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Getting into shape can be a daunting proposition, especially if it's been a while since you laced up a pair of running shoes.
Getting fit takes work, after all, and you're not likely to go from couch surfing to running marathons overnight.
But everyone needs to start somewhere. So why not start right here? Make some powerful positive moves for your health by following these easy lifestyle changes that you can begin right now.
Get SMART
Here's a great change you can make without even moving off the sofa: Start setting goals for leading a healthier life.
"I think setting some goals is really motivating," says Chris Kwan, a personal trainer for Core Ten Fitness in North Vancouver.
The trick is learning how to set those goals, and for that, Kwan recommends getting SMART.
"I call them SMART goals - specific, measurable, achievable, relevant and they've also got a timeframe. There's really a reason to be doing it," she says.
Hayley McGowan, a personal trainer at Method Personal Training just up the road in West Vancouver, is also a fan of SMART.
"It's important to set goals that are realistic. If you're not realistic, you're not going to meet your goals, and you're just going to feel like a failure," McGowan says.
"Don't look at the big picture, like, 'I have to lose 40 pounds.' Instead, think, I'm going to move 30 minutes three times this week."
Kwan suggests setting both short- and long-term goals, then listing specific actions for achieving your short-term goals.
"Then write it down. It makes it more real," she says. "And then just get started."
One of the easiest changes you can make is simply using smaller-sized plates and cups, suggests Sue Mah, a Toronto-based dietitian with Nutrition Solutions.
Portion sizes have exploded in the last few decades. We've become so used to seeing super-sized everything that it's a bit of a shock to learn how small a recommended portion size actually is.
It's also a bit of surprise to realize how big our plates have become. Just compare your trendy new dinner plates to Granny's china. Think about it: If you fill that big plate with food then eat everything on it, you can easily - and unconsciously - consume hundreds more calories at every meal.
Even though a smaller plate may contain less food, the mind's eye sees it as the same amount. That makes it a painless way to cut calories without even noticing.
Start moving (just a little)
Go for a walk, do some stretches, dance around the living room - you'll be amazed at what just a little bit of exercise does for your body and your mind.
"People are often intimidated by exercise, but you don't need to do a lot to get a lot of benefit," says Denis Collier, a dietitian and certified exercise physiologist for Collier Fitness in Toronto.
"The most benefit you can get is going from being inactive, a couch potato, to being moderately active. If you get 150 minutes of moderate activity a week, you're going to get wonderful health benefits from that."
In fact, all you need is 20 minutes a day to do something active. If you're already getting some exercise, add another 20 minutes a day and you'll see even more benefits.
"Every step counts," Collier says.
Take a break
"The biggest thing I hear all the time is 'I don't have time,' " says McGowan. "The first thing I do is make my clients find the time for themselves. Because when you have the time, you can change how you use that time."
She encourages her clients - many of whom are young, busy moms - to find 20 or 30 minutes in a day to read a book, take a bath, do something, anything just for themselves.
Once they've carved out that time, she encourages them to use it take a walk, lift some weights or do a bit of yoga.
Soon, working out becomes a habit they can't live without, and their thought patterns will change, she says: "Not 'I don't have time,' but 'I'm going to make time.' "


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JBER celebrates Hispanic heritage
Soldiers and Airmen gathered together inside Hangar 1 on Joint Base Elmendorf-Richardson Oct. 12 to recognize the contributions made by the Hispanic community in the course of American history.
The event is an annual coordinated effort between the Army and Air Force equal opportunity offices on JBER as a capstone event to National Hispanic Heritage Month.
The national observance is part of an official proclamation approved by Congress and signed into law by the president officially assigning Sept. 15 to Oct. 15 as the period of Hispanic heritage awareness.
The Movers and Shakers children's dance team from the Kennecott Youth/Teen Center performed a choreographed dance number and dazzled the crowd with their hip-hop style dance moves.
They were followed by Pro Bono Coordinator for Alaska Legal Services Eric Cordero Giorgana, who was born in Mexico and became an American citizen, and served as the guest speaker for the event.
"I didn't realize just how diverse America was until I got here," Giorgana said. "This nation derives its strength from its diversity and you represent the finest of that blending," he said, addressing the service members in the audience.
Giorgana highlighted numerous contributions of the Hispanic community over the years that have bettered the American people, such as courageous service to the U.S. military and helping to shape the American workforce and contributing to industry that has helped to strengthen the fabric of our nation.
"I was actually speechless when I got the invitation to be the guest speaker for today's event. It is a tremendous honor." Giorgana said. "And, if there's one other thing that the Hispanic community is well known for, it would be great food."
Following Giorgana's remarks, the guests in attendance were treated to a bounty of Hispanic foods to include chicken and beef flautas, spicy cheese queso and nacho chips, Spanish-style rice and handmade guacamole, all served by Soldiers and Airmen.
One of the volunteer servers, Air Force Staff Sgt. Yanet Hernandez, a diet technician with the 673d Medical Support Squadron, handed out food to the guests as they came by the serving line and expressed her joy in being able to assist with such an event.
"I'm very happy to be a part of something like this," she said. "I'm Hispanic myself and I really hope that everyone, especially the kids are able to take something away from today. I mean, what's better than a culture with great food?"

subset: commoncrawl


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New 2020 Kia Optima S
- Stock: NC20590
Basic Info
Exterior:Snow White Pearl
Engine:Regular Unleaded I-4 2.4 L/144
Fuel Efficiency:24 CITY / 32 HWY
Key Features
Android Auto
Apple CarPlay
Backup Camera
Blind Spot Monitor
Fog Lights
Forward Collision Warning
Hands-Free Liftgate
Interior Accents
Keyless Entry
Lane Departure Warning
Parking Sensors / Assist
Power Seats
Push Start
Side-Impact Air Bags
Vehicle Details
- Black Grille w/Chrome Surround
- Body-Colored Front Bumper
- Body-Colored Power Heated Side Mirrors w/Manual Folding and Turn Signal Indicator
- Body-Colored Rear Bumper w/Chrome Bumper Insert
- Chrome Door Handles
- Chrome Side Windows Trim, Black Front Windshield Trim and Chrome Rear Window Trim
- Clearcoat Paint
- Fixed Rear Window w/Defroster
- Front Fog Lamps
- Fully Automatic Projector Beam Halogen Daytime Running Auto High-Beam Headlamps w/Delay-Off
- Fully Galvanized Steel Panels
- Laminated Glass
- LED Brakelights
- Light Tinted Glass
- Lip Spoiler
- Perimeter/Approach Lights
- Spare Tire Mobility Kit
- Tires: P235/45R18
- Trunk Rear Cargo Access
- Variable Intermittent Wipers
- Wheels: 7.5J x 18 Machine Finish Alloy
- Wheels: 7.5J x 18" Machine Finish Alloy
- 2 12V DC Power Outlets
- 2 LCD Monitors In The Front
- 2 Seatback Storage Pockets
- 60-40 Folding Bench Front Facing Fold Forward Seatback Rear Seat
- 8-Way Driver Seat
- Air Filtration
- Analog Display
- Cargo Features -inc: Spare Tire Mobility Kit
- Cargo Space Lights
- Carpet Floor Trim and Carpet Trunk Lid/Rear Cargo Door Trim
- Cloth/Leatherette Seat Trim
- Cruise Control w/Steering Wheel Controls
- Day-Night Rearview Mirror
- Delayed Accessory Power
- Driver / Passenger And Rear Door Bins
- Driver And Passenger Visor Vanity Mirrors w/Driver And Passenger Illumination, Driver And Passenger Auxiliary Mirror
- Driver Foot Rest
- Engine Immobilizer
- Fade-To-Off Interior Lighting
- Fixed Antenna
- FOB Controls -inc: Cargo Access
- Front Bucket Seats -inc: 10-way power adjustable driver w/2-way power lumbar and 6-way adjustable passenger seat w/manual height adjuster
- Front Center Armrest and Rear Center Armrest
- Front Cupholder
- Front Map Lights
- Full Carpet Floor Covering
- Full Cloth Headliner
- Full Floor Console w/Covered Storage, Mini Overhead Console w/Storage and 2 12V DC Power Outlets
- Gauges -inc: Speedometer, Odometer, Engine Coolant Temp, Tachometer, Trip Odometer and Trip Computer
- Glove Box
- HVAC -inc: Underseat Ducts
- Interior Trim -inc: Metal-Look Interior Accents
- Leather Steering Wheel
- Leatherette Door Trim Insert
- Manual Air Conditioning
- Manual Anti-Whiplash Adjustable Front Head Restraints and Manual Adjustable Rear Head Restraints
- Manual Tilt/Telescoping Steering Column
- Outside Temp Gauge
- Passenger Seat
- Perimeter Alarm
- Power 1st Row Windows w/Driver And Passenger 1-Touch Up/Down
- Power Door Locks w/Autolock Feature
- Power Rear Windows
- Proximity Key For Doors And Push Button Start
- Radio w/Seek-Scan, Clock, Speed Compensated Volume Control, Steering Wheel Controls, Voice Activation and Radio Data System
- Radio: AM/FM/MP3 Audio System -inc: 6 speakers, 8 color touch-screen display, auxiliary and USB input jacks, Bluetooth wireless technology and support for Android Auto and Apple CarPlay
- Rear Cupholder
- Redundant Digital Speedometer
- Remote Keyless Entry w/Integrated Key Transmitter, Illuminated Entry, Illuminated Ignition Switch and Panic Button
- Remote Releases -Inc: Smart Trunk Proximity Cargo Access and Power Fuel
- Streaming Audio
- Systems Monitor
- Trip Computer
- Turn-By-Turn Navigation Directions
- Urethane Gear Shifter Material
- Radio: AM/FM/MP3 Audio System -inc: 6 speakers, 8" color touch-screen display, auxiliary and USB input jacks, Bluetooth wireless technology and support for Android Auto and Apple CarPlay
- Radio w/Seek-Scan, Clock, Speed Compensated Volume Control, Steering Wheel Controls, Voice Activation and Radio Data System
- Streaming Audio
- Fixed Antenna
- 2 LCD Monitors In The Front
- Turn-By-Turn Navigation Directions
- 150 Amp Alternator
- 18.5 Gal. Fuel Tank
- 2.88 Axle Ratio
- 4-Wheel Disc Brakes w/4-Wheel ABS, Front Vented Discs, Brake Assist and Hill Hold Control
- 80-Amp/Hr 800CCA Maintenance-Free Battery w/Run Down Protection
- Electric Power-Assist Speed-Sensing Steering
- Engine: 2.4L DOHC I4 GDI
- Front And Rear Anti-Roll Bars
- Front-Wheel Drive
- Gas-Pressurized Shock Absorbers
- Multi-Link Rear Suspension w/Coil Springs
- Quasi-Dual Stainless Steel Exhaust w/Chrome Tailpipe Finisher
- Strut Front Suspension w/Coil Springs
- Transmission: 6-Speed Automatic w/Sportmatic -inc: drive mode select system (comfort, eco, sport)
- ABS And Driveline Traction Control
- Airbag Occupancy Sensor
- Blind-Spot Collision Warning Blind Spot
- Curtain 1st And 2nd Row Airbags
- Driver Knee Airbag
- Dual Stage Driver And Passenger Front Airbags
- Dual Stage Driver And Passenger Seat-Mounted Side Airbags
- Electronic Stability Control (ESC)
- Forward Collision-Avoidance Assist (fca) and Rear Cross-Traffic Collision Warning
- Lane Keeping Assist-Line (LKA-L) Lane Departure Warning
- Lane Keeping Assist-Line (LKA-L) Lane Keeping Assist
- Low Tire Pressure Warning
- Outboard Front Lap And Shoulder Safety Belts -inc: Rear Center 3 Point, Height Adjusters and Pretensioners
- Parking Distance Warning Rear Parking Sensors
- Rear Child Safety Locks
- Rear View Monitor with Parking Guidance Back-Up Camera
- Side Impact Beams
- Forward Collision-Avoidance Assist (FCA) and Rear Cross-Traffic Collision Warning
Tech Specs
- Vehicle Name: Kia Optima
- Body Style: Sedan
- Drivetrain: Front Wheel Drive
- EPA Classification: Mid-Size Cars
- Passenger Capacity: 5
- Passenger Volume: 120.7
- Base Curb Weight: 3298
- Fuel Economy Est-Combined: 27
- EPA Fuel Economy Est - City: 24
- EPA Fuel Economy Est - Hwy: 32
- Engine Order Code:
- Engine Type: Regular Unleaded I-4
- Displacement: 2.4 L/144
- Fuel System: Gasoline Direct Injection
- SAE Net Horsepower @ RPM: 185 @ 6000
- SAE Net Torque @ RPM: 178 @ 4000
- Trans Order Code:
- Trans Type: 6
- Trans Description Cont.: Automatic w/OD
- Trans Description Cont. Again:
- First Gear Ratio (:1): 4.21
- Second Gear Ratio (:1): 2.64
- Third Gear Ratio (:1): 1.80
- Fourth Gear Ratio (:1): 1.39
- Fifth Gear Ratio (:1): 1.00
- Sixth Gear Ratio (:1): 0.77
- Reverse Ratio (:1): 3.38
- Final Drive Axle Ratio (:1): 2.88
- Cold Cranking Amps @ 0° F (Primary): 800
- Tons/yr of CO2 Emissions @ 15K mi/year: 6.6
- Maximum Alternator Capacity (amps): 150
- Suspension Type - Front: Strut
- Suspension Type - Rear: Multi-Link
- Suspension Type - Front (Cont.): Strut
- Suspension Type - Rear (Cont.): Multi-Link
- Front Tire Order Code:
- Rear Tire Order Code:
- Spare Tire Order Code:
- Front Tire Size: P235/45VR18
- Rear Tire Size: P235/45VR18
- Spare Tire Size:
- Front Wheel Size: 18 X 7.5
- Rear Wheel Size: 18 X 7.5
- Spare Wheel Size:
- Front Wheel Material: Aluminum
- Rear Wheel Material: Aluminum
- Spare Wheel Material:
- Steering Type: Rack-Pinion
- Brake Type: 4-Wheel Disc
- Brake ABS System: 4-Wheel
- Disc - Front (Yes or ): Yes
- Disc - Rear (Yes or ): Yes
- Front Brake Rotor Diam x Thickness: 12
- Rear Brake Rotor Diam x Thickness: 11.2
- Drum - Rear (Yes or ):
- Rear Drum Diam x Width:
- Fuel Tank Capacity, Approx: 18.5
- Front Head Room: 39.8
- Front Leg Room: 45.5
- Front Shoulder Room: 58.1
- Front Hip Room: 56
- Second Head Room: 37.8
- Second Leg Room: 35.6
- Second Shoulder Room: 56.4
- Second Hip Room: 56
- Wheelbase: 110.4
- Length, Overall: 191.1
- Width, Max w/o mirrors: 73.2
- Height, Overall: 57.7
- Track Width, Front: 62.9
- Track Width, Rear: 63.2
- Min Ground Clearance: 5.3
- Trunk Volume: 15.9
- Country of Origin: United States KIA Passenger Cars
- Wheels: 7.5J x 18 Machine Finish Alloy
- Front Bucket Seats
- Cloth/Leatherette Seat Trim
- Radio: AM/FM/MP3 Audio System
- Carpet Floor Mats
- Cargo Hook
- Cargo Net
- 4-Wheel Disc Brakes
- 6 Speakers
- Air Conditioning
- Electronic Stability Control
- Front Center Armrest
- Rear Parking Sensors
- Spoiler
- Tachometer
- ABS brakes
- AM/FM radio
- Anti-whiplash front head restraints
- Brake assist
- Bumpers: body-color
- Delay-off headlights
- Driver door bin
- Driver vanity mirror
- Dual front impact airbags
- Dual front side impact airbags
- Four wheel independent suspension
- Front anti-roll bar
- Front fog lights
- Front reading lights
- Fully automatic headlights
- Heated door mirrors
- Illuminated entry
- Knee airbag
- Leather steering wheel
- Low tire pressure warning
- Occupant sensing airbag
- Outside temperature display
- Overhead airbag
- Overhead console
- Panic alarm
- Passenger door bin
- Passenger vanity mirror
- Power door mirrors
- Power driver seat
- Power steering
- Power windows
- Radio data system
- Rear anti-roll bar
- Rear seat center armrest
- Rear window defroster
- Remote keyless entry
- Security system
- Speed control
- Speed-sensing steering
- Split folding rear seat
- Steering wheel mounted audio controls
- Telescoping steering wheel
- Tilt steering wheel
- Traction control
- Trip computer
- Turn signal indicator mirrors
- Variably intermittent wipers
- Auto High-beam Headlights
- Blind spot: Blind-Spot Collision Warning warning
- Front Wheel Drive
- Power Steering
- Brake Assist
- Aluminum Wheels
- Tires - Front Performance
- Tires - Rear Performance
- Heated Mirrors
- Power Mirror(s)
- Integrated Turn Signal Mirrors
- Rear Defrost
- Intermittent Wipers
- Variable Speed Intermittent Wipers
- Rear Spoiler
- Daytime Running Lights
- Automatic Headlights
- Fog Lamps
- AM/FM Stereo
- MP3 Player
- Bluetooth Connection
- Auxiliary Audio Input
- Smart Device Integration
- Steering Wheel Audio Controls
- Power Driver Seat
- Bucket Seats
- Driver Adjustable Lumbar
- Pass-Through Rear Seat
- Rear Bench Seat
- Adjustable Steering Wheel
- Trip Computer
- Power Windows
- Leather Steering Wheel
- Keyless Entry
- Power Door Locks
- Keyless Start
- Remote Trunk Release
- Hands-Free Liftgate
- Cruise Control
- Cloth Seats
- Premium Synthetic Seats
- Driver Vanity Mirror
- Passenger Vanity Mirror
- Driver Illuminated Vanity Mirror
- Passenger Illuminated Visor Mirror
- Security System
- Engine Immobilizer
- Traction Control
- Stability Control
- Front Side Air Bag
- Rear Parking Aid
- Blind Spot Monitor
- Cross-Traffic Alert
- Lane Departure Warning
- Lane Keeping Assist
- Tire Pressure Monitor
- Driver Air Bag
- Passenger Air Bag
- Front Head Air Bag
- Rear Head Air Bag
- Passenger Air Bag Sensor
- Knee Air Bag
- Child Safety Locks
- Back-Up Camera
- 4 Cylinder Engine
- Gasoline Fuel
- 6-Speed A/T
- Transmission w/Dual Shift Mode
Other Vehicles You May Like
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Car is nice and roomy. Plenty of great safety features. Nice looking car. Very reasonable price. I would recommend this car to everyone. I will buy another kia.Read more reviews at Cars.com
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Answer call
Turn GPS on or off
Making a video call on my mobile phone using FaceTime
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Bluetooth is a wireless connection which can be used to establish a connection to eg. a wireless headset or keypad.
Find "Bluetooth"
Tap Settings.
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Turn on Bluetooth
Tap the indicator next to "Bluetooth" to turn on the function.
Pair Bluetooth device with your mobile phone
Tap the required Bluetooth device and follow the instructions on the screen to pair the device with your mobile phone.
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Tap the Home key to return to the home screen.
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The IWC Tribute to Pallweber Edition "150 Years" Story
In 1884, IWC manufactured the first so-called Pallweber pocket watches. These innovative timepieces showed the hours and minutes in a digital format with large numerals on rotating discs. In its anniversary year, IWC honours this pioneering achievement with the IWC Tribute to Pallweber Edition "150 Years". This model is limited to 250 watches and has an 18-carat 5N gold case, a white dial with a lacquered finish, and white display discs. As a reference to the design of the historical Pallweber watches and a tribute to F.A. Jones – the American watchmaker who founded IWC – the windows of the digital display are labelled as "Hours" and "Minutes". The IWC-manufactured 94200 calibre advances the display discs by using a separate wheel train with a barrel of its own. The fact that the flow of power in the main wheel train is uninfluenced guarantees a precise rate and a 60-hour power reserve.


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Ticket your event
ATG Tickets is the joint-largest ticketing company in the UK and is one of the world's leading live entertainment ticketing companies. ATG Tickets manages the ticketing, revenue management, customer service, group sales and ecommerce needs for venues, producers, promoters, artists and events across the UK and internationally.
ATG Tickets is an integral part of ATG the UK's largest theatre group with 11 venues in London's West End and a further 28 across England and Scotland – around 400,000 seats ticketed per week. Its Senior Management team has extensive experience in the industry –offering stability, experience and a comprehensive knowledge of the West End, Regional and international live event ticketing.
Don't just take our word for it. Here's what our customers say:
'We have found ATG Tickets's sales department always ready to respond to our needs and flexible in their approach to tailoring the service they offer. They are considerate and committed business partners and their level of expertise has made a significant contribution to our continuing success.'
Dagmar Walz, General Manager, The Old Vic Theatre
'When organising an outdoor project as large as Pops in the Park, it was an essential part of the jigsaw puzzle to be able to rely on a 'sound' box office system. ATG Tickets really did excel in this area, not only by offering front line support but more importantly being willing to offer advice and their expertise - a 100% thorough service.'
Chris Evans, Head of Press and Marketing, Royal Philharmonic Orchestra
Please email Mark Bower ([email protected]) or Barry Grant ([email protected]) to find out more and discuss your needs.


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Hollywood Realtors - You have no worries when trusting us with your valued clients. Apply for a Hollywood, FL Home Mortgage
We are a full service Hollywood Fl, home mortgage broker business that has been helping Florida Realtors get their clients approved for a home mortgage since 1998. Our goal is to guide the clients that our valued Realtor partners refer to us from application to closing. We want you as a Hollywood Realtor to trust us 100% so that when you get a client, you can submit a buyer's offer with the full confidence and backing of an established home lender.
Meet Russ McClosky
Types of Financing Available
We provide full mortgage broker services for your clients. We want to get your clients approved and our list of elite lenders offer many programs to help. We close more home loans and as a result you close more sales.
Google Online Reviews
The very best to work with. Excellent in finding the best rates. And all in a timely matter. No stress. Couldn't ask for anyone better than this team. Very satisfied customer.
Jo Riley
Orietta Vergara
Mark Metten
Hello Russ
I never been so pleased working with a group like you and your staff. They are very knowledgeable and helpful in getting a loan process complete. I wanted to …More
Kevin Krutz
As a loan originator, I've never had the resources and support that I have at Edison Mortgage Group. It is Incredible!! The combined experience of The McClosky Team provides a wealth of knowledge and leadership. I am able to offer Buyers a wide variety of loan options and help my Realtors CLOSE THE DEAL.
Kerry L. Gross
The McClosky Team at Edison Mortgage Group is the definition of TEAM work and professionalism! I highly recommend Russ and Debbie for ANY and ALL financing needs. Their knowledge is impressive & their dedication unparalleled. Amazing work & I couldn't be happier with the results!
Jennifer Hamilton
Edison team is amazing to work with! They know what they are doing and very responsive. Great sense of urgency. The loans are well packaged, process is smooth and things close on time! Great partners to have!
Sheri Sanders
I have known the owners of Edison Mortgage for over 20 years, and have been part of their team for 2 years. Being part of a team that values the customer above all else is refreshing and overdue in this industry. I'm thankful for this, but more importantly, my customers are thankful.
Jon Vredevoogd
Russ and Debora McClosky and the team over at Edison Mortgage are the most professional and passionate brokers I have ever worked with! They go above and beyond to get the deals done on time. I highly recommend using Edison Mortgage.
Michelle Wilde
Russ and his team took the stress and worry out out mortgage process.
They kept me in the loop as to the progress and made this a hassle free loan. I would highly recommend Russ and his Edison team. #1 for many reasons.
Paul DeBiase
Russ is helping us move homes. Satisfied customers in both the new construction we have built, and the ease of completing the sale thru Russ means our business grows. Thanks Russ
Mike Donnelly
I have know Russ McClosky for over a decade. He and his company is dedicated to getting the job done. He is straight forward and will hold your hand through the whole process. You will have piece of mind at a very stressful time. We here at Certified Inspection Services of SW Florida LLC, HIGHLY RECOMEND
Donna Fontz Donna Fontz
Best Mortgage Company. They are very helpful and walk you through the whole process. They always keep you in the loop. Thanks Russ and Debbie.
Gislind Vercher Home Electronix
Edison Mortgage Group is composed of mortgage professionals who are knowledgeable, friendly, and eager to make your experience a positive one. Top notch in my book!
Angela Hicks
Top 4 Reasons to Use Edison Mortgage Group
Lowest Home Loan Fees In The Florida Mortgage Industry
Full Service & Trustworthy
Learn how easy it is to get a home loan.
Find out more about our home loans and mortgage broker services.
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Russ McClosky
Edison Mortgage Group, Inc.
North Fort Myers, Florida 33903


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The lemma:
Any uncountable set $S$ of finite sets has an uncountable subset $\Delta \subseteq S$ and an $x$ such that $\forall a,b \in \Delta$, if $a \neq b$ then $a \cap b = x$. $\Delta$ is called a $\Delta$-system.
I've seen this lemma used in independence proofs, such as the famous result that the negation of the continuum hypothesis is consistent with ZFC, but it seems like it would be useful in other fields as well. Does anyone have any examples with this lemma outside pure set theory?
See also the finite and generalized infinite versions posted below.


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Grads with a degree in the Personal & Culinary Services field have average starting salaries of $33,654 and average mid-career incomes of $52,161. Depending on the school, salaries can vary by as much as $17,069. Look through the list below, and choose wisely.
If we do not have graduate salary data on a school it will not be included in this ranking. To see all of the colleges offering this program check out our listing of Annual Personal & Culinary Services Graduates. To see a list of all the colleges that offer online degree options in Personal & Culinary Services, check out our listing of Annual Personal & Culinary Services Graduates From Programs Offered Online.


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jherd123 necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 58 diseños de 16 diseñadores freelance.
I have a website currently being developed called Ink Battle..please include the text "beta" on all designs. The winner must provide 2 versions of the logo, one with the beta text and one with it removed.
Ink Battle
It is a web 2.0 site where users can create an account and share pics of their tattoos.
I had a couple ideas for the design…A close up of an arm wrestle with "Ink" tattooed on one arm, and "battle" tattooed on the other.
Or "ink" written above the image of the arm wrestle, and "battle" written below it.
Or any other combination.
Some incorporation of the tattoo gun (used to draw a tattoo).Two tattoo guns that have arms coming out the top of each gun in an arm wrestle like grip.
Two figures shooting each other with a tattoo gun.. signifying an ink battle.
Or the two T's in "battle" turned into tattoo guns aimed at each other.
Or the I in "ink", and the L in "battle" turned into tattoo guns firing at each other.
Would also consider a slick and simple, minimalistic web 2.0 kind of design.
All ideas welcome as I am not married to any concept in particular (as you can probably tell).
- Don't want capital letters
- Don't want corporate designs
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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Atlanta Hebrew & Bible School - Serving Metro Atlanta - Call: 404-538-1474 or
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Wednesday, December 26, 2012
Phosphorous Binder Equivalent Dose
You skim through the list of prerequisites and see that yes, the nutritionist has been by to review dietary sources of phosphorous, the dialysis nurse has checked in on adherence to phosphorous binding medications, there's no activated vitamin D on the med list and you've explored increasing the frequency of dialysis or moving to extended nocturnal with the patient before and it's not in the cards.
Is there anything rational that can be done with the phosphorous binder dose to improve phosphorous control? Thanks to the good work of the folks at the Frequent Hemodialysis Network (FHN) trial the answer is yes.
During the trial the investigators faced the question of whether or not changes or substitutions in multi-binder regimens represented increases or decreases in phosphorous binding capacity. In order to answer this question the investigators combed through stool and urinary phosphorous recovery studies of individuals given various phosphate binders. In these trials individuals were given test meals with known amounts of phosphorous. The amount of free phosphorous appearing in the stool or urine was measured with and without binders with the difference being considered the amount of phosphorous being bound to binders in the gut.
With this information in hand the FHN group additionally looked at parallel group trials were patients on dialysis were given one of two binders and then had their doses titrated to equal serum phosphorous levels. What emerged was a picture of the relative phosphorous binding capacity of various common binders. Below is a table of commonly used phosphorous binders and the derived phosphate binder equivalent doses.
As you can see, all the phosphate binder equivalent doses are referenced to 1g of calcium carbonate. So as an example, 5 tabs of 800mg sevelamer carbonate binds an equivalent amount of phosphorous (5 times 0.6 = 3) to 3 tabs of 500mg lanthanum carbonate (3 times 1.0 = 3).
Now, where ones phosphorous should ideally be is unclear (as nicely pointed out over at PBF a while back) as is the choice of agent (unless you count the realization that chronic aluminum binders where a bad deal).
Both the KDOQI and KDIGO guidelines don't endorse any one class binders over any other (again, excluding aluminum) though KDIGO gives a "2C = we suggest based on low grade evidence" that calcium based binders be restricted in the presence of arterial calcification, adynamic bone disease or persistently low PTH. KDOQI, based on expert opinion, suggests that the amount of calcium from binders be limited to 1.5g/day (there are 200mg of calcium in a 500mg calcium carbonate tab and 169mg of calcium in a 667mg tab of calcium acetate).
Posted by Graham Abra at 4:26 PM 0 comments
Labels: bone metabolism, Graham Abra, phosphate binders
Tuesday, December 25, 2012
Top nephrology-related stories of 2012
It's hard to believe another year has come and gone. 2012 proved to be a year of ups and downs in the nephrology community. Large clinical trials from the failed phase 3 bardoxalone study in diabetic nephopathy to the positive results of the tolvapan TEMPO 3/4 trial in ADPKD dominated the scene. The passing of a transplantation pioneer and Nobel Prize awardee Dr. Joseph Murry and the awarding of the 2012 Nobel prize to Drs. Lefkowitz and Kobilka for their work on G-coupled protein receptors were two stories that also garnered attention. This is by no means a complete list of all of the major news stories this year. Feel free to add to the list in the comment section below. As usual, I will summarize each of the top 10 studies/stories that you voted for in our year-end poll in increasing order of votes (in %). A total of 78 votes were received.
10. PEAK data showed that first-year mortality on dialysis was cut by 12% (14%)- Kidney Care Partners launched the Performance Excellence and Accountability in Kidney Care (PEAK) effort in 2009 in an attempt to decrease the high mortality (2009 USRDS data showed a 30% first year mortality) that is seen in patients during the first year of dialysis. The goal was to decrease first year mortality by 20%. This campaign focused on patient education, case management, nutrition, anemia management, dialysis adequacy, catheter use and psychological and social support. The results showed a cumulative 12.5% drop in first-year mortality after dialysis initiation. The data was presented to a congressional educational briefing to help maintain adequate funding of ESRD care. These results are encouraging and with more concerted efforts I hope the goal of further reduction is reached.
9. Drs. Lefkowitz and Kobilka awarded the Nobel Prize in Chemistry (15%)- Dr. Lefkowitz and his former post-doc Dr. Kobilka both received the Nobel prize in chemistry in 2012 for their body of work on G protein-coupled receptors. This important work defined how cell surface receptors mediate some of the basic physiological functions mediating both normal homeostasis and pathologic disease. The majority of medications used to treat hypertension, kidney disease and cardiovascular disease target G protein-coupled receptors. These include alpha- and beta- adrenergic receptor blockers and angiotensin receptor blockers (ARBs). This was quite an achievement that has led to the development of a large repertoire of medications to treat not only cardiovascular disease but many other diseases such as depression (SSRIs), allergies (anti-histamines), and many others. Congrats to a well deserved award. These groups are further defining how these receptors signal. An phase II clinical trial exploring the novel beta-arrestin biased angiotensin receptor ligand in heart failure is ongoing.
7. Chloride restrictive IV fluid administration shown to be superior to chloride liberal in the ICU published in JAMA (21%)- This was a provocative study performed in an ICU setting at a single center at the University of Melbourne, Australia. Joel Topf at PBF and Gearoid here on RFN have excellent blog posts about study and its implications. In short these investigators conducted a prospective, open label, sequential period study in 760 ICU patients comparing a control group with usual practices (chloride liberal) to an experimental group that instead received lactated solution (Hartmann solution), Plasma-Lyte 148 or chloride-poor 20% albumin (chloride restrictive). The primary outcome was looking at an increase in baseline creatinine to peak creatinine and AKI as dictated by RIFLE criteria. They reported that the chloride restrictive group had a lower change in creatinine (0.16) vs. chloride liberal group (0.25). Interestingly they found a significant reduction in AKI with a much lower need for acute dialysis (78 in the liberal vs. 49 in the restrictive). However, no differences were seen in mortality or length of ICU stay. As Joel stated in his PBF post "this is an intriguing paper and I look forward to more data, even if it means the surgeons were right".
7. Passing of Dr. Joseph Murray first surgeon to successfully perform a kidney transplant (21%)- Coming in at a tie for 7 in our poll is the passing of a giant in field of nephrology- Dr. Joseph Murray at age 93. Ajay Singh at The Kidney Doctor has an excellent post about Dr. Murray. In 1954 he performed the first successful kidney transplant at the Peter Bent Brigham Hospital in Boston, MA between the identical Herrick twins. This was truly a monumental achievement that ushered in a new era in the treatment of kidney failure. I would recommend reading Surgery of the Soul, a autobiography of Joseph Murray.
6. Diuretics beat ultrafiltration in decompensated CHF published in NEJM (29%)- Coming in at number 6 pitted aggressive therapy with diuretics and vasodilators (pharm group) in 94 patients versus mechanical ultrafiltration (UF group) in 94 patients with decompenstated heart failure (the CARRESS-HF trial). This trial was stopped early due to a lack of evidence of benefit as well as an excess of adverse events with ultrafitration. Before this trial was published the use of mechanical ultrafiltration was starting to garner more popularity as a means of volume removal in CHF with cardiorenal syndrome. However, this study reported that the use of stepped pharmacologic-therapy (diuretics and vasoactive agents) was superior to ultrafiltration. The pharmacologic group had a -0.04 increase in creatinine while the UF group had a +0.23 increase at 96 hrs. There was no difference in weight loss between the groups. However, there was more serious adverse events in the UF arm (72% vs. 57%) owing mainly to bleeding, renal failure (17 UF and 14 Pharm) and catheter complications. There was no difference in mortality (although there was a trend towards higher mortality in the UF group) or rehospitalization rate. This trial puts serious question to the use of UF in decompensated CHF with cardiorenal syndrome. Read the editorial accompanying this article for more perspective.
4. Results of ALTITUDE trial using aliskiren combined with ACEi and ARB published in NEJM (30%)- Coming in at at tie for 4th was the ALTITUDE trial. The results were presented at ASN Kidney Week in San Diego this year and published simultaneously in the NEJM. This was a large prospective double blinded placebo controlled trial involving 838 centers in 36 countries. 8606 patients with type 2 diabetes were randomly assigned to 2 groups- Placebo + ARB or ACEi or Aliskiren (300mg) + ARB or ACEi. This trial was stopped early after the planned second interim efficacy analysis where they concluded that the increased rate of adverse events was not offset by any measurable cardiovascular or renal benefit from aliskiren and in fact favored the placebo arm. The primary end-point was a composite of the time to cardiovascular death or a first occurrence of cardiac arrest with resus, nonfatal MI, nonfatal stroke, heart failure hospitalization, ESRD, death from renal failure, doubling of serum creatinine. The primary end point was reached in 783 patients in the aliskiren arm and 732 in the placebo arm. (P=0.12 CI 0.98 to 1.20). BP was lower in the aliskiren group as was the amount of albuminuria. However, there were no differences in secondary renal end point. There was an increase in adverse events in the aliskiren arm most notably hyperkalemia and hypotension. This was a large well conducted trial that does not the support the addition of direct renin blockade to ACEi or ARB therapy in patients with type 2 diabetes and chronic kidney disease.
4. Supreme Court upholding of the Affordable Care Act (30%)- The Supreme Court determined that the Affordable Care Act (ACA) was constitutional with the exception of the mandatory medicaid expansion earlier this year. Dr. Barry Staube, former Chief Medical Officer of CMS and current Director of the Marwood Group discussed how the ACA will affect patients with kidney disease and their providers in a brief commentary at eAJKD.
3. Results from the EVOLVE trial using cinacalcet in ESRD published in NEJM (33%)- Coming in at number 3 is the behemoth EVOLVE trial also presented at ASN Kidney Week in San Diego this year and published in NEJM. This was the largest and longest randomized clinical trial ever performed in patients on dialysis. Joel Topf reported on this story at eAJKD and in more detail at PBF. The trial was designed to test the hypothesis that treatment with cinacalet (an allosteric modifier of the calcium sensing receptor, a G protein-coupled receptor) would reduce the risks of death and nonfatal cardiovascular events among patients with secondary hyperparathyriodism who were undergoing dialysis. They found that the main cardiovascular end-point was not significantly different from the placebo arm nor was all cause mortality. However, as pointed out by Joel and discussed in the NEJM article, the cinacalcet group was on average older (55 yrs vs. 54) and age-adjusted analysis did show a "nominally" significant reduction in mortality. A significant reduction in parathyroidectomy was also noted. Side effects were seen in both groups but were more frequent with cinacalcet (hypocalcemia, nausea and vomiting). How this study will change practice will be born out in time. I applaud all of the investigators in pursuing an important issue that is germane to both patients and providers.
2. Phase 3 clinical trial (BEACON) testing bardoxolone in diabetic nephropathy abruptly stopped (38%)- The biggest shock of the year comes in at number 2. Just a few weeks before ASN Kidney Week came the announcement from Reata that the BEACON trial was stopped. They cited "excess serious adverse events and mortality in patients taking bardoxolone". RFN first picked up the story back in 2010 when I posted on preliminary results from the first 24 weeks of the 52 week phase IIb study that was presented at ASN that year. At that time it was noted that patients in the bardoxolone group had a mean elevation in eGFR of 10 ml/min when compared with the placebo arm. This was odd given that our most successful therapies, ACE inhibitors and ARBs typically lead to a drop in glomerular pressure and a slight rise in creatinine when started. In addition it was also noted that there were higher rates of nausea, decreased appetite, hypomagnesemia and muscle spasms with bardoxolone. The full results of the 52 week study were eventually published in NEJM and commented on by Gearoid. Again the rise in eGFR and higher adverse event rates were noted with bardoxolone but now additionally a rise in albuminuria was seen. Some interesting potential mechanisms for this emerged, including a down regulation in megalin which Gearoid posted on and the idea that albuminuria is not a perfect surrogate for future changes in renal function was also raised and commented on at PBF. With the above as backdrop, bardoxolone was the RFN number 5 story of the year in 2011. When the phase 3 study folded, Reata bailed on Kidney Week, no attempt to impart lessons learned or what next steps for the scientific community might be, just disappeared. Bardoxolone received a lot of hype and there was hope that this drug would represent a significant new treatment for patients with diabetic nephropathy. Looks like the end of the road for bardoxolone.
1. Results from TEMPO 3:4 trial using tovaptan in ADPKD published in NEJM (51%)- The major bright spot of the year was at ASN Kidney Week in San Diego to a packed late-breaking clinical trial audience when the TEMPO 3:4 results were presented. This was also reported by Joel at eAJKD. This was a randomized double blinded placebo controlled clinical trial comparing the vasopression antagonist tolvaptan to placebo in patients with Autosomal Dominant Polycystic Kidney Disease. This study showed that tolvaptan, as compared with placebo, slowed the increase in total kidney volume and the decline in kidney function over a 3-year period in patients with ADPKD. This is a major breakthrough, but several questions remain. How will these results this hold up over time and will this drug decrease the rate of progression to ESRD. Furthermore, the cost of tolvaptan is considerable and this therapy would be lifelong if proven effective.
Again, quite a busy and exciting year in the world of nephrology in 2012. Thanks to all of the contributors and readers for keeping the site fun, interesting and educational.
Thanks for supporting RFN and happy holidays.
Posted by Matt Sparks at 1:00 AM 0 comments
Labels: Matt Sparks, poll results, Top Stories
Wednesday, December 19, 2012
Who reads the Renal Fellow Network?
One thing that I would like to reiterate: Graham and I have been involved in the site for a few years now and both of us are beyond the initial "discovery" phase where everything we see is new. As a result, our areas of interest may not coincide exactly with fellows who are earlier in their training. We have benefited greatly from the contributions of other nephrology fellows from around the country (and abroad). I would like to take this opportunity to again invite new contributors to the Renal Fellow Network. This blog is maintained on an entirely voluntary basis and we are dependent on contributors who give their valuable time to help educate others. If you are interested, please email Graham or me.
Happy Holidays from the RFN
Posted by Gearoid McMahon at 10:09 AM 1 comments
Labels: Gearoid McMahon, poll results
Sunday, December 16, 2012
Poll: Top Nephrology-Related Stories of 2012
Posted by Matt Sparks at 4:26 PM 3 comments
Labels: Matt Sparks, poll
Wednesday, December 12, 2012
Pearls for Boards
2) The three C3 immunoflourescence patterns of post strep GN 1) Starry Sky (most common) 2) Garland (less common) 3) Mesangial (resolving Starry Sky).
3) Troubles from Star Fruit 1) Seizures in dialysis patients 2) Hyperoxaluria -> AKI, Nephrocalcinosis, and Calcium Oxalate stones.
4) Avoiding aminoglycoside toxicity - reduce the dose frequency.
5) Membranous risk categories by proteinuria and renal function: Low - less than 4 g/day, normal fxn, Med - 4-8g/day normal fxn, High - more than 8g/day, abnormal fxn.
Posted by Graham Abra at 11:14 PM 3 comments
Labels: Graham Abra, Nephrology Boards
Visitor Poll
Every once in a while we like to get an idea of who our audience is. As a result, we have started a poll which will remain open for the next 7 days. The website was originally started with a nephrology fellow audience in mind but we know from the comments that our readers come from a more diverse group. We would appreciate if anyone visiting the site over the next few days could take a second and click one of the answers on the right hand side of the screen. This poll is completely anonymous.
Thanks from RFN.
Thanks from RFN.
Posted by Gearoid McMahon at 7:03 AM 4 comments
Labels: Gearoid McMahon, poll
Tuesday, December 11, 2012
Fruit Flies and Kidney Stones
Developing accurate animal models of human diseases is a well-established research goal but a recent paper reporting a new animal model of nephrolithiasis caught my attention. Kidney stones are an important cause of morbidity and dealing with them is estimated to cost more than $5 billion yearly in the US alone. The majority of cases are due to calcium oxalate stones which variously results from increased urinary calcium excretion or increased urinary oxalate (which may be due to increased production or gut absorption of oxalate).
A group in the Mayo clinic and Glasgow have developed a fruit fly model of calcium oxalate nephrolithiasis. Fruit flies have a single transparent kidney tubule and feeding the larvae a diet high in oxalate for just two days leads to the formation of visible calcium oxalate kidney stones.
video if this happening in the supplemental data of the manuscript. There are also some micro-CT images of the fruit flies with the stones in situ. The rapid formation of stones in these flies makes it an excellent model for the study of nephrolithiasis.
Also, it's really cool.
A group in the Mayo clinic and Glasgow have developed a fruit fly model of calcium oxalate nephrolithiasis. Fruit flies have a single transparent kidney tubule and feeding the larvae a diet high in oxalate for just two days leads to the formation of visible calcium oxalate kidney stones.
video if this happening in the supplemental data of the manuscript. There are also some micro-CT images of the fruit flies with the stones in situ. The rapid formation of stones in these flies makes it an excellent model for the study of nephrolithiasis.
Also, it's really cool.
Posted by Gearoid McMahon at 12:38 PM 4 comments
Labels: Gearoid McMahon, nephrolithiasis
Monday, December 10, 2012
Image of the Month - Pathology
A 60 year-old woman with a longstanding history of hypertension, scleroderma and MGUS presented to the emergency room with diarrhea, vomiting and AKI (creatinine increased from baseline of 1.5mg/dl to 3.1mg/dl). She had a distant history of membranous nephropathy diagnosed on a renal biopsy 25 years previously. She had been worked up in the renal clinic for CKD and had a renal US showing relatively small kidneys. Her medications included an ACE inhibitor.
On admission, she had no hematuria. Her BP was elevated although she had a significant postural drop. She had dipstick proteinuria and she was empirically started on oral steroids for a possible GN. A renal biopsy was performed:
The image above is of the renal cortex. A single glomerulus is seen (A) which is hypoperfused. There is significant dilatation of the tubules (B) indicating acute tubular injury. There is attenuation and degeneration of the tubular epithelial cell layer. At the lower end of the image is an atrophic tubule with a hyaline cast.
This image again shows a hypoperfused glomerulus. However, the main finding here is an extremely damaged arteriole (A). There is multilayering within wall of the vessel (that was replicated throughout the biopsy). The vascular lumen is almost occluded with endocapillary proliferation and remodeling of the vessel wall.
In some areas of the biopsy (better perfused), the glomeruli looked relatively normal. There was some mesangial expansion with irregular capillary loops but no evidence of membranous disease.
IF showed some minimal deposition of IgG in the mesangium but equal kappa and lamda light chains.
Finally, the EM showed multiple mesangial deposits (A) of uncertain significance but again, no evidence of membranous disease. Notably, there were was no evidence of active inflammation in the biopsy.
Following the report of the biopsy, the steroids were stopped. The patient's blood pressure was controlled and her renal function returned to baseline within a few days. It is likely that this acute episode was related to volume depletion and acute tubular injury exacerbated by her severe underlying vascular disease. Interestingly, she now has no albuminuria and she is back on her ACEi. The significance of the mesangial deposits remains unclear and she will be followed on an ongoing basis in the renal clinic.
We often see patients like this on consult who present with AKI following a GI illness while on an ACEi. However, we don't normally get to see the pathology in these very common case.
Click on any image to enlarge
On admission, she had no hematuria. Her BP was elevated although she had a significant postural drop. She had dipstick proteinuria and she was empirically started on oral steroids for a possible GN. A renal biopsy was performed:
The image above is of the renal cortex. A single glomerulus is seen (A) which is hypoperfused. There is significant dilatation of the tubules (B) indicating acute tubular injury. There is attenuation and degeneration of the tubular epithelial cell layer. At the lower end of the image is an atrophic tubule with a hyaline cast.
This image again shows a hypoperfused glomerulus. However, the main finding here is an extremely damaged arteriole (A). There is multilayering within wall of the vessel (that was replicated throughout the biopsy). The vascular lumen is almost occluded with endocapillary proliferation and remodeling of the vessel wall.
In some areas of the biopsy (better perfused), the glomeruli looked relatively normal. There was some mesangial expansion with irregular capillary loops but no evidence of membranous disease.
IF showed some minimal deposition of IgG in the mesangium but equal kappa and lamda light chains.
Finally, the EM showed multiple mesangial deposits (A) of uncertain significance but again, no evidence of membranous disease. Notably, there were was no evidence of active inflammation in the biopsy.
Following the report of the biopsy, the steroids were stopped. The patient's blood pressure was controlled and her renal function returned to baseline within a few days. It is likely that this acute episode was related to volume depletion and acute tubular injury exacerbated by her severe underlying vascular disease. Interestingly, she now has no albuminuria and she is back on her ACEi. The significance of the mesangial deposits remains unclear and she will be followed on an ongoing basis in the renal clinic.
We often see patients like this on consult who present with AKI following a GI illness while on an ACEi. However, we don't normally get to see the pathology in these very common case.
Click on any image to enlarge
Posted by Gearoid McMahon at 11:23 AM 3 comments
Friday, December 7, 2012
Mg & K
It is well known that hypokalemia does not correct easily if it is accompanied by hypomagnesemia. A medical student I met looked into this topic and found a "Science in Renal Medicine" article. According to this article, one of the mechanisms through which hypokalemia occurs in a hypomagnesemic state is through renal potassium wasting. Several observations have shown that magnesium infusion decreases renal K secretion in the distal nephron.
A study from Nature found that ROMK (aka Kir), one of two potassium channels in the distal nephron, is responsible for the distal renal K wasting in hypomagnesemia. The mechanism is that the intra-cellular free Mg blocks the pore of the ROMK channel and limits potassium secretion in a concentration-dependent manner; therefore low intracellular Mg level increases potassium secretion.
Some renal Mg wasting disorders (e.g. Mg channel TRPM6 mutation) do not always present with hypokalemia. Why is that? The reason is that you need 2 components for potassium excretion. One is increased K permeability of the ROMK, and the other is a driving force to secrete K like increased distal Na delivery or an elevated aldosterone level (via enhanced Na reabsorption in the distal nephron). It seems in these disorders you don't have the second determinant for K secretion.
Another fascinating renal physiology article! Now we are still confused but have a better understanding of hypomagnesemia in a case of hypokalemia.
Posted by Tomoki Tsukahara
Posted by Gearoid McMahon at 2:46 PM 1 comments
Wednesday, December 5, 2012
CNS mass and crystals after kidney transplantation
A gentleman with ESRD secondary to polycystic kidney disease comes in with vomiting and headache eight months after kidney transplantation. Brain MRI shows a small single enhancing lesion in the temporal lobe. Lumbar puncture reveals an elevated opening pressure (41), WBC 121 (77% lymphs), elevated total protein (210) and low glucose (41). Cultures are negative.
The top 3 differentials of CNS masses in post-transplant kidney recipients are: neurotoxoplasmosis, lymphoma and tuberculoma. EBV negative status prior to transplantation increases your risk of post-transplant lymphoproliferative disorder (PTLD) and checking EBV VL could help with initial evaluation. Coming from endemic areas of tuberculosis (TB) raises the suspicion for tuberculosis. TB in kidney transplant recipients is a particular challenge both diagnostically and therapeutically. Atypical clinical presentations (extra-pulmonary) and negative tuberculin skin tests/sputum smears are frequent. The treatment of TB also has its own challenges, which include pharmacokinetic interactions between immunosuppressive and antituberculous medications (reduction of FK by more than 60% is required), allograft-related drug toxicities, and inadequate immune responses to Mycobacterium tuberculosis due to exogenous immunosuppression.
In general, empirical therapy of neurotoxoplasmosis is instituted in immunosuppressed patients with an enhancing brain lesion, consisting of sulfadiazine, pyrimethamine and leucovorin. Reduction of immunosuppression is also indicated and follow up imaging is performed. Last resource if no improvement and negative work up is to perform a brain biopsy to obtain tissue specimen.
Treatment of neurotoxo with high doses of sulfadiazine may precipitate acute kidney injury by crystal formation (~30% of patients), in particular if volume depletion is present and urine pH is 5.5 or less. Intra-renal crystalluria may be prevented by maintaining fluid intake above three liters per day (PO or IV). Monitoring of serial urinalyses for the development of crystalluria is recommended. For those developing crystalluria, intravenous bicarbonate solution to alkalinize the urine (goal pH above 7.15) is administered. The patient above developed significant AKI (creatinine increased from 1 to 4) after sulfadiazine treatment and crystals were identified in the urine (representative figure).
Be aware of potential drugs/toxins** that might form intratubular crystals and precipiate AKI. Act pre-emptively with fluid hydration +/- alkalinization of urine depending on the toxin.
** Acyclovir (IV), sulfonamides, ethylene glycol, high dose vitamin C, methotrexate, protease inhibitors, phophate enemas, orlistat
*** Remember that for MTX renal toxicity, there is glucarpidase as a last resource to quickly reduce MTX levels in patients with AKI and persistently high MTX levels 48 hrs after dosing.
Posted by Leonardo V Riella, MD, PhD at 11:18 AM 0 comments
Sunday, December 2, 2012
eJournal Club - Albuminuria and AKI
This month's eJournal club concerns biomarkers of AKI. There has been considerable interest in developing novel biomarkers of AKI and CKD and a lot of effort has been focused on novel biomarkers such as NGAL, KIM-1 and IL-18. The TRIBE-AKI consortium has published a number of well-designed studies investigating novel and traditional biomarkers. The reason that these biomarkers are desired is because creatinine elevations tend to occur relatively late in the course of AKI and therefore, the sense is that this is too late to initiate therapies which may prevent progression of AKI. However, the results of these biomarker studies have been relatively disappointing and they have not yet entered regular clinical practice.
This month in CJASN, a study was published looking at the performance of post-operative albuminuria as a biomarker of AKI in patients following cardiac surgery. The highest quintile of albuminuria was associated with a RR of 2.97 for AKI relative to the lowest quintile. While this appears good and the AUC for a model including albuminuria to predict AKI was 0.81, the majority of patients with albuminuria did not develop AKI and the model missed a significant number of patients with AKI. Still, when you combine this with other studies showing that the urinalysis is an excellent predictor of outcome in patients with AKI, older biomarkers are not looking so bad after all. Perhaps we will be able to come up with a combination of biomarkers which will allow us to better predict those patients at greater risk of AKI. To me, it seems that the bigger issue is low sensitivity rather than low specificity. I would rather have a model which will allow me to rapidly rule out those who will not develop AKI than one that will misclassify patients into a low risk group.
It was interesting in this study that ACR was not a good predictor of AKI – the absolute level of albumin performed better. This is at odds with the majority of studies which suggest that albumin should be corrected for creatinine level. This is possibly due to the large variation in creatinine generation in patients in the ICU – although relatively constant under normal circumstances, the amount of creatinine produced daily changes rapidly in sick patients – as was evidenced by a recent study of creatinine excretion in patients on CRRT.
Posted by Gearoid McMahon at 8:54 PM 0 comments
Labels: AKI, biomarkers, Gearoid McMahon, Journal Club, proteinuria
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By now, pretty much the whole world knows Europe is in a bad financial state. Tomorrow I plan to go to a country which declared its bankruptcy end of 2008. It is remarkable how quickly Iceland has come back from its all time low! Maybe not a bad idea for the other EU countries to follow its lead...
The image above was shot last night in my home country Belgium, just as a large line of thunderstorms passed overhead.
Image details:
Nikon D800 with 70-200 2.8 VR2 lens
ISO 280 f6.3, 70mm, 1/160sec
RAW development in LR4
ColorEfex Pro4 for contrast optimization
Remember, "The future starts today, not tomorrow" - Pope John Paul II"


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A Truth Journal: Funny Post: Russia To World Stage Declares, "We're Baaaack!": 4 funny video clips from "Puss In Boots" animated film. Check out all the links as many are polls.
From Denny: Oh, how I have missed the Russians on the world stage. Affectionately deemed as Denny's Fightin' Yard Cats, the Russians never fail to throw paws (at America), amuse by pinning some unlucky misbehavin' ears to the ground in a show of dominance (to Syria) or provoke reasonable people to deeper thought on international issues (yes, the World).
At least the Russians "get it" about discussing world issues in depth and detail as opposed to my American government - and their lazy think tanks. Those think tank guys spend more time dreaming up catchy political slogans, tweeting arguments on social media, yessing each other in an echo chamber and talking like they skim the news headlines rather than invest in solving serious world problems. Come to think of it, much of that sounds a lot like the Russian Yes Government in relation to how they behave with Putin...
Is your cat giving you "face" with this large meow, mugging you for treats?
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Sunday 02/24/2013, 8:30 am - 11:30 am
Skill LevelEasy
Class Hours3
TeacherAnne Berk
View Anne's profile
Inside Intarsia with Anne BerkIntarsia allows a knitter to create motifs, stripes and geometric shapes in any direction, controlling fabulous color effects. Intarsia is fun when done efficiently and this class will teach you the techniques, tricks and tips to de-mystify the process. Class project is a bag which can be felted. Students will have the choice of three charted motifs, or they can design their own.
Supplies10-20 yards each of 100% worsted weight wool yarn in at least 3 colors; straight or circular needles US 7 if you are not felting the bag (US 8 or 9 US if you planning to felt). We will be working flat knitting.
Sharp scissors, notebook, pen or pencil with an eraser, stitch markers, blunt tapestry needles (large and small), flexible tape measure, small calculator, and needles & crochet hooks of various sizes.


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House Dems made ACA vow, too
President Barack Obama isn't the only one who promised incorrectly that anyone who wanted to keep their existing health plan under Obamacare could do so. Plenty of vulnerable House Democrats did, too, and their GOP rivalries are determined to make them pay for it in the 2014 midterms.
GOP strategists are digging through reams of old statements, videos, and other clips – all with the hopes of capturing Democrats offering the same faulty vow that's landed Obama in a world of hurt.
The National Republican Congressional Committee has cataloged over a half-dozen Democratic incumbents in challenging races who previously said that people would be able to keep their plans. One is Minnesota Rep. Rick Nolan, who says on his official website that, "If you like the plan you have, you can keep it. And in fact, you'll get a host of other built-in new consumer protections."
Another is New York Rep. Tim Bishop, who once wrote in a message to his constituents: "A central feature of reform will be preserving the freedom to choose what works best for you and your family—if you like your doctor, keep your doctor. If you like your current plan, keep your current plan."
( WATCH: 6 major players in HealthCare.gov debacle)
And West Virginia Rep. Nick Rahall was once recorded telling an audience: "Those who like their plan will be able to keep it."
And this week, Oregon Rep. Kurt Schrader – who's harshly criticized the president over the botched ACA rollout – found himself under fire from Republicans after it was revealed that language on the congressman's website stating, "If you are insured and happy with your coverage, nothing changes," had been deleted.
Republicans intend to use the statements in TV ads next year to clobber Democrats as untrustworthy – a strategy that Oregon Rep. Greg Walden, the NRCC chairman, telegraphed on Friday.
"You can't get away from your votes, you can't get away from your statements," Walden told reporters at a breakfast hosted by the Christian Science Monitor. "I think they're in real trouble."
Democrats scoff, arguing that they'll have plenty of cover by the time the midterms roll around. On Friday, 39 Democrats - including Nolan, Bishop, and Rahall, and dozens of other vulnerable lawmakers – voted for the Republican-sponsored bill that would allow insurers to continue selling plans that were cancelled under Obamacare.
"When the law was passed by the Congress, the intention of the law was to 'grandfather' insurance plans that were in existence at the time of law's passage. It is incredibly frustrating that individuals are losing policies that they want, even in the face of that congressional intent and understanding," Rahall said in a statement. "That's a big problem, and why I have voted to allow existing health insurance plans to continue into next year. I intend to keep pressing to see that the flaws in the program are fixed."
Oliver Longwell, a spokesman for Bishop, said the congressman "voted for the Upton bill to ensure that consumers would continue to have access to current plans if insurers choose to offer them for 2014. He believes that satisfies the intent of Congress in including the grandfather clause in the law."
And some Democrats contend that, after the president's fix, whatever statements Democrats made in the past about Obamacare's impact on existing plans won't make much of a difference. Obama proposed Thursday allowing people to retain health care plans that don't comply with the health care act's benefit standards for another year — though his plan will require the cooperation of wary insurance companies, who would have to agree to extend the coverage.
"For consumers who want to keep their health care plans, President Obama has offered a commonsense fix – and Democrats worked hard to make sure that pledge is supported," said Jesse Ferguson, the Democratic Congressional Campaign Committee deputy executive director. "Republicans are now being unmasked as dishonest after they doubled down rhetorically on the importance of helping Americans keep their plan – but opposed President Obama's fix because of their knee-jerk ideological obsession with opposing everything with President Obama's name on it."


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We swore we were going to stop passing along this nonsense, but it seems like this time "The Hobbit" is ready to roll. No, really.
Peter Jackson has agreed to write, direct and produce the two-part saga (didn't we all assume this from the beginning?), and now a deal brokered between MGM and Warner Bros. has given the film a green-light to start shooting in February, reported The Wrap.
And on top of that comes word that Martin Freeman has finally found time in his busy schedule to star in the lead role, reported Deadline. Freeman's a great choice and it comes as no surprise he was able to make to make for this around his obligations to a second season as Dr. Watson on BBC's "Sherlock."
U.S. & World
Also being courted for the cast are Michael Fassbender, David Tennant and James Nesbitt, who's been offered "'Bofur,' whoever that is," tweeted Pajiba.
But not all the news is good, as Jackson has still not yet forged a peace with the New Zealand labor unions that have called on their members to boycott the project. Of course there's too much money at stake--on both sides--for this not to get resolved, and a resolution is expected sooner rather than later..
The first "Hobbit" is due December 2012, and both will be in 3D. Hopefully "The Hobbit" will generate enough money for MGM to somehow save James Bond from limbo.


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CEO Vince Steckler announced today that AVAST Software's antivirus products are now protecting more than 200 million PCs, smartphones and devices worldwide.
"We are now securing over 200 million computers, and phones around the world," said Mr. Steckler in a video address to avast! Antivirus users. "This is a milestone that no other software security company has ever come close to."
AVAST is used by more people than the combined users of competitors AVG Technologies, Symantec, and McAfee. The software is available in 43 languages, many of them localized by volunteers, and has over 1 million users in 38 different countries. The largest markets for AVAST are Brazil with 28 million customers, France with 15 million, and the U.S. and Russia with over 13 million each. Data from the October report by OPSWAT shows that AVAST leads overall in worldwide product market share for antivirus applications.
AVAST Software co-founder, Eduard Ku?era, introduced free antivirus protection years ago because he believed that all computer users deserve protection from harmful threats, and that computer safety should not be a luxury only a few can afford.
"Our philosophy is we should not be a good product, but a perfect product," Ku?era said. "We provide the community with a perfect product."
So perfect, that 72% of AVAST users have recommended it to someone else, which is the primary way AVAST spreads it message since virtually no money is spent on advertising. AVAST has never strayed from the vision of offering a high-end antivirus product for free while building a wide user base.
"And it's all due to you, our loyal users who recommend and distribute our product to their family and friends," said Steckler, "I can't think of a better way of celebrating our 25th year in business. Thank you for your loyalty!"
Thank you for using avast! Antivirus and recommending us to your friends and family. For all the latest news, fun and contest information, please follow us on Facebook, Twitter and Google+. Business owners – check out our business products.


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Biography: John Baglin
John Baglin joined the ISU Physics Department and Ames Lab in 1963, as a Fulbright Fellow from Melbourne, Australia. He worked on photonuclear reactions at the electron synchrotron with Dan Zaffarano, Barney Cook, Al Bureau, Jim Griffin, and many others. And he relished the research, the teaching and the friendly community of Ames. In 1965, he moved to Yale, to work at the 60 MeV linac there. In 1970, he returned to Ames, with his wife Coral (also a nuclear physicist), to plan a new accelerator facility. In 1973, John joined IBM's Watson Research Center in Yorktown Heights, NY, doing basic research in applications of energetic ion beams to thin film analysis, ion implantation, and radiation effects in solids -- an exciting change of field. In 1988, he transferred to IBM's Almaden Research Center, San Jose, CA, to manage a new accelerator lab, specializing in the physics of materials that make up advanced data storage systems, such as magnetic disk drives, or nano-structured / self-assembled materials. He is currently working on ion beam patterning of magnetic disk storage media, and diamond-like tribological protective films for heads and disks. And he remains convinced, as always, that Physics is fun!
John's continuing interest in education issues and innovation is reflected in the series of Symposia on Materials Education that he organized at Materials Research Society meetings since 1994. He is Editor-in Chief of the Journal of Materials Education, and Vice President of the Materials Education Council. And he currently chairs the ISU Physics and Astronomy Council. John is a Fellow of the American Physical Society, and a former President of the Materials Research Society. He also chairs the Commission on Membership of the International Union of Materials Research Societies.
John and Coral both enjoy choral singing (currently with Schola Cantorum of Palo Alto and their church choir). And when not doing science, or singing, or traveling, they enjoy looking after their home property on a hillside, miles from Silicon Valley, overlooking the orchards, vineyards and farmlands near rural Morgan Hill. They welcome visitors !


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Alon Goldstein – IKIF
19th International Keyboard Institute and Festival at Hunter College
July 20th, 2017
Scarlatti: Four Sonatas
Schubert: Fantasy in C Major, D. 760 "Wanderer"
Liszt: Paraphrase on "Miserere" from Verdi's "Il Trovatore", S. 433
Bartok: Suite, Op. 14
Debussy: Masques
D'un cahier d'esquisses
L'isle joyeuse
Alon Goldstein is a very likable musical personality. He bows in a modest way, and likes to make comments about the composers, and the music he plays, always concluding by thanking his audience yet again for being there. They respond to him warmly. His performance style is not at all flashy, but he's an excellent pianist who plays a very enjoyable, and satisfying program.
The first Scarlatti Sonata, in C Minor (Mr. Goldstein says the composer called them "exercises"), was played sotto voce, and sounded very intimate, sometimes with a bell-like purity. This was followed by the jaunty C Major Sonata, where he showed his fine musicianship by varying the expression whenever a phrase, or section repeated. The minuet-like Sonata in G Major had a droll charm, as well as delicacy. The Scarlatti group ended with the amazingly adventurous E Major Sonata, which traverses a remarkable number of keys before returning to its "home base" of E Major.
Mr. Goldstein's performance of the Wanderer Fantasy reminded me a bit of Robert Goldsand, not because he sounded like Mr. Goldsand, but because, like Mr. Goldsand, he goes his own way interpretively, not adhering to any preconceived notions of how a work should sound. The question is "Does his way 'work?'" It was quite different from other versions I've liked, beginning, for example with a not very fast first movement tempo, ending with a last movement which started at quite a clip, and having some nice, individual touches, such as a staccato left hand accompaniment in the third movement which I don't remember other pianists bringing out. The answer for me was "Yes, indeed!" it 'worked'; I liked this interpretation.
Liszt's Paraphrase on the "Miserere" was dark and turbulent in the early A Minor section, then gorgeous and virtuosic when it shifted to A Major.
His playing of the Bartok Suite also had individual ideas, such as a pokey and whimsical mood in the first movement, an accusatory feeling in the second, a maniacal outburst in the middle of the third movement, and a fourth movement which sounded both nostalgic and surreal, and had a beautiful ending.
Though he is not a "colorist" in the usual sense, Mr. Goldstein captures moods very well, so his Debussy playing was effective. "Masques'' was invigorating, thoughtful and exotic. "D'un cahier d'esquisses" was dream-like, and had a great calm. "L'isle joyeuse" was intense, fanciful, and ended with a massive sound.
Mr. Goldstein played one encore, the Second Argentinean Dance of Ginastera. Sounding sentimentlal and as if from far away, it was gorgeous!
Donald Isler
Alon Goldstein - IKIF
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Re: Alon Goldstein - IKIF
A marvelous program. Wish I could have enjoyed it with you and your Mom.
There's nothing remarkable about it. All one has to do is hit the right keys at the right time and the instrument plays itself.
-- Johann Sebastian Bach
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Prosecutorial Discretion Is Misnomer
[Policing Wall Street]
For those neophytes, who do not understand the corruption of the Department of Justice, prosecutorial discretion is what the United States Attorney uses to protect well-connected criminals. Explained simply the Manhattan District Attorney, United States Attorney, Securities and Exchange Commission, or any governmental agency cannot be compelled to prosecute a criminal. The United States Attorney can pick and choose whom he wishes to prosecute. (This is also true of the New York Stock Exchange, which for many years was permitted to regulate itself as a self-regulated entity.)
William Johnston, former partner in LaBranche and former President of the New York Stock Exchange, was one of those well-connected individuals, who flagrantly violated federal law and was protected from prosecution for his crimes. Johnston was a close friend of Dick Grasso, former Chairman of the NYSE, - he of the $190 million payday. (Much of this is public information and has been discussed in my lawsuit to obtain my FBI files and also has appeared previously on the internet.)
Until 1995 Johnston earned as much as $6 million per annum as a senior partner in LaBranche & Co., one of the largest NYSE specialist firms. Now most Americans would be happy to earn $6 million in a year. But not Johnston. No Johnston was not happy with $6 million per year. Johnston wanted more.
So what did Johnston do? His first action was to set up an illegal professional trading account at Spear Leeds and Kellogg. Was it illegal? Most assuredly. All members of a stock exchange must declare their brokerage accounts to the stock exchange to which they are a member and to the Securities and Exchange Commission so that the accounts can be monitored. This includes all accounts even pension accounts.
But Johnston did not declare this account. Johnston set up this account at Spear Leeds and Kellogg so that he could illegally trade the stock of AT&T- a stock in which Johnston served as the specialist. Now this was totally illegal. There was also the question of tax avoidance because these accounts were alphanumeric and the names did not appear on the account. This issue of tax avoidance and tax fraud was explained to me by Joseph Roffler, a former senior managing director in charge of professional margin at Spear Leeds. Also a clerk from Spear Leeds and Kellogg informed me of this arrangement.
In the 1990s there was a room called the QT (Questionable Trade) Room. This was a room where trades were trades, which did not match, were resolved.
So there was Billy Johnston, who was unhappy with his salary of $6 million per annum, illegally trading the stock of AT&T for his illegal personal account at Spear Leeds and Kellogg while simultaneously acting as the specialist in the account. And in the morning the untouchable Johnston would saunter into the QT Room to verify that his illegal trades had cleared.
This is totally proscribed by the Securities and Exchange Act, as quoted below:
Securities Exchange Act of 1934
Section 240.11a-1
(a)No member of a national securities exchange, while on the floor of such exchange, shall initiate, directly or indirectly, any transaction in any security admitted to trading on such exchange, for any account in which such member has an interest, or for any such account with respect to which such member has an interest, or for any such account with respect to which such member has discretion as to the time of execution, the choice of security to be bought or sold, or whether any such transitions shall be one of purchase or sale
It is even more onerous for specialists. And by the way no matter what the NYSE says there are no floor traders at the NYSE. There are specialists and floor brokers- but no traders since 1989. Any trading by a NYSE floor member for his personal account is illegal.
So with the law so airtight, how was Johnston able to trade illegally- especially if the NYSE and the United States Attorney knew of Johnston's illegal trading?
That question will be answered in subsequent columns.
Manfredonia, a former trader, was thrown out of Wall Street and shunned after he became a whistleblower.
"Speaking Truth To Empower."
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Tuesday, March 10, 2009
Purposely Said – Dr. Linda F. Beed
Electronically Yours
This month's theme focuses attention upon online resources.
The words online and resources immediately caused my head to rotate at a rapid pace. How on earth could I give you so much information within the confines of this article? Once the swiveling subsided I was able to harness the plethora of ideas demanding to have their say.
The Internet is a wonderful thing. Its invention and constant evolution has made it possible for even the agoraphobic to enjoy a social life. With the depressing of a button the world is brought to you. The same is applicable when seeking information necessary for establishing and keeping abreast with the business of writing.
You may be wondering how to start your search. What is the link to finding this or that? Well, I'll be very honest, just ask the computer. Sounds crazy, but no one told me that you could ask the computer questions. Because they didn't, I did and it led me to information I needed and would need later. One such query led me to OWL/Online Writing Lab (http://owl.english.purdue.edu/internet/index.html). On this site I learned the variety of possibilities for exploration as well as Internet basics.
Google, Yahoo and similar search engines store seemingly limitless information. Type in your query and up pops a host of avenues to follow. As you become savvier you will learn how to use key words to pinpoint your search efforts.
Looking for information on writing? You can query the Internet with specific questions such as: 1) Articles on setting up your writing business; 2) Books on the craft of writing; 3) The complete directory for self-publishers; 4) Your marketing plan, and so on.
The phenomenon of the Internet's ability to connect us to research needs and social communities that lend support to common goals is commendable.
Need to connect with other writers? Search Yahoo and Google Groups for your specific need. Also, consider social networks such as MySpace, Nings, Shelfari, Shoutlife, Writing Blogs, Blog Talk Radio, Twitter and Facebook.
*Please note that serious consideration should be given before joining any online group.
There is much more information to be found and applied to your writing and business process. Rather than overwhelm you I will stop with what we have here. As I leave you I would like to remind you of something very important. Instant information is a wonderful thing, if it is the right information. The convenience of online information is no guarantee that what you receive is true, relevant or up-to-date information. Be sure to check references and ask questions before applying information to your process.
Before leaving you I would be remiss if I did not leave a few links for you to explore. Since my passion is for the aspiring/novice author I have chosen links for the most frequently asked questions. The list is brief, but will give you a starting point. Further questions may be referred to Dr. Linda Beed @ http://email@example.com
Please use 'Industry Question' in the subject line.
Copyright/ISBN: http://www.loc.gov/loc/infopub/
State Licensing for Business:
Seek information on state licensing in your state
Federal Licensing:
Have a question about a specific company. Try these literary watchdog sites:
Predators & Editors: http://anotherealm.com/prededitors/
Writer Beware Blogs: http://accrispin.blogspot.com/
As stated before there are many more resources available. Take your time, ask questions and do your homework.
Until next time, remember—Purposely Said words can destroy or create a life. Linda!
Dr. Linda Beed is an educator, speaker, children's minister and author of Business Unusual. She co-moderators BWChristianLit, maintains its sister online blog and is the Review Editor for KDGospel Media Magazine.
You can find her on the web at:
lindabeed.com / MySpace / On Assignment Reviews / BWChristianLit
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About Me
- LaShaunda
- I believe in promoting authors and their books. Let me introduce you and your books to online readers.
I'm also a happily married mother of three who's trying to break into the Christian writing field. The writing road can be rocky.
I'm available for:
Online promotion coaching
Contact me at:email@example.com


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Transboundary cooperation among adjacent countries epitomizes the ambition of the Rio +20 conference. As discussed during the side event organized by IUCN and the Italian Government (DGCS) at the UN Conference on sustainable development (Rio+20), it offers some early results and insights into the relevance of natural resource management for the green economy.
International policy and strategic goals can indeed be institutionalized and translated into effective practice applied at regional to local levels. A panel debate involving national and regional leadership addressed the critical questions determined by the Rio +20 Conference of establishing cooperation between countries and sectors within countries to pursue sustainable development goals.
The event addressed voices of government, protected area management agencies, local government, and NGOs. Deliberate investments in transboundary situations in Africa, South Eastern Europe and Mesoamerica highlighted the opportunities, conditions for success and likely outcomes of cross-border natural resource governance.
"Transboundary conservation areas are natural solutions that may provide opportunities for a better institutional framework and green economy", says Kathy McKinnon, Vice Chair World Commission on Protected Areas (WCPA). In particular, the lessons spoke to the potential, risks and options associated with using conservation action as a foundation for employment, food security, watershed management and disaster risk reduction while maintaining ecosystem integrity and biodiversity conservation outcomes: "transboundary connectivity conservation initiatives in Nicaragua and Costa Rica have addressed many challenges and issues brought by the context and prospect of a green economy, through the promotion of ecotourism and payments for environmental services", says Olivier Chassot, Tropical Science Center, IUCN WCPA Transboundary Conservation Specialist Group.
Transboundary cooperation is an essential cross-cutting theme that resonates with different realities across time and regions."It's symptomatic of how similar the issues we deal with are when it comes to transboundary nature conservation initiatives in the three different continents," states Tomasz Pezold, IUCN Programme Office for South Eastern Europe.
The event also stressed the utility of north-south investment and exchange, and south-south technology transfer and capacity development. "Nature as a neutral platform makes for a powerful message that conveys the idea of transboundary conservation and collaboration in general," concluded Cyrie Sendashonga, Global Director, IUCN Policy and Programme Group.
By Jérôme Duberry, Global Communications.
For more information or to set up interviews, please contact:
Brian Thomson, IUCN Media Relations, m +41 79 721 8326, e firstname.lastname@example.com;
Jérôme Duberry, IUCN Media Relations, t +41 22 999 0127, e firstname.lastname@example.com;


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To start with your question: My personal view, not supported by any serious research on my part, is that speakers of all languages can say anything and everything they might conceivably wish to say in their own language. If new concepts are introduced from outside, there may be a borrowing* of lexis, but the speaker's language will handle the grammar.
English grammar has been, and will continue to be, influenced by the grammar of other languages. AmE, for example, has been influenced by Yiddish, and that influence is having its effect on other dialects. But this is part of the 'same GRAMMATICAL ability to deal with nuances as other languages'.
The grammar of English has changed, and continues to change. To take one example, the progressive (continuous) aspect has been a comparatively recent addition to our range of tenses/aspects. A need was (not consciously!) felt, and the form appeared to satisfy that need.
The 2011 grammar of English will not be able to cope with the needs of the speakers of 2111. But, by the time we get to 2111, the 2111 grammar of English will be able to cope with it.
As you, rightly, point out, case endings in English have almost disappeared, as has the importance of grammatical (not natural) gender. Philo, if he joins this thread, will disagree, but I think that the subjunctive is 'decaying' in BrE.
I think that's enough for a first response.
* 'borrowing'. What a silly word. We are going to use it for a time and then hand it back?
(And notice the American/Yiddish influence on that last [asterisked] sentence.)
English Teacher


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Democrats first want to complete work on legislation reauthorizing farm programs when the Senate returns next week from a one-week break.
Kathleen Hunter
The Senate plans to start work during the week of June 10 on legislation to revise U.S. immigration law and create a path to citizenship for undocumented immigrants, a spokesman for Majority Leader Harry Reid said.
Spokesman Adam Jentleson said that Democrats first want to complete work on legislation reauthorizing farm programs when the Senate returns next week from a one-week break. He said the chamber will then turn to the immigration measure, which the Judiciary Committee approved 13-5 on May 21.
The Senate measure, S.744, seeks to balance opening the door to U.S. citizenship for 11 million undocumented immigrants, sought by Democrats, with enough border-security improvements to satisfy Republicans. The measure includes an agreement reached last week between Democrats and Republican Senator Orrin Hatch of Utah on visas for high-skilled foreign workers.
"We would like to finish the farm bill next week so we can move on to immigration the week of the 10th," Jentleson said in an e-mail. He said Reid, a Nevada Democrat, would "strongly prefer not to wait any longer" to begin working on the immigration bill.
Senate Democrats want to pass the immigration legislation before July 4.
Hispanic Voters
The last congressional bid to pass comprehensive immigration legislation stalled in 2007. Republicans are trying to reconnect with Hispanics after President Barack Obama won 71 percent of the constituency's votes in his re-election in November.
Jentleson said there was "a strong possibility" that during work on the farm bill next week, the first amendment senators may consider would be a proposal to prevent a doubling of student loan interest rates on July 1.
Unless Congress acts, student loan interest rates will rise to 6.8 percent. Senate Democrats want to extend the current 3.4 percent rate for two years.
The Republican-controlled House on May 23 passed a bill that would peg new student-loan interest rates to yields on the 10-year Treasury note, meaning that the rates would fluctuate. It would also set maximum caps on those variable rates.