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Event Info > Day of Event
26th Parkinson's Unity Walk (PUW) Postponed
Due to COVID-19, this year's event has been postponed. We are working to reschedule for a date to be determined. In the meantime, your participant center and our online tools remain active. Follow updates here.
The 26th Walk has been postponed.
100% of donations go to Parkinson's disease research funded by four major U.S. Parkinson's foundations.
In addition to raising awareness and funds for research, we are also a day of community and education! Visit informational booths which will include Ask the Healthcare Experts, and meet with representatives from sponsors and foundations sharing information and resources with members of the Parkinson's community.
72nd Street Bandshell, Central Park, New York, NY
(Use 72nd Street Park entrances on Fifth Avenue or Central Park West)
Google Map for Directions
REGISTRATION OPEN: 8:30 am to 11:30 am
BOOTHS OPEN: 8:30 am to 1:00 pm
WALK ROLLING START: 8:30am through 11:30am. The Parks Department has asked that we are off the Walk route by 12 noon.
Register and roll! Start walking when you're ready rather than waiting for the Walk to start. After you check in at the Registration tent, enjoy the Walk route and informational booths at time that's right for you, and at your own pace. Our emcees will still be shouting out to our teams at the Start and Finish of the Walk throughout the event.
BANDSHELL PROGRAM TIMELINE - available in April 2020
- Map of Walk Route
- Event Map - available in April 2020
- Map of Central Park
- Register, be counted and let us know you're here!
- Check in at the Registration tent once you've arrived at the Walk. Confirm that you've already registered. If you haven't, give us your name and contact information so we can share information with you about the Walk.
- Pick up your PUW giveaways including your PUW button. Insert the number of years you've been participating in the Walk on the button. Whether this is your 1st year or your 26th, wear the button proudly and share how long you've been a PUW walker.
- Turn in your donations.
While there is no registration fee, we encourage all registered walkers to raise funds on behalf of the Walk – 100% of donations go to research.
Any of our Registrars can help you on the day of the Walk. Go to any seated Registrar; there are no special lines; make only one stop to check-in, pick up your button, bag, and hat, and turn in donations. All walkers are registered as individuals, even if they are part of a team -- there is only one envelope per walker so you will be sure to get credit as the fundraiser. We recommend that you allow extra time to go through Registration.
Team Registration Deadline: All teams must be registered prior to the day of the Walk.
(Team registrations will not be accepted on the day of the Walk.)
Deadline to Give and Turn in Donations: June 6, 2020. All donations received by June 6, 2020 will be credited to the 2020 Walk.
(The Parkinson's Unity Walk issues tax receipts for donations of $250.00 or more that were made offline via check or credit card. For lesser amounts, a canceled check or credit card bill is sufficient under current tax law. If you would still like a receipt, please click here to request one.)
Be empowered and take advantage of the educational information available at the Walk. Learn about resources for people living with Parkinson's and their families. In addition to the organizations listed below, visit the Ask the Healthcare Experts booth on Margot Zobel Way.
Click below to view 2020:
- PUW Sponsors
- Parkinson's Disease Organizations Benefitting from Unity Walk Donations
- Movement Disorders and Rehabilitation Centers
Complimentary snacks and bottled water will be served at the Refreshments Booth on Margot Zobel Way.
Stop by the Team Photo Booth on Margot Zobel Way between 8:30 am -12:30 pm and receive a printed copy of your photo to take home with you. You will also receive a digital copy via email and can download the photo from the vendor's website and forward it to your team members and supporters.
Entire Walk route is wheelchair accessible. We do not provide wheelchairs. Click here for rentals.
Golf carts are available for those in need of assistance.
Golf carts are available at 72nd Street entrances, on the Walk route, and at the beginning of Margot Zobel Way.
- Light snacks and drinks will be provided. Pack a heavier lunch and extra drinks based on your needs.
- Each participant will receive a tote bag to hold information from our sponsors. If you think you'll need it, bring a light bag/backpack to help you hold extra items while you walk. Parkinson's Unity Walk Staff and volunteers can not hold personal belongings while participants walk.
- Make a sign in memory or honor of a friend or loved one at the Make-a-Sign Area.
- Central Park is a smoke-free environment. Please observe general Park Rules and Regulations.
- Strollers and dogs are allowed in Central Park and along the Walk route. Please be considerate of fellow walkers. Dogs must be on leash starting at 9 am, per Park rules. Dog owners must observe and refer to Central Park's website for additional rules and information about dogs in the Park.
Stop by this booth and have your questions answered by a:
- Movement disorder specialist
- Neurosurgeon
- Movement disorder nurse practitioner
- Physical therapist
- Occupational therapist
- DBS programmer
- Nutritionist
Click for a printer friendly version


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Bandas Live
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VOA Associates completes mixed-use high rise condominium development in Chicago's South Loop
Lexington Park is a mixed-use high rise condominium and retail development in the South Loop area of Chicago. The building stands 387 feet tall, with 35 storeys, located across from McCormick Place to the southeast and Michigan Avenue to the west. The site connects multiple neighbourhoods, commercial South Michigan Boulevard, South Loop residential, McCormick Place Convention Complex and the Burnham Park system east of Lake Michigan. 320 condominiums, 400 car parking and ground floor retail make up the building, with unit types from loft style to larger bedroom units with lake views.
The residential building blends with the neighbourhood, relating to the McCormick Place complex and adding vitality to existing pedestrian-heavy neighbourhoods. The building transitions between city and neighbourhood scale through a small loft building next to a tall tower with lake views. The parking structure along south Michigan Avenue is concealed, enhancing the pedestrian experience. The complex 'floats' above the retail, and creates a cohesive visual identification with the neighbourhood.
Between the loft and tower, a roof terrace creates open space for the residents and brings a park into the middle of the complex. Common rooms for socialising and fitness open onto the terrace. Lexington Park greets the visitor entering the city from the Stevenson Expressway to the south. It identifies a boundary from a distance and connects neighbourhoods creating a better urban experience for the city of Chicago.


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About two years ago, the City of Estherville stepped forward to improve the condition of existing housing in the south-central portion of the community by applying for a housing rehabilitation grant.
The grant program gives up to 10 homeowners the opportunity to fix up their homes with forgivable loans of up to $24,999. The only requirements are that the homeowners either own or be in the process of buying a home through a qualified financial institution (i.e. unfulfilled contracts for deed do not apply) and that the homeowner live on the property for a minimum of five years.
When put into perspective of $250,000 homes, the $24,999 forgivable loans don't sound like a whole lot of money. However, when you consider that the amount is probably enough to replace the siding, doors, windows and roof of a home, you can see the value of the program.
To date, five Estherville homeowners have had their homes rehabilitated through the program.
And they should be heartily congratulated. Five additional homes are on schedule for rehabilitation through the program.
As one of the investing stakeholders in the project, I was glad to see it happen. Quite frankly, I would have qualified for the program since I live in the target area and my income was within $400 of qualifying. Had I applied for the program and had my application accepted, I would have been proud to have had before and after photos taken of my home and published in the newspaper. However, I felt in my particular case it would have been a conflict of interest to apply for a forgivable loan since I made the initial contact with Carol Keizer of Northwest Iowa Planning & Development Commission who contacted the City of Estherville and wrote the project grant.
I have had at least one other stakeholder who has inquired about the program. Understandably, he would like to know what happened to his investment. I assured him that the funding is in place and it is being invested to make a significant impact on the condition of housing in Estherville, which is particularly necessary during the current economic downturn.
Since privacy issues are a concern, the City of Estherville has not published the names of those who received forgivable loans under the housing rehabilitation program. City of Estherville Community Development Director Barb Mack told me she has contacted those people and told them I would like to do a story about their homes. However, no one who has benefited from the program has yet stepped forward.
I am asking that anyone who would like to have his or her home showcased in the Daily News to call me at 362-2622. I would like to publish any before and after photos and show what an impact the housing rehabilitation program has made in Estherville.
There are a number of reasons I would like to do this.
First, it would show other Estherville homeowners, and other Emmet County communities who might be interested in a similar project, the value of the program. There were 40 applicants for 10 projects on the first go-around in Estherville. I would hope there would be at least that many applicants if the City of Estherville should decide to apply for a second housing rehabilitation grant.
Also, it would validate to stakeholders the fact that their investment went to a good cause. Obviously, anyone likes to see a return on investment. In the case of the housing rehabilitation program, there is an emotional return on one's investment by seeing housing improvements for the citizens of Estherville.
In addition to the emotional return on investment, there is also the long-term return on investment with an improvement in the housing stock in the community. Banks, real estate agents and other people who invested matching funds in the project will eventually see their investments returned when they sell those same homes or give loans for people to buy them.
I was appointed to the board of directors of the Northwest Iowa Regional Housing Trust Fund, Inc., last week. The purpose of the trust fund is very similar to that of the housing rehabilitation program.
Also administered through the Northwest Iowa Planning & Development Commission, the purpose of the trust is to use local investment to leverage state funds to improve the housing stock in the area.
Depending in income level, people may qualify for low- or no-interest loans or even outright grants to renovate their homes.
If people who have received forgivable loans through the housing rehabilitation program in Estherville are willing to step forward and let others know how well the program works, that would go far to pave the way for the future success of the Northwest Iowa Regional Housing Trust Fund.
So if you have benefited from the housing rehabilitation program in Estherville, please call me at 362-2622. Let us show the readers of the Daily News and the citizens of Estherville how valuable the housing rehabilitation program really is and give others the same opportunity you have received.
So let's all work together to make the Northwest Iowa Regional Housing Trust Fund a success.


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12 Sep
Another reader's bike
12 Sep
Another reader's bike
11 Jan
New Reader's Bike
Another beautiful bike! Thanks for sharing Cameron, and make sure to check out his blog post about it!
3 Jan
Guest Post from Zack Jiang – Frame wrapping guide
Hey guys this is Zack Jiang with Bamboo Bike Supplies (bamboobikesupplies.wordpress.com), we provide essential supplies for those wanting to build their own bamboo bikes. I'm also one of the founders at Stalk Bicycles (stalkbicycles.com). I got in touch with Mike a few months ago and wanted to do a guest post. I've been steering myself out of the fabrication scene and been wanting to open up and share more on the craft of building with folks. I decided on a quick guide for composite wrapping. This was my biggest hurdle when I first started a few years ago but in my opinion also one the most essential factors in building a quality frame. Check it out: Here.
26 Nov
New Reader's Bike
23 Sep
New bike-centric bamboo supplier!
Happy to report we have more options these days for getting what you need to get it done. I have been talking lately with Zack Jiang of Stalk Bamboo Bikes, an Oakland based bamboo builder. In addition to the amazing work he is doing at Stalk, he has an ebay store to help you get the bike building essentials at a reasonable price. Check out his store here. This is the real deal Zack hand-picks the best tubes and has even visited the hemp farm (yes, you can do in the bay area). To contact them directly please email: firstname.lastname@example.com.
20 Apr
Reader/Engineer Takes on the Bamboo~
You should all take a look at this engineering manual that documents Blair Frandeen's bamboo bike building experience. He's got specs, diagrams, new techniques, cost analysis and all kinds of useful stuff. Thanks to Blair for sharing!


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Mother warns parents about dangers of new school craze
A MOTHER is warning parents about a new school craze, which has left her son with a serious injury, after she fears it will spread around Wales.
The 'salt and ice challenge' is where students dare each other to combine salt and ice on their skin, which causes a chemical reaction.
The Swansea mother said that the challenge has left her son with severe burns, to the point where medical staff were debating whether it warranted a skin graft. Ultimately it was decided not to be necessary as the boy had maintained full motor skills in the hand.
According to the mother, the reaction is very similar to frost bite, with the temperature falling far below that of ice rapidly.
It was such a deep burn that the nerve endings had been burnt and there was no feeling on the burn itself – just the skin surrounding the area.
She hopes that by spreading the word of this 'challenge' other parents will be able to warn their children about the dangers before anyone else is seriously injured.
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Man arrested for illegal fishing in Teifi valley
A MAN has been arrested after environmental crime officers from Natural Resources Wales (NRW) spotted an illegal net in a mid-Wales river.
The officers were conducting a routine patrol of the River Teifi on Thursday (May 14) when they came across a net in the water.
Following an investigation carried out in partnership with Dyfed Powys Police, a man was arrested on suspicion of illegal fisheries offences in the Teifi valley.
At the scene, officers retrieved the net which contained seven dead sea trout.
David Lee, NRW's North and Mid Wales Operations Team Leader, said:
"Thanks to the excellent work of our officers and Dyfed Powys Police we were able to prevent further damage to the Teifi sea trout population.
"We take any activity that threatens sea trout and salmon extremely seriously and this is especially true of illegal fishing.
"Nets can potentially capture large numbers of fish and given the current challenges facing stock numbers currently every sea trout or salmon taken represents another blow to our efforts to protect these iconic fish."
Despite the current Coronavirus lockdown, NRW officers are continuing to patrol Welsh rivers and people are encouraged to check that fish they buy locally – particularly through social media – are from a legitimate source.
If you see any suspicious or illegal activity on our rivers please report it to the NRW incident hotline on 0300 065 3000.
Mother-daughter foot patrol brings 30 year career to a poignant end for Chief Inspector
AS Chief Inspector Nicky Carter ended a 30 year career in policing, there was no better way to do it than going out on patrol with her daughter.
And for PCSO Charlotte, taking to the streets of Lampeter with her mum was a fitting way to mark her first six months at Dyfed-Powys Police.
Patrolling together in uniform was something the mother-daughter pair had long imagined, with PCSO Carter wanting to join the police from a young age.
The 19-year-old said: "I joined in September 2019, and have wanted to be a part of Dyfed-Powys Police since I can remember. I was inspired by my mum working in the force, and thought it would be a great career.
"I'm really glad I joined before she retired, as it gave us the opportunity to go out on foot patrol in the town where mum had been the local Inspector. It was really lovely."
Embarking on a career she'd planned since childhood, PCSO Carter took the chance to gain valuable advice from her mum – whose experiences on the frontline inspired her to join.
"Mum has told me to always treat people as I would wish to be treated," she said. "That's something I'll take forward with me."
"I'm six months in now, and I enjoy dealing with the public and offering reassurance to people in the communities of Lampeter town and surrounding areas."
For former CI Carter, the foot patrol drew a 30-year career – starting at North Wales Police – to a poignant close.
She ended her time at Dyfed-Powys Police in her home division of Ceredigion, transferring to Aberystwyth in 2006 to take up an inspector post.
Despite admitting there will be concerns for her only child as policing inevitably comes with risks, it was a career she encouraged.
She said: "I was very proud of Charlotte wishing to join Dyfed-Powys. As I retire I still consider that policing offers tremendous job satisfaction and I know that the organisation looks after and cares for its staff.
"I encouraged her to find out about the PCSO role before she applied, and also encouraged her to attend an open evening in Ceredigion to speak to staff. I wanted her to make an informed decision to join the organisation.
"As a parent and a former officer, it is natural to be concerned about what may occur when Charlotte is at work. However, the training, mentoring and support from staff and supervisors is second to none, so that offers me reassurance."
Looking back at 30 years in policing, CI Carter has achieved plenty to inspire her daughter – and other women thinking of joining. From being a founding member of female networks in two forces, and a committee member of the British Association of Women in Policing, she has also proudly contributed to local and national work to ensure all staff reach their full potential.
She was humbled to receive a leadership award from Chwarae Teg in 2017, and represented chief officers at the International Association of Women Police awards in Alaska in 2019, where two Ceredigion officers were rewarded for their bravery.
When it comes to passing on her wealth of experience to her daughter, the former CI urged her to always consider her own wellbeing as well as that of the community.
"The most important advice I have given Charlotte is to look after herself and her wellbeing as whilst policing is a very rewarding role, it is one that can be both challenging and stressful at times," she said.
Ben Lake MP "disappointed" after Agriculture Bill amendment on the standard of food and agricultural imports is rejected by House of Commons
The UK's new Agriculture Bill was put before MPs on Wednesday (13 May) for the final time as it reached the Report Stage and Third Reading.
Alongside farming unions and campaign groups, Ben Lake MP has lobbied for the Bill to include a number of important amendments. One of the amendments sought to introduce a legal requirement that agricultural or food products imported into the UK under future trade agreements would need to be produced or processed according to equivalent animal health, welfare and environmental standards as those required of UK prodcuers.
This amendment, in the form of New Clause 2, and which was tabled by the Chair of the Environment, Food and Rural Affairs Committee Neil Parish MP, was rejected by the Commons. All Plaid Cymru MPs supported the amendment and Ben Lake MP said he was "disappointed" that the house did not vote in favour of an amendment to prevent the importation of products produced to lower animal health and environmental standards, and which in turn would have supported the high standards of Welsh produce.
Ben Lake MP said:
"Without this amendment there remains no legal requirement for future UK trade agreements to ensure that any agricultural or food imports are produced to the same standards as those required of domestic producers.
"Farmers in Wales strive to produce quality food in a sustainable manner, but the failure to include this amendment to the Agriculture Bill risks undermining these efforts by keeping the door open to imports produced to lower environmental and animal welfare standards.
"I have always argued that in order to protect our own high standards it is crucial that a level playing-field is maintained in relation to imports, and that farmers in Wales are not put at a disadvantage by having to compete with imports that are produced to lower standards. I sincerely hope that this amendment will be adopted by the House of Lords, so that the House of Commons has another opportunity to support it."
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Monogram Engraved Ring Box, Custom Ring Box, Personalized Ring Box "ZCS"
$ 30.00
Rustic and virtually one of a kind due to wood's natural variations, our custom engraved wooden ring box is a charming way to hold wedding bands or any small keepsakes.
Please allow for slight variations in the wood and shape of each box. These are handmade and no 2 boxes will be alike.
Material: Teak Wood
Size: Each box is approximately 2.5"
Please put all of your custom information in the personalization section and we will send you a proof to your email within 24 hours if you choose to get one. Once you approve your proof your item will be made and shipped out the next day.


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Features and benefits
SAF and SAW housings share some of the following features and benefits:
Simple mounting and dismounting
To simplify mounting and make alignment more accurate, the feet of SAF and SAW housings have a flat, square design.
To make it easier to separate the cap and base, pry slots are cast into the housing. Smaller sizes have sphered dowel pins to further ease cap removal.
Mounting instructions are supplied with each housing.
Caps and bases individually marked
The housing base and cap are matched during manufacture and are not interchangeable with the caps and bases of other housings. To help avoid mismatch, each cap and base are numbered (fig. 1).
Grease or oil lubrication
These housings are designed to accommodate both grease and oil lubrication. The sump in the housing base acts as a reservoir to provide an adequate quantity of grease or oil.


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Sweetwater Media necesitaba un nuevo diseño de logotipo y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 646 diseños de 87 diseñadores freelance.
Hello – We are a start-up media company and this is the first of many exciting websites in development.
About Already Worn:
AlreadyWorn.com is a website for the savvy shopper. Shoppers who love a bargain and the thrill of the discount "hunt." We don't need brand new, to pull off price tags, to throw away money on retail-store prices. We look for deals with our every purchase, but refuse to sacrifice quality. To us 'secondhand' does not mean sub-par. We see character, individuality, and the uncommon. You will not find us in the Mall every weekend, buying what we're told to buy.
But, quality secondhand goods will not come looking for you. They must be pursued, searched out. AlreadyWorn.com will help you in that search. And not just for clothing. Any previously owned item is fair game. AlreadyWorn.com is Pandora's Box for the shrewd shopper. So, bargains beware, we are searching and we will find you!
Hipsters, the Thrift/Vintage Trend, Farmers, Single Parents, Blue Collar, College Students, Senior Citizens, Antiquers, Low-Income Families, and Fashion Designers. We realize this is a diverse audience, but that is the challenge at hand and precisely why we have come to you, the expert, for help.
We are trying to convey the theme of "reusability" and our logo should represent our belief in the value of reused goods. It should look and feel like "AlreadyWorn"/Secondhand, but still be refreshing. It is essential that this logo represents secondhand goods as a whole, not just clothing.
The "A" in 'Already' and the "W" in 'Worn,' fit together quite well as the focal point of the design, but we are open to any suggestions and new ideas. We would like to incorporate 2 designs throughout our site – 1) AlreadyWorn 2) Lettermark design with the "A" & "W" to utilize for icons and things like an iphone app. Again, creativity is welcomed, as these are just our initial thoughts.
What we want:
- Clean, Simple, and Memorable design that can easily scale down to mobile website
- Must be Vector based eps
- Must be layered file both AI & PSD
Colors: Feel free to experiment, but please don't use more than 3. The logo should still be effective without color.
Please, No: Cartoons, animals, stock photos, clip art, cheesy fonts.
Thank you in advance! We look forward to watching the contest and potentially finding someone we can work with on future projects!
Patrick & AlreadyWorn Team
Descubre cómo funciona un concurso de diseño u obtén más información sobre nuestros servicios de diseño de logo.


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NASHVILLE, Tenn. – Four days after dropping a game against Tennessee in Knoxville, the Tennessee State men's basketball will try to knock off another SEC opponent in Auburn on Tuesday night.
Against the Volunteers, Patrick Miller led TSU (0-6) in scoring for the sixth straight time with 20 points on 5-of-10 shooting. The Chicago native also recorded season-highs with 6 assists and five rebounds.
Miller has been the team's go-to player all season long and the senior leads TSU in points per game (22.2), steals (nine), assists (20), three-pointers (10), field goals (46) and free throws (31).
The point guard is also first in the OVC in minutes played per contest for the second consecutive season, averaging 37.7.
M.J. Rhett and Jay Harris each scored in double figures against Tennessee as Rhett finished with 14 and Harris poured in 12.
Harris has really come on as of late and has matched his career-high of 12 points in back-to-back contests. The junior is a spark-plug coming off of the bench defensively, but has emerged as a leader at the offensive end.
Harris is sixth in the conference in free throw shooting, having made 15-of-18 for an 83 percent conversion rate. His contributions at the line have allowed the Tigers to shoot 73 percent as a team, ranking them fourth in the league.
TSU will need all the freebies it can get against Auburn who are fresh off two wins over OVC teams, Jacksonville State (78-54) on Tuesday and Murray State (75-67) on Saturday.
Auburn (3-1) is led by Chris Denson and KT Harrell who are averaging 21.8 and 18.3 points per game, respectively.
AU is getting done on the glass, the Tigers are plus-7.5 in rebounding margin, and scoring early, having outscored opponents in the first half 150 to115.
TSU is 0-1 against Auburn and lost 89-56 in the only meeting during the 2006-07 season. TSU is 1-21 all-time against teams for the SEC and the school's only win came over South Carolina in 2011-12.
Tigers meet Tigers at 7 p.m. on Tuesday night in Auburn, Ala.


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A Lebanese judge on Wednesday indicted three people, including a former Cabinet minister and a top Syrian intelligence general, in a bombing plot in Lebanon, a move that could raise tension in Lebanon over the civil war in neighboring Syria.
The National News Agency said military investigative judge, Riad Abu Ghaida, demanded the death penalty for former information minister, Michel Samaha, Syrian Brig. Gen. Ali Mamlouk and a Syrian colonel who was identified only by his first name, Adnan.
Mamlouk, who heads Syria's powerful National Security Council, was accused of being involved with Samaha in plotting a wave of attacks in Lebanon at the behest of Syria. The August arrest of Samaha, a close aide to Syrian President Bashar Assad, was an embarrassing blow to Syria, which has long acted with impunity in Lebanon.
Lebanon, a country plagued by decades of strife, has been on edge since the deadly uprising against Syrian President Bashar Assad began in March 2011. Lebanon and Syria share a complex web of political and sectarian ties and rivalries and there are fears in Lebanon that Syria's civil war could spill across the border.
Lebanese are divided between those who support Assad and others who back the opposition. Clashes between pro- and anti-Syrian groups have left dozens of people dead during the past two years.
According to the indictment that was carried by the news agency, the former Lebanese information minister moved the explosives from Syria to Lebanon in his personal car after they were handed to him by the Syrian colonel.
The indictment said the former minister, Samaha, told the Syrian colonel and general that he would recruit people to carry out attacks in Lebanon's northern region of Akkar targeting Syrian rebels and weapons smugglers to Syria. It said Mamlouk, the general, told Samaha that "hindering weapons smuggling into Syria and carrying out attacks against Syrian gunmen and smugglers is good for the Syrian regime."


text: Heavy Discounts Inside! Shop Now At The Discount Bonanza! Biswajit Das on November 30, 2018 No Comments Get Free Shipping on All Products Sitewide. View in browser DownloadThe App Have a question or want to place an order? Call our helpline no. 011-30473000 LargeEnterprise Buyon Credit FranchiseProgram BulkRequirements Browse By Category Safety Electrical Solar Pumps Material Handling Automotive Power Tools Agriculture & Landscaping Hand Tools Office Supplies Testing & Measuring Instruments Cleaning Connect with us For more info call 011-30473000 (9am-8pm) For Bulk requirement or Sales Query, email at [email protected] 10 lakh+ Products | 7700+ brands | Secure Payment To Unsubscribe Click Here Share This Facebook Twitter Google+ Linkedin Pin It Biswajit Das


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Nov. 6 is the Tuesday after the first Monday of the eleventh month in a year divisible by four. In other words: Presidential Election Day. A day of monumental significance, a day in which the future of our country takes a turn one or the other, and a day of more nerves and jitters than you can shake a stick at!
Here are five things to prepare that will quell the butterflies making the rounds in your stomach.
1. Pancakes for dinner
There are few things more comforting than flipping the day around and ending it with a big mess of flapjacks. See 5 ways to fix pancakes to find recipes for Organic Oatmeal Pancakes, Whole Wheat Blueberry Pancakes, Sweet Potato Pancakes, Ricotta Cinnamon Pancakes with Sauteed Apples and Moby's Vegan Blueberry Pancakes. Refrain from prudence with the butter and syrup. (Photo: Flickr/AcquiredLife)
2. Macaroni and cheese
Sorry to be predictable here, but nothing — nothing — says "comfort" like macaroni and cheese. This soothing-to-the-freaked-out-soul recipe for Baked Macaroni and Cheese is guaranteed to calm your watching-the-returns anxiety. And if you manage to have any leftovers, we implore you to read 9 ways to use up leftover macaroni and cheese. Why? Let's just put it this way: "Grilled mac n' cheese sandwich." (Photo: Shutterstock/Lilyana Vynogradova)
3. Double Baked Potatoes with Blue Cheese and Chives
Part mashed potatoes, part stuffed potato skins, these decadent Double-Baked Potatoes with Blue Cheese and Chives can purportedly solve almost every family dispute, and they promise to make you forget about Nov. 7 for at least the 12 minutes it will take you to devour them. (Photo: Enrique Gili)
4. Grown-up, boozy cupcakes
Because nothing makes people feel better than cupcakes and booze, together! These Chocolate Stout Cupcakes with Baileys Frosting are naughty, naughty, naughty. And good, good, good. Just remember: Do not operate heavy machinery when under the influence of the saucy little cakes. (Photo: Flickr/Chris Blakeley)
5. Spiced apple crumb pie
Because few things scream, "Go, America!" like pastry dough baked with apples. Although apple pie recipes go as far back as the days of Chaucer, in the 19th and 20th centuries, apple pie became synonymous with American prosperity and national pride. So in honor of your candidate, and because apple pie tastes really, really, good …say Happy Election Day with a Spiced Apple Crumb Pie. And if that doesn't work, resort to Plan B: Spiked Apple Pie Punch. (Photo: Flickr/sleepyneko)
Find more recipes to soothe your election season soul with MNN's recipe archive.


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Gay Party Squad 9Favorites [+]
Pay-Per-Minute Viewing
You can now enjoy this movie on your iPhone®, iPad®, or compatible Smart TV & Android devices.
Purchase Options
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Streaming Rentals
Available MP4 sizes:SD 480p (1.55 GB)
HD 720p (2.91 GB)
HD 1080p (4.3 GB)
DRM-free downloads offer content that is not limited by standard Digital Rights Management (DRM) access technologies. These technologies allow hardware manufacturers, publishers, copyright holders and individuals to limit the usage of digital content.
When you purchase DRM-free downloadable content, that content is available for you to download on any computer and save to a disk whenever you like. You can also download to multiple computers. There is no timeframe associated with your purchase and the content will not expire.
Running Time: 99 minutes
Studio Name: Club Bangboys
Series: Gay Party Squad
Director: Peter Stallion
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Smartphone Insights 2014: United Arab EmiratesMiddle East / Africa, Mobile | 28-Nov-2014
AUD $10,450.00 (including GST)
Nielsen Smartphone Insights is a syndicated survey providing detailed understanding of smartphone and feature phone users and revealing the challenges and opportunities that exist as the mobile landscape continues to evolve. The fieldwork for UAE was conducted in Q1'2014. It was conducted through face-2-face interviews. A total of 1505 contacts were made to know the incidence of smartphone.
- Penetration & Demographics
- Device Path To Purchase
- Brands
- Smartphone Habits
- Advertising
- Shopping
For more information, please contact Prajakta Bhatkar at: firstname.lastname@example.com./all/united-arab-emirates-smartphone-insights-2014
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Embattled police academy official is fired
The embattled assistant director of the Iowa Law Enforcement Academy has been fired, weeks before he was set to retire following a 48-year career in law enforcement.
Academy Director Arlen Ciechanowski told The Associated Press that he has dismissed assistant director Michael Quinn. He said he couldn't elaborate because it's a confidential personnel issue.
The firing is puzzling because Quinn announced in April that he would retire June 30 following months of criticism for making inappropriate sexual and threatening remarks to female cadets and colleagues.
Ciechanowski had let Quinn stay in his job but gave him a final warning after a 2012 investigation found that he violated anti-discrimination and violence-free workplaces policies.
Democrats and advocates for victims had repeatedly criticized Gov. Terry Branstad's administration for keeping Quinn, who declined comment.


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Callaway X Forged UT Ironview other products
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This driving iron's characteristics should give you a more penetrating ball flight than a hybrid and with less curve, which is why we think it's a great fairway finder for good iron strikers.
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- Traditional long iron looks with modern power and forgiveness
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- Available in 18°, 21° and 24° lofts
Versatility and control from the tee is only possible with this club if you're using a shaft suited to your swing, which we can ensure come the end of a custom fit session.


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This is an archive page. The links in this content are no longer being updated.
Rachel Iadicicco (301) 734-3255
Karen Eggert (202) 690-4178
WASHINGTON, Oct. 6, 2008--The U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) proposes to revise existing regulations regarding the importation, interstate movement and environmental release of certain genetically engineered (GE) organisms under the Plant Protection Act (PPA) of 2000. These proposed revisions to the regulations are in response to emerging trends in biotechnology. New regulations will address the current and future needs of the agency and provide a high level of environmental protection.
"This is the most comprehensive review and revision of our biotechnology regulations since they were first developed in 1987," said Cindy Smith, administrator of APHIS. "Revising these regulations now will allow us to ensure effective oversight for years to come."
The proposed changes will also improve regulatory processes so they are more transparent to stakeholders and the public, make more efficient use of agency resources and eliminate unnecessary regulatory burdens. The proposed rule also addresses several provisions from the 2008 Farm Bill regarding the improvement of the management and oversight of GE organisms regulated under the PPA of 2000. This proposal does not cover vertebrate animals.
Proposed changes include aligning the regulations with the plant pest and noxious weed provisions of the PPA of 2000. Under the proposed rule, certain GE organisms would be subject to the regulations if they could pose a plant pest or noxious weed risk, or their plant pest or noxious weed risk is unknown.
APHIS proposes to discontinue the notification procedure but retain the permitting procedure for authorizing the importation, interstate movement or environment release of those GE organisms that fall within the scope of the regulations. The proposed permitting system could be adapted to address a wide variety of different species and genetic modifications.
The proposed regulations would improve and clarify the petition procedure to approve nonregulated status, whereby a GE organism is no longer subject to APHIS' biotechnology regulations. All previous determinations of nonregulated status made under the current regulations would continue to have nonregulated status under the revisions being proposed.
The proposed regulations would also establish a new petition procedure for APHIS to approve new conditional exemptions from the requirement to obtain a permit, which is currently done by amending the regulations. The proposed procedure would be more efficient, yet still allow for public comment.
APHIS is seeking public comment on the proposed rule. APHIS will consider all public comments submitted during the comment period before any regulatory changes are put in place. Because the public is a key partner in the rulemaking process, APHIS is scheduling three public meetings that will take place in California on Oct. 28, in Missouri on Oct. 30 and the Washington, D.C., area on Nov. 13, to allow interested parties to express their views in person. Meeting dates and locations will be published in the same Federal Register notice announcing the proposed rule.
APHIS' broad biotechnology regulatory authority falls under the scope of the PPA of 2000, which combined and modernized the authorities under which APHIS regulates certain GE organisms, including the Federal Plant Pest Act, the Plant Quarantine Act and the Noxious Weed Act.
The proposed rule is available on the APHIS Web site at http://www.aphis.usda.gov. Notice of this proposed rule is scheduled for publication in the Oct. 9 Federal Register. Consideration will be given to comments received on or before Nov. 24. Send two copies of postal or commercial delivery comments to Docket No. APHIS-2008-0023, Regulatory Analysis and Development, PPD, APHIS, Station 3A-03.8, 4700 River Road, Unit 118, Riverdale, MD 20737-1238. Comments can be submitted on the Federal eRulemaking portal at http://www.regulations.gov/fdmspublic/component/ main?main=DocketDetail&d=APHIS-2008-0023. Click on "Add Comments," to view public comments and related materials available electronically.
Comments received are posted on the Regulations.gov Web site and also can be viewed at USDA, Room 1141, South Building, 14th St. and Independence Ave., S.W., Washington, D.C., between 8 a.m. and 4:30 p.m., Monday through Friday, excluding holidays. To facilitate entry into the comment reading room, please call (202) 690-2817.


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Corner of I-275 & Dale Mabry
Phone: (813) 872-6353https://goo.gl/maps/sdY3WWCEy3M2 -
MPG Disclaimer: *Based on 2019 EPA mileage and driving range ratings. Use for comparison purposes only. Your MPGe/MPG and driving range will vary depending on driving conditions, how you drive and maintain your vehicle, battery age/condition, and other factors.
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- Chronic seasonal COPD-like:
- Introduction
- Causes
- Treatments
- Diagnosis
- Misdiagnosis
- Community
Have a symptom?
See what questions
a doctor would ask.
See what questions
a doctor would ask.
Chronic seasonal COPD-like symptoms: symptoms such as dyspnea, cough with sputum , wheeze etc. See detailed information below for a list of 4 causes of Chronic seasonal COPD-like symptoms, Symptom Checker, including diseases and drug side effect causes.
» Review Causes of Chronic seasonal COPD-like symptoms: Causes | Symptom Checker »
Home medical tests possibly related to Chronic seasonal COPD-like symptoms:
Listed below are some combinations of symptoms associated with Chronic seasonal COPD-like symptoms, as listed in our database. Visit the Symptom Checker, to add and remove symptoms and research your condition.
See full list of 501 Symptom Checkers for Chronic seasonal COPD-like symptoms
Review further information on Chronic seasonal COPD-like symptoms Treatments.
More Chronic seasonal COPD-like symptoms animations & videos
Some of the comorbid or associated medical symptoms for Chronic seasonal COPD-like symptoms may include these symptoms:
See all associated comorbid symptoms for Chronic seasonal COPD-like symptoms
Research the causes of these more general types of symptom:
Research the causes of broader types of this symptom:
Research the causes of related medical symptoms such as:
Research the causes of these symptoms that are similar to, or related to, the symptom Chronic seasonal COPD-like symptoms:
Read more about causes and Chronic seasonal COPD-like symptoms deaths.
Sinusitis is overdiagnosed: There is a tendency to give a diagnosis of sinusitis, when the condition is really a harmless complication of another infection, such as a common cold....read more »
Whooping cough often undiagnosed: Although most children in the Western world have been immunized against whooping cough (also called "pertussis"), this...read more »
Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be...read more »
Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur...read more »
Tremor need not be Parkinson's disease: There is the tendency to believe that any tremor symptom, or shakiness, means Parkinson's disease. The reality is...read more »
Rare diseases misdiagnosed as Parkinson's disease: A rare genetic disorder is often misdiagnosed as Parkinson's disease for men in their 50's. The disease Fragile X...read more »
Chronic lung diseases hard to diagnose: Some of the chronic lung diseases are difficult to diagnose. Even the well-knowns conditions such as asthma or lung cancer often...read more »
Read more about Misdiagnosis and Chronic seasonal COPD-like symptoms
Other ways to find a doctor, or use doctor, physician and specialist online research services:
Research extensive quality ratings and patient safety measures for hospitals, clinics and medical facilities in health specialties related to Chronic seasonal COPD-like symptoms:
Research Hospital & Clinic Quality Ratings »
Rare types of medical conditions and diseases in related medical categories:
Conditions that are commonly undiagnosed in related areas may include:
The list below shows some of the causes of Chronic seasonal COPD-like symptoms mentioned in various sources:
See full list of 4 causes of Chronic seasonal COPD-like symptoms
This information refers to the general prevalence and incidence of these diseases, not to how likely they are to be the actual cause of Chronic seasonal COPD-like symptoms. Of the 4 causes of Chronic seasonal COPD-like symptoms that we have listed, we have the following prevalence/incidence information:
See the analysis of the prevalence of 4 causes of Chronic seasonal COPD-like symptoms
The following list of conditions have 'Chronic seasonal COPD-like symptoms' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.
Select from the following alphabetical view of conditions which include a symptom of Chronic seasonal COPD-like symptoms or choose View All.
Ask or answer a question about symptoms or diseases at one of our free interactive user forums.
Medical story forums: If you have a medical story then we want to hear it.
See a list of all the medical forums
Medical Conditions associated with Chronic seasonal COPD-like symptoms:
COPD-like symptoms (22 causes), Respiratory tract symptoms (5166 causes), Throat symptoms (3410 causes), Mouth symptoms (6864 causes), Breathing symptoms (3381 causes), Breath symptoms (3023 causes), Head symptoms (10192 causes), Face symptoms (8109 causes)
Symptoms related to Chronic seasonal COPD-like symptoms:
Cough (1407 causes), Wheezing (764 causes), Breathlessness (1528 causes), Shortness of breath (1528 causes), Fever (2274 causes), Infection (1293 causes), Bronchitis (273 causes), Emphysema
Doctor-patient articles related to symptoms and diagnosis:
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Copyright © 2014 Health Grades Inc. All rights reserved. Last Update: 13 August, 2015 (0:32)


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In 2009, Sports Illustrated estimated that 78% of NFL players were bankrupt or faced serious financial stress within two years of ending their careers. It also estimated that 60% of professional basketball players were broke within five years of retiring from the NBA. Athletes including Dorothy Hamill, John Daly, Lenny Dykstra, Scottie Pippen and, more recently, Mike Tyson (who is currently suing his financial advisor for fraud) have experienced headline-making money management difficulties.
But it's not for lack of trying. Believe it or not (although we rarely see them this way) professional athletes are employees of corporations.
Now the research firm BrightScope has listed the top organizations in the sports industry with the highest ranked 401(k) plans containing more than $25 million in assets.
"It's easy to see our favorite athletes and sports teams on television and not relate to them as employees of their respective organizations with retirement plans, just like you and me," said Brooks Herman, head of data and research for BrightScope. "However, saving for the future is still very important even for members of public and popular organizations like these."
Key statistics found on the list of the organizations with the best 401(k) plans:
- Average account balance for plans listed is $91,933
- 88.89% is the average participation rate for plans on the list
- Average company generosity for plans listed is $8,343; the median is $1,910
- Average salary deferral for plans listed is $6,784; the median is $5,467
Keep reading for the sports organizations with the highest ranked 401(k) plans (Company Name — Plan Name — BrightScope Rating):
15. New York Racing Association — The 401(k) Plan of the New York Racing Association — 59.72
14. Anschutz Entertainment Group — Anschutz Entertainment Group, Inc. 401(k) Plan — 61.91
(Anschutz has ownership interests in the Los Angeles Kings, the Los Angeles Galaxy, the Los Angeles Lakers, and owns the Staples Center.)
13. Penske Racing South — Performance Group 401(k) Retirement Savings Plan — 63.59
12. Speedway Motorsports — Speedway Motorsports 401(k) Plan and Trust — 64.55
11. Joe Gibbs Racing — Joe Gibbs Racing 401(k) Savings Plan — 69.60 10. National Football League — The National Football League Capital Accumulation Plan — 71.75
9. National Hockey League — National Hockey League Savings Plan for National Hockey League/NHL Enterprises Employees — 76.47
8. National Football League — NFL Pension Plan — 76.48
7. Major League Baseball Office of the Commissioner — Major League Baseball 401(k) Plan and Trust — 80.91
6. National Basketball Association — NBA Retirement Plan — 81.52 5. Savings Board of the NFL Player Second Career Savings Plan — NFL Player Second Career Savings Plan — 83.36
4. Board of Trustees of the National Hockey League Players' Pension Plan — National Hockey League Players' Pension Plan — 87.25
3. Pension Committee of MLB Players Benefit Plan — Major League Baseball Players Investment Plan — 90.00
2. U.S. Member Clubs of the National Hockey League — National Hockey League Pension Plan for Players of United States Member Clubs — 90.46
1. National Basketball Association — NBA-NBPA 401K Savings Plan — 91.91
Check out these related stories on AdvisorOne:


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Enjoying Hot air balloon trips is something the entire family can $do, but it is also a popular way to go on a date! When you speak with the firm you are thinking about booking with, don't forget to ask how many others will be aboard the balloon.
When it is time for your adventure, your company will offer to let you help with the assembly and inflation of the balloon. Go ahead and do it - it adds to the entire experience!
Be sure to bring a camera and plenty of film!
You'll be surprised at how many pictures you take before, during and after your flight. Bring more film or memory than you think you'll use. Once you're in the air and snapping away you sure don't want to be surprised by running out!
You can bring cameras for still or video, and we suggest you carry them in a protective case. Your pilot may ask you to put your cameras away during landing to make sure there are no objects that could fly out of your hand and hurt someone. Once you're on the ground you can start shooting again.
Famous Balloon Quote:


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Tuesday, July 3, 2012
Wading Back Into the Fray
Yes, your somewhat devoted blogging scribe (scribing blogger?) is back from a few weeks of much deserved rest and relaxation. But fear not! By virtue of all the technology and the digital video and the Twitter, I already know what's on your mind, and how gosh-darned fed up with all of it that you are. Which is why I'll spare you any long-winded defense of Francisco Cordero. You all seem to viscerally hate him, and hate John Farrell for not hating him as-much-if-not-more than you, so...go ahead. Have at it. I'm not talking you off that ledge.
Later this week, I'll delve into a midway report card for the team, talk a little All-Star mumbo jumbo, and maybe even finish off the ponderous piece on why we shouldn't be so focused on the acquisition of major league talent. (It's a bit heavy-handed at this point, so I have to dial down the sanctimony a tad.)
In the interim, a few thoughts and observations on the state of the Jays.
What's the Deal with Ricky Romero: Last year, Ricky Romero struggled with his location down the stretch, but there was something to admire in his ability to tough it out and manage to get outs and ground balls when necessary. This was part of that mystical je ne sais quoi that big time, front of the rotation hurlers have, and it was great to think that Romero had evolved into something beyond a thrower. He was a Pitcher. Genuflect in respect.
This was a happy thought at the time, especially since the notion was that Romero's lack of command was somehow just a side effect of a long season, and it would return to its full glory after he had a full offseason to rest and refuel. But from the very first game of the season, Romero has struggled to locate, and seems to have had more trouble locating his fastball than his breaking pitches. Which seems strange, though the best explanation for this seemingly backwards state of affairs might be that he's overthrowing the fastball when he gets behind. What ensues is missing by the "one lousy inch" that Romero mentioned in the offseason promo campaign...except that it's not one inch, and it's not isolated to a handful of occasions. Add it all up, and Romero has missed expectations by a mile this year.
There are volumes of dime store psychology pushed out on Twitter about Romero's state of mind, and while it's probably unwise to wander into that sphere, there's something to be said for containing one's emotions on the mound. Roy Halladay famously referred to his "next pitch" mantra, in which he'd allegedly block out the situation or result of the last pitch, and focus all his energy into selecting and executing the next one. If Halladay happened to leave a spare copy of Harvey Dorfman's "The ABC's of Pitching" hanging around the clubhouse, Romero might do well to leaf through it.
Last Month's Whipping Boy: Remember when people thought that Colby Rasmus was all messed up, and that Tony LaRussa was right, and that the Jays should demote him to send a message, and that Travis Snider should be playing centre field instead, and that Alex Anthopoulos isn't really as smart as all us Kool-Aid drinkers think because he took on this underachiever?
Yeah, me neither.
Oh, Wandy: Not that this fire needs any more gas tossed upon it, but if the Jays are looking to find a solution to their pitching woes - and oh, what woe! - then the most desirable option out there might be Wandy Rodriguez.
Or maybe it just seems that way because your favourite blogger just has a bit of a Wandy fixation. And maybe he occasionally comes up with alternate lyrics to Barry Manilow's "Mandy" to express his adoration for the Astros' diminutive lefty. Not that there's anything wrong with that.
One note of caution on this, though: In 25 interleague starts, Wandy has a 5.09 ERA, and has allowed 22 homers. He probably walks a few too many batters (3.12 per nine for his career) and gives up a few too many homers (1.02 per nine).
But given the state of the Jays' pitching staff and the dearth of available starters, it might not be the worst move to take a shot on a guy who has been mostly effective and quite healthy, averaging 30 starts per year since 2007. Plus, he's still under control for another year with an option for 2014.
Arbitrary Endpoints and Such...: In 26 games as the Jays leadoff batter, Brett Lawrie has posted a .372 OBP and .527 SLG, for an .899 OPS. Also 10 of his 16 doubles have come since the change in the order, as have four of his eight homers.
Maybe the point is that a player who gets jacked up on caffeine and sugar and overly-articulate handshakes and raw maple-flavoured scrappitude should be let out of the gates as soon as possible. Because that buzz might dissipate by the third inning.
Finally: Sorry about not being around more. I'll be right here for you, through the rest of the season. You have my full attention, or at least as much of it as I can spare.
7 comments:
- Colin said...
I like the "we" thing. It makes you sound more important, like you have a team of underlings feeding your thoughts.
Besides, it's your bit. Without it, all you have left is reasonableness and class.
- July 3, 2012 at 3:58 PM
In 26 games as the Jays leadoff batter, Brett Lawrie has posted a .372 OBP and .527 SLG, for an .899 OPS. Also 10 of his 16 doubles have come since the change in the order, as have four of his eight homers.
how does this square with the Keith Law approved wisdom that where a player bats in the lineup makes no difference to his performance?
- July 3, 2012 at 4:11 PM
- Tao of Stieb said...
I dunno. It probably doesn't square with it to well, right?
I sit somewhere in the middle of the two camps: I think that the notion that batting order has no impact over the course of a season is bunk. But I also don't lose my mind over it. Or at least I try not to.
- July 3, 2012 at 4:29 PM
nice to see you back.. we ...enjoy your writing
- July 3, 2012 at 6:21 PM
- July 4, 2012 at 1:51 AM
Nice to see this blog back in action - love reading about my Jays!
- July 4, 2012 at 5:13 PM
- CJohnson said...
I think changing a player to the leadoff will have a more pronounced effect on their numbers, because usually leadoff hitters try to play a certain role where everyone else in the lineup is just another hitter.
If playing leadoff effects Lawrie's approach in such a way that it improves his at-bats somehow, then I'm all for it!
- July 13, 2012 at 4:17 PM


text: CDD> Zoning and Development> Zoning> Zoning Ordinance The Zoning Ordinance As a public service, this page provides links to electronic versions of the Zoning Ordinance Text of the City of Cambridge, Massachusetts. Our goal is to make zoning more accessible by placing this information on the Web. The Ordinance is a complex legal document. View the Zoning Ordinance Maps View or Purchase Print Copies of the Zoning Ordinance and Maps PLEASE NOTE: The online versions of the City of Cambridge, Massachusetts Zoning Ordinance and Maps are provided for reference and the convenience of having the Ordinance in a computer-readable format. The print version of the Zoning Ordinance, together with any amendments adopted by the City Council subsequent to the most recent update to the print version, remains the official version of the Ordinance. If any discrepancies exist between the print and web versions of the Zoning Ordinance, the print version, together with any City Council amendments, shall be considered correct. There is an interim period between the date when the City Council adopts a text or map amendment to the Zoning Ordinance and the revision date of this web site. Zoning text and map amendments, as well as corrections, will be placed on-line as available. Recent amendments to the Zoning Ordinance may appear on the Web prior to being incorporated into the print version of the Ordinance. View Recent Amendments Adopted into the Zoning Ordinance. Article Title 1.000 Preamble 2.000 Definitions 3.000 Zoning Districts 4.000 Use Regulations 5.000 Development Standards 6.000 Off Street Parking and Loading Requirements 7.000 Signs and Illumination 8.000 Nonconformity 9.000 Procedures and Administration 10.000 Appeals, Variances, and Special Permits 11.000 Special Regulations 12.000 Planned Unit Development 13.000 Planned Unit Development Districts 14.000 Mixed Use Development District: Cambridge Center 15.000 Cambridgeport Revitalization Development District 16.000 North Point Residence, Office and Business District 17.000 Special Business, Office and Industrial Districts 18.000 Traffic Mitigation and Construction Management 19.000 Project Review 20.000 Overlay Districts 21.000 Transfer of Development Rights 22.000 Sustainable Design and Development 23.000 Standards for Urban Agriculture View or Purchase Print Copies of the Zoning Ordinance and Maps To purchase a paper copy of the Zoning Ordinance, visit the Office of the City Clerk at City Hall, 795 Massachusetts Avenue in Central Square. The Clerk's office also has copies of the Zoning Map for sale. Call 617/349-4260 for more information. Zoning Maps may also be purchased at the Community Development Department offices, 344 Broadway. Call 617/349-4600 for more information. For More Information For more information contact Liza Paden at 617/349-4647 or firstname.lastname@example.com.


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blueglimmer avait besoin d'un nouveau design de logo et a lancé un concours sur 99designs.
Un gagnant a été sélectionné de 48 designs proposés par 24 designers freelance.
"BabyToddler.org" will be a new baby & toddler group site. It needs a fun, smart web 2.0 style logo.
Please Note, the domain name has been changed from babygroups.co.uk to better target our audience.
Desired Color Scheme:
Nothing strict - maybe some primary colours or pastels.
Desired Style:
I would like a clean web 2.0 style but with a fun personality. The lettering must be clear and readable. No flash.
Accepted File Formats:
vector-based or psd
This logo is needed for a new baby & toddler playgroups site - so it is aimed at families. The feel should be colourful and cute - think babies and toddlers. The style should be web 2.0 but with a fun slant. The logo should be mainly the 'BabyToddler.org' lettering.
Some small cute or striking illustration (own artwork only please) included alongside the lettering would be very nice. Maybe something like a stack of coloured beakers, baby bottle, crawling baby, or pull-along toy.
I will leave regular feedback and hope to be back with a 2nd contest soon to get the template designed. Therefore I hope for some good entries and a logo with colours I can base the site's look on.
Savoir comment fonctionne un concours de design ou en savoir plus sur nos services de design de logo.


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God Bless Our Prophet Dear
31243, Hymns, God Bless Our Prophet Dear, 24
God bless our prophet dear;
May health and comfort cheer
His noble heart.
His words with fire impress
On souls that thou wilt bless
To choose in righteousness
The better part.
So shall thy kingdom spread,
As by thy prophets said,
From sea to sea.
Truth burns in ev'ry soul;
As one united whole,
We hasten to the goal
We long to see.
Oh, may thy Saints be one,
Like Father and the Son,
Nor disagree.
United heart and hand,
So may we ever stand,
A firm and valiant band
Text: Bernard Snow, 1822–1894, alt.
Music: Harry A. Dean, 1892–1987. © 1985 IRI


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MTV Scores AVATAR Trifecta...
Jim here. MTV has got a special AVATAR Q&A coming up with James Cameron, Sam Worthington and Zoe Saldana! It is entitled: "AVATAR Live: An MTV News/Facebook Forum".
Look for it on Thursday, December 3 (yes we are into December now!) at 3PM Eastern. It will be streamed live online (it is not clear if it will be on MTV as well) and will be 30 minutes in duration.
Exclusive AVATAR footage will be shown and you can send in your real time questions via Facebook or MTV.com.
Thanks A@ronW for the heads up!
Oh and Screenrant has the goods on a 30 minute TV special on MTV - it is an AVATAR featurette showing off even more unseen footage! It is set to air (Dec 16) only two days before the movie opens (Dec 18). Again, you can have your questions answered by various cast and crew! Submit them through AVATAR's official Facebook page.


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Our History
Vasilow's Confectionery specializes in fresh, small batches of chocolates, nuts, and confections made with the finest natural ingredients and chocolate available. In fact, it's the same chocolate brothers Louie and Jim used in 1923, when they opened their store and made available to the residents of upstate New York some of the finest candies ever created.
In 1969, after years of hard work, and countless hours spent over a copper kettle, which regularly reached temperatures of 325 degrees, the brothers reluctantly agreed that it was time to retire. When word circulated that Vasilow Bros. Confectionery was closing, many locals begged, pleaded, and threatened the brothers to go on "just a bit longer". Among those who protested most fervently was Louie's twelve-year old grandson.
Years passed, yet the memories of Vasilow's lived on for many. In 1999, someone decided to re-create those memories, fulfilling a life long dream. Remember Louie's grandson? Gambling that connoisseurs would still seek chocolates and confections prepared using the strictest of guidelines (the ones outlined by his ancestors), plans were drawn, papers were signed, equipment was purchased, and ingredients were sourced. The culmination of those efforts were realized in 2002, when Vasilow's Confectionery was reborn, much to the delight of "old-timers" and "first-timers" alike.
Two generations later, times may have changed, but our commitment to produce candy of superlative quality has not. Having had the privilege of observing true masters creating their finest offerings is a secret unto itself, and the endeavor to replicate the treasures crafted by them has been a tremendous undertaking, one which has not been taken lightly.
Our proprietary recipes, many from the original Vasilow Bros. book of formulations, combined with contemporary creations such as our signature truffles, have enabled us to preserve the art of "homemade" candy making, creating a taste-pleasing blend of old and new.
The care we take in producing our decadent sweets is similarly reflected in the way they are presented. Sending a fifteen-piece truffle assortment to that someone special? Perhaps a "Get well soon" bag of chocolate-covered Gummi Bears? Regardless of the occasion, the uniquely elegant manner in which we package all of our products promises to please. Whether you're the proud presenter, or the gratified recipient of our confectionery perfection, rest assured that it will create a truly magical experience.
Since its inception eighty years ago, customers have always associated the Vasilow's name with excellence in quality confections. Although our location today is a few blocks away from the shop where Grandpa and Uncle Jim started it all, the commitment to provide our customers with the freshest, finest, and best tasting candy available remains unchanged.


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Sunday, November 24, 2013
CX bike from the first official batch 1990
Posted by swiggco world at 5:00 PM
3 comments:
- virag said...
very neat. new bikes are so good, great builders, great tubing, good components, but gosh darn, i do love a classic. this cross frame is wicked awesome. tange #2! columbus sp! fillet brazed! as soon as i get my time machine runnin', ima gettin' one for me.
- November 25, 2013 at 11:28 AM
- Zac Stanley said...
Beautiful, Paul.
- November 25, 2013 at 7:58 PM
- Unknown said...
Absolute classic!
- November 28, 2013 at 11:07 PM
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I don't know about you all but I love to celebrate our beautiful country's birthday just like we celebrate our family's birthdays…with cupcakes!! This fun patriotic twist works well with just about any white cupcake mix! They are so fun and easy to make, even the kids will be begging to help make them. For this batch I decided to go with a wedding cake recipe because let's face it, I don't know anyone who can say no to wedding cake! Paired with a simple buttercream frosting these sweet treats are sure to fly at your 4th of July cookout. I even topped them with super cute cake toppers from Kori who was on the Craftaholics Anonymous 2013 Creative Team with me!
Wedding Cake Cupcakes
Yield: 2 dozen | Prep Time: 15 minutes | Cook Time: 20 minutes
1 16.25 ounce box white cake mix
1 cup all purpose flour
1 cup granulated sugar
3/4 teaspoon salt
1 1/3 cup water
2 tablespoons vegetable oil
1 teaspoon vanilla extract (you may use almond if you would like)
1 cup sour cream
4 large egg whites
1. Preheat your oven to 325 degrees. Line your muffin tins with cupcake liners and set aside.
2. In a large bowl bowl whisk together cake mix, flour sugar and salt. Add remaining ingredients and mix well until all ingredients are well blended, approximately 2 minutes.
3. Scoop batter into your lined muffin tin about 3/4 of the way full.
4. Bake 18-20 minutes or until a toothpick inserted into the center of the cupcake comes out clean. Cool in tins for 5 minutes and then transfer to a cooling rack to cool completely.
Recipe from Recipe Girl
Classic Buttercream Frosting
Yield: approximately 4 1/2 cups
3/4 cups unsalted butter, at room temperature
2lbs powdered sugar (approximately 8 cups)
1/3 cup milk
2 teaspoons vanilla extract (You can also substitute almond extract)
2-4 tablespoons milk
1. Allow butter to stand at room temperature for 30 minutes.
2. In a very large mixing bowl beat butter with an electric mixer on medium speed until smooth.
3. Gradually add 2 cups of the powered sugar beating well. Slowly add in the 1/3 cup milk and vanilla. Gradually beat in the remaining powdered sugar. Beat in additional milk until frosting reaches spreading consistency.
Recipe from BHG Cupcake Magazine
Patriotic Variation: 4th of July Cupcakes
You can make almost any flavored cupcake as a base for this fun twist but I chose a clean white base so that I had as close to a true "red, white and blue" color scheme as possible.
1. Follow recipe instructions until your batter is completely mixed and then seperate the batter equally into three bowls. For the wedding cake recipe above each bowl had approximately 1 3/4 cup of batter.
2. Put one bowl aside untouched to be your white layer. Add red and blue food coloring to the other two bowls until you achieve the desired shade you are would like. Tip: For recipes where I'm worried the extra liquid may dilute the recipe I love to use gel food colors. Especially when you are trying to use red food coloring and in order to get more of a red rather than pink I think they are very helpful. Give them a try!
3. Spoon each color into lined muffin tins in your desired order. For this recipe I spooned about a tablespoon of each color into the tin (*Remember the tins should only be filled 3/4 of the way full!) After each addition try your best to smooth out each layer so they completely cover the previous layer. This will help to give you distinct layers that will not run together while baking. Bake as according to recipe directions, pipe with a tasty frosting, add fun sprinkles and be sure to mix it up with cute free 4th of July cupcakes toppers!


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Cowboys owner Jerry Jones was on the radio Tuesday morning, but he didn't have much to add from Monday's assessment of quarterback Tony Romo's status.
Jones reiterated that Romo has not been ruled out of Sunday's game and that he's going through treatment in hopes of being cleared by doctors in time to face the Eagles. Jones wouldn't discuss more about Romo's medical condition, citing HIPAA regulations, choosing to leave his status a "question mark" as the week unfolds.
Jones was willing to say a bit more about coach Jason Garrett, however. Jones, who said he wouldn't give repeated votes of confidence in the coach, said that Garrett is not coaching for his job this weekend.
"He has a bright future with the Cowboys," Jones said on 105.3 The Fan, via Charean Williams of the Fort Worth Star-Telegram.
There's no timeframe on that future, of course, and Jones has the right and the ability to change his mind at any moment. For now, though, the Cowboys have remained steadfast when it comes to Garrett remaining on the job whether or not they beat the Eagles this weekend.


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Music Teacher's Applet for HanDBase
Music Teacher's Applet for HanDBase - This applet is intended to be used by music teachers who need to track hours taught, income information and student info. It will help you to keep tabs on your student's progress as well as financial info for billing/income purposes. This applet includes 4 files - 2 database files and 2 forms files...Read more


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Well, it looks like the forums are working again. At least for me. I've been having lots of trouble using them before. Oh well.
....might as well give this thread a purpose. When is the comic gonna start up again? This is a good comic, and it keeps me laughing. I hope to see more in the future.


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Isn't it funny how we always want what we can't have? The girl with the round and pert backside wishes that her rear were 5 times smaller. Meanwhile, the girl with the non existent posterior wishes to achieve a larger butt. Well, if the grass is greener on the other side, just water yours! If you've got a small behind, you can create the illusion of a larger one with butt enhancing jeans. Here's how to do it.
Look for light weight denim – This material is very stiff and heavy. If you try to stuff a flat butt into denim jeans, it will only create a flatter looking behind.
A little stretch goes a long way – Your butt enhancing jeans should additionally contain some stretch. A mixture of 98 percent cotton and 2 percent lycra is best. This combination of lycra and cotton, especially when it's in a nice tight-weave fabric that's fitted through the hip and thigh area will help lift your buttocks. Too much lycra and your jeans may start to ripple like a pair of leggings. If there's not enough cotton content, there won't be enough structure to hold you up.
It's all in the pockets – The most effective trick for creating the illusion of a bigger butt is to choose jeans with flap pockets. The added bulk of the flap will enhance and add dimension to your tiny tush. True Religion is notoriously famous for their flap pocket designs. You can also try Hudson, Rock & Republic, Frankie B and Paige for addition flap pocket styles.
Pocket placement – If you're not a fan of flap pockets, or if you've already bought too many of them, you can also try denim with regular pockets. Be sure to aim for a pair with smaller pockets that sit higher and this will help make your rear look lifted.
Cut is also important – Look for jeans with a slight tapering at the knee, such as a straight leg or skinny style. This cut will make your bum look a bit larger in comparison to the rest of your body. Great styles to try are True Religion Billy, Julie or Stella, Siwy Harmah or Rose, and Hudson Emily or Paige.
How low can you go – Actually, you don't want to go too low when it comes to the jean rise. The goal is to project more, not less. A pair of low rise denim will only reduce the size of your rear. Instead, opt for a pair with a medium rise.
Color me right – Since dark colors minimize, dark denim and indigo will create a slimming effect. You do not want this kind of effect on your barely there behind! Try to find light colored or medium blue denim. Grey is very flattering and will also work.
Like a great bra, butt enhancing jeans can also lift and separate what little you have. So it wasn't in your genes to have a nice, round bottom. Big deal. Be happy with what you've got and just improvise!


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Let the birthday celebrations begin …..
As it's my birthday today, I decided to write a letter to myself. I tend to celebrate my birthdays with gusto – for example, when I turned 50 I spent the whole year in birthday mode! So indulge me…..
Optimism about one's ageing exerts measurable, positive effects on the brainJohn Medina in brain rules for ageing well, 10 principles for staying vital, happy and sharp
December is party month
My birthday is in mid-December, just two weeks out from Christmas. I love the month of December – it's party mode all month for me. I don't know if it's something I've learnt to do so that I don't miss out on any attention or if it's just the pure joy of having a birthday but I just love to celebrate. Being showered with love and gifts, all month, is also great fun!
I must admit I take a dim view of anyone who sends me a birthday card (yes I still get some cards in the actual real mail, but these days the money inside is missing) with a cheaper Christmas stamp on the envelope. And don't even think about wrapping my birthday gift with Christmas paper because that's all you have lying around the house at the moment. Definite no-no. I'm not being ungrateful, would you wrap a birthday present in May with Christmas paper? No I didn't think so 🙂
Happy Birthday to me!
OK – I admit that I saw this idea on someone else's blog and loved the idea. I left a comment on her post and she encouraged me to give writing my own birthday letter a go, so here I am. Come and enjoy the trip down memory lane with me.
Dear 1 year old Deborah: Apparently you were called Deborah in those days! Enjoy being the first born because soon enough you'll have a sister and a brother for company. Don't expect to see your father very much in your first few years, he's married to the Navy too.
Dear 5 year old Debbie: You are lucky to have made it to 5 years of age, what with car accidents with your mother, surviving dreadful illnesses and hospitalisation for months! Thankfully all that baby fat gave you the strength to carry on. You are now a proud big sister.
Dear 10 year old Debbie: Girl Guides, running, bike riding, reading, hanging out with friends and your new house in the bush make life one big adventure which sets the scene for your future.
Dear 16 year old Debbie: Who would have guessed that starting a part-time job as a check out chick would lead you to meet a tall, dark, handsome stranger who would feature heavily in your future life.
Soon after this you travel on your first overseas trip on a school excursion and survive a horrific accident in which 3 people die and you receive a Bravery Award from the Queen as a result.
Dear 19 year old Debbie: Your 19th birthday and in exactly a month's time you'll be marrying the love of your life. When your father asks if you're sure it's what you want to do at only 19, that there's no rush, that there's a big wide world out there to explore – tell him you'll do all the travel and adventuring together as a family. You've already started a new life by moving away from home, to Newcastle, and started saving to buy your first home together.
Dear 22 year old Debbie: Once you have your own house, it seems the right time to start a family and it doesn't take long. Melanie arrives half way through the year and changes you from a couple, into a family of three, and you wonder how your heart can love someone so much.
Dear 25 year old Debbie: Life continues to get busier with the arrival of Sarah half way through this year, your heart continues to grow with love. Melanie and Sarah are dubbed by some friends as Search and Destroy.
Dear 28 year old Debbie: By the time you are 28 you are the proud and happy mother of three beautiful and clever daughters with Eliza being your Bicentennial Project. How much love can your heart take? You are also a qualified breastfeeding counsellor (bet you didn't see that one coming) and enjoy helping other mothers over the phone while your daughters wreak havoc around you. They love it when the phone rings – it means they can go wild and you can't do anything about it.
Dear 32 year old Debbie: Don't hesitate to take on the world, it's a scary thought travelling to the other side of the world for the first time and going on a Teacher Exchange with three little girls in tow is full of unknowns, but believe me, it's well worth the effort. Saying yes to the opportunity becomes one of those life changing moments you'll never regret.
Dear 40 year old Debbie: You know how you always wanted to be a teacher? Well it finally happens and you start studying by distance education with 3 teenage girls at home, while also working 2 part-time jobs. Graduation is a very proud moment, with the Mathematician and two of your girls there.
Your father rings you to tell you the story of how you came to be named Debbie – very special – treasure this moment.
Dear 50 year old Debbie: This is a huge year for you. Turning 50 with a combined 110th birthday party with your friend Ros who turned 60, with a surprise visit from Melanie all the way from England, followed by an extended family weekend to a Queensland island where Sarah surprised you by coming home from England as well. You had all three girls, your parents, your brother and sister – and you met your youngest daughter's new boyfriend (spoiler alert: he goes onto to become her husband). Then you continue the birthday celebrations by travelling to Europe with your parents, sister and daughters and go on a barge and bike ride from Paris to Bruges. This time with your parents turns out to be very special.
Since turning 50 you have lost your brother-in-law who died suddenly at age 55 and you wonder how you can cope with the awful grief. Then a few years later your father dies and only a few months later your father-in-law dies suddenly while you are travelling the world on your 3 month Odyssey. It is an extremely sad time so take every opportunity to see them, talk with them and show your love. You also become Mother of the Bride – twice!
Dear 52 year old Debbie: A great idea! Why don't you prepare yourself for a monumental photo at the precise moment of 12.12pm on 12/12/2012! It's a once in a lifetime opportunity 🙂
Dear 56 year old Debbie:Don't panic but your career of teaching in a men's correctional centre (YES, a prison) spanning over 2 decades, is about to end and you'll be VERY upset about it all. In fact it makes you very sick and stressed, as it's not your choice to finish up this way. Being made redundant is always hard but remember, it's not you that's been made redundant it's the job. Hang in there, life will get better.
Dear 58 year old Debbie: Happy birthday Granny Debs! Yes, you're a grandmother now and don't you just love this new role? Make sure you enjoy your new granddaughter but don't neglect your own children, they were here first remember, and still need you to help and guide them through adulthood.
It's a bittersweet birthday this year as it's the first one since you lost your father in January and your father-in-law in July. Spend time doing what you love is my only advice to you, as you never know what is around the corner. You and the Mathematician take a huge 3 month Odyssey during the year and visit bucket list places like Iceland, cycling in Amsterdam and the Tour de France.
It's the end of wearing your 57 years bold t-shirt so put it away for your sister's birthday, you know she'll love to wear it one day soon 🙂
Happy birthday from me to you.
12 December 2018
It seems I have enjoyed writing a birthday post every year since starting my blog! did I tell you i love having my birthday??
I just needed to crunch some leaves – 2015
What makes the birthday girl so special – 2017
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About Mt. Sinai St. Luke's Roosevelt
Mt. SinaiSt. Luke's Division
By Bus
By Subway
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Mt. Sinai Roosevelt Division
By Bus
By Subway
By Car
A Heritage of Surgical Excellence
There are various types of polyps that can be found in the large bowel. The most common type of colon polyp is the adenoma which is a benign tumor (premalignant) that has the potential to develop into an invasive cancer if left in place and allowed to grow for years. Very rarely, polyps are found that have already developed into small cancers; these are called polyp cancers. Some polyps have begun the transformation to cancer; in this situation, microscopically, the polyp cells more closely resemble a cancer than an adenoma yet there is no invasion beyond the innermost layer of the colon wall. These are given the name dysplastic polyps or "carcinoma in situ".
The second most common type of polyp, usually quite small, is called a hyperplastic polyp. Although hyperplastic polyps arise in the colon they are more often found in the rectum. Thankfully, hyperplastic polyps are not capable of transforming into a cancer. A third category of polyps, inflammatory, are found in patients who have had colitis related to inflammatory bowel disease, or infection. Thankfully, these polyps do not have the capacity to turn into a cancer.
Polyps come in a variety of shapes and sizes. Some are flat and grow directly on the surface of the colon while others are like small mushrooms that protrude into the colon on thin flexible stalks. Adenomas range in size from several millimeters (1/16 of an inch) to over 10 cm (3 inches). The chances that a given adenoma polyp may contain an invasive cancer is related to the size of polyp and to the type of adenoma that is present.
It is usually not possible to distinguish between adenomas (which can turn into a cancer) and the other types of polyps just by looking at them. Therefore, when polyps are found they are removed or at least biopsied. Most polyps are small enough that they can be removed or destroyed at the time of colonoscopy. A small percentage of polyps are too large to be removed with the colonoscope. These larger polyps are removed in the operating room by resecting a portion or segment of the colon or through a combined laparoscopic and colonoscopic method.
The great majority of benign colon and rectal polyps are small or moderate sized and can be removed through the colonoscope in the outpatient setting using a variety of instruments that are passed through a narrow channel in the colonoscope. Very small polyps are destroyed with a forceps that grasps and removes small pieces of the rectal lining. Larger polyps are removed most often with a metal snare (like a noose) that is passed through a thin insulated hollow plastic tube. The snare and plastic sheath are passed through a channel in the colonoscope to the scopes tip and beyond. The snare is placed around the polyp (often shaped like a mushroom) and tightened while electric current is passed through the wire. This cauterizes the stalk of the polyp while it is being cut. If possible, the polyp is recovered and sent for pathological analysis. Polyps can also be directly burned or cauterized with heat or electric current, usually after one or several biopsies have been obtained. Larger polyps, especially the flat ones, are more difficult to treat colonoscopically.
Ideally, a polyp is removed completely and intact with a single application of the wire snare. However, this is not possible for some middle sized and larger polyps. One approach to these lesions is to remove them in pieces using the wire snare multiple times. To make it easier and safer to remove these larger polyps saline or other solutions are sometimes injected into the bowel wall via a catheter (with a needle at its tip) which is passed through the colonoscope. The injected fluid expands and swells the bowel wall making it thicker which protects the deeper muscle layers of the bowel wall from injury when the snare is used to remove parts of the polyp. In some cases it is not possible to fully remove the polyp at one colonoscopy. In this situation it is common to mark or "tattoo" the location of the polyp with India ink or another dye so that the area can be easily found. The colonoscopy is usually repeated months later at which time an attempt is made to remove the remaining polyp, usually with a metal snare, as before. It may take 3 or 4 colonoscopies to fully destroy a larger polyp using the colonoscope.
Unfortunately, when some polyps are initially found they are judged too large to be removed with a colonoscope in an endoscopy suite. Also, in some patients, after several attempts to colonoscopically remove a polyp, the gastroenterologist will make the judgement that the polyp can be fully destroyed with the scope. In these situations the patient is usually referred to a surgeon after the polyp has been tattooed with India ink.
Historically, a segmental "cancer type" bowel resection is carried out to remove adenomas of the colon that are judged not amenable to removal with a colonoscope. In this case a 7 to 10 inch length of colon is resected (the polyp is usually in the middle of the specimen) along with the lymph nodes and blood vessels supplying the bowel after which the remaining ends are rejoined. Many patients ask why so much bowel is removed to treat a benign polyp? The reason is that 10 to 15 percent of large, supposedly benign, polyps that come to surgical resection are found to contain invasive cancers. Certainly, for the 10-15 percent of patients with cancers the lengthier and more extensive resection is logical and appropriate. In regards to the remaining 85-90 percent of patients with benign polyps the cancer type resection is not necessary. If there were a way to be reasonably certain that a polyp was, in fact, benign, then, perhaps, the radical resection could be avoided.
An important method of judging a polyp is by taking multiple biopsies of it through the colonoscope. Another useful method is to inject saline into the bowel wall beneath the polyp to see if the polyp "lifts" off the deeper layers of the bowel wall. The injected fluid greatly expands the middle layer of the bowel wall that separates the inner lining from the outer muscle coating of the colon. If the polyp rises, then the lesion is not invading into the muscular layer (a characteristic of invasive cancers). This saline lift test is easily done through the colonoscope. Yet another method is endoscopic ultrasound which uses sound waves to determine whether the polyp is invading and into the deeper bowel wall layers. Simply taking a close look at a polyp can also provide important information to the surgeon. What are the alternatives to a full segmental cancer type resection for polyps judged benign by the above tests?
Some large benign polyps can be removed by resecting a small oval shaped piece of the bowel wall (part of the circumference only) that includes the polyp and a small rim of normal bowel wall. This is called a "wedge" resection. This operation avoids extensive dissection and does not include division of the blood vessels supplying the area or removal of the lymph nodes. In short, it is a much smaller and less radical operation that requires minimal dissection of the colon and removes far less tissue. The chances of having a complication after this type of surgery is lower because less has been done. Patients usually go home in 1 to 2 days as opposed to 3 to 5 days after the standard cancer type bowel resection.
The "wedge" resection is best performed laparoscopically after the polyp's location in the colon is marked with india ink tattoos via the colonoscpe. The india ink injections are given with a long needle catheter that is passed through the colonoscope. These marks tell the surgeon where the polyp is located and permit the wedge resection. After marking, the polyp and adjacent bowel wall is resected with a narrow stapler that is inserted through a hollow 1 inch "port" in the abdominal wall. The colonoscope, still in the colon, observes the process and verifies that the stapler is well positioned to remove the polyp. The specimen is removed through one of the laparoscopic port wounds in a plastic bag after which a pathologist immediately examines the polyp and carries out one or several "frozen sections" to verify that the lesion is an adenoma only. The patient remains on the operating room table asleep while the polyp is evaluated. In the unlikely situation that the frozen section reveals an invasive cancer, then a standard cancer type resection would be immediately carried out laparoscopically.
Another way to remove some of these polyps is to perform a colonoscopy in conjunction with laparoscopy in the operating room with the patient under general anesthesia. The laparoscopic instruments can be used to push on the outside of the colon wall to make it easier for the doctor driving the colonoscope to grasp the polyp with a snare. In this way, some polyps that could not be removed during a regular outpatient colonoscopy can be excised. It is also possible to use advanced colonoscopic polypectomy methods to remove these polyps. One such method is called ESD or Endoscopic Submucosal Dissection. In this method a thin wire connected to an electric cautery machine is passed through an insulated sheath through the colonoscope and used to make an incision around the polyp (like a knife). Then other colonoscopic tools are used to lift and dissect beneath the polyp in order to fully detach it. If successful, at the end, the polyp has been removed in one piece and the underlying muscle layer remains intact. If successful, this method avoids removing even a "wedge" of the entire bowel wall.
At Mount Sinai St. Luke's-Roosevelt Hospital our approach is to assess all patients with large benign polyps who are sent for a standard colon resection and determine if either the laparoscopic "wedge" or the combined laparoscopic / colonoscopic polypectomy methods can be utilized. The goal is to remove the polyp via the least invasive method possible. If successful, patients are home sooner with all or more of their colon in tact. Because it is not possible to be certain before surgery that a polyp can be removed via a combined laparoscopic/colonoscopic or wedge method, patients must consent to a standard colectomy in addition to the less invasive polyp removal methods. The consent states that, at the end of the procedure, the polyp will have been removed by one of the 3 methods with the standard cancer type resection being the last resort.
When the colonoscopy is performed in the operating room on the day of surgery if the polyp lifts when injected and is judged resectable via colonoscope then an attempt will be made to excise it using a variety of colonoscopic tools. If needed, the polyp can be manipulated externally with laparoscopic instruments to facilitate removal. If the polyp is successfully removed a test is done to make sure that the colon wall is not perforated after which the scopes are removed and the patient woken up.
If it is not possible to fully remove the polyp using colonoscopic methods, the borders of the polyp are marked with india ink and then an attempt is made to do a laparoscopic wedge resection of the polyp and the adjacent colon wall with a stapler. The colonoscope, still in place, views the placement of the stapler to make sure all is well. If successful, then the specimen is put in a plastic bag and removed through one of the small wounds.
However, if the polyp will not lift when injected, is judged too large for coloniscopic or wedge resection, or looks like a cancer then the standard cancer type bowel resection would be immediately performed.
If you would like further information about the above polyp removal methods or about colonoscopy, in general, please contact the Section of Colon and Rectal Surgery at Mount Sinai St. Luke's-Roosevelt Hospital.
Minimally Invasive Colorectal Resection to Treat Colon Cancer
- April 27, 2010