Gut fungi might be linked to obesity and inflammatory bowel disorders
10-16-17 To understand the origins of pain, ask a flatworm
10-14-17 Magic mushrooms can 'reset' depressed brain
10-13-17 Magic mushroom extract changes brains of people with depression
10-13-17 Sperm age calculator tells men how decrepit their sperm are
10-13-17 DNA study provides insight into how to live longer
10-13-17 Unlocking the body clock
10-13-17 A dementia smell test
10-13-17 The rise of obesity-related cancers
10-13-17 Surgeon aims to diagnose deformities of extinct saber-toothed cats
10-13-17 We've drawn iconic sail-wearing Dimetrodon wrong for 100 years
10-13-17 Did meteorites help start life?
10-12-17 A potential drug found in a sea creature can now be made efficiently in the lab
10-12-17 Gene study shows human skin tone has varied for 900,000 years
10-12-17 Blind cave fish lost eyes by unexpected evolutionary process
10-12-17 I spent three days as a hunter-gatherer to see if it would improve my gut health
10-12-17 There's no rest for the brain's mapmakers
10-12-17 Perfectly preserved fossil salamander even has last meal in gut
10-11-17 Wake-up call: How a lack of sleep can cause Alzheimer's
10-11-17 Top tips to get a better night's sleep and improve your health
10-11-17 Most versatile stem cell ever may help us understand miscarriage
10-11-17 Caesarean sections cause obesity and microbiome changes in mice
10-11-17 In many places around the world, obesity in kids is on the rise
10-11-17 What modern society can learn from birdsong
10-11-17 Mass extinctions 'offer cautionary tale'
10-10-17 We're more Neandertal than we thought
10-10-17 Human hearts kept 'asleep' in a box can survive outside the body
10-10-17 New deep-sea sponge could play a starring role in monitoring ocean health
10-10-17 Drone designers accidentally explain colour of albatross wings
10-10-17 Singapore scientists reveal origins of durian's pungent aroma
10-10-17 New evidence on how birds took to the air
10-9-17 Evolution's rules mean life on Earth isn't that varied after all
10-9-17 Cold climate may have driven ancient humans' move out of Africa
10-9-17 Ancient whale turns up on wrong side of the world
10-9-17 Anti-doping agency to ban all gene editing in sport from 2018
10-9-17 Superbugs may meet their match in these nanoparticles
10-9-17 The medical mystery of split-brain patients
10-9-17 Exploding stars could have kick-started our ancestors' evolution
10-6-17 Little-known drug keeps climbers' minds sharp at high altitude
10-6-17 Europe's Stone Age fishers used beeswax to make a point
10-5-17 Parenting advice gets a fact-check
10-6-17 Protein injection could prevent hair loss during chemotherapy
10-5-17 Side effects are worse when we think medication looks expensive
10-6-17 New book offers a peek into the mind of Oliver Sacks
10-5-17 Ancient humans avoided inbreeding by networking
10-4-17 We're nearly ready to use CRISPR to target far more diseases
10-4-17 We've finally seen how the sleeping brain stores memories
10-4-17 Luhan Yang strives to make pig organs safe for human transplants
10-4-17 KC Huang probes basic questions of bacterial life
10-4-17 Lena Pernas sees parasitic infection as a kind of Hunger Games
10-4-17 Your 'risk intelligence' decides how much of a daredevil you are
10-4-17 Different meditation types train distinct parts of your brain
10-4-17 Our braininess may have evolved thanks to less sticky neurons
10-4-17 Why are humans so hairy?
10-4-17 Christina Warinner uncovers ancient tales in dental plaque
10-4-17 Early farmers may have polluted the sea 4000 years ago
10-4-17 New York City mice may be evolving to eat fast food like pizza
10-4-17 WHO launches bold plan to slash cholera deaths by 90 per cent
10-3-17 First global pledge to end cholera by 2030
10-3-17 Six in seven contact lens wearers take unnecessary risks with their eyes
10-3-17 The rise of agricultural states came at a big cost, a new book argues
10-3-17 A baby ichthyosaur's last meal revealed
10-3-17 Prehistoric reptile's last meal revealed
10-2-17 Life may have begun millions of years earlier than we thought
10-2-17 Body clock mechanics wins U.S. trio the Nobel Prize in physiology or medicine
10-2-17 Medicine Nobel for scientists who unpicked our body clocks
10-2-17 Body clock scientists win Nobel Prize
10-2-17 We're nearly ready to use CRISPR to target far more diseases
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131 Evolution News Articles


text: The cities museum has been robbed by a notorious gang of robbers known as The Museum Thieves. The police received an anonymous phone call late one night that said the gang would be hold up in an abandoned factory on the outskirts of town. We need to get there as quickly as possible and investigate because more than likely they will already be gone from the scene but hopefully we can gather some clues as to where their next destination or heist may be.


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Condor Rip Away EMT Pouch - Multicam
Description: Molle EMT Pouch with innovative Rip Away design mounts easily to any modular webbing system. Rip away from heavy velcro for emergency use in combat or medical use. Perfect to store first aid and other medical supplies on the field. Also works as a utility pouch to keep your valuables safe such as keys, phone, wallet and more. Multiple pockets include a zipper secured mesh pocket on its own fold out section.Access to the pouch is secured by a durable zipper. Constructed of Genuine Crye Precision MultiCam
- Genuine Crye Precision Multicam material, sewn in foreign country.
- Tri-fold design.
- Multiple pockets and elastic loops for storage. -
- Double zipper closure.
- Additional 2" webbing, with pull-tab for quick/temperary
Color; Multicam
Copyright 2018 Phoenix-Tactical.com | Sitemap |


text:
1) Get in an extra stretch, gain flexibility and help your body recover with Yoga being held every Monday at 7:30pm and every Saturday at 8:15am.
2) The first workout for the 2015 CrossFit Open will be announced TONIGHT at 5pm! If you have not signed up and joined Team Insanity through games.crossfit.com be sure to do so right away and be a supportive part of our community. This year there is a Rx, Scaled and Teen division so no reason why you can't jump in on this fun competition. For the next 5 weeks, we will be having Friday Night Lights from 5:30pm – 7:30pm. The last official afternoon class will be the 4:30pm class and we will be running heats for the remainder of the evening. Please bring in your friends and family to cheer you on.
Clean High Pull + Clean
1 x (2 + 1) @ 70%
1 x (2 + 1) @ 75%
2 x (2 + 1) @ 80%
1 x (2 + 1) @ 75%
800 m Run
100 Double Unders
1000 m Row
No WODs Posted
Posted on 02/25/2015 at 12:00 AM


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JPSC Head Master Principal Notification 2017 Apply for 1336 Posts
Jharkhand Public Service Commission (JPSC) has announced a new employment notification JPSC Head Master Principal Notification 2017 on its official website to fill 1336 Headmaster and Principal Vacancies. JPSC is providing an opportunity for the eligible candidates through Jharkhand PSC Recruitment 2017. JPSC Head Master Recruitment 2017 will be soon released in the month of February, 2017. Job seekers who are searching for the Latest Jharkhand Govt Jobs 2017, those must download the official advertisement and must read all the details thoroughly. JPSC invites the online applications from interested and eligible candidates. Online applications will soon available at its official page. Suitable candidates may download the online application form and follow the below simple steps provided by us and submit the filled application form on or before closing date.
Vacancy Details about JPSC Head Master Principal Notification 2017:
Total Number of Posts: 1336 Vacancies.
Name of the Posts:
- Head Master.
- Principal.
Age Limit:
Candidates must possess the lower age and upper age details as per Jharkhand Govt Rules and Regulations.
Educational Qualification:
Applicants must possess Graduation Degree or Post Graduation Degree or equivalent examination from any recognized university.
Selection Procedure:
Candidates will be selected done based on the applicants performance in written examination and followed by the personal interview.
Salary Details:
Shortlisted applicants will get attractive and impressive pay scale as per organization norms.
Application Fee:
Applicants are provided with the pay scale for the appointed vacancies as per JPSC norms.
Important Dates:
- Starting date for online application form: Soon Updated.
- Last date to submit the filled application form: Shortly Available.
How to apply for JPSC Head Master Principal Notification 2017:
- Visit the official website of JPSC www.jpsc.gov.in.
- After that, click on the link of JPSC Recruitment 2017.
- Then, click on apply online link.
- Now fill the application form with correct details.
- Enter fee details and etc.
- Upload your scanned photograph and signature.
- Attach all your required documents.
- Finally, click on submit button.
- Take a printout of it for future reference.
Official Website: jpsc.gov.in
Candidates who are going to apply for this JPSC Head Master Principal Notification 2017, those must follow our website regularly.


text:
As the Sacramento Buddhist communities come near to realizing the long-held dream of a dedicated-dharma practice-center close to home, I began to ponder the slippery concept of sacred space. What difference does the physical space matter to a dedicated-practicing-Buddhist who places her foundational faith in the interconnectedness—the dependent origination—of all things material, and nonmaterial? Can't…
Sacred Space
Posted on September 29, 2016
by Ellen Robinson-Haynes - Transitions and Changes


text:
Packed with features essential to monitoring
the environment, the Xplorer series breaks
price barriers and is simple to use. Designed
for consumer and professional use, the Xplorer
does not include complicated and seldom-used
features such as downloading and storing.
Press one button, and instant readings are
at your fingertips.
Designed in Switzerland and built to our
demanding specifations, the SKYWATCH Xplorer
series is engineered to provide a lifetime
of accurate and dependable use.
• Dimension: 3.5 x 1.5 x 0.75 in,
2 oz. (41 x 93 x 17 mm, 50 g)
• One button operation
• EL Backlight
• Completely sealed; internal sensors
• Weatherproof (can be submerged 6
• Replaceable Lithium battery (included
and installed)
• Stainless steel back
• Auto-off after one minute (can be
disabled to remain on)
• Included lanyard
• One year warranty
• Designed in Switzerland
• Balanced impeller is integrated
into wind meter
• The impeller is magnatized, producing
a magnetic field when rotating which is
measured internally
• Damage to the impeller is unlikely
due to the small opening, but repair can
be performed
XtremeBigAir - XBAStore.com - Pismo Beach - California | Telephone: 805.574.9200 | Email: email@example.com


text:
Want to get in contact with us? Not surprising. I mean we are pretty cool after all.
If you have general questions regarding our games, email us at firstname.lastname@example.com
If you're a member of the gaming press, or any kind of press for that matter, and you want to contact us than you should message us at firstname.lastname@example.com
We'll try to get back to you as soon as we can!


text:
TOKYO, Oct 26 (Reuters) - Japanese government bonds were mostly flat on Thursday as market players looked to the European Central Bank's policy meeting as well as who will be chosen as the next chief of the U.S. Federal Reserve.
The 10-year JGB yield was flat at 0.065 percent while the price of the 10-year JGB futures ticked up 0.03 point to 150.38.
The 20-year yield rose 0.5 basis point to 0.595 percent while the 30-year yield was flat at 0.865 percent .
While the market was mostly little changed, the two-year yield fell 1.0 basis point to minus 0.015 percent after an auction of 2.2 trillion yen two-year JGBs attracted solid demand.
The bid-to-cover ratio in the auction was 5.93, well above 4.11 in the previous auction.
The auction's tail, or the gap between the lowest and accepted price was 0.004, much narrower than 0.009 in the previous two-year JGB auction, pointing to strong demand.
Later in the day, the European Central Bank is expected to signal a reduction in its bond-buying scheme as the bank gradually withdraws its post-crisis stimulus.
Reporting by Tokyo Markets Team; Editing by Sunil Nair


text:
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Scores based on 162 reviews
Invoice history based on 116 reviews.
Digital Aerial (4G filtered) & Accessories fitted, All Aerial Installs have a 2 Year Guarantee, TV Wall Mounting Experts, All leads & Cables Hidden, CCTV Installation, Sky & Freesat Installers, Debit & Credit Cards welcome.Proud to say we are "Trading Standards Approved Tradesman" working alongside The Business Approval Register which is part of Trading Standards UK, We are also members of South Tyneside's council run "Safe Traders" scheme who again work with Trading Standards in ensuring a high standard of work along side a fair price charged in & around South Shields, Plus being an active member of Checkatrade we hope gives our customers added piece of mind that they can trust us with the quality of our products & the high standards we set ourself's with every job we do, ... We are happy when "YOU" are happy & that's our promise.
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text:
In 2014 Seymour Out Bush completed the Temple Bay Pond Apple Project, with the main objective of the project was capacity building of the participants in the form of training, mentoring and on-ground control work. This included mapping and surveying of Pond Apple, then starting the removal of the surveyed Pond Apple.
In 2015 the second stage of this project delivered further capacity building and mentoring to the Wuthathi and Kuku y'au people, with Pond Apple survey and control within the Temple Bay area. This included on-ground training with empathies given to OH&S, Quad training at Temple Bay, then followed by control of the mapped Pond Apple by the trainees and a map produced.
A total area of 2.34Ha was surveyed with predominately mature adult plants surveyed as well as smaller fruiting Pond Apple plants.
The T.O's trainee rangers were provided a workshop on weed and feral impacts on country and culture, training in mapping using fulcrum app for Pest and weed mapping and control by Cape York NRM staff member.