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SAMJ: South African Medical Journal
versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.101 no.2 Cape Town Fev. 2011
Heart transplantation: Research that led to the first human transplant in 1967
J Hassoulas
The first experimental heart transplantation was performed by Demikhov in Moscow in the very early 1940s. His experiments were discontinued during World War II but, when they resumed in 1946, he produced a large volume of work devising 24 different methods of heterotopic heart transplantation within the chest. During the 1950s, many research workers transplanted the heart in the orthotopic position and also transplanted the heart and lungs en bloc. They used various methods, including cardiopulmonary bypass (heartlung machine). During the 1960s, Lower and Shumway established beyond doubt that heart transplantation was a possibility. Christiaan Barnard, using their surgical techniques, performed the first human-to-human heart transplant, in December 1967 in Cape Town.
Early transplantation attempts1,2
The possibility of replacing diseased tissues and organs with healthy ones from the same or other species has interested man since ancient times. In the Iliad, Homer mentions a monster called the Chimera that possessed the characteristics of various animals, e.g. a lion's body with wings. There are references throughout Greek mythology to mythical humans possessing one or more animal limbs.
About 2 000 years ago in India, rhinoplasty and similar operations for the repair of various facial defects were performed by using local skin flaps, i.e. autologous skin transplants. These operations were described by Celsus in Graeco-Roman medical literature, and it seems that they were also performed in Greece and Rome. Fifteenth-century Italian surgeons also devised pedicle flaps for plastic procedures but, owing to church interference in medical matters, this technique had to be abandoned. Much later, English army doctors stationed in India rediscovered procedures for plastic operations on the nose and introduced them in England.
Apart from the successful transplantation of autologous skin, no transplantation of any tissues or organs seems likely to have taken place until about a century ago. There is evidence that successful skin transplants on sheep were performed in Milan in the 18th century, and it was claimed that these skin allografts (homografts) were successful. This might have been possible if the animals were from the same region and could therefore be genetically related, but those researchers went on to claim that xenografts took as well, and ascribed this fact to the 'good air that prevails in Milan', which casts serious doubt on the validity of these experiments. Paul Bert, a student of Claude Bernard and an early worker on transplantation research, wrote a thesis and later produced about 200 publications on the subject of animal tissue grafting. Except for autografting of the skin, he was unable to reproduce the Milanese claims. Bert's works were published in 1876 and were translated into English in 1943. He noted the behaviour of autografts, allografts and xenografts, and believed allografts could have a successful outcome.
Corneal transplants were carried out as far back as 1872 using xenografts, but were unsuccessful. Allograft corneal grafts, however, were the first successful tissues to be transplanted, the earliest being around 1930.
Organ transplantation was first attempted in the early 20th century. Previously, Murphy and Beck had devised vascular suturing methods, and these were used by Carrel in transplanting organs. Carrel observed that kidneys transplanted from one site to another in the same animal had a better survival rate than those from other animals. He believed, however, that the functioning of the transplanted organ depends on the success of the vascular anastomosis. This thinking persisted until the 1940s, with many researchers spending all their time and effort devising better and faster techniques for the anastomoses of vessels.
Some human application of these techniques was attempted. Ullman, in 1902, having experimented with kidney allograft transplantation in dogs, transplanted a pig's kidney into the elbow of a uraemic woman. The kidney did not function and he thought this was due to technical problems. At that time, many other research workers reported experimental kidney transplantation, some of whom also attempted transplantation from animals to man. The overall experience was reviewed by Guthrie in 1912, who summed up the situation as follows: 'No one, though many experiments have been reported, has yet succeeded in keeping an animal alive for any great length of time which carried the kidney or kidneys of another animal, after its own kidneys were removed ... the outlook is by no means hopeless and the principle of immunity which yields such brilliant results in many other fields would be worthy of being tested in this case'.1
Blood groups and transfusions3,4
Blood grouping and blood transfusions are an integral part of transplantation. Ancient Greek and Egyptian writings show that, even in those early times, blood transfusions were held to be both advisable and indeed possible. The first recorded attempt to use blood for therapeutic purposes was in 1492. However, in this instance, Pope Innocent VIII was probably given blood orally. Following the discovery of the circulation of blood by Harvey in 1616, several further experiments paved the way for the first transfusion. In 1656, the famous English architect Sir Christopher Wren administered beer and wine intravenously to dogs, resulting in their intoxication and thereby proving that substances can be given intravenously. In 1665, another Englishman, Lower, transfused blood from one dog into another. In 1667, a Frenchman, Denis, performed the first blood transfusion by transfusing lamb's blood into a human recipient. Using calf 's blood for his fourth blood transfusion, and the second blood transfusion for the recipient concerned, a fatal haemolytic reaction followed. Denis was tried for manslaughter and, although acquitted, transfusions were banned in Paris, London and Rome, and no further advances in this field were recorded for 150 years. Eventually, the first human-to-human blood transfusion was successfully performed in 1818 by Bundell, an English obstetrician. Interest in transfusion therapy thereby revived, but this was not used on a large scale owing to the frequent and often fatal reactions that resulted.
In 1900 and 1901, Landsteiner published his discovery of the ABO blood group system. This important discovery was not clinically applied until 1911. Discoveries such as the use of citrate as an anticoagulant in 1914, and later the addition of dextrose to the anticoagulant solution, increased the lifespan of the red blood cells in vitro. The Rh system was discovered in 1940 by Landsteiner and Wiener. During World War II, blood transfusions were commonly performed. Following this experience, blood banks were established worldwide and blood transfusion became a safe and everyday procedure.
Historical aspects of cardiac surgery
Direct surgery on the heart is a comparatively recent event. Between 1810 and 1824, the great military surgeon Larrey5 drained the pericardial sac successfully. He noted the pressure effects created by blood-stained pericardial effusions sustained in war wounds. Block6 in 1882 showed that a rabbit's heart could be sutured with success. In 1897, Rehn7 successfully sutured a stab wound to the heart of a man. The famous surgeon Stephen Paget asserted in 1896 that 'the surgery of the heart has probably reached the limits set by nature to all surgery'.
Brunton8 wrote in 1902 of the possibility that mitral valve stenosis might be treated surgically. He and others stimulated the notion that surgery on the heart is possible, yet others strongly criticised such ideas. Experimental activity followed, and this knowledge was later applied clinically in the surgical treatment of mitral stenosis. The results were very poor, however, with almost all patients dying during the procedure. Two patients who managed to survive were probably not much relieved of their symptoms. In retrospect, the development of the valvulotome, devised by Cutler to cut the mitral valve open, has been blamed as something that kept cardiac surgery back for 20 years.
In 1925, Soutar, for the first and only time in his life, felt the mitral valve through the left atrial appendage and saw the possibilities of mitral valvotomy by this approach. It was, however, only after 1948 that Baily, Brock and Harken9 successfully performed a considerable amount of mitral valvotomies and showed that the best approach is through the left atrial appendage. Considerable contribution to this success came through developments in anaesthesia, tracheal intubation, mechanical ventilation and advances in the design of surgical clamps by Potts, DeBakey, Cooley and others. These innovations placed cardiac surgery on a sound foundation.2
The following years saw the spectacular development and perfection of pump-oxygenators, heart valves and techniques that have made cardiac surgery an everyday procedure that can be offered to all, with a mortality and morbidity equal to or lower than other forms of major surgery.
Early experimental orthotopic heart transplantation and heart and lungtransplantation
In 1953, Neptune et al.10 were the first to attempt complete orthotopic transplantation of the heart and lungs in canine experiments, using moderate profound hypothermia with circulatory arrest for periods up to 30 minutes. The superior vena cava and aorta were rapidly sutured first; the donor trachea was intubated and ventilated, and partial circulation resumed. Finally, the inferior vena cava was sutured over polythene tubing, thereby completely restoring circulation. Heparin was not used. They relied upon decreased coagulability at low temperatures. Three such transplants were reported, with survival up to 6 hours. The transplanted heart maintained the full circulation and, upon restoration of body temperature to normal, reflexes and spontaneous respiration returned. Similar heart and lung transplants were performed by Sen et al.11,12 in India, using deep hypothermia and circulatory arrest. The basic principles of this method were established.
Orthotopic isolated transplantation of the canine heart was first performed by Goldberg et al.13 in 1958. With the use of cardiopulmonary bypass, 3 orthotopic transplants were performed where the transplanted heart sustained the circulation for periods from 20 minutes to 2 hours after discontinuation of bypass. In the same year, Blanco et al.14 used cardiopulmonary bypass in transplanting the heart and lungs. The transplantation of both organs was done for technical reasons, to minimise the number of anastomoses necessary. Function of the transplanted viscera was documented for up to 4½ hours after completion of surgery.
In a series of heart transplants, heart and bilateral lung transplants, and heart and one lung transplants in 1957, Webb and Howard15 concluded that the latter would circumvent respiratory paralysis by leaving one innervated lung in the recipient. The same authors, together with Neely,16 in 1959 reported further experimental work in the transplantation of the heart with the right lung. Their experience with autotransplants of the heart and lungs demonstrated that if the trachea is sectioned at the carina so as to leave a well-innervated trachea, spontaneous return of respiration is possible.
Experimental heterotopic heart transplantation within the chest
The transplantation of the canine heart as an additional heart within the chest was first performed by Demikhov in 1946.17 This experience, together with that of experimental transplantation of many vital organs, is presented in a book published in 1962. The original text in Russian was published in 1960. His first attempts at heart transplantation started in 1940, when he transplanted the heart in the inguinal region of cats. During World War II, the experiments were discontinued. Demikhov resumed experimental transplantation of the heart in 1946, subsequently devising 24 different methods for transplanting an additional heart in the chest. In most of these methods, a part of the donor's lung was also transplanted; 250 such experiments were performed over a period of 14 years. Many animals died during surgery as a result of bleeding or technical problems. Most died a few days after surgery from infections, haemorrhage, pneumothorax and other complications. A few animals survived to a couple of weeks or more, and one survived for 32 days.
Since these experiments were done without the aid of cardiopulmonary bypass, the lengths of the various vessels of the donor heart had to be long to reach the vessels to be sutured to the recipient. Suture-line complications were the most frequent problem. Many variations of anastomosing these vessels were used, from direct suture to the use of collodion tubes over which the vessel was sutured. Use was made of a vascular suturing machine devised by Russian engineers and surgeons. Many anastomoses eroded through and many others clotted up, resulting in the rapid death of the animals. Infection was a major problem as antibiotics were not used.
However, many animals survived and observations were recorded. The peripheral pulse was double. The electrocardiograms taken showed the 2 different QRS-complexes of the 2 hearts, similar to today's human heterotopic heart transplants. Electrocardiograms done over days and weeks showed a gradual decrease in donor heart voltage and eventual ventricular fibrillation. However, Demikhov did not relate this to rejection of the graft. Although mentioning incompatibility of tissues and other physiological causes for the death of the transplanted organs, he considered the major reason to be mechanical, within the myocardium, or due to causes around it, e.g. pericardial effusion. Professor Christiaan Barnard visited Demikhov in Moscow. In his book One Life,18 he mentions that he visited the Soviet Union after his return from Minneapolis in the early 1960s and that he presented a paper at a conference in Moscow at the time.
Sen et al.,11 in a preliminary 1965 report of 100 canine heart transplant experiments, included 5 experiments performed in which the donor heart supported the circulation as an accessory heart in the chest. The technique used was that the aorta and pulmonary artery of the donor heart were sutured end-to-side on the recipient's descending thoracic aorta and pulmonary artery. The left atrial appendage of the donor heart was sutured to the left atrial appendage of the recipient heart. Only in 3 experiments did the heart start beating after surgery and continue to beat for 6, 8 and 48 hours respectively. From this limited experience, the authors formed no opinion other than to suggest further studies.
Reemtsma,19 (in 1964) and McGough, Brewer and Reemtsma20 (in 1966) described a technique for the insertion of an intrathoracic auxiliary heart, functioning in parallel with the recipient heart.
Experimental orthotopic heart transplantation in the 1960s
During this decade, the feasibility of heart transplantation was established beyond doubt. Lower and Shumway and associates emerged as the main researchers in this new and promising field. The first series of completely successful heart transplants was reported by Lower and Shumway in 1960.21 The canine heart was transplanted orthotopically using a technique devised by them, whereby a cuff of both atria is left behind in the recipient's chest and the donor atria are sutured onto these cuffs. The other two anastomoses are the aorta and the pulmonary artery. This was performed using cardio-pulmonary bypass. Five out of a series of 8 animals survived the operation, living between 5 and 21 days. The postoperative convalescence was uncomplicated and the animals returned to normal activity. Postmortem histological examination of the heart revealed severe acute rejection, with massive round cell infiltration, patchy necrosis, interstitial haemorrhage and oedema. These observations confirmed that the immunological mechanism of the host attacks the heart and that this leads to rapid myocardial failure.
In 1961, Lower, Stofer and Shumway22 published a more detailed article on their experimentation with orthotopic heart transplantation. Obtaining and preserving the graft in a viable state was a problem they gave attention to, resorting to refrigeration in cold saline to diminish the heart's metabolic requirements during the anoxic period. The surgery for removing the donor heart and the transplantation techniques are discussed. Significant progress included using the posterior walls of the atria of the recipient, obviating the need for multiple anastomoses of the cavae and pulmonary veins. Serial electrocardiograms obtained on surviving animals showed gradual decrease in voltage. Histological analysis confirmed the process of homograft rejection.
Heart and lung transplantation was also attempted by Lower et al.23 in 1961. In 6 experiments, 4 animals died within 24 hours of surgery, and 2 survived for 5 days. The postoperative respiration rate of the animals was decreased and the respiration pattern was altered.
By the mid-1960s, considerable information had been obtained on many aspects of heart transplantation, such as the development of an uncomplicated surgical technique, preservation of the myocardium during interruption of coronary blood flow, adequate function of the anatomically denervated transplanted heart postoperatively, and the diagnosis and treatment of acute rejection. This provided the scientific foundation upon which clinical heart transplantation commenced.
The first human-to-human heart transplant was performed on 3 December 1967 in Cape Town by Professor Christiaan Barnard. This historical event opened a new and exciting chapter in medical science. Media coverage evoked much mixed and even heated reaction at times regarding the question of ethics in organ transplantation.24 Due to varying enthusiasm and sensationalism, an inaccurate picture of the facts was given, presenting transplantation to the lay public as both a panacea and also an unjustified, unethical form of treatment.24 The medical profession responded with mixed feelings: some believed that this form of therapy was unjustifiable and unethical,24 while others responded with tremendous enthusiasm, which was reflected by the fact that over 100 heart transplants were performed in various centres around the world in the next year (1968).
The rather poor results following this experience, however, had a negative effect on the initial enthusiasm for heart transplantation. Only a few institutions maintained active heart transplant programmes, including the University of Cape Town. Professor Barnard24 stated in 1970: 'To curb transplantation at this stage would be to strangle one of the most promising and exciting fronts of medical endeavour of this century. From the experience gained in the problems of rejection, methods of immunological control will be improved and vital organ replacement will become a routine and life-saving procedure. To deny medicine its full thrust in this direction would be irresponsibly shortsighted. Indeed, it is difficult not to conclude that any withdrawal from this new frontier would be professionally unethical. We have only to continue transplantation on a most active scale.'
Worldwide, 101 heart transplants were performed in 1968, 47 in 1969 and, since then, an average of about 25 annually. By July 1977, 345 heart transplants had been performed by 65 transplant teams in 22 countries on 337 recipients. During the 1980s, worldwide interest in this procedure was renewed, owing to the fact that the therapeutic value of heart transplantation had been proven. During 1981, more than 100 heart transplants were again performed. It was estimated that at least 666 heart transplants had been performed worldwide by March 1982.
The registry of the International Society for Heart and Lung Transplantation: Twenty-third Official Adult Heart Transplantation Report - 2006, presents information on the 73 000 heart transplants performed worldwide from 1982 to 2005.25 The one-year survival was reported to be about 80% and 5-year survival 70%. Careful patient selection, together with vigorous postoperative management, today ensures the satisfactory rehabilitation of selected heart disease patients who would otherwise die. Future improvements in methods of immunosuppression and the refinement of prolonged myocardial preservation techniques26,27 will greatly extend the horizon of heart transplantation in the near future.
Currently, about 3 000 heart transplants are performed annually worldwide. However, in the USA alone, there is a need for assistance to the heart in more than 70 000 patients annually who are in terminal heart failure. They need more help than maximal medical therapy. Consequently, human-to-human heart transplantation still has very little impact on the treatment of end-stage heart failure. Therefore, an intensive search for improved, permanent mechanical devices as alternatives to heart transplantation has to continue 'on a most active scale'.24
1. Rapaport FT, Dauset J. Human Transplantation. New York: Grune & Stratton, 1968: 3. [ Links ]
2. Davis L. Christopher's Textbook of Surgery. 9th ed. Philadelphia: WB Saunders, 1969: 1424. [ Links ]
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4. Sturgis CC. Hematology. 2nd ed. Springfield, Ill: Charles C Thomas, 1955. [ Links ]
5. Norman JC. Cardiac Surgery. 2nd ed. New York: Appleton-Century-Crofts, 1972:671-674. [ Links ]
6. Block MH. Über Wunden des Herzen und des Herzbentelf. Verh Deutsch Ges Chir 1882;11:108. [ Links ]
7. Rehn. Ueber penetrirende Herzwunden und Herzhalt. Arch Klin Chir 1897;55:315. [ Links ]
8. Brunton TL. Possibility of treating mitral valve stenosis by surgical methods. Lancet 1902;1: 352. [ Links ]
9. Ellis HF. Surgery for acquired mitral valve disease. Philadelphia, USA: WB Saunders, 1967: 15-17. [ Links ]
10. Neptune WB, Cookson BA, Bailey CP. Complete homologous heart transplantation. Arch Surg (Chicago) 1953;66:174. [ Links ]
11. Sen PK, Parulkar GB, Pandy SR, Kinare SG. Homologous canine heart transplantation: A preliminary report of 100 experiments. India J Med Res 1965;53:674. [ Links ]
12. Sen PK, Shah CB, Satoskar RS. Studies on isolated heart lung preparations in the hypothermic animal. J Internat Coll Surgeons 1956;26:32. [ Links ]
13. Goldberg M, Berman EF, Akman RC. Homologous transplantation of the canine heart. J Internat Coll Surgeons 1958;30:575. [ Links ]
14. Blanco G, Adam A, Rodriques-Perez D, Fernandes A. Complete homotransplantations of the canine heart and lungs. Arch Surg (Chicago)1958;76:20. [ Links ]
15. Webb WR, Howard HS. Cardiopulmonary transplantation. Surgical Forum 1957;8:313. [ Links ]
16. Webb WR, Howard HS, Neely WA. Practical methods of homologous cardiac transplantation. J Thoracic Surg 1959;37:361. [ Links ]
17. Demikhov VP. Experimental Transplantation of Vital Organs. New York: Consultants Bureau, 1962: 54. [ Links ]
18. Barnard C, Pepper CB. Christiaan Barnard: One Life. Toronto: MacMillan, 1969. [ Links ]
19. Reemtsma K. The heart as a test organ in transplantation studies. Ann N Y Acad Sci 1964;120:778. [ Links ]
20. McGough EC, Brewer PL, Reemtsma K. The parallel heart: Studies of intra-thoracic auxiliary cardiac transplants. Surgery 1966;60:153. [ Links ]
21. Lower RR, Shumway NE. Studies on orthotopic transplantation of the canine heart. Surg Forum 1960;11:18. [ Links ]
22. Lower RR, Stofer RC, Shumway NE. Homovital transplantation of the heart. J Thorac Cardiovasc Surg 1961;41:196. [ Links ]
23. Lower RR, Stofer RC, Hurley EJ, Shumway NE. Complete homograft replacement of the heart and both lungs. Surgery 1961;50:842. [ Links ]
24. Barnard CN. Experience with human heart transplantation in "Sterilization and preservation of biological tissues by ionizing radiation". Vienna: International Atomic Energy Agency, 1970. IAEA - PL - 333/10:79-94. [ Links ]
25. Twenty-third Official Adult Heart Transplantation Report - 2006. J Heart Lung Transplant 2006;25:869-879. [ Links ]
26. Wicomb W, Cooper DK, Hassoulas J, et al: Orthotopic transplantation of the baboon heart after 20 to 24 hours' preservation by continuous hypothermic perfusion with an oxygenated hyperosmolar solution. J Thorac Cardiovasc Surg 1982;83:133-140. [ Links ]
27. Hassoulas J, Barnard CN. Heterotopic cardiac transplantation. A 7-year experience at Groote Schuur Hospital, Cape Town. S Afr Med J 1984;65(17):675-682. [ Links ]
Accepted 16 July 2010.
Dr J Hassoulas, MB ChB, MMed (Thor Surg), MD, is an associate professor at the Medical School, University of Crete, Greece.
Corresponding author: J Hassoulas (email@example.com)


text:
PULLMAN, Wash. -- As soon as Mike Leach ambles through the doors of a coffee shop called Café Moro, he is greeted by a friendly woman who almost killed him. The woman corners him near the door, and the woman tells him how she was backing her car out of the driveway the other day and there he was, strolling along, phone pressed to his ear, meandering in his own little thought bubble, and that if she hadn't looked twice she might have plowed right through him. I can see the newspaper headline materialize, and given the brief flash of panic in Leach's blue eyes, I wonder if he sees it, too -- RENEGADE FOOTBALL COACH DIES IN FREAK ACCIDENT -- and he informs the woman in the coffee shop that there was a purpose behind his obliviousness: He has started walking to work especially so he can get all of his phone calls out of the way while he's in transit.
It's a Friday morning in Pullman, a sparse little college town clearing the decks for Easter weekend, and the local football coach is wearing a Washington State sweatshirt and cargo shorts and worn-in sneakers. This is his walking uniform, and if you're thinking maybe it makes him look like an adolescent mallrat -- if you're thinking, Mark Richt would never go out in public looking like this -- well, what the hell does he care? The whole legend of Mike Leach was born of a contrarian ethos. He was the football coach who played rugby in college instead of football, the football coach who went to law school, the football coach with quirks up to his ears, the football coach who broke loose from the cautious paradigm that the sport had operated under for decades. If it is the norm for most men in his profession to maintain a wary distance from their public, either emotionally or physically (and often both), then of course Mike Leach is going to wade right in. And so he freely engages with the concerns of this potential grim reaper in the coffee shop, just as I will watch him, later on this same day, draw a construction worker into an extended conversation about the local cheese.
Part of the reason Leach is so open to random interaction is because he fears developing tunnel vision; therefore, if he happens across, say, a custodian who suggests that he enjoys watching Leach's offense run a certain play, Leach will get back to his office and contemplate whether he should be running said play more often, about whether maybe there's "some little nuancey thing" he might be missing. This means that sometimes Leach gets to chatting, and occasionally he chats for so long that he throws off the whole regimented practice and meeting schedule of his own football team. One day during spring drills, quarterback Connor Halliday tells me, Leach -- and Halliday refers to him as "Leach" -- made him an hour late for his weightlifting session because he got a phone call and didn't start the quarterbacks meeting until around the time the quarterbacks meeting was supposed to be ending. He seems almost pathologically determined to glean a new perspective from every conversation, which explains why I am here to speak to a football coach about the life and legacy of an Apache Indian war leader, but also explains how our conversation quickly evolves into a discussion about the hills in my new hometown of San Francisco, and about the steaks at Peter Luger's in my old hometown of Brooklyn.
A moment after we sit down, he's back up again, pointing out the hills that he hikes over to get from his home to his office -- sometimes, he says, he'll be doing a national radio show spot and huffing for breath at the same time -- and he points out the tower on campus that (his own metaphor) looks like something out of the television show Dark Shadows, and then he's procuring a paper cup to catch the residue from the plug of Grizzly chewing tobacco he inserts into his mouth. We talk about D.B. Cooper, and about Edward Snowden ("I haven't figured out if I love the guy or hate the guy"), and about his left-handedness, and about an explorer named Thor Heyerdahl, because Mike Leach has just written this book called Geronimo: Leadership Strategies of An American Warrior, which will be released by Simon & Schuster's Gallery Books on May 6, and the first indication that this book will not be a conventional popular history comes in the opening sentence, which reads as so:
"When I was a kid growing up in Wyoming, there were Cowboys and Indians, and I always wanted to be an Indian."
And the second indication that this book is a Mike Leach production -- that he did not just farm it out and throw his name on the front -- comes on Page 3, when he cites explorers like Heyerdahl in criticizing the very idea that the Indians might have come to America, as many anthropologists believe, over the Bering Strait Land Bridge.
"Why leave a warm climate to freeze your asses off?" Leach writes in the footnotes, and if that seems almost purposefully antagonistic, this is Mike Leach, too: Three years into his second act as a football coach, he'd still rather embrace the controversy than adhere to a doctrine he finds flawed.
* * *
I can't think of an active college football coach who has ever taken the time to write a book that wasn't directly related to football. Neither could Leach's co-author on this project, a Washington State University English professor named Buddy Levy. Woody Hayes used to lecture on history and rant about politics -- he even taught classes that had more to do with the dangers of pot-smoking than they did with football-coaching techniques -- but the idea that he would take time away to write a book about, say, George Patton, would have seemed antithetical to his occupational obsessiveness. And sure, it's not difficult to draw football-related inferences from some of the leadership lessons interspersed throughout Geronimo, but the motivation, for both Leach and his co-author, was to tell an accessible version of the story of an Apache war leader who spent much of his life as an anti-hero.
"We almost never, ever talk about football," Levy says. "He'd call me on the phone, and we'd go over the chapters line by line, word by word. There I was, sitting and talking to him about the book, and I'm thinking, 'Maybe I should tell him we need a new punter.'"
Levy has already written respected books about explorers and conquistadors and a bird called the chukar partridge. This is his first collaboration, and it most likely would not have happened without the aid of cosmic coincidence. Leach was referred to Levy through a New York literary agent named Scott Waxman, who suggested they discuss working on a Geronimo book. Leach had been obsessed with Geronimo since elementary school. The first time his mom took him to a library, he went straight to the section on Indians, pulled out a very dry academic tome on Geronimo and the Apaches, and forced his mother to read it to him, night after night. It was full of violence and disturbing imagery: Geronimo and his allies were captured and continually betrayed by the white man, and Geronimo's body was literally riddled with bullet wounds, and despite his mother's censorship of certain NC-17 aspects of the story, Leach entered into a lifelong fascination with a figure who did not let up fighting until he was a very old man. The Geronimo obsession became one of those Leach Things, a page in the catalogue of the man's peccadillos, in the same way the culture of piracy came to define him after Michael Lewis profiled Leach for The New York Times Magazine back in 2005.
So Waxman set up Levy and Leach after Leach finished his first book, an autobiography called Swing Your Sword, with journalist Bruce Feldman. At the time, the coach was on a forced two-year hiatus in Key West after being fired amid legal disputes and accusations at Texas Tech. Then Leach got the job at Washington State, and the idea might have died right there, except that in one of his first weeks on the job, Levy showed up in Leach's office. Leach had no idea who he was at first; Leach had no idea the same guy he'd talked to about Geronimo -- the same guy whose biography of Davy Crockett he'd read and liked, the same guy who made regular appearances on a History Channel program called Brad Meltzer's Decoded, which explored mysteries and conspiracy theories like whether Harry Houdini was murdered -- actually worked at Washington State. "Let's write this book," Levy said, and so they did: They spent the summer of 2012 meeting at Café Moro, talking for hours, reviewing Levy's research and the first drafts of the chapters. Levy would record their conversations and then he'd go back and transcribe them, rewinding and fast-forwarding through the digressions, like the time when Leach went off on a 90-minute tangent about apartheid. They'd go over the chapters line-by-line, and Leach would add the lessons and the "commentary" at the end of each chapter.
The finished product is, frankly, kind of a strange book. Because so much of Geronimo's life was steeped in violence and betrayal, because he raided and pillaged dozens of villages himself, he is a complex figure to put at the center of a motivational tome. But then, Mike Leach is kind of a strange guy, and the book manages to mirror the psyche of its author: It is an entertaining account of the details of Geronimo's story while also reflecting the digressive nature of Leach's psyche. Interspersed throughout, highlighted in gray, are sidebars that are tangential to Geronimo's story but seemed interesting to Leach: the intimate details of Apache sex life, the notion that Mongol warlords ate steak tartare by riding around with meat under their horses' saddles, the rumor that Geronimo's skull was stolen by the Skull and Bones society at Yale. The whole thing meanders and skips along and throws in asides like a rousing Leach conversation. Even the leadership lessons and commentary do not adhere to Oprah-esque principles: Leach decries the inefficiencies of bureaucracies and extols the virtue of holding grudges. "In many instances," he writes, "getting even is vital in order to protect your people (and your interests) from future damage."
There is, of course, an undercurrent of revenge present throughout the book. How could there not be, when Geronimo's mother, wife and children were killed by Mexican raiders when he was 22? And even if Leach's obsession with Geronimo dates back long before his dismissal at Texas Tech, it's hard not to think about Texas Tech when you read the book. It's hard not to wonder if Leach still feels burned by what happened there, when a player, Adam James, the son of then-broadcaster Craig James, accused him of mistreatment, and when the administration at Texas Tech refused to back him up after Leach declined to apologize. Even now, nearly five years later, he is still being condemned by his ex-employers for his handling of the situation. It's hard not to wonder if, even though Leach won the public-relations battle against the James family (if not any of his lawsuits against various entities), the perceived betrayal still flummoxes him. Leaders expose themselves to massive criticism, especially from the media, Leach writes, in a chapter that describes exaggerated newspaper reports of Geronimo's mayhem. Remain true to your vision and judgment.
"We had a heck of a time at Tech," says Leach, who admits he's still fighting to get paid for the 2009 season. "We had 10 huge years. There's a point where we all need to applaud one another and support one another. You just keep on rolling."
* * *
And so Mike Leach finds himself here, in Pullman, in one of the most isolated settings in the Pac-12, a town with a tiny airport located right at the edge of the Idaho border. It feels like the perfect setting for him, because there is no template for success, because while Washington State has a history of producing great quarterbacks, it has never really produced a consistently great football team. At a job like this, just as he did at Texas Tech, Leach can essentially lay down his own foundation, can put his mark on a program that doesn't have a distinct national impression. His first year was a struggle (a 3-9 record, a contentious relationship with some of the players associated with the previous coaching regime), but last year, the Cougars won six games and played in the New Mexico Bowl, and in a few weeks they'll open an opulent football facility that will allow them a chance to better compete for recruits. Last week, Leach got a verbal commitment from Rivals.com's 14th-rated quarterback in the country.
Leach still operates on the same principles that he did at Texas Tech. He still coaches the quarterbacks and calls the plays, speeding up and slowing down the tempo as he sees fit. ("It's kind of like Geronimo," he says, and he's joking, but also not joking: "I get a vision. It's like an impulse.") He still believes in the passing game as the driver of the offense, and he still thinks that people -- including his own players -- tend to overanalyze things, which is why sometimes he'll speed up his tempo just to get them to stop thinking so damned much. He still believes that anyone can draw up a good play ("I could go to any junior high school in the country and find good plays"), but that the way one packages those plays -- the way a coach picks and chooses from among them -- is what sets a great offense apart. He still believes his offensive linemen should be enormous and split wide across the field ("They have football so big people can slam into big people, and if they do it well they get to run over little people"), and he still believes that football should be as violent and unregulated as it can be without causing permanent harm to its participants -- he hates the new rule that outlaws hitting a quarterback below the knees, even though "you'd be hard-pressed to find a team that rule benefits more than us." He still believes that the rulebook should be shrunken to the size of a pamphlet, which is why this whole debate over the hurry-up offense feels to him like an excuse to tamp down the creative renaissance for which Leach served as a central provocateur. His direct disciples include out-of-the-box coaches like Art Briles, Kliff Kingsbury and Dana Holgorsen; to say that the modern game would look completely different without Leach's influence is no longer an overstatement. And those changes are the reason why an attempt to tamp down up-tempo offenses this offseason failed as miserably as it did.
"Football's always been a game where there's a lot of creativity," Leach says. "Stuff gets dusted off the shelf, and broken down again. I don't like to see any of this changing of the game. If you sit and pluck away at the integrity of the sport, the whole thing gets bent out of shape and you're gonna regret it."
There is, of course, an implied "enemy" in this argument, a natural adversary, and having just read 250 pages of Leach's explications on Geronimo's varied adversaries and the way Geronimo both respected them and outthought them, I felt like I had to ask him about Nick Saban, a primary advocate in the battle against the up-tempo offense. And, as is often the case, Mike Leach does not deliver the answer you might expect.
"Oh, I like him," Leach says. "I think he's a great recruiter, and he's a very fundamental guy, just as we are here, too. He holds his players accountable. These being the most important things, we agree 100 percent."
* * *
A partial list of topics that Mike Leach broaches during one afternoon of film study with his quarterbacks:
1. The most accurate gauge of a quarterback's success. ("Do you march down the field and score?")
2. The psyche of running backs. ("They need to feel like they're superhuman, because running backs should be superhuman. That's why they play running back. When we were picking sides as kids, no one ever said, 'Hey Mike, why don't you play running back?'")
3. That time when George Costanza fled a children's birthday party by plowing over every kid and senior citizen in his way.
4. That time he went to a Jerry Seinfeld performance at Texas Tech.
5. An offensive lineman nicknamed "The Continent."
6. The original version of The Longest Yard.
7. Zen and the art of play-calling. ("You've got plays that are your identity, that are what you do.")
8. That time Wes Welker, who played for Leach at Texas Tech, kicked a field goal for the Miami Dolphins. (Leach really seems to love talking about Welker, who appears to have altered the passing-game paradigm in the NFL the same way Leach did at the college level.)
9. Speedy receivers. ("You've got to keep fast guys going fast, so they keep going fast.")
10. Offensive line play. (When an offensive lineman doubles up on a lineman rather than blocking an onrushing linebacker, Leach says, "He needs to put meat on his own table.")
11. Mistakes. ("Some quarterbacks have the Midas touch of s---, you know.")
* * *
It is insane, the scale on which college football operates these days, and that insanity renders itself in Technicolor when it is explored by a man who carries himself as unpretentiously as Mike Leach does. We're touring Washington State's new $61 million football operations center, the kind of building that just seems to go on and on, as Leach examines the ceiling and consumes apple slices from a Ziploc bag. The construction is due to be completed in May, and Leach walks past the sliding equipment lockers, a yellow hard hat on his head, a pair of blue booties pulled over his sneakers. "Somebody's gonna lose a child in there," he mutters, and then we move on, to the expansive locker rooms, to the weight room, to the Hall of Fame and the offices and tutoring rooms and more offices and even more offices. There is a station for a nutritionist; there is a treadmill set inside a small pool for rehabilitation purposes. Leach still isn't entirely sure which office is supposed to be his. He seems legitimately fascinated by the process of welding a metal bannister. He talks to the construction workers, offers restaurant suggestions, and by the time we get back to his current office the day is nearly over.
Leach walks me back to my car. He tells me about how when he worked his first job, at Cal Poly-San Luis Obispo, they used to put down an orange cone to save their parking space when they went to lunch, and how most of the time the cone would still be there when you got back, but every so often, the cone would be flattened under the tires of someone's Impala and they'd have to slip under the chassis and retrieve it. He talks to me about the process of writing, and the meticulous process of editing, and the idea that once a book is out of your hands, its out there, in the world, forever. He waves at some people he knows, people who recognize him; he seems aware of his own place in this little community.
The thing about Geronimo was that he ended his life as a celebrity. All those years in hiding, all those years in the wilderness, all those years being portrayed as a demon, and in his final days Geronimo made promotional appearances at Wild West shows and World's Fairs and statewide parades, basking in the admiration of the white man and the knowledge that his battles had been proven just. And the analogy is not perfect -- the analogy is never perfect, as I assume Mike Leach, now the most accomplished author/college football coach of his age, understands at this point -- but you can see the way Leach, at 53 years old, is easing into his own legacy, both the revolution he created and the ugliness it unearthed at his previous job. What were once radical ideas don't seem as radical as they once did. In a weird way, Leach was so successful in altering the most conservative of American sports that his own ideas have now filtered into the mainstream. The most iconoclastic coach of his generation will soon find himself in an office with more square footage than he could ever need.
"I know vaguely what iconoclast means," he says. "The status quo, I'm already pretty familiar with the status quo."

subset: commoncrawl


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Battery life is one of the most important things on a smartphone, if you run out of it you're left with no phone. That's why we've decides to share these awesome 10 tips from the BlackBerry blog, check them out:
Check for BlackBerry 10 OS Updates
Whenever a new BlackBerry 10 OS update is released, make sure to install it on your smartphone so that you can take advantage of any available optimizations which can help improve your battery life. Typically, you'll receive a notification of a new update, but to check for updates manually, open Settings, tap Software Updates followed by Check for Updates.
Tip: To access your BlackBerry Z10 Settings, swipe down from top of the screen while viewing your Home screen and tap Settings.
The radios on your smartphone are designed with efficiency in mind, so turning off Wi-Fi, Bluetooth or NFC as well as changing your cellular connection to use a different network technology may not improve battery life. We recommend using Wi-Fi whenever possible because it offers substantial power savings, so make sure you are actively adding Wi-Fi networks and hotspots to your smartphone as you come across them.
Note: If you've set up Media Sharing on your BlackBerry Z10, considering turning off it temporarily if need to maximize your battery life.
The BlackBerry Z10 smartphone is designed make efficient use of the battery; however, you should still follow best practices to maximize your battery's lifespan. Always use an official BlackBerry charger, charge for an extended period of time when possible, avoid charging in small increments (i.e. less than 15 minutes), and do not your leave smartphone in direct sunlight (i.e. your vehicle's dashboard) or in extremely cold temperatures.
- Whenever possible, it is recommended that customers use Active Sync or IMAP over POP when setting up a new account because they are more efficient protocols for a mobile device. If you need assistance setting up a new account, review the BlackBerry Z10 User Guide or contact your account provider for more information.
- If you have set up multiple accounts that support email, contacts, and calendar synchronization, enable synchronization for accounts that you only plan on using; this will ensure that any activity that occurs is necessary. To review account synchronization settings, tap Accounts within Settings followed by tapping the account you want to customize and/or delete.
- Remove any accounts that you are no longer actively using to reduce overhead and to prevent them from using the battery to stay updated.
If you receive many notifications throughout the day, make sure you review and customize your notification profiles. For example, if your smartphone is set to vibrate, this will use more battery life than having the LED light up as more notifications arrive. If you receive a lot of notifications overnight as well, swipe down from the top of the screen after locking your smartphone to enable Bedside Mode, which will turn off all notifications overnight.
Screen Brightness
A significant way to reduce battery usage is to decrease the brightness of the BlackBerry Z10 display. Within Settings, tap Display and move the Brightness slider to a reduced setting that you find comfortable.
Lock Screen
To prevent accidental taps and presses that can turn on your screen (and decrease battery life), lock the screen by pressing the Power/Lock key on the top of your smartphone.
Screen Lock Timeout
In addition to using the Power/Lock key to lock your screen, an important setting that you should customize is the Screen Lock Timeout. This setting controls how long your smartphone will wait before turning off the screen after being left idle. The less time that the screen is on, the more battery is conserved. To adjust this value, go to Settings, tap Display and change the Screen Lock Timeout.
Use a Case or Holster
Depending on which of type case or holster you are using, putting your BlackBerry Z10 in it may or may not turn off the display. On top of protecting your smartphone, using a case that turns off the display is a great way to save battery life. To browse a variety of these cases, visit http://www.shopblackberry.com or check the available cases that are provided by your local retailer(s).
Note: If your screen does not turn off when you insert your BlackBerry Z10 into the case or holster, verify that you are using an official BlackBerry accessory or contact the manufacturer for additional assistance.
Review Application and Game Refresh Settings
It's a good idea to review the refresh settings within your favorite third-party apps and games, as some of them might maintain active connections to services or data that is still being transferred.
With these tips you should be able to save battery life and make sure your Z10's juice lasts longer. Thanks Ty for this awesome tutorial!


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This Positive Life: Newly Living With HIV, Josh Robbins Is "Still Josh" -- and Still an Advocate
March 25, 2013
Josh Robbins was already an HIV advocate in Nashville, Tenn., when he was himself diagnosed with HIV in January 2012. He'd supported local HIV organizations' events as a small-business owner, and was even part of an HIV vaccine study. Then a brief unprotected sexual encounter put him on the other side of his advocacy activities. "I needed some of those services that Nashville CARES has provided, that I have supported for years but never thought I would use," Josh recalls. Because he was in a vaccine study beforehand, he's been in HIV care practically since the day he became positive -- and he's been open about his HIV status for almost as long, even videotaping his diagnosis appointment for YouTube. "I don't think that what I'm doing, or what I've done and what I'll continue to do, is brave," he says; "But if it helps one person or two people here feel like they're OK, then that's enough." In this interview, Josh opens up about disclosure, stigma, growing up gay in the U.S. South -- and befriending the man from whom he acquired HIV.
Josh, welcome to This Positive Life.
Well, thank you. I've been looking forward to it.
Can you start by describing how you found out you were HIV positive?
Yeah, absolutely. I had unprotected sex on December 18, 2011. We started with a condom and then the condom came off. I really didn't think that we were going to really continue, or go back into anal intercourse. And then things got hot and heavy again. So we had unprotected sex for about five minutes. And that's not a stretch. I mean, it was really just, like, five minutes.
He didn't get off, actually. There was a knock on my door, so we had to end it quickly. One of my really good friends stopped by and needed to talk. He had some things going on. And so it was kind of an end-it-and-that's-it. So that was on December the 18th.
I really didn't honestly think a whole lot about it.
And then on Jan. 2, 2012, I started getting really sick, kind of like the flu-like symptoms that they talk about. I had a fever, chills, just didn't feel good. I really just thought I had the flu. So the next day on the 3rd I went to one of those doctor-in-the-box type things, one of those urgent cares. They thought that I just had some kind of flu-like thing going on. They didn't know what it was; they just gave me some cough medicine for my throat, because my throat was really hurting.
I came home. Still felt terrible. And the next morning I woke up and had, like, 30 sores in my mouth. Again, I wasn't thinking about HIV at all. I kind of got mad, and I called my mom and my sister. And my mom and sister both worked at hospitals, my mom as an RN. They immediately thought that I obviously just had an allergic reaction to whatever the medicine was.
I went back to the doctor two days after that. The doctor came in and looked at everything, and reviewed his notes. He left the room and he came back in with a nurse and he said, "We need to talk about your high-risk behavior." And it kind of hit me right then. In my gut, I knew that it was HIV.
They wanted to test me there but they couldn't, because I'd been involved in an HIV vaccine study here in Nashville. I was very active in our community, as far as talking about prevention. But I was still kind of oblivious to it. I told them that I couldn't get tested at that office, which they didn't take too kindly to, because they really wanted to test me for that.
I had to call the HIV vaccine program because I was a volunteer and I could only be tested there. I had to go in. And then, from going in to the vaccine study program, till I finally got the results, which was January 24, that was like three weeks or so. So I actually found out from the medical professionals at the hospital that I'd been doing the vaccine trial with.
It sounds like you were practicing safer sex that entire time, and this was a slip-up.
Yeah, I think that it was. I mean, there had been other times that I trusted someone, or asked them their status, and I knew them. What I'd been really focused on in 2011, specifically because of the vaccine program, was not allowing my trust in someone and me judging their character to be the factor of whether I wanted to have protected or unprotected sex with them. That was something that I was working on in 2011. And so with him, it was a slip-up.
How old were you at the time?
Well, my birthday was January 12, so in the middle of feeling sick and doing my first test, and then my second test, and then my third test with my vaccine program, my birthday was dead in the center. So I was 28 at first and then halfway through that three-week process I had my 29th birthday.
You filmed yourself getting the test; is that right?
"I knew that as soon as they said that I was HIV positive that I would forget anything else they said. And so I [audio-recorded my diagnosis] for that purpose -- so that I could listen back to what they said; but also because I wanted to hear those words again."
Yeah. That week after I came back from the doctor-in-a-box that said I was showing symptoms of acute HIV syndrome -- it was on a Friday -- I couldn't get into the vaccine program to meet with them until Monday. So I was sick, not feeling good, and on top of that, I knew in my gut that I had contracted HIV.
During that two-and-a-half to three-week process of me finally getting what the final result was of this test, I started writing and videoing just little things, how I felt at the moment. The reason why I did that was because I didn't want to forget it. I didn't want to forget how I felt. In the unlikely case that I got out lucky, and it was just the flu, or something, I wanted to remember what I felt like then, and how everything kind of flashed before me.
When I went in on the 24th, when I got my final result of being positive, I did video. And then when I went in the actual room, I just audio-recorded it. And the reason why I did that was simply because I didn't want to forget what they said. If it was a positive result, number one: At that time I didn't know one person that had ever told me that they were HIV positive. Number two: I also knew that as soon as they said that I was HIV positive that I would forget anything else they said. And so I did it for that purpose -- so that I could listen back to what they said; but also because I wanted to hear those words again.
A couple weeks after I got that result and I hadn't really told anybody, then I went back and listened. And I heard how powerful it was from an outsider's perspective. So I decided to put it online in a little short video clip on YouTube.
I Just Found Out I'm HIV Positive, Now What? I'm Still Josh -- I Have HIV
The staff and the medical professionals at the Vanderbilt HIV vaccine study are so caring and so honest and gracious. One of the guys that's kind of over the program that I'm in was prepping me; and we really had an open dialogue. I told him that my gut said that I had been infected. During that three-week process, he started going down the road of, well, what does this mean? He started talking to me about viral loads and CD4 counts. Then I started doing a lot of research, because I had no idea what he was talking about.
When I walked in on the 24th to get the results . . . again, I knew in my gut what the result would be. What I was surprised about was the viral load. I don't know. For some reason, in my mind, 175,000 is what I expected. Now that I know what I know, it's just funny that I even thought that. But 175,000 was what I expected. So when he said that I had a positive viral load, he followed that sentence up with that my viral load was at 5.5 million. That was a shock for me. It was a real big shock.
What was the first thing that you did to help you come to terms with your diagnosis?
I had already made a decision. I'm really close with my family. I have a mom, a stepdad, my father, and my stepmom. And then I have a sister and two stepbrothers. But I've known them my whole life and so they're like my brothers. My family as a whole has been through a lot in the past couple years. My dad had a seizure, almost died. My sister had carbon monoxide poisoning on a trip. She almost died. One of my stepbrothers had a motorcycle accident, and he died twice; and they brought him back to life. And my mom has MS [multiple sclerosis]. With all that's happened with my family, we've gotten really close. We've always told each other that if there was ever any kind of news or anything that we needed to tell each other, that we would do it immediately, and that we wouldn't hold the information.
Before I went to get my results, I purchased a plane ticket to go home that night. I knew that if it was positive, then I don't know that I would have gone and bought a ticket. I would have been scared, and that sort of thing. So I kind of just started my day and then, you know, bought a ticket; then went and got my results; then came home and got my bags; and then I went to the airport. I immediately flew home.
And so the day that I found out, I told my mom and my stepdad. My sister picked me up from the airport. And then I drove down and woke my dad and stepmom up -- they were asleep -- and shared the news with them, as well. So immediately, within 24 hours, I had a support group, which was my family, the people that I'm the closest with.
The next day, I flew back home in the morning; and I went to work the next day. Probably the hardest call, on top of telling my family, is that I knew that -- because I was negative via a blood test on November 30, 2011; then I had unprotected sex December 18, and then I was sick January 2, 2012 -- so I knew timeline-wise exactly who the person was. And I knew that they didn't know that they were positive. And so that was a very difficult call. But I did that call within 24 hours of finding out, too. Because I wanted to get it out of the way.
What was that conversation like?
It was a difficult conversation. First, I texted him to see where he was and if he could chat. To be completely transparent, it wasn't somebody that I was extremely good friends with. It was someone that I had a bunch of drinks with -- it was a one-night stand kind of thing. I was just glad that I had his phone number, to be honest. This may make me sound terrible, but that is being real.
So I texted him and said, "I need to chat with you. Call me." And he called me immediately and said, "What's going on?"
I said that I'd just found out that I was HIV positive and, based on my timeline, that I really, really, really strongly encouraged him to go get tested. And he actually put the words in my mouth. He said, "Because I'm the only one that you could have gotten it from?"
And I said, "Yeah."
There was a pause there. He didn't really even know where to go. So I helped him and got him in touch with the people at Nashville CARES to test him. I introduced him to those people and then, when he found out that he was positive, helped him know what to do next, where to turn and that sort of thing. He was going through the process of meeting with people, trying to find a doctor and that sort of thing; it was a process that I just went through a couple weeks before him, so I was able to kind of lead him in that direction.
We are friends now, and we chat all the time. He is not open at all about his status, which is completely his choice. And I've honored that. And so I haven't disclosed who he is to anyone, either. [Editor's note: The man who exposed Josh to HIV, who is now a friend, wrote a blog entry about getting the call from Josh that led to his own diagnosis -- read this story from his perspective.]
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Walk In Bathtubs FAQ in Ridgewood, NY
Do you have questions about purchasing a walk-in bathtub in Ridgewood or a walk in shower? We get phone calls each day from folks who want to purchase a walk in bathtub in Ridgewood but just don't know where to start. Because walk in tubs aren't as popular as standard tubs, and because showrooms aren't readily available in Ridgewood, walk-in tub fact-finding can be overwhelming. The best place to search for walk in bathtub and walk in shower information is online or over the phone. For more information on Independent Home Products, LLC's walk in bathtubs, installed in all of New York, simply call (888) 366-8507 or see answers to FAQ below.
Below are questions we are asked (FAQ) about our custom walk in tubs and showers:
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What's shameful about all this is the way TRU has handled the whole release. Seems like everyone and their sister has known 5/1 was the release date, but you have to go through a dozen TRU employees to find one who knew about it. There was also supposed to be a dedicated endcap for the EU wave, which I'm sure was part of Hasbro's agreement. But I only know of one store that bothered to put up a display.
The one store I hit this morning didn't bother with an endcap and I can understand why - they dedicate almost an entire aisle to Star Wars so for them to dedicate any more space to Star Wars would probably be silly.
I don't blame the people who missed out so far being upset at all. I don't know that it's really something that I attribute to TRU employees too much though, or the company in general. Did they advertise that these figures would be available? I don't believe they did. We were all just hoping that they would. I blame Hasbro for their mismanagement of Legacy for the past year or so - not the retailers.
...That would just be good business sense. So the conclusions you could draw from that are:3) The endcap was optional based on store stock and the amount of space already dedicated to Star Wars
Ok, few more comments on the whole endcap thing...
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April 19, 2019 | Timber 2 Table Wild Game Recipes
April 17, 2019 | Timber 2 Table Wild Game Recipes
March 14, 2019 | From Video
February 21, 2019 | From Galleries
PRATT, KS -- The Kansas Department of Wildlife and Parks (KDWP) has announced that the 2011 Kansas Spring Turkey Atlas will be available March 28 at KDWP offices and license vendors around the state. An online version is currently available on the agency's website, www.kdwp.state.ks.us. To view or download the atlas from the KDWP website, click Hunting/Where To Hunt In Kansas/2011 Spring Turkey Atlas. View or print all or portions of the atlas.This is an indispensible tool for anyone looking for a new place hunt, or for those who don't yet have a place to go. The atlas pinpoints access to all land in Kansas open to public spring turkey hunting, including Walk-In Hunting Access land, which is private land leased by KDWP. This spring, more than 174,000 acres of Walk-In land are available, in addition to state and federal wildlife areas.The 2011 spring youth/disabled and archery turkey seasons run April 1-12. The regular spring season runs April 13-May 31. Turkey permits allow hunters to use a shotgun, crossbow, or bow throughout the regular season.Turkey permits valid in units 1, 2, and 3 may be purchased online from the Kansas Department of Wildlife and Parks (KDWP) website, www.kdwp.state.ks.us, or over the counter at any license vendor. A regulations summary may be downloaded from the KDWP website and printed or obtained at KDWP offices and license vendors. The brochure can be used only for general regulations regarding the 2011 Kansas spring turkey hunting season.
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April 29, 2011 | From News Articles
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April 22, 2019 | The Realblog with Stephanie Mallory
April 22, 2019 | From Galleries
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One thousand days ago, the governments of the United States and Ireland came together to commit to promote nutrition for mothers and young children through the 1,000 Days partnership. Why 1,000 days? During the critical 1,000 days from pregnancy to age 2, better nutrition can have a lifelong impact on a child's future and help break the cycle of poverty.
Today, during an event co-hosted by Bread for the World Institute and Concern Worldwide, U.S. Agency for International Development (USAID) Administrator Rajiv Shah and Irish Minister of State for Trade and Development Joe Costello renewed the U.S. and Irish governments' commitment to the goals of the 1,000 Days partnership.
"Ensuring that a child receives adequate nutrition during the critical 1,000-day window from pregnancy to a child's second birthday can yield dividends for a lifetime, for children, for families and for nations A well-nourished child will perform better in school, more effectively fight off disease, and even earn more as an adult, contributing more to their society," Dr. Shah said at the event. "We will continue to work with our partners to promote targeted action and investment in nutrition, utilizing the scientific evidence behind cost-effective interventions that are proven to improve nutrition and save lives, especially for women and children."
Since its launch in 2010, the 1,000 Days initiative has made progress in mobilizing partners to support country-led nutrition strategies and increase action and investments designed to improve the nutritional status of women and children during the 1,000 day window. The 1,000 Days partnership has grown to include over 80 entities from civil society, academia, businesses, and government. All of these partners have come together to raise awareness of the importance of the 1,000 days window, champion greater action and investment in maternal and child nutrition, and catalyze partnerships among different sectors to scale up efforts to reduce malnutrition.
By shining a light on the strong returns on investment and the science of the 1,000 days window, the 1,000 Days partnership has brought about a sea-change in the way donor and country governments and other partners target their policies, programs, and investments to improve the nutritional status of women and children.
At today's event, Dr. Shah announced that the U.S. government has nearly doubled nutrition-specific funding through our global health programs and has tripled agriculture funding since 2008. Dr. Shah also announced that the U.S. government is providing more than $1 billion for nutrition-specific interventions and nearly $9 billion on nutrition-sensitive activities over fiscal years 2012-2014.
You can read Dr. Shah's full remarks here, and you can read the 1,000 Days partnership progress report of the first 1,000 Days of action here. Learn more about U.S. government investments in nutrition by visiting feedthefuture.gov.


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City Room
Ruling Delayed on Adding Cancer to 9/11 Fund Illnesses
The decision, which was due last Saturday, is now expected by the end of next week.
James Zadroga was a New York police detective who worked for hundreds of hours on the smoldering pile at ground zero after the Sept. 11 attacks, and whose subsequent death led to a fierce public debate about the health problems suffered by rescue workers after 9/11.
The highly decorated detective, who died in January 2006 at the age of 34, did not smoke and had no history of asthma, and his family has long believed that his 450 grueling hours of work at ground zero had left his lungs fatally scarred with toxic chemicals, fiberglass and pulverized concrete.
That belief was reinforced in April 2006 by an autopsy by Dr. Gerard Breton, a retired pathologist who had worked for the Ocean County medical examiner's office for a decade. He concluded "with a reasonable degree of medical certainty" that the death was due to respiratory failure that was "directly related to the 9/11 incident."
The finding appeared to make the detective's death one of the strongest cases arising out of post-Sept. 11 illnesses, and it gave momentum to lawsuits on behalf of thousands of responders, downtown residents and others claiming injuries related to 9/11.
However, New York City's chief medical examiner, Dr. Charles S. Hirsch, rejected the finding that Mr. Zadroga's death was directly related to his work at ground zero. He concluded that it was misuse of prescription medication, not World Trade Center dust, that caused the detective's lung ailments.
The medical examiner's conclusion quickly reopened old wounds and renewed debate on questions that had generated lawsuits on behalf of thousands of responders and residents of Lower Manhattan. And it prompted a round of responses: bitter comments by the victim's family, demands for clarification by a congresswoman, and renewed pledges by Mayor Michael R. Bloomberg to seek health care and justice for all who have suffered as a result of 9/11.
In October 2007 Mayor Bloomberg also caused a storm of outrage while accepting an award at Harvard's School of Public Health when he claimed that Zadroga was not a hero. ''We wanted to have a hero and there are plenty of heroes,'' Bloomberg said. ''It's just in this case science says this was not a hero.''


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The trailers and TV ads for "Lincoln" — with their wall-to-wall music, stately proclamations and reverent tone — suggest an unrestrained Steven Spielberg, fully indulging his worst tendencies. They won't win any truth-in-advertising awards either — a good thing, since what we get is far better than they lead you to expect.
The life of Lincoln — here played by Daniel Day-Lewis — is not exactly untrod territory; our 16th president has been used as a character in hundreds of films and TV shows, of which at least a dozen had biographical aspirations. Spielberg and screenwriter Tony Kushner have wisely focused the movie on one important, eventful month in Lincoln's life — January 1865 — during the struggle to get Congress on board with the 13th Amendment, which prohibited slavery. (Perhaps 10 or 15 of its 150 minutes fall outside that span.)
While there are brief nods to his home life — primarily dealing with the overwhelming grief both he and his wife (Sally Field) still feel over the death of 11-year-old son Willie three years earlier — this is primarily about Lincoln the politician and secondarily about the various characters' ambivalent attitudes toward slavery, abolition and the equality of the "races." Lincoln may be fighting to end slavery, but that doesn't mean that his beliefs are altogether enlightened.
Here he is not only a politician, but a real rough-and-tumble one. He has nowhere near enough votes in the House for the 67% supermajority he'll need to derail a filibuster — a tactic the Democratic minority will undoubtedly use to stop passage. Some things never change, and it's hard to miss the similarities between 1865 and the 21st century.
The job has to be done before the end of the month, so Lincoln authorizes three lobbyists/enforcers/thugs (Tim Blake Nelson, John Hawkes and a nearly unrecognizable James Spader) to cajole, bribe, threaten and generally use all means necessary to ensure the votes. By focusing more on tactics than on ideology, Spielberg manages to scrape away some of the hagiographic sheen the years have provided, to reveal a tougher, more human Lincoln.
It's vaguely ironic that Spielberg hired a Brit to play our most revered president — hey, even Raymond Massey was Canadian — but Day-Lewis is physically a close match and a good enough actor to pull it off. In his voice — reedy, thin and frequently at a mutter — he apparently comes closer to the historical facts than most of his predecessors.
"Lincoln" is brilliantly cast throughout: In addition to Day-Lewis, Field, Spader, Nelson and Hawkes, we get Joseph Gordon-Levitt, Hal Holbrook, David Strathairn, Jackie Earle Haley, Bruce McGill, Jared Harris and, last but definitely not least, Tommy Lee Jones.
While Day-Lewis gets to repeat some of Lincoln's jokes, and Spader and his buddies provide moments of humor, it's Jones (as Thaddeus Stevens, the most emphatic antislavery congressman) who provides all the funniest moments. He thereby almost walks away with the film and is guaranteed an Oscar nomination for supporting actor (which he will very likely win).
One of the strangest (arguably worst) aspects of "Lincoln" is that, while Lincoln is the protagonist, he doesn't have any internal character arc; at the end, he is internally much the same man as at the start. Stevens is the only one confronted with a true crisis of conscience. Jones plays it brilliantly, and we get to identify with Stevens at that moment more than we ever do with Lincoln. We are never put in Lincoln's place; we are always looking at him.
John Williams has, as usual, written a fine score. To his and Spielberg's credit, it's also a short score. In one of the most noticeable differences from the trailer, music is used sparingly, a decision that provides a more immediate, you-are-there feel.
The only major downside to "Lincoln" is the omission of the vampires. Talk about a whitewash!
ANDY KLEIN is the film critic for Marquee. He can also be heard on "FilmWeek" on KPCC-FM (89.3).


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SportyPal 1.2.5
Related Software Categories: Alarms and Reminders | Calendar Tools | Card Makers | Contact Management | Daily Information Tools | Diary Keeping Tools | Foods and Beverage | Genealogy | Health and Nutrition | Hobbies
SportyPal is an easy to use intuitive application for your mobile phone. You activate it when you start your running, cycling, walking, rollerblading or similar exercise. In two simple clicks it will start to log and map your position, movement, distance, tempo and calories burned. It will not affect normal operation of your mobile phone, so you can still listen to music, receive and initiate calls and messages. When you finish exercising, the collected performance information will be stored on your mobile. Later you can review it, compare it with other exercises or check your best performance achievements. SportyPal will present each exercise in a map view, draw elegant graphics charts of your performance or present summarized information. SportyPal is intuitively designed to assist you improve your performance in running, cycling, blading, walking, skiing or other workouts involving similar activities. The real brilliance of SportyPal comes with the web integration. You have a possibility to upload your workouts on the internet with a simple click of a button on your mobile phone. Registering to SportyPal web application will enable you to have instant access to your workouts performance and maps from anywhere. The web application provides additional functionality for analysis of your fitness workouts. You can also share your exercises with your friends, comment on their performance or organize virtual competitions.
Platforms: Handheld , Other , Handheld/Mobile Other , Java , Windows Mobile 2003 , Windows Mobile 2005
System requirements: .NET Compact Framework 2.0 or higher
Tags: Mobile Phone, Sport
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FLUSHING MEADOWS, N.Y. -- Top seed Novak Djokovic beat Argentina's Diego Schwartzman in three sets Monday night in their first-round match at the U.S. Open.
Djokovic started his quest for an eighth Grand Slam title with a 6-1, 6-2, 6-4 win in the final match of the night at Arthur Ashe Stadium.
The Wimbledon champion Djokovic has a run of four straight finals at the Open, including a championship in 2011 against Rafael Nadal. Djokovic lost last year to Nadal, but the Spaniard isn't defending his title this year due to a right wrist injury.
Playing his first career tour-level main draw match on hard courts, the 22- year-old Schwartzman was no match for the world's No. 1...


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The Advanced Electric Drive Vehicle Education (AEDVE) Program is a program of the National Alternative Fuels Training Consortium (NAFTC) at West Virginia University and funded by the U.S. Department of Energy. The AEDVE program provides information, educational opportunities, and outreach activities for multiple audiences to educate America on next generation vehicles. These audiences include: automotive technicians, consumers, first responders, secondary school educators and students, charging infrastructure engineers and installers, and fleet operators.
To register for training, or to see what training is available at this time, visit the NAFTC training schedule. For more information about the Advanced Electric Drive Vehicle Education Program, please Contact Us.


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Sidux, a Great Alternative to Ubuntu
First Impressions
Sidux is a new Debian derivative that's still just a baby, born in January 2007. Sidux announced a brand-new release on June 26, Sidux 2008-02, so we're going to kick the tires and take it for a drive, and see what sets it apart from other children of Debian. Currently it offers a choice of the KDE or Fluxbox desktop, and it supports both 32-bit i686 and AMD64. There is also an XFCE variant. Before trying it out for yourself, be sure to read the Quick Start section in the excellent and exceptionally helpful Sidux manual before burning it to a CD.
Today I'll report first impressions, and next week dig into its guts. In a nutshell, I think Sidux is a great choice for Debian fans who want Debian Sid in a nice polished package, and who want it as plain vanilla as possible, rather than heavily-modified as so many Debian derivatives (such as Ubuntu) like to do.
- Skip Ahead
- 1. First Impressions
- 2. First Impressions
- 3. First Impressions
- 4. First Impressions


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(born 1972). U.S. rapper, record producer, and actor, Eminem was known as one of the most controversial and best-selling artists of the early 21st century. A white performer who had won acceptance in an art form dominated by African Americans, Eminem was revered by some critics but reviled by others. Some accused him of misogyny and homophobia. Arguably, he became one of pop music's most controversial figures.
Marshall Bruce Mathers III was born on Oct. 17, 1972, in St. Joseph, Mo. He had a turbulent childhood, marked by poverty and allegations of abuse. At age 14 Mathers began rapping in clubs in Detroit, Mich., and, when unexcused absences kept him in the ninth grade for the third year, he quit school, determined to make it in hip-hop music. As Eminem, he made a name for himself in the hip-hop underground, but his first album, Infinite (1996), sold poorly, and he continued to work menial jobs.
When Eminem placed second in the freestyle category at the 1997 Rap Olympics in Los Angeles, he came to the attention of Dr. Dre, founding member of pioneering rappers N.W.A. and the head of Aftermath Entertainment. By this time Eminem had developed the persona of the inhibitionless Slim Shady, who gave voice to Eminem's id in often vulgar and violent lyrics. With Dr. Dre as his producer and mentor, Eminem released The Slim Shady LP early in 1999. Benefiting from the inventive channel-surfing music video for the hit song "My Name Is" and the instant credibility of Dr. Dre's involvement, the album went multiplatinum, and Eminem won two Grammy Awards and four MTV Video Music Awards.
Grounded in his life experience but seemingly reflecting a troubled psyche, Eminem's songs outraged many, including the Gay & Lesbian Alliance Against Defamation, which denounced him as a homophobic misogynist. His tumultuous relationship with his wife, Kim, was chronicled in songs in which he rapped about killing her. In 2000 Eminem was charged with assault when he allegedly pistol-whipped a man he saw kissing her; the couple divorced in 2001, and their relationship remained rocky (in 2006 the couple remarried and divorced again). His mother also sued him for defaming her in song and in interviews.
In 2000 Eminem released The Marshall Mathers LP—the fastest-selling album in the history of rap. The incredible success of the album brought more controversy. To silence critics, in 2001 Eminem performed a duet with openly gay musician Elton John at the Grammy Awards, where The Marshall Mathers LP was nominated for best album of the year. Later that year he recorded the album Devil's Night with D12 (also known as the Dirty Dozen), a Detroit-based rapping sextet, and toured with the group. He also created his own record label, Shady Records. The D12 collective, 50 Cent, and other rappers signed to and released albums with the label.
When he finished touring in 2002, Eminem made his acting debut in the semiautobiographical 8 Mile. The gritty film was a critical and commercial success. The following year he won an Academy Award for "Lose Yourself," a song featured in the movie. Eminem's later works include The Eminem Show (2002) and Encore (2004). While both albums proved successful, neither brought Eminem the attention garnered by his previous two. In 2005 he issued a greatest-hits set—Curtain Call: The Hits—that topped the charts. Eminem then stepped out of the public eye, resurfacing briefly in 2006 to eulogize friend and D12 member Proof, who was killed outside a Detroit nightclub.
In 2008 Eminem published the memoir The Way I Am, which included photos, drawings, and lyrics. The following year he released Relapse, his first collection of new material in five years. While it featured solid production from Dr. Dre, the album met with middling reviews because of its over-the-top attempts to shock and its somewhat dated catalog of pop culture references. Nevertheless, Relapse won the 2010 Grammy Award for best rap album, and Eminem shared the Grammy for best rap duo or group with Dr. Dre and 50 Cent for the single "Crack a Bottle." Eminem's 2010 release Recovery was a response to the criticisms leveled at Relapse, and it was his sixth album to top the Neilsen SoundScan chart for weekly sales. At the 2011 Grammy Awards Eminem repeated in the best rap album category, winning for Recovery, and the album's lead single, "Not Afraid," was honored for best rap solo performance.


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Express. Home of the Daily and Sunday Express.
Rabbatts warns of challenge to football
Shocking footage of racist abuse of Leeds striker El-Hadji Diouf is a stark warning of the challenge the game still faces, according to Football Association independent board member Heather Rabbatts.
The FA has contacted Leeds to ask for Diouf's version of events as part of an investigation into Sky Sports News footage that appeared to show the Senegal striker being racially abused during a match at Millwall in November.
A 53-year-old man was arrested on Tuesday in connection with the allegations, while Millwall have also re-opened an investigation into the incident. Rabbatts told the Press Association: "What we saw was shocking and horrible and from the FA's perspective it revealed the challenge that we have still to face in dealing with racism."
The film appeared to show Diouf alerting the referee, Mark Halsey, and making stewards aware of his allegations but Millwall insisted no complaint of racist abuse was made by the player at the time.
Rabbatts, a former member of Millwall's board, added: "It's the responsibility of all of us involved in the game that where those incidents take place, they are reported so that we can take action. It is a real concern that many feel they cannot report such abuse."
It is understood Leeds have provided the governing body with the Senegal striker's version of what happened. An FA statement said: "We were concerned by the video footage and we have requested a copy for our full consideration. We will work with all the relevant authorities, including the police, to investigate fully."
The FA urged anyone "subject to or witness to racial abuse" to report it. Football League chairman Greg Clarke also stressed the need for players to be given the support to report incidents of racist abuse.
Clarke said: "To have our players subjected to such vile and filthy abuse deserves nothing more than the culprits being arrested and facing the full weight of the law. There's two issues, one is we have to continue to work with the clubs on our anti-racism programmes which are agreed with the FA.
"Secondly is the reticence of black players to come forward and feel comfortable in supporting it. If we've created an environment that doesn't support black players in confronting this issue we've done something terribly wrong.
"We've got wrap ourselves around our black players and give them our support to report such episodes and then deal with such episodes extremely severely."


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Win Tickets to 'Lady's Night Out' @ Showare Center
Win tickets to see 'Lady's Night Out' @ The Showare Center Aug. 2nd Kent, Wa. Ginuwine, Adina Howard, Soul For Real, Jon B, Changing Faces, J Holiday, Case performing Live! When you hear any of the performing artists in the 'Back in the Day Lunch Buffet', be caller #7 to get your name in the Drawing Box. Winner will be drawn Aug. 1st in the morning 'Maddhouse' 8:40 am. Good Luck!


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Email Template Machine from VerticalResponse
You're a believer in the value email provides your digital enterprise, you're skilled at audience segmentation, and of course, knowledgeable in all the various forms of list acquisition - but can you code an email?
If not, don't worry! A new tool from Vertical Response, the InstaEmail Template Machine, enables companies to create professional-grade email templates. The system takes a URL input from a user, which then detects the images and color scheme found on the submitted website. The images and color options are then presented in a two-step customization process for users. Users can choose from six layout options (including various placements for the logo, header image, primary and secondary text) and modify the background color, color for the text links and an accent color. Users can then 'push' the newly created email design to their VerticalResponse account, download it as a ZIP file, or even copy the HTML code for use outside of VerticalResponse.
The InstaEmail Template Machine is free and there is no limit to how many templates can be generated using the tool. The best part? Users are not required to have a VerticalResponse account.
"Even though we offer more than 700 pre-designed email templates to our customers, some companies prefer their email newsletters to have a more custom look. But creating a template from the ground up can be a huge challenge, especially for small businesses that don't have the technical or HTML know-how," said Janine Popick, VerticalResponse CEO. "Our InstaEmail app significantly simplifies the process and enables small businesses to create a great-looking, custom template quickly and easily."