text:
Participating Organization(s)
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Funding Opportunity Title
Management of HIV-Related Lung Disease and Cardiovascular Co-Morbidity (R34)
Activity Code
R34 Clinical Trial Planning Grant Program
Announcement Type
Related Notices
Funding Opportunity Announcement (FOA) Number
Companion FOA
Catalog of Federal Domestic Assistance (CFDA) Number(s)
FOA Purpose
This FOA invites clinical trials planning grant (R34) applications to support the initial organization, protocol development, and necessary preliminary studies critical for the design of robust Phase II and III clinical trials in HIV-infected populations with lung disease alone or with cardiovascular co-morbidity. The focus of the clinical trials designed in this program will be on optimizing intervention strategies for HIV-related lung disease, with or without co-morbid cardiovascular disease, to reduce morbidity and mortality associated with these conditions.
Posted Date
November 17, 2011
Open Date (Earliest Submission Date)
February 15, 2012
Letter of Intent Due Date
February 15, 2012
Application Due Date(s)
March 15, 2012, by 5:00 PM local time of applicant organization.
AIDS Application Due Date(s)
Not Applicable
Scientific Merit Review
June, 2012
Advisory Council Review
August, 2012
Earliest Start Date(s)
September, 2012
Expiration Date
March 16, 2012
Due Dates for E.O. 12372
Not Applicable
Required Application Instructions
It is critical that applicants follow the instructions in the SF 424 (R&R) Application Guide, except where instructed to do otherwise (in this FOA or in a Notice from the NIH Guide for Grants and Contracts). Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions. Applications that do not comply with these instructions may be delayed or not accepted for review.
Part 1. Overview Information
Part 2. Full Text of the Announcement
Section I. Funding Opportunity Description
Section II. Award Information
Section III. Eligibility Information
Section IV. Application and Submission Information
Section V. Application Review Information
Section VI. Award Administration Information
Section VII. Agency Contacts
Section VIII. Other Information
Clinical trials are needed to develop optimal intervention strategies for HIV-related lung disease, with or without co-morbid cardiovascular disease, to reduce morbidity and mortality associated with these conditions. The goal of this program is to support the initial organization, protocol development, and necessary preliminary studies, including small pilot studies needed for designing robust phase II and III clinical trials in HIV-infected populations with lung disease, alone or with cardiovascular co-morbidity. The primary questions that this initiative will address are whether early detection and prompt, appropriate management of lung disease or lung disease coupled with cardiovascular disease can reduce deaths and illness from these conditions and improve quality of life.
Although the scientific literature may provide the rationale for conducting a clinical trial, investigators often lack critical information about the intervention, the plausible outcome, or recruitment necessary to complete design of the trial. Preparatory pilot studies can fill this information gap, thereby improving trial design and knowledge of trial feasibility.
Applications must demonstrate that the proposed R34 pilot studies will yield information that is both necessary and sufficient to permit the design of a clinical trial. Applicants should describe the planned full-scale trial in sufficient detail to establish the significance of the trial and to provide a context for the proposed R34 award activities.
Applicants are encouraged to provide strong evidence of their qualifications and ability to conduct clinical trials and basic mechanistic research, including availability of appropriate institutional resources, experienced investigative team members, previous investigative experience in related studies, and potential availability of suitable patient populations.
R34 awardees may prepare and submit an application for a full clinical trial during the final year of the R34 award period. Please note that an R34 award does not guarantee or imply that the NHLBI will accept for review or fund a subsequent full clinical trial application.
One application may contain more than one protocol for a clinical trial, if the trials may be run concurrently, i.e., they do not compete for resources or could co-enroll participants.
The NHLBI anticipates that the R34 award period will yield competitive investigator-initiated clinical trial grant applications and robust and successful clinical trials. The products of a successful R34 award period are the data necessary to design and carry out a well-executed clinical trial, a decision that a trial is not feasible or justified, or evidence that additional studies must be completed before proceeding to a full trial.
Despite the significant burden presented by pulmonary and cardiovascular diseases in HIV infected individuals, uncertainty exists about optimum treatment regimens and management. Even though good evidence-based treatments exist for many heart and lung conditions when they occur in the general population, these treatment options may not represent optimal management in the setting of HIV infection.
Large existing AIDS cohorts and study infrastructure represent important opportunities to move this research forward. These patient cohorts are available through studies supported by the NHLBI, National institute of Allergy and Infectious Diseases (NIAID), and National Institute of Alcohol Abuse and Alcoholism (NIAAA) - Veterans Aging Cohort Study (VACS), but inclusion of pulmonary research in current on-going trials is relatively rare.
This initiative would promote new collaborations among investigators with pulmonary expertise, cardiovascular expertise (if appropriate for the project), infectious diseases/HIV expertise, and biostatisticians expert in designing, coordinating, and investigators expert in designing, coordinating, and conducting clinical trials in HIV -infected populations. The studies should be designed to utilize, existing well-characterized cohorts since this could greatly reduce costs. Multi-site studies are likely to be necessary since the cohort size needed to power these studies may be too large for one site to handle. It is anticipated that most of the proposed clinical investigations will involve the use of currently marketed and indicated or repurposed therapeutic agents, alone or in combination. However, Phase II and III clinical trials of investigational agents under an IND are allowable under this FOA.
Studies in Veterans Administration (VA)/NIAAA-supported, NIAID-supported, and NHLBI-supported cohorts have reported high rates of lung and cardiovascular abnormalities in HIV-infected cohorts occurring at a younger age than in the general population. For example, in an analysis of pulmonary diseases in the VACS over 33,000 HIV-infected persons (65% on antiretroviral therapy) compared to more than 66,000 uninfected persons (adjusted for age sex, race, ethnicity, and site) the reported disease rates - pneumonia 20.3 per 1000 person years vs. 5.8, chronic obstructive pulmonary disease (COPD) 20.3 per 1000 person-years vs.17.5, lung cancer 2.3 per 1000 person years vs. 1.3, pulmonary hypertension 1.2 per 1000 person years vs. 0.8, and pulmonary fibrosis 0.9 per 1000 person years vs. 0.8 - were all significantly increased (p<0.001) . Lung conditions, such as COPD and pulmonary hypertension appear to be important health problems and may be under diagnosed in HIV-infected patients.
Cardiovascular data from the VACS of over 81,000 HIV positive and negative individuals (followed from 2003 to 2008) showed that HIV infection doubled the risk of myocardial infarction after accounting for traditional risk factors and also that greater risk correlated with lower CD4 counts and or higher viral loads. (Freiberg abstract data presented at Conference on Retroviruses and Opportunistic Infections (CROI) Boston 2/27/11-3/02/11). In a smaller study of more than 8,400 veterans participating in VACS, HIV-infected veterans were found to have an increased risk of heart failure (hazard ratio 1.81) compared to non-infected veterans.
A pulmonary study published in 2010 using data from the VA electronic database of over 33,000 HIV-infected subjects (median age 45 years) reported that COPD is the most common non-infectious disease in HIV-infected patients, with 16% carrying a baseline or incident diagnosis of COPD, based on ICD codes. Considerably higher rates have been observed in ongoing prospective studies of HIV-infected cohorts, in which pulmonary function testing is performed. As with risk of MI, risk of COPD and other lung diseases also correlate with lower CD4 counts and or higher viral loads.
Lung disease and cardiovascular disease often occur as co-morbid conditions. In the general population COPD is an independent risk factor for cardiovascular disease and for other lung diseases including lung cancer and pneumonia, which are already elevated in the HIV-infected population and associated with a higher risk of mortality than in the general population.
Lung and cardiovascular diseases, normally more prevalent in older populations, are now starting to have an increasing impact on HIV-infected populations in the US and other industrialized nations where effective antiretroviral therapy has increased the average age of the HIV-infected population.
The aging effect is compounded in HIV-infected populations because cardiovascular and lung complications are occurring in younger age groups.
The CDC estimates (based on 2007-2008 data) that HIV prevalence is over 800,000 in the US, with more than 40,000 new cases each year. CDC predicts that by 2015 one half of the HIV-infected population will be over age 50. We need to intensify our efforts to address the problem of HIV-associated lung diseases now.
The NHLBI anticipates that the Management of HIV-related Lung Disease and Cardiovascular Co-morbidity R34 program will result in well-crafted, highly competitive clinical trial grant applications that will lead to robust and successful clinical trials. This planning grant program will allow investigators or groups of investigators to develop competitive phase II or III clinical trials of intervention strategies for HIV-related lung disease, or lung disease with co-morbid cardiovascular disease to improve management and long term outcomes and to reduce morbidity and mortality.
During the planning period investigators can assemble a research team, consisting of a data coordinating center and clinical sites, that might be single centers or have several collaborating ancillary sites, define and prioritize research questions, collect information on the feasibility of the therapies to be tested and patient availability needed for timely recruitment, and develop a protocol(s). Applications will need to demonstrate a sufficiently important scientific question(s) and existence of sufficient clinical trials infrastructure to merit proceeding to the design of a clinical trial(s). Evaluation of applications in response to this FOA, will also take into consideration the significance and potential impact of the full-scale clinical trial(s).
Each R34 application will be required to propose one, or if appropriate, more than one clinical trial protocol(s) that addresses the central issue of identifying treatment strategies in HIV-related lung disease and, if appropriate, treatment(s) aimed at the cardiopulmonary co-morbidities that can reduce morbidity and mortality.
Investigators will be expected to utilize existing cohorts, to use efficient and innovative trial designs, and to have multidisciplinary teams that combine state-of-the-art clinical trial expertise and biostatistics with expertise in pulmonary disease, cardiovascular disease, including cardiopulmonary imaging, immunology, and infectious diseases – especially HIV and co-infections. Collaborations among pulmonologists, cardiologists (if there is a cardiovascular component) and infectious disease specialists are required and inclusion of basic scientists with expertise in these disciplines is strongly encouraged.
Since the program requires strong leadership in several clinical sciences it is well suited to multiple PD(s)/PI(s). Applicants are strongly encouraged to utilize the multiple PD(s)/PI(s) mechanism and to consider having a pulmonologist as one of the PD(s)/PI(s). Applicants are encouraged to assemble teams of 3 to 5 clinical centers that will work together to develop an application.
Studies designed from the outset to accommodate bedside-to-bench-to-bedside research are highly desirable. Resources are scarce and data and specimens associated with these clinical cohorts might be used to fill some of the many gaps that remain both in understanding pathogenesis and in improving treatment of lung and cardiovascular disease in HIV-infected persons. Applicants are encouraged to collaborate with basic researchers during this planning period to design the planned trial(s) to collect specimens for future (or maybe concurrent) basic investigations and to jump start the process by identifying hypotheses that might be tested and by collecting preliminary data. Planning ahead in this manner may permit the investigators to design studies that can collect scientifically meaningful samples without compromising the main study.
It is anticipated that NHLBI will convene annual R34 investigator meetings (1-2 days each) in the Washington DC metropolitan area on specific high priority areas related to this FOA. Such meetings will provide an opportunity for investigators to discuss progress of their research and facilitate successful completion of R34 project goals. Applicants should include travel costs in their applications for up to three investigators to attend these annual meetings. If the R34 application needs to have a Data and Safety Monitoring Board (DSMB), then funds associated with running the DSMB should be budgeted for in the application.
Examples of research activities that might be appropriate in R34 grants include but are not limited to the following:
SELECTED RESEARCH EXAMPLES related to Management of HIV-related Lung Disease and Cardiovascular Co-morbidity may include, but are not limited to those listed below:
Funding Instrument
Application Types Allowed
The OER Glossary and the SF 424 (R&R) Application Guide provide details on these application types.
Funds Available and Anticipated Number of Awards
The number of awards is contingent upon NIH appropriations, and the submission of a sufficient number of meritorious applications.
Future year amounts will depend on annual appropriations.
The NHLBI intends to commit $2.0 million total costs in FY 2012 to fund up to four awards, with a total cost commitment of $4.0 million over the two-year period.
Award Budget
Application budgets are limited to a maximum of $400,000 direct costs in any year, but need to reflect actual needs of the proposed project.
Award Project Period
The scope of the proposed project is up to a maximum of two years, FY2012 and FY2013.
NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made in response to this FOA.
Higher Education Institutions
The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:
Nonprofits Other Than Institutions of Higher Education
For-Profit Organizations
Non-domestic (non-U.S.) Entities (Foreign Institutions) are
not eligible to apply.
Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.
Foreign components, as defined in the NIH Grants Policy Statement, are allowed.
Applicant organizations must complete the following registrations
as described in the SF 424 (R&R) Application Guide to be eligible to apply
for or receive an award. Applicants must have a valid Dun and Bradstreet
Universal Numbering System (DUNS) number in order to begin each of the following
All Program Director(s)/Principal Investigator(s) (PD(s)/PI(s))
must also work with their institutional officials to register with the eRA
Commons or ensure their existing eRA Commons account is affiliated with the eRA
Commons account of the applicant organization.
All registrations must be completed by the application due date. Applicant organizations are strongly encouraged to start the registration process at least 4-6 weeks prior to the application due date.
Any individual(s) with the skills, knowledge, and resources
necessary to carry out the proposed research as the Program Director(s)/Principal
Investigator(s) (PD(s)/PI(s)) is invited to work with his/her organization to
develop an application for support. Individuals from underrepresented racial
and ethnic groups as well as individuals with disabilities are always
encouraged to apply for NIH support.
For institutions/organizations proposing multiple PD(s)/PI(s), visit the Multiple Program Director(s)/Principal Investigator(s) Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF 424 (R&R) Application Guide.
This FOA does not require cost sharing as defined in the NIH Grants Policy Statement.
Applicant organizations may submit more than one application, provided that each application is scientifically distinct.
NIH will not accept any application in response to this FOA that is essentially the same as one currently pending initial peer review unless the applicant withdraws the pending application. NIH will not accept any application that is essentially the same as one already reviewed.
Applicants must download the SF424 (R&R) application package associated with this funding opportunity using the "Apply for Grant Electronically" button in this FOA or following the directions provided at Grants.gov.
It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.
For information on Application Submission and Receipt, visit Frequently Asked Questions – Application Guide, Electronic Submission of Grant Applications.
Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review.
By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:
The letter of intent should be sent to:
Director, Office of Scientific Review
Division of Extramural Research Activities
National Heart, Lung, and Blood Institute
National Institutes of Health
6701 Rockledge Drive, Room 7214
Bethesda, MD 20892-7924 (Express Mail Zip: 20817)
Telephone: (301) 435-0270
Email: email@example.com
The forms package associated with this FOA includes all applicable components, mandatory and optional. Please note that some components marked optional in the application package are required for submission of applications for this FOA. Follow all instructions in the SF424 (R&R) Application Guide to ensure you complete all appropriate "optional" components.
All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:
Resource Sharing Plan
Individuals are required to comply with the instructions for the Resource Sharing Plans (Data Sharing Plan, Sharing Model Organisms, and Genome Wide Association Studies; GWAS) as provided in the SF424 (R&R) Application Guide, with the following modification:
Do not use the Appendix to circumvent page limits. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide, with the following modification:
Part I. Overview Information contains information about Key Dates. Applicants are encouraged to submit in advance of the deadline to ensure they have time to make any application corrections that might be necessary for successful submission.
Organizations must submit applications via Grants.gov, the online portal to find and apply for grants across all Federal agencies. Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIH's electronic system for grants administration.
Applicants are responsible for viewing their application in the eRA Commons to ensure accurate and successful submission.
Information on the submission process and a definition of on-time submission are provided in the SF424 (R&R) Application Guide.
This initiative is not subject to intergovernmental review.
All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Pre-award costs are allowable only as described in the NIH Grants Policy Statement.
Applications must be submitted electronically following the instructions described in the SF 424 (R&R) Application Guide. Paper applications will not be accepted.
Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.
For assistance with your electronic application or for more information on the electronic submission process, visit Applying Electronically.
All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile Component of the SF 424(R&R) Application Package. Failure to register in the Commons and to include a valid PD(s)/PI(s) Commons ID in the credential field will prevent the successful submission of an electronic application to NIH.
The applicant organization must ensure that the DUNS number it provides on the application is the same number used in the organization's profile in the eRA Commons and for the Central Contractor Registration (CCR). Additional information may be found in the SF424 (R&R) Application Guide.
See more tips for avoiding common errors.
Upon receipt, applications will be evaluated for completeness by the Center for Scientific Review and responsiveness by the NHLBI. Applications that are incomplete and/or nonresponsive will not be reviewed.
Applicants are required to follow the instructions for post-submission materials, as described in NOT-OD-10-115, with the following modifications:
· Applicants may submit a two-page data update, including any figures, as a pdf file. The data update must be countersigned by the Institutional Official in the Office of Sponsored Research and must be received by NHLBI by Monday, May 7, 2012. It should be e-mailed to the SRO. Check the eRA Commons for the SRO assignment. Please contact the assigned SRO for further updates concerning this.
Only the review criteria described below will be considered in the review process. As part of the NIH mission, all applications submitted to the NIH in support of biomedical and behavioral research are evaluated for scientific and technical merit through the NIH peer review system.
Reviewers will provide an overall impact/priority score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).
Reviewers will consider each of the review criteria below in the determination of scientific merit, and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.
Does the project address an important problem or a critical barrier to progress in the field? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field? Does the planned full-scale trial address a significant public health concern?
Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or New Investigators, or in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD(s)/PI(s), do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project? What is the quality of the pulmonary expertise? What is the quality of the expertise in the clinical management of HIV-infection? What is the quality of the expertise and leadership in the design, coordination, and conduct of clinical trials? If the project contains a cardiac component, what is the quality of the expertise in cardiology? If basic research is included in the application, what is the quality of basic research expertise?
Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?
Are the overall strategy, methodology, and analyses
well-reasoned and appropriate to accomplish the specific aims of the project?
Are potential problems, alternative strategies, and benchmarks for success
presented? If the project is in the early stages of development, will the
strategy establish feasibility and will particularly risky aspects be
If the project involves clinical research, are the plans for 1) protection of human subjects from research risks, and 2) inclusion of minorities and members of both sexes/genders, as well as the inclusion of children, justified in terms of the scientific goals and research strategy proposed? Are the proposed pilot studies both necessary and sufficient to permit the design of a full-scale clinical trial?
Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?
As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact/priority score, but will not give separate scores for these items.
Protections for Human Subjects
For research that involves human subjects but does
not involve one of the six categories of research that are exempt under 45 CFR
Part 46, the committee will evaluate the justification for involvement of human
subjects and the proposed protections from research risk relating to their
participation according to the following five review criteria: 1) risk to subjects,
2) adequacy of protection against risks, 3) potential benefits to the subjects
and others, 4) importance of the knowledge to be gained, and 5) data and safety
monitoring for clinical trials.
For research that involves human subjects and meets the criteria for one or more of the six categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Human Subjects Protection and Inclusion Guidelines.
Inclusion of Women, Minorities, and Children
When the proposed project involves clinical research, the committee will evaluate the proposed plans for inclusion of minorities and members of both genders, as well as the inclusion of children. For additional information on review of the Inclusion section, please refer to the Human Subjects Protection and Inclusion Guidelines.
Vertebrate Animals
The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following five points: 1) proposed use of the animals, and species, strains, ages, sex, and numbers to be used; 2) justifications for the use of animals and for the appropriateness of the species and numbers proposed; 3) adequacy of veterinary care; 4) procedures for limiting discomfort, distress, pain and injury to that which is unavoidable in the conduct of scientifically sound research including the use of analgesic, anesthetic, and tranquilizing drugs and/or comfortable restraining devices; and 5) methods of euthanasia and reason for selection if not consistent with the AVMA Guidelines on Euthanasia. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.
Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.
Not Applicable
Not Applicable
Not Applicable.
As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact/priority score.
Applications from Foreign Organizations
Not Applicable
Select Agent Research
Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).
Resource Sharing Plans
Reviewers will comment on whether the following Resource Sharing Plans, or the rationale for not sharing the following types of resources, are reasonable: 1) Data Sharing Plan; 2) Sharing Model Organisms; and 3) Genome Wide Association Studies (GWAS).
Budget and Period of Support
Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.
Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by the NHLBI,,in accordance with NIH peer review policy and procedures, using the stated review criteria. Review assignments will be shown in the eRA Commons.
As part of the scientific peer review, all applications:
Appeals of initial peer review will not be accepted for applications submitted in response to this FOA.
Applications will be assigned to the appropriate NIH Institute or Center. Applications will compete for available funds with all other recommended applications submitted in response to this FOA. Following initial peer review, recommended applications will receive a second level of review by the NHLBI Advisory Council. The following will be considered in making funding decisions:
After the peer review of the application is completed, the PD(s)/PI(s) will be able to access his or her Summary Statement (written critique) via the eRA Commons.
Information regarding the disposition of applications is available in the NIH Grants Policy Statement.
If the application is under consideration for funding, NIH
will request "just-in-time" information from the applicant as
described in the NIH Grants
Policy Statement.
A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization for successful applications. The NoA signed by the grants management officer is the authorizing document and will be sent via email to the grantee's business official.
Awardees must comply with any funding restrictions described in Section IV.5. Funding Restrictions. Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs.
Any application awarded in response to this FOA will be subject to the DUNS, CCR Registration, and Transparency Act requirements as noted on the Award Conditions and Information for NIH Grants website.
All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Grantees, and Activities. More information is provided at Award Conditions and Information for NIH Grants.
Cooperative Agreement Terms and Conditions of Award
Not Applicable.
When multiple years are involved, awardees will be required to submit the Non-Competing Continuation Grant Progress Report (PHS 2590) annually and financial statements as required in the NIH Grants Policy Statement.
A final progress report, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement.
The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for awardees of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All awardees of applicable NIH grants and cooperative agreements are required to report to the Federal Subaward Reporting System (FSRS) available at www.fsrs.gov on all subawards over $25,000. See the NIH Grants Policy Statement for additional information on this reporting requirement.
We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.
Customer Support (Questions regarding Grants.gov registration and
submission, downloading or navigating forms)
Contact Center Phone: 800-518-4726
Email: firstname.lastname@example.com
GrantsInfo (Questions regarding application instructions and
process, finding NIH grant resources)
Telephone 301-710-0267
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eRA Commons Help Desk(Questions regarding eRA Commons
registration, tracking application status, post submission issues)
Phone: 301-402-7469 or 866-504-9552 (Toll Free)
Email: email@example.com
Hannah H. Peavy, M.D.
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0222
Cheryl L. McDonald, M.D.
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0560
Director, Office of Scientific Review
Division of Extramural Research Activities
National Heart, Lung, and Blood Institute
National Institutes of Health
6701 Rockledge Drive, Room 7214
Bethesda, MD 20892-7924 (Express Mail Zip: 20817)
Telephone: 301-435-0270
Fax: 301-480-0730
Email: firstname.lastname@example.com
Mr. Andre Walker
National Heart, Lung, and Blood Institute (NHLBI))
Office of Grants Management
6701 Rockledge Drive, Room 7146
Bethesda, MD 20892-7924 (Express Mail Zip: 20817)
Telephone: 301-435-0166
Fax: 301-451-5462
Email: email@example.com
Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 45 CFR Parts 74 and 92.
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text:
The leaders of Northern Ireland's five main political parties have agreed to hold further talks next week on their disagreement about the future of Dr Richard Haass's proposals.
They met at Stormont this afternoon to discuss how they might deal with recommendations made by the US diplomat on problem areas of the peace process.
Following a one-hour meeting at the Stormont office of First Minister and DUP leader Peter Robinson, they agreed to reconvene next week for further discussions.
The attendees at this afternoon's meeting included Sinn Féin's Martin McGuinness, Alliance leader David Ford, Alasdair McDonnell of the SDLP and the UUP's Mike Nesbitt.

subset: commoncrawl


text:
Sneak Peek: New Kitchenware From West Elm Kitchen
West Elm is one of my favorite places to shop for modern yet affordable tableware. I have been finding especially good things there lately; I picked up an organically-shaped white platter before Thanksgiving, and some perfect little dessert bowls. This summer promises even more from West Elm, as they launch an all-new collection of kitchen accessories. They're not just interested in the dining room; it seems they want to come into the kitchen as well. Here's an advance peek at some of the new stuff!
The Summer 2011 collection isn't a full-on assault on Crate & Barrel and kitchen supply stores. There aren't any food processors or whisks on display. But there is more than West Elm's usual range of simple tableware. They are offering some kitchen accessories like cutting boards, a mortar and pestle, and the most adorable butter dish ever. This puts them closer to Anthropologie in the retail space — not necessarily focused on practical tools, but offering some stylish, stand-out pieces for the kitchen.
The new lines coming out this week include a collection ("Flow") of rustic stoneware tableware with a handmade feel. Really lovely stuff — I especially like the wood-topped storage jars (I hope they have seals!) and the large salad bowls.
The other line is called "The Modern Collection" and it is inspired by Scandinavian design, pop art, and whimsical color. Lots of bright, juicy color and a bit of retro flair here. (Have I mentioned that butter dish?)
Look for this new kitchen collection online and in West Elm stores starting right now. I'm looking forward to checking it out in person and seeing how it all looks in real life.
• See the new kitchen line: Kitchen Accessories at West Elm
Do you shop at West Elm for any of your tableware or kitchenware? What good buys have you found there?
Related: Simple White: 10 Handmade White Bowls
(Images: West Elm)


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Heisey hits 2 HRs, leads Cueto, Reds over Pirates
Heisey hits 2 HRs, leads Cueto, Reds over Pirates
Chris Heisey hit two home runs, including a tiebreaking shot in the ninth inning, and Johnny Cueto overcame an early jolt to earn his 16th win as the Cincinnati Reds beat the Pittsburgh Pirates 3-2 Sunday.
Heisey's solo drive with one out in the ninth off Jared Hughes (6-5) helped the Reds avoid getting swept at PNC Park. Heisey began the day with just five homers in 229 at-bats this year.
Cueto (16-8) gave up a home run to Josh Harrison on his first pitch of the game. Jordy Mercer homered off Cueto in the second for a 2-0 lead.
Cueto wound up pitching eight innings and tied Dodgers ace Clayton Kershaw for the major league lead in victories.
Aroldis Chapman struck two in a perfect ninth for his 29th save.


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Would You Stand Underneath a Chandelier Made of Scissors?
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Our pals over at iittala sent over this video and it gave me a nice little eye candy work break today. It's of a group of very creative people putting together an amazing pavilion at their parent company, Fiskars. I'm not sure how long it took, but the video gives you the satisfaction of seeing it all come together in a little over two minutes.
I love the chandelier made of Fiskars orange-handled scissors; it's so clever and beautiful, but adds tension to the space. Which begs the question, how comfortable would you be standing underneath it? I think I would be a bit nervous, yet I would want to see the view from directly beneath it.
The pavilion opened in May of this year at Fiskars Group headquarters in Arabia, Helsinki. Pentagon Design created the installations from various products from their brands, including Iittala, Fiskars, Gerber, Arabia and Hackman.
The installation includes Ateenan aamu (Morning in Athens) glass pendants and Kastehelmi votives designed by the likes of Kaj Franck and Oiva Toikka creating a pixilated art piece that lets the light through.
Toikka also designed the many beautiful iittala birds I'm constantly coveting. Right now my favorite is the Whooper Swan in Gray, but tomorrow it will probably be the owl or the magpie!
Have you ever seen a really cool installation made of something unexpected? One that sticks out in my mind was a lampshade made of aviator sunglasses at the International Contemporary Furniture Fair years back.


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|7.94 / 10
|November 23, 2016
|Robert Zemeckis
|Graham King, Robert Zemeckis, Steve Starkey
|Paramount Pictures
|Brad Pitt, Marion Cotillard, Matthew Goode, Lizzy Caplan, Raffey Cassidy, Jared Harris, Simon McBurney
|121 minutes
In 1942 Casablanca during WWII, Max Vatan (Brad Pitt), a French-Canadian intelligence officer, meets French Resistance fighter Marianne Beausejour (Marion Cotillard), on a deadly mission behind enemy lines.
They fall in love while working together on a mission to kill a German official, and afterwards Max convinces Marianne to come with him to London to marry him. She does and the happy couple soon have a child together. However, their relationship is threatened by the pressures of war, especially when Max is told that Marianne may be a Nazi spy. He's given 72 hours to find out the truth, and if the suspicions are true, he's ordered to execute her or be hanged himself.
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My dear friend Rebekka had Hannah and I over for pastries and french pressed coffee for a cozy morning in on a chilly winter's day.
Bundles of eucalyptus, sprigs of boxwood, and blood-red roses adorned the wooden table in her laughter-filled dining room. We crafted, drank, got our cameras sticky from our eucalyptus stained fingers. Of course, we followed our wonderful morning the best way we knew how. A trip to the Nashville flea market, where many treasures were discovered (and some purchased).this tutorial. That's where we got the idea, but then of course we didn't refer to it. What can I say, not one for directions!


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Seriously, enough with the fruit already.
Heather Corinna replies:I have had sex with my girlfriend many times now. And she still has not had her "cherry" popped. She is a soccer player and is very active and I have heard that could effect the "cherry" being popped. So is it just me? Or could it be other factors that could affect the cherry being popped?
You probably put the word cherry in quotes because you're not exactly sure what on earth it even is.
That's understandable, since nobody really does, as it's not something real.
Usually, when people talking about "cherry-popping," when it comes to sex, they are colloquially saying that someone simply had intercourse for the first time. That derives from long-ago ideas about the hymen -- a very thin membrane which covers the vaginal opening of women at birth, and which erodes over time into adulthood -- and the fact that people for a long time, and sometimes still, think it "pops" with first intercourse, and if it does not, then a woman clearly has had intercourse before.
But I can assure you, it doesn't usually "pop." If anyone is sitting around waiting for a popping sound, they're in for a long wait. And there is no cherry in the vagina.
Since -- hope springs eternal -- I am determined to have this be the last question we ever answer on this subject in this section, let me be clear.
For the most part, all women are born with a hymen, even though the appearance of the hyman and the vulva can vary a whole lot, and it sits just behind the vaginal opening and, at birth, usually covers it. As a girl grows into a woman, that thin membrane (think of that little membrane that connects your tongue to the bottom of your mouth to get an idea of the thinness I'm talking about) slowly wears away. It first gets what we call micro-openings, very tiny openings, and over time, those openings expand more and more, due to vaginal discharges, hormones, menstrual flow, general physical activity (one doesn't have to be a soccer player), and yes, also due to any sort of vaginal sex, including masturbation, if and when that occurs. Vaginal intercourse or manual sex with vaginal entry does tend to further that process, or speed it up some, but not by popping anything. That tissue, being so thin, and being without nerve endings of its own, tends to be very flexible, so save when we are talking about forced intercourse or other sex, or genital injury, a penis or fingers will just wear it away more and more over time. Eventually, there will only be traces of it around the edges just inside the vaginal opening: sometimes those are easy to see or discern, sometimes they blend pretty seamlessly into the rest of the tissue of that area.
What age a woman is at often makes a difference, too. Very young women are likely to have more hymen left to wear away than women in their late teens or early twenties, with or without vaginal sex. Ultimately, we don't know why the hymen even exists. It doesn't really serve any real purpose, save perhaps to help keep bacteria out of the vagina and away from the reproductive organs during development. But even that is only an educated guess.
Can a hymen more dramatically break or tear? It can, but when that happens it is most commonly due to injury, sex someone is forcing on that woman, someone having intercourse with very young women, very rough intercourse, or people being really hasty about intercourse. If a male partner were to race into vaginal intercourse before their female partner who had a good deal of hymen left was highly aroused, or try and push himself in like a battering ram, rather than be gradual, tearing can happen. But no one is likely to hear a popping sound: what you're more likely to hear is a female partner expressing pain.
Sometimes, that wearing away will cause bleeding, but sometimes it won't, and bleeding during sex when it happens isn't always just about hymens. Bleeding can also occur because of a partner being too rough and causing injury, because of abrasion from lack of lubrication, lack of arousal or fear. Some sexually transmitted infections can cause bleeding or spotting with intercourse. But when there isn't any bleeding, that doesn't automatically mean someone's hymen isn't wearing away or that they don't have one. It might have worn away on its own mostly already, the way it's wearing away simply might not be causing any bleeding, or, what's left of the hymen may be so minimal, or situated in such a way, that at any given time, vaginal sex isn't having any effect on it at all.
(Some women do have what are called resilient hymens, which means that for those women -- around one in every 2,000 women, last I checked -- all of this gradual wearing away isn't really happening, and for those women, entry of a penis or fingers into the vagina is difficult or impossible. That can, however, be remedied by a very simple, outpatient surgical procedure. However, if the two of you are having intercourse, then your girlfriend is not one of these women, as a resilient hymen either totally blocks vaginal entry or makes the attempt incredibly painful.)
All that said, I'm not sure what it is you or you and your partner are waiting for here. Maybe you expect bleeding when there isn't any, or maybe you are waiting for something to signal that something has been popped. But it sounds to me like you're likely waiting for something that isn't going to happen, and isn't based on a realistic understanding of the female sexual anatomy and what happens -- or doesn't -- during vaginal intercourse.
I'd encourage you not to -- in case this is part of what is going on -- think of causing bleeding as some sort of status issue; as something that proves you've done sex right. In other words, that until a woman bleeds, or a male partner gets some proof he "popped her cherry," sex hasn't been real or complete. Bleeding happens during sex sometimes, for sure, but you're not likely to meet a woman who WANTS to be bleeding during sex, or sees that as a positive. Any changes that happen to a woman's genitals are her own changes, not something someone else should look to own, and sex being of import is about if the people having it are enjoying themselves, physically and emotionally, and finding it important. Without that, even at those times that we might see bleeding or have a genital change, those physical issues can't make sex a major event in our lives.
We good? Here are a few more links to make it all clear, once and for all:


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Let's get ready for a vocal rumble.
The final 16 contestants took the stage last night to compete for the remaining spots on their coaches' teams, and a spot in the live shows. Remember: each coach is able to get one more additional steal, and it was Christina and Adam's turn to give someone another chance.
The contestants needed to pick a song that would showcase their talent, and prove they are worthy of a spot on the live shows.
Team Adam: Lina Gaudenzi and "I'd Rather Go Blind" by Etta James vs. Preston Pohl and "No Woman No Cry" by Bob Marley
Coach Adam's team kicked off the night with two classic songs, bur rehearsal found him second-guessing whether they were the right song choices.
Lina Gaudenzi wanted to show off the bluesy-side of her voice with the Etta James classic, while Preston Pohl wanted to challenge himself vocally with the reggae hit. Both performances started off a little shaky; the judges agreed that it was all about the best recovery, saying Preston delivered a stronger performance. Coach Adam decided to keep Preston for the live shows.
Team Blake: E.G. Daly and "I Can't Make You Love Me" by Bonnie Wright vs. Ray Boudreaux and "Hard to Handle" by Otis Redding
The key to this Team Blake performance was control. One contestant kept it, while the other lost it at a most crucial point.
Actress-turned-singer E.G Daly performed the Bonnie Wright hit "I Can't Make You Love Me," while soul-man Ray Boudreaux performed Otis Redding's "Hard to Handle." While it was easy for Ray to handle his performance, E.G fell apart towards the end of hers -- Coach Christina pointed out how she lost control of her voice. Coach Blake decided that Ray had the better performance all-around, and E.G.'s time on "The Voice" was over.
Team Christina: Anthony Paul and "The Other Side" by Jason Derulo vs. Jacquie Lee and "Stompa" by Serena Ryder
Anthony Paul and Jacquie Lee had something to prove. As the two youngest contestants on Team Christina, each wanted to deliver a stellar performance that would set them apart from the competition.
A front-runner since his audition, Anthony chose Jason Derulo's pop hit (which came with a warming from Coach Christina). Underdog Jacquie knew she had to deliver with her performance of Serena Ryder's "Stompa" to keep up with her competition.
Jacquie's performance blew coaches Adam and CeeLo away, while all the coaches agreed Anthony was less-than-stellar. Coach Christina deemed Jacquie the winner, and Anthony went home without a save.
Not only did Jacquie win that knockout round, but Adam called her "the cutest person I have ever seen."
Team CeeLo: Stephanie Anne Johnson and "Don't Know Why" by Norah Jones vs. Tamara Chauniece and "No One" by Alicia Keys
Oh CeeLo, this indeed was a tough one.
Coach CeeLo paired two of his team's biggest talents to face off in one of the night's best vocal duels. Stephanie Anne Johnson grabbed her guitar and performed "Don't Know Why," while Tamara Chauniece put a reggae twist on hit "No One."
Each lady added her own flare, showcasing both performance and vocal talent. While Coach Christina loved every second of it, Coach Adam wasn't too thrilled. Coach CeeLo complimented Tamara by comparing her to a young Anita Baker, and told Stephanie that she delivered with her choice of song and instrument.
After taking a minute to make a tough decision, CeeLo chose Tamara. In a split-second decision, Christina got Stephanie Anne in the steal -- making "The Voice" history by giving a contestant a third chance to compete on the show.
Team Adam: James Wolpert and "More Than a Feeling" by Boston vs. Juhi and "I Heard it Through the Grapevine" by Marvin Gaye
The Battle of the Bookworms! James Wolpert and Juhi were ready to prove they each had enough soul and talent to make it to the live rounds. James chose to take the rock n roll route with his performance of "More Than a Feeling," while Juhi decided to spice up "I Heard it Through the Grapevine" (this one was for you, CeeLo).
James lost the glasses and showcased vocal control and slight nerves during his performance of what the coaches called the toughest rock song to perform, while Juhi delivered edge with her performance. Although he seemed a little nervous, coach Adam decided to pick James based on his past performances and not let his off night determine his fate. Juhi was sent home.
Team Blake: Austin Jencks and "I'll Be" by Edwin McCain vs. Brandon Chase and "Even if it Breaks Your Heart" by Eli Young Band
When it came down to delivering emotion, Team Blake's final two contestants left it all on the stage. Austin Jenckes chose to dedicate "I'll Be" to his father, who passed away when he was 16; Brandon Chase used all his bottled-up emotions to perform "Even if it Breaks Your Heart."
Both performances moved the coaches, but Austin and his guitar shined a little more in the coaches' eyes. Coach Blake decided to go with his good buddy Austin, leaving Brandon and his emotions out of the competition.
Team CeeLo: Caroline Pennell and "The Way I Am" by Ingrid Michaelson vs. George Horga Jr. and "Because of You" by Neyo
In another battle of the young contestants. Caroline chose "The Way I Am" to showcase her talent and style, while George Horga Jr. switched it up with "Because of You."
Caroline made Coach Blake want to go out, buy and cat and sit by the fireplace sipping hot chocolate (well, if that's a compliment, take it), while George sang flat for most of his performance. That made the decision easy for Coach CeeLo, who chose Caroline for the final spot on his team.
Team Christina: Matthew Schuler and "Cosmic Love" by Florence and the Machine vs. Will Champlin and "When I Was Your Man" by Bruno Mars
In the final performance of the night, team Christina favorite Matthew Schuler chose a Florence and the Machine hit to show off his larger than life voice, while Will Champlin slowed down the pace, dedicating "When I Was Your Man" to his wife, who is battling a brain tumor.
Both men earned stating ovations from the coaches, leaving Christina with a tough decision. She decided to keep Matthew Schuler, while Will Champlin went back home to team Adam in the steal.
With all of the teams completed, next week the coaches will take their contestants into the live rounds. Now it isn't up only to the coaches; America gets a say in who will stay and who will go.
Which team do you think is the strongest? Not sure? Find out next Monday, Tuesday and Thursday, as the live shows kick off.


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HONOLULU (AP) — A jury on Thursday acquitted a federal agent of murder in his second trial for the 2011 shooting death of a man at a Hawaii fast-food restaurant, but they couldn't reach a verdict on other lesser charges.
Nearly a year ago, another set of jurors deadlocked in the case against State Department Special Agent Christopher Deedy, and a judge declared a mistrial.
Judge Karen Ahn later ruled the new jury could consider a lesser charge of manslaughter — an option the previous jury didn't have. The foreman in last year's trial said jurors deadlocked with eight in favor of acquittal and four for conviction. Legal observers blamed the hung jury on the lack of a manslaughter option.
This time, the jury said the shooting wasn't murder, but they couldn't decide if Deedy was guilty of reckless manslaughter, or assault in the first or second degree.
The judge said Deedy could face a third trial on those counts, but defense attorney Thomas Otake said outside court: "We firmly believe there are legal motions we can file to dispose of those charges. ... Our position is enough is enough."
Deputy Prosecuting Attorney Janice Futa said she was disappointed with the acquittal and will recommend a third trial.
The family of Kollin Elderts, who was killed, abruptly left the courtroom after hearing the result. They criticized prosecutors last year for not asking for manslaughter, but prosecutors said the evidence didn't support a manslaughter charge.
Ahn said she included it this time in part because the state Supreme Court has since made the law clearer on the issue.
Elderts family spokeswoman Kalama Niheu said the family was devastated and prosecutors didn't do enough to get justice. Futa declined to comment on that criticism.
"Christopher Deedy is a very irresponsible, cowardly individual that took away the heartbeat of our family and forever changed us," Niheu said, reading from a statement. "Because of the poor decisions he made that tragic night, including drinking and walking our Waikiki streets with a loaded personal firearm, we can never forgive him."
Deedy, 30, took the stand at both trials. The Arlington, Virginia, man maintained he acted in self-defense and was trying to protect others from an aggressive Elderts in the Waikiki McDonald's.
Deedy was in town to help provide security for an international economic summit but was off-duty when he shot Elderts, 23.
Much of his testimony at the latest trial was the same as last year's, but this time he was clearer about his intention to kill Elderts, in what seemed like an attempt to avoid a ruling to include reckless manslaughter as an option for jurors.
Deedy said that when he pulled the trigger three times, he intended "to stop the threat, to kill the assailant."
He was fueled by alcohol, power and a warning from a fellow agent about the hostility of Hawaii locals toward government employees and outsiders, prosecutors told the juries in both trials.
The prosecution tried to portray Deedy as drunk and inexperienced. The defense countered that Deedy had only a few drinks and was acting in line with his law-enforcement training when he intervened in a potentially dangerous situation.
Deedy, who went to the McDonald's after a night of bar-hopping with friends, said Elderts was bullying a customer.
Jurors began deliberating Aug. 5. They got some time off as Hawaii braced for Tropical Storm Iselle and Hurricane Julio.
Earlier Thursday, the jurors were brought into the courtroom, and it seemed Ahn was expecting them to say they were deadlocked and that more time wouldn't help, as she made plans with attorneys for declaring a mistrial if necessary. But the forewoman said it was possible they could reach a verdict with more time, so the judge told them to keep deliberating. They returned with their verdict a few hours later.
"Today is just a day where we're relieved. We're relieved that they acquitted him of murder and that they did not convict him of anything," Otake said. "No matter what, there's no winners in a case like this. ... The Elderts, they've lost a loved one."
Follow Jennifer Sinco Kelleher at http://www.twitter.com/JenHapa .


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Alaska Sphinx, Go Behind the Scenes of 65 with Chris Anthony
Chris Anthony checks in during a shoot for #65 in Alaska's Chugach Mountains.
Chris Anthony checks in while filming in Alaska's Chugach Mountains for the 2014 Warren Miller film. In the clip, athletes Ingrid Backstrom and Jess McMillan wait for the perfect conditions before they rip their lines.
From Chris:
The Group arrived at 10:30 AM and started the long set up. By the time the girls got to ski it was near 2:30. The girls sat on top for more than two and half hours waiting for everything to be perfect. This was after going through full safety checks.
This was one of those epic moments that will take maybe a few minutes in the film, but took almost all day to nail. The entire group admitted this day was meant for this to happen, as conditions could not have been more perfect. Moments like this are not planned. They are gifted. The crew sat for 6 days than had 3 days of amazing filming.


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Three more South Floridians have had big finishes at the World Series of Poker:
Noah Schwartz of North Miami Beach finished second of 1,021 in event No. 22, a $1,500 pot-limit Omaha event. He earned $1712,931.
Michael Mizrachi finished fourth of 246 in a $2,500 7-card stud tournament, earning $43,188.
Robert Mizrachi finished third of 241 in a $5,000 Omaha Hi-Low tournament. He won $128,074.
So far Matt Waxman of Parkland is the only braclet winner, but Darryll Fish of Fort Lauderdale came close, as did Steven Wolansky.
The main event begins July 5.


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text: Lacrosse goalies, you are the last line of defense for your team and the most unique player on the field in terms of required reflexes and strength. You need the best quality gear to maximize your performance on the lacrosse field and ComLax can help get you there. You will find goalie heads for all levels of play from leading brands like Brine, STX, Warrior and more. If you're looking for additional guidance, check out our guide to choosing lacrosse goalie gear to help you along the way.


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Friday, July 04, 2008
Fourth of July
Well, I'm not so crazy about nationalism, but I am crazy about a dinner theme. So I was cooking for my Grandpa tonight, and decided to go the traditional 4th of July route. In the end we ended up having a little party with my parents and a friend joining us for dinner as well.
Here's the plate: potato salad, corn & watermelon (both from the fammy! - that's my love name for the farmers' market), and Amy's California Burgers. Trying to push all the right 4th of July culinary buttons. All was delicious! I'm a half-bun person, when it comes to burgers, that is.
Just about the only potato salad I've ever really loved: it's from "Vegan Mediterranean Kitchen" by Donna Klein. It's so simple and so freakishly delicious.
I really embraced the holiday theme with dessert. Shortbread crust, vanilla pudding filling, topped with raspberries, blueberries, and strawberries. Those blueberries were grown by a family friend who I used to babysit! Now he's growing some super awesome organic blueberries that are *definitely* the best I've tasted. That's pretty rad.
also, isn't that a fun tart pan? One of the two new tart pans I bought last month in Fort Bragg.
One more glamour shot. Ooooh, yum!
14 comments:
Haha, when is the farmers' market NOT exciting?? ;0) Glad that you were able to make lots of delicious purchases.ReplyDelete
I agree with Cecilia - that tart is BEYOND gorgeous!!
Hey, I was in NC last week too! It's funny how things differ though because NC was a big improvement for me coming from IL. But coming from CA, I can definitely see how you'd find it sub-par, especially if you weren't in a populated area.ReplyDelete
Anyway, your farmer's market haul is gorgeous!
Amey! Hi! It's Taylor, Alan and Cindy's daughter. I have to admit, I googled you months ago, and found your awesome blog, though never got around to posting back. I wasn't sure how, honestly, but just figured it out.ReplyDelete
I can't believe how incredible your dishes are! You really seem to utilize a ton of ingredients! They look so tasty and fresh; it's really inspiring to get me up and cook something. IN FACT, I was watching a few vegan videos today, and I think it's something I'm going to do. Maybe start vegetarian to ease into it, but I really think I'll be happier for it. Not sure the socially appropriate length for these comments, but just wanted to share. :) I'd love to chat sometime, you can e-mail me at firstname.lastname@example.com
Hope you're doing well!!!
That's quite a bountiful booty load from the fammy there, sis-tah!!! And you sure have a talent of making desserts over-the-top beautiful -- the tart is so pretty and perfectly suited for the 4th.ReplyDelete
I;m not nationalistic, either--but I do love long weekends and your pretty tart.ReplyDelete
That may be the most beautiful tart I've ever seen!ReplyDelete
Your tart is so patriotic and festive!ReplyDelete


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LITTLE ROCK, Ark. (AP) — A 12-year-old Arkansas girl who has been battling a rare and often-fatal infection caused by a brain-eating amoeba is now able to drink liquids and eat some food.
Kali Hardig was diagnosed last month with an infection caused by an amoeba called Naegleria fowleri.
There were 128 such infections reported in the United States between 1962 and 2012, according to the Centers for Disease Control and Prevention. Before Kali, doctors could only point to one known survivor in the U.S. and another in Mexico.
So it's incredible that Kali (pronounced KAY'-lee) is alive, let alone making such progress.
"She's now eating some orally, although she's not doing real great with that because she hasn't eaten in so long," one of her doctors, Dr. Esther Tompkins, said Thursday. "But she's allowed to eat and drink whatever she wants now."
So far, Tompkins said that has meant water, crackers and some other food.
Kali is drinking "mostly just water because she says other stuff doesn't taste very good to her," Tompkins said. "She's had some Ritz crackers ... with peanut butter, and she likes chocolate pudding."
Health officials believe Kali got sick after a trip to a now-shuttered Arkansas water park that features a sandy-bottomed lake.
Naegleria fowleri (pronounced nuh-GLEER'-ee-uh FOW'-lur-ee) often is found in warm bodies of freshwater, such as lakes, rivers and hot springs. The amoeba typically enters the body through the nose as people are swimming or diving. It can then travel to the brain, causing a devastating infection called primary amebic meningoencephalitis, or PAM. That's what Kali has been battling.
Initial symptoms usually start within one to seven days and may include headache, fever, nausea and vomiting. The disease progresses rapidly, and other symptoms can include stiff neck, confusion, loss of balance, seizures and hallucinations.
Moreover, the infection destroys brain tissue and can cause brain swelling and death.
Doctors say Kali's success is due in large part to experimental treatment and early detection and diagnosis.
Kali's mother, Traci Hardig, brought her to Arkansas Children's Hospital with a nasty fever on July 19.
Doctors cooled Kali's body down to try to reduce the swelling, and they won clearance to treat her with a breast-cancer drug.
Tests have since shown no sign of the parasite in her system.
Beyond her latest feat of eating and drinking, Kali has been relearning to walk and talk.
"She can answer questions, follow commands," said Tompkins, a staff pediatric rehab doctor at Arkansas Children's Hospital. "She's walking back and forth from her room to the therapy room now with just hand-held assistance with some braces on her feet, so that's pretty exciting for her."
Kali likely has months of outpatient therapy in store once she's released from the hospital. That could happen as early as next month, as she continues to impress doctors, relatives and other supporters with her accomplishments at the hospital.
"She's doing great. She's making progress every day," Tompkins said. "It's just a slow, steady build."
Follow Jeannie Nuss at http://twitter.com/jeannienuss


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MedCath is a hospital operator focusing on cardiovascular procedures. Cardiovascular surgery is one of the most profitable medical specialties,[1], and the number of potential patients is growing as the US population ages, since victims of cardiovascular disease are typically 55 or older.[2]
In many aspects, MedCath's facilities operate like independent surgery centers - the firm shares ownership with the physicians staffing its hospitals and saves costs through specializing in the most lucrative procedures. As a result, MedCath, along with other operators of specialty hospitals, has found itself competing for market share and waging legal battles with traditional hospital operators, which argue that specialty facilities take the most profitable patients, making it impossible for their facilities to remain profitable. A moratorium by the federal government on the development of specialty hospitals hindered the development of new facilities from 2003-2006, and more recent bills have attempted to reinstate the limits, threatening MDTH's growth.[3]
Despite their distinction from traditional hospitals, MedCath's facilities are officially licensed as hospitals, and this creates certain restrictions that can create costs and limit the company's earnings. For instance, they must still operate emergency rooms, which are some of the most expensive procedures provided by hospitals.[4] MedCath's hospitals also treat an above-average proportion of Medicare patients, and stand to lose out as the US government considers cutting reimbursements to deal with rising Medicare expenditures.[5]
MedCath owns an interest in and operates 11 hospitals and 25 diagnostic and therapeutic centers throughout the United States, with a concentration in the Southeast and Southwest. Although the firm's hospitals are licensed as general acute care facilities and offer patients a range of services, they primarily focus on providing cardiovascular care.[6] MedCath receives revenue from private insurers, including managed care plans, the federal government (under the Medicare program), state governments (under their respective Medicaid programs), and directly from patients.[7]
In 2007, MedCath's total revenues rose 1.8% to $719 million, driven by growth in the hospital segment, where revenue on a same facility basis increased 4.2% from the prior year. The growth is attributable both to an increase in admissions (2.6% annually) and higher net revenues per admission resulting from renegotiations of several managed care contracts. Revenues at MDTH's diagnostic and therapeutic centers, on the other hand, fell $2.9 million.[8]
MDTH's net income fell 8.3% to $11.5 million in 2007. While operating expenses held steady, and medical supplies and bad debt expense actually fell 2% and 3% respectively when compared to 2006, MDTH faced sizable non-operating losses. First, the firm sold its equity interests in two facilities (Tucson Heart Hospital and Heart Hospital of Lafayette) at a loss;[9] also, a recapitalization of a third facility (Harlingen Medical Center) contributed to a $9.9 million loss on the early extinguishment of debt.[10]
|Hospital revenue ($mm)
|Licensed Beds
|Patient Days (thousand)
|Occupancy Rate (% of beds in service)
|Average Length of Stay (days)
As the number of specialty hospitals in the United States reaches approximately 200, concerns have arisen that these facilities are detrimental to the profitability of the hospital industry as a whole. Critics believe that specialty hospitals cherry-pick the most profitable patients, performing exclusively lucrative, low-risk surgeries and leaving lower margin treatments to generalist hospitals.[14] Because generalist hospitals use the income provided by high-margin operations to finance certain unprofitable services and procedures, losing these operations can completely erase profits.[15] To address these concerns, opponents of specialty hospitals have made great efforts to limit their growth. In 2003, Congress passed a moratorium on the opening of new specialty facilities that lasted until 2006.[16] While that moratorium has been lifted, as recently as June 2008, Congress considered a bill that would have again blocked the opening of new specialty hospitals, as well as the expansion of existing facilities.[14] The bill is now under consideration by the Senate; if it becomes law, MDTH's growth prospects will be seriously handicapped, as the firm receives the majority of its revenues from specialty hospitals. Even if it does not, the likelihood of legislation blocking the firm's development will rise if a Democratic president is elected in November, since Democrats tend to oppose specialty hospitals.[3]
Medicare expenditures have grown swiftly in the past several years, reaching 5.3% of U.S. GDP in 2006.[17] To stem this growth, the federal government is taking steps to decrease the rates at which it compensates healthcare providers such as MedCath.[18] Since the likelihood of cardiovascular disease increases with age, more of MDTH's patients are 55 and older than is typical for the hospital industry as a whole. As a result, the firm derives a higher proportion of revenues from Medicare than most other hospitals, and stands to lose more from any changes in reimbursement policies. However, MDTH has decreased the proportion of Medicare patients at its hospitals during the past few years, mitigating the potential impact of this trend - the percentage has fallen from 49% in 2005 to 45% in 2006 to 42% in 2007.[19]
Historically, the hospital industry has been characterized by low levels of competition, with most communities home to only a few hospitals. However, the number of new facilities for delivering hospital services, such as physician-run outpatient surgery centers and diagnostic centers, has grown rapidly. For instance, in 2007, there were 4900 registered outpatient surgery centers alone[6], accounting for 31% of the 50 million surgeries performed each year.[20] These centers are able to offer patients identical procedures at lower costs than traditional hospitals for several reasons: they are not required to operate emergency rooms and intensive care units, some of the most expensive services that a healthcare facility can provide[4]; they see fewer uninsured patients, since the same physicians who own stakes in the centers are responsible for referring patients to them[21]; and they selectively choose which types of surgeries to perform, typically focusing on a small number of high-margin procedures.[22] MedCath has responded to this competitive threat by emulating independent centers in its hospital operations and even operating therapeutic and diagnostic centers of its own. Despite these steps, however, the facilities that account for over 90% of its revenue remain licensed as hospitals, legally required to operate emergency rooms and treat uninsured patients, making outpatient surgery centers a threat for the firm.
The retirement of the baby boomers, who make up slightly over a quarter of American's population, has had an economic as well as demographic impact on the nation.[23] A rapid increase in the number of elderly Americans provides an opportunity for hospital owners like MDTH.[24] People 65 and over account for 40-50% of total spending on healthcare; the per capita healthcare spending in this age group is 3-5 times higher than for people under 65.[25] As a result, healthcare expenditures are already growing swiftly, rising 6.7% in 2006 to reach $2.1 trillion.[26] While all hospitals will benefit from this trend, MDTH is better positioned to do so than many competitors. Over 90% of the firm's patients live in markets where the number of people 55 and older (the primary victims of cardiovascular disease) is expected to rise 17.6% in the next five years, higher than the national average of 16.1% expected growth.[2]
MedCath's competitors consist of all providers of cardiovascular care, a group comprised primarily of other general acute care hospitals. In addition to for-profit facilities, MDTH has to compete with nonprofit hospitals, which benefit from government support and tax exemptions that MDTH does not receive. Finally, the firm's facilities compete for outpatient procedures with independent diagnostic and therapeutic centers located in their markets. Most of MDTH's facilities have two to three competitors located in their geographic area.[27] Texas, where three of the firm's hospitals are located,[28] is a particularly competitive market, as many of the nation's specialty hospitals are located in the state.[14]
MDTH's specialty focus is a primary competitive advantage for the firm - cardiovascular procedures are some of the most profitable surgical specialties, accounting for as much as 35% of a typical hospital's revenue.[1] By focusing on these procedures alone, MDTH maximizes its revenues per procedure.
Furthermore, as specialty hospitals, MDTH's facilities benefit from many of the operational efficiencies that have proved successful in ambulatory surgery centers, thus equipping them to compete more effectively with these firms. For instance, operating rooms do not need to be refitted with different equipment for each surgery, since the same types of procedures are performed there over and over. This, in turn, allows the hospitals to invest in technologically advanced tools for cardiovascular operations.[2]MedCath has also emulated ambulatory surgical centers' practice of partnering with physicians by giving them minority stakes in the facilities they work in. All of the firm's hospitals and many of its diagnostic and surgery centers are partially owned by physicians, which has served as a valuable recruitment tool.[2] Industry operating metrics show that MDTH, despite owning a relatively small number of hospitals, extracts higher profits from them; for instance, the firm has one of the highest occupancy rates in the industry, while average patient stays are some of the shortest.[29]
Operating 25 of its own diagnostic and therapeutic centers allows the firm to maintain a foothold in that market as well; the facilities enjoy higher margins than hospitals - they account for only 7% of MDTH's revenue, but comprise 11% of its income.[30]
|Company Name
|Hospital revenue ($mm)
|Licensed Beds
|Patient Days (thousand)
|Occupancy Rate (% of beds in service)
|Average Length of Stay (days)
The hospital industry is fragmented, with hundreds of providers of various sizes spread throughout the country, none holding more than 1% of the total market. Competition is limited by geographic constraints (there are never more than a few hospitals in one geographic area). Specialty hospitals are a small sector of this market, accounting for about 3%[14] of the 6013 hospitals in the United States.[31] With only 11 facilities, MedCath is one of the smaller firms in the industry, holding about 5% of the specialty hospital market by volume.[14]


text:
I just got a brand new load of parts in for a computer I'm building.
I ordered a Gigabyte GA-7N400-L1 Motherboard and a AMD Athlon XP 2500 Processor.
I just got done putting it all together but when I turn the power on I get five beeps then the computer shuts down. According to the manual it says its a CPU problem.
I hope I didn't ruin it but I might of when I installed the heatsink which is a Coolermaster HAC-V81 Skt A/7/370 Copper Core Fan on it.
Theres a little sticker that goes over the bottom of the heatsink, and you put the thermal paste on top of the sticker. I then put the heatsink with the thermal gel on top of the processor. After I received the beeps I took the heatsink off to check the processor, and there was some of the white paste on top of the processor a little bit below the four rubber plates on the corners whre the heat sink sits, and a little paste right in the middle of the processor around a chip that the heatsink also touches.
I guess my question is, is it alright for the paste to acutally be on the top of the processor?
I know some people are probably lauging at me right now, but I wanna make sure I didn't ruin it. I'm hopeing that maybe its just a bad processor that I can return for another one. Or maybe the socket on the motherboard is bad?
btw: it is a ZIF socket. I believe I put it in right because it slid right in with now assistance from me.


text:
Japanese and Chinese Studies: Japanese Studies
JAPN 434 Conversational Japanese II (1)
Emphasis on development of practical conversational proficiency in a culturally and linguistically appropriate way in both formal and informal styles. Intensive training in oral expression and listening comprehension exercises, including authentic listening materials and vocabulary enlargement.
- Prerequisite: JAPN 432 or consent of instructor
- Offering: Spring
- Instructor: Loftus, Fujiwara


text:
WMC 2012 Schedule Event
Panel Information:
|Date: March 20
|Time: 12:30 PM
|Room: C
Remix Culture: Mixing & Mashing
With today's musical landscape evolving at lightning speed, professional remixers need to arm themselves with the right knowledge. What do you charge for a remix? What are the types of contracts available? What if your track is a Mashup? What are your options?


text:
Home > Home, Garden & Office > Pet Supplies > Front Style Pet Dog Carrier Backpack w/ Legs Out Design Size M - Black
Product Details
- Open top pet pouch carrier with legs out design
- Easy-access side zips, hook and loop fasteners elastic top closure, breathable mesh fabric
- Well padded to ensure the comfort for both you and your pet
- Fully adjustable straps, with internal leash attachment
- Can be worn on your front or back
- Color: Black
- Material: Nylon
- Size: M
Note: Please check the size to make sure your pet will fit properly.
Size Chart:
|Overall Length
|Chest Girth
|Front & Rear Legs Distance
|Approx. 13 inch / 33 cm
|Approx. 18 inch / 45.7 cm
|Approx. 5 inch / 12.7 cm
Package Includes:
- 1 x Dog Carrier


text:
Hey all,
After speaking to members of the community, I've made some changes to the forums to make things easier to navigate, and reduce the number of subforums to better match the rate of activity here.
Here are my "patch notes":
- Moved General Chat from Multiplay to General section
- Moved Trading Post to General section
- Merged all Techie Zone and General section threads into the General Chat subforum
- Moved MMO and Console Gaming forums to under the Gaming section
- Created news links in Multiplay & Insomnia
- Created this new Announcements forum
- Shifted things around a bit for better readability
- Created "General Silliness" forum for all random / silly / jokey threads (similar to the old Random forum)
Hopefully this won't negatively impact your experience at all. There was only one merged subforum with a post made in the last week, and all changes were made with consultation so I feel pretty confident about them. Feedback is appreciated


text:
Bear Grylls can survive in the wild. Can you?
The famed adventurer and NBC are looking for teams who feel they can survive in remote locations around the world. And they're coming to Chicago to find them.
Casting producers for the upcoming NBC adventure reality series (tentatively titled "Get Out Alive," so that might help with your decision to apply) will conduct an open casting call Dec. 1 at XSport Fitness. They're looking for "dynamic" teams of two. These "confident and competitive duos" can be married, siblings, parent/child, best friends, engaged couples, co-workers, dating couples, exes, drinking buddies or pretty much any combination.
You just have to be up for spending time with only your partner in a remote wilderness location, and maybe having to squeeze camel dung for water (or some other gross thing Grylls has shown us how to do on his series "Man Vs. Wild"). In other words, you must have what it takes to survive the wild. (Oh and you should be 21 by Feb. 1, 2013.)
You've got a better chance if you have a special relationship or a great story to tell. You should be adventurous with great personalities, too.
For details and to apply visit the NBC Bear Show site. The series is set to premiere in Summer 2013.
Casting call details:
When: 10 a.m.-4 p.m. Dec. 1
Where: XSport Fitness, 819 South State St., Chicago
Want more? Discuss this article and others on Show Patrol's Facebook page.


text:
SAN FRANCISCO -- So it's come to this. Joe Blanton, the fourth member of a pitching rotation that features a Big Three, is pitching in the season's most important game.
I'm assuming much of the debate back home today as been about starting Blanton over Roy Halladay. As I wrote for Tuesday's paper, the other scenario was an enticing one. Halladay and Roy Oswalt have had success pitching on short rest. Cole Hamels has never done it, but if there ever was a time to do it, it's now.
Instead, the Phillies chose Blanton.
"I think it's the best way to go," pitching coach Rich Dubee said.
The pitching coach made it clear in the days leading up to Game 4 that if he were to skip Blanton, he would bring every starter back on short rest. It was all or nothing.
The Phillies decided that wasn't in their best interest. If Blanton has to make one start in this series, he will make it now. That makes sense.
For those in the camp saying Halladay should start Game 4 and Blanton could pitch later in the series, that's just downright silly. If the Phillies lose Game 4, yes, they are on the brink of elimination. But Game 4 is less important than a Game 5 or Game 6, which Blanton could have been bumped back to pitch in.
"What's the difference? You've got to win four to win the series," Dubee said. "I know what we've got in Joe Blanton. He's a good pitcher. The guy's pitched very well in the second half. He's pitched well against San Francisco this year."
So with that, a primer to a Joe Blanton start...
Beware the first inning.
In 28 starts this season, Blanton allowed 20 first-inning runs. That's a first-inning ERA of 6.43. During the season, Blanton said no one thing contributed to the rough starts. But he did admit to failing to make adjustments quick enough at times.
When Blanton steps on the mound at AT&T Park, he will have gone 22 days without starting a game. His last outing was against his own team, eight days ago in a simulated game at Citizens Bank Park.
It all adds up to a troublesome formula for the first inning. If Blanton isn't sharp early and fails to make adjustments like he has in the past, the Phillies could find themselves in a quick hole. And for an offense that has done nothing, that could be a big issue.
You know, the Giants haven't hit the cover off the ball either.
Did you know? The Phillies (.194) have a better batting average in this series than the Giants (.189). OK, a lot of it came in Game 2, when the Phillies scored six runs, but really, San Francisco has simply managed hits at key times while the Phillies haven't.
And as a colleague pointed out Tuesday, the Giants are batting Pat Burrell cleanup after all. This is a lineup Blanton can succeed against. In his only start against the Giants this year, Blanton allowed two runs on eight hits in 6 1/3 innings of an 8-2 win.
The Giants with at least 10 at-bats against Blanton in their careers have not fared well for the most part.
Aubrey Huff: 4 for 20, 2 K
Juan Uribe: 1 for 11, 3 K
Pat Burrell: 3 for 12, 3 HR, 5 K
Cody Ross: 3 for 11, 1 HR, 6 K
The Burrell matchup will be interesting. As usual, feast or famine.
He's pitched in Game 4s before.
And he hasn't done too badly. In five career Game 4 starts, Blanton has a 4.03 ERA. His strikeout to walk ratio is 27 to 10. Of the five Game 4s he has started, the Phillies have won four -- the lone exception being Game 4 of the 2009 World Series.
Last season, in a similar situation to this one, Blanton pitched Game 4 of the NLCS. Against the Dodgers, he pitched six innings, allowed four runs (three earned) and walked two. The Phillies won, 5-4, and won the series the next night.
He actually wasn't bad down the stretch.
Blanton's season numbers were disappointing overall. He finished the season with a 4.82 ERA, his highest since 2006. His strikeouts were down and his hits were way up.
But after the all-star break, Blanton had a 3.33 ERA in 15 starts. He struck out 7.9 batters per nine innings during that stretch. In 13 of the 15 starts he pitched at least six innings.
Given that, the bullpen is available.
Charlie Manuel said Tuesday he would be happy if Blanton could give him five innings. The Phillies won't push their luck with Blanton, whose numbers after the fifth inning are somewhat scary (35 ER in 36 1/3 innings from the sixth inning on).
Only Jose Contreras was used in relief during Game 3. He pitched two scoreless innings, needing 24 pitches to do it. Contreras is likely available for Game 4, but is probably further down the list.
Manuel didn't have to use Chad Durbin in Game 3 and his ideal plan for Game 4 likely involves the righthander in some capacity.


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The institute recently awarded the museum its "Connecting to Collections Bookshelf," a core set of conservation books and online resources, in cooperation with the American Association of State and Local History.
The Country Doctor Museum is one of 19 museums or libraries in North Carolina, and 3,000 nationwide, to receive the award.
"The IMLS Bookshelf will provide immediate, up-to-date information when questions or problems come up requiring informed answers," said Anne Anderson, curator of the Country Doctor Museum. "The IMLS Bookshelf would have proven valuable when a broken heart pressure monitor leaked beads of mercury out of its storage box onto the floor, when 25 boxes of medical antiques were left anonymously on the front porch, or when rainwater from a coastal tropical storm flooded one of our buildings. With our limited staff, the IMLS Bookshelf will offer expert advice and guidance in times of urgent need."
The institute's bookshelf focuses on collections typically found in art and history museums and in libraries' special collections, with an added selection of texts for zoos, aquaria, public gardens and nature centers. It addresses such topics as the philosophy and ethics of collecting, collections management and planning, emergency preparedness and culturally specific conservation issues.
The resource series is a crucial component of "Connecting to Collections: A Call to Action," a conservation initiative launched by the institute in 2006. The multi-faceted, multi-year initiative puts a nationwide spotlight on the needs of America's collections, especially those held by smaller institutions, which often lack the human and financial resources necessary to adequately care for their collections. The Country Doctor Museum is operated by East Carolina University's Laupus Library. For more information, call 252-235-4165 or visit the Web site at www.countrydoctormuseum.org.
Crystal Baity
| 252-744-3764


text:
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You can obtain status and/or reserve this item by contacting us. We can also be reached by calling toll free 1-866-326-9377 (Dialing from outside the US +01 314 772 3566) between 10AM and 6PM CST (-6 GMT).
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