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The Anthem Area Chamber of Commerce will host its first ever local business expo and career fair, Business Forward Expo 19, on Saturday, April 13, 2019, from nine o'clock am until four o'clock pm. The event, a new addition to the chamber's ongoing Keep Local program, will focus on supporting local businesses first by showcasing only local businesses and employment opportunities.
This free community event will be held on the Shops at Arizona plaza, commonly known as the 'ACE Hardware' plaza, located at 3434 West Anthem Way, across from the community park in Anthem.
Local residents and job seekers are encouraged to attend Business Forward Expo 19 to meet local business owners; get access to special discounts and promotions; and register on-site for local career opportunities. In addition to business vendors and the career center, there will be live demonstrations throughout the day and entertainment.
Guests can also choose from a wide selection of dining options offered on-site from Amped Coffee Company, Filiberto's Mexican Food, Poke Shack and Sam's Frozen Yogurt.
Business vendor booths start at only $50 and are limited to Anthem Area Chamber of Commerce members only. Vendor registration opens March 1, 2019. For more information or to register as a vendor, please visit AnthemAreaChamber.org or contact Heather Maxwell, at 623.322.9127 or by email at [email protected]


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Taipei, Thirteen Taiwanese have been arrested in Thailand on suspicion of telecoms fraud, the Criminal Investigation Bureau (CIB) announced at a news conference Thursday.
A man surnamed Wu along with 12 accomplices were recently detained by the Thai authorities with the assistance of their CIB counterparts in a villa in the southern suburbs of Bangkok on information provided by victims after a six month investigation, according to the CIB.
Wu, who is believed to be a senior figure in the criminal ring, was found to have set up telecommunications equipment in the villa to conduct fraud schemes when investigative officers raided the premises, the CIB said.
An initial investigation found that the Taiwanese fraud ring allegedly swindled NT$30 million (US$955,261) from 20 people in Taiwan by posing as law enforcement and national health officials, the CIB said.
The 13 Taiwanese will be taken back to Taiwan by CIB investigators and be referred to the Taoyuan District Prosecutors' Office for further investigation, it added.
From May 2016 to Aug. 14, 2019, 244 Taiwanese were convicted of crossborder fraud crimes in foreign countries, and are currently serving their sentences in those countries, CIB statistics show.
A total of 770 fraud suspects have been deported to Taiwan, while 652 have been sent to China, the figures indicate.
Source: Focus Taiwan News Channel

subset: commoncrawl


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Hurricane Maria is expected later today. The storm's path is taking it toward some of the already-devastated islands in the Caribbean.
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This Humax 500gb is not sold by Amazon but by a company through Amazon series' option (to record all programmes in a series).It can record programmes in standby mode. So far i have 95 recorded programmes stored to watch including films and A perpetual 'stammer' had500GB Humax is 21 months old (got 24 month warranty from John Lewis).UPDATE 06/08/2011: So today I removed the clock boardinput, allowing you to connect the receiver to a TV set without a SCART connection.
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The high speed circular sawing machine is one kind of circular sawing machine, and it is the specific kind that the circular sawing machine classifies according to the running speed.So we should be a kind of circular sawing machine for basic learning and understanding, so that you can correct use and reasonable use in the practical work, at the same time can also be used in this device has good effect, rather than to waste it.
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Royal Cobalt Blade is a magical sword made of highly concentrated Cobalt Gems. It does little physical damage to the enemy, but does great magical damage.[1]
Special Effect
A normal attack enchants a magic skill.[1]
The Combat Tournament - Siege Round
After Hardcore Leveling Warrior increased his intelligence with his lucky coin skill, his max mana increased enough for him to equip Royal Cobalt blade and An Apprentice Magician's Hat, allowing him to enter Swordmage Mode.[1]
Notes & Trivia
- It requires a high level of intelligence to equip as HCLW was automatically disarmed once his Lucky Coin buff wore off.[1]
- Hardcore Leveling Warrior spent quite a lot of money borrowing it from Heart Heater.[1]
Community content is available under CC-BY-SA unless otherwise noted.


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No, that's not what I thought when temperatures dropped from 25 degrees Celsius on Thursday to 13 degrees Celsius on Saturday. I didn't feel like looking for my stockings yet and I actually liked not having to think about jackets and umbrellas. But hey: I live in Berlin and even though there's quite a lot of consensus about the summers being awesome, every season means new opportunities. Let's be positive and think about all the good things that are waiting for us now!
Eating Real Food (Cheesecake!)
Loyal readers of this blog already know that I've been having a little love affair with (New York) cheesecake ever since I moved to Berlin – and I'm not the only one. Cafés and bakeries are constantly competing to bake the best one in Berlin and the cheesecake lovers are benefiting whilst the creamy, crunchy goodness is exploding in their mouths. During summer, I tried to hold back a little – because cheesecake doesn't look too good in a bikini.
Now that my beach body is hibernating however, my hunt for the best cheesecake in town is at the top of my list again. For now number 1 is still A.Horn (crunchy base, creamy filling and a layer of handmade berry jam on top), very closely followed by Five Elephant (even crunchier base, great creamy filling, but I'm missing some sourness). A little research tells me that I should definitely try Princess Cheesecake – they somehow seem to have specialized – and Katie's Blue Cat this fall. Let the games begin!
The best cheesecake in Berlin (so far): A.Horn. Image courtesy of Daphne Damiaans.
- Café A. Horn: Carl-Herz-Ufer 9, Kreuzberg
- Five Elephant: Reichenberger Straße 101, Kreuzberg
- Princess Cheesecake: Tucholskystraße 37, Mitte
- Katie's Blue Cat: Friedelstraße 31, Neukölln
Being Outside and Loving the Colours
Going to the supermarket was quite a challenge last autumn. Red leaves, yellow leaves, orange leaves – I couldn't stop taking pictures of the trees and collecting fallen leaves. Seriously, it became annoying and I had no idea what to do with all those huge leaves in my house. However, there's no denying that Berlin looks stunning in the fall. Every street becomes a little autumn painting and with the sun using its last energy to light it all up, there's no better moment to take a long walk than now – also because of all the above mentioned cheesecake.
If you want to keep it close to 'home', you can just go to a nearby park. Walk up the hill in Volkspark Friedrichshain for an instant fall feeling, for example. If I feel like putting a little more effort into my walk, I go the Landwehrkanal in Kreuzberg. The buildings along this canal are among the most beautiful in Berlin and on top of that it's a great location for autumn colours and people watching – and Five Elephant, Katie's Blue Cat and Kaffee A.Horn (actually directly on the canal) are just a few steps away. Still looking for more nature? Take the train north, east, south or west and before you know it, the city couldn't be further away. There are great walks in the Grunewald (south-west of Berlin) and near the many lakes around Erkner (south-east of Berlin).
The buildings along the Landwehrkanal are even more beautiful at this time of year. Image courtesy of Daphne Damiaans.
Volkspark Friedrichshain turning yellow. Image courtesy of Daphne Damiaans.
- Volkspark Friedrichshain: U5 Strausberger Platz, walk 5-10 minutes north.
- Landwehrkanal: U1 Prinzenstraße, then walk about 3 minutes south.
- Grunewald: Visit Berlin – has a lovely walk in this area.
- Erkner: Erkner: RE1 and S3 Erkner, then walk eastwards.
Getting Comfy at the Movies
Now this is something I haven't been doing nearly enough in Berlin. There are so many beautiful movie theatres in the city – and this autumn I'm planning on finally visiting some more of them. I won't just walk into any theatre and buy tickets for the next movie, however. In case you weren't aware yet: if you want to see the original version of movies in Germany, rather than a dubbed version, you have to proceed with caution. Always look for the sign 'OV' (original version) or OMU (original with subtitles), otherwise you might be facing a very, very long night at the movies listening to your favourite Hollywood actors in German.
But even within a small radius from my house, there are plenty of options. My personal favourite is of course Kino International at Karl-Marx-Allee, just a few minutes' walk from where I live. It opened two years after the Wall was built and still has a very elegant 1960's interior. If you're looking for something more intimate, you can head deeper into Friedrichshain for B-ware! Ladenkino. A cinema couldn't be more Berlin than this: it's a bar, café, movie store and movie theatre in one – and the right place to watch truly unique art-house films. In Prenzlauer Berg, there's Filmtheater am Friedrichshain, opened in 1925 and already worth a visit just because of the amazing building.
- Kino International: Karl-Marx-Allee 33, Mitte
- B-ware! Ladenkino: Gärtnerstraße 19, Friedrichshain
- Filmtheater am Friedrichshain: Bötzowstraße 1-5, Prenzlauer Berg
Warming up by the Fireplace
Yes, having a beer or glass of white wine in the sun whilst watching the people of Berlin pass by is amazing. And with a little luck you might still be able to do so in October or November, possibly covering your legs with a rug. But what I might love even more is finding a snuggly (German: 'kuschelig') corner of a bar, ordering a craft beer or a glass or red wine and warming up as the rain and wind are doing their thing outside.
It gets even better when there's a fireplace, something I can only dream of once having in my own home. For now I'll find real warmth in Café am Neuen See, surrounded by the greenery of the huge Tiergarten park. Cheese fondue and an open fire are on the menu in Linda Carell, combined with Dutch (Go Holland!) and Belgian speciality beers. In the mood for more French? One of last winter's best discoveries was Crêplala, a crêperie settled in the cutest little building and, of course, with fireplace.
- Café am Neuen See: Lichtensteinallee 2, Tiergarten
- Linda Carell: Rhinower Straße 3, Prenzlauer Berg
- Crêplala: Kantstraße 85A, Charlottenburg


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When you started shopping for gear for your first baby, you probably placed the big-ticket items at the top of your list: the stroller, the crib or bassinet, and of course — the all-important car seat.
So important is this last item that many labor and delivery units even check your car seat before they let you go home with your sweet bundle of joy.
You check the latest car seat guidelines and recommendations, make sure your desired seat will properly fit your car and your needs, and make the purchase — sometimes spending upwards of $200 or $300. Ouch! (But well worth it to keep your precious cargo safe.)
So it makes sense to wonder: When baby #2 comes along, can you reuse your old car seat? Or if your friend offers you a seat their child has outgrown, can you use that? The short answer is maybe, maybe not — because car seats have expiration dates.
This comes as a surprise to many parents (it's not like purchasing a dozen eggs or a loaf of bread, after all!), but car seats expire for good reason. Let's take a closer look.
There are actually a few reasons why car seats expire, and no, car seat manufacturers wanting to inconvenience you isn't one of them.
1. Wear and tear
Your car seat may be one of the most-used pieces of baby gear you own, perhaps rivaled only by the crib. With each supermarket, day care, or play date run, you're likely buckling and unbuckling your baby numerous times.
You'll also find yourself adjusting the seat as your little one grows, cleaning up messes and spills as best you can, and cringing as your tiny teether chews on straps or bangs on cupholders.
If you live in an area with extreme temperatures, your seat may also bake in the sun while your car is parked and get tiny cracks in the plastic that you can't even see.
All of this takes a toll on the fabric and parts of a car seat, so it stands to reason that the seat — designed to keep your child safe — won't last forever. And without a doubt, you want to make your child's safety remains intact.
2. Changing regulations and standards
Transportation agencies, professional medical associations (like the American Academy of Pediatrics), and car seat manufacturers are constantly conducting and evaluating safety and crash tests. This is a good thing for parents everywhere.
Also, technology is forever evolving. (Don't we know it. Why is our two-year-old laptop already outdated?!) This means that car seat safety stats can be improved with as new features, materials, or technologies are introduced.
Say you buy a car seat that is rear-facing and will hold your child up to a certain weight, but then the weight guidelines change for a rear-facing seat. It may not be the law that you have to replace your seat, but the manufacturer may discontinue it and stop making replacement parts — not to mention, you no longer have the safest seat possible for your little one.
An expiration date may account for these changes and makes it less likely that you'll have a seat that's not up to snuff.
3. Manufacturer testing has its limits
When a manufacturer — be it Graco, Britax, Chicco, or any number of other car seat brands — tests a car seat, they don't assume you'll still be cramming your 17-year-old in it and driving them to their senior prom. So it stands to reason that they don't test car seats to see how they hold up after 17 years of use.
Even all-in-one car seats — ones that transform from rear-facing to forward-facing to boosters — have weight or age limits, and car seat and booster use generally ends by age 12 (depending on child's size). So car seats aren't usually tested beyond about 10–12 years of use.
4. Recalls
In an ideal world, you'll register your car seat as soon as you buy it so the manufacturer can let you know of any product recalls. In the real world, you're up to your eyeballs in all things newborn related — not to mention sleep deprived. You may indeed be using a (recent and unexpired) hand-me-down car seat with no registration card in sight.
So expiration dates ensure that even if you miss a recall announcement, you'll have a relatively up-to-date car seat that is more likely to be free of problems.
A note on used car seats
Before you purchase a car seat from a yard sale or borrow one from a friend, check for a recall via the manufacturer's website. Safe Kids also maintains an ongoing list.
Note also that a used car seat may be less safe than a new one. A used car seat or booster is generally not recommended unless you can be absolutely sure it hasn't been through an accident.
There's no universal answer to this, but we'll give it our best shot: Generally, car seats expire between 6 and 10 years after the date of manufacture. Manufacturers such as Britax and Graco publish this on their websites.
No, it doesn't suddenly become illegal to use a car seat at 10 years and 1 day after it was made, and there won't be a warrant out for your arrest. But we know that you'd do anything to keep your sweet babe safe, and that's why it's recommended that you replace your car seat once it expires.
Looking for information about when your specific car seat expires? The best place to check is the manufacturer's website. Most brands have a page dedicated to safety information where they tell you how to find the expiration date.
For example:
- Graco shares that its products have expiration dates on the bottom or back of the seat.
- Britax tells users to find the date of manufacture — by using the serial number and instruction manual — and then provides expiration dates based on when different types of seats were made.
- Chicco provides an expiration date on the seat and the base.
- Baby Trend gives an expiration date for its car seats as 6 years post-manufacture. You can find the manufacture date on the underside of the car seat or the bottom of the base.
- Evenflo car seats have a date of manufacture (DOM) label. Most models expire 6 years after this date, but the Symphony line lasts for 8 years.
You don't want anyone else using your expired car seat, so taking it to Goodwill or throwing it in the dumpster as is aren't good options.
Most manufacturers recommend cutting the straps, slicing the seat itself, and/or writing on the seat with a permanent marker ("DO NOT USE – EXPIRED") before disposal.
Truth be told, if you also want to take a baseball bat to your car seat and let out some pent-up aggression in a safe environment… we won't tell.
Baby stores and big-box retailers (think Target and Walmart) often have car seat recycling or trade-in programs, so keep an eye out or call your local store to ask about their policy.
It's tempting to be cynical and believe that car seat expiration dates exist to support a billion-dollar baby gear industry wanting to get more money out of you. But actually, there are important safety reasons behind limiting the life of your car seat.
While this doesn't mean you can't take your sister's car seat when your nephew outgrows it — or use baby #1's car seat for baby #2 a couple years later — it does mean that there's a certain time frame within which this is OK. Check your seat's expiration date by looking at its label, usually at the bottom or back to the seat.
We recommend registering your car seat as well — and carefully following installation instructions to avoid compromising the safety of the seat. After all, your baby is the most precious cargo your vehicle will ever transport.


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To make using the HYC60LI cordless chainsaw as simple as possible, it features tool-less chain tensioning and automatic chain lubrication. This allows you to get the very best performance out of your chainsaw at all times.
The HYC60LI uses the Oregon low kick-back chain bar and has the standard chain brake, which provides a safer cutting experience by stopping the chain immediately in the event of a kick-back.
The 58V, 2.5Ah battery and charger supplied with this chainsaw are compatible with all the cordless tools in the Hyundai 60LI range which includes string trimmer, blower, hedge cutter, mower and pole pruner.
Gardenlines Tip: you will need chain oil for this item which is NOT INCLUDED
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For more information, please watch the video clip below:


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Helden der Region
Am 04.10.2019 verlieh Wirtschaftskammerpräsident Josef Herk gemeinsam mit Landeshauptmann Hermann Schützenhöfer den vom Wirtschaftsbund ins Leben gerufenen "Helden der Region-Award". Michael Regner wurde in der Kategorie #Tradition für seine großartigen Leistungen für die Region Murtal zum "Helden der Region" gekürt.
Pastry Regner in the Kleine Zeitung
Shortly before Easter 2019 an article about our company appeared in the Kleine Zeitung.
Our new Easter assortment is here!
Sugar baker ball 2019
Extension confectionery
Valentinas chocolate cream
The palmfat-free chocolate cream from the 13-year-old Valentina is produced in our house. At the moment she is not only "full in the mouth"
A few links:
The chocolate cream is available in the varieties whole milk, espresso and white with poppy seeds. Please direct your orders to Mrs. Yvonne Rehklau: email@example.com
400 years Schwarzenberg in Murau
The Schwarzenbergtorte comes from the house of Regner ...
For the 400th anniversary of the Schwarzenberg dynasty we can deliver the dessert to the Schwarzenbergtafel which will take place in Murau on the 15th and 16th of July. However, not only for the dinner, but also during the exhibition (until 14 October 2017) there will be this Schwarzenberg dessert in Murau at the Egidiwirt and the Gasthof Lercher in Murau.
From the 13th of August, on the occasion of the 80th birthday of the Prince of Schwarzenberg, the Schwarzenbergtorte will officially be in business. But what is actually in this Schwarzenbergtorte ??
A chocolate base with almonds and without flour as base. On top of that, a kernel of dark chocolate mousse wrapped in a bilberry cream with blueberry pieces. The whole thing embedded in velvety blue-sprayed chocolate.
Our coffee house in a new style
After a short renovation period we were able to reopen our restaurant on Palmsamstag 2016 in new splendor.
A new modern style where young and old feel comfortable and like to come to enjoy coffee, cake or our homemade ice cream.
Come and feel at home in the house Regner in Seckau!
Award of the province of Styria
On July 4, 2014, we received the highest award that a company in Styria can receive from the state. We now have the right to manage the Styrian coat of arms and are very proud of it.
A big thank you for this great award and recognition! Thanks also to all our great employees, they are the pillars of our company!
BBC in the Seckauer-Gingerbread bakery
The British television BBC visited with the Hairy Bikers in summer 2011, the best culinary art in Austria. Also with us they found themselves and looked at the gingerbread baking more closely.
At Easter 2012, this post watched approximately 5 million viewers inside the BBC's main evening program.
By the way, the Hairy Bikers stated that they liked the tour through Austria best.
Opening ceremony of our new bakery
On July 29, 2011, after a year of construction, we opened our new bakery. 500 guests celebrated this opening with us.
246/5000 On the Open Day, July 30th, around 3,000 foodies and sweet toothers from far and wide came to experience and enjoy the delicious gingerbread and confectionery products produced in the new Seckauer gingerbread bakery.


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Councils call for changes to broadband minimum standard
Some rural areas are in danger of falling into a digital "twilight zone" according to the Local Government Association.
The representative body for local authorities in England has launched a new campaign, Up to Speed, aiming to ensure every resident and business has access to faster broadband.
It warned that the government's pledge to give everyone a minimum download speed of 10Mbps by 2020 will soon be outdated.
Mark Hawthorne, chairman of the LGA's People and Places Board, said: "The government's planned commitment to universal broadband across the country is a significant step forward.
"However there is a real concern that as the broadband needs among households and businesses in rural areas grow they will be left lagging behind because the national minimum standard quickly becomes obsolete."
Related content
Local government GCloud sales rocket in March
Invigorating the public sector revolution
He said that the minimum standard should be altered to become a percentage of average national speeds.
Hawthorne said: "Without this there is the real possibility of some areas – particularly in rural and hard-to-reach areas - falling into a digital twilight zone."
The LGA has also called for clarification on whether the government will specify a minimum performance for upload speed.
It said that upload speeds were vital for businesses who need to send digital invoices, upload large files to the cloud or publish high resolution images on their websites.
Hawthorne added: "Councils are best placed to understand the digital needs of local areas. They are at the centre of improving mobile connectivity through helping implement superfast broadband programmes, organising local initiatives to raise residents' and businesses' digital skills and working with mobile operators to best place infrastructure."
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NCAAOM Wants Comcast/NBCU To Spend $800 Million On Minority Programming
The National Coalition of African-American Owned Media wants a merged Comcast/NBCU to set aside 10% of its channel capacity for African-American owned channels, and spend 10% of its annual progamming budget.
That came as NCAAOM's response to a number of diversity pledges made by Comcast, including four African-American- owned channels and spending $20 million on a development fund, which NCAAOM called "extemely insulting."
NCAAOM is headed by Stanley Washington and is backed by two partners in D.C. law firm Patton Boggs, including former FCC Chairman Kevin Martin, who is representing a number of deal critics.
NCAAOM on June 7 through a press release threatened to launch a boycott of Comcast unless it added 100% African-American-owned channels, declaring its position in advance of a House Judiciary Committee hearing in Los Angeles on the proposed deal.
NCAAOM has also filed a petition to deny the merger.


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Era: Edo period.
Fuchikashira: Shakudo, rabbit and flowers are engraved with gold color.
Menuki: Shakudo, Naginata and dragon are engraved with gold and silver color.
AOI estimation paper
Price : 60,000 JPY-. (include shipping fee.)


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Date & Time
Mon 3 Feb 2020
6:00 PM – 7:00 PM Central Time
Simpson County Literacy Center
231 S. College Street
Franklin Kentucky 42134 Contact
270-813-0276 firstname.lastname@example.com Franklin Garden Club https://www.facebook.com/franklinkygardenclub/
Join master gardeners from the Franklin Garden Club for conversation and appetizers as we discuss garden questions and concerns. Whether you are an absolute beginner or an advanced gardener, or any skill level in-between, we'd love to have a conversation with community members who want to know more about growing gardens indoors or out. If we don't know answers to your questions, we'll make sure we help you find them.
Free! Everyone is welcome.
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text: Psywar Report post Posted October 23, 2011 Thanks for the votes guys. I greatly appreciate it. I'll send you a cupcake Charles lol (a zucchini one ). Hey, as long as I can slather it in Chocolate Frosting I am down! Share this post Link to post Share on other sites


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24 Feb 2010: Sweiss NJ, Salloum R, Gandhi S, Alegre ML, Sawaqed R, et al. (2010) Correction: Significant CD4, CD8, and CD19 Lymphopenia in Peripheral Blood of Sarcoidosis Patients Correlates with Severe Disease Manifestations. PLOS ONE 5(2): 10.1371/annotation/a75007e1-492a-4bcb-80a8-28b4d432c099. https://doi.org/10.1371/annotation/a75007e1-492a-4bcb-80a8-28b4d432c099 View correction
Sarcoidosis is a poorly understood chronic inflammatory condition. Infiltration of affected organs by lymphocytes is characteristic of sarcoidosis, however previous reports suggest that circulating lymphocyte counts are low in some patients with the disease. The goal of this study was to evaluate lymphocyte subsets in peripheral blood in a cohort of sarcoidosis patients to determine the prevalence, severity, and clinical features associated with lymphopenia in major lymphocyte subsets.
Methodology/Principal Findings
Lymphocyte subsets in 28 sarcoid patients were analyzed using flow cytometry to determine the percentage of CD4, CD8, and CD19 positive cells. Greater than 50% of patients had abnormally low CD4, CD8, or CD19 counts (p<4×10−10). Lymphopenia was profound in some cases, and five of the patients had absolute CD4 counts below 200. CD4, CD8, and CD19 lymphocyte subset counts were significantly correlated (Spearman's rho 0.57, p = 0.0017), and 10 patients had low counts in all three subsets. Patients with severe organ system involvement including neurologic, cardiac, ocular, and advanced pulmonary disease had lower lymphocyte subset counts as a group than those patients with less severe manifestations (CD4 p = 0.0043, CD8 p = 0.026, CD19 p = 0.033). No significant relationships were observed between various medical therapies and lymphocyte counts, and lymphopenia was present in patients who were not receiving any medical therapy.
Citation: Sweiss NJ, Salloum R, Ghandi S, Alegre M-L, Sawaqed R, Badaracco M, et al. (2010) Significant CD4, CD8, and CD19 Lymphopenia in Peripheral Blood of Sarcoidosis Patients Correlates with Severe Disease Manifestations. PLoS ONE 5(2): e9088. https://doi.org/10.1371/journal.pone.0009088
Editor: Jacques Zimmer, Centre de Recherche Public de la Santé (CRP-Santé), Luxembourg
Received: December 29, 2009; Accepted: January 20, 2010; Published: February 5, 2010
Copyright: © 2010 Sweiss et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: Grant Support and Disclosures: TB Niewold: NIH K08 AI083790, NIAID Clinical Research Loan Repayment AI071651, Arthritis National Research Foundation Eng Tan Scholar Award, Lupus Research Institute, University of Chicago CTSA Core Subsidy Grant and Collaborative University of Chicago/Northshore University Health System Translational Research Pilot Grant from UL1 RR024999. NJ Sweiss: Investigator initiated grant support from Abbott, Genentech and BMS for sarcoidosis research, Young investigator award, Foundation for Sarcoidosis Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The commercial funders, BMS, Genentech and Abbott, supported clinical trial research in sarcoidosis to use novel therapies. It did not support the work in this manuscript and does not alter adherence to PloS One polices. The authors have no financial conflicts of interest.
Sarcoidosis is a systemic inflammatory disease characterized by noncaseating granulomas which consist of CD4+ T-cells and macrophages surrounded by CD8+ T-cells [1]. This inflammation can affect any number of organs, including the lung, liver, heart, skin, and nervous system. The etiology of sarcoidosis is unknown, but likely involves genetic factors, which interact with environmental exposures to result in disease susceptibility [2]. The immune dysregulation in sarcoidosis is classically manifested by hypergammaglobulinemia and paradoxical cutaneous anergy to particular antigens such as tuberculin protein [3]. This paradox of anergy co-existing with an inflammatory condition remains poorly understood.
Lymphopenia occurs in over 50% of sarcoidosis patients and is associated with chronic disease [4], [5], [6]. While early studies have suggested that sarcoidosis-associated lymphopenia is due to T-cell depletion [7], few studies have focused on the various peripheral blood lymphocyte subsets in sarcoidosis. Miyara and colleagues investigated the presence and function of regulatory T cells in the lung and blood of patients with sarcoidosis. It was demonstrated that CD4+CD25brightFoxP3+ cells accumulated in the periphery of sarcoid granulomas, in BAL washings, and in peripheral blood of patients with active disease. These cells effectively suppressed the proliferation of effector cells but not their production of TNF. This may explain the paradoxical state of T cell anergy in these patients that is associated with active local inflammation. However, to our knowledge, detailed examination of the various lymphocyte subsets in the peripheral blood in sarcoidosis patients has not been described. Thus, the goal of this study was to evaluate lymphocyte subsets in peripheral blood in a cohort of sarcoidosis patients followed at the University of Chicago Rheumatology Clinic to determine the prevalence, severity, and clinical features associated with lymphopenia in major lymphocyte subsets.
Materials and Methods
We performed a retrospective review of the laboratory records for lymphocyte subset testing in sarcoidosis patients at the University of Chicago Hospital between November 2006 and January 2008. Our analysis was limited to individuals who received full testing by flow cytometry and included the following cell counts: Absolute CD4 (515–1642 cells/µL), CD8(212–887 cells/µL) and CD19 (103–581 cells/µL). The medical records of patients and controls were reviewed according to the study approved by the University of Chicago Institutional Review Board. Because this was a retrospective chart review, patient consent was waived by the Institutional Review Board as the study approved by the Institutional Review Board required no therapeutic intervention. Twenty-eight patients were identified. Inclusion criteria were patients with biopsy-proven sarcoidosis who attended the University of Chicago Sarcoidosis Center for new or return appointments and had full lymphocyte subset data available.
Clinical data were obtained by the primary study physician (NJS) and abstracted to include clinical manifestations related to sarcoidosis, demographics, and medical therapy. Lymphocyte subset data in the sarcoidosis cohort were compared to 100 healthy individuals who were tested by the clinical laboratory for assay standardization. Results were also compared between groups of patients defined by disease manifestations or medical treatment. Severe organ system involvement was defined as chronic sarcoidosis with at least one of the following disease manifestations: neurologic, cardiac, ocular, or advanced pulmonary disease defined as forced vital capacity (FVC)<40% of predicted. Patients with severe sarcoidosis typically require corticosteroid-sparing agents secondary to corticosteroid failure.
Flow Cytometry
CD4, CD8, and CD19 cells were counted in whole blood using flow cytometry techniques at the University of Chicago Clinical Laboratory following standard protocols with fluorescently labeled antibodies. The proportion of cells positive for CD4, CD8, and CD19 was multiplied by the total number of lymphocytes, and cell counts were reported as number of cells per microliter (cells/µL). Normal ranges for CD4, CD8, and CD19 cell populations were derived from the healthy donor cohort used to standardize the assay. Low count was defined as results below the lower level of normal for CD4 (515–1642 cells/µL), CD8 (212–887 cells/µL) and CD19 (103–581 cells/µL).
Statistical Analysis
Fisher's exact test was used to compare categorical data, and quantitative comparisons were performed using an unpaired t-test or Mann-Whitney non-parametric t-test as appropriate depending upon whether the data were normally distributed as assessed by the D'Agostino and Pearson omnibus normality test. P-values shown are all two-sided, and uncorrected for multiple comparisons.
Patient Characteristics
In this cohort of 28 sarcoidosis patients, 18 were African-American, and ten were European-American. The mean age was 51.6 years, with a wide spectrum of organ system involvement (Table 1). Seven patients (25%) had cardiac and 7 had skin involvement, 4 patients (14%) had clinically significant lung involvement, 4 (14%) had neurologic involvement, and 6 patients (21%) had liver involvement. A total of 24/28 patients in this cohort (86%) required therapy.
Significant CD4, CD8, and CD19 Lymphopenia Was Present in Sarcoidosis Patients
The majority of sarcoidosis patients exhibited reduced lymphocyte subset counts, including CD4 (57%), CD8 (54%), and CD19 cell counts (54%) as compared to healthy controls (Figure 1A, p<4×10−10). Only eight patients (29%) demonstrated values within the normal range for all three lymphocyte subsets. Lymphopenia was profound in some cases, and five of the patients had absolute CD4 counts below 200. There were no significant differences by gender or ethnicity (European vs. African-American ancestry) in any of the lymphocyte subset counts. CD4, CD8, and CD19 lymphocyte counts were significantly correlated (Spearman's rho 0.57, p = 0.0017, Figure 1B), and 10 patients (36%) exhibited reduced lymphocyte counts in all three subsets.
A) Peripheral blood lymphocyte measurements show that 16 patients (57%) had lower than normal CD4 counts, 15 patients (54%) had lower than normal CD8 counts, and 15 patients (54%) had lower than normal CD19 counts. The box indicates the normal range for cell counts (95% of normal control subjects fell within this normal range) (p<4×10−10). B) Correlation between lymphocyte counts in sarcoidosis patients. CD4∶CD8 correlation shown in purple, and CD4∶CD19 shown in blue, with Spearman's rho and p-value indicated for each correlation.
Lymphopenia in Sarcoidosis Patients Is Not Related to Medical Therapy but Instead to Severity of Disease
Reductions in lymphocyte subset counts were not significantly different in patients who were taking disease-modifying anti-rheumatic drugs (DMARDs, including methotrexate, azathioprine, leflunomide and mycophenolate mofetil) (n = 14), prednisone (n = 18) or tumor necrosis factor alpha (TNF-α) inhibitors (n = 6) (p>0.5, data not shown). Four patients had not been taking any medical therapy, and three of these patients had abnormally low lymphocyte counts. Patients with severe organ system involvement as defined in the Methods had lower lymphocyte subset counts as a group than those patients who did not have these disease manifestations (CD4 p = 0.0043, CD8 p = 0.026, CD19 p = 0.033, Figure 2).
Severe organ system involvement is defined as outlined in the methods.
This study provides the first report of frequent and severe CD4, CD8, and CD19 lymphopenia in sarcoidosis patients to our knowledge. All lymphocyte subsets were highly correlated with each other, suggesting that many patients have severe overall T- and B-cell lymphopenia in peripheral blood. Lymphopenia was frequently present in patients who were not receiving any medical therapy, and while immunosuppressive therapies may reduce lymphocyte numbers in the peripheral blood [8], we found that there were no significant relationships between specific medical therapies and lymphocyte counts. In contrast, severe organ system involvement was associated with lower lymphocyte subset counts, suggesting that lymphopenia may relate more to disease pathology than medical therapy. This finding could suggest that lymphocytes are depleted in peripheral blood due to increased infiltration of target organs. In one study of pulmonary sarcoidosis patients undergoing bronchoalveolar lavage (BAL), there was a was a significant relationship between an increase in the number of CD4 positive T cells in the BAL fluid and a decrease in the absolute number of CD4 positive T cells in the peripheral blood [9]. Alternatively, lymphopenia could represent either suppression of lymphogenesis due to cytokines or other influences, or increased peripheral destruction due to activation-driven cell death or other mechanisms. Longitudinal follow up studies would be of high interest to determine whether lymphopenia is corrected with therapy, as other disease manifestations are effectively treated. Such results would further strengthen the hypothesis that lymphopenia underlies disease pathology rather than being a result of generalized immunosuppression.
Author Contributions
Conceived and designed the experiments: NJS TBN. Performed the experiments: NJS RS SG MLA TBN. Analyzed the data: NJS RS SG MLA TBN. Contributed reagents/materials/analysis tools: NJS RS SG MLA DP TBN. Wrote the paper: NJS RS SG MLA RS MB KP RPB DRM JG TBN.
- 1. Noor A, Knox KS (2007) Immunopathogenesis of sarcoidosis. Clin Dermatol 25: 250–258.
- 2. Zissel G, Prasse A, Muller-Quernheim J (2007) Sarcoidosis–immunopathogenetic concepts. Semin Respir Crit Care Med 28: 3–14.
- 3. Gerke AK, Hunninghake G (2008) The immunology of sarcoidosis. Clin Chest Med 29: 379–390, vii.
- 4. Hedfors E, Holm G, Pettersson D (1974) Lymphocyte subpopulations in sarcoidosis. Clin Exp Immunol 17: 219–226.
- 5. Lower EE, Smith JT, Martelo OJ, Baughman RP (1988) The anemia of sarcoidosis. Sarcoidosis 5: 51–55.
- 6. Selroos O, Koivunen E (1979) Prognostic significance of lymphopenia in sarcoidosis. Acta Med Scand 206: 259–262.
- 7. Kataria YP, LoBuglio AF, Bromberg PA, Hurtubise PE (1976) Sarcoid lymphocytes: B- and T-cell quantitation. Ann N Y Acad Sci 278: 69–79.
- 8. Slade JD, Hepburn B (1983) Prednisone-induced alterations of circulating human lymphocyte subsets. J Lab Clin Med 101: 479–487.
- 9. Baughman RP, Hurtubise PE (1985) Systemic immune response of patients with active pulmonary sarcoidosis. Clin Exp Immunol 61: 535–541.


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Guest Blog: Alex's Story
I have been an ice skater since I could remember. The minute I learned to walk, my mother had me running around the house in diapers and ice skates. Skating has been, and always will be, part of my identity. When I turned 17, I decided that I would turn pro and from that point, my future did a flip flop. Prepared to go off on a scholarship to college at 18, instead I began traveling the world with huge production companies— Disney, Royal Caribbean, etc— and I was performing in different


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Freisen Hotel
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How to Get to Freisen
What are the closest airports to Freisen?
- • Saarbruecken (SCN), 22.6 mi (36.4 km) from central Freisen
- • Frankfurt (HHN-Frankfurt - Hahn), 28.4 mi (45.7 km) from central Freisen
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What is there to see near Freisen:
- • Saar-Hunsrueck Nature Park (17.4 mi/28 km from the city center)
- • Bostalsee (7.8 mi/12.5 km from the city center)
- • Lichtenberg Castle (5.5 mi/8.8 km from the city center)
When is the best time to visit Freisen?
- • Hottest months: July, August, June, September (average 74°F)
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The Queen of Scots
Next to Elizabeth Woodville, queen consort of Edward IV of England, Mary, Queen of Scots is my next favorite. The first portrait of her in this blog is one of my favorites of her. She looks so regal and innocent in it – makes me wonder how things would have turned out if Francis ll … [More]


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Global Medical Polycarbonate Market: Snapshot
The potential of polycarbonates as an engineered thermoplastic has expanded over the decades, including in the worldwide medical industry. They have been utilized in wide spectrum of medical applications in devices and equipment used in a variety of medical processes. Depending on the purpose, the industry adopts medical polycarbonates with varying attributes—with different combination of strength, optical clarity, heat resistance, and dimensional stability. A better understanding of the science coupled with continuous advances in resin manufacturing techniques has catalyzed the development of medical polycarbonates of required safety and biocompatibility. This is one of the key drivers of the medical polycarbonate market.
Extensive demands for medical polycarbonates are in making intravenous connectors, and devices used in renal processes, cardiac surgeries, and in general surgical instruments. For instance, the devices used in renal dialysis need to be made with materials with outstanding optical clarity and strength to withstand cracking. In surgeries, clinicians have been using devices with marked structural stability, including high tensile strength. Further, medical device makers adopting medical-grade polycarbonates seek materials that will allow the devices to be sterilized several times with negligible loss of performance in medical procedures. This is a notable trend underpinning the steady expansion of new products in the market. However, a prominent and recurrent concern has been the presence of bisphenol A (BPA) in polycarbonates. The presence of BPS is indispensable and are present in traces in polycarbonates. That said, their presence may be of considerable health risk for patients and clinicians alike. The science behind addressing such concerns is growing fast to meet the unmet need. This will undoubtedly expand the potential of the medical polycarbonate market in the coming few years.
Medical Polycarbonate Market: Product Overview
- Polycarbonates are among the fastest growing plastics in the medical device industry, primarily due to the favorable combination of cost and performance factors
- Medical polycarbonates possess optical clarity & colorability, durability/impact resistance, ductility for rigorous use, high heat resistance, low water absorption, dimensional stability, UV light/gamma radiation resistance, high flow & enhanced release, flame retardancy, sterilizability, chemical resistance, and biocompatibility characteristics
- Medical polycarbonates are widely used in medical devices for renal dialysis, cardiac surgery products, surgical instruments, and IV connection components
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Polycarbonate to Create Traction in Medical Industry
- In terms of application, the medical polycarbonate market can be segmented into eyewear, surgical instruments, wound care, drug delivery systems, electro-medical equipment, and others
- Demand for medical polycarbonates in medical tubing connectors is high owing to their high degree of dimensional stability
- Polycarbonates possess high transparency and are widely used transparent medical devices where visual monitoring of blood or other biological fluids is essential. Hence, demand for medical polycarbonates in transparent medical devices is projected to increase during the forecast period.
- Polycarbonates are gaining popularity among medical device manufacturers, as they possess high fracture strength and toughness that make them helpful in manufacture of delicate probes used in non-invasive surgical procedures
- Polycarbonate medical products can be sterilized with ethylene oxide, gamma radiation, electron beam radiation, and steam autoclaves. Medical polycarbonate medical devices do not undergo product failure when exposed to gamma rays and electron beams used in radiation sterilization. However, medical polycarbonate substitutes such as Teflon, rubber, polyurethane, and polypropylene are unable to withstand these radiations.
- Therefore, demand for polycarbonate in the medical industry is anticipated to increase in the near future due to their exceptional properties
High Demand for New Manufacturing Technologies to Boost Medical Polycarbonate Market
- High incidence rate of Hospital Acquired Infections (HAI) in developed nations such as the U.S. has compelled medical device manufacturers to develop new polycarbonates with higher levels of chemical resistance
- Increase in incidence of Hospital Acquired Infections (HAI) has boosted the usage of disinfectants to clean surfaces and medical equipment. This has led to pitting, cracking, color changes, and other unintended consequences of polycarbonate materials used in medical devices and equipment.
- In order to counter these negative situations, medical device and equipment designers are switching toward new polycarbonate materials with exceptional chemical physical characteristics
Replacement of Conventional Materials by Polycarbonate in Medical Devices & Equipment
- Medical device and equipment designers are planning to integrate an ergonomic grip into product design by developing and manufacturing light weight and functional polycarbonate products
- Ongoing improvements in physical and mechanical properties of medical polycarbonates and new polycarbonate formulations are increasingly substituting metals in medical device designs
- Medical device manufacturers are shifting toward metal-to-plastic transformation, wherein polycarbonates are predominantly used over metals owing to their higher tensile strength, and lighter, cheaper, more flexible, and easier to process characteristics
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Environmental Concerns Hampering Market Growth
- BPA (bisphenol A) is one of the primary ingredients used in manufacture of polycarbonates
- Of late, increase in trace levels of BPA in medical devices has become a topic of public safety debate
- Higher traces of BPA can cause endocrine disruption, hormone mimicry, carcinogenicity, and other human developmental and behavioral issues
- The Government of Canada has limited the usage of BPA in medical devices and equipment to be safe up to certain limits. However, public pressure to be sustainable and environmentally conscious has compelled manufacturers to make necessary changes in the selection of BPA-free polycarbonates for medical devices and equipment. This is expected to hamper the medical polycarbonate market in the near future.
North America Anticipated to Dominate Global Medical Polycarbonate Market
- In terms of region, the medical polycarbonate market can be divided into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa
- North America and Europe accounted for significant share of the global medical polycarbonate market in 2018
- North America is a leading consumer of medical polycarbonate, followed by Europe and Asia Pacific. Rise in demand for polycarbonate in the medical industry in developed economies such as the U.S., the U.K., and Germany is expected to boost the demand for medical polycarbonate during the forecast period.
- The medical polycarbonate market in Asia Pacific is anticipated to expand at a rapid pace during the forecast period, due to the increase in awareness about medical polycarbonate among medical plastic product manufacturers. Rise in demand for medical polycarbonate in Asia Pacific has encouraged medical plastic product manufacturers in China to establish new production lines. This is likely to boost the demand for medical polycarbonate in the country in the next few years.
- Asia Pacific is the major producer of medical polycarbonate in the world. Countries such as China, India, and South Korea have strong distribution network of medical plastic products to meet the growing needs of consumers. China manufactures substantial amount of medical polycarbonate and exports it to Europe and North America.
- Advancements in polycarbonate compositions and the advent of manufacturing technologies are estimated to drive the medical polycarbonate market in Asia Pacific in the near future
- Increase in FDI investment in the medical industry in developing economies of Asia Pacific is also a key factor that is anticipated to drive the medical polycarbonate market in the region during the forecast period
- Implementation of stringent regulations against edible consumption of medical polycarbonate grades in the U.S. is expected to hamper the demand for medical polycarbonate in North America in the near future
Key Players in Medical Polycarbonate Market
Key players operating in the global medical polycarbonate market focus on distributing their products through strong distribution channels in order to increase their market share. Major players operating in the medical polycarbonate market include:
- Asahi Kasei Corporation
- Chi Mei Corporation
- Covestro AG
- Ensinger
- Entec Polymers
- Lone Star Chemical
- Mitsubishi Chemical Corporation
- RTP Company
- Trinseo S.A.
Global Medical Polycarbonate Market: Research Scope
Global Medical Polycarbonate Market, by Type
- Radiation Grade
- High-Temperature Grade
- Lipid Resistant Grade
- Others
Global Medical Polycarbonate Market, by Application
- Eyewear
- Surgical Instruments
- Wound care
- Drug Delivery Systems
- Electro-medical Equipment
- Others
Global Medical Polycarbonate Market, by Region
- North America
- Canada
- Europe
- Germany
- France
- Italy
- Spain
- Russia & CIS
- Rest of Europe
- Asia Pacific
- China
- Japan
- India
- Rest of Asia Pacific
- Latin America
- Brazil
- Mexico
- Rest of Latin America
- Middle East & Africa
- South Africa
- Rest of Middle East & Africa
The report offers a comprehensive evaluation of the market. It does so via in-depth qualitative insights, historical data, and verifiable projections about market size. The projections featured in the report have been derived using proven research methodologies and assumptions. By doing so, the research report serves as a repository of analysis and information for every facet of the market, including but not limited to: Regional markets, technology, types, and applications.
The study is a source of reliable data on:
- Market segments and sub-segments
- Market trends and dynamics
- Supply and demand
- Market size
- Current trends/opportunities/challenges
- Competitive landscape
- Technological breakthroughs
- Value chain and stakeholder analysis
The report has been compiled through extensive primary research (through interviews, surveys, and observations of seasoned analysts) and secondary research (which entails reputable paid sources, trade journals, and industry body databases). The report also features a complete qualitative and quantitative assessment by analyzing data gathered from industry analysts and market participants across key points in the industry's value chain.
A separate analysis of prevailing trends in the parent market, macro- and micro-economic indicators, and regulations and mandates is included under the purview of the study. By doing so, the report projects the attractiveness of each major segment over the forecast period.
Highlights of the report:
- A complete backdrop analysis, which includes an assessment of the parent market
- Important changes in market dynamics
- Market segmentation up to the second or third level
- Historical, current, and projected size of the market from the standpoint of both value and volume
- Reporting and evaluation of recent industry developments
- Market shares and strategies of key players
- Emerging niche segments and regional markets
- An objective assessment of the trajectory of the market
- Recommendations to companies for strengthening their foothold in the market
Note: Although care has been taken to maintain the highest levels of accuracy in TMR's reports, recent market/vendor-specific changes may take time to reflect in the analysis.
Medical Polycarbonate Market


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