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Incidence and Mortality
Vulvar cancer accounts for about 5% of cancers of the female genital system in the United States.
Estimated new cases and deaths from vulvar cancer in the United States in 2012:[1]
The vulva is the area immediately external to the vagina, including the mons pubis, labia, clitoris, Bartholin glands, and perineum. The labia majora are the most common site of vulvar carcinoma involvement and account for about 50% of cases. The labia minora account for 15% to 20% of vulvar carcinoma cases. The clitoris and Bartholin glands are less frequently involved.[2] Lesions are multifocal in about 5% of cases. About 90% of vulvar carcinomas are squamous cell cancers.[3] This evidence summary covers squamous cell cancers and vulvar intraepithelial neoplasias (VIN), some of which are thought to be precursors to invasive squamous cell cancers.
Survival is dependent on the pathologic status of the inguinal nodes and whether spread to adjacent structures has occurred. The size of the primary tumor is less important in defining prognosis.[4] In patients with operable disease without nodal involvement, the overall survival (OS) rate is 90%; however, in patients with nodal involvement, the 5-year OS rate is approximately 50% to 60%.[5]
Risk Factors
Risk factors for lymph node metastasis include the following:[5,6,7,8,9]
Overall, about 30% of patients with operable disease have lymph nodal spread.
In many cases, the development of vulvar cancer is preceded by condyloma or squamous dysplasia. The prevailing evidence favors human papillomavirus (HPV) as a causative factor in many genital tract carcinomas.[10] The HPV-related basaloid and warty types are associated with VIN. About 75% to 100% of basaloid and warty carcinomas harbor HPV infection. In addition to the much higher prevalence of HPV in these subtypes than in the keratinizing subtypes, the basaloid and warty subtypes also share many common risk factors with cervical cancers, including multiplicity of sex partners, early age at initiation of sexual intercourse, and history of abnormal Pap smears.[11] HPV-associated VIN (termed usual-type VIN when high-grade 2 and 3) is most common in women younger than 50 years, whereas non-HPV VIN (termed differentiated-type VIN when high-grade 3) is most common in older women. The former lesion-type VIN grade 1 is no longer classified as a true VIN.[12,13]
The pattern of spread is influenced by the histology. Well-differentiated lesions tend to spread along the surface with minimal invasion, whereas anaplastic lesions are more likely to be deeply invasive. Spread beyond the vulva is either to adjacent organs such as the vagina, urethra, and anus, or via the lymphatics to the inguinal and femoral lymph nodes, followed by the deep pelvic nodes. Hematogenous spread appears to be uncommon.
Presented below is an adaptation of the histologic classification of vulvar disease and precursor lesions of cancer of the vulva developed by the International Society for the Study of Vulvar Disease.[1] This evidence summary deals with vulvar intraepithelial neoplasias (VIN) and invasive carcinomas.
Non-neoplastic epithelial disorders of skin and mucosa
Paget disease of the vulva
Other histologies
The diagnosis of vulvar cancer is made by biopsy. The patient may be examined under anesthesia. Cystoscopy, proctoscopy, x-ray examination of the lungs, and intravenous urography (as needed), are used for staging purposes. Suspected bladder or rectal involvement must be confirmed by biopsy. The staging system does not apply to malignant melanoma of the vulva, which is staged like melanoma of the skin.[1]
Definitions: FIGO
The Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) and the American Joint Committee on Cancer (AJCC) have designated staging to define vulvar cancer; the FIGO system is most commonly used.[1,2] Stage is based upon pathology staging at the time of surgery or prior to any radiation or chemotherapy, if they are the initial treatment modalities.[3]
Grade is reported in registry systems. A two-, three-, or four-grade system may be used. If not specified, the following system is generally used:[1]
Standard primary treatment for vulvar cancer is surgery. Radiation is usually added to surgery in patients with stage III or IV disease.[1,2,3] Newer strategies have integrated surgery, radiation therapy, and chemotherapy and tailor the treatment to the extent of clinical and pathologic disease. Patterns of practice in combining these treatments vary.[4]
Since invasive and preinvasive neoplasms of the vulva may be HPV-induced and the carcinogenic effect may be widespread in the vulvar epithelium, patients should be followed regularly for symptoms or signs of recurrence. Because there are few patients with advanced disease (stages III and IV), only limited data are available on treatment efficacy in this setting, and there is no standard chemotherapy regimen for these patients. Physicians should offer eligible patients with stage III or IV disease participation in clinical trials.
Information about ongoing clinical trials is available on the NCI Web site.
Role of Surgery
Primary surgery
Until the 1980s, the standard therapeutic approach to therapy for invasive locoregional vulvar carcinomas was radical surgery, including complete en bloc resection of the vulva and regional lymph nodes. Because of the high attendant complication rates, wound healing problems, lymphedema, and functional deficits, the trend since then has been toward more limited surgery, often combined with radiation therapy.[5] (Refer to the Role of Radiation Therapy section of this summary for more information.)
In tumors clinically confined to the vulva or perineum, radical local excision with a margin of at least 1 cm has generally replaced radical vulvectomy; separate incision has replaced en bloc inguinal node dissection; ipsilateral inguinal node dissection has replaced bilateral dissection for laterally localized tumors; and femoral lymph node dissection has been omitted in many cases. However, the different surgical techniques have not been directly compared in randomized controlled trials. In addition, even the nonrandomized studies suffer from lack of uniform staging definitions and clear descriptions of lymph node dissection or ancillary radiation.[6][Levels of evidence: 3iiiDii, 3iiiDiv] The evidence base is therefore limited.
Nodal surgery
Another strategy to minimize the morbidity incurred by groin-node dissection in patients with early clinical-stage disease is sentinel node dissection, reserving groin dissection for those with metastases to the sentinel node(s).
In a multicenter case series, 403 patients with primary vulvar squamous cell cancers smaller than 4 cm and clinically negative groin nodes underwent 623 sentinel node dissections using radioactive tracer and blue dye for sentinel node identification.[7] All patients had radical resection of the primary tumor. Node metastases were identified in 26% of sentinel node procedures, and these patients went on to full inguinofemoral lymphadenectomy. The patients with negative sentinel nodes were followed with no further therapy.
Local morbidity was much lower in patients who underwent sentinel node dissection than in patients with positive sentinel nodes who also underwent inguinofemoral lymphadenectomy: wound breakdown 11.7% vs. 34.0%; cellulitis 4.5% vs. 21.3%; chronic lymphedema 1.9% vs. 25.2%, respectively (P < .0001 for all comparisons). Mean hospital stay was also shorter: 8.4 vs. 13.7 days (P < .0001). After two local recurrences in 17 patients with multifocal primary tumors, the protocol was amended to only allow patients with unifocal tumors into the study. Actuarial groin recurrence for all patients with negative sentinel node dissections at 2 years was 3% (95% confidence interval [CI], 1%–6%) and 2% (95% CI, 1%–5%) for those with unifocal primary tumors.[7][Level of evidence: 3iiiDiv]
Therefore, sentinel node dissection may be useful when performed by a surgeon experienced in the procedure, and it may avoid the need for full groin node dissection or radiation in patients with clinically nonsuspicious lymph nodes. (Refer to the Role of Radiation Therapy section of this summary for more information.)
Role of Radiation Therapy
Groin lymph node metastases are present in approximately 20% to 35% of patients with tumors clinically confined to the vulva and with clinically negative nodes.[7,8] Lymph node dissection is traditionally part of the primary surgical therapy in all but the smallest tumors. However, a major cause of morbidity after surgery is groin node dissection, which is associated with high rates of wound breakdown, lymphocele formation, and chronic lymphedema. Some investigators recommend radiation therapy as a means to avoid the morbidity of lymph node dissection, but it is not clear whether radiation therapy can achieve the same local control rates or survival rates as lymph node dissection in early stage disease.
Inguinal nodes
A randomized trial to address the radiation therapy issue in patients with clinically localized vulvar cancer has been reported.[8,9] In that study, women with disease clinically confined to the vulva, who did not have groin lymph nodes clinically suspicious for metastases, underwent radical vulvectomy followed by either groin radiation (50 Gy in 2 Gy fractions) or groin dissection (plus groin radiation if nodes were pathologically involved).
Although the planned accrual was 300 patients, the study was stopped after 58 women were randomly assigned to it because of worse outcomes in the radiation therapy arm. Five (18.5%) of 27 women in the radiation therapy arm and 0 of 25 women in the surgery arm had a groin recurrence, but this difference was not statistically significant (relative risk [RR], 10.21; 95% CI, 0.59–175.78). There were ten deaths in the radiation therapy arm versus three deaths in the groin dissection study arm (RR, 4.31; 95% CI, 1.03–18.15). Disease-specific mortality was not statistically significantly different between the two arms; however, there were eight versus two vulvar cancer-related deaths (including one related to groin dissection), in the radiation therapy arm and groin dissection arm, respectively (RR, 3.70; 95% CI, 0.87–15.80).[8,9][Level of evidence 1iiA] There were fewer cases of lymphedema in the radiation therapy arm (0 vs. 7) and shorter hospital stays. The dose penetration of the radiation (3 cm for full dose) has been criticized as inadequate.[8] In summary, the trial was stopped prematurely, and little can be said about the relative efficacy of the two treatment approaches.[8]
Pelvic nodes
Pelvic radiation has been compared to pelvic node dissection in the setting of documented groin node-positive disease. Patients with clinical stage I to stage IV primary squamous cell carcinoma of the vulva in whom groin nodal metastases were found at radical vulvectomy and bilateral groin node dissection were randomly assigned during the surgical procedure to receive either ipsilateral pelvic node resection or pelvic radiation (45 Gy–50 Gy at 1.8 Gy–2.0 Gy per fraction).[10] Because of a perceived emerging benefit of radiation, the planned accrual of 152 was stopped after 114 patients were randomly assigned. However, the apparent benefit of radiation was subsequently attenuated with further follow-up.
After a median follow-up of 74 months, the 6-year overall survival (OS) rate was 51% in the radiation arm versus 41% in the pelvic node dissection arm (hazard ratio [HR], 0.61; 95% CI, 0.3–1.3; P = .18). Vulvar cancer-specific mortality was statistically significantly lower in the radiation study arm: 29% versus 51% in the pelvic node resection arm (HR, 0.49; 95% CI, 0.28–0.87; P = .015) However, there were 14 intercurrent deaths in the radiation therapy arm versus two deaths in the pelvic dissection study arm. Late chronic lymphedema was similar in the radiation therapy and pelvic dissection groups arms (16% vs. 22%), respectively.[10][Level of evidence: 1iiB]
Radical radiation therapy can be used for patients unable to tolerate surgery or deemed unsuitable for surgery because of site or extent of disease.[11,12,13,14]
Role of Chemotherapy
There is no standard chemotherapy for vulvar cancer, and reports describing the use of this modality in the setting of metastatic or recurrent disease are anecdotal.[5] Extrapolating from regimens used for anal or cervical squamous cell cancers, chemotherapy has been studied in combination with radiation in the neoadjuvant setting or as primary therapy in advanced disease. Chemotherapy regimens have included various combinations of 5-fluorouracil (5-FU), cisplatin, mitomycin-C, or bleomycin.[5] There is no clear evidence of improvement in survival or palliation. Given the advanced age and comorbidity of many patients with advanced or recurrent vulvar cancer, patient tolerance is a major consideration in the use of these agents.
Systemic treatment for inoperable patients
A systematic review of the use of neoadjuvant chemoradiation in patients who were considered inoperable or who would have required extensive surgery, such as pelvic exenteration, colostomy, or urinary diversion revealed no randomized trials.[15] Five nonrandomized studies that met the inclusion criteria of neoadjuvant chemoradiation administered in this population with an intent to permit curative surgery were reviewed.[16,17,18,19,20] The five studies used four different chemoradiation schedules and different radiation therapy dose-fractionation techniques. In the four studies using 5-FU + cisplatin or 5-FU + mitomycin-C, the operability rate after chemoradiation ranged from 63% to 92%.[16,17,18,19]
In the one study using bleomycin, the operability rate was only 20%.[20] In summary, there is evidence that neoadjuvant chemoradiation with 5-FU plus either cisplatin or mitomycin-C may convert patients to more operable status, but the evidence base is limited by study design. In addition to a paucity of randomized trials, interpretation of these studies is complicated by the lack of a standard definition of inoperability.[4][Level of evidence: 3iiiDiv] Treatment-related toxicity is substantial.
Systemic treatment for operable patients
There is also limited evidence regarding the use of neoadjuvant chemoradiation in advanced operable cases of vulvar cancer, but the available data do not suggest an advantage to this approach. A systematic review found only one randomized trial that addressed this issue, and it was published only in abstract form.[4,21] In that trial, 68 patients with advanced vulvar cancer (T2 >4 cm, T3, any case with positive lymph nodes) were randomly assigned to receive preoperative neoadjuvant radiation therapy (50 Gy) concomitantly with 5-FU plus mitomycin-C versus primary surgery. Neoadjuvant therapy-related serious toxicity was high (13 of 24 patients; 10 patients had wound diastasis). After a mean follow-up of 42 months, the 5-year OS rates in the neoadjuvant and primary surgery groups were 30% and 49%, respectively (RR of death, 1.39; 95% CI, 0.94–2.06; P = .19).[4,21][Level of evidence 1iiA]
Traditionally, there were three grades of vulvar intraepithelial neoplasia (VIN). However, there is little evidence that all three grades are part of the same biologic continuum or that Grade 1 is even a cancer precursor. In 2004, the International Society for the Study of Vulvar Disease changed its terminology, reserving the designation VIN for two categories of lesions based on morphologic appearance:[1]
The term VIN 1 was eliminated.[1] Disease that was previously called VIN 1 (grade I) is generally observed without definitive treatment.
High-grade VIN is usually managed with active therapy because of a higher risk for progression to invasive disease.[2] Estimates of progression rates are imprecise. A systematic literature review that included 88 untreated patients with VIN 3 reported a 9% progression rate (8 of 88 patients) to invasive vulvar cancer during 12 to 96 months of observation. In the same review, the spontaneous regression rate was 1.2%, all of which occurred in women younger than 35 years.[3] However, in a single-center study, 10 of 63 (16%) untreated women with VIN 2 or VIN 3 progressed to invasive cancer after a mean of 3.9 years.[4]
VIN lesions may be multifocal or confluent and extensive. It is important to perform multiple biopsies in treatment planning to exclude occult invasive disease. VIN located in nonhairy areas can be considered an epithelial disease; however, VIN occupying hairy sites usually involves the pilosebaceous apparatus and requires a greater depth of destruction or excision because it can track along hair roots.
Surgical Interventions
The principal treatment approach is surgical, but there is no consensus on the optimal surgical procedure. The goal is to remove or destroy the entire VIN lesion while preserving vulvar anatomy and function. Simple vulvectomy yields a 5-year survival rate of essentially 100% but is seldom indicated. Other more-limited surgical procedures, including separate excision of multiple lesions, are less deforming.[5] The choice of treatment depends on the extent of the disease and the preference or experience of the treating physician. There are no reliable data comparing the efficacy and safety of the various surgical approaches.
A systematic literature review identified only a single randomized trial comparing any of the surgical approaches.[2] In that trial, 30 women with high-grade VIN were randomly assigned to receive carbon dioxide (CO2) laser ablation versus ultrasound surgical aspiration (USA).[6] There were no statistically significant differences in disease recurrence, painful dysuria or burning, adhesions, or eschar formation between the two treatments after 1 year of follow-up. Scarring was observed in 5 of 16 women treated with laser ablation and 0 of14 women treated with USA (P < .01), but consequences of the scarring on sexual function or quality of life were not reported.[6][Level of evidence 1iiDii] The trial was too small to draw reliable conclusions about the relative efficacy of these surgical techniques. The remainder of the surgical literature is derived from case series and is prone to important study biases.[Level of evidence 3iiiD]
Whatever procedure is used, patients are at substantial risk of recurrence, particularly when the lesions are high grade or multifocal.[7] The most common sites of recurrence are the perianal skin, presacral area, and clitoral hood. About 4% of patients treated for VIN subsequently develop invasive cancer.[8,9]
Nonsurgical Interventions
Because of the physical and psychosexual morbidity associated with many vulvar surgical procedures, nonsurgical approaches have been studied. Some of these approaches, including topical 5-fluorouracil, gamma-interferon, bleomycin, and trinitrochlorobenzene, have been largely abandoned because of intolerable local side effects, such as pain, irritation, and ulceration, or high recurrence rates.[10,11] Photodynamic therapy, using topically applied 5-aminolevulinic acid as the sensitizing agent for 635 nm laser light, has also been studied. However, data are limited to small case series with variable response rates.[12,13][Level of evidence: 3iiiDiv]
More recently, among women with high-grade VIN, substantial response rates and acceptable tolerability were reported for topical imiquimod 5%, an immune-response modifier with activity in HPV 6/11-associated vulvar condylomata. Three randomized placebo-controlled trials (including a total of 104 patients) with clinical response as their primary endpoints.[Level of evidence: 1iDiv] have been reported in either peer-reviewed-journal or abstract format.[14,15,16,17] The results of these trials were summarized in a systematic review.[11] At 5 to 6 months, the complete and partial response rates in patients were 36 of 62 and 18 of 62 in the combined imiquimod arms versus 0 of 42 and 1 of 42 in the combined placebo arms (relative risk [RR], 11.95; 95% confidence interval [CI], 3.21–44.51).
In the only trial reporting progression to cancer (at 12 months), there was no difference in progression rate, but the trial was severely underpowered because only 3 of the total 52 women included developed invasive disease by 12 months.[16] The only trial reporting quality of life [16] showed no difference between imiquimod and placebo. Local side effects of imiquimod included pain, edema, erythema, and a single case of erosion. However, no patients had to discontinue treatment as a result of toxicity.
Standard treatment options:
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
(Refer to the Treatment Option Overview section of this summary for a more detailed discussion of the roles of surgery, lymph node dissection, and radiation therapy.)
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
(Refer to the Treatment Option Overview section of this summary for a more detailed discussion of the roles of surgery, node dissection, and radiation therapy.)
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
(Refer to the Treatment Option Overview section of this summary for a more detailed discussion of the roles of surgery, node dissection, radiation therapy, and chemotherapy.)
Modified radical or radical vulvectomy with inguinal and femoral lymphadenectomy is the standard therapy.[1] Nodal involvement is a key determinant of survival.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Stage IVA
Standard treatment options:
Stage IVB
There is no standard treatment approach in the management of metastatic vulvar cancer. Local therapy must be individualized depending on the extent of local and metastatic disease. There is no standard chemotherapy for metastatic disease, and reports describing the use of this modality are anecdotal.[17] However, by largely extrapolating from regimens used for anal or cervical cancer, chemotherapy has been studied. Regimens have included various combinations of 5-fluoruracil, cisplatin, mitomycin-C, or bleomycin.[6,17,18] Given the advanced age and comorbidity of many patients with advanced or recurrent vulvar cancer, patient tolerance is a major consideration in the use of these agents. Physicians should offer eligible patients participation in clinical trials.
Information about ongoing clinical trials is available from the NCI Web site
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IVA vulvar cancer and stage IVB vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
Treatment and outcome depend on the site and extent of recurrence.[1] Radical excision of localized recurrence may be considered if technically feasible.[2] Palliative radiation therapy is used for some patients. Radiation therapy with or without chemotherapy may be associated with substantial disease-free periods in some patients with a small local recurrence.[3,4,5] When local recurrence occurs more than 2 years after primary treatment, a combination of radiation therapy and surgery may result in a 5-year survival rate of greater than 50%.[6,7]
There is no standard treatment approach in the management of metastatic vulvar cancer. There is no standard chemotherapy, and reports describing the use of this modality are anecdotal.[8] However, by largely extrapolating from regimens used for anal or cervical cancer, chemotherapy has been used, but with no clear evidence of improvement in survival or palliation. Regimens have included various combinations of 5-fluoruracil, cisplatin, mitomycin-C, or bleomycin.[8,9] Given the advanced age and comorbidity of many patients with advanced or recurrent vulvar cancer, patient tolerance is a major consideration in the use of these agents. Physicians should offer eligible patients participation in clinical trials.
Information about ongoing clinical trials is available from the NCI Web site.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
This summary was comprehensively reviewed and extensively revised.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Purpose of This Summary
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of vulvar cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Reviewers and Updates
This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).
Board members review recently published articles each month to determine whether an article should:
Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.
The lead reviewers for Vulvar Cancer Treatment are:
Any comments or questions about the summary content should be submitted to Cancer.gov through the Web site's Contact Form. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.
Levels of Evidence
Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Adult Treatment Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations.
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PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary]."
The preferred citation for this PDQ summary is:
National Cancer Institute: PDQ® Vulvar Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/treatment/vulvar/HealthProfessional. Accessed <MM/DD/YYYY>.
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If you find yourself on the northwest side of the metro area today you should join us for USM Tuesday - 5:30.Freshly mowed today!
~5:30 today at USM - bag tags in play and a nice day at hand...
Quote from: Kevin Montgomery on July 10, 2012, 09:00:37 AM~5:30 today at USM - bag tags in play and a nice day at hand... Kevin I will see you tonight!! Want me to bring anything special?? I can stop by the shopette or something, if you need anything!!!
woohoo! come on down to Old Pike! I'll have to peel myself away from the old pike duties and visit yall at USM. Cheers~

subset: commoncrawl


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Davids toppling Goliaths in England and Africa feature in FIFA.com's latest stats review, along with the invincibility of a goalkeeper in France, a breathtaking goal in the United Arab Emirates, and scoring feats for two Argentinians.
minutes without conceding is what Paris Saint-Germain goalkeeper Salvatore Sirigu has gone following a seventh successive clean sheet in the league on Sunday. The 26-year-old Italian last leaked a Ligue 1 goal when Valentin Eysseric's 85th-minute effort earned Nice a 2-1 defeat over Carlo Ancelotti's side on 1 December, but the Parisians have since shut out Evian Thonon Gaillard, Valenciennes, Lyon, Brest, Ajaccio, Bordeaux and most recently Lille to assume pole position in Ligue 1. Sirigu is still some way short of the Ligue 1 record of 1,176 minutes without conceding, set by Bordeaux's Gaetan Huard in 1992/93. PSG only managed two shots on target against Lille – their lowest total in the 2012/13 Ligue 1 – and both were unsuccessful. However, a 67th-minute Aurelien Chedjou own-goal proved enough for them to complete the league double over Les Dogues for the first time since 1996/97.
years since the last time a non-league side dumped top-flight opposition out of the FA Cup, Luton Town repeated the feat against Norwich City on Saturday, thanks to substitute Scott Rendell's unanswered 80th-minute goal. And while Sutton United's 2-1 win at home to Coventry City in 1989 was mightily impressive, Luton's triumph was arguably even more so given how the gulf in class has widened between the English divisions and by the fact the Hatters were on their travels. It was not a good weekend for the elite in the FA Cup, with five top-tier sides being defeated by ones from the lower leagues for the first time since 1994 and only seventh since 1927. Liverpool, despite Luis Suarez's eighth goal in as many games, lost 3-2 at League One's Oldham Athletic to exit the competition at the hands of lower-league adversaries for the sixth time since 1999/2000, while Aston Villa, Queens Park Rangers and Tottenham Hotspur were also upset.
years since Algeria became the last defending champions to suffer first-phase elimination at the CAF Africa Cup of Nations, Zambia suffered the same fate. Herve Renard's side drew all three of their Group C outings, and though that extended the country's record undefeated run in the competition to 11 matches across three editions, it proved insufficient to secure them a top-two place and a trip to the knockout phase. Nigeria beat Zambia to that due to Victor Moses's late brace earning them a 2-0 win over Ethiopia, but the section was unexpectedly won by Burkina Faso. An 11th-hour Alain Traore goal snatched Les Etalons a 1-1 draw with Nigeria first time out, before the same player scored twice to inspire Paul Put's men to a 4-0 defeat of Ethiopia and first victory in 19 attempts in the Cup of Nations since a 1-0 reverse of Guinea in 1998. Then, a goalless draw with Zambia sent Burkina Faso beyond the first stage of the competition for only the second time in history.
Al Ain players – the entire team including the goalkeeper – touched the ball in the 19-pass move leading to the goal which sealed a 4-0 win over Ajman on Saturday. It was scored by Yousuf Ahmad – ironically with his first touch after rising from the bench! The victory – which was indebted to 21-year-old United Arab Emirates playmaker Omar Abdulrahman, who was involved in all four goals – was Al Ain's ninth in succession and extended their lead at the top of the UAE Pro League to nine points with 12 rounds remaining. Al Ain have now scored a staggering 53 goals in their 14 outings this season (3.8 per game) – one more than they did in their title-winning, 22-game campaign of 2011/12.
goals is what Sampdoria's Mauro Icardi and Lionel Messi of Barcelona netted at the weekend – a feat only one man had managed previously in Europe's 'big five' leagues in 2012/13. That man was Falcao, who was on target five times in Atletico Madrid's 6-0 dismantling of Deportivo in December, meaning all three hail from South America. The 19-year-old striker, who joined Samp from Barça in 2011, helped the Genoa outfit thrash Pescara 6-0 – the first time they have scored more than five times at their Stadio Marassi home since a Vincenzo Montello treble and a Jurgen Klinsmann goal inspired a 6-3 defeat of Napoli in December 1997. Messi, meanwhile, fired Barcelona to a 5-1 win against Osasuna that left him having scored nine of his side's last 15 goals, while he surpassed Cristiano Ronaldo to become the only man to have netted four goals in a La Liga game more than twice since the turn of the century.


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We have thankfully come to the end of a truly wet, windy and horrible winter! The horrors of high winds, flooding, fallen trees and loss of energy supplies in the UK have been very well reported in the news, what they don't tend to say is that Western France gets it about a day before the UK!! Redmill has stood up well to the torrential rain, high winds and general weather battering magnificently, although we have had one or two tree casualties. Although the weather was awful it has also been quite mild and the fish have eaten over twice the amount they did last winter, and we have some new arrivals who are proving to pile on the pounds already.
Redmill Bait is supplied by http://www.shorelinebaits.com
The Depot, Pixham LaneDorking, Surrey RH4 1PHUK - England & Wales
Tel: 01483 727535 / Mob: 07967 321115
Tel (France): 0033 297 933 890
Identifiant SIRET 801 020 769 00015


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Cheese steaks are a Philadelphia tradition: thin slices from a rich and very fatty slab of beef, fried up and topped with a heavy cheese sauce. We've cut down on the fat considerably—but not on the taste. All it needs is a cold beer or a glass of pinot noir on the side.
Ready In


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text:
Monday, March 10, 2008
Truck Series Ratings Up At Atlanta
SPEED was happy with a 31% increase in viewership for the Craftsman Truck Series race from Atlanta.
The SPEED TV package for this series did not change much this year. It is a solid and comfortable presentation, sometimes a bit on the dry side. Rick Allen has a certain style of play-by-play, and Phil Parsons and Michael Waltrip share roles of providing commentary and analysis.
Ray Dunlap and Adam Alexander cover both the garage and pits, and are very familiar with all aspects of the series. Krista Voda has been giving this TV presentation a "family feel" since she joined the program, and why she departs from the air after the pre-race show is still anyone's guess.
The series struggles with the lower exposure on SPEED. This is simply due to the cable systems distribution of the network. It is often on the added digital tier or requires a special purchase of a group of sports-related channels. Hopefully, SPEED-HD will eventually bring this network the level of visibility that it needs to grow in the public eye.
The total number of homes watching the race grew from 565 thousand to 753 thousand.
If you are a fan of the Truck Series, or have comments about the coverage on SPEED, please feel free to add them. Just click on the COMMENTS button below. Thanks.
24 comments:
- bevo said...
Give me the "dry presentation" any day of the week. They do a great job covering the race. I don't need any extra entertainment. The race itself is entertaining enough for me. The problem with so much sports coverage these days is this desire to add so called entertainment to the package.
And yes I do sound like an old coot!
- March 10, 2008 at 7:40 PM
- Daly Planet Editor said...
Most consistent TV package in the history of NASCAR TV.
- March 10, 2008 at 7:47 PM
- SophiaZ123 said...
I wish ALL PRE RACE shows were 30 minutes. I enjoy the truck races a lot.
I have had to cut back on Race Day because by the time the race starts and I watch VL (speed report when I can) and WT, I am TV'd out.
I hope the Truck series stays basic.
I do wish SPEED would go on regular basic for ALL to see.
Geez, they removed the game show channel here last year to bump it UP a tier above SPEED???
Regular folks with families and basic cable could BOOST the Truck series recognition something fierce. Seeing older drivers, telling it like it is would be refreshing to get new fans in.
- March 10, 2008 at 7:47 PM
- Anonymous said...
Here's hoping the higher ratings are evidence to a new sponsor that the series is worth investing in.
Even though's SPEED's TV crew is excellent, their hands are tied with the very short fields and the low purses likely not drawing top talent beyond the older drivers. Only 6 of the 32 drivers last Friday got more than 15,000 dollars in prize money. The basics of the series need to be reworked for it to get more attention.
- March 10, 2008 at 7:49 PM
- Ken-Michigan said...
Pretty good coverage of the trucks on friday night.
There was a late race pit stop that was missed when they called for a commercial break, but i'd bet that wont happen again, but still its a pretty large mistake by SPEED.
As we covered on here during the truck race, there really is a need to keep the weather issues as part of the telecast.
Rain showers were all around the speedway all day and I dont see a problem with coming back from a break and getting a peek at the radar to see which way was the rain is moving & late in the race RAIN became an issue. They can be very unobtrusive about it by simply putting the radar in a box lower right or lower left for a few seconds....make reference to it and get rid of it.
JD - I think we were both watching the radar and we saw the rain coming.
- March 10, 2008 at 7:52 PM
- Truck Series Fan! said...
I enjoyed the truck race and think that Rick Allen & Phil Parsons do a super job. I sometimes think that Micchael Waltrip goes a little overboard but they all have lots of experience now with the trucks. And Ray & Adam I like a lot both are so knowledgable especially Ray with the craftsman tools. Anyway, I find the truck races great to watch because a lot of the drivers are "still hungry" and Friday nights are great racing.
- March 10, 2008 at 8:12 PM
- Newracefan said...
I started watching the trucks because of Mikey and stayed because of the presentation and the racing itself. Now if they can just get the prize money better so teams can make a decent living we will have a consistant full field. Maybe the new sponser will help.
JD I know you would like Krista for the entire race but in what capacity, we all whine about the trips to the Hollywood Hotel, etc. during a race and these races a prety short where would she fit in. Don't get me wrong I love Krista a would like to see more of her.
- March 10, 2008 at 8:26 PM
- Modman75 said...
I love the truck series and the job that Speed does is excellent. I make an effort not to miss these races. The races on Sunday are so uninteresting now that I rarely watch.
I agree, integrate Krista somehwere into the race broadcast, even as another pit reporter.
Now if they would just start showing the Whelen Modified races there would be no reason at all to watch cup racing anymore lol
- March 10, 2008 at 8:41 PM
- Steve L. said...
I've been watching the trucks faithfully for the last few years. Those guys race hard and are very exciting to watch.
Rick and Phil have meshed well together but MW seems to go over the top with his false excitement at times.
They always seem to have a good balance of pit reporting and are good with talking to drivers who are released from the infield care center.
I'm glad they got rid of the creepy music they used last year.
It's good race coverage without a bag full of hype. Good for them with their high ratings!! Keep up the good work guys!
- March 10, 2008 at 8:52 PM
- Anonymous said...
Love the truck race production SPEED offers.
The racing is the focus, not this years' music video or gimmick camera (which had been done before) or electronic gizmo.
That's how racing should be covered. And the trucks are fun to watch because they don't try to dress the races up.
- March 10, 2008 at 8:57 PM
- SophiaZ123 said...
31 per cent is a huge increase and for such a limited cable channel. Think SPEEd would ever give race rights to other Fox channels?
These are some of the best races and not hyped up to the latest 'young gun du jour.' As somebody said the drivers are hungry.
I hope they get better sponsorship so we can see a full field each week. This series DESERVES it.
Yes, Cup is tough to sit thru with it's excess length, cautions and BS.
- March 10, 2008 at 9:11 PM
- batchief said...
The trucks broadcast seems to have hit on a blend of the right ingredients. An increase of 31% is phenomenal and I hope it continues throughout the season. My wife and I also would like to see more of Krista during the entire broadcast but do understand that at some of the races there just isn't enough personnel and equipment to support 3 pit reporters.
- March 10, 2008 at 9:39 PM
- Daly Planet Editor said...
I think now that Krista is a veteran of the Fox NASCAR broadcasts, maybe SPEED could put their heads together and figure out how to use her during the Truck Series races a bit better.
Bestwick has proven that an infield studio during the race can work, especially during long cautions. This series also suffers from the lack of a third pit reporter. If SPEED wants to continue to build momentum, stop losing one of your on-site announcers after the first thirty minutes. Give her a role.
- March 10, 2008 at 11:32 PM
- Charlie said...
I enjoy the camera work during the Truck races. Good camera coverage.
- March 11, 2008 at 1:33 AM
- Anonymous said...
IMO, the trucks not only have the best racing in Nascar but the best TV coverage. Mikey can be a bit over the top sometimes, but Phil and Rick keep the reins tight enough to bring him back under control.
I love the simple, straightforward coverage that focuses on the RACE and the racing issues.
I agree about Krista. I don't understand why she doesn't move to a slot on pit road after the pre-race is over.
BTW -- for DirecTV Speed is in the Choice Extra package -- the same tier as The History Channel, Discovery, Disney, The Weather Channel, HGTV, and similar staples of cable programing.
- March 11, 2008 at 7:41 AM
- Daly Planet Editor said...
The SPEED guys stopped by to agree that they got rooked on the last pit stop when they went to break.
They just guessed wrong, and that does not happen too much.
I guess Krista is busy with Fox right now, so perhaps we will see more of her when the TNT and ESPN parts of the Cup package begin.
The Fox guys do the next couple of races, and the SPEED crew returns at Kansas.
Like to thank the NCTS TV crew for taking the time to read your comments, and taking the time to respond.
- March 11, 2008 at 9:59 AM
- Anonymous said...
I am still very frustrated about Dish Network not carrying Speed HD yet. I have sent numerous e-mails (to the point where they don't even reply anymore) and have made phone calls. They have NO CLUE when they are going to expand their HD package. If you have the same issue, please write and call them! It is just very disappointing to watch Sprint and Nationwide races in HD, then have to watch the truck series in SD.
If you are trying to decide between Directv and Dish Network, I highly recommend Directv. Again, I am a Dish customer and I am very unhappy that they will not even provide a timeframe for HD upgrades. We deserve to watch the NCTS races in HD!
- March 11, 2008 at 10:31 AM
- Anonymous said...
The Truck race should be an example for the other series TV crews. Yes, Mikey can be over the top, but his enthusiasm is great because IMO, it is sincere. Same as DW. That's why I am a little more forgiving of them. Unlike others we've seen who try to manufacture excitement.
Regarding some of the comments in all of the blogs at this site. I think it is amazing that people at the different networks are actually reading what we have to say and in many cases acting on it. Why do some of the posters here have to do the "angry man/woman" thing and rant on threatening to stop watching (although last year with ESPN it was warrante LOL!). State your issue and offer a solution.
- March 11, 2008 at 10:44 AM
- Anonymous said...
I tape the trucks every week. I do wish DISH would go to HD. OT. Why does FOX do 4 car split screens on pit stops? People watching on a 21" can't see anything.
- March 11, 2008 at 11:53 AM
- batchief said...
anon 11:53, I think "a reason" could be that they have 4 pit reporters and they feature a car that each is covering and can report on.
- March 11, 2008 at 12:06 PM
- Lisa Hogan said...
I am a big fan of the Truck Series. I think that SPEED is #1 at covering The Race!
I have always liked how the booth tries to mention every driver, owner, sponsor and manufacturer involved in that race. I believe that goes a long way in attracting sponsors to the series. Every team has fans and SPEED allows them to see their favorite.
SPEED coverage is not perfect; but, it's the closest thing we have these days. :)
- March 11, 2008 at 1:03 PM
- Anonymous said...
I love the trucks. It's about the racing and not all of the gossip and other crap that permeates the Nationwide and Cup races.
Being at the Truck races is even better. It's not as crowded and the atmosphere is a lot more relaxed and fun.
- March 11, 2008 at 1:28 PM
- Getting to know NASCAR Bob and Hoss said...
Much like all the above folks, I agree that the Truck Series has a great show, straight forward coverage ('cept for Mikey) and now in HD is even better. (Folks, get Direct TV for Speed in HD). However, I am not sure if it's me or not, but the trucks seem to have changed a bit with the addition of the tapered plate that now sits below the carburator and the gear changes in the rear. From what I have seen so far, the trucks seem to be more spread out and not running close like they did last year. Maybe it's the tracks they have run on so far. I guess I will sit back and see what happens on the half mile and one mile tracks. I sure would not want to see them running like the current cup cars.
- March 11, 2008 at 3:16 PM
- Anonymous said...
The Truck Series is the best racing right now that NASCAR has. The pre-race show is the right length and the pit reporters are on the ball with their knowledge. The only improvement I would make is go back to the original announcing team. As they've proven on the Cup side, two's company, three's a mess.
- March 11, 2008 at 7:53 PM


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|Disaster Management Ethics - Trainer's Guide - 1st Edition (Disaster Management Training Programme, 104 p.)
Careful preparation is the key to any successful presentation. If you are familiar with your audience, it is important to tailor the material presented to relate to their experience. Look over all of the material available, then select those materials suitable to the time constraints of the training session and the needs of the participants. Try to augment the materials with items that are "closer to home" for the audience. Related articles from local newspapers and magazines can strengthen the points being made and increase their relevance for individual participants.
In spite of your best efforts to keep on track, the discussion of ethics in disaster management will likely be an "explosive" exercise and may go far afield from the material presented. This is not necessarily a problem, as long as the discussion covers related areas of concern to the audience and are related to the main points of the module. It will be up to you to decide if the material being covered is of value to the group. Time is always short and should be used to the best advantage of all concerned. To make these decisions, you will have to be familiar enough with the material to know which parts can be left out or covered very quickly with your particular audience.
Make workshop site arrangements
The physical environment of the training can either strengthen or weaken your presentation. When properly attended to, small matters of detail can make a training session run smoothly. The following are a few of these "small matters" which should not be overlooked:
· Secure meeting room space that includes a main meeting room that will be large enough for plenary sessions as well as provide adequate space for small group sessions.
· Look over the central meeting space and be aware of window and door locations, especially considering room temperature and ventilation.
· Identify the location of electrical outlets.
· Decide on a room setup arrangement that best facilitates presentation and discussion.
· Arrange the screen and projector to allow for exit and entry from the room without disruption of the session.
· Test equipment before the presentation.
· Set up stands and flip charts in each of the small group breakout areas that will be utilized.
Gather and prepare materials
· If you intend to use a flip chart for presentations or group exercises, be sure to have an adequate supply of stands, paper and markers. Make sure the markers are in good working order and stands are stable.
· Bring tape and pins if you need to attach sheets to a wall.
· Make sure you have a blackboard and chalk or appropriate markers for a white board if you do not intend to use a flip chart for plenary sessions.
· Make sure you have a screen and overhead projector available with extra light bulbs and extension cords, if necessary.
· Bring name tags for all participants, sufficient copies of handouts you intend to use, paper and pencils.
Background on adult learning
The participants in this training session are your colleagues and you have much to learn from each other. Just as you bring knowledge and expertise, they too bring many life and work experiences that may provide helpful examples and insightful perspectives to the workshop materials. The more traditional didactic manner of education will not always be the best method to use. Consider the following points as you plan your presentation:
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Big Bang Theory Lawsuit
Big Bang Theory Lawsuit
Heirs Scratch and Claw Over Soft Kitty
I just got done with a post about a stupid lawsuit and I immediately happened on another. The heirs of the author of Soft Kitty, often uses in the TV show Big Bang Theory, are trying to get their paws on some of the show's cash. (Yes, Sheldon that is sarcasm) Just in case, you don't know about the song or the show.
Soft Kitty, Warm Kitty
Personally, I love The Big Bang Theory. Sheldon Cooper is an iconic character, the show is well written and I watch it regularly. I don't like seeing Big Bang Theory lawsuit when I search Google. I for hope they don't get scratched too badly on this one. (Yes Sheldon that was satire.) Continue reading "Big Bang Theory Lawsuit"


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We are so happy to have you as a resident!
Show us how you #ilivehappy at our community!
Please contact us if you need any of the following fixed :
Top Reasons to say "No" to Plastic Straws
1. Straws kill marine life
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We wanted to share a few reminders about our pet policy.
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Tag us in your photos! We love seeing your pets, celebrations, and everyday life! If you ever need any help, feel free to reach out to our Leasing Office. Or stop by our office and ejoy a cup of coffee. Our goal is to make coming home the best part of your day!
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What can we learn from Bangladesh about climate change?
Development Economics. Her research includes how saltwater encroaches on soil and drinking water, making it ... a recent article on our CFAES Stories website. Chen studies climate change and migration in Bangladesh as ... professor emeritus in Ohio State's Department of Sociology and one of Chen's co-researchers, stands in the ...
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Katrina Cornish, Endowed Chair and Ohio Research Scholar in CFAES' Department of Food, Agricultural and ... for exceptional research discoveries and for the role the faculty member played in translating those ... has greatly expanded our capacity to positively impact the people and forests of the region." Read ...
Have your hay, and eat it, too
tell you the nutrients your herd could be lacking, and can help you set up a strategic feeding plan. ... This plan could include supplementing with other feeds to provide the vitamins or nutrients your hay ... nutrients," Wiseman said. "The most important part is knowing what you have in your hay now and knowing what ...
Chow line: Growing giant pumpkins
water. Fertilizer and lime: When planting, you'll need to have the soil tested to determine whether lime ... and fertilizers are needed based on your soil requirements. Planting and space requirements: The ... record-sized pumpkins on display. Now my son wants to grow giant pumpkins like that in our backyard. Is that ...
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Ohio 4-H helps our youth develop and practice the leadership skills necessary to succeed in ... strengthening our communities. A gift to Ohio 4-H is an investment in our youth and our community's ... add to our current programming. You know how invaluable Ohio 4-H can be to young people. Please ...
Converge on 'Wicked Systems Problems' Nov. 18 in Columbus
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News tips and events for the week of Nov. 4
transdisciplinary research and system approaches to solve grand challenges in our food, water, and energy systems. ... to prevent people from getting sick from food: The Center for Foodborne Illness Research and ... safety experts with those at Ohio State to discuss how to apply findings from research to reduce the ...
Chow Line: Enjoy holiday meals in moderation
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Converging on Wicked Systems Problems
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Then And Now
December 5, 2011 by Leave a Comment
Mostly about Utah
I'm Rick Willoughby. I live in Utah, a retired Software Engineer. I'm a Mormon, married with 5 children and 12 grandchildren.
I emigrated from England in my late twenties, bringing with me one small suitcase and a few dollars. I appreciate the opportunities America has given me and the friendliness of the people to new citizens.
I blog about my family as well as politics, religion, finance, technology, and other topics.
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Man accused of killing 2 women, raping 9-year-old appears in court
James Maxwell enters not guilty plea
The man who investigators said could be a serial killer was in court Thursday morning.
James Maxwell is accused of killing two prostitutes and was arraigned on murder charges.
Maxwell said he didn't commit the crimes.
"We'll waive the reading of the indictment, and we'll plead not guilty," said Maxwell's attorney, Kim Heller.
Heller, a court appointed attorney, entered the not guilty plea after briefly speaking with his client.
Heller was just appointed to the case and knows little about the circumstances that put Maxwell in jail.
The body of missing prostitute Chasity Starr was found buried in Maxwell's backyard in June, after police got a tip, and earlier this month, police connected Maxwell to the slaying of prostitute Pamela Will.
Will's body was found dumped in Ormond Beach.
Heller said a not guilty plea shouldn't be a surprise.
"That's fairly standard. I mean, we're always going to enter a not guilty. It could be, he might not have done it. I mean I don't know, you never know," said Heller.
Investigators claim Maxwell picked the women up, brought them to his Port Orange home and strangled them.
Prosecutors haven't decided whether they'll seek the death penalty for Maxwell and if they do, Heller might have to withdraw because he's never handled a capital murder case.
"It requires some specialized legal knowledge, and I'm not, I've never done one, so they need to have someone experienced that's done that," said Heller.
The judge tentatively set a trial for December, but that could change depending on if the state decides to goes for the death penalty and if Maxwell's court-appointed lawyer has to remove himself.
Maxwell is also facing charges in connection with the kidnapping and rape of a 9-year-old neighbor girl.
Investigators said the investigation for more victims is still active.


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Follow RFF News on your cell phone. Text follow rff to 40404 you will receive txt messages with RFF News
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He seems very confident!
"I sit out in the enclosure with the monkeys for hours at a time"
Quote from: Prophet on January 18, 2012, 01:57:46 PM"I sit out in the enclosure with the monkeys for hours at a time"It's like a Coach reincarnation!
Name (Age): Greg Smith (64)Tribe Designation: Manono Inspiration in Life: Tarzan, who is empathic toward nature; kind, brave, noble, manly, and Scaramouche (the Raphael Sabatinni version) a statesman, romantic, adventurer, swordsman and empathic toward the needs to women. Hobbies: Art, music, adventure, entomology and primatology. Pet Peeves: Inequity and deceit. SURVIVOR Contestant You Are Most Like: Coach Ben Wade he seems to be a romantic, adventurer, poetic and creative. Why You Think Youll Survive SURVIVOR: Im of the jungle and part of nature. Why You Think You Will Be the Sole SURVIVOR: Other than the misfortunes of contretemps, I hope to outwit, outplay, outlast.
Personal Claim to Fame: Adopting and raising my family of 12 marmoset monkeys.
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The Enforcement of Intellectual Property Rights Act of 2008, which was blasted by consumer groups and library associations this week as an "enormous gift" to the content industry, won the approval of the Senate Judiciary Committee this afternoon by a 14-4 vote. As first reported by Ars this morning, a series of amendments were added during committee mark-up, providing privacy safeguards for records seized under the law and stripping away several controversial provisions—though not the hotly contested section empowering the Justice Department to litigate civil infringement suits on behalf of IP owners.
One significant change to the proposed legislation addressed, at least in some small measure, a concern broached by Public Knowledge and other consumer groups in a letter to the Judiciary Committee yesterday. Though the amended bill still creates expanded provisions for civil forfeiture of property implicated in an IP infringement case—potentially including servers or storage devices containing the personal data of large numbers of innocent persons—lawmakers altered the bill's language to affirmatively require a court to issue a protective order "with respect to discovery and use of any records or information that has been impounded," establishing "procedures to ensure that confidential, private, proprietary, or privileged information contained in such records is not improperly disclosed or used." They did not, however, go so far as to immunize the data of "virtual bystanders" from seizure, as the letter had requested.
The forfeiture section was also modified to exclude, as grounds for seizure, the violation of the "anticircumvention" provisions of the Digital Millennium Copyright Act. The old language would have allowed for forfeiture of tools that could be used to circumvent digital rights management software.
Excised, as well, was language that would have barred the "transshipment" through the United States of IP infringing goods. Since different countries have different IP rules, this language would potentially have defined goods that were legal in both their country of origin and their final destination—because, for instance, differences in copyright terms allowed works to fall into the public domain overseas while still under copyright in the US—as contraband.
The amendments also added a seat for a representative of the Food and Drug Administration, as well as any "such other agencies as the President determines to be substantially involved in the efforts of the Federal Government to combat counterfeiting and piracy" on the "interagency intellectual property enforcement advisory committee" that the bill would create.
Two new provisions were tacked on to the end of the law. The first directs the Comptroller General to conduct a study of the impact of piracy on domestic manufacturers and develop recommendations for improving the protection of IP in manufactured goods. (Wouldn't it be better to do this sort of thing before enacting enforcement legislation?)
The second is a nonbinding "sense of congress" resolution stipulating that, while "effective criminal enforcement of the intellectual property laws against such violations in all categories of works should be among the highest priorities of the Attorney General," the AG should give priority, in cases of software piracy, to cases of "willful theft of intellectual property for purposes of commercial advantage or private financial gain," especially those "where the enterprise involved in the theft of intellectual property is owned or controlled by a foreign enterprise or other foreign entity." Which is to say, that copy of Photoshop you pulled off BitTorrent last week isn't on the top of the Justice Department's docket… yet.
Remaining intact was language that would give the Justice Department authority to pursue civil suits against IP infringers, awarding any damages won to the patent, copyright, or trademark holders. Critics have blasted this provision as a gift of free, taxpayer-funded legal services to content owners. The bill now goes to the full Senate, and must still be recognized with its counterpart legislation in the House, which lacks the language deputizing the DoJ to bring suit on behalf of IP owners.Posted on
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5 results
This script do a quickly get user back to root level(level 0) of the model and select none. It will save a lot of clicks or Esc key pressing when you are working in deep levels.
The Script lets user split a Sketchup multi-page.layout file to one-page.layout files. It will be helpful in teamwork on big projects.
This script creates pipes from edges in selected groups/components, also adding fittings to vertices. Can update after edit the source (group/component of edges), and replace/ edit the fittings, size, etc...
A small plugin, give a "Toggle Display Color By Layer"'s button and also add a command to menu Extensions so you can create a shortcut for this feature.
Normalize Linear Dimensions of a SketchUp LayOut File with selective options.


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Harris County DA Mike Anderson dies
Harris County District Attorney Mike Anderson, who announced in May that he had cancer, died Saturday from the illness.
In an email to staffers Saturday, First Assistant Belinda Hill mourned "a good man doing great things."
"When my longtime friend and colleague Mike Anderson asked me to be his First Assistant last year, I accepted the offer because it was an opportunity to return to the office I loved and work closely with a man for whom I had a great deal of respect," Hill wrote. "I believed that we would do great things together for years to come."
Anderson, 57, took office Jan. 1, following his election in November. His campaign enjoyed wide support from prosecutors in the office and area law enforcement.
He announced his illness by releasing an email to his staff that did not include details about the type of cancer or when it was diagnosed. The office has not released any other details about his condition.
Hill said Anderson drew strength from the 600 people, including 240 attorneys, in the office, which is the largest in Texas.
"It's important for you to know that Mike truly loved each of you and this office. During the lowest points of his illness, coming to the office restored his spirits and gave him strength," Hill wrote. "The irony, of course, was that we all in turn drew strength from him, even as his illness took hold. His sense of justice, his wisdom and support, his easy laugh, and, most of all, his friendship were his gifts to us."
Anderson was a retired judge when he decided to run against then-Harris County District Attorney Pat Lykos in the Republican primary in March 2012. He defeated Lykos and went on to an overwhelming victory in November against Democrat Lloyd Oliver.
Anderson spent 12 years as a felony criminal court judge, following his 16 years as a prosecutor.
His wife, Devon Anderson, is a criminal defense attorney and also a former state district judge. They have two children.
Condolences began pouring in Saturday, including from Houston Mayor Annise Parker.
"My prayers are with the family of Mike Anderson today," Parker said in news release. "He was a well-respected public servant. His death is a loss to Harris County."
Retired district attorney Johnny Holmes, who supported Anderson's campaign, said he would be missed.
"Mike was a neat guy. He was certainly a conscientious, hard-working and competent prosecutor," Holmes said. "I had faith in his judgment and that's why I came out so strong in support of his candidacy."
Holmes said Anderson was in hospice care and died about 1 a.m. Saturday morning.


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Liberty Park
Cerritos, California 1 course · 9 holes Driving directions
Course reviews
Most votes | Newest first | Oldest first
+1 votes Dennis Clark › December 3, 2010
My favorite little nine hole lots of ace runs...
+0 votes Cameron Aragonez › May 19, 2011
Not a bad course, plays a little faster than Twila-Reid but it was more of the atmosphere, around the 8th and 9th hole closest to the main road, there were a lot of ignorant idividuals driving by and yell profanities/ derogatory slurs towards hispanics; happened a number of times. That's just dumb people with nothing better to do I guess.
+0 votes J.D. Clements › April 1, 2013
+0 votes jason summers › September 22, 2013
Short and to the point! Easy little nine holer!
+0 votes Luis Perez › March 1, 2017
-1 votes Shawn Hillman › August 28, 2011
The course was definately meant for children. My 10 year old daughter loved it. She got her first birdie here.


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|Hattiesburg, Miss.
|High School:
|Oak Grove HS
2009: Played in and started all 20 games as a sophomore... nine goals and six assists for 24 points... 59 shots, 35 on-goal (.593)... four game-winning goals, the most on the team.
2008: 19 Starts at center midfield, 5 goals, 3 assists, 13 points... scored the equalizing goals off Sewanee and Oglethorpe... both were headers off corner kicks... ranked 7th in the SCAC in shots with 47.
Pre-BSC: A five-year starter at Oak Grove High School... earned Most Valuable Player honors three of those years... led the team in scoring sophomore season... tied for top scorer her junior year... four-time All-District honoree... named to the 2008 Mississippi All-State First Team... named to the All-Stars South Team and served as a co-captain of the team... led Oak Grove to a 5A State Championship her junior year... involved in the Mississippi Olympic Development Program (ODP) for six years... played select soccer with the Hattiesburg Youth Soccer Association... won a state championship in 2001 and was a State Cup finalist in 2003, 2004, and 2007... played with the Mississippi Fire in 2006, also leading them to a State Championship... co-captain for the HYSA United in Hattiesburg... member of the Beta Club, Student Council, National Honor Society, and Fellowship of Christian Athletes... served as senior class secretary... Spanish Club President at Oak Grove... senior year, named Miss Oak Grove, Homecoming Queen, and Class Favorite... inducted to the Athletic Hall of Fame... was top 10 percent of her class.
Personal: Born on Dec. 15, 1989... daughter of Phil and Nadine Amaya... has two brothers, Anthony and Daniel and one sister, Maria... majoring in Psychology.


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More frequent visual field testing may lead to earlier detection of glaucoma progression
In patients with glaucoma, frequent visual field testing may be associated with earlier detection of the condition's progression, according to a report published Online First by Archives of Ophthalmology, one of the JAMA/Archives journals.
According to background information in the article, visual field testing is one of the main ways of monitoring patients with glaucoma for progression. "Estimating rates of progression can help identify patients who are progressing at a faster pace and are therefore at serious risk of developing visual disability during their lifetime," write the authors. "These patients can be subjected to more aggressive treatment or more frequent follow-up." However, frequent visual testing may not be appropriate or useful for every patient. A suggestion of at least three examinations per year for achieving optimal sensitivity and specificity for detection of clinically significant rates of progression may not be supported by evidence based on real patient data.
Kouros Nouri-Mahdavi, M.D., M.Sc., and colleagues from the Jules Stein Eye Institute, University of California, Los Angeles, examined data from the Advanced Glaucoma Intervention Study (AGIS). They selected 468 eyes of 381 patients ages 35 to 80 years with primary open-angle glaucoma no longer controlled by maximally tolerated medical treatment. Participants had a baseline visual field AGIS score of 16 or less, at least three years of follow-up and at least 10 visual field examinations with a reliability score of two or less. Researchers included all visual field tests performed within the first year of follow-up as well as the last available visual field tests. In addition, they assembled a low-frequency data set by deleting, for one group, every other visual field test from the second year of follow-up onward; and a high-frequency data set for which none of the visual field tests were deleted. The researchers compared the two data sets in terms of the proportion of progressing eyes and the time to progression.
Patients were followed up for a median of nine years (the range was 3.2 to 13 years). The high-frequency data set had a median number of visual field examinations of 20; for the low-frequency data set, this median number was 12. Researchers determined that the high-frequency data set was more likely to detect progression. Improvement was also detected in some eyes. When data were censored (curtailed to account for partially unknown values) at five years, the results did not change significantly.
"In summary, we found that a twice-yearly schedule of visual field testing resulted in earlier detection of glaucoma progression compared with a yearly schedule, especially with global trend analyses," write the authors. "Validation of these findings in other patient populations would be desirable. Our results have significant health care policy implications with regard to determining the frequency of visual field testing in patients with glaucoma."
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May 15-17, 2020 – Aix en Provence, France
If you are interested in booking an expo booth at the IRONMAN Village or need more detailed information, please contact us: [email protected]
Click here to download the IRONMAN European Village Brochure for a full schedule and pricing overview.
The IRONMAN Village is the meeting point of athletes and spectators (registrations, massages, welcome desk, finish line). The Village is an iconic feature of the event and offers our athletes the best products available in the industry. You have the chance to present your brand to a highly engaged and promising target group that is actively seeking to improve their race.
Fri, May 15
IRONMAN Village Expo 10:30am - 9:00pm
Athlete Check-In, Registration & Bag Pick-Up
Sat, May 16
IRONMAN Village Expo 09:00am - 7:00pm
Athlete Check-In, Registration & Bag Pick-Up IRONKIDS
Sun, May 17
IRONMAN Village Expo 09:00am - 5:00pm
Iron Girl Race Day
IRONMAN Village 3x3m Booth
Athlete Bag Inserts (only in combination with booth or partnership)
We are looking forward to your request!
[email protected]
Interested in more? Join the IRONMAN partner family!
There is more to the IRONMAN world than our Villages! Look at the schedule to find full distance and short distance triathlon, cycling and running events all over Europe. Our offer ranges from Village and digital packages, over endemic partnership packages, all the way to prestigious title partnerships. Contact us now for more information on all partnership opportunities!


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There are over 100 surgeries described for
bunions. Research does not indicate which type of
surgery is best—surgery needs to be specific to your condition. More than one
procedure may be done at the same time.
The general types of bunion surgery include:
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Middle East respiratory syndrome coronavirus (MERS-CoV) - update
1 June 2013 - The Ministry of Health in Italy, through the European Union's Early Warning Response System, has notified WHO of a laboratory-confirmed case with Middle East respiratory syndrome coronavirus (MERS-CoV) in a resident in the country.
The patient is a 45-year-old man with recent travel from Jordan. He returned to Italy on 25 May 2013 with symptoms of cough and fatigue. His condition deteriorated and he was hospitalised on 28 May 2013. He is currently in stable condition.
Laboratory test was conducted by the influenza reference laboratory of Tuscany and confirmed by the National Influenza Center of the Istituto Superiore di Sanità.
Globally, from September 2012 to date, WHO has been informed of a total of 51 laboratory-confirmed cases of infection with MERS-CoV, including 30 deaths.
WHO has received reports of laboratory-confirmed cases originating in the following countries in the Middle East to date: Jordan, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). France, Germany, Italy, Tunisia and the United Kingdom also reported laboratory-confirmed cases; they were either transferred there for care of the disease or returned from the Middle East and subsequently became ill. In France, Tunisia and the United Kingdom, there has been limited local transmission among patients who had not been to the Middle East but had been in close contact with the laboratory-confirmed or probable cases.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. Specimens from patients' lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.
Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.
All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
WHO continues to closely monitor the situation.
The following document has recently been published on the WHO website:


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titular bishop
One who has been appointed by the Holy See to a diocese which, in former times, had been canonically established and possessed cathedral church, clergy, and laity, but on account of pagan occupation of the diocesan territory has now neither clergy nor people. See titular sees.
- "". . CatholicSaints.Info. 18 October 2008. Web. 15 November 2019. <>