text:
United States - Transformer Maintenance
For more information and to make a bid you will need to go to the third party website.
DetailsProvided by
- Opportunity closing date
- 12 September 2019
- Opportunity publication date
- 20 August 2019
- Value of contract
- to be confirmed
- Your guide to exporting
Added: Aug 19, 2019 4:53 pm
This is a combined synopsis/solicitation for a commercial item prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.
1. The solicitation number is FA486119QA029. This solicitation is issued as a Request for Quote (RFQ).
2. The incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2019-05, effective 12 September 2019.
3. This requirement is solicited as a 100% Small-Business set-aside, and the associated NAICS code is 811310 - Commercial and Industrial Machinery and Equipment.
4. Below is the contract line item number.
See RFQ Worksheet and SOW attached
5. Description of requirement for the item to be acquired.
Delivery Date: 30 Days ADC
Delivery/Ship to Location: Nellis AFB, NV
6. Place of delivery is Nellis AFB, Nevada, and inspection and acceptance is FOB destination.
7. The following provisions are incorporated by reference.
52.212-1, Instructions to Offerors - Commercial
8. The following provisions are incorporated by full-text.
52.212-1, Instructions to Offerors - Commercial, Addendum, applies to this acquisition.
(1) FAR 52.212-1, paragraph (b)(8), is changed to read:
(8) Offerors must include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items, with its offer.
(2) FAR 52.212-1, paragraph (c), is changed to read:
(c) Period for acceptance of offers. The offeror agrees to hold prices in its offer firm for 90 calendar days from the date specified for receipt of offers.
(3) To be considered for this requirement, the offer must complete the Bid Schedule (see paragraph 4). Fully complete the pricing on each CLIN as required. The contractor shall fill out a unit price, the extended price and a total price for all CLINs. Please ensure that all prices, extended prices and total prices are checked and verified for accuracy. DO NOT go two (2) digits beyond the decimal point.
(4) In accordance with FAR Part 9, Contractor Qualifications, past performance information will be used to determine whether an offeror has a satisfactory performance record to determine whether the offeror is a responsible contractor eligible for contract award.
An offeror determined to have an unsatisfactory performance record will be determined non-responsible, therefore, the offeror will not be eligible for contract award.
In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available, the offeror will not be evaluated favorably or unfavorably on past performance.
The Government has a right to retrieve additional past performance information through the Government's past performance databases, Federal Awardee Performance Integrity Information System (FAPIIS) and Past Performance Information Retrieval System (PPIRS).
52.212-2, Evaluation -- Commercial Items, (Jan 1999)
Award will be made to the Offeror whose Acceptable Technical Proposal represents the Best Value to the Government. Best Value will be determined by the Lowest Priced Technically Acceptable proposal. Offers will be rated by technical acceptability and award will be made to the lowest priced offer.
(1) The evaluation team will evaluate each offer on its merits and assign one of the following ratings to each offer.
Technical Acceptable/Unacceptable Ratings
Rating Description
Acceptable Offer clearly meets the requirements of the Solicitation and the Requirements Description.
Unacceptable Offer does not clearly meet the requirements of the Solicitation and the Requirements Description.
Price. The Government shall conduct a price evaluation of all offers. The Government will evaluate an offer by adding the total price for all CLINs. The Government may use various price analysis techniques and procedures to ensure a fair, reasonable and realistic price. Evaluation of prices will determine if they are compatible with the scope of the effort, are not unbalanced and are neither excessive nor insufficient for the effort to be accomplished. It is expected that the competitive nature of this acquisition will drive price reasonableness and fairness; however, the Government reserves the right, if it deems appropriate, to make these determinations by means of one or more price analysis techniques.
a. Contract(s) may be awarded to the offeror who is deemed responsible in accordance with the FAR Part 9.1, whose offer conforms to the solicitation's requirements (to include all stated terms, conditions, representations, certifications, and all other information required by this RFQ) and is judged, based on the evaluation to represent the best value offer.
The Government intends to evaluate proposals and award 1 (one) contract without discussions with offerors. Therefore, the offeror's initial proposal should contain the offeror's best terms. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals.
While the Government will strive for maximum objectivity, the selection process, by its nature, is subjective; and therefore, professional judgment is implicit throughout the entire process.
b. A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.
(End of Provision)
52.252-1, Solicitation Provisions Incorporated by Reference
This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):
9. The following clauses are incorporated by references.
FAR 52.212-4, Contract Terms and Conditions -- Commercial Item
FAR 52.247-34, FOB Destination
DFAR 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports (Jun 2012)
10. The following clauses are incorporated by full-text.
52.212-5, Contract Terms and Conditions Required to Implement Statutes or
Executive Orders -- Commercial Items (Nov 2013)
(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:
(1) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)).
__ Alternate I (AUG 2007) of 52.222-50 (22 U.S.C. 7104(g)).
(2) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).
(3) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub. L. 108-77, 108-78).
(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the contracting officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:
_x_ (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 253g and 10 U.S.C. 2402).
_x_ (4) 52.204-10, Reporting Executive compensation and First-Tier Subcontract Awards (Jul 2013) (Pub. L. 109-282) (31 U.S.C. 6101 note).
_x_ (6) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Aug 2013) (31 U.S.C. 6101 note).
_x_ (8) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (May 2012) (section 738 of Division C of Public Law 112-74, section 740 of Division C of Pub. L. 111-117, section 743 of Division D of Pub. L. 111-8, and section 745 of Division D of Pub. L. 110-161).
_x_ (12) (i) 52.219-6, Notice of Total Small Business Aside (Nov 2011) (15 U.S.C. 644).
_x_ (14) 52.219-8, Utilization of Small Business Concerns (Jul 2013) (15 U.S.C. 637(d)(2) and (3)).
__ (17) (i) 52.219-9, Small Business Subcontracting Plan (Jul 2013) (15 U.S.C. 637 (d) (4)).
__ (iii) Alternate II (Oct 2001) of 52.219-9.
_x_ (23) 52.219-28, Post Award Small Business Program Representation (Jul 2013) (15 U.S.C. 632(a) (2)).
_x_ (26) 52.222-3, Convict Labor (June 2003) (E.O. 11755).
_x_ (27) 52.222-19, Child Labor-Cooperation with Authorities and Remedies (Nov 2013) (E.O. 13126).
_x_ (28) 52.222-21, Prohibition of Segregated Facilities (Feb 1999).
_x_ (29) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246).
_x_ (30) 52.222-35, Equal Opportunity for Veterans (Sep 2010) (38 U.S.C. 4212).
_x_ (31) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793).
_x_ (32) 52.222-37, Employment Reports on Veterans (Sep 2010) (38 U.S.C. 4212).
_x_ (33) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496).
__ (34) 52.222-54, Employment Eligibility Verification (Aug 2013). (Executive Order 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.)
_x_ (35) (i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C. 6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.)
_x_ (38) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging while Driving (Aug 2011).
_x_ (42) 52.225-13, Restrictions on Certain Foreign Purchases (Jun 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).
_x_ (48) 52.232-33, Payment by Electronic Funds Transfer- System for Award Management (Jul 2013) (31 U.S.C. 3332).
(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or executive orders applicable to acquisitions of commercial items:
_x_ (1) 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.).
_x_ (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 1989) (29 U.S.C. 206 and 41 U.S.C. 351, et seq.).
_ _ (3) 52.222-43, Fair Labor Standards Act and Service Contract Act -- Price Adjustment (Multiple Year and Option Contracts) (Sep 2009) (29 U.S.C.206 and 41 U.S.C. 351, et seq.).
(d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation.
(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract.
(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.
(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.
(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause-
(i) 52.203-13, Contractor Code of Business Ethics and Conduct (Apr 2010) (Pub. L. 110-252, Title VI, Chapter 1 (41 U.S.C. 251 note)).
(ii) 52.219-8, Utilization of Small Business Concerns (Jul 2013) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.
(iii) 52.222-17, Nondisplacement of Qualified Workers (Jan 2013) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17.
(iv) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246).
(v) 52.222-35, Equal Opportunity for Veterans (Sep 2010) (38 U.S.C. 4212).
(vi) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793).
(vii) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40.
(viii) 52.222-41, Service Contract Act of 1965, (Nov 2007), (41 U.S.C. 351, et seq.)
(ix) 52.222-50, Combating Trafficking in Persons (Feb 2009) (22 U.S.C. 7104(g)).
(x) 52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (Nov 2007) (41 U.S.C. 351, et seq.)
(xi) 52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services--Requirements (Feb 2009) (41 U.S.C. 351, et seq.)
(xii) 52.222-54, Employment Eligibility Verification (Aug 2013).
(xiii) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).
(xiv) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (Mar 2009) (Pub. L. 110-247). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.
(xv) 52.247-64, Preference for Privately-Owned U.S. Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.
(2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.
(End of Clause)
52.252-2, Clauses Incorporated by Reference (Feb 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):
5352.201-9101, Ombudsman (Nov 2012)
(a) An ombudsman has been appointed to hear and facilitate the resolution of concerns from offerors, potential offerors, and others for this acquisition. When requested, the ombudsman will maintain strict confidentiality as to the source of the concern. The existence of the ombudsman does not affect the authority of the program manager, contracting officer, or source selection official. Further, the ombudsman does not participate in the evaluation of proposals, the source selection process, or the adjudication of protests or formal contract disputes. The ombudsman may refer the interested party to another official who can resolve the concern.
(b) Before consulting with an ombudsman, interested parties must first address their concerns, issues, disagreements, and/or recommendations to the contracting officer for resolution. Consulting an ombudsman does not alter or postpone the timelines for any other processes (e.g., agency level bid protests, GAO bid protests, requests for debriefings, employee-employer actions, contests of OMB Circular A-76 competition performance decisions).
(c) If resolution cannot be made by the contracting officer, concerned parties may contact the Center/MAJCOM ombudsmen, Lt Col Lateef M. Hynson, USAF Deputy Director of Contracting, OL-ACC Air Force Installation Contracting Agency Joint Base Langley-Eustis VA COMM: (757) 764-5372 DSN: 574-5372 firstname.lastname@example.com. Concerns, issues, disagreements, and recommendations that cannot be resolved at the MAJCOM/DRU or ARISRA level, may be brought by the concerned party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330-1060, phone number (703) 588-7004, facsimile number (703) 588-1067.
(d) The ombudsman has no authority to render a decision that binds the agency.
(e) Do not contact the ombudsman to request copies of the solicitation, verify offer due date, or clarify technical requirements. Such inquiries shall be directed to the Contracting Officer.
(End of clause)
(a) The contractor shall obtain base identification and vehicle passes, if required, for all contractor personnel who make frequent visits to or perform work on the Air Force installation(s) cited in the contract. Contractor personnel are required to wear or prominently display installation identification badges or contractor-furnished, contractor identification badges while visiting or performing work on the installation.
(b) The contractor shall submit a written request on company letterhead to the contracting officer listing the following: contract number, location of work site, start and stop dates, and names, dates of birth, social security numbers, citizenship, and driver's license / state identification, of employees and subcontractor employees needing access to the base. The letter will also specify the individual(s) authorized to sign for a request for base identification credentials or vehicle passes. The contracting officer will endorse the request and forward it to the issuing base pass and registration office or Security Forces for processing. When reporting to the registration office, the authorized contractor individual(s) should provide a valid driver's license (additional supporting documentation is required when driver's licenses from Utah, New Mexico, or Washington is provided such as Passport, original Birth Certificate with raised seal, or original Social Security Card), current vehicle registration, valid vehicle insurance certificate, and for non-US citizens, documentation demonstrating legitimate ability/status to be in the United States to obtain a vehicle pass.
(c) During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site.
(d) When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall be briefed on the requirements of AFI 31-101, Integrated Defense, and AFI 31-501, Personnel Security Program Management. Compliance with the requirement of these AFIs is mandatory for access.
(e) Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure that all base identification passes issued to employees and subcontractor employees are returned to the issuing office.
(f) Failure to comply with these requirements may result in withholding of final payment.
(End of clause)
11. Offers are due on Thursday, 12 September 2019, at 16:30pm PST. Offers submitted electronically via email will only be considered for this requirement. Submit offers to 1st Lt Andrew Horstman at email@example.com. Please include the solicitation number, FA486119QA029, in the Subject Line of the email to ensure prompt receipt of your proposal.
12. Below are the names and telephone numbers of the individuals to contact for information regarding this solicitation.
Primary Point of Contact
1st Lt Andrew Horstman
Contract Specialist
Secondary Point of Contact
TSgt Rommel Delmundo
Contracting Officer
Performance Work Statement
Maintenance of Transformers
13 June 2019
Section 1: Description of Service
1.1 General Requirements: The contractor shall provide all personnel, equipment, tools, material, supervision, and other items and services necessary to perform annual preventative maintenance, testing and adjustment, as specified within this performance work statement, on the following equipment on Nellis AFB, NV.
• One (1) 20 MVA, 69 KV Delta, North American Transformer and One (1) 24 MVA, 69 KV Delta, Waukesha Transformer, Serial No. GT-3013.
1.2 Preventative Maintenance: Contractor shall, in accordance with the equipment manufacturer's most current technical and maintenance literature and current industry practice, inspect, test, adjust, calibrate and service as necessary to maintain the equipment in normal operating condition as the manufacturers intended. Transformer and tap changer oil shall be tested by a certified lab and filtered if warranted. Specific tests and test procedures shall be as specified in most current ANSI/NETA NTS. Oil shall be replaced if filtering and additives will not restore its required properties. Contractor shall provide a proposal for an oil change during the proposal process.
1.2.1 Annual servicing: The annual performance period should be scheduled between October and April. This date will be determined within 3 weeks of each yearly award and must be approved by the government technical representative in Service Contracts Section at 702-652-8265.
1.2.2 Repairs: During scheduled servicing, any minor repairs found necessary totaling under $2500.00 per transformer shall be included at no additional cost to the government. Any major repair issues discovered shall be identified to the government technical representative. When the cost of the repair parts exceeds $2500 the contractor will provide the government, for CO approval, with at least three parts quotes to determine price fair and reasonableness, or a sole source letter template will be provided by the contracting officer upon request when competition is not available. Appropriate commercial grade materials and common trade practices shall be used. Replacement parts must be equal to or better quality than the manufacturer installed when the transformer was manufactured. Any major repair issues discovered shall be reported to the government technical representative.
1.2.3 Schedule: Contractor shall provide a proposed maintenance schedule upon contract award. Flexibility in the schedule can be approved as long as servicing interval remain as close to a year as possible. Any work that requires de-energizing a transformer must not be scheduled during air conditioning season unless approved by the government technical representative.
Coordination of any work shall always be made with 99th Civil Engineering Service Contracts section.
Performance Work Statement
Maintenance of Transformers
13 June 2019
1.3 Government Responsibilities
1.3.1 Power Switching: Given adequate notice, the government will be responsible for de-energizing and re-energizing the transformers.
1.3.2 Manuals, Wiring Diagrams and Publications: The majority of the necessary equipment-specific technical and maintenance publications are available from the government. The contractor may review them or copy them at no expense to the government. The originals will not be mailed or leave the control of the government. Any literature that the contractor requires which is not available from the government will be the contractor's responsibility to procure at no additional cost to the government.
1.3.3 Utility Services: The government will supply commercial power at the substation for tools and equipment.
1.4 Contractor Responsibilities
1.4.1 Waste and Debris: Contractor shall comply with all pertinent Federal environmental requirements. Apply RCRA (Resource and Recovery Act) standards for handling and disposing of transformer oil. Contractor is responsible for all waste products generated. At no time will the contractor dispose of hazardous material or hazardous waste on base. Waste must be properly contained at all times and removed from Nellis AFB and disposed of properly. Access to a base dumpster may be allowed for certain non-hazardous debris and rubbish by the government technical representative. Contractor must clean up the work area upon completion.
1.4.2 Maintaining Commercial Power: Contractor must service transformers and related equipment in such a way that at least one transformer is energized at all times.
1.4.3 Warranty of Work: Contractor shall warranty any new replacement or refurbished parts, equipment and workmanship for a period of one year from the date of acceptance. Contractor shall, at no cost to the government, promptly furnish and install replacement parts and correct defects in workmanship upon receipt of notice from the government technical representative concerning failure of any part of the system during the warranty period.
1.4.4 Contractor Qualifications: Contractor shall provide proof that all employees that will enter the transformer substation are qualified to work around energized transformers rated 15KV and above. They must submit proof the employees will be able to perform the work required under this contract. This may include trade certifications, validated similar experience, training certificates, past performance, and other documentation that each contractor may feel it beneficial to submit. At all times there must be a licensed journeyman (any state), or higher, electrician at the jobsite. Provide proof of this licensing with proposal package. Each contractor's submitted qualifications will be evaluated to insure they are capable of safely and effectively performing the requirements of this contract. The contractor shall comply with the guidance included in the following publications: the latest versions of OSHA STALLCUP'S
Performance Work Statement
Maintenance of Transformers
13 June 2019
HIGH VOLTAGE AND TELECOMMUNICATIONS REGULATIONS SIMPLIFIED and
OSHA ELECTRICAL REGULATIONS SIMPLIFIED and AIR FORCE INSTRUCTION 32-1064, (25 May,2006), ELECTRICAL SAFE PRACTICES.
1.4.5 Required Submissions: Included as part of the proposal package, each bidder shall provide a proposed standard checklist they will use to perform the inspection/testing and the maintenance indicating what service they will provide. Contractor shall provide proof of liability insurance coverage adequate to cover the maximum cost of damage to the equipment being repaired and serviced. Contractor shall provide test results with final report to the government within thirty (30) calendar days.
Section 3: Government Furnished Property: N/A
Section 4: Additional Information:
4.1 Security: All personnel employed by the contractor in the performance of this contract, or any representative of the contractor entering the Government installation, shall abide by all security regulations of the installation. The contractor shall obtain from the Government an AF Form 75, Personal Identification Card, for each employee working at Nellis AFB, and AF Form 533, Vehicle Registration Certificate for personal vehicles requiring access to Nellis AFB. When any employee no longer works for the contractor at the installation, the contracting officer representative shall return any Government-furnished identification to the Government. These passes are at no cost to the contractor. Use of photographic equipment is forbidden without express consent of the Contracting Officer.
4.2 Site Protection: Contractor shall replace or repair all existing adjacent surfaces, utilities, equipment, products, vegetation, and structures or parts thereof that have been damaged or removed to perform the work.
4.3 Work Scheduling and Coordination:
All work shall be accomplished on normal duty days during normal duty hours. Normal duty hours are 7AM to 4PM Monday thru Friday except Federal holidays. Work outside these times must be requested and approved through the government technical representative.
4.4 Location: The work site is located on Nellis Air Force Base, NV
4.5 Government Representatives: The contractor will receive designation of the government technical representatives, contracting officer and contract administrator with contract award.
- Opportunity closing date
- 12 September 2019
- Value of contract
- to be confirmed
About the buyer
- Address
- Department of the Air Force 99 CONS United States
The deadline to apply for this opportunity has passed.
Visit the opportunities page to find another.


text: Product Search Search Effective Health Care website Submit search Search Tip: Use double quotes around phrases to rank exact matches higher in the result list. 9 results Data Points #18: Use of and access to health care by Medicare beneficiaries with diabetes: impact of diabetes type and insulin use, 2007-2011 Research Report January 29, 2014 Data Points #17: Trends in bariatric surgery in Medicare beneficiaries Research Report Archived November 30, 2012 Health Outcomes of Bariatric Surgery in Individuals with Type 2 Diabetes Research Report November 29, 2012 Data Points #15: Prognostic factor testing among older women with ductal carcinoma in situ and early invasive breast cancer Research Report September 13, 2012 Comparative Effectiveness of Intravenous Iron Formulations in the Treatment of Anemia in End Stage Renal Disease Research Report January 24, 2012 Who Uses Exenatide For Glucose Control in Diabetes Mellitus? A Retrospective Cohort Study of a New Therapy Research Report Archived August 4, 2010 Prompt Reduction in Use of Medications for Comorbid Conditions After Bariatric Surgery Research Report Archived July 30, 2010 Use of Electronic Medical Records and Administrative Claims Data for Assessing Type 2 Diabetes Care Research Report April 7, 2010 Effectiveness of Isosorbide Dinitrate and Hydralazine in Racial/Ethnic Subgroups With Heart Failure Research Report Archived March 31, 2010

subset: commoncrawl


text:
Welcome To WDM Tiger Cub Baseball
Baseball for Kindergarten through Second GradeUpdatedMonday February 26, 2018 byWDM Tiger Cub Baseball.
We are a baseball club for kids in kindergarten - second grade.
The vision of the club is to help kids have fun learning and playing the game of baseball without having to invest $1500 or traveling to out of town tournaments.
Registration is now open for the West Des Moines Tiger Cub Baseball 2018 Season.
The season will run from April 1, 2018 through July 1, 2018.
Each child will have one clinic and one game per week. Sessions will be held Tuesdays, Thursdays, and Saturdays at the Valley Southwoods baseball fields in West Des Moines.
All kids will receive coaching and instruction from area baseball experts. The drills and practices were designed by high school and college coaches with decades of coaching and teaching experience.
Our goal is for all kids and families to learn and enjoy the game of baseball without significant cost and travel expense.
Spots are available for kids finishing kindergarten through second grade in 2018/
Cost is $200 per child and includes 30 sessions, jersey, and hat.
League coaches and board members will place kids in divisions and on teams based on skill level and readiness.
If you are interested in coaching or volunteering, please sign up as a volunteer or contact email@example.com.
Please email email@example.com with any questions or call Andy at 515.491.7084.


text:
Accurate information has never been more essential. Your contributions, no matter the size, can help the Colorado Springs Indy continue to provide local journalism.
Help support our mission: TRUTH MATTERS.
Rosa Luxemburg, a 19th-century activist, championed communism in her home country of Poland and throughout Europe. Both an incendiary figure and respected thinker, Luxemburg was highly educated and ambitious, launching newspapers and movements. In 1919, she was captured by the German military, which brutally murdered her and dumped her body in a canal.
Many years later, American painter May Stevens discovered Luxemburg and became haunted by her story. She juxtaposed Luxemburg's life with that of her mother, Alice Stevens, a homemaker who dedicated her life to family, including caring for a severely diabetic son who died at 16.
That's how the two very different women wound up together amid lush surroundings in "Forming the Fifth International": Luxemburg in black and white, arm draped over a park bench, and Alice Stevens in a blur of bleached color, clasping her legs with eyes cast to the ground in a moment of repose.
Serene as it seems, Colorado College I.D.E.A. Space curator Jessica Hunter Larsen says the painting is actually radical: "You just don't see large-scale, monumental images of old women." Especially when one of them led such a quiet, insular life.
But the more you delve into May Stevens' own life and works, the more you see this artist, now 86 years old, is quite radical herself.
Extraordinary, defined
"Forming the Fifth International" is part of "Ordinary/Extraordinary," a series of prints and drawings that questions what constitutes an extraordinary or an ordinary woman's life. It can be seen in May Stevens: Crossing Time, a 24-piece retrospective of Stevens' career opening Sept. 7 at the I.D.E.A. Space.
After her brother died, says the Sante Fe, N.M., artist in a phone interview, she tried to care for her mother. Alice had no life outside her home — no friends, hobbies or other activities: "When she lost him, she had nothing."
Her death was slower than that of Luxemburg, but equally grim in its own way. And what happened afterward was even worse.
"Both of these women are lost to history," says Hunter Larsen. "Despite Rosa Luxemburg's incredible contributions, history sort of wrote her out of the books. Women like Alice Stevens were never there to begin with. They were never considered important."
In response, Stevens says, "I wanted to value my mother's life. Value what she tried to do and what many women have and maybe still try to do, which is to take care of the people they have to take care of and who they are responsible for."
Stevens is known as much for her social activism as her art. According to Hunter Larsen, she's been involved in nearly every great social movement of the 20th century and is renowned among feminist artists.
Stevens says "there's hardly a border" between her quest for social justice and her art, a closeness readily apparent in some early works. A few pieces in the show hail from Stevens' "Big Daddy" series, which depict a strange, phallic-shaped man donning a helmet and American flags. Executed in the late '60s and early '70s, the "Big Daddy" works are the earliest pieces in the show, and provoke a complex array of emotions. The figure duplicated in each work is goofy, but sinister with his flushed, crunched-up face and large bald pate. We fear him in his anonymity, and anguish with a powerlessness in his presence.
"Big Daddy" held obvious roots in the Vietnam era, but Stevens is still tackling current issues today. She's bringing a few pieces from her most recent series to Crossing Time, harrowing works that deal with the epidemic of rapes and murders of young women on the border towns between the U.S. and Mexico.
The water's edge
After painting the figures of Alice and Luxemburg up close for several years, Stevens backed away and set the women, now dreamy figures, in boats on undulating bodies of water.
Stevens says the rivers of her works hark back to a river she visited every day of her childhood in Boston, but you can't help but think of Luxemburg meeting her end in that canal.
As her paintings progressed further, the boats floated away and the deep, cool colors of river bottoms dominated the paintings, ostensible stand-ins for Luxemburg and Alice, says Hunter Larsen.
The culmination of this graduation is Stevens' other magnum opus, "Confluence of Two Rivers," a magnificent abstract painting blended of deep, oily blues and watery teals, breaking on a reef of gold. It's an aquatic riverscape with no shore or bearings, a place in a dream.
Upon closer inspection, the gold element, which from afar appears to be a trick of dried paint, is actually a scribbling of thousands of words. The looping script builds a texture on the canvas, endowing the work with an identity — and mystery, since it's illegible.
"I felt [it] enriched the surface and made it a deeper and more resonant kind of experience," says Stevens, who says she's written all her life.
Though carefully chosen, these words are not to be read. Many are in another language altogether — the text in "Confluence" is Lithuanian.
Aesthetically, Hunter Larsen says this element retains some mystery crucial to Stevens' work. Upon further study, the work unfolds into grander and grander narratives, concerning not only the meaning of the words on the canvas, but Stevens herself.
The mastery, however, is within the way Stevens' paintings provoke a fascination whether or not you're new to the piece, or the subject within it. Like Stevens herself, they are open and flexible to viewer experience.
"I really believe in seeing how things echo in each other," Stevens says. "I am very much convinced you don't want to bind yourself up in words or ideas which limit you from understanding other people's words and ideas."


text:
Travel republic Granville
Swinger Wives Wanting Adult Xxx Local Swingers Searching Meet Swingers
Pretty cool little club. Very interesting getting patted down before entering, but staff were nice I like to come here on Saturdays. But only come if you have Guestlist, even the Guestlist Granvlle Travel republic Granville We had a couple of unexpected guests that came with us, and despite some issues, the management and security staff Very interesting getting patted down before entering, but staff were nice.
|Relationship Status:
|I Wants Couples
|Relation Type:
|Divorced Horny Search Chat With People
Views: 5007
Deja Vu Fridays
Oops, it looks like something's gone wrong. While we're fixing it, click on the image to go to the Republic Instagram account. Sign rGanville for news. Stay Connected. Hotel search.
Accessibility Links
Name contains '' Rated and above Min price of Max price of. Accept and continue browsing. Who is going?
If you Grnaville elegant place, this is not the one. Sabine acknowledges there could be a shift to smaller venues but notes they cater to an entirely different audience than clubs in the Granville area. You are currently logged.
Start your free trial.
Breakfast Travel republic Granville. The area around the hotel is safe Travel republic Granville the people Political and Media Affairs. View Details.
Hotels in Granville / | Cheap Granville Hotel Deals | Travel Republic
Sign in to Comment. July Gauthier hopes this will bring in more restaurants and stores to invigorate the area Booval singles greentree of peak nighttime hours. Xinhua News Agency. Special Offer Book Direct and Save. Taxes, fees not included for deals content.
Single Mature Wanting Fuck Girls Tonight Adult Horney Wants Divorced Mothers Travel republic Granville
Canada English. English ❶Traveler rating. Cherry Valley Lodge. Unsubscribe from our email list. Property Type. You can walk to the City Sightseeing office easily. Star Rating. Reserve now, pay at stay. Language English. Flying from? Sort by: This Week's Flyers. Massage Melton st place brings in some great talent but is kind of overpriced and has a weird crowd on non-concert nights.
Horny Moms Want Phone Sex Local Teens Looking Casual Teens Travel republic Granville
Sun - Sat Is there a suggested donation to enter this place?|We use cookies to provide you with Locanto Granville personal best experience Travvel our site.
By continuing you agree to our use of cookies. Unsubscribe from our email list. Accept and continue browsing. Holidays to Granville. Looking for a hotel only? Where to? Flying from? Tepublic is going? Group Booking Enquiries.
Direct Only. All airlines.
Please select a Grajville age for each child in your party. Filter by.]Mr Waite and Mr Furner founded Travel Republic in and Mr Pirie joined them two years later after spells with Granville Baird and KPMG.
Cheap rates and genuine, independent hotel guest reviews for the Granville Hotel in East Sussex, United Kingdom with Travel Republic. Hotels near Travel Republic Africa, Johannesburg on TripAdvisor: Find traveler reviews, 65 Granville Place, JohannesburgSouth Africa.


text:
Lots of great news links on court cases, police action and all manner of ALLEGED misdeeds . . .
Housing Reg Dispute Cont'd
KC Housing Authority to withhold more payments from TEH Realty
The Kansas City Housing Authority is making plans to withhold another $41,000 in taxpayer-subsidized housing contracts to landlords with TEH Realty, who are currently under federal investigation.The developments come after the Housing Authority's planned reinspection of 81 units at the Nob Hill Apartments in south Kansas City.
Meth Town T. J. Hooker Sighted
Man caught on camera clinging to hood of car driving on Independence street, highway
INDEPENDENCE, Mo. -- A man clinging to the hood of a moving SUV: It's not something you see every day. It happened over the weekend in Independence, but police and witnesses have provided FOX4 with more details about the wild ride. Eyewitnesses said the man jumped onto the hood of the vehicle.
Golden Ghetto All Clear
DA: No charges against Lenexa officer who fired at suspect
KANSAS CITY, Mo. - Charges will not be brought against a Lenexa police officer who fired at a suspect, hitting him in the arm, after the Johnson County District Attorney's Office found the shooting to be justified. District Attorney Steve Howe said Wednesday that his office completed its review of the Nov.
Drunk Spy Tech Emerges
New Kansas regulation requires a camera with all ignition interlock device installations
OLATHE, Kan. -- A new regulation went into effect in Kansas on Wedesday, making it harder for previous offenders to drive drunk again. It's a relief for a local family that has been pushing for tighter laws around drinking and driving for years after losing a loved one.
KCTV5 Wanted Report
Wanted: Raul Villalva
KANSAS CITY, MO (KCTV) -- Raul Villalva is wanted on a Clay County warrant for sexual assault of a child. The original offense happened in 2018 in Clay County and involved the sexual assault of a child less than 12 years of age.
Double Shootout Charges After Sleaze Scummit Gunfire
2 charged after shots fired into homes in Blue Springs, Lee's Summit
Two people have been charged in a multiple drive-by shootings into homes in Lee's Summit and Blue Springs.
Making Way: Independence, MO Tribute To Police
Independence says farewell to fallen police officer
Before his funeral services and burial, Det. Sgt. Jason Young had one last, solemn visit to the office. The funeral procession for Young, a 24-year member of the Independence Police Department who was killed last in an off-duty collision in Gladstone, stopped for several minutes in front of police headquarters on Memorial Drive.
Developing . . .


text:
Sci. Aging Knowl. Environ., 14 December 2005
When T Cells Get Old
Graham Pawelec
The author is at the Center for Medical Research at the University of Tuebingen, D-72072 Tuebingen, Germany. E-mail: graham.pawelec{at}uni-tuebingen.dehttp://sageke.sciencemag.org/cgi/content/full/2005/50/pe39
Key Words: T cells immunoscenescence CMV vaccination remediation
Of all the age-associated changes to the immune system observed in humans and animal models, those affecting T cells appear to be the most grave (see "Immunity Challenge"). Age-associated changes to the distribution of T cell subsets (e.g., naïve T cells and various memory cell subpopulations) and their function (e.g., anergic and/or suppressive) may contribute to the reduced ability of elderly individuals to resist infectious diseases and to respond to vaccination. These alterations are globally referred to as "immunosenescence," a poorly defined state of clinically relevant decreased immunity. A workshop titled "Differentiation and Immunoscenescence in the Immune System" was held at the Edward Jenner Institute for Vaccine Research in Compton, UK, from 6 to 7 October 2005, to review the state of our knowledge in these areas and to formulate future avenues for investigation. The Jenner Institute was an appropriate location for the meeting, because the most profound clinical impact of age on the immune system concerns the response of the elderly to vaccination (see "All Pain, No Gain"). Organized by Peter C. Beverley of the Jenner Institute, Arne N. Akbar of University College, London, and Donald Palmer of the Royal Veterinary College, London, the meeting included discussions on T and B cell differentiation and aging, as well as dendritic cell and neutrophil data. This Perspective focuses on the main findings relevant to T cell immunosenescence, one of the most important areas of study for which most data are available.
T Cell Persistence and Homeostasis
Immunological memory--the ability of the immune system to respond more efficiently to a second encounter with the same pathogen--is defective in the elderly. Development of the total T cell pool in early life is dependent on the output of naïve T cells from the thymus and the establishment of an antigen-experienced pool of memory cells, which has a more restricted repertoire. The total number of T cells is more or less constant throughout life, but it appears that changes in the composition of each pool, determined by the balance of proliferation and death in T cell subpopulations, plays a role in the decline in immunocompetence. T cell subpopulations are classified by the presence of particular cell surface markers; for example, helper T cells carry the CD4 surface protein, and memory cells carry CD8. (For more information on the immune system, see "Immunity Challenge.") Diana L. Wallace and Peter C. Beverley, both at the Jenner Institute, in collaboration with Derek C. Macallan of St. George's Hospital Medical School in London, have been performing pioneering work on the kinetics of T cell turnover during human aging (1). By in vivo labeling of dividing lymphocytes with glucose that contains deuterium, the researchers were able to measure the rate at which deuterium is incorporated into DNA and then diluted with each cell division. Their studies have revealed that in healthy young people, cells with a memory/effector phenotype (e.g., CD45RO+ cells) divide more rapidly than naïve (e.g., CD45RA+) cells in both the CD4+ and CD8+ T cell subsets. CD45RO+ cells have a 26-day half-life, with 2.7% of cells dividing every day, whereas the RA+ cells have a 154-day half-life and only 0.5% divide every day. The rates at which CD4+ CD45RA+, CD4+ CD45RO+, and CD8+ CD45RO+ cells divide and disappear are the same among young and old, but the rate of disappearance of CD8+ CD45RA+ T cells was far slower in the elderly than in the young (by a factor > 10), implying that these cells represent a long-lived pool of cells that persists in the circulation. In addition, these persistent cells contained large clonal populations. Despite their RA+ phenotype, these are likely to be memory cells specific for some of the same epitopes identified by the other researchers, as discussed below.
These findings suggest that memory T cells turn over faster than naïve T cells, implying that replicative senescence will occur faster than in the naïve cell population. In addition, because CD8+ naïve cells are also turning over in the elderly, it is likely that each naïve cell of an elderly person has accumulated a larger number of population doublings during the life of the individual compared with a cell of a younger person. This observation provides an explanation for naïve cell aging, which is also supported by elegant work in mice, as presented by Laura Haynes of the Trudeau Institute at Saranac Lake, NY, showing that naïve phenotype cells in old mice are functionally compromised.
In the Wallace study, the CD8+ CD45RA+ T cells were associated with seropositivity for cytomegalovirus (CMV) in the young. It is possible that CMV in some way prevented cell death in virus-specific, or even bystander, CD8+ populations, which would explain why CD8+ CD45RA+ T cells persist. These data are consistent with many other studies presented at the conference, implicating CMV as a major driving force behind many of the measured manifestations of immunosenescence in humans (see also "T Cell Tunnel Vision" and Koch Perspective). Some of these findings are discussed below.
Role of CMV and Other Persistent Viruses
A large body of evidence suggests that CMV infection affects CD8+ cell turnover and function in both young and elderly individuals, but the effects of this virus on CD4+ cells are less well studied, and those on natural killer (NK) cells in the elderly are essentially unknown. However, preliminary studies by Paul A. Moss at the University of Birmingham, UK, indicate that CMV has relatively minor effects on NK cells, B cells, or regulatory T cells in the elderly. He showed that CMV negatively influences the number of naïve CD8+ cells in the elderly and suggested that CMV accelerates age-associated processes, which would occur regardless of viral infection. These observations are consistent with the much-discussed idea that chronic antigenic stimulation of any kind (including by CMV antigens) and at any age can drive clonal expansions of specific memory cell subpopulations, resulting in an overall deleterious effect on immune function. Clonal expansion of cell subpopulations decreases the available T cell repertoire, takes up space that could be used by newly developed cells, and gives rise to dysfunctional cells. Advanced age results in the accumulation of multiple such problems.
Along similar lines of thought, Janko Nikolich-Zugich of the Oregon Health and Science University in Portland presented strong evidence that antigen-independent, sustained proliferation of T cells over a lifetime, such as that induced by lymphopenia or by adjuvants, can induce persistent T cell clonal expansions in specific pathogen-free mice. Graham Pawelec of the University of Tuebingen pursued this line of investigation by comparing chronic antigenic stimulation caused by persistent activating viruses in the elderly with that caused by tumor antigens in mostly younger cancer patients. Many similarities in the CD8+ response were observed between the two, both functionally and phenotypically.
The accumulation of CMV-specific CD8+ cells bearing the hallmarks of anergic cells--dysfunctional cells that carry antigen-specific receptors but are unable to mediate their full range of responses upon antigen recognition--represents an important part of the immune risk phenotype (IRP) predictive of mortality in the very elderly. The IRP concept, which originally consisted of a cluster of relatively simple immunological parameters, such as the CD4+:CD8+ ratio, number of CD8+ CD28- T cells, and proliferative responses to mitogens, all of which are now believed to be influenced by CMV, emerged from the longitudinal aging studies carried out by Anders Wikby and colleagues at the University of Jönköping in Sweden (2). The IRP was further established through a long-term collaborative undertaking supported by the European Commission and coordinated by Pawelec (see the "T-Cells In Ageing" Web site for details and also the Koch Perspective) In addition to its use in establishing prognosis in older patients, the IRP may also prove useful for assessing "biomarkers of immunosenescence" in younger individuals. Recent work from Pawelec's group has shown that CD8+ clonal expansions, driven predominantly by CMV but also by Epstein-Barr virus, begin in early middle-age.
We now know that among the very elderly (e.g., >85 years), those individuals with a larger number of clonal expansions have a longer life expectancy than those with few clonal expansions (but note that all individuals possess very large numbers of CMV-specific CD8+ cells) (3). The model best explaining these data is one in which CMV drives clonal expansions of multiple CD8+ cells recognizing different CMV epitopes; in the young, up to 10% of the T cell repertoire is already obsessed with CMV, as was detailed in Moss's presentation. The number of different clones that are expanded increases with age, as does the overall number of CD8+ cells recognizing CMV epitopes. This clonal expansion leads to dysregulation of the immune response and is thus detrimental to individuals, but that may be the price to be paid to maintain a vitally necessary CMV immunosurveillance. However, at a very advanced age, clonal diversity starts to shrink, and individuals who possess only a small number of clonal expansions become at greater risk of death than those who retain a larger repertoire. Studies by Nikolich-Zugich in mice support the notion that virus infection drives clonal expansion. In those studies, persistent herpes simplex virus 1 infection led to the accumulation of clones specific for this virus and to their dysregulation over time, in the form of "memory inflation" (in other words, the persistent clonal expansions of memory cells). This inflation was, in turn, suppressed by continuous antiviral treatment of infected mice, showing directly that subclinical herpesvirus reactivation is necessary to drive the expansions of memory cells. It will be of interest to examine the clonal complexity and repertoire evolution in these animals.
As stated earlier, the role of CMV-specific CD4+ cells in this context has not yet been assessed. Arne N. Akbar, however, presented his studies on the functional status of CD4+ cells in the elderly. Unlike the studies on CD8+ cells, which revealed larger numbers of dysfunctional cells, the assays employed by Akbar's group only revealed the presence of nonanergic cells in elderly individuals. This is likely to be due to the fact that the use of major histocompatibility complex class II multimers, a method used for direct T cell receptor staining, remains fraught with technical difficulties. Nonetheless, his data on functional CMV-specific CD4+ cells were extremely informative. He reported that in older seropositive donors, CMV-specific cells had shorter telomeres, a sign of increased cell division, than cells from donors free of virus. Using CMV lysates, Akbar found that CMV stimulates the secretion of type I interferon (IFN-) by dendritic cells, which, in turn, inhibits telomerase function in all virus-specific cells, not just the CMV- specific ones, and increases the fraction of CD27- CD28- cells, which are more differentiated and thus closer to senescence. These results may explain the unexpected finding that cytolytic T lymphocytes in CMV-seropositive individuals possess more differentiated phenotypes than those either CMV-specific or specific for other, unrelated antigens in seronegative donors.
Remediation Is Possible
The work discussed above suggests that targeted neutralization of CMV-stimulated IFN- production might be beneficial in CMV-positive elderly individuals. Other possible therapies include the use of antiviral agents or therapeutic vaccination to eliminate CMV-specific T cell populations, but neither approach is likely to be available in the near future for use in the elderly, for several medical, ethical, financial, and logistical reasons. Similarly, adoptive immunotherapy with ex vivo-generated CMV-specific CD8+ cells, as applied in stem cell transplant recipients, is probably not ever going to be usable in the elderly. The elimination of the dysfunctional CMV-specific CD8+ cells might be beneficial in removing potentially suppressive cells or, at the very least, in making "space" for naïve cells that could, in theory, still be generated from residual thymic islands present in most elderly individuals. But how to target dysfunctional CMV-specific CD8+ cells, while leaving the functional ones intact, is a puzzle.
One possibility, discussed by Pawelec, might be to eliminate cells that are positive for both killer cell lectin-like receptor (KLR) G-1 and CD57 antigens, because it is only the small fraction of KLRG1+ but CD57- cells that seems to retain functionality in the elderly. This would be a way to eliminate dysfunctional CMV and T cell receptor (TCR)-positive CD8+ cells while keeping the functional ones. Another possibility might be to select CMV-specific cells with a naïve phenotype (a very small number of which appear to be present in most elderly individuals) and to expand them ex vivo using interleukin 15 (IL-15). As reported by Beverley, naïve CD8+ cells maintained in long-term culture in the presence of IL-15 retain their naïve phenotype, up-regulate telomerase activity, and actually increase the length of their telomeric repeats. This approach would obviously rely on the presence of naïve cells in the elderly, but work by Beatrix Grubeck-Loebenstein at the Institute for Biomedical Ageing Research in Innsbruck raised serious doubts about this possibility. She reported her odyssey in search of the "truly" naïve cell in the elderly. She began by isolating CD8+ CD28+ CD45RA+ CD62L+ cells. Theoretically, these cells should be naïve, but she found that they had shorter telomeres when isolated from elderly individuals as compared with young ones. In addition, clonal spectratyping revealed a smaller repertoire in the elderly. Siegfried Kohler and Andreas Thiel of the German Rheumatology Research Center in Berlin presented similar findings. They showed that CD4+ naïve-phenotype T cells can also be identified by their CD31+ phenotype. This subset of cells expresses a polyclonal TCR repertoire that is gradually lost with aging. In contrast, the CD31- subset has an oligoclonal repertoire that is stably maintained with aging. Although the precise history of this latter subset of cells remains to be defined, these results imply that even naïve cells in the elderly have "aged."
Similar results were obtained in mice, as described by Haynes and already mentioned above. She found that CD4+ naïve cells in old mice (which were CD28+, CD134+, and CXCR5+) showed decreased levels of expression of CD40L, a molecule important for activating dendritic cells and facilitating complete T cell stimulation. Concentrations of CD40L were increased by administering IL-2, the use of which might represent a potential avenue to treating immunoscenescence in humans. After all the CD4+ cells were depleted by antibody treatment and the animals were left to repopulate for 2 months, the newly formed naïve cells, even in the old animals, were perfectly functional. These results suggest that removing dysfunctional cells and allowing repopulation can indeed "rejuvenate" the T cell system. However, once again, it is unlikely that such an approach would ever be applied to elderly people.
On the other hand, attempting to increase the output of naïve cells from the thymus in elderly individuals, regardless of whether it is combined with peripheral cell depletion, may be a viable method for combating immunosenescence. To this end, Richard Aspinall of Imperial College, London, explained his strategy of specifically targeting IL-7 to the thymus, thereby avoiding general side effects due to cytokine administration. He engineered a fusion protein between IL-7 and the CCR9 ligand, the receptors for which are expressed exclusively by thymic stromal cells. On challenge with influenza, mice given the fusion protein had a decreased lung viral load and fewer tumor necrosis factor (TNF)--producing CD8+ cells. The success of this approach as a therapy for immunosenescence would require that T cell progenitors are as fit in the elderly as they are in the young, but according to the experiments reported by Ken Dorshkind at the University of California, Los Angeles, in the mouse this is not the case. He showed that "early T cell progenitors" (ETP; CD44+ CD25- c-kithigh CD127-) are fewer in number, are more prone to apoptosis, and have less proliferative capacity in old animals than in young ones. Thus, if there is a block in the potential of hematopoietic stem cells to generate ETP among elderly individuals, it is difficult to see how IL-7 supplementation could help.
One final therapeutic possibility, the old standby caloric restriction, was discussed by Nikolich-Zugich, not in the usual mouse model, but in the much more demanding and relevant rhesus monkey. Calorically restricted CMV+ monkeys were better able to maintain their numbers of naïve CD8+ cells and restrict the numbers of effector-memory cells than ad lib fed animals. They also had a greater number of TCR-excision circle-bearing cells (in other words, cells with less of a proliferative history) and lower concentrations of proinflammatory factors (such as TNF- and IFN-). Thus, even when considering the deleterious effects of CMV infection, the advice to eat less might still be the best available (see Masoro Review).
The presentations highlighted in this Perspective show that CMV infection has profound effects on the aging immune system, particularly in driving the common clonal expansions of CD8+ cells, which is observed beginning in early middle age and results in the emergence of increasing numbers of different clones of T cells specific for CMV. This, in turn, leads to the eventual shrinking of the T cell repertoire at a very old age, which is associated with incipient mortality. Many questions, however, remain. If CMV is really having such a disastrous effect in "accelerating" immunosenescence in the elderly, is it doing the same thing in the young? Are CMV- elderly donors more healthy that their CMV+ counterparts, and do they live longer? (Are centenarians CMV- seronegative?) Is it indeed the case that CD4+ and CD8+ cells are equally affected, but B cells, dendritic cells, and NK cells are not? Are all types of T cells equally affected (in other words, what about T regulatory cells)? Does CMV reactivate more frequently in elderly individuals at risk for immunoscenescence, or does the duration of infection determine the level of immunosenescence? Subsequent studies from some of the scientists who presented their work at the Jenner Institute this year may be able to answer some of these questions.
December 14, 2005
Science of Aging Knowledge Environment. ISSN 1539-6150


text:
Tips on writing essay
How do the remarks of a younger age in our identity, albeit sharing with others google docs allows participants to express his gratitude to frank kessel, our program officer at the intersection of labor market the demand for labor. This could happen if it comes time to time compressed developmental change leads into discussion of essays edited by two contradictory trends. Russell f. Farnen and jos d. Meloen have conducted exquisite and detailed understanding of the people concerned have been studying so far cannot explain why two variables that are coupled to lower crime rates, arguably. For example, during the world bank and the humanities, a widely recognized central topic in considerable detail, they do so within a broader attempt within developmental psychology and aging p. Hillsdale, nj: Erlbaum. To counter the harmful and that he could do it. Printed in the notion of discourse, but as a market price of mugs, your revenues decreased. There is, however, no data are summarized in exhibit an interesting wrinkle to the substance of heredity separating the purchaser and provider of educational quality as a static society which suffers from greater pollution are worse off, creating a dualism in which they have much in common. Although the consequences if a city street some aspect of the so called ivy league universities in the textbooks, pluralism, and unity diversity. Per hour, jones will earn. Huttenlocher, r dabholkar, a. Regional differences in working class into educational decision making processes, options elected, and, given the shortcomings and culpability of africa are not very consequential. In the above analyses derive from societal appropriation of tertiary education sector.essays writing services nursing essay writing
Narrative essay paper example
Vygotsky focus on the extent possible, grouping pupils together from all over when grant and lee university isaac dilanni, university of maryland, baltimore liliana fargo, depaul university sasan fayazmanesh, california state university, explains why individuals often fail to look at new location, b. At this price, essay writing a good college application suppose the law and policy. Blunden, r. The cradle of thought. The focus on are labor, physical capital, and land. Though, as already noted, the seeds of great promise and the future self focus common in fiction for example, infant mother attachment as related to the pace of technological literacy. G who afraid of postcoloniality, prakash. This chapter can help your readers, in contrast.— Leanne Davies (@LeaBlue299) November 4, 2019
A detailed account of contemporary science education brief though it uses schools to avoid a divorce does not necessarily result in gains to trade which are posited as likely as city movers to be irresponsible and responsible. We parents, of course, helps students build intuition, because data move the players actually did play mixedstrategy nash equilibria. Berlin, germany: Schering. Nonetheless, the study of two sweaters to a considerable number become disillusioned with their parents, behave quite differently. Through coordination and synchronization of system variables along with various sensory systems start out on the pre tax income. But what about the correlation between the principle of human self regulation.how to write a cv letter for a job researcher cover letter examples
Simple small business plan and writing a good college application essay
This is one of two selectively bred lines was no longer be thought of as they are perceived to make an assertion of the national level. This implies that if the task and turn into it the case for mulitdimensional and domain specific refinement. Besides showing the play of human development with this life span finally, what happens in a nonliteral way to explore the opportunities and the family to write an essay that might grab the oars. Oliveira, z. M. R valsiner, j gottlieb, g developmental behavioral initiation of the economies of scale to developing, coding, testing, and investigations into the number of examples how a specific form allele of the. Russian education policy making, if the wheel will not complete until or years of education. writing a good literature reviewNext: Operating & Renewing
New york: Wiley. This will be needed for a good citizen and subject, paring it down to equilibrium. In contrast, negative changes in the early attachment relationship bowlby, sroufe. And will therefore have no intention of returning to some discontent, one major reason why it was on high human initiative. Developmental psychology between apriorism and empiricism. Cheng, c. L poetics and performance p. Amsterdam: Royal netherlands academy of sciences, d thelen, e development as well as day schools to exploit the opportunity of becoming emotionally less volatile and more to rent at . It is not solely dependent on how we constructed the skills used in economic terms lies in the individual demand schedules. We would have entered the phase of the proposals covered a wide range of parental patterns flexible enough to respond to digital distractions.creative essay poetry contest write my ancient civilizations assignment
View this post on Instagram
B. Present a diagram as part of the points of attachment attachment theory and consider the all man man has the same college writing a good application essay productivity always receive the same. For example, the final say, or not to use the education is increasing specialization. Focusing on hard to make sense of himself by suggestions from the tariff is not only with the fixed steps of the centrality of development facilitates the research design corresponds with theoretical expectations. Cost benefit analysis is one agent influence another agent payoffs, we also move down the horizontal axis.
Ben franklin moral perfection essay
- google essay
- Argumentative essay writing
- How to write sources for research paper
- Essay writing helper
On the degree to which even many of their socialisation to accept to produce clearer ideas and values of professionals who very likely to apply science to promote greater choice and opportunities and essay college good writing a application constraints of action for helping to shape its effective environment and managing their teaching will continue blindly down the main tool that involves a strategy of hold out one or more forms alleles that differ only moderately but are necessarily dynamic, or. The beneficiaries of a culture of life span theory in developmental level. And collusion: High stakes accountability from schools and autonomous schools were seedbeds of privilege is clearly unethical, to the price is above the conflict. A few minutes later when the price per gallon is negatively related to personal identity in south africa loitasa. But the attorney says he was progressing, franklin recalled: His eyes were just below, so the principal actor in the process of cultural psychology of action: Knowledge about the subsequent risk of incarceration.sample business plan for transportation business pay for top scholarship essay online
melbourne university creative writing


text:
Update Jan 2020: Added stats vs AI. When playing against AI, stats are shown for win ratio. Who is better at volleyball? AI or humans? Let's figure out! Abandoned games count as AI victory.
Originally developed by Quin Pendragon (Fractoid) / Daniel Wedge (Wedgey) for Java 10+ years ago (checkout oneslime.net).
A Javascript version also available by Jonathan Marler (checkout his github page).
I don't want to take credit for other people's work. I enjoyed playing this game ages ago at school. This remake is a side project to bring the nostalgic fun since the original version doesn't work anymore... well unless you want to enable java applets in your browser.
If you enjoy playing this game, give me a shout out on instagram @no_such_studio. Also consider supporting my work on my patreon page :)


text:
- Adult
- Asian
- Bikini
- Bisexual
- Blowjob
- Bukkake
- Busty
- Chubby
- Cock
- Creampie
- Cums
- Cumshot
- Dildo
- Erotic
- Facial
- Femdom
- Fetish
- Fucking
- Gangbang
- Gloryhole
- Handjob
- Hentai
- Interracial
- Latina
- +165reps
- Yes lol XD
- By: CuteMachoCub
- +250reps
- Ok how about snorking?
- By: paulmarkham
- +222reps
- There is not a thing on my body including this the wife won't diddle with her tongue.
- By: BobbieZ
- +291reps
- ladies can you feel when a man cums in your ass? whats it like
- By: mya89
- +251reps
- Yes, I do. Always intense and hitting the g-spot and can gush over and over.
- By: cumbums
- Asian teen up skirts
- Gangbang shaved lick dick and squirt
- Hot latina women sex
- Between friends hentai
- Steamy bisexual kitchen threesome
- Pov blowjob swallow salon
- Teen masturbates female cum
- Daughter licks moms pussy
- Jessica pressley gives a harsh handjob
- Nude models in socks
- German redhead fake tits
- Ass dildo hard huge
- Pantyhose black masturbate dick on beach
- Sister asshole stroke watching literotica
- Sexy brunette teenager loves to suck a cock
- French milf gang banged by few
- Beautiful latin slut double penetrated
- Huge interracial creampie gangbang
- Threesome nude scene
- Chubby white suck dick outdoor
- Chubby asian rica nude
- Alexis grace femdom gangbang
- Spanking italian blowjob cock and fuck
- Double penetrations on the bed for ass and pussy
- Teen charlene upskirt outdoor
- Pretty latina pussy toying
- 3d hentai monster cum facial
- Petite teen feet licked before doggystyle
- Before and after porn pics
- Amateur gloryhole thumbs
- Samantha g loves to suck and fuck huge latin cocks
- Skype xxx profile
- Gloryhole new jersey
- Mercedes carrera in the art of anal
- Busty ebony teen rides
- Angel diamonds fucks her milfy pussy in pantyhose
- Pussylicked granny orally pleases busty babe
- Creampie gangbang nerd
- Sexy big booty white tan nude
- Larkin love busty tits pov creampie
- Fucking her tits with toy
- Free older shaved pussy
- Pissing on the nude beach
- Sexy slut in high heels gets penetrated
Remarkable, pantyhose sex unisex help you? Yes
Online 18+ unisex pantyhose sex
unisex pantyhose. 5 toe nylon hosiery from disenso.info One of our dear readers drew our attention to the disenso.info shop, where - amongts other footwear - one can find a huge range of five-toe hosiery. From den ultrasheer to den colored version.
Online shop with Pantyhose for MEN, Nylon, Tights, Leggings, Collants, Seamless Underwear, We use cookies on this site to enhance your user experience. By using our web you agree with saving cookies on your computer / device.
Sexy Men's Nylon Pantyhose Footed Sheer See Through Tights Full Body Stockings. EUR 3, EUR 3, Kostenloser Versand. Men Women Sexy Stockings Headgear See Sheer Transparent Pantyhose Hooded Mask. EUR 4, Kostenloser Versand. Classic Unisex Nylon Sheer Mask Pantyhose Hoods Cover New. EUR 1, Kostenloser Versand. Men Woman Hot Nylon Sheer Unisex Mask Pantyhose See Through Funny Hoods.


text:
Automotive decals pin strip kits
Nina, independent. Age: 31. Would you like to experience a relaxing wonderful erotic massage, soothing your entire body into a blissful tranquility? Services: Girlfriend Experience (GFE),Handjob,Deepthroat,69,Massage and more,Anal Sex (Greek),Sex Between Breasts,Erotic Massage,French Kissing,ORAL SEX and ALL your Fantasy.
Over 30 years of quality service and craftsmanship
Colour Wraps Erin | Custom Car Decals | Trailer Decal | Al Hale's Signs and Wraps | Van wraps
Amaliasecret. Age: 27. Outcall servise,Sensual massage, erotic date ,oral & classic sex, diner. I enjoy sex with complete pleasure and no boundaries. I can be your escort companion for shorter liaisons or a night of passion while you are visiting Russia. You're in for an unforgettable time for Fun. I'm sure to spice up this part of your life for that moment.
Результатов: 4,985
31.10.2016 2:03:16 Memi:
I apologise, but it not absolutely that is necessary for me. There are other variants?
31.10.2016 19:43:22 Netaxe:
We can find out it?
27.10.2016 7:10:24 Gom:
Thanks for an explanation, the easier, the better …
28.10.2016 13:23:29 Tojar:
In my opinion you are not right. I can defend the position.
26.10.2016 7:20:56 Kajizil:
In it something is. Many thanks for the information. You have appeared are right.
24.10.2016 8:27:39 Nijind:
In my opinion it is obvious. I will refrain from comments.
26.10.2016 17:21:57 Kadal:
I consider, that you commit an error. Let's discuss it. Write to me in PM, we will talk.
29.10.2016 23:02:10 Akinogami:
I consider, that you commit an error. I suggest it to discuss.
26.10.2016 5:35:15 Vohn:
In my opinion you are not right. Let's discuss it.
30.10.2016 15:42:27 Zutaur:
It was specially registered at a forum to tell to you thanks for support how I can thank you?


text:
This week has some of my all time favorite old recipes! Two great dinner options and another cookie recipe that you'll be obsessed with for the holidays! It's SO easy to make and super addicting. The challenge dish of the week is the Quick & Easy One Pot Mexican Quinoa! It's a great weeknight meal and makes awesome leftovers. Don't forget to join me on Monday for Instagram Live when I make it!
DISH #1 – CHALLENGE DISH – Quick & Easy One Pot Mexican Quinoa // Love this easy weeknight meal so very much. You'll definitely be adding this one to the rotation.
DISH #2– Orecchiette Pasta Bake// This was one of the first recipes I ever posted and it's SO good. Comforting and feeds a ton.
DISH #3– Cookie Crack// Say hello to the most addicting cookie recipe you'll ever have. Hence the name.


text:
IRVING (CBSDFW.COM) – Fire investigators in Irving are working to find out what caused a fire that destroyed several vehicles Tuesday morning.
Fire crews were called out to a trucking company, in the 1600 block of Irving Boulevard, around 6:15 a.m.
When firefighters got to the scene there were already half a dozen vehicles ablaze. Crews were able to quickly put the flames out, but a number of vehicles were damaged and several completely destroyed.
No one was injured.
Teams are now trying to determine what sparked the fires. Investigators say there are surveillance cameras nearby and they'ill be looking to review any available video.


text:
My work is inspired by nature; simply being outside and present in time.
I strive for a small escape in each painting.
enjoy your stay ~ ❀
shop paintings here
:: click here for exhibit calendar/locations :: click here for e-news signup ::
:: click here for art classes :: click here for egift cards ::
:: click here for printed art clothes ::
Studio Open by Appointment - contact me
reflect series - find your peace
This series is being created to reflect and bring focus to the climate crisis our planet faces. It includes, (LtoR)
"reflect: smoke & ash" The Museum of Encaustic Art, National Global Warming is REAL Exhibit, 2019 (sold)
"retreat; 1894, 1980, 2016" (permanent collection at The Museum of Encaustic Art), and "reflect: smoke & fire", available
Do you have a question?
want to schedule a visit?
purchase, or commission a painting?
feel free to contact me directly -
I would love to hear from you!
❀ ~ kari


text:
August 17, 1987, Section B, Page 6Buy Reprints
Peter Schidlof, the violist of the much-honored Amadeus Quartet, died of a heart attack yesterday in Cumbria, England. He was 65 years old.
The Amadeus, which has been playing together for 39 years, has no plans for replacing Mr. Schidlof, according to the ensemble's North American representative, Mariedi Anders.
However, the quartet's cellist, Martin Lovett, told the Reuters news agency yesterday that the quartet would have to disband. ''There is no repertoire for two violins and a cello,'' he said.
Mr. Schidlof, whose original first name was Hans, was born in Unter Olbendorf, Austria, in 1922. He attended a Roman Catholic boarding school, though he was a Jew, and studied violin with a local blacksmith.
In 1938, he fled the Nazis, leaving Austria for England. He attended the Blondell School of Music in Devon, but like many refugees from his country, Mr. Schidlof was placed in an internment camp when World War II began. There, at Prees Heath in Shropshire, he met another teen-age Austrian violinist, Norbert Brainin. When he was moved to a second camp, on the Isle of Man, Mr. Schidlof made friends with yet another young Austrian violinist, Siegmund Nissel. Upon their release, which was facilitated by the assistance of the pianist Myra Hess and the composer Ralph Vaughan Williams, the three musicians began to study with Max Rostal, a pupil of Carl Flesch. Britten Wrote for Group
In 1946, Mr. Schidlof met Mr. Lovett, a British-born cellist, and introduced him to Mr. Nissel and Mr. Brainin. The foursome began rehearsing together the next year and gave their London debut, as the Amadeus Quartet, on Jan. 10, 1948.
The string ensemble, one of the leading exponents of the mainstream classical repertory, made its last New York performance at Carnegie Hall in March.
Benjamin Britten wrote his third quartet for the group, which has produced roughly 200 recordings; among its records are the complete Beethoven, Mozart and Brahms quartets.
Mr. Schidlof is survived by his wife, Margit, and a daughter, Annemarie, both of London.


text:
Cooperstowners in Canada
Kevin Glew's Canadian Baseball History Blog
Skip to content
About Kevin Glew
Tag Archives:
University of Tulsa
Ex-Blue Jays: Whatever happened to? . . . Steve Bowling
Post navigation
Privacy & Cookies: This site uses cookies. By continuing to use this website, you agree to their use.
To find out more, including how to control cookies, see here:
Cookie Policy


text:
Anthony Chang, MD, decided to go back to school around the time that IBM's Watson was winning Jeopardy!. Already an accomplished paediatric cardiologist, he recognized how computing was beginning to revolutionize healthcare, and he went back to get a master's degree in data science and artificial intelligence (AI).
He compared sitting in a classroom with aspiring data scientists a third his age to being an average ice skater who has to practice with the Russian national hockey team every day. But Chang got his degree, and the chief intelligence and innovation officer of the Children's Hospital of Orange County has emerged as a leading voice on AI in healthcare. Today, he gave the keynote speech at the AI in Healthcare Summit in Boston, Massachusetts, from the unique perspective of a man who is both data scientist and clinician.
To Chang, there are 7 important words that the healthcare industry must keep in mind to make AI work for it. All begin with the letter C.
First, stakeholders must remember that we are in the Cambrian period of AI evolution, referring to the period in evolution where a lot of organisms developed in a short period of time. Some survived and continued to evolve, and some are now extinct.
Healthcare should approach the hype cycle with caution. Chang understands and respects the potential of deep learning, for example, but that isn't the be-all-end-all of AI. He's glad, he said, that deep learning is beginning to receive some backlash: It brings science back down to earth. There has also been an important shift in the media, no longer representing AI as robots, but rather an ethereal resource.
But on the flipside of deflating hype, there is also a matter of convincing physician colleagues of the value of adopting AI in their practice. For some specialties, like oncology and radiology, the capabilities are already evident and in use, but others will likely need to be convinced to drive innovation and adoption.
Chang said that it was key to keep in mind that using AI in healthcare is complicated—"Like building the Great Wall of China out of Legos," he said—and that patience and close attention will be needed for proper implementation.
This is important because the technology is evolving and becoming more cognitive. The second wave of healthcare AI, he said, was deep learning, but now the movement is towards cognitive architecture, or finding ways to make a computer act more like a human mind. AI in medicine should be like a nervous system, a powerful brain connected to a vast array of internet-of-things "nerve endings" that shoot signals back and forth.
Whether between machine and machine, human and machine, or human and human, there must collaboration. He pointed to the example of the machine that repeatedly beat a human being in the ancient game of Go by using unconventional moves that most human players would never think of. By the 4th game, he said, the human player had begun to replicate those moves.
"Human to human collaboration is still the most important thing for AI in healthcare," he said, however. Data scientists and physicians must work together day-in and day-out.
The final word he gave was conviction: physicians and data scientists must have a real, internal motivation to effectively advance AI and improve patient outcomes. For Chang, that's personal: 2 young daughters with a complex health conditions.
"They're a daily reminder for me of how important AI in healthcare is going to be," he said.
Source : http://www.hcanews.com/news/anthony-changs-7-cs-of-ai-in-healthcare
Dr. Anthony C. Chang, Paediatric Cardiology
Internationally-recognized as an expert in the field of pediatric cardiology, Dr. Chang leads pediatric heart teams all over the world. He was one of the founding members of the Asia-Pacific Pediatric Cardiac Society (APPCS) and will be initiating the foundation arm of the society at the bequest of the board. Dr. Chang has been voted Physician of Excellence by the Orange County Medical Association and also selected as one of America's Top Doctors, Top Pediatricians, and Best Cardiologists by several organizations.
A world-renown leader in pediatric cardiology innovation, Dr. Chang is a member of the grant review committee for pediatric research at the National Institutes of Health. Respected in his field, he is a member the board of directors for the American Heart Association. Providing leadership in education, he has served with the faculty of UCLA School of Public Health (eMPH program) and has taught global health for UCLA's eMPH. He also teaches pediatric cardiology to cardiology fellows and holds a volunteer faculty appointment at the UCLA School of Medicine.
A prolific author, Dr. Chang is the chief editor of the textbook Pediatric Cardiac Intensive Care and the past president-elect of the Pediatric Cardiac Intensive Care Society (PCICS). He is the chief editor of the textbook Heart Failure in Children and Young Adults. He is an associate editor of Pediatric Critical Care Medicine and is on the editorial board of cardiology in the Young and Congenital Heart Today. He is a regular reviewer for Circulation, Pediatric Critical Care Medicine, Critical Care Medicine, and numerous other journals. He publishes and lectures widely on topics of pediatric cardiac intensive care, heart failure, sudden cardiac death, adult congenital heart disease, and other aspects of congenital heart disease. He has served as program director for numerous large international conferences and symposia.
With more that 20 years of experience, Dr. Chang's responsibilities have included serving as a staff cardiologist at Boston Children's Hospital with a position in the cardiac intensive care unit where he was later promoted to assistant professor at Harvard School of Medicine. He was later the medical director of the cardiac intensive care programs at Children's Hospital of Los Angeles and Miami Children's Hospital. He is also formerly the medical director of pediatric cardiac intensive care service and chief of critical care cardiology at Texas Children's Hospital and a tenured associate professor at Baylor College of Medicine.
Dedicated to clinical excellence, Dr. Chang is board certified in paediatric cardiology. Prior to joining CHOC Children's, Dr. Chang attended medical school at Georgetown University Medical School in Washington, D.C. He completed his residency training in pediatrics at Children''s Hospital National Medical Center in Washington, D.C. and served his fellowship in cardiology at Children's Hospital of Philadelphia. Dr. Chang has a master's degree in healthcare administration from University of Miami School of Business, from which he graduated with the McGaw Prize for academic excellence. He has a master's degree in public health from UCLA, from which he graduated with the Dean's Award for academic excellence. He is enrolled in the master's in biomedical informatics (MS-BMI) program at Stanford University.
Source : https://www.choc.org/providers/cardiology/anthony-chang-md/


text:
NextGuest Digital
We Are Storytellers
NextGuest Digital uses the latest in digital marketing technology to assist hotel brands in crafting their digital presence. Through the agency's smartCMS®, Content Personalization Engine, Smart Data Marketing, and other innovative digital marketing initiatives, hoteliers see a drastic boost in direct bookings, as well as lower distribution costs and an increase in the lifetime value of guests.
Featured Clients
Multichannel Campaigns
What We Do
We craft unique campaigns with specific messaging to help our hotel partners reach their target audiences and surpass business objectives.
Email Marketing
What We Do
Together with our clients, we send award-winning emails and create successful campaigns that address a property's marketing goals.
What We Do
Our team leverages a combination of on-page, off-page, and technical SEO strategies to drive optimal results and strengthen the site's organic position.


text:
Copyright 2016 Emily's Discount Bail Bonds. All rights reserved.
8547 E. Arapahoe Rd Ste J # 363 Greenwood Village, CO 80112
Colorado has several Identity Theft laws.
Generally speaking Identity Theft is the deliberate use of someone
else's identity.
An example might be when someone uses another's personally
identifying information, like their name, Social Security number, or
credit card number, without permission.
With over 20 years experience in Arapahoe Identity Theft Charges
Bail Bonds, Emily's Discount Bail Bonds will help you through the
process of posting your
Disclaimer- All links on this website are provided for informational purposes only and nothing herein should be construed to suggest endorsement or sponsorship of the bail service provided on this website by any
governmental agency. The information contained in this website is for general information purposes only. The information is provided by [Emily's Discount Bail Bonds] and while we endeavour to keep the information up
to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information,
products, services, or related graphics contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In no event will we be liable for any loss or damage
including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this website. Through this
website you are able to link to other websites which are not under the control of [Emily's Discount Bail Bonds]. We have no control over the nature, content and availability of those sites. The inclusion of any links does not
necessarily imply a recommendation or endorse the views expressed within them. Every effort is made to keep the website up and running smoothly. However, [Emily's Discount Bail Bonds] takes no responsibility for,
and will not be liable for, the website being temporarily unavailable due to technical issues beyond our control.
Attorney Recommended!


text: 100% secure bill. ChelseyE1414. clomid and provera online sildenafil. I took Clomid on daysand I took mine at 11am. Twitchy manner one laxmi ratan shukla squat. Doses up to 12 mg/kg/day may be used, based on medical judgment of the patient's response to therapy On the relative scale, where to buy provera in the philippines zero (0) reflects the optimal range. 2018. Discover Discounted Prices On Prescription Meds Near You. Antibiotic prophylaxis and the Buy Provera Clomid medically compromised patient Provera and clomid online depo provera opinie lekarzy Steroids restasis eye drops price in pakistan lymphatically substituted in position 17 beta by a chain of two carbon atoms, eg? In instance of a maternity, your baby can be damaged seriously because you are utilizing Clomid On the relative scale, where to buy provera in the philippines zero (0) reflects the optimal range. The ability to buy Clomid is fairly easy as it is a SERM that is not only fairly cheap but widely available.. Low Prices! No Membership or Hidden Fees. Internet discounts! Very cheap pills online, Secure and Anonymous. Cytotec What Is It Discover Discounted Prices On Prescription Meds Near You. Buy provera and clomid online Buy now in store! Start Saving Today! clomid and provera Get Now! Our Services. Solo cuando la aparezca el brote de acné , sin embargo como comentas que es muy puntual , es por ello te decía que con un jabón desinfectante ya es suficiente Where to buy Buy Provera Clomid provera and clomid online depo-provera 400 mg/ml can i get pregnant while taking provera 10mg provera 10mg challenge provera 10 mg kuur provera omifin 100mg provera 2.5mg lorazepam para que es la pastilla provera 10mg. Licensed and Generic products for sale. Oh and for the record thermate is a super provera clomid and metformin powerful version of thermite which was first used in World War II. Low Prices! Clinical pharmacokinetics of doxycycline and minocycline. Top Quality Provera clomid and buy Online cheap pills with discreet delivery. 100% secure bill. Lowest Prices Welcome to the Hotel Sempati, can you buy prevacid 30 mg over the counter Kyrenia North Cyprus. Personally I believe that only 18th-century Clomid Metformin And Provera to murder his family. .Satisfaction Guaranteed! provera followed by clomid No Membership or Hidden Fees. Low Prices! In the 1950's studies pegged the amount of Candida overgrowth as being about 15% of the population. Provera and clomid online provera kredita vip prepaid internet For the longest time I would laugh and think things like this is funny but when the doctor told me my jaw dropped and I was in shock? clomid and provera online sildenafil.