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With no fewer than three Catholic bishops resigning over sexual abuse charges in recent days, Pope Benedict XVI may offer a more substantial repentance for a sex scandal that continues to batter Catholic churches around the globe, Vatican officials say.
The papal apology would arrive at the end of "the year of the priest" in the church in June – and may eclipse the official "sorrow" and "shame" in the pope's letter to the Irish church this spring after terrific public fulminations in that largely Catholic country, over pedophile priests.
"I wouldn't be surprised" if the pope takes a further step, says Cardinal William Levada, of the Congregation of the Doctrine of the Faith.
The "year of the priest" coming in a year of great scandal has intensified a struggle inside the church over the image and concept of priests in the 21st century.
Pope Benedict this spring put forward the Vatican model priest at the end of his letter to the Irish church. Jean Marie Vianney, a 19th century French priest who overcame a lack of education to serve his flock 16 hours a day or more and was known for his radical piety, is the model. Mr. Vianney's talent for reading thought and tales of his levitation have also brought a cult of mysticism and secrecy around him; he is venerated by hardcore groups like the Society of St. Pius X, whose namesake pope beatified Vianney in 1904.
"Vianney is thought to be a useful model for many new Catholic priests in rural or developing nations," says Andreas Batlogg, editor of the Jesuit-based Catholic intellectual journal Stimmen der Zeit in Munich, Germany.
Yet Benedict's choice of Vianney caused loud and palpable groans in many parts of US and Europe. Modern-oriented Catholics and theologians see the choice as a political model of a priest closed off from society, overly idealized, hard for young Catholics to relate to, and one whose effect will be to increase a sense of distance between priests and ordinary people, and promote a view of priests more spiritually gifted than regular Catholics.
"We need an example, but this is a pastor of 230 people in a small French village in the 19th century," says Mr. Batlogg.
A different model of priest
Pope Benedict's own experience as a priest dates to a brief post-war period in the almost wholly Catholic Bavarian countryside – a time the pope describes fondly in his writings.
Those pushing a different model say that priests work in a world Vianney had no idea of – crowded urban parishes with high-powered professionals, including women; a world of counseling on drugs and pornography, violence, and the other ills that flesh is heir to in a spiritually confused and values-conflicted world unlike French or Bavarian towns.
At the largest Benedictine school in the US, the education of new priests – which started 10 years ago under the influence of then-Cardinal Ratzinger – moved sharply toward the model of the priest educated in isolation, when Vatican directives began to forbid men and women educated together.
One member of the Benedictine order who is close to the university but was not authorized to speak to the media described the directives, which came out of Cardinal Ratzinger's office, as part of a "purification of the church concept in which women should not be in the classes. A lot of us feel this creates instead a fortress church, a reclusive model…priests leave school and immediately go into communities and work with married people, and women, but have had little contact with either group in their priestly formation. This all originated in the Vatican."
Marked by the Holy Spirit?
A more significant struggle theologically over the identity of modern priests in the church is between those who believe literally that an ordained Catholic priest has been indelibly marked or named by the Holy Spirit, once that priest takes the vows – and those who feel that such marking or naming is subjective and metaphorical, not literal.
[Benedict this weekend sought to affirm control over a hard-line group, the Legionaries of Christ, whose influence in the past decade in Latin countries has grown quite powerful – but whose leader, the Rev. Marcial Maciel, was unable to adhere to the churches mandatory celibacy, having fathered several children and molested young men in a seminary. The Vatican will appoint a guide for the group, which has contributed significant funds and sets of strongly orthodox believers to Vatican causes.]
Fewer priests these days
At the same time, a shortage in priests is looming.
"The problem for us isn't the future, the problem is now," says a French priest in the 16th district of Paris.
Numbers are falling: Some 700 foreign priests, mostly from Africa, work in French parishes.
In Germany, one finds Polish, Indian, and African men taking up priestly slack. A senior priest in Bavaria says his graduating seminary class in 1982 had 90 priests; this year's class has fewer than 10.
The situation caused French Catholic groups in the year of the priest to launch a public relations campaign depicting "cool padres" – posters with virile and handsome guys with collars and wind-blown hair, looking confidently at the public.
One affirms, "I have a passion for Christ and I say it. I am a priest." The campaign, "And why not me," is designed to reach young Frenchmen at a time when only 100 a year are ordained. Last year the numbers dropped from 16,800 to 15, 200. (French bloggers had a field day when it was discovered the two poster-clergy were not Catholic priests but models from the entertainment industry.)
When a handful of Catholic theology students at the University in Tubingen were asked at a recent informal meeting if they wanted to be priests, they looked at each other and laughed. None did.
At Tubingen, among more than 400 students studying theology to work in the church, which together with the Protestant church in Germany, is the second largest employer in the nation – only eight say they want to join the priesthood.
How the scandal has hurt
The current pedophile scandal which may reach some 8,000 priests guilty of predatory behavior dating from 1965 to present, and payouts of $6 billion worldwide – has harmed the atmosphere for recruiting and for a normal priestly life.
Frank Flinn, a religious studies professor Washington University in St. Louis and author of the Encyclopedia of Catholicism says that models promoting a mystical class of priests is taking place "in the face of gut-wrenching corruption of priests themselves. I really feel for the good priests out there, and there are many."
Luis Cesbron is head priest at a chapel of the Congregation of the Holy Spirit – an order that helps set up African churches and train local clergy. He worked in Cameroon nearly 30 years before giving communion at Sainte Therese de l'efant Jesus in Paris. Cesbron describes a life working with good priests "who live close to the people, walk with them, and are very good at listening to them."
"The gospel asks us to help people rise and walk; they need to rise in every way, socially, politically, economically," says Mr. Cesbron. "We tried to help people stand up… see that they are not limited by their income or education."
In Cesbron's view, the current model of the priest "dates to Vatican 1, to the counter-reformation, it is a model from the 16th century, and the model needs to finally adapt. That is bound to happen, it will be reformed, there is no logical choice for us."


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Visteon Corp. announced $800 million in new financing today, including a $600 million seven-year loan and $200 million revolving line of credit.The Van Buren Township-based supplier will use the cash to pay for bond redemption and other corporate purposes, Jim Fisher, director of corporate communications, said in an email. Last month, Visteon announced a deal to sell its 50 percent stake in Korean joint venture Duckyang Industry Co. Ltd., after the company said it would divest from the automotive interiors business completely in January. The deal represents the first of three deals with three separate buyers to do that. The Duckyang deal is expected to close this month; the other two are being negotiated. While attempting to dump its interiors division, Visteon continues to build up its electronics division. In January, Visteon announced the $265 million acquisition of the electronics unit of Johnson Controls Inc., which makes instrument clusters, infotainment displays and body electronics. The deal is expected to close in the first half of this year and could grow Visteon's electronics operation to $3 billion in annual sales. The deals are part of the supplier's latest efforts at a turnaround since exiting Chapter 11 bankruptcy in 2010. Visteon had sales of $7.4 billion in 2013, and employs about 24,000 people across facilities in 29 countries.
Dustin Walsh contributed to this report.


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TURIN, Italy (AP) Italy tied Croatia 1-1 in the first round of the Davis Cup on Friday after Andreas Seppi beat Ivan Dodig 6-2, 6-7 (2), 6-4, 6-4.
In the opening singles on red clay, Marin Cilic of Croatia rallied past Paolo Lorenzi 6-1, 6-7 (6), 4-6, 6-3, 6-2 in 3 hours, 43 minutes. Lorenzi was a late replacement for flu-ridden Fabio Fognini.
Saturday's doubles in the best-of-five series pits Italy's Simone Bolelli and Lorenzi against Mate Pavic and Nikola Mektic.
Seppi is ranked a career-high No. 18 after reaching the fourth round of the Australian Open.
Italy is looking to win its first World Group series since 1998, when it finished runner-up. Croatia won the Davis Cup in 2005. The winner faces Spain or Canada in the quarterfinals.


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There are no standard therapies for the management of central sleep apnea (CSA). Either positive pressure therapy (PAP) or supplemental oxygen (O2) may stabilize respiration in CSA by reducing ventilatory chemoresponsiveness. Additionally, increasing opioid use and the presence of comorbid conditions in US veterans necessitates investigations into alternative titration protocols to treat CSA. The goal was to report on the effectiveness of titration with PAP, used alone or in conjunction with O2, for the management of CSA associated with varying comorbidities and opioid use.
This was a retrospective chart review over 3 years, performed at a VA sleep disorders center. The effects of CPAP, CPAP+O2, and BPAP+O2, used in a step-wise titration protocol, on consecutive patients diagnosed with CSA were studied.
CSA was diagnosed in 162 patients. The protocol was effective in eliminating CSA (CAI ≤ 5/h) in 84% of patients. CPAP was effective in 48%, while CPAP+O2 combination was effective in an additional 25%, and BPAP+O2 in 11%. The remaining 16% were non-responders. Forty-seven patients (29%) were on prescribed opioid therapy for chronic pain, in whom CPAP, CPAP+O2, or BPAP+O2 eliminated CSA in 54%, 28%, and 10% cases,, respectively. CPAP, CPAP+O2, and BPAP+O2 each produced significant declines in the AHI, CAI, and arousal index, and an increase in the SpO2.
The data demonstrate that using a titration protocol with CPAP and then PAP with O2 effectively eliminates CSA in individuals with underlying comorbid conditions and prescription opioid use. Comparative studies with other therapeutic modalities are required.
A commentary on this article appears in this issue on page 565.
Chowdhuri S; Ghabsha A; Sinha P; Kadri M; Narula S; Badr MS. Treatment of central sleep apnea in US veterans. J Clin Sleep Med 2012;8(5):555-563.
The treatment of central sleep apnea (CSA) continues to lack a universally recognized standard of care.1 Variable etiologies of CSA and the presence of concomitant disorders influence the choice of therapy. Thus, therapeutic options have varied markedly from positive airway pressure (PAP) devices, including continuous positive airway pressure (CPAP),2–6 bilevel positive airway pressure therapy (BPAP),7–9 and adaptive servoventilation,10–13,20 to supplemental O2,14–17 carbon dioxide,21,22 and/or pharmacologic agents.23–25,29,30 The outcomes of therapy have also varied considerably, with limited evidence to establish the effectiveness of any therapy for CSA.26–29,31,32 The majority of published literature has focused on the treatment of CSA secondary to congestive heart failure (CHF),2–11,15–22,26–29 with very little data on patients with "primary" CSA23,24 or CSA secondary to causes other than CHF.33 In addition, there is very little data on the treatment of CSA related to opioid use and CSA that is concomitant with OSA.13,35 The latter entities are of increasing importance in the US veteran population due to the increased use of prescription opioid drugs for chronic pain control and the risk for opioid related deaths.34
Central apnea (CA), defined as the cessation of breathing with an absence of respiratory effort, occurs as cycles of apnea alternating with hyperpnea. The ventilatory overshoot in the recovery period leads to hypocapnia and recurrent apneas. Treatment strategies primarily focus on preventing the "overshoot." Positive pressure therapy, in the form of CPAP, BPAP, or ASV, and supplemental O2 are two potential modalities that could stabilize respiration by dampening post-apneic hyperventilation and breathing instability.14,36 Evidence in the literature supports the potential utility of each approach, but neither, separately or in combination, has been studied in large unselected patient populations.
Current Knowledge/Study Rationale: Standard positive airway pressure (PAP) titration protocols for central sleep apnea (CSA) are poorly defined. Our goal was to determine the impact of a step-wise titration protocol using PAP therapy and supplemental oxygen, on CSA, in a sleep clinic population of patients with multiple co-morbid conditions and, particularly, with prescription opioid drug use.
Study Impact: The results confirm that CPAP eliminates central apneas in 50% of CSA cases, while CPAP in combination with oxygen is effective in an additional 25%. CSA related to prescription narcotic used is very common in the veteran population and PAP alone and in combination with oxygen are effective alternative therapies in this sub-population of patients.
In 2006, we initiated a stepwise protocol to standardize the initial management of central sleep apnea during PAP titration. Nasal CPAP was applied initially, followed by oxygen supplementation, aiming to stabilize breathing during sleep via reduced chemoresponsiveness.36 We are reporting our experience using a chart-based retrospective analysis that investigated whether instituting the above protocol during attended PAP titrations eliminated CSA in the veteran population.
The site of the study was the Detroit Sleep-Wake Disorders Center, an AASM accredited sleep center at John D. Dingell VA Medical Center in Detroit, MI. The Human Investigation Committees of Wayne State University School of Medicine and Detroit Veterans Affairs Medical Center approved the retrospective research project.
Polysomnographic (PSG) studies were performed using a digital polygraph (SomnoStar 8.5, Yorba Linda, CA, USA or Compumedics E-series, Abbotsford, Victoria, Australia) in a standard fashion, as per the AASM manual.1 Electroencephalogram (EEG) was recorded using the international 10-20 system of electrode placement (EEG: C3-A2 and C4-A1; EOG, O-A2); electrooculograms (EOG), and chin electromyograms (EMG) were recorded using standard methodology. Airflow was monitored by nasal pressure transducer (PTAF 2, Philips Respironics, Murrysville, PA, USA) and thermistor during the diagnostic phase, or by the flow channel from the PAP (OmniLab Advanced, Phillips Respironics, Murrysville, PA, USA) pneumotachometer during the PAP titration phase. Respiratory effort was determined via the respiratory impedance plethysmography (RIP, Philips Respironics, Murrysville, PA, USA). Pulse oximetry oxygen saturation (SpO2), was measured by the pulse oximeter incorporated in the digital polygraph systems. The device algorithm followed AASM guidelines for averaging SpO2.37 Sleep staging and arousals were scored according to standard methods; and obstructive apneas, central apneas, and hypopneas were scored based on current published AASM guidelines. The "alternate" scoring criterion provided by the 2007 AASM manual was used to score hypopneas: 50% reduction in flow associated with a 3% oxygen desaturation or an arousal.37 Patients were diagnosed with OSA if the sum of the obstructive apneas and hypopneas per hour of sleep (the apnea-hypopnea index [AHI]), was ≥ 5/h. Patients were diagnosed with CSA if the number of CA per hour of sleep (central apnea index [CAI]) was > 5/h during a baseline PSG or the diagnostic portion of a split-night PSG. When the majority of the respiratory events were obstructive apneas or hypopneas, the sleep technologists followed the usual laboratory PAP titration protocol, starting at CPAP 4-5 cm H2O and increasing by 2 cm H2O with a goal of eliminating respiratory events,65 with AHI < 10/h and CAI ≤ 5/h. The presence of frequent central apneas (corresponding with CAI > 5/h) during the baseline full-night PSG or the diagnostic portion of a split-night PSG was an indication to activate the CSA titration protocol (described below). The laboratory titration protocol is to titrate PAP to eliminate snoring, snore arousals, and REPRs (respiratory effort related arousals) and markers of flow limitation.
The CSA treatment protocol was designed as a technologist-driven protocol that was utilized in all patients with CSA, regardless of its etiology or the presence of concomitant OSA. The protocol was developed prior to the wide availability of ASV, which was not attempted if the above protocol was successful. Positive pressure titration was initiated at CPAP 4-5 cm H2O and titrated upward to 10-14 cm H2O. If frequent central apneas persisted at CPAP pressures of 10-14 cm H2O, then CPAP was not increased further, in order to avoid further hyperinflation and hypocapnia. Instead, supplemental O2 was added at 2 liters per minute (L/min) to dampen the post-apneic ventilatory overshoot,36 and increased by 1 L/min to maintain oxygen saturation ≥ 93%, keeping CPAP at the same level. Oxygen saturation was maintained at ≥ 93%, to ensure that it was consistently > 90% even if apnea occurred, and allowing for a 2% device error. Supplemental oxygen at above goal was continued for ≥ 20 minutes. If central apneas persisted despite the addition of adequate supplemental O2 for ≥ 20 min, CPAP was switched to BPAP while maintaining oxygen saturation ≥ 93%. Initial BPAP setting was adjusted to keep the inspiratory positive airway pressure setting (IPAP) 2-3 cm H2O higher, and the expiratory positive airway pressure setting (EPAP) 2 cm H2O lower than the previous CPAP setting. These were adjusted upward if hypopneas and obstructive apneas in addition to CA appeared, but keeping the IPAP-EPAP difference low (4-6 cm H2O) to prevent further hypocapnia and central apneas. The usual laboratory protocol was to achieve optimal titration65 in both supine and lateral positions. Eighty-four patients underwent a second or third night study for an initial or repeat PAP titration according to the above treatment protocol.
A cross-sectional analysis of the data was performed on consecutive patients identified as having CSA by chart review for the period between January 2006 and June 2009, who received the diagnosis of CSA during an overnight baseline PSG or the diagnostic portion of a split-night PSG study. Patients with CPAP-emergent CSA (CAI < 5/h on the diagnostic portion of the PSG but ≥ 5/h during the titration phase of full-night PAP titration study or a split-night study) were not included in this analysis, as this was not the objective of the study. Moreover, the natural history of PAP-emergent CSA is that these resolve spontaneously over time.60,61 Demographics and medical history data that could influence the presence of CSA and hypoxia were extracted, including age, gender, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, medical history of heart failure (CHF), coronary artery disease (CAD), atrial fibrillation, hypertension (HTN), diabetes (DM), stroke, chronic obstructive pulmonary disease (COPD), and the use of opioid drugs. In addition, from the sleep study reports and charts we recorded the type of sleep study (baseline full-night or split-night PSG study), AHI, CAI, minimum oxygen saturation, the presence or absence of Cheyne-Stokes breathing/periodic breathing, and when available, transthoracic cardiac echocardiogram (ECHO) reports for ejection fraction (EF) and the presence or absence of diastolic dysfunction. Following initial variations in protocol implementation during the technologist training period, the protocol was followed more consistently and patients underwent titrations using the protocol on either the first night or a repeat study night. For the purpose of data analysis, an optimal response was defined as CAI ≤ 5/h and an AHI < 10/h. If the CAI remained > 5/h after undergoing ≥ 2 treatment options per the above protocol, these individuals were described as non-responders. The sleep stage percentages of total sleep time (TST) were calculated at baseline and during the entire titration period of the study. Arousal index was calculated as the number of AASM-defined arousals per hour of sleep and included arousals related to all respiratory events-including RERAs (respiratory effort related arousals).37 In order to clarify the effect of optimal therapy on sleep continuity, the arousal index was calculated during the baseline study period and, specifically, for the period of PAP or PAP+O2 therapy that produced an optimal response (as described above).
Two patterns of central apneas were noted: one, with a distinct oscillatory crescendo-decrescendo breathing pattern, and second, with repetitive apneas but without the oscillatory pattern. Periodic breathing (or Cheyne-Stokes respiration pattern) has been defined as repetitive crescendo-decrescendo pattern of central apneas and hypopneas lasting ≥ 10 min.37 To ascertain if periodic breathing produced an optimal response with PAP or PAP+O2 therapy in each patient, a periodic breathing index was calculated. The highest peak in the sine-wave crescendo-decrescendo oscillatory breathing pattern was first identified, then the number of peaks were summed and divided by the corresponding total sleep time to arrive at the index. The periodic breathing index was calculated at baseline and during optimal response in each of the 3 therapy groups.
A subgroup analysis for opioid users was completed. In 17 of 47 individuals with PRN opioid prescription, we were unable to determine the actual ingested dose even though the chart review indicated that the majority were using the prescribed dosing on a regular basis. To assess the impact of prescription opioid use, dosing was converted to a 24-h equipotent dose of oral morphine sulphate using the online Hopkins Opioid Conversion Program.63 Morphine equipotency for tramadol, propoxyphene, and buprenorphine could not be determined due to unavailability of a reliable dose conversion factor.
Descriptive statistics of the study population were evaluated (Table 1). One-way ANOVA or ANOVA on ranks with the Dunn test of multiple comparisons and the z test of proportions were used to compare the baseline characteristics among the groups: entire group, CPAP alone, CPAP+O2, and BPAP+O2. The pre-therapy AHI, CAI, and minimum oxygen saturation on the baseline diagnostic PSG were compared with the values obtained on optimal PAP alone or on optimal PAP plus O2 using paired t-tests (AHI) for each intervention group. For nonparametric data (CAI and minimum SpO2), the Wilcoxon signed rank test was used for comparison. All results are presented as mean ± standard deviation (SD). The level of statistical significance was set at p < 0.05. A commercially available computer statistical package was used to analyze the data (Sigma Stat 3.11.0, SPSS).
Demographics and baseline characteristics
(more ...)
CSA was diagnosed in 162 patients following 41 full-night diagnostic/baseline and 121 split-night overnight attended PSG studies. The protocol was completed appropriately in 151 patients. Concomitant OSA was present in 149 of the 151 patients. The baseline characteristics of the patients are given on Table 1. Prescription opioid drug use was the most common risk factor for CSA (29%, 47 of 162 patients), even more common than the history of CHF (20%) or stroke (6%). All patients were naïive to CPAP at the time of titration, except one individual who had returned for a repeat split-night study and had CSA on the baseline portion of the study that resolved on CPAP alone. There was an optimal response in 127 of the 151 (84.1%) patients following the protocol (Table 2). In addition, the most common therapeutic modality that was effective was CPAP in 48% of individuals (Table 2). Significant reduction in AHI and CAI to AHI < 10/h and CAI < 5/h, respectively (Figure 1A-C), was achieved on final optimal settings with a concomitant significant increase in minimum oxygen saturation noted in each therapeutic group, thus establishing the presence of an optimal response to therapy. The time interval between the initiation of supplemental oxygen and the resolution of CSA in the CPAP+O2 group was 97.8 ± 79 min (median 78 min, range 0 to 285 min; Figure 2). Finally, in 12 patients, the addition of oxygen did not eliminate CA adequately (CAI > 5/h) despite attaining adequate oxygen saturation. A significantly higher percent of this non-responder group compared to the entire sample had underlying systolic cardiac dysfunction (25% vs 10%, p < 0.01), while other baseline characteristics were similar. Table 3 provides an assessment of sleep architecture on each therapeutic modality that produced an optimal response. The overall sleep architecture was improved compared with baseline but was not significantly different among the 3 therapy groups. The arousal index was elevated at baseline. Compared to baseline values, the arousal index was markedly reduced on the PAP/PAP+O2 therapy settings that produced an optimal response in all 3 groups (Table 3). The percentage of stage 1 was markedly reduced, but not in the "normal" range for the overall titration duration which included an initial titration period when apneas and hypopneas still persisted, prior to optimal response; however, on optimal PAP/PAP+O2 therapy, stage 1 was only 13%, with 87% of time with optimal response being stage N2/N3 and REM sleep (also see Figure 2 as example). This along with the improvement in the arousal index indicates an improvement in sleep continuity with optimal CPAP or optimal PAP+O2 combination therapy.
Numbers of individuals with optimal response to the protocol
This figure demonstrates a significant decline in AHI and CAI associated with a significant increase in minimum oxygen saturation during titration with each of the 3 interventions as per the CSA titration protocol in the entire group. (A) CPAP, (B) CPAP plus oxygen, and (C) BPAP plus oxygen. AHI, apnea hypopnea index; CAI, central apnea index; CSA, central sleep apnea; CPAP, continuous positive airway pressure; BPAP, bilevel positive airway pressure; *p < 0.05.
This figure demonstrates a significant decline in AHI and CAI associated with a significant increase in minimum oxygen saturation during titration with each of the 3 interventions as per the CSA titration protocol in the entire group. (A) CPAP, (B) CPAP plus oxygen, and (C) BPAP plus oxygen. AHI, apnea...
Comparison of sleep parameters for all patients at baseline and on therapy
Position channel: B, back; R, right; L, left; S, side. Therapy channel: numbers indicate CPAP (cm H2O) while the horizontal dark blue line indicates time period when supplemental O2 was added to the circuit, starting from the arrow (↓), initially at 2 Lpm and then increased to 3 Lpm. On the respiratory event channel, the light blue, red, pink, and green bars represent central apneas, obstructive apneas, mixed apneas, and hypopneas, respectively. Respiratory events channel: numbers indicate duration of event in seconds; LM, leg movements. The clock time is indicated on the top border of the figure. Both obstructive and central events were at present at baseline and were partially resolved with CPAP, whereas the residual central apneas were completely eliminated by the addition of supplemental oxygen; (↓) denotes addition of O2. Following an increase in the supplemental O2 to 3 Lpm there was an optimal response (see text for definition). The sleep architecture also improved significantly on the optimal setting of CPAP plus oxygen at 3 Lpm, with maximum percentage of TST on this setting being stage N2 followed by stage R sleep. The salutary effect of supplementary O2 was noted 25 min after adding supplemental O2, or approximately 10 min (horizontal arrow, ←→), after reaching 93% SpO2, represented by the elimination of central apneas.
The hypnogram from an individual patient undergoing a night study demonstrates an "optimal response" upon adding supplemental O2 to CPAPPosition channel: B, back; R, right; L, left; S, side. Therapy channel: numbers indicate CPAP (cm H2O) while the horizontal dark blue line indicates time period when supplemental O2 was added...
Periodic breathing pattern was observed in 41 patients during their respective baseline study periods. The remaining patients experienced repetitive central apneas but without a crescendo-decrescendo periodic breathing pattern. Of the individuals with oscillatory periodic breathing pattern, echocardiography was available in 28 and showed that 14 (50%) had diastolic (in the absence of systolic) cardiac dysfunction, 10 (36%) had systolic left ventricular dysfunction, and 4 had normal cardiac function by echocardiography. The periodic breathing index (see Data Analysis) decreased significantly with CPAP (n = 25, 30.9 ± 24.9/h vs. 0.4 ± 1.4/h, p < 0.001), CPAP+O2 (n = 16, 27.2 ± 17.3 vs. 1.1 ± 3.5/h, p < 0.001) and BPAP+O2 (n = 5, 42.2 ± 31.5 vs. 1.0 ± 2.3/h, p = 0.04), respectively.
Forty-seven patients (29%) were on prescribed opioid therapy for chronic pain control. The prescribed opioid drugs included hydrocodone (n = 19), oxycodone (n = 10), morphine (n = 7), methadone (n = 6), codeine (n = 3), oxymorphone (n = 1), propoxyphene (n = 1), buprenorphine (n = 1), and tramadol (n = 7). The exact dosing of opioid therapy was available from the medical record in 44 patients. The 24-h morphine sulfate equipotency dosing for the group was 93 ± 102 mg, with a median dose of 40 mg and maximum dose of 363 mg. The characteristics of the opioid users were not significantly different from the parent group: 94% males, BMI 33.9 ± 7.4 kg/m2, AHI 77.4 ± 33.1/h, CAI 37.6 ± 28.9/h, minimum O2 saturation 80.5% ± 5.5%, ESS score 13 ± 5. However, the opioid user subgroup was younger, 53.7 ± 11.5 vs 59.0 ± 11.5 yrs, p < 0.01; only 6 individuals had a concomitant history of CHF, with 5 patients with EF < 55%; the proportion of individuals with CHF in opioid users was similar to that in the entire group, (13% vs 20%, p = ns). The titration protocol was fully implemented in 41 patients, with optimal response noted in 36 (89%). CPAP was the most effective treatment (Table 2) followed by PAP with oxygen supplementation. There were also significant improvements in AHI, CAI, and oxygen saturation, compared with baseline values in this subgroup (Figure 3) with the titration protocol.
This figure demonstrates that in a sub-group of opioid users, the AHI and the CAI declined significantly, with a significant increase in the minimum oxygen saturation, using the CSA titration protocol; *p < 0.05.
This figure demonstrates that in a sub-group of opioid users, the AHI and the CAI declined significantly, with a significant increase in the minimum oxygen saturation, using the CSA titration protocol; *p
To date, only small studies15–19 conducted mostly in patients with underlying CHF, have demonstrated the effectiveness of adding O2 for the management of CSA. However, no study has evaluated the effectiveness of a combination therapy of PAP and supplemental oxygen on the evolution of central apneas in an unselected population of patients with a mix of etiologies for CSA.
This study revealed several important findings: (1) CPAP therapy was effective in 50% of the study population, affirming that CPAP remains the initial therapeutic option when CSA is observed on a sleep study. (2) Supplemental O2 therapy with PAP was effective in an additional 35% of cases, regardless of the etiology of CSA. These therapies reduced CSA with an improvement in sleep continuity and periodic breathing. (3) Narcotic use is very common in patients with CSA, and these results may be applicable to patients and of importance to practitioners outside of the VA system. We found that narcotic use was a more common risk factor for CSA than heart failure. (4) PAP with adjunctive oxygen therapy was effective in CSA with opioid drug use and may be considered as alternative therapy when central apneas are not eliminated by CPAP alone.
Evidence supports the salutary effect of nasal CPAP in the treatment of central sleep apnea,2,4,6,39,40 with the strongest evidence obtained from studies of patients with central apnea in relation to heart failure.66 The therapeutic effects of nasal CPAP could be due to restoring upper airway patency and stabilization of the respiratory control system. Central apnea rarely occurs as a single event, but as cycles of apnea/hypopnea alternating with hyperpnea, often in association with obstructive events. Once apnea occurs, several factors promote further instability.41 Central apnea results in pharyngeal airway narrowing or occlusion41–43; therefore, resumption of spontaneous breathing requires opening an occluded airway, overcoming tissue adhesion force and perhaps gravitational forces.44 Furthermore, based on prior data, there is an "inherent inertia of the ventilatory control system"45 that prolongs a central apnea and only allows resumption of respiratory activity after the arterial PCO2 is 4-6 mm Hg above eupnea. The prolongation of apnea leads to variable asphyxia (hypoxia and hypercapnia) and transient arousals, resulting in ventilatory overshoot, subsequent hypocapnia, and further apnea/hypopnea.
The aforementioned sequence may explain the reported therapeutic effects of nasal CPAP in the treatment of central apnea. First, nasal CPAP restores upper airway patency, resulting in dampening of ventilatory overshoot, and mitigation of subsequent hypocapnia. CPAP increases nocturnal PaCO2, perhaps by dampening ventilatory overshoot and hypocapnia,46 as well as by increased lung volume.52 Edwards et al. have shown that CPAP stabilizes chemoreflex control of the respiratory system in the newborn lamb, via increased lung volume and decreased loop gain.47 In addition, improvement in the cardiac output59 with improved circulation time may contribute to stable breathing in individuals with CHF. However, the response to PAP in non-CHF patients indicates that the decreased propensity to central apnea may also be due to improved oxygenation, mitigation of intermittent hypoxia, increased lung volume, restoration of upper airway patency, and unloading of respiratory muscles. Our data do not allow us to ascertain the relative contribution of each potential mechanism.
We noted that the timeline for resolution of central apnea after initiation of supplemental oxygen was inconsistent with a peripheral chemoreceptor inhibition. While the duration of time required to reach SpO2 of 93% may determine the time taken to eliminate the central apneas, in majority of the patients, resolution of central apnea required more than 5 minutes after reaching the goal SpO2 level, indicating that the response was a central phenomenon and not a peripheral chemoreceptor response, since a peripheral chemoreceptor response would have occurred within a few breaths of adding oxygen. Therefore, we interpret our findings as a consequence of central stimulatory effect rather than peripheral inhibitory effect of hyperoxia. The present study corroborates our previous study demonstrating that sustained levels of oxygen at FiO2 0.40 to 0.70 mitigates the susceptibility to hypocapnic central apnea in healthy adults during sleep.36 Likewise, there is evidence that adding oxygen at FiO2 as low as 30% for 30 minutes resulted in increasing minute ventilation by 21% above room air levels.48 Thus, sustained hyperoxia is a ventilatory stimulant. Specific mechanisms of hyperoxic hyperventilation include increased brain tissue PCO2 via cerebral vasoconstriction,49 the Haldane effect,50 or a direct stimulatory effect on chemosensitive respiratory neurons51 via production of reactive oxygen species. The net effect of hyperoxia is alveolar hyperventilation, decreased plant gain, and increased CO2 reserve, thus stabilizing respiration36 during sleep.
The aforementioned discussion is applicable to post-hyperventilation central apnea. Nevertheless, it is unclear if the same mechanisms apply to CSA due to opioid use, given the uncertainty regarding the underlying mechanisms. It is possible that increased oxygen level increases chemoreceptor output56 in this scenario too, while increased upper airway collapsibility may be countered by PAP; however, the latter explanation is speculative and needs further exploration in experimental settings.
Several methodological issues should be considered for proper interpretation of our findings. First, our protocol does not allow us to test the effects of adaptive servo-ventilation (ASV) on central apnea, which was not included in the main pathway, as it was not available when this protocol was initiated in our facility. ASV may contain features that combine the mechanical effects of CPAP with dampening of ventilatory overshoot. A small study in patients with CSR compared the effects of CPAP vs. BPAP vs. ASV vs. O2 alone, however CPAP plus O2 was not included as a comparison group.20 Another study13 that included CPAP plus O2 in a small group patients (n = 7) noted a decline in CSA; however, the majority (> 60%) had CPAP-emergent or "complex-CSA," unlike the population described in our study. A randomized study with direct comparisons of CPAP plus O2 with ASV is required to assess the relative effects of each approach as well as relative cost-effectiveness. While BPAP with oxygen did produce an optimal response, a spontaneous mode of BPAP without a back-up rate was used, which is a limitation of this study. We recommend that future studies compare the efficacy of BPAP and oxygen, both in the spontaneous and spontaneous-timed modes. Second, our study was limited by the retrospective design, the predominance of males (because of the study location in a VA medical center), and the lack of longitudinal comparisons among different treatment arms. Third, the presence of REM sleep could have eliminated the central events during the latter portion of the PAP titration; however, the majority of sleep time was in NREM sleep with REM occupying only 8% to 14% of the TST. Fourth, we referred to the AASM scoring manual37 for a qualitative definition of Cheyne-Stokes/periodic breathing pattern. However, proper quantification of periodic breathing cycles requires concomitant measurement of esophageal or supraglottic pressure for accurate classification of central and obstructive events, especially hypopnea. Finally, given the retrospective nature of the study we were unable to confirm the actual ingested dose of opioid medications. However, we expect that the patients were regularly ingesting the prescribed dosing of opioid for treatment of chronic pain. In addition, it was not possible to retrospectively determine the exact etiology triggering CSA in each patient. However, our primary goal at the outset of the study was to simulate real clinical situations where CSA coexists with comorbid conditions and to determine the role of O2 supplementation as a simple and easily accessible measure in this patient group.
Our study included a population of patients referred from multiple VA medical centers, with many underlying etiologies of CSA, and not just limited to patients with CSA due to heart failure or "primary" CSA. The recently published AASM Practice Parameters64 provide guidance for the treatment of CSA in several clinical settings, and supports the use of CPAP alone or supplemental oxygen alone for the treatment of CSA. However, the document does not address the use of combination therapy of PAP plus supplemental oxygen because such studies are lacking. Moreover, there is very limited evidence for the management of CSA due to opioid use53, as noted in the practice parameter64. The practice parameter also highlighted the absence of a large series evaluating the role of "dead space" and recognized that carbon dioxide is not universally available and is difficult to administer.64 While ASV is now available, the cost of these devices is much greater than the cost of CPAP, and the latter may be sufficient in half of the patients with CSA. Additionally, ASV is not used as first line treatment for CSA, and alternative therapies are required for the management of CSA that persists on CPAP. The current study contributes to the available literature by providing a real-life scenario where OSA frequently coexists with CSA in both patients with CHF and prescription opioid medication users. To our knowledge, this is also the largest series of patients with CSA associated with prescription opioid use that describes the effect of the three different therapeutic modalities, in contrast to prior studies.53 These results are of great relevance in the US veteran population given the increasing trend for prescription opioid drug use for pain control.34,58,62
This study purports to simplify the management of CSA in a step-wise fashion in a sleep clinic-based population with underlying co-morbidities and prescription opioid use. The results shows that in individuals who fail initial CPAP during a titration study, a majority of residual CSA can be eliminated effectively by using oxygen adjunctively with PAP. Prospective comparative efficacy and cost-effectiveness trials using different treatment modalities are needed to expand on these findings.
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
Dr. Chowdhuri has received funding from VHA Career Development Award-2 and Dr. Badr from VHA Merit Review Award. The authors acknowledge the assistance of Gregory Koshorek, B.Sc.
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text:
Sophia Garcia's emotional issues send her into a state of frenzy that's so debilitating she can't work. The 22-year-old San Ysidro resident was put at ease by two cats and Gordo, a 10-year-old Border Collie.
When property management staff discovered she had three pets, they told her she could only have one. Garcia gave the cats away, secured official approval from her therapist for an additional emotional-support animal, but her landlord ignored that request.
An end to that conflict looked promising in August, when nonprofit Legal Aid Society of San Diego, which provides free legal help, intervened. In late August, Garcia's landlord granted permission for another pet and later agreed to fair-housing training.
Those results stem from a revamped San Diego city program designed to curb violations of the U.S. fair-housing law, which shields homeowners and renters from housing discrimination based on age, sex, race, disability, marital status and other identifiers. For the first time, the program not only educates, it also enforces the national fair-housing law.
"I felt really embarrassed because it went so far for something so small and ridiculous," said Garcia, who has adopted a cat, Kina. "I felt really humiliated ... I didn't know I could exercise those rights."
Do you have a fair-housing issue? Call the City s hotline: (800) 462-0503.
The Fair Housing Act, signed into law 45 years ago, has recently re-entered national focus. The
Earlier this month, the department launched its first app to help homebuyers and renters determine if their fair-housing rights have been encroached on and lets users file complaints from their iPhones or iPads.
Even though the Fair Housing Act has existed for decades to encourage integration, problems still arise. Housing advocates have reported an uptick in violations, intentional or accidental, in light of predatory practices stemming from the foreclosure crisis and an influx of military veterans returning from war with disabilities.
The mission of providing fair-housing services was temporarily threatened when the city's program lapsed for about 17 months, said Appaswamy "Vino" Pajanor, executive director of Housing Opportunities Collaborative in San Diego, which now works in connection with Legal Aid to provide fair-housing services to city residents.
By law, cities that receive certain federal money must provide a program that helps the public with issues of housing discrimination. San Diego has typically contracted with nonprofits for such services.
The city lacked such a program from December 2010 to late May because contracts with providers weren't renewed and the process to find new contractors lagged, said Michele St. Bernard, project manager for the city's fair housing program.
Despite a lack of a formal agreement, residents were still able to receive help through the city during that time, St. Bernard said.
The city and the nonprofits involved appear eager to move past those 17 months and discuss the new program, which began in mid 2012.
It has begun to help a new crop of San Diego city residents like Garcia but in a much different way than previous versions of the program.
In the past, the city's fair-housing programs did a good job of educating the public on fair-housing rights. What was lacking was enforcement to make landlords, home sellers and lenders accountable for violations, advocates say.
Now, the Housing Opportunities Collaborative, a nonprofit based downtown, talks to residents at community events, conducts fair-housing counseling and oversees a hotline for residents to report fair-housing problems.
Complaints with merit are forwarded to Legal Aid, another partner in the contract. If a violation is found, then the organization will work with the property manager or landlord to find a resolution. If mediation isn't possible, then an official complaint may be filed or lawsuit is considered. Legal Aid also fields case referrals.
It's available only for Apple devices, including iPhones, iPads and
"There had been virtually no enforcement or complaint process," said Gregory Knoll, executive director of the Legal Aid Society of San Diego. "This can not only guide people through the process, but we can actually provide representation to them. This will be very key in attempting to really change behavior."
A change in behavior was evident in the Garcia case. In addition to training and other efforts, the property management company installed two posters in all the laundry rooms that raise awareness of fair-housing policies.
"It's very impressive," Garcia said. "From two little cats to now every single resident seeing those placards..."
Another element of the program is auditing. Testers are sent out to community to pose as renters or homebuyers to detect possible violations. The tests, coordinated by the Fair Housing Council of San Diego, focus on the protected classes or are driven by complaints.
More than 100 audit tests are planned for this fiscal year, said St. Bernard, with the city.
The remodeled program is still in its early stages, but all the parties involved say they have a clear idea of the effort's goal.
"Ideally," Knoll said, "what a successful fair-housing program does is help the community help itself to remove any vestiges of discrimination in the housing market."
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ETSU men's and women's soccer teams earn NSCAA Team Academic Award
KANSAS CITY, Kan. (Nov. 22, 2013) - For the third consecutive year, both the ETSU men's and women's soccer teams received the NSCAA Team Academic Award. ETSU was one of just 186 schools nationwide to have both teams recognized with the award.
This year marks the fifth consecutive season the women's team has received the distinction and the ninth time overall. The Bucs compiled a cumulative team GPA of 3.53, ranking 22nd in the nation.
The men's team has received the award the past three years. The squad maintained a 3.26 team GPA en route to winning the program's second Atlantic Sun Championship.
ETSU saw three players earn Atlantic Sun All-Academic First Team honors this season, with Sarah Zadrazil (St. Gilgen, Austria), Kristoffer Ibsen (Aalborg, Denmark), and Ryan Coulter (Dublin, Ireland) each being recognized for their academic achievements.
ETSU was one of seven Atlantic Sun member institutions to have both teams receive the NSCAA Team Academic Award along with Florida Gulf Coast, Jacksonville, Mercer, North Florida, Stetson, and USC Upstate.
All ten Atlantic Sun women's soccer programs won the award.NSCAA Team Academic Award HistoryETSU Women's Soccer – 2002, 2003, 2006, 2009, 2010, 2011, 2012, 2013ETSU Men's Soccer – 2011, 2012, 2013


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Political party registration
An overview of what parties are required to do if they want to register with us as a political party.
As regulator, we ensure that these rules are followed and work with governments to ensure the rules are workable.
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We produce guidance for those we regulate to help them comply with the rules on political funding and spending. If you are a political campaigner please go to our guidance pages for more information on the rules.
An overview of what parties are required to do if they want to register with us as a political party.
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Arranged by Subject
The index is made up of five general sections corresponding to the general classifications under which the particular papers have appeared in these volumes for a number of years; that is, The Accounting Profession, Accounting Principles and Problems, Auditing Procedures and Problems, Tax Considerations, and Management Advisory Services.
To find a paper on a particular subject, the reader should first decide the general area of his interest and then examine the list of subtitles. Under the subtitles papers have been listed in chronological order by year, and within any particular year alphabetically by author.
Papers included in volumes for 1955 through 1964 may be located through the index in the 1970 volume.
Section 1 — The Accounting Profession
Subject Author
Business and Economics
Accounting—The Language of Business
and Finance
Maurice S. Newman
65 - 28
The Forces of Change
John W. Queenan
68 - 5
Education and Experience Requirements
for Certified Public Accountants
Elmer G. Beamer
69 - 18
Should Continuing Education Be a
Professional Requirement?
Elmer G. Beamer
70 - 34
Continuing Education—A Professional
Elmer G. Beamer
71 - 8
Future Accounting Education
and Research
Michael N. Chetkovich
71 - 3
Ethical Standards (see also Public Relations)
Ethics of Auditing and Reporting
Ralph S. Johns
66 - 26
Financial Statements
The Meaning and Significance of
Financial Statements
Malcolm M. Devore
67 - 38
Functions, Qualifications, and
The Accountant of Tomorrow
John W. Queenan
66 - 5


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C.V. Starr East Asian Library Receives Bön Canon Gift from the Tibetan Buddhist Resource Center
NEW YORK, August 19, 2008 On June 16, the C.V. Starr East Asian Library acquired as a generous donation a 501-volume set of the Bön Canon from the Tibetan Buddhist Resource Center in New York City. The Bön religion, despite having incorporated many influences from Tibetan Buddhist schools, remains distinct for tracing its doctrine and teachings to Shenrab Miwo and its historical roots to the ancient kingdom of Shangshung, which is said to have stretched from western Tibet into what is now northern India and Pakistan.
The Canon contains two sections: the Bön Kanjur (179 volumes) and the Bön Tanjur (322 volumes). The Kanjur—more precisely the "Ka"—is primarily comprised of teachings attributed to Shenrab Miwo. The edition donated to Columbia University was published by the Ancient Tibetan Text Publishing House (Lhasa) and printed in Chengdu in 1999. It most closely represents the content of the Belkyung manuscript Kanjur from eastern Tibet, and includes an especially valuable unnumbered volume which records the teaching lineages.
The Tanjur—here called the "Katen"—contains the commentaries of later teachers and treasure-revealers, or finders of hidden texts. The edition donated to Columbia was compiled and published in 1998 by Sokdé Tenpé Nima Rinpoché from Nagchukha. It includes 22 volumes unavailable in preceding editions. As a set, these versions of the Bön Kanjur and Tanjur comprise one of the later and more inclusive formations in a canonization process dating back to at least the fifteenth century.
Users may access the Bön Canon in the Rare Books Room of the C.V. Starr East Asian Library. Please contact the Tibetan Studies Librarian (firstname.lastname@example.com) for information on catalogs and other finding aids for locating individual titles or authors.
The C. V. Starr East Asian Library is one of the major collections for the study of East Asia in the United States, with over 820,000 volumes of Chinese, Japanese, Korean, Tibetan, and Western language materials, as well as some holdings in Mongol and Manchu, and over 6,500 periodical titles. The collection, established in 1902, is particularly strong in Chinese history, literature, and social sciences; Japanese literature, history, and religion, particularly Buddhism; and Korean history. The Library's website is located at: www.columbia.edu/cu/lweb/indiv/eastasian/.
Columbia University Libraries/Information Services, is one of the top five academic research library systems in North America. The collections include over 10 million volumes, over 100,000 journals and serials, as well as extensive electronic resources, manuscripts, rare books, microforms, maps, graphic and audio-visual materials. The services and collections are organized into 25 libraries and various academic technology centers. The Libraries employs more than 550 professional and support staff. The website of the Libraries at www.columbia.edu/cu/lweb is the gateway to its services and resources.


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SANTA PAULA, CA—August 24, 2007-Thomas Aquinas College is again ranked in the top tier among the nation's liberal arts colleges in the 2008 edition of U.S. News & World Report's annual college guide, "America's Best Colleges," which was released on August 17, 2007. Thomas Aquinas College's ranking is 83rd out of 106 schools in the top tier. Thomas Aquinas College is one of only seven liberal arts colleges statewide to have been ranked in the top tier, along with Pomona, Claremont McKenna, Harvey Mudd, Scripps, Occidental, Pitzer, and Westmont.
Thomas Aquinas College was also placed by U.S. News in the top 25 liberal arts colleges for the relatively low debt that its graduates incur in the course of four years at the school. Moreover, in the category of "Highest Proportion of Classes under 20 Students," Thomas Aquinas College tied for first place with the American Jewish University (CA) in having 100% of its classes with fewer than 20 students. It was the only Catholic institution in the country to be singled out for recognition by U.S. News in this category.
Jonathan Daly, Director of Admissions, was pleased by the U.S. News' rankings. "They are indeed gratifying," he said. "But it is worth noting that rankings alone don't capture the heart of what we do at Thomas Aquinas College. Great good is accomplished in the minds and souls of the young people at Thomas Aquinas College through its rigorous and unique curriculum and its unswerving fidelity to the Magisterium of the Church. No college ranking system can measure that!"
Orientation for freshmen at the 4-year, Catholic, co-ed college was held on August 16. On August 20, the college held its annual Convocation Day, which began with a Mass of the Holy Spirit offered by Bishop Robert Morlino of Madison, Wisconsin, followed by a formal matriculation ceremony presided over by President Thomas E. Dillon. Classes began on Monday evening, August 20.


text: It has a wireless radio frequency range of 300 feet. When triggered the RF signal activates the alarm. Uses one 9-volt battery (not included). Easily protect every window and door of your home. Comes with wall mount and requires 3 AA batteries not included. Can be used with the HA-SYSTEM and EWD-1


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In Memoriam: Anne McCaffrey (1926-2011)
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November 23, 2011 | madame librarian
Anne Inez McCaffrey (1 April 1926-21 November 2011) award-winning author of the "Dragonriders of Pern" series, has died of a stroke at her Ireland home. She was 85 years old. Ms. McCaffrey, the first woman to receive a Hugo Award for fiction and the Nebula Award, was named 22nd Grand Master of the Science Fiction Writers of America in 2005 and inducted into the Science Fiction Hall of Fame in 2006. She was the first science fiction writer to make the New York Times Bestsellers List.
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"You can be right. You can be dead right and bring death to all those around you." Jean Vanier
Monday, 11 January 2016
David Bowie - China Girl
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Audi Melges 20 : Michael Kiss crowned U.S. National Champion
Monday, 30 August 2010
Congratulations to 2010 Audi Melges 20 U.S. National Champion Michael Kiss on Bacio and his crew comprised of son Mitchell and Chris Rast. It's been a Kiss summer. First, Mitchell place third at the Men's Radial Worlds. Morgan, his daughter placed second at the Women's 420 Worlds and now, Michael has won the most prestigious prize in the Audi Melges 20 Class. Earlier this spring, he also won the coveted Charleston Race Week title as well.
"This still has not sunk in yet." said Kiss. "This is just unbelievable. This is good. I never envisioned that we could really sail this well. We've sailed together a lot. This team won Charleston. We went to Italy and sailed the Gold Cup to raise the bar. That was really good for our game. And, we sailed last weekend too. I just can't believe it. The coordination of our crew is really strong right now."
In second overall was John Arendshorst on Blink and Steve Sisson helming for Tony Tabb on USA-88 was third.
Both races planned for Sunday were sailed under decent breeze of 10-12 knots, partial sunshine and less lumpy seas than in days past. Race 1 was a course 4, 1.0nm beats with Arendshorst managing a great start as did Simon Strauss on Simplicity rounding the top mark in first. Kiss rounded mid-fleet. His lack luster start was anything but a deterrent. He poured on the speed downwind challenging for the lead. Arendshorst stayed strong taking the win, Kiss finished second and Jon Messenger on CAN-142 was third.
Kiss chose not to race the final heat, leaving Arendshorst, Tabb and Strauss to battle it out. Seventeen year-old Alex Post, helming for his father Erik on Vaya Con Dios shot out front of the fleet taking the bullet in the final race, winding down the championship on a youthful note.
This weekend, the Audi Melges 20 demographics ran the gamut. John Arendshorst won the Masters division. Kate Mullin on CAN-141 won best helmswoman, and junior sailor Alex Post received most accomplished in the youth category, the Audi Melges 20 has proven that it is a boat that truly has something for everyone.
As with every event, Championships don't happen without the incredible effort of many involved individuals — the Macatawa Bay Audi Melges 20 Nationals was no different. First and foremost, thanks to all the competitors that traveled from near and far to enjoy a weekend complete with the best summertime conditions and all scheduled races complete. In particular, Simon Strauss and his Simplicity crew of brother Quentin Strauss flew in from Valencia and Nigel Young from the UK to be with the fleet. The class would like the thank title sponsor Audi and Melges Performance Sailboats. Thanks to Regatta Chair John Donnelly, MBYC Members Michael and Tovi Kiss, Tony Tabb, John Arendshorst, Erik Post and the entire Macatawa Bay Yacht Club for their warm hospitality. A very special thanks to PRO Shannon Bush and her team for a very organized and professional job on race committee.
See Melges 20 images:
TOP TEN RESULTS (After 8 Races, FINAL)
1.) Michael Kiss/Mitchell Kiss, Bacio; 1-1-1-1-1-2-2-[24/DNS] = 9
2.) John Arendhorst/Scott Nixon, Blink; 3-3-3-3-[12]-11-1-3 = 27
3.) Steve Sisson/Tony Tabb, USA-88; 7-2-6-8-3-8-6-[9] = 40
4.) Simon Strauss/Nigel Young, Simplicity; 5-4-4-2-15-[17]-10-4 = 17
5.) Paul Reilly/Andy Burdick, Red Sky Sailing Team; 9-7-7-5-[13]-4-7-5 = 44
6.) Kate Mullin/Harry Melges III, CAN-141; 2-14-5-6-11/ZFP-3-[15]-6 = 47
7.) Alex Post/Erik Post, Vaya Con Dios; 8-[15]-9-12-8-5-4-1 = 52
8.) George Gamble/Sam Rogers, A Little Wicked; 4-8-2-11-10-7-12-[14] = 54
9.) Sid Gorham/Seadon Wijsen, Funner; 6-10-11-7-[16]-9-9-2 = 54
10.) Eric Wynsma/Anthony Kotoun, Superfly; [14]-12-8-4-2-10-13-7 = 56
Joy Dunigan
The venue has been secured and the dates are set. The 2011 Audi Melges 20 Miami Winter Series is on. The first event takes place in mid-December 11-12, the second on February 12-13. The third event will be held in conjunction with the famous Bacardi Miami Sailing Week on March 10-12. More than 20+ boats are expected at each event! Stay close to melges20.com as all the details will be published very soon. Save the dates and be there!
Last Updated ( Monday, 30 August 2010 )