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For supposedly rational creatures we humans seem irrationally drawn to Magic Beans. Being a geezer I've been around long enough to see quite a few flavors come and go. What they all have in common is that by the time you start reading about them everywhere, the end is near.
Let's see…
I remember Growth Stocks were all the rage awhile back.
Why, any management worth its salt should be able to plow profits back into the business and reach even greater heights. Value Stocks that paid dividends? Clearly run by managements with no vision, so lacking in ability that they could think of nothing better to do with profits than to pay them out. You want growth! Find companies with "forward thinking" (what a wonderful phrase!) leaders skilled in deploying capital.
Growth Stocks. You couldn't go to a party without some guy telling you about his latest killing. Left everything in the dust. Until they didn't.
I remember Actively Managed Funds.
The investment world is littered with the remains of once super-star fund managers.*
I remember Houses.
Opps. Strike a nerve? Yep, stocks and bonds went up and down but houses? Houses could only go up. See people will always need a place to live, right? Seemed to make sense at the time. Why banks, and how could they ever be wrong, would even loan you money on all your equity. You could cash out profits and still live in the place. What could possibly go awry?
I'm sure glad I learned how to lose money in real estate back in the 80s and before it was fashionable. Saved me a bundle in avoiding this latest debacle.
I remember Gold.
How could I not? Every time I turned on the TV, opened the paper or listened to the radio people were spending huge sums of advertising money to tell me I, too, could get rich buying (preferably from them) Gold. It is, after all, the one true store of value through human history. There was even one place that offered to sell it to you and then, for a fee, store it for you as well. You never even had to see the stuff. Mmm, think about that for a moment. Yikes.
A few weeks back it was pushing $2000 an ounce on its way to $5000. Or $10,000. Or, well, $1566 as of year end and falling.
I remember (reading about) Tulip Bulbs.
You can too: http://en.wikipedia.org/wiki/Tulip_mania
Now? Now it seems everywhere I turn the new flavor of Bean is Dividend Investing or, even more impressively, The Dividend Aristocrats. Here's an example:
Go ahead. Head on over there and have a read. It is clear and well written. Take some time to poke around Mr. MM's site as well. Its a good one.
Welcome back. Now here's my 2 cents:
As I mentioned at the end of that post, I actually made some money last year riding the Div-Stock wave. Mmmm, with all this new popularity I should be taking my chips off the table soon. No better sign than the end is near for them.
So no Magic Beans in The Dividend Aristocrats, but they likely won't be as poisonous as some of the other Beans. You'll just lag behind the market over the next decade. In fact here's a bet that will likely make you more money: Within 5 years you'll be reading about how Growth Stocks are the sure path to prosperity and Value (dividend) stocks are for losers who can't do the simple home work of analyzing the good stocks. This will be wrong, too.
What is poisonous in The Dividend Aristocrats post is this:
"For a great primer on valuing stocks, check out the Intelligent Investor, by Warren Buffett's mentor, Benjamin Graham. Read it, and then get to work combing the Aristocrats for bargains."
It is a great book and by all means take the time to read it. But remember, when Graham wrote it, Index Funds would not be invented for several more decades and mutual funds were few and far between. Analyzing and choosing individual stocks was the only option.
But now, thank you Jack Bogle, we have index funds. With these we can own the entire market and outperform over time all but the rarest of professional money managers.
This idea that if you read a few books and study what Warren Buffet has done you, too, will outperform the market is, to steal a phrase from Sean's dad, Horse Hockey. Dangerous horse hockey at that.
People have been trying for decades and yet, there is still only one Warren. Think about it this way:
Remember Muhammad Ali?
The Warren Buffet of Boxing in his day. You and I could have followed his training regiment, maybe even engaged Angelo Dundee to show us the ropes. We could have gotten in top shape, done all our homework. Learned the "sweet science." And, after all that effort, would you climb in the ring with Joe Frazier or George Foreman or Sonny Liston?
Not me. I'm no Ali. Or Warren. Neither are you. (Unless of course you are, in which case: Welcome back.)
You know what Warren Buffet recommends for individual investors? Broad based Index Funds. Graham, were he still alive, would too.
A little humility goes a long way in saving your ass and your stash.
*Addendum: At various points on this blog I suggest only about 20% of active managers out-perform the index. That's being a bit generous.
This is a ball park figure based on the many articles on this I've come across on this over the years. In fact you can Google this question and find several falling around this percentage. I'm not sure why they vary. Some look at different time frames. Some at different metrics. Some factor in costs, some don't.
Clearly it is easier to get lucky and outperform the shorter the time you need to do it. Even I called the market almost exactly last year, and I can assure you it was no more than luck: https://jlcollinsnh.com/2014/01/01/1st-annual-louis-rukeyser-memorial-market-prediction-contest-2013-results-and-your-chance-to-enter-for-2014/
Vanguard has done research on this looking at a 15-year time frame:
In it they point out that 45% of actively managed funds fail to even survive over that time, let alone outperform. Only 18% both survived and outperformed. And even those frequently had long periods of underperformance.
So even if you are lucky enough to pick one of the out-performers, it will be tough to live with.
This article references studies done for an even longer period: 1976-2006, 30 years: http://www.marketwatch.com/story/almost-no-one-can-beat-the-market-2013-10-25
The results are even more shocking. As the article says:
"Barras, Scaillet and Wermers tracked 2,076 actively managed U.S. domestic equity mutual funds between 1976 and 2006.
"And — are you sitting down? Only 0.6% — you read that right, 0.6% — showed any true skill at beating the market consistently, 'statistically indistinguishable from zero,' the three researchers concluded."
On reflection, calling the out-performers at 20% I am too generously off the mark.

subset: commoncrawl


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JOHNSON CITY, Tenn. (Nov. 1, 2008) - Sophomore guard Micah Williams (Manchester) scored a game-high 19 points and freshman guard Adam Sollazzo (Tampa, Fla.) dished out a game-high seven assists as the ETSU men's basketball team opened the 2008-09 season with an 84-61 exhibition win over nearby Milligan College Saturday inside Memorial Center.
In front of a crowd of 2,149, the Buccaneers' new-look defense forced 23 Milligan turnovers and held the Buffaloes to just 43 percent shooting from the field. Meanwhile, the Bucs hit on 53 percent of their shots from the field and out-rebounded Milligan 40-23.
"There was some good and there was some bad," said ETSU head coach Murry Bartow. "Our goal was to hold them under 60 points so we weren't too happy with that last possession, but we're just young and that's part of the learning process for our team. I thought Micah made some big shots and showed what he's capable of doing, and I think Adam really showed what kind of future he could have for us."
Playing without sophomore forward Tommy Hubbard (Boston), senior guard Jocolby Davis (Meridian, Miss.) and freshman post Seth Coy (Montgomery, Ind.) - all of whom are nursing injuries - the Bucs used a 20-2 run midway through the first half to make a 12-10 Milligan advantage a 32-16 ETSU lead with 6:26 left before the break. From there the two teams traded baskets and ETSU led 42-25 at the intermission.
In the second half, the Buffs hung in and actually cut the lead to 13 at 54-41, but the Bucs outscored Milligan 24-10 over the next seven minutes to make it 82-54 in the final minutes.
Along with Williams' 19 points, senior Courtney Pigram (Memphis) added 14, freshman Jarvis Jones (Memphis) scored 13 and senior forward Kevin Tiggs (Flint, Mich.) netted 12. While Sollazzo dished out seven assists to just three turnovers, senior forward Greg Hamlin (Flint, Mich.) led all players with 10 rebounds on the night.
For Milligan, Jeff Barnes led the way with 16, while Derrick Nave and Darrell Miller scored 11 and 10 points, respectively.
"We need to get healthy because we're just banged up right now," Bartow said. "Defensively we did a lot of good things today, but offensively we need to get better. We have Temple in two weeks so we're going to get back to work."
The Bucs will return to action in another exhibition contest next Saturday, Nov. 8 inside Memorial Center against Mars Hill. Tip is scheduled for 4 p.m.


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Displaying 1 - 1 of 1 items.
Thesis: Dismantling Legal Constraints to Contraception in the 1900s
In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the time, the Comstock Act was the first federal anti-obscenity law that targeted contraception. However, social acceptance of birth control changed at the turn of the twentieth century. In this thesis, I analyzed legislation, advocates, and literature pertinent to that social change to report on the events leading up to the decriminalization of contraception.
Format: Essays and Theses
Subject: People, Legal, Reproduction


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Facebook's $1 messages: One more way to get your credit card
The latest update to Facebook Messages did more than just change a few settings. It's also a sign of the social network seeking yet an opportunity to encourage impulse purchases.
Facebook, which began the year with a reputation for caring more about its users than about making a buck, is ending the year with the rollout of yet another way to try to squeeze more money from its members.
This latest money-making effort comes with a revamp of its popular Messages service -- that part of Facebook through which you can message/e-mail your "friends" and, in fact, those who aren't your friends. What's changing -- and a spokesman describes it to CNET as a "small experiment" -- is that Facebook will start charging some people for messages they want to send to people they're not friends with.
The $1 cost seems steep just to shoot someone a message, but no matter. Facebook will surely drop the price if no one uses it. But the bigger point: This latest "test" shows that Facebook, eager to prove to Wall Street that it's building a cash-generating empire, is looking for more ways to add revenue streams not tied to advertising and, importantly, is trying to get more user credit cards on file.
Unlike some other titans of consumer tech -- namely, Apple and Amazon -- Facebook has a vast wealth of data about all of us but relatively few credit cards. Most of the credit card numbers it has -- a number it won't disclose -- it's accumulated from people who play games and pay up for virtual items. But that's far from enough for Facebook's ambitions.
The company has recently added other features that require credit card, and so far Facebook has given no indication for how those are going. In October, for instance, it started letting people pay $7 to promote a post. And earlier this month, it opened up Facebook Gifts to all U.S. users and added a range of new retail partners so that users can send friends everything from wine to clothes from BabyGap -- provided, of course, they enter a credit card. Anyone who's tried it might notice that Facebook doesn't take PayPal. Then, the next time you decide to buy a gift, your information card information pops up and is ready to go.
This is the way Facebook wants it, particularly if it rolls outs more services and offers that people can pay for through their phones. The more credit cards Facebook has on file, the more likely mobile users will send gifts or whatever else Facebook has in store as part of its business plan.
Facebook's messaging effort hardly seems like a slam dunk. To be fair, Facebook seems to be tip toeing into this, probably aware that some people might get annoyed if strangers are suddenly blasting them with messages. The pay-to-message experiment comes as part broader changes to Facebook's messaging system, which today is rolling out to every user worldwide. It's all a bit confusing in that Facebook sort of way.
Before these changes, users could send messages to strangers unless those people set restricted privacy settings, something Facebook says most people don't do. Under the new system, users can message anyone regardless of their privacy settings; the messages end up in a folder labeled "other," which is designed to catch spam. That's where the money comes in. To bypass the recipients "other" folder, users can pay $1 to make sure their messages end up in a person's main inbox. (This is not currently available for Pages, only individual Facebook members).
There is no way to opt out of this newly updated Messages system. The only way not to get messages from strangers is to block them after the fact. While those who don't want to message strangers may find the $1 messaging service odd, there are others who may find the option handy.
Facebook argues it would be useful if you were, for example, planning a surprise party for a friend through Facebook. Four of the five people you are inviting to this party are friends with you as well, but one is not. You could make sure the fifth person gets the invite in their Inbox, instead of the "other" folder, by paying the $1. Additionally, there are people -- recruiters, job seekers, public relations folks or (ahem) journalists -- who use Facebook to network.
Facebook won't say how many people use the messaging now or how many people send messages to users who aren't their friends. But if it rolls it out worldwide and only a small portion of Facebook's billion-plus members decide this is a worthwhile, there's still plenty of potential -- both for cash and credit.
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How to Capture Attention and Establish Trajectory
Frank Lloyd Wright said an expert is someone who has "stopped thinking because he 'knows.'"*
I ignored Warren Berger's email. It arrived on February 24, 2014, and sat in my inbox for weeks. He's written, "A More Beautiful Question." It sounded boring.
I don't need another book about questions. I'm the most curious question-asker I know. Leaders hire me to ask questions. I'm an expert. But, Warren's email wouldn't go away.
Knowledge closes minds; ignorance opens them.
You may be smart, but in a world where knowledge grows exponentially, no one knows.
The most dangerous lie leaders believe is they know.
Warren and I finally connected. I hate to admit it, but, he's as passionate about questions as I am. Worse yet, he's thought about questions in ways that hadn't occurred to me.
For example, what if your mission statement ended with a question mark? Statements are final and boring. Warren says they may even be arrogant.
Questions are invitations.
Mission Question:
A mission question says, "This is what we're striving for – we know we're not there yet, but we're on the journey."*
The feeling of "not yet" pulls you forward.
We love answers, at first. But, answers become outdated burdens with time.
A beautiful question lasts a lifetime.
Organizational questions:
Questions capture attention and establish trajectory. Your organization answers questions. What are they?
Everything you do is the answer to a question.
Connection happens when questions align. What if you create an organizational document titled, "These are the questions we're answering?"
Personal questions:
I've been answering three questions for ten years.
- Why did I suck at leadership for so long?
- How can I be a better leader today?
- How can I help others develop their leadership?
What questions are you answering?
What are your organization's questions?


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(RNS) In the wake of historic victories for gay rights supporters in last month's elections, a pair of USA Today/Gallup Polls find growing acceptance among Americans toward gay men and lesbians — and soaring optimism among gay Americans that issues involving homosexuality will one day no longer divide the nation.
In a survey of respondents who identified themselves as lesbian, gay, bisexual or transgender, three of four say they are generally open with others about their sexual orientation. More than nine of 10 say people in their community have become more accepting in recent years.
That feeling is ratified in a nationwide USA Today poll of all Americans that finds broad acceptance of economic rights for same-sex couples and majority support for gay marriage and adoption. A 51 percent majority predict that at some point, the country will reach a general agreement on such issues.
The changes echo times when attitudes toward African-Americans and women were in flux, scholars say. With young adults by far the most tolerant of homosexuality — among those 18 to 29 years old, 73 percent support same-sex marriage — the trend seems more likely to accelerate than reverse.
More than a third of Americans surveyed say their views have changed significantly over time toward gay marriage, an issue being battled in states across the country and before the Supreme Court. The high court could announce soon whether it will accept cases challenging California's Proposition 8 and the 1996 Defense of Marriage Act, which bars federal programs from recognizing same-sex marriages.
"They have changed from 'this is appalling' to, you know, 'what is wrong with that idea?'" said Mary Ann Schmertz, 82, a real estate agent in Wilkinsburg, Pa., describing her own views on the issue. In a follow-up interview after she was polled, she noted that her next-door neighbors are a gay couple.
"Why should they be discriminated against?" she said. "They're paying taxes. They're leading decent lives."
To be sure, significant opposition remains. While 53 percent support gay marriage, 46 percent oppose it. A third would go further: They say gay or lesbian relations between consenting adults should be illegal.
Lance Crawford, 29, a loan officer in Andover, Minn., could accept the idea of some benefits for gay couples, but he draws the line at the institution of marriage.
"I don't agree with it based on science reasons alone," he says, calling homosexuality unnatural. "It just opens the door for even more things in the future" that could undermine the country's morality.
Since 1998, voters in 30 states have approved constitutional amendments that define marriage as between a man and a woman, and eight other states have enacted statutes barring gay marriage. Nine states and the District of Columbia have moved to legalize same-sex marriages.
Since the issue was engaged in earnest less than two decades ago, public opinion has been reshaped. In 1996, a Gallup Poll found Americans opposing same-sex marriage by an overwhelming 68 percent to 27 percent. Now, an analysis of aggregated polls over the past decade shows movement toward support in every age group and every region.
In the new survey, the only age group in which a majority opposes same-sex marriage are those 65 and older, and the only region with majority opposition is the South.
Last month's elections may have marked a turning point. Maine, Maryland and Washington became the first states to approve same-sex marriage by popular vote. A fourth state, Minnesota, defeated a proposed constitutional amendment that would have defined marriage as between a man and a woman.
There were groundbreaking elections as well. In January, Tammy Baldwin of Wisconsin will become the first openly gay member of the U.S. Senate. Kyrsten Sinema of Arizona will be the first openly bisexual member of the U.S. House. A record four state legislatures — in California, Colorado, Oregon and Rhode Island — are poised to be led by openly gay Assembly speakers.
"We saw a landslide for equality across this country," says Chad Griffin, president of the Human Rights Campaign, the nation's largest political group representing lesbian, gay, bisexual and transgender interests. "There really is no other way to describe what happened on Election Night other than it was a watershed moment for equality in this country."
Brian Brown, president of the National Organization for Marriage, argues that the ballot measures legalizing same-sex marriage passed "in the deepest of deep-blue states." They are a spur to opponents, including his group, as they prepare for future battles.
"The biggest lesson for us is we will never again allow us to be outspent in this way," he said.
One possible reason behind changing attitudes: Nearly eight in 10 adults say they know a relative, friend or co-worker who is gay, and most describe that relationship as a close one. In the survey of gay men and lesbians, 73 percent say they are generally open about their sexual orientation with other people; 26 percent say they aren't.
"When you have a brother or sister or relation, a friend, whatever, it's a personal thing," says Mike Haigerty, 49, of Indianapolis, who was called in the poll. The director of religious education at a Catholic parish, he opposes same-sex marriage as a "slippery slope" that would separate sex from procreation in violation of his church's teachings.
Still, he says, "One of my closest friends has a younger brother who has a partner. I see their family at Christmas. Doug and John are great guys. We just don't talk about it. It's like 'don't ask, don't tell.'" When the issue is seen through the perspective of people you know, Haigerty says, "that really pulls on people's hearts."
Asked in an open-ended question why they back gay marriage, about one in 10 supporters cite friends or family members who are gay or lesbian. One-third volunteer that love and happiness should matter, not sexual orientation, and one-third cite equal rights. Fourteen percent say the issue shouldn't be one that is up to the government or them.
Asked why they are against gay marriage, nearly half of opponents say it violates the Bible's precepts or their religion; 16 percent call it morally wrong. Six percent say civil unions should be enough.
Indeed, a broad national consensus has emerged on granting same-sex couples the economic rights that civil unions generally guarantee. In the poll, more than three of four Americans support inheritance rights for same-sex couples and say gay men and lesbians should have access to their partners' health insurance and employee benefits.
Even among the demographic groups most strongly opposed to gay marriage — seniors, conservatives, Republicans and frequent churchgoers — a majority endorse those rights.
The national poll of 1,015 adults, taken Nov. 26-29, has a margin of error of plus or minus 4 percentage points. At the end of the survey, 4.9 percent said in response to a question that they were gay, lesbian, bisexual or transgender. That's higher than the 3.5 percent response Gallup typically has gotten, possibly because the previous survey questions dealt mostly with gay rights.
A separate poll was taken Nov. 27-29 of 251 adults who had identified themselves as lesbian, gay, bisexual or transgender in the Gallup daily tracking poll this year. The margin of error for that survey is plus or minus 6 percentage points.
(Susan Page writes for USA Today.)


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Taiwanese consumer electronics maker BenQ plans to launch a smartphone and a netbook running Google's Android operating system next year, a company representative confirmed Thursday.
The announcement adds BenQ to a growing list of companies either making or planning smartphones and mini-laptops running Android software instead of Microsoft Windows offerings. Android is a smartphone operating system developed by Google that is meant to make communications and Web browsing easy, especially on Google sites such as Gmail and Google Maps. The majority of netbooks today use Windows XP.
BenQ currently sells netbooks under the name Joybook Lite running Microsoft Windows XP, mobile phones with the Symbian OS and a mobile Internet device with a Linux OS. A few years ago, the company was a contender in the worldwide mobile phone industry but its acquisition of Siemens' mobile phone division went sour over mounting losses and lost market share.
The company hopes to market an Android-based smartphone next year, a BenQ representative said, as it attempts to rebuild its name in mobile phones. A netbook based on Android is also in the works, but its makeup hasn't yet been decided.
Most mini-laptops shown at Computex Taipei running Android use microprocessors from Arm Holdings, usually in chipsets from companies such as Qualcomm, Texas Instruments or Freescale Semiconductor. But Acer displayed a version of its Aspire One netbook with an Intel Atom microprocessor that also ran Android. Acer plans to ship that device in the third quarter.
Mini-laptops with Android from several other companies have been seen at Computex, including from Elitegroup Computer Systems, Inventec, Asustek Computer subsidiary Pegatron and an Android Eee PC from Asustek.


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Oxygen is one of the most significant keys to deciphering past climates. Oxygen comes in heavy and light varieties, or isotopes, which are useful for paleoclimate research. Like all elements, oxygen is made up of a nucleus of protons and neutrons, surrounded by a cloud of electrons. All oxygen atoms have 8 protons, but the nucleus might contain 8, 9, or 10 neutrons. "Light" oxygen-16, with 8 protons and 8 neutrons, is the most common isotope found in nature, followed by much lesser amounts of "heavy" oxygen-18, with 8 protons and 10 neutrons.
The ratio (relative amount) of these two types of oxygen in water changes with the climate. By determining how the ratio of heavy and light oxygen in marine sediments, ice cores, or fossils is different from a universally accepted standard, scientists can learn something about climate changes that have occurred in the past. The standard scientists use for comparison is based on the ratio of oxygen isotopes in ocean water at a depth of 200-500 meters.
What climate factors influence the ratio of oxygen isotopes in ocean water?
Evaporation and condensation are the two processes that most influence the ratio of heavy oxygen to light oxygen in the oceans. Water molecules are made up of two hydrogen atoms and one oxygen atom. Water molecules containing light oxygen evaporate slightly more readily than water molecules containing a heavy oxygen atom. At the same time, water vapor molecules containing the heavy variety of oxygen condense more readily.
As air cools by rising into the atmosphere or moving toward the poles, moisture begins to condense and fall as precipitation. At first, the rain contains a higher ratio of water made of heavy oxygen, since those molecules condense more easily than water vapor containing light oxygen. The remaining moisture in the air becomes depleted of heavy oxygen as the air continues to move poleward into colder regions. As the moisture reaches the upper latitudes, the falling rain or snow is made up of more and more water molecules containing light oxygen.
Ocean waters rich in heavy oxygen: During ice ages, cooler temperatures extend toward the equator, so the water vapor containing heavy oxygen rains out of the atmosphere at even lower latitudes than it does under milder conditions. The water vapor containing light oxygen moves toward the poles, eventually condenses, and falls onto the ice sheets where it stays. The water remaining in the ocean develops increasingly higher concentration of heavy oxygen compared to the universal standard, and the ice develops a higher concentration of light oxygen. Thus, high concentrations of heavy oxygen in the ocean tell scientists that light oxygen was trapped in the ice sheets. The exact oxygen ratios can show how much ice covered the Earth.
Ocean waters rich in light oxygen: Conversely, as temperatures rise, ice sheets melt, and freshwater runs into the ocean. Melting returns light oxygen to the water, and reduces the salinity of the oceans worldwide. Higher-than-standard global concentrations of light oxygen in ocean water indicate that global temperatures have warmed, resulting in less global ice cover and less saline waters. Because water vapor containing heavy oxygen condenses and falls as rain before water vapor containing light oxygen, higher-than-standard local concentrations of light oxygen indicate that the watersheds draining into the sea in that region experienced heavy rains, producing more diluted waters. Thus, scientists associate lower levels of heavy oxygen (again, compared to the standard) with fresher water, which on a global scale indicates warmer temperatures and melting, and on a local scale indicates heavier rainfall.
Paleoclimatologists use oxygen ratios from water trapped in glaciers as well as the oxygen absorbed in the shells of marine plants and animals to measure past temperatures and rainfall. In polar ice cores, the measurement is relatively simple: less heavy oxygen in the frozen water means that temperatures were cooler. Oxygen isotopes in ice cores taken from mountain tops closer to the equator are more difficult to measure since heavy oxygen tends to fall near the equator regardless of temperature. In shells, the measurement is far more complicated because the biological and chemical processes that form the shells skew the oxygen ratio in different ways depending on temperature.
Fossilized oxygen isotopes
The shells of tiny plants and animals and corals are typically made of calcium carbonate (CaCO3), which is the same as limestone, or chalk, or silicon dioxide (SiO2), similar to the compound common in quartz sand. As the shells form, they tend to incorporate more heavy oxygen than light oxygen, regardless of the oxygen ratio in the water. The biological and chemical processes that cause the shells to incorporate greater proportions of heavy oxygen become even more pronounced as the temperature drops, so that shells formed in cold waters have an even larger proportion of heavy oxygen than shells formed in warmer waters, where the difference is less notable. This temperature-based skew effect means that the oxygen isotope make-up of shells would not precisely match the make-up of the ocean water in which they grew. Scientists must correct for this skew if they are to learn about the ratio of oxygen isotopes in the ocean waters where the shells formed.
Correcting for the Skew: Scientists can correct for the temperature factor by looking at other chemicals in the shells. In coral, for example, the balance between strontium and calcium is determined by temperature. By measuring the amounts of these chemicals in the coral, scientists can determine the ocean's temperature, then calculate how much more heavy oxygen the shells were likely to incorporate at that temperature. Discrepancies in the oxygen isotope ratio after the temperature correction reveal changes in the ocean's local salinity, which is related to evaporation, rainfall and runoff, and global salinity—a measure of the total amount of ice in the world.
The oxygen isotope ratio has the potential to tell scientists about past climate anywhere that the ratio is preserved in water chemistry or elsewhere. Scientists are moving forward to apply this powerful tool to more and more branches of paleoclimatology.


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Today's book feature is for the romantic at heart. I hope you enjoy today's book and as always, please leave an honest review .
Book title:
Reel Love
Author's name:
Elizabeth Hartey
Sometimes you land a great job, meet your soul mate and live happily ever after – nothing else required. This isn't one of those times.
Annie Caslo is a successful young doctor, but when she begins rethinking the career choices she's made, she makes a decision to find a way to stay focused and achieve her true ambitions – that is, until fate steps in and she is thunderstruck by Colt Ballard. He's six foot three inches of heart-stopping hotness, an adept, roguish soccer star and one of her interns. But he's a player – on and off the field – and Annie has better things to do. Still, the combustible chemistry between them is impossible to resist – Colt brings out feelings she never knew existed and Annie's swept off her reluctant feet.
When she continues to second-guess her life choices, opportunitites and obstacles begin piling up higher than the greasy Mexican food stacks she hates to admit loving. While in a state of emotional turmoil, she gets a celestial visit from a hunky, Hollywood heartthrob lookalike, who claims to be her guardian angel. He takes her on a magical road trip to self-discovery with the help of several dearly departed film icons.
Drawn into the excitement of a life she's always dreamed of, this new life threatens to shatter the life and love she already has – unless her quirky angel can help her find a way to have it all.
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About the Author:
Elizabeth lives and writes in Pennsylvania.
As a lover of the northeast USA, Elizabeth and her husband moved to the Poconos several years ago to open a Chiropractic Clinic. Four children and a menagerie of animals later, she has finally found time to fulfill her lifelong dream of writing novels. A dreamer at heart, romance is, of course, the genre she spends most of her time writing and reading into the wee hours of the morning. When she's not juggling work responsibilities and writing, she enjoys swimming, knitting, hiking the beautiful hills and woods around her home, and spending time with her family.
Connect with Elizabeth at the following links:
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By Diego Ore
CARACAS (Reuters) - Venezuela said on Tuesday it would start crushing abandoned cars and bicycles to provide raw materials for housing construction and supplement drastically reduced amounts of local steel.
"We have sent 10,485 automobiles, 9,651 motorbikes and 539 bicycles to the national steel industry," Maria Martinez, a deputy justice minister, said during a visit to an abandoned car deposit outside Caracas.
That quantity of steel, she said, could be used for rebars, which reinforce concrete, in the construction of tens of thousands of housing units.
In one of late socialist leader Hugo Chavez's most popular policies, the "Great Venezuelan Housing Mission," authorities built or refurbished more than 250,000 housing units in 2012 for low-income families. That fell to around 150,000 last year.
Production of rebars in March 2014 was at an 18-year monthly low of 8,796 tonnes, down from 46,051 tonnes in March last year.
Venezuelan steelmaker Sidor has an installed annual capacity of 5 million tonnes, but output has declined since its nationalization six years ago due to frequent protests and insufficient investment.
Total steel output reached a 16-year low of 1.5 million tonnes in 2012, and was only slightly higher at 1.6 million in 2013.
The steelmaker's problems are part of a general malaise in the South American OPEC nation's once-buoyant metals industry.
(Reporting by Diego Ore; Writing by Andrew Cawthorne; Editing by Toni Reinhold)


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Italy and Golf is recognized as the pioneering Italian luxury golf and travel company in the world. Since 2008, we've been designing and implementing luxury golf experiences in Italy, a country where our personal connections run deep. We offer custom-made golf trips on the Italian peninsula, linking you with the country's finest "links," while throwing in a few once-in-a-lifetime experiences to round out your vacation.
Whether it's organizing a private table for two in front of Michaelangelo's David, flying Italy's
chef-of-the-moment in to cook at your own Tuscan villa, or tracking down the local nonna for that oh-so-delicious tortellini recipe, we at Italy and Golf go the extra mile to make each of our trips perfect little miracles—surprising, novel, and always made to fit.
Give us a call or drop us a line. We'd love to hear from you.
From all of us at Italy and Golf.


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Alex Rodriguez, others suspended by MLB for drugs
NEW YORK (AP) — Alex Rodriguez was suspended through 2014 and All-Stars Nelson Cruz, Jhonny Peralta and Everth Cabrera were banned 50 games apiece Monday when Major League Baseball disciplined 13 players in a drug case — the most sweeping punishment since the Black Sox scandal nearly a century ago.
Ryan Braun's 65-game suspension last month and previous punishments bring to 18 the total number of players disciplined for their relationship to Biogenesis of America, a closed anti-aging clinic in Florida accused of distributing banned performing-enhancing drugs.
The harshest penalty was reserved for Rodriguez, a three-time Most Valuable Player and baseball's highest-paid star. His suspension covers 211 games, starting Thursday, and he is expected to appeal.
The New York Yankees slugger admitted four years ago that he used performance-enhancing drugs while with Texas from 2001-03 but has repeatedly denied using them since.
via Alex Rodriguez, others suspended by MLB for drugs


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Mad-As-Hell Pastor Declares Holy War on Wedding Photographers
A couple exchanging vows on their wedding day were visibly stunned when their very own pastor stopped the ceremony in the middle so he could scold the photographers for standing too close.
"Please sirs, leave, please," the Episcopalian priest testily tells the photographer and videographer standing directly behind the altar. "This is a solemn assembly not a photography session. Please move or I will stop."
As the bride and groom glance at each other with bewilderment at the officiant's clearly long-standing grudge against people with cameras, he continues to damn the professionals hired by the family to perdition.
"I will stop the ceremony if you do not get out of the way," insists the mad-as-hell minster. "This is not about the photography, this is about God."
Damn photosexuals ruining the sanctity of marriage.


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Wingshooting is an eye/hand coordination game. The eyes see the target and send information about the target to the brain. The brain then signals the finger to pull the trigger once the desired lead picture is confirmed. This process sounds easy, and it is when the pieces of the puzzle fall into place. So let's get right to those pieces of the puzzle.
Once a shooter learns to use his vision to see the target, he must have a working knowledge and understanding of the physical movement required to place the muzzle of his shotgun in a location relative to that moving target. When the muzzle of the gun is pushed to the right spot, the pellets from the fired shotshell will impact the intended target.
He must take into consideration that he is sending a speeding shot charge traveling somewhere in the neighborhood of 800 miles per hour in the direction of a moving target traveling at a much slower pace.
The very best shooters seem to have a knack for deciphering information that includes target speed, angle and distance so as to allow their eyes and hands work as a team in placing the shotgun muzzle in just that right spot relative to the target as the trigger is pulled. The not so skilled or trained, however, can visibly struggle with the same challenge.
It is true that some members of the species homo sapien have inherently better physical and visual skills to draw from. These individuals tend to be the so-called "natural" shots that you might hear about from time to time. This natural ability is merely a superior blend of eye/hand coordination that one might find in professional athletes such as baseball or tennis players.
In fact, most professional athletes make excellent wingshooters because of their ability to let their eyes lead their hands to a successful end. Great vision and superb reflexes allow those natural shots to see and react to moving objects in a totally different way than does the average shooter.
Since most shooters don't have the aforementioned tremendous natural ability, it is comforting to know that wingshooting skills can be learned and subsequently developed through proper training and practice. Like most top athletes in other sports, the best shooters constantly hone their skills by taking quality instruction and practicing continuously.
This book is written to provide concise information that, when applied properly, can open a number of doors that lead to significant improvement of one's wingshooting skills. The most effective way to do this is to break a successful shot down to its most basic elements.
First of all, shooting a shotgun is much like pointing your finger. You will find that by simply focusing on an object and then pointing at it with either hand, chances are pretty good that you will never miss that object with your finger. This will be the case whether the chosen target is stationary or moving. Give it a try. Pick out an object and point at it while keeping both eyes open.
Remember to point and not aim. Right on, I'll bet. So if you can successfully allow the eyes to lead the hands to an object without a shotgun in them, chances are you can do the same thing with a shotgun in hand.
Keep in mind that wingshooting is quite different from shooting a stationary object with a rifle or a pistol. Those types of firearms have both front and rear sights that must be properly aligned on a target in order to hit it with a single projectile.
Since this alignment must be very precise, hitting a moving object like a speedy game bird with either of them would be very difficult. Click here to read part 2
This article is an excerpt from the Gun Digest Book of Shotgunning.
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If you have unneeded swap space, you can remove it.
Become superuser.
Remove the swap space.
# /usr/sbin/swap -d /path/filename
The swap file name is removed so that it is no longer available for swapping. The file itself is not deleted.
Edit the /etc/vfstab file and delete the entry for the swap file.
Recover the disk space so that you can use it for something else.
# rm /path/filename
If the swap space is a file, remove it. Or, if the swap space is on a separate slice and you are sure you will not need it again, make a new file system and mount the file system.
For information on mounting a file system, see Chapter 40, Mounting and Unmounting File Systems (Tasks).
Verify that the swap file is no longer available.
# swap -l
The following examples shows how to delete the /files/swapfile swap file.
# swap -d /files/swapfile # (Remove the swap entry from the /etc/vfstab file) # rm /files/swapfile # swap -l swapfile dev swaplo blocks free /dev/dsk/c0t0d0s1 136,1 16 1638608 1600528


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Is 'Jackass 4′ Secretly in the Works?
'Jackass 3D' was (another) huge hit in the franchise, so 'Jackass 4′ always seemed like something of an inevitability. But part of the fun of 'Jackass 3D' was watching the stunts catch up on the aging cast and there was some speculation, they're retire after completing the trilogy. Not quite. 'Jackass 4′ looks like it could be on the way after all…
Some online sleuths at What Culture recently found out that Paramount Pictures has purchased a handful of domain names centered around 'Jackass 4′ including jackass4movie.com. What's most interesting is that the majority of the sites registered center around Johnny Knoxville's "Bad Grandpa" character (jackass4badgrampa.com, jackass4badgrampamovie.com and jackass4badgrandpa.com among them).
Obviously there are no details about the film (would it center entirely on the Bad Grandpa character and how exactly does that work?…) but domain names have an interesting way of predicting the future. Both 'Skyfall' and 'Star Wars 1313' were outed after web-savvy folk recognized a number of interesting online purchases.
The "Bad Grandpa" skits revolve around Knoxville, under makeup and prosthetics to look like an old man, going out in public and acting, well, like a jackass. People get shocked, upset and sometimes challenge him to a fight (yes, the challenge what they think is a decrepit old man to a fight). We've included one of the skits below so you can familiarize yourself.
So what do Knoxville and pals have in store for 'Jackass 4?' Do you think it'll be a film based on that one character or just another compilation of their usual stunts?


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Dec 13, 2012
European court of human rights finds against CIA abuse of Khaled el-Masri
America must now apologise to the German citizen, a victim of mistaken identity who
was kidnapped and beaten by the CIA
By Amrit Singh
Source: The Guardian
The much-maligned European court of human rights has this week shown itself at its
very best: standing up for the rights of an individual who has been denied justice for
almost nine years since he was abducted, secretly detained, and tortured under the
CIA's rendition program.
Khaled El-Masri, a German national, was seized by Macedonian security officers on
31 December 2003, at a border crossing, because he had been mistaken for an al-
Qaida suspect. He was held incommunicado and abused in Macedonian custody for
23 days, after which he was handcuffed, blindfolded, and driven to Skopje airport,
where he was handed over to the CIA and severely beaten.
The CIA stripped, hooded, shackled, and sodomized el-Masri with a suppository – in
CIA parlance, subjected him to "capture shock" – as Macedonian officials stood by.
The CIA drugged him and flew him to Kabul to be locked up in a secret prison known
as the "Salt Pit", where he was slammed into walls, kicked, beaten, and subjected to
other forms of abuse. Held at the Salt Pit for four months, el-Masri was never charged,
brought before a judge, or given access to his family or German government
The CIA ultimately realised that it had mistaken el-Masri for an al-Qaida suspect with a
similar name. But it held on to him for weeks after that. It was not until 24 May 2004,
that he was flown, blindfolded, earmuffed, and chained to his seat, to Albania, where
he was dumped on the side of the road without explanation.
In December 2005, German Chancellor Angela Merkel told a press conference – while
then Secretary of State Condoleezza Rice stood by her side – that the United States
had admitted it had made a mistake. But the US government still refused to
acknowledge its shameful conduct in el-Masri's case and waged a successful
campaign to prevent other governments from disclosing the truth.
El-Masri's subsequent search for justice has repeatedly been thwarted. The United
States succeeded in getting el-Masri's US lawsuit dismissed on "state secrets"
grounds without even responding to his allegations; in 2007, the US supreme court
declined to review that dismissal. The Macedonian government resorted to bald-faced
lies, claiming that it played no role in his detention or abuse, despite overwhelming
evidence confirming his account. The German government refused to disclose what it
knew about el-Masri's case, and apparently caved to US pressure not to seek
extradition of CIA officials involved in el-Masri's rendition.
Today, the European court of human rights delivered a measure of justice to el-Masri.
It vindicated his account of his ill-treatment, and unanimously found that Macedonia
had violated his rights under the European Convention, including by transferring him
to US custody in the face of a risk of ill-treatment, and facilitating and failing to prevent
his being subjected to CIA "capture shock" at Skopje airport.
This is the first court to comprehensively and specifically find that the CIA's rendition
techniques amounted to torture. The decision stands in sharp contrast to the abject
failure of US courts to deliver justice to victims of US torture and rendition.
Both the United States and Macedonia must now issue el-Masri a full-scale public
apology and appropriate compensation. Macedonia should also commit to an
internationalized investigation capable of holding its officials accountable. There are
plenty of examples of such inquiries into national issues that are too politically
charged to handle unaided: Northern Ireland's 1997 Independent International
Commission on Decommissioning (IICD) included members from Canada, the United
States, and Finland.
But Europe's work is not over yet. Macedonia was not the only European country
complicit in CIA renditions. A 2006 inquiry by Swiss Senator Dick Marty implicated 14
European governments – including the United Kingdom – in the CIA's "spider's web"
of rendition operations. But with the exception of Italy, whose highest court recently
upheld the convictions of US and Italian officials for involvement in rendition, neither
the UK nor other complicit countries – including Lithuania, Romania, and Poland,
which hosted secret CIA prisons – have conducted effective investigations capable of
holding officials accountable for their participation in rendition.
The human rights principles at stake extend to the use of the death penalty.
European governments are prohibited from transferring criminal suspects to the
United States if they risk execution; yet Abd al-Rahim al-Nashiri, a Saudi national, was
secretly flown to Guantánamo Bay after being held in secret CIA prisons in Romania
and Poland. He now faces a possible death sentence after a trial by military
commission that does not meet international standards.
The European court's decision in the el-Masri case is a clarion call for accountability
for the flagrantly illegal CIA rendition program.
The time has come for European governments to stand up to the United States and
break the conspiracy of silence, regardless of the diplomatic consequences. As
former Human Rights Commissioner for the Council of Europe, Thomas Hammerberg,
rightly said on the occasion of the tenth anniversary of the 11 September attacks:
"The purported cost to transatlantic relations of pursuing such accountability cannot
be compared to the damage inflicted on our European system of human rights
protection by allowing ourselves to be kept in the dark."


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Hurricane Preparedness
Florida's prime tropical location has many benefits. The sun, the sand, the surf—what's not to love? Our area's relaxed atmosphere and environment make it a great place to vacation or stay for a lifetime. Many locals know that our sunshine state comes with some downsides which can include hurricanes. By staying thoroughly prepared, you can effectively manage the effects of these storms. Follow these tips for ways to keep your family safe this hurricane season.
Create an Evacuation Plan
If your area is ordered to evacuate, you should leave as early as possible to avoid possible traffic congestion. Devising a plan is imperative for your family. Ask yourself, how will you communicate during the storm? Where will you meet if you are separated? Which route will you take? Does your local shelter accept all pets or only service animals? Will any of your elderly neighbors need rides? These are all things to consider when developing your family's emergency preparedness plan. Share the plan with family members digitally so everyone has access to it while they're on the move.
Keep Storm Supplies Stocked Year-Round
Don't wait until the last minute to grab water, flashlights, batteries, first aid kits and nonperishable food. Shelves may be empty or you may have to wait in long lines to purchase what you need. Instead, create a food supply to keep in stock year-round along with a two-week supply of water. Each person in your household needs at least one gallon of water per day, including pets. Keep more water in stock for pregnant women or anyone who is ill. Take note of expiration dates on store-bought water. Replace non-store bought water in supply every six months.
Make Sure Your Home Is In Tip Top Shape
Give your house a storm checkup. Be sure to look for roof leaks or other structural flaws that may become more severe or compromised if faced with hurricane force winds. Before a storm, clean out your gutters and drains, board up your windows and place sandbags at entry points around your home. The City offers sand and bags to residents free of charge. Check the City website before a storm for distribution locations.
Check Your Flood Insurance Coverage
Your home can flood regardless of where you live, even if it's not near water. Before Hurricane Irma, Florida residents called their insurance companies to add flood coverage to their policies, only to learn that it can take up to 30 days for it to go into effect. Add protection early and check your home's risk of flooding by entering your address at www.floodsmart.gov.
Make Copies of Important Documents
Store print copies in waterproof containers or create password protected digital copies of important documents. Take pictures of your valuables along with their serial numbers and upload those as well. You may need to have these files on hand when submitting claims to prove ownership of your house, car, boat, computer and other valuables.
Gather Prescription Medicine
Have more than just a couple days of prescription medicine on hand. Some pharmacies will remain closed for weeks after a hurricane. Also, check on elderly or ill neighbors to verify they have an adequate supply of medication.
Know Where to Find Storm Information
If you have questions before, during and after a storm, it's important to know whom to contact in the event something happens during a hurricane. Although your address may be listed as Altamonte Springs, you might actually fall under Seminole County's jurisdiction. To find out, enter your address at the Seminole County Property Appraiser website (www.SCPAFL.org). This will help you determine whether you call the City or county for assistance.
Additional Resources:
- National Hurricane Center
- Seminole County Office of Emergency Management
- Centers for Disease Control & Prevention
- Department of Homeland Security


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Academic Exchange to USC
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M.S.Sc. Programme in Clinical Psychology
(2019 Entry)
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(2019 Entry)
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Music as Medicine: Can singing together prevent cognitive decline in aging?
Interview Skills Workshop
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Meaning survives visual crowding, but not semantic integration over time
Training in Guided Self-Help for Low Intensity Psychological Interventions
Semantic Retrieval and Integration during Sentence Reading: Evidence from Temporal and Spatial Dynamics
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(2018 Entry)
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(2018 Entry)
Understanding individual differences in psychiatry – genetics versus environmental influences
The Social Construction of Adolescence: Insights from the United States and China
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Future Orientation: Temporal Correlates, Genetic Mechanisms,and their Implications for Health Behaviors and Depression
Applied Decision (Neuro)science: Culture, Beauty and Architecture
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Eye Movements in Reading: Perceptual Span and Parafoveal Processing
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OVERVIEW: What every practitioner needs to know
Are you sure your patient has rabies? What should you expect to find?
The symptoms found in a patient with rabies infection depend on 1) the form and 2) the stage of the disease. There are two classic forms of rabies: encephalitic and paralytic. A third, much less common form is discussed later. Each of these forms evolve through five general stages: incubation, prodromal, acute neurological, coma, and death.
Apart from the initial pain and inflammation from tissue destruction at the site of the bite, the incubation stage is largely asymptomatic, regardless of the form that the disease possesses.
In the prodromal stage the patient may subjectively experience systemic, nonspecific flu-like symptoms including low-grade fever, malaise, nausea, vomiting, anorexia, irritability, and sore throat. Also, during the prodromal period the patient may experience focal symptoms at the portal of innoculation including pain, parasthesias, and pruritus. In the paralytic form of rabies the prodromal period may present with choreiform movements of the bitten limb.
Following the prodromal stage is the acute neurological syndrome in which the patient experiences a variety of symptoms that depend on the clinical form that the rabies infection has undertaken.
Encephalitic rabies. In the encephalitic form of rabies the acute neurological syndrome classically includes painful pharyngeal spasms after exposure to a gust of air (aerophobia) or a drink of water (hydrophobia). The patient may also experience fever, hypersalivation, hyperactivity, fluctuating consciousness, and seizures.Related Content
Paralytic rabies. In the paralytic form of rabies the acute neurological syndrome may present with generalized weakness and quadriparesis, thereby making it difficult to distinguish from Guillain–Barré syndrome. Distinguishing symptoms in paralytic rabies may include a lack of sensation disturbances (with the exception at the bite site), the presence of bladder dysfunction, and persistent fever coinciding with limb weakness. Cerebral involvement may not appear until late in the course making the diagnosis difficult.
During the coma stage the patient may become nonresponsive, and in addition experience worsening hydrophobia, prolonged apnea, and generalized flaccid paralysis which leads to respiratory and cardiovascular collapse. The ultimate end point in the natural history of an untreated rabies infection is death.
Key physical findings:
focal brain stem signs
hemisensory loss
Horner syndrome
convulsive/nonconvulsive seizures
fluctuating consciousness that changes between normal, agitation, confusion, depression, and coma
hyperactive gag reflex
phobic or inspiratory spasms
autonomic dysfunction including hypersalivation, fixed pupils, piloerection, excessive sweating, priapism, spontaneous ejaculations
local reaction at site of bite
excoriation secondary to pruritus
weakness (paralytic rabies)
percussion myodema (paralytic rabies)
bladder dysfunction (paralytic rabies)
How did the patient develop rabies? What was the primary source from which the infection spread?
On a global scale, rabies infection transmitted from a canine vector represents the overwhelming majority of cases. However, in developed countries domestic animals (dogs, cats, and cattle) only account for 10% of human exposures, while wild animals (skunks, foxes, raccoons, bats, and coyotes) account for the other 90%. In the United States, bats represent the most common source of clinical rabies infection.
Rabies is usually transmitted from infected animal bites, but may also be transmitted by scratches, secretions that contaminate mucous membranes, aerosolized virus that enters the respiratory tract, and corneal transplants.
Which individuals are of greater risk of developing rabies?
In developed countries, individuals at high risk for exposure to rabies virus includes: veterinarians, animal handlers, laboratory personnel who handle infected specimens, diagnosticians, cave explorers where the virus is common, and travelers to areas with endemic canine rabies. These individuals would benefit from preexposure prophylaxis.
While all bites should be treated with the same urgency, individuals who have sustained bites on the head, face, neck, and hand, particularly with bleeding, carry the highest risk of developing clinical rabies and are generally associated with shorter incubation periods.
Beware: there are other diseases that can mimic rabies:
Diseases that can mimic encephalitic rabies:
viral encephalitis (i.e. Japanese, eastern equine, West Nile)
delirium tremens
acute substance intoxication (i.e. cocaine, amphetamines)
acute psychoses
bacterial meningitis
cerebral malaria
post-rabies vaccination encephalopathy
bite of an elapid snake (i.e., cobra)
Diseases that can mimic paralytic rabies:
Guillain–Barré syndrome
bite of an elapid snake (i.e., cobra)
What laboratory studies should you order and what should you expect to find?
Results consistent with the diagnosis
Most routine laboratory tests are nondiagnostic, however hyponatremia is often present, and routine cerebrospinal fluid (CSF) chemistries often show a moderate lymphocytosis (5 to 30 white cells/μL) , normal glucose, and a moderate increase in protein (usually <100mg/dL).
Results that confirm the diagnosis
Saliva: Diagnostic laboratory tests include detection of virus ribonucleic acid (RNA) (by reverse transcriptase polymerase chain reaction, RT/PCR) and isolation of infectious virus in cell culture.
Skin biopsy: A section of full thickness skin 5 to 6mm in diameter should be taken from the posterior region of the neck at the hairline. The sample should contain a minimum of approximately ten hair follicles and include the cutaneous nerves at the base of the follicle. Laboratory tests to be performed include RT/PCR and immunofluorescence staining for viral antigen.
Serum and CSF: Due to intermittent shedding of virus, serum antibodies to rabies virus may not be present until several days after the onset of clinical signs and may appear even later in the CSF, therefore serial testing is often needed. If no vaccine or rabies immune serum has been given, the presence of antibody to rabies virus in serum is diagnostic of infection. If the patient has been immunized, a second specimen should be obtained a few days later to see if antibody titers are rising. Antibody to virus in CSF, regardless of the immunization history, suggests virus infection. Laboratory tests include indirect immunofluorescence and virus neutralization.
What imaging studies will be helpful in making or excluding the diagnosis of rabies?
Head imaging can neither definitively diagnose nor exclude rabies. However, certain findings in head magnetic resonance imaging scans may be suggestive or consistent with rabies, including hypersignaling in the brainstem, hippocampus, or hypothalamus. Gadolinium enhancement is only found in the late stages of the disease.
What consult service or services would be helpful for making the diagnosis and assisting with treatment?
If you decide the patient has rabies, what therapies should you initiate immediately?
Key principles of therapy:
Unless vaccine is administered prior to the onset of symptoms, rabies infection is nearly always fatal. Symptomatic rabies treatment is largely supportive. Therefore, the cornerstone in management of rabies infection is 1) exposure prevention, 2) pre-exposure prophylaxis, and 3) postexposure prophylaxis.
Other key principles in rabies therapy:
The US Centers for Disease Control and Prevention recommends postexposure prophylaxis for anyone who has contact with a bat, even if there is no evidence of a bite. This is because the bite mark of a bat can be extremely small, the virus can be transmitted via aersolization, and the bite may have occurred in an individual unable to communicate or who is unaware of the incident. Possible examples include when a bat is found in the room of any person who awakens from sleep, young infants, intoxicated individuals, and mentally incapacitated individuals.
The animal responsible for exposure should be captured and undergo testing for rabies. Postexposure prophylaxis should be discontinued if the animal in question is found to have a negative rabies test.
Anti-infective agents:
Pre-exposure prophylaxis: Administered to individuals who are at high risk for coming in contact with rabies virus.
Three 1mL intramuscular injections of either human diploid cell vaccine (HDCV, trade name Imovax) or purified chick embryo cell vaccine (PCECV, trade name RabAvert) administered on days 0, 7, and 21 or 28.
Postexposure prophylaxis: The precise course of postexposure prophylaxis is dependent on the vaccination status of the individual who has been infected. The decision to initiate postexposure prophylaxis should occur swiftly, as delays may increase an individual's risk for developing clinical rabies. When used appropriately, postexposure prophylaxis is nearly 100% effective.
The first step is always thorough wound cleansing with soap and water for a minimum duration of 15 minutes. Virucidal antiseptics such as povidone iodine and ethanol may also be used. Closure of bite and scratch wounds should be avoided.
Protocol from here depends on the vaccination status of the infected patient. For patients not previously vaccinated, who were vaccinated more than 2 years earlier, or whose titers have decreased below 0.5IU/mL.
Either rabies vaccine (HDCV or PCECV) should be administered immediately (day 0) and subsequently administered on day 3, 7, and 14. Vaccine should be administered at a site distant from administration of human rabies immune globulin (HRIG), as HRIG can interfere with the immune action of the vaccine. If the patient is immunosuppressed than an additional dose of vaccine should be given on day 28.
HRIG (tradename HyperRAB S/D or Imogam Rabies HT) 20IU/kg should be immediately administered directly into the wound, or if no wound is apparent, intramuscularly in the upper arm or lateral thigh muscle. If HRIG is not given on the same day the first vaccination is given (day 0) it can be given up to day 7 of the vaccination series. After day 7 an immune response should have occurred so use of HRIG is no longer warranted.
For patients who have received vaccination within the previous 2 years:
HDCV or PCECV should be administered immediately (day 0). A second dose should be administered on day 3.
No HRIG is warranted as passive antibody administration may interfere with innate antibody production.
If I am not sure what pathogen is causing the infection what anti-infective should I order?
If rabies exposure is suspected, the postexposure prophylaxis per above should be swiftly initiated. Summary of prophylaxis recommendations are show in Table I.
Table I.
|Type of prophylaxis
|Pre-exposure prophylaxis
|Rabies vaccine
|1mL on days 0, 7, and 21 or 28
|Postexposure prophylaxis in patients not previously vaccinated, were vaccinated >2 years earlier, or whose titers have decreased to <0.5IU/mL
|Rabies vaccineHuman rabies immune globulin
|1mL on days 0, 3, 7, and 1420IU/kg (0.133mL/kg) on days 0–7
|Postexposure prophylaxis in patients vaccinated within previous 2 years
|Rabies vaccine
|1mL on days 0 and 3
2. Other key therapeutic modalities
Symptomatic rabies in the absence of prophylaxis has been shown to be nearly uniformly fatal. Therefore, the cornerstone of human rabies management remains prophylaxis.
Treatment of symptomatic rabies is usually palliative, and focuses mostly on nutrition, pain control, sedation, and appropriate quarantine measures.
The Milwaukee Protocol was developed after the survival of a young patient in Wisconsin diagnosed with symptomatic rabies. To date, she remains the only documented survivor of symptomatic rabies infection in a patient who did not receive some form of prophylaxis. The protocol consists of induction into a therapeutic coma with ketamine—which has been shown to inhibit rabies virus replication in vitro—and benzodiazepines with subsequent administration of amantadine and ribavirin. Subsequent uses of the Milwaukee Protocol or variants of the protocol have not resulted in patient survival.
What complications could arise as a consequence of rabies?
What should you tell the family about the patient's prognosis?
Prognosis in patients with potential rabies virus exposure but who receive timely prophylaxis remains excellent from both a morbidity and mortality standpoint.
Rabies is associated with the highest case fatality of any infectious disease. Ergo, prognosis in patients with symptomatic rabies infection remains exceedingly poor. It should be stressed that family members of patients with symptomatic rabies that elect to undergo aggressive treatment protocols such as the Milwaukee Protocol must be informed about the high likelihood of mortality, and that even if mortality is averted that there is a high likelihood that the patient will experience permanent neurologic sequelae.
What-if scenarios:
Factors that may be associated with better outcomes in symptomatic rabid patients are younger age, vaccination before the onset of symptoms, relatively few or no comorbidities, and early presentation at the time of treatment initiation.
How do you contract rabies and how frequent is this disease?
Each year approximately 55,000 people worldwide die of rabies, with 95% of victims reported residing in Asia or Africa. Only 61 cases of human rabies were diagnosed in the United States from 1980 through 2006, an average of approximately two per year. In developing countries, the overwhelming majority of rabies transmission happens from dogs. In the United States, where there are strict canine vaccination policies in place, rabies vectors are primarily sylvatic and include bats, raccoons, skunks, foxes, and coyotes. The majority of clinical rabies cases in humans within the United States have been attributed to bat-associated rabies, and in particular silver-haired bats (Lasionycteris noctivagans) and eastern pipestrelle bats (Pipistrellus subflavus).
Although the incidence of human rabies is very low in the United States, approximately 16,000 to 39,000 cases with contact to potentially rabid animals receive rabies postexposure prophylaxis annually.
While on a global scale the vast majority of rabies cases are found in Asia and Africa, rabies is endemic to the continental United States, Canada, Europe, Latin America, and Australia as well. Hawaii remains rabies free, as do several other islands, including the British Isles, New Zealand, Japan, Taiwan, and many of the Caribbean islands.
What pathogens are responsible for this disease?
Rabies is caused by infection from a negative-stranded, RNA virus with the following classification:
Order: Mononegavirales
Family: Rhabdoviridae
Genus: Lyssavirus
There are seven recognized genotypes. The genotypes responsible for causing human rabies are types 1 (which is found in terrestrial animals), and 3 to 7.
How do these pathogens cause rabies?
Generally, rabies is transmitted by saliva from infected animal bites, but may also be transmitted by scratches, secretions that contaminate mucous membranes, aersolized virus that enters the respiratory tract, and corneal transplants.
In canine rabies virus, the viral glycoprotein may bind to nicotinic acetylcholine receptors on the muscle, whereas in some bat lyssaviruses the virus may bind to unknown receptors in the dermis or epidermis.
After budding from the plasma membrane of the muscle cells, the virus is taken up into unmyelinated nerve endings at neuromusclar junctions or at the muscle spindles, and is transported to the central nervous system via retrograde axoplasmic flow. Travel from the peripheral nerves to the central nervous system (CNS) occurs at a rate of anywhere between 8 to 100mm/day.
Once the virus reaches the dorsal-root ganglia and anterior-horn cells it replicates again. At the dorsal-root ganglia, viral replication may be recognized and attacked by the immune system, resulting in ganglioneuronitis which clinically manifests itself as prodromal neuropathic pain at the bite site. This is clinically significant because once the patient is experiencing prodromal symptoms, prophylaxis with vaccine and HRIG has not been shown to be able to prevent death.
Once the virus reaches the CNS rapid dissemination occurs, with preferential localization to the brainstem, thalamus, basal ganglia, and spinal cord. From there, the virus centrifugally spreads from the CNS throughout the rest of the peripheral nervous system and the organs they innervate, especially to highly innervated areas such as salivary glands. This causes the classic presentation of hypersalivation and spasms of the pharyngeal muscles at the sound, sight, or taste of water. All major neural and nonneural organs may contain significant viral load.
Eventually the systemic viral burden manifests itself as encephalomyelitis, generalized nervous system failure, and death.
What other clinical manifestations may help me to diagnose and manage rabies?
Apart from the more common encephalitc and paralytic form of rabies, there is a third, atypical form that is seen less often.
Patients who have bat-associated rabies are at higher risk for developing the atypical form of rabies.
In the atypical form of rabies the acute neurological syndrome consists mostly of neuropathic and even radicular pain, convulsive and nonconvulsive seizures, hallucinations, hemiparesis, hemisensory loss, ataxia, vertigo, and facial and bulbar weakness with preserved arm strength or bilateral arm weakness.
What other additional laboratory findings may be ordered?
Brain biopsy: This test is not usually done antemortem, however virus isolation RT/PCR and immunofluorescence staining for viral antigen can be diagnostic for rabies infection.
How can rabies be prevented?
Prevention is the cornerstone in rabies management. Apart from the specific measures required in preexposure and postexposure prophylaxis (please see section on "Anti-infective agents" above), exposure prevention is a vital component in rabies prevention.
A society that creates and enforces strict animal vaccination policies is a key preventative measure. Pets should be supervised so they do not come into contact with wild animals. Communities should maintain animal-control agencies to remove stray or wild animals. Wild animals that are a natural reservoir of rabies virus, such as coyotes, raccoons, skunks, foxes, and bats should be enjoyed at a distance but not adopted or handled by nonprofessionals. At-risk homes can be bat-proofed by covering ventilation openings with screens.
WHAT'S THE EVIDENCE for specific management and treatment recommendations?
Manning, SE, Rupprecht, CE, Fishbein, D. "Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices". MMWR Recomm Rep. vol. 57. 2008. pp. 1-28. (The Advisory Committee on Immunization Practices periodically updates the recommendations on a variety of communicable diseases, including rabies.)
"Bats and rabies: a public health guide, 2008". 18 May 2011. (The Centers for Disease Control provides common sense guidelines and facts pertaining to rabies on their public website.)
Finnegan, CJ, Brookes, SM, Johnson, N. "Rabies in North America and Europe". J R Soc Med. vol. 95. 2002. pp. 9-13. (A brief summary on the state of rabies in North America and Europe, including vaccine use, and prevalence.)
Fishbein, D, Robinson, L. "Rabies". N Engl J Med. vol. 329. 1993. pp. 1632-8. (An early paper describing the epidemiology, pathology, and prevention of rabies.)
Hankins, D, Rosekrans, J. "Overview, prevention, and treatment of rabies". Mayo Clin Proc. vol. 79. 2004. pp. 671-6. (A paper describing the overview, prevention, and treatment of rabies.)
Hemachudha, T, Laothamatas, J, Rupprecht, C. "Human rabies: a disease of complex neuropathogenic mechanisms and diagnostic challenges". Lancet Neurol. vol. 1. 2002. pp. 101-9. (A paper describing the neuropathogenic mechanisms and diagnostic challenges in rabies.)
Jackson, A. "Rabies". Can J Neurol Sci. vol. 27. 2000. pp. 278-83. (A broad paper on the epidemiology, pathology, and prevention of rabies.)
"The Milwaukee protocol". 18 May 2011. (The formal proposal for a seminal treatment protocol for rabies.)
Meslin, FX. "Rabies as a traveler's risk, especially in high-endemicity areas". J Travel Med. vol. 12. 2005. pp. S30-40. (A paper expounding on the level of risk of acquiring rabies depending on endemicity of the geographic area.)
Nigg, AJ, Walker, PL. "Overview, prevention, and treatment of rabies". Pharmacotherapy. vol. 29. 2009. pp. 1182-95. (A paper expounding on the overview, prevention, and treatment of rabies.)
Takayama, N. "Rabies: a preventable but incurable disease". J Infect Chemother. vol. 14. 2008. pp. 8-14. (A paper describing the limitations experienced by the medical community in curing rabies, but expounds on the preventability of the disease.)
"WHO expert consultation on rabies". (The World Health Organization provides a comprehensive overview on the state of the global rabies situation.)
Wunner, WH, Briggs, DJ. "Rabies in the 21st Century". PLoS Negl Trop Dis. vol. 4. 2010. pp. e591(An opinion piece on the state of rabies in modern times, and a proposed way forward.)
DRG CODES and expected length of stay
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
- OVERVIEW: What every practitioner needs to know
- Are you sure your patient has rabies? What should you expect to find?
- How did the patient develop rabies? What was the primary source from which the infection spread?
- Which individuals are of greater risk of developing rabies?
- Beware: there are other diseases that can mimic rabies:
- What laboratory studies should you order and what should you expect to find?
- What imaging studies will be helpful in making or excluding the diagnosis of rabies?
- What consult service or services would be helpful for making the diagnosis and assisting with treatment?
- If I am not sure what pathogen is causing the infection what anti-infective should I order?
- What complications could arise as a consequence of rabies?
- What should you tell the family about the patient's prognosis?
- What-if scenarios:
- How do you contract rabies and how frequent is this disease?
- What pathogens are responsible for this disease?
- How do these pathogens cause rabies?
- What other clinical manifestations may help me to diagnose and manage rabies?
- What other additional laboratory findings may be ordered?
- How can rabies be prevented?
- WHAT'S THE EVIDENCE for specific management and treatment recommendations?
- DRG CODES and expected length of stay


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2008-08-16 - Olympic Village Station
Today we are featuring the photographs of Jared D., who had the opportunity to walk and ride the Canada Line currently under construction in Vancouver, Canada. His photographs provide a unique view behind the scenes.
All images Copyright © 2008, Jared D. All rights reserved. For licensing information, contact Jared at fro_bo_cop at hotmail.com


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Although solar cell technology for converting the sun's power into electricity has improved steadily in recent years, high costs and inefficiencies have kept it from being a serious replacement for fossil fuels. A few high-tech heavyweights—IBM, Intel and Hewlett-Packard (HP)—hope to change this using the same formula of mass production and commoditization that helped them make personal computers mainstream over the past three decades.
IBM last week announced plans to make solar panels covered with a thin film of chemical compounds. The idea is that the film, when applied to different surfaces such as glass or brick, can produce solar energy more efficiently than conventional silicon wafer–based solar cells—which are made of materials similar to those used to fabricate computer chips. (That's right—a company built on chips based on silicon is trying to get the world to move away from using it in solar cells.)
Also last week, Intel spun off a new solar tech company called SpectraWatt, which was born with $50 million in investment capital from Intel, Cogentrix Energy LLC, PCG Clean Energy and Technology Fund and Solon AG.
Meanwhile, HP earlier this month began licensing technology to Xtreme Energetics, Inc., in Livermore, Calif., designed to help that start-up company deliver rooftop solar energy systems that produce twice as much energy as conventional solar panels at half the cost.
The timing of the push is right, according to a June McKinsey and Company report: Although the cost of manufacturing and installing a photovoltaic solar power system has dropped over the past 20 years, the cost of generating electricity from conventional sources has been rising, along with the price of natural gas.
The McKinsey study noted that as competition grows in the market to deliver solar cells, competitors must relentlessly cut costs by improving manufacturing processes, investing in research and development, and moving production to low-cost countries. IBM, Intel and HP are well-positioned to leap these hurdles thanks to decades of fine-tuning manufacturing processes for PCs, computer processors, and other tech equipment, not to mention their multimillion dollar R&D budgets and worldwide facilities in places such as China and India.
This helps these companies improve the performance of their products while cutting costs. "We need [companies such as] IBM making this technology to get this stuff to the marketplace," says Larry Kazmerski, director of the National Center for Photovoltaics at the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) in Golden, Colo.
A typical solar cell has an efficiency of 15 percent—about one sixth of the sunlight striking the cell generates electricity, according to NREL. Silicon wafer–based solar cells, which account for 90 percent of installed solar capacity, are more efficient, converting up to 20 percent of the sun's energy, whereas thin-film cells generally convert only about 10 percent. This gap is expected to close over the next few years, making thin-film cells—which cost half that of silicon-wafer cells—a better bet.
The least expensive solar cells today are made using thin films of cadmium telluride. The typical cadmium telluride cell converts solar energy into electricity with 10 percent efficiency at a cost of about $4 per watt—although NREL claims to have developed a prototype that converts at 16.5 percent efficiency. IBM's CIGS technology—for copper, indium, gallium and selenide—is a thin-film approach that will initially be able to convert at least 15 percent of the solar energy it receives into electricity, says Supratik Guha, a senior manager at IBM's T. J. Watson Research Center in Yorktown Heights, N.Y. That compares with 19.9 percent efficiency for NREL's version of CIGS thin-film solar cells.
Photovoltaic solar panels made from crystalline silicon can produce energy for between $2.25 and $3 per watt. CIGS on glass panels can drop that cost to $1.50 per watt, Guha says, but he also acknowledges that solar energy will not be able to compete with fossil fuel–based electricity until it costs less than $1 per watt.
One way IBM is hoping to cut costs is by making its cells through a process that dissolves the semiconductor materials in a solvent to create a solution that is placed on a glass or metal sheet and heated until the materials adhere. Until now, thin-film solar cells have been made in vacuum chambers—the semiconductor materials are placed on the glass or metal and then air is pumped out of the chamber, creating pressure that fuses the materials. But such vacuum chambers are expensive to build and complicated to operate (requiring monitoring of pressure, temperature, current, voltage, time and other factors during the process of making the thin film). Guha is cautiously optimistic that the new process will be an improvement, "Conceptually, this is simple," he says. "But it's still a largely unproven process."
IBM will be partnering with Tokyo Ohka Kogyo Co., Ltd.—a manufacturer of computer chips, LCD televisions and other devices that require surfaces treated with chemicals to develop the cells; he hopes to bring them to market by 2011.
Intel's SpectraWatt will start building a manufacturing facility in Oregon by the end of the year and plans to begin shipping thin-film solar cells made from crystalline silicon to solar panel makers by the middle of 2009. "All of the different solar technologies out there are all driving toward the same goal," says SpectraWatt chief executive Andrew Wilson, "finding a technology that creates a commodity out of solar energy. The customer cares about their cost per kilowatt hour."
Intel is looking at components of solar energy systems outside of the cell itself, says Wilson, who is tight-lipped about the specifics of SpectraWatt's technology. He points out that the solar cell is only about 25 percent of the technology required to make an energy collection and conversion system. "Intel is looking to drive [down] the cost of the overall system," he adds, "not just the solar cell."
HP and researchers at Oregon State University have been developing see-through transistors since 2002 by baking zinc tin oxide—a semiconductor—into glass or plastic . HP originally envisioned the technology as a way to create computer displays in car or train windows, but Xtreme Energetics wants by 2010 to begin including this circuitry in its solar panels to improve their ability gather sunlight—another take on the thin-film model.
Because the solar panels would be transparent, Xtreme is also hoping that architects and builders will be willing to incorporate these unobtrusive solar panels into their designs. "Today, most of these solar cell farms sit out in the desert," says Xtreme CEO Colin Williams. "The problem with these desert-based utilities is that they're not anywhere near their customers, so they have to transport the power, which leads to a loss of energy. We wanted to offer something that a company could install on the roof of its data center."
It is still much too early to determine whether IBM, Intel and HP will be as successful creating a mass market for solar energy on par with what they did for computers. "Thin film will be able to take the cost of electricity down to better compete with existing utility prices," says Vasilis Fthenakis, senior scientist at Brookhaven National Laboratory's National Photovoltaic Environment Research Center in Upton, N.Y., and a Columbia University professor of environmental engineering. "But we really need to see in detail what these companies are proposing and whether it will truly be different from the solar technology already being developed for the past several years."
The companies are funding their own research, without government subsidies or tax incentives, which may or may not come once the technology is ready to hit the market. "The big question," Fthenakis says, "is who can bring the price down in an unsubsidized market."
Solar Sell: Companies that Mass Marketed PCs Turn to Photovoltaics
IBM, Intel and HP—three companies that fueled the development of PCs over the past 30 years—have just made major commitments to solar energy
Although solar cell technology for converting the sun's power into electricity has improved steadily in recent years, high costs and inefficiencies have kept it from being a serious replacement for fossil fuels. A few high-tech heavyweights—IBM, Intel and Hewlett-Packard (HP)—hope to change this using the same formula of mass production and commoditization that helped them make personal computers mainstream over the past three decades.


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Ozzy Osbourne Giving One Lucky Fan a Free Colonoscopy!
Ozzy Osbourne and his wife Sharon are teaming up with CBS and New York – Presbyterian Hospital on a public service initiative to increase awareness for colon cancer and promote early colonoscopy screenings to help save lives. Sharon, Ozzy and 'The Late Show With David Letterman' announcer Alan Kalter helped launch the 2012 CBS Cares Colonoscopy Sweepstakes by appearing in a PSA that aired last weekend during CBS' '60 Minutes.'
One lucky winner will receive a free colonoscopy, which can be important in helping detect colon cancer early and making treatment easier. No, Ozzy won't actually be performing the procedure — despite taking on the Dr. Ozzy moinker for his 'Trust Me, I'm Dr. Ozzy' advice book — but really it's better that way, isn't it?
"Ozzy and I are proud to be part of this innovative project by CBS," says Sharon, a colon cancer survivor. "My life was saved by a colonoscopy that Ozzy urged me to have and I hope everyone who sees the campaign will enter the sweepstakes and talk to their doctor about the importance of screenings."
The winner and a guest will receive a four-day / three-night trip to New York with airfare and hotel accommodations included, $500 spending cash and, of course, a free colonoscopy at New York – Presbyterian Hospital (for the winner only). In addition, the winner can expect to experience some pretty gnarly side effects:
"As the colonoscopy begins, you will be given a drug that will make you feel like you're at an early 70′s Black Sabbath concert — but without the music," reads an explanation of the procedure. "If the doctor starts to look like Ozzy, please report the side effect to him or the Prince of Darkness – whomever you see first."