clinial trials are medical research studies carried out under very strict guidelines and they are the building blocks of scientific progress. researchers, physicians and other healthcare professionals rely on these studies for scientifically sound information on whether or not treatments are safe and effective. to start, the research team must first determine the objective of the study - for example, whether an experimental treatment is safe or whether a treatment known to work for hyperhidrosis on one part of the body will work for hyperhidrosis on another part of the body. the research team then designs the study to answer that question, including developing a protocol for the trial. clinical trials with human subjects follow only after the completion of tests using laboratory animals. these trials fall into four categories called phases. in phase i a trial tests a potential new treatment with a small number of volunteers ( 20 - 80 individuals ) to determine the treatment ’ s safety and potential side effects. phase ii studies test a treatment with known dose and side effects with a larger number of volunteers to learn more about side effects, how the body responds to the treatment, and whether the treatment is effective in treating the condition. the new treatment is compared with commonly used treatments and monitored for long - term side effects in phase iii and iv trials. phase iv trials are done after the treatment is marketed. clinical researchers call the standard scientific approach for trying out treatments a “ double - blind, randomized, controlled clinical trial. ” such trials are " grade a " research because the researcher has taken precautions to get the most unbiased results possible. ideally, such research can also be replicated ; that is, another researcher using the same protocol would get similar results. the " control " aspect refers to the fact that researchers are usually looking at how one treatment stacks up against another or even against no treatment at all. to make the comparison useful, the investigator must try both methods on similar groups of subjects. researchers call the treatment with the predictable, or known effect, the control. the control may be a standard, commonly used treatment, or it may be a placebo. a placebo is an inactive pill, liquid, powder, or other modality with no treatment value ( commonly referred to as a " sugar pill " ). some studies use both a standard treatment and a placebo as controls. the control helps an investigator find out if any changes in the experimental group are, in fact, due to the new treatment. trials are randomized because researchers assign patients by chance either to the group getting the new treatment ( called the treatment group )


. the control helps an investigator find out if any changes in the experimental group are, in fact, due to the new treatment. trials are randomized because researchers assign patients by chance either to the group getting the new treatment ( called the treatment group ) or to the group receiving a standard treatment or placebo ( called the control group ). this randomization keeps the study ' s results from being affected by human choices or other factors not related to the treatments being tested. in some studies, the patient does not know whether he or she is in the treatment or control group ( a single - blind study ) ; in others, neither the patient nor the researcher know ( a double - blind study ). this, again, is a way of avoiding bias in the results. sometimes when people know what treatment they are getting, it changes the way they react ; similarly, the researchers ' own expectations about the treatment could influence how they perceive patients ' reactions, side effects, and progress during the study. participants in clinical trials are randomly assigned once they ' ve been accepted into the study and have agreed to participate by signing an informed consent. all clinical trials have guidelines about who can participate. these guidelines are an important part of medical research that helps to produce reliable results. the factors that allow someone to participate in a clinical trial are called " inclusion criteria " and those that disallow someone from participating are called " exclusion criteria ". the criteria are based on such factors as age, gender, the type and stage of a disease or condition, previous treatment history, and other medical conditions. before joining a clinical trial, a participant must qualify for the study. some research studies seek participants with illnesses or conditions to be studied in the clinical trial, while others need healthy participants. it is important to note that inclusion and exclusion criteria are not used to reject people personally. instead, the criteria are used to identify appropriate participants and keep them safe. the criteria help ensure that researchers will be able to answer the questions they plan to study. the exact clinical trial process depends on the kind of trial being conducted. in general, the clinical trial team includes doctors and nurses as well as social workers and other healthcare professionals. they check the health of the participant at the beginning of the trial, give specific instructions for participating in the trial, monitor the participant carefully during the trial, and stay in touch after the trial is completed. some clinical trials involve more tests and doctor visits than the participant would normally have for an illness or condition. for all types of trials, the participant works with a


monitor the participant carefully during the trial, and stay in touch after the trial is completed. some clinical trials involve more tests and doctor visits than the participant would normally have for an illness or condition. for all types of trials, the participant works with a research team. clinical trial participation is most successful when the trial ’ s specific instructions ( or protocol ) are carefully followed and there is frequent contact with the research staff. informed consent is the process of learning the key facts about a clinical trial before deciding whether or not to participate. it is also a continuing process throughout the study to provide information for participants. to help someone decide whether or not to participate, the doctors and nurses involved in the trial explain the details of the study. if the participant ' s native language is not english, translation assistance can be provided. then the research team provides an “ informed consent document ” that includes details about the study, such as its purpose, duration, required procedures, and key contacts. risks and potential benefits are explained in the informed consent document. the participant then decides whether or not to sign the document. informed consent is not a contract, and the participant may withdraw from the trial at any time. clinical trials that are well - designed and well - executed can help eligible participants to : there are risks to clinical trials. the ethical and legal codes that govern medical practice also apply to clinical trials. in addition, most clinical research is federally regulated with built in safeguards to protect the participants. the trial follows a carefully controlled protocol which is a set of instructions or a study plan which details what researchers will do in the study. as a clinical trial progresses, researchers report the results of the trial at scientific meetings, to medical journals, and to various government agencies. individual participants ' names will remain secret and will not be mentioned in these reports. every clinical trial in the u. s. must be approved and monitored by an institutional review board ( irb ) to make sure the risks are as low as possible and are worth any potential benefits. an irb is an independent committee of physicians, statisticians, community advocates, and others that ensures that a clinical trial is ethical and the rights of study participants are protected. all institutions that conduct or support biomedical research involving people must, by federal regulation, have an irb that initially approves and periodically reviews the research. if you are considering participating in a clinical trial, talk to a physician who knows your medical history and is familiar with hyperhidrosis ( preferably a dermatologist ). for help finding a physician,


initially approves and periodically reviews the research. if you are considering participating in a clinical trial, talk to a physician who knows your medical history and is familiar with hyperhidrosis ( preferably a dermatologist ). for help finding a physician, visit our physician finder. also discuss clinical trial options with your loved ones. before making any decisions, you should know as much as possible about the clinical trial and feel comfortable asking the members of the healthcare team questions about it - such as the care you may expect while in a trial, and the cost of the trial. the following additional questions might be helpful to you if you decide to discuss participation in a trial with its healthcare team. some of the answers to these questions will also be found on the trial ' s informed consent document. yes. most clinical trials provide short - term treatments related to a designated illness or condition, but do not provide extended or complete primary health care. in addition, by including your healthcare provider in your clinical trial experience and getting him / her involved with the research team can help to ensure that any other medications or treatments you may be using will not conflict with the study or pose any additional risks. yes. a participant can leave a clinical trial at any time. when withdrawing from the trial, the participant should let the research team know about it, and the reasons for leaving the study. clinical trials are sponsored or funded by a variety of organizations or individuals such as physicians, medical institutions, foundations, voluntary groups, and pharmaceutical companies, in addition to federal agencies such as the national institutes of health ( nih ), the department of defense ( dod ), and the department of veteran ' s affairs ( va ). trials can take place in a variety of locations, such as hospitals, universities, doctors ' offices, or community clinics.


- scientists & leadership - isb research - education & outreach seattle - relocating is stressful, even for a microbe. knowing how a microorganism can quickly adapt to challenges of a new habitat helps researchers better understand how commensals ( good microbes ) and pathogens colonize diverse environments including soil, plant roots, and the human gut. institute for systems biology ( isb ) researchers are the first to discover that a protein once thought to have no regulatory function in microbes actually helps them to rapidly adapt to new environments. isb scientists had previously discovered that the gene encoding this protein, called transcription factor b ( tfb ), is present in multiple copies in many microorganisms called archaea – especially those that are known to live in environments that are constantly changing. to understand why, the researchers used an interdisciplinary systems approach that systematically analyzed across many environments the consequences of deleting each copy of the gene or introducing a mutated copy on the health of one such organism, halobacterium salinarum, that lives in saturate brine. simultaneously, they observed how all of the other genes and the complex molecular networks in h. salinarum responded to these genetic manipulations. they integrated millions of data points generated from thousands of such experiments and analyzed patterns in these data across evolutionary timescales by analyzing genome sequences of diverse organisms. they made the remarkable discovery that the microbe gained capability for acclimating to new environments by simply transferring genetic information from one copy of the tfb gene to another, akin to cutting and replacing text in one copy of a document from an edited version. because it has seven variant copies of tfbs, h. salinarum could perform a large array of such mix - and - match experiments to explore new solutions for adaptation. how does this work? nitin baliga, professor and director of isb and senior author on the paper, explained that " tfbs bind to different locations in the genome and function like wires inside the cell to execute programs that determine which genes in the genome need to be turned on or off and when. " in other words, by transferring information across tfbs, an organism can rapidly rewire its networks to generate new programs that enable new capabilities with the same set of genes. " it´s astounding, " remarked dr. baliga. this discovery helps us to understand how archaea colonize diverse environments to give structure and function to microbial communities. this is important for two reasons : first, arch


of genes. " it´s astounding, " remarked dr. baliga. this discovery helps us to understand how archaea colonize diverse environments to give structure and function to microbial communities. this is important for two reasons : first, archaea make up 20 percent of biomass on earth and serve important roles in biogeochemical cycles, which are similar to our circulatory systems and necessary to maintain a health planet. second, understanding the mechanics of adaptation will help us better understand and predict how microbes and communities might respond to pollution or climate change due to anthropogenic activities. furthermore, because they have similar functions in eukaryotic organisms we can also begin to understand how duplicated copies of tfiib proteins reorganize networks for development of body plans in animals. understanding that this family of proteins in archaea have regulatory consequences for adaptation into new environments is " knowledge that can be applied to understanding how the tfiib proteins might have come to mediate the encoding and execution of regulatory programs in humans, " said serdar turkarslan, the lead author of the paper, which was published on nov. 22 in " molecular systems biology. " this study was supported by the u. s. department of energy´s genomic science funding, the national institutes of health, and the national science foundation. about the institute for systems biology the institute for systems biology ( isb ) is an internationally renowned, non - profit research institute headquartered in seattle and dedicated to the study and application of systems biology. founded by leroy hood, alan aderem and ruedi aebersold, isb seeks to unravel the mysteries of human biology and identify strategies for predicting and preventing diseases such as cancer, diabetes and aids. isb ' s systems approach integrates biology, computation and technological development, enabling scientists to analyze all elements in a biological system rather than one gene or protein at a time. founded in 2000, the institute has grown to 13 faculty and more than 300 staff members ; an annual budget of more than $ 50 million ; and an extensive network of academic and industrial partners. for more information about isb, visit www. systemsbiology. org


recent years have seen an upsurge of interest in knowledge. leading organisations now recognise the importance of identifying what they know, sharing what they know and using what they know for maximum benefit. many organisations employ knowledge engineers to capture knowledge from experts using the principles and techniques of knowledge engineering. the emphasis is on a structured approach built on a sound understanding of the psychology of expertise and making use of knowledge modelling methods and the latest web technologies. knowledge acquisition in practice is the first book to provide a detailed step - by - step guide to the methods and practical aspects of acquiring, modelling, storing and sharing knowledge. the reader is led through 47 steps from the inception of a project to its successful conclusion. each step is described in terms of the reasons for the step, the required resources, the activities to be undertaken, and the solutions to common problems. in addition, each step has a checklist which lists the key items that should be achieved during the step. knowledge acquisition in practice will be of value to knowledge engineers, knowledge workers, knowledge officers and ontological engineers. the book will also be of interest to students and researchers of ai, computer science and business studies. several technologies are emerging that provide new ways to capture, store, present and use knowledge. this book is the first to provide a comprehensive introduction to five of the most important of these technologies : knowledge engineering, knowledge based engineering, knowledge webs, ontologies and semantic webs. for each of these, answers are given to a number of key questions ( what is it? how does it operate? how is a system developed? what can it be used for? what tools are available? what are the main issues? ). the book is aimed at students, researchers and practitioners interested in knowledge management, artificial intelligence, design engineering and web technologies. " they [ the two books ] are both very readable and very informative. " engineering manager, usa " they are excellent as you manage to explain a complex subject with great clarity. " editor of it magazine, uk " i believe that it will be very useful for the students. " paperback : 138 pages publisher : polimetrica, international scientific publisher ( march 3, 2008 ) hard copies are available from polimetrica and most good bookshops. a free softcopy of the book is available at the e - lis and arxiv repositories. knowledge practitioners ' reference books for those who want to find out more about knowledge technologies or the steps involved in capturing, structuring and publishing knowledge


what to expect from 802. 11ac source : aruba networks the new technologies that will make up the final ieee 802. 11ac wi - fi standard are extensions of the physical - layer wireless techniques pioneered in 802. 11n. these extensions include the use of multiple antennas at the transmitter and receiver to exploit multiple input / multiple output ( mimo ) for parallel delivery of multiple spatial streams. although consumer and residential wi - fi applications are a primary focus for these 802. 11ac technologies, they will also have a considerable impact on enterprise wireless lans ( wlans ). 802. 11ac increases the amount of wireless bandwidth in a cell, allowing a single access point ( ap ) to serve the same number of wi - fi clients with greater per - client throughput. alternatively, a single ap will serve more wi - fi clients with the same throughput. this is a crucial capability in environments that serve high densities of wi - fi clients, such as lecture halls, conference centers, stadiums and other large public venues. the trend toward more antennas - from small devices like tablets and smartphones to larger aps packed with more than four antennas - will make mimo and beamforming more prevalent than ever and vastly improve the reliability of wi - fi connections. consequently, it will be easier to provide wi - fi coverage around physical obstructions like elevator shafts and stair wells. these features also deliver signal range improvements and signifcantly increase the reliability of wireless connections.


roux - en - y gastric bypass is the most commonly performed operation for weight loss in the united states, according to the american society for bariatric surgery. in this procedure, the surgeon creates a small pouch at the top of the stomach to restrict food intake. then, a y - shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach and the first part of the small intestine. this reduces the amount of calories and nutrients the body absorbs. physicians on the medical staff at texas health presbyterian hospital plano often perform roux - en - y gastric bypass laparoscopically. with laparoscopy, the surgeon makes one or more small incisions through which slender surgical instruments are passed. this technique eliminates the need for a large incision and allows for a faster recovery. patients who have undergone roux - en - y gastric bypass surgery must modify their food choices because of a " dumping syndrome " often caused by the surgery. when patients eat a meal high in simple carbohydrates, which contain sugars that are rapidly absorbed by the body, they may experience an unpleasant reaction. stomach contents move too quickly through the small intestine causing symptoms such as nausea, bloating, abdominal pain, weakness, sweating, faintness and sometimes diarrhea. lifelong mineral supplementation is also required for gastric bypass patients as the bypassed portion of the intestine is where the majority of calcium and iron absorption takes place. the roux - en - y gastric bypass has been proven in numerous studies to result in durable weight loss and an improvement in weight - related medical illnesses, according to the american society for bariatric surgery. half of the weight loss often occurs during the first six months after surgery ; weight loss usually peaks at 18 to 24 months. the obesity - related conditions that may be improved or cured with this gastric bypass procedure include type 2 diabetes, hypertension, high cholesterol, arthritis, venous statis disease, bladder incontinence, liver disease, certain types of headaches, heartburn, sleep apnea and many other disorders. the negatives associated with roux - en - y gastric bypass include a higher initial complication rate, the need to supplement vitamins and minerals for the rest of the patient ' s life ; and the potential for malnutrition if the patient doesn ' t comply with their doctor ' s recommendations. discuss these and other potential complications with your


conservatives blame poor government policy for causing the housing bubble, while progressives blame the financial industry. while most arguments on the right focus on the government - sponsored enterprises fannie mae and freddie mac, its stance actually might not need to rely on them. data indicates that the government ' s broader efforts to make housing an attractive investment has funneled money away from business and into the housing sector. this analysis comes from university of chicago economist casey mulligan, via the new york times economix blog. he analyzed the value of housing capital, as a measure of profitability, in the u. s. from 1950 to 2000. he calculates it to be average out to 5. 7 % over the period. here ' s his chart : it was 6. 4 % in 2000. he then did a separate calculation to determine the value of business capital. at 15. 3 % over the 50 - year period, excluding taxes, it was much higher. this implies overinvestment in housing. mulligan explains : business capital has been so profitable to the economy because it is more scarce. it ' s the law of demand : the less business capital there is, the higher the rate of return that remaining business capital earns because each unit of capital serves more customers. a low profit rate for housing is a symptom of its abundance. this would seem to imply that prudent investors would be better off investing in business than housing, since business capital is more productive than housing capital. so what happened? the government made housing look like a more attractive investment. mulligan also calculated profitability with taxes taken into account : the business - residential profitability gap is almost 10 percent, but our attempts to adjust both profit rates for applicable taxes show that the after - tax profitability gap is zero to five percentage points. in other words, tax differences sweeten residential real estate investment. they result in it looking nearly as profitable as business investment. there are a few things to note about this finding. first, it ' s important to bear in mind that this was all before the housing bubble ; mulligan ' s analysis ends in the year 2000. in other words, the overinvestment in housing obviously got much, much, worse in the seven years that followed. this begins to show one reason why so much money flowed to real estate instead of to other investment options. the second implication is arguably even more important. business growth in the u. s. during that decade was weaker than it could have been because


. this begins to show one reason why so much money flowed to real estate instead of to other investment options. the second implication is arguably even more important. business growth in the u. s. during that decade was weaker than it could have been because so much investment was coaxed towards real estate by the government instead of towards other more technology - driven industries. if the u. s. wonders why it ' s having so much trouble with economic growth now, it can look to the overinvestment in real estate over the past decade, which ultimately resulted in a tragic amount of capital destruction. third, this analysis shows the extent to which residential real estate benefits from favorable tax treatment and business suffers from relatively unfavorable tax treatment. if the government wants to figure out how to create jobs, there ' s its answer. it should reduce the tax benefits provided to real estate and provide them to businesses instead. up to now the government has had a dual - rationale for its preference for housing investment. one end it appreciates is promoting homeownership, because it has long ( wrongly ) viewed owning a home as a part of the american dream. second, the housing industry lobby is very powerful, as is evidenced by the ridiculously expensive but politically untouchable mortgage interest deduction. it ' s time for washington to challenge this status quo and begin to encourage americans to put their money in more productive investments that will facilitate stronger long - term economic growth.


body composition tests december 19, 2011 the tests and measurements described in this fact sheet provide detailed measurements of fat and lean body mass. repeated measurements can be helpful in monitoring body shape changes associated with lipodystrophy ( see fact sheet 553 ) or with wasting syndrome ( see fact sheet 519 ). some of these measurements are used to determine if someone is overweight. excess weight is associated with a higher risk of heart disease. low weight, including an unintended weight loss of 5 % or more, may also be a sign of health problems ( see fact sheet 519 ). there are pluses and minuses for each method. some have to do with cost. also, a trained technician can often make a big difference in measurements. try to use the same technique and technician if you are tracking changes over time. this word just means measuring the body. anthropometry is the simplest technology. it involves using a tape measure to take key readings, such as biceps, thigh, waist, and hips. a trained technician is very important for this method. calipers ( a metal tool ) are used to " pinch " body tissue in several places. the measurements are compared to standards. people doing the measurement should be trained so that the measurements are standardized. divide your waist measurement ( at the narrowest point ) by your hip measurement ( at the widest point. ) in general, a healthy waist to hip ratio is below 0. 9 for men and below 0. 8 for women. these may not hold true for people with hiv who have fat accumulation around the waist. in general, a waist size over 40 " for men or over 35 " for women is associated with greater health risk. in bia, a person is weighed. age, height, gender and weight or other physical characteristics such as body type, physical activity level, ethnicity, etc. are entered in a computer. while the person is lying down, electrodes are attached to various parts of the body and a small electric signal is circulated. this signal cannot be felt. bia measures the resistance ( impedance ) to the signal as it travels through the body muscle and fat. the more muscle a person has, the more water their body can hold. the greater the amount of water in a person ' s body, the easier it is for the current to pass through it. higher fat levels result in more resistance to the current. fat tissue is about 10 % - 20 % water, while fat - free mass ( which includes muscle, bone


person ' s body, the easier it is for the current to pass through it. higher fat levels result in more resistance to the current. fat tissue is about 10 % - 20 % water, while fat - free mass ( which includes muscle, bone, and water outside muscles ) averages 70 % - 75 % water. bia values depend on a person ' s age. normally you can get an analysis of your results when the test is done. this is a calculation based on your weight and height. the formula is : ( weight in kilograms ) divided by ( height in meters squared ; or multiplied by itself ). to convert pounds to kilograms, divide by 2. 2. to convert height to meters, first convert height to inches ( 12 x feet, plus extra inches ). then divide by 39. 4. for example, let ' s say that someone weighing 165 pounds is 5 ' 8 " tall. bmi result categories are : for more information and a convenient bmi calculator that uses pounds and inches, see the web site " calculate your bmi " at http : / / nhlbisupport. com / bmi / tomography means looking at slices of the body. cat scanning uses x - rays to do this. it is helpful in calculating the ratio of fat within the abdomen compared to fat under the skin. the equipment is expensive. this x - ray technique divides the body into fat - free ( lean ) mass, bone mineral content, and fat. different amounts of the x - ray energy are absorbed by different types of tissue. dexa scans are very accurate but can be expensive due to the cost of the machine. dexa scans are also used to measure bone density ( see fact sheet 557. ) this technique uses a magnetic field to create an image of the body. the image shows the location and amount of fat. this is very expensive due to the cost of the machine and reading the scans. this method determines body volume. first the person is weighed dry. then they are immersed in water in a tank and weighed again. bone and muscle are more dense than water, and fat is less dense than water. a person with more bone and muscle will weigh more in water than a person with less bone and muscle. the volume of the body is calculated and body density and body fat percentage are calculated. this technique may underestimate the body fat percentage of athletes, and overestimate body fat in elderly people. body composition measurements can be helpful, over time, in tracking changes due to hiv or


january 13, 2012 raltegravir ( isentress ) is a drug used for antiviral therapy against hiv. it was formerly known as mk - 0518. it is manufactured by merck. raltegravir is the first " integrase inhibitor " drug. when hiv infects a cell, it combines its genetic code into the cell ' s own code. this is shown in fact sheet 106, step 5. raltegravir blocks this process. when raltegravir blocks integration, hiv infects a cell but cannot make more copies of itself. raltegravir was approved in 2007 as an antiretroviral drug against hiv as part of an antiretroviral regimen. it was studied first in adults who had used antiretroviral therapy for some time whose virus had already developed resistance ( see fact sheet 126 ) to existing antiretroviral drugs. late in 2008 it was approved for use in patients just starting antiretroviral therapy. raltegravir has not been studied in children, pregnant women or older adults. there are no absolute rules about when to start antiretroviral drugs. you and your health care provider should consider your cd4 cell count, your viral load, any symptoms you are having, and your attitude about taking hiv medications. fact sheet 404 has more information about guidelines for the use of antiretroviral medications. raltegravir is taken twice a day. it will most likely be used by people who have very few choices of antiretroviral medications in pill form. if you take raltegravir with other antiretroviral drugs, you can reduce your viral load and increase your cd4 cells. this should mean staying healthier longer. the hiv virus is sloppy when it makes copies of its genetic code ( rna ). many new copies of hiv are mutations : they are slightly different from the original virus. some mutations can continue to multiply even when you are taking an antiretroviral drug. when this happens, the drug will stop working. this is called " developing resistance " to the drug. see fact sheet 126 for more information on resistance. raltegravir has shown activity against hiv that already has resistance to several other hiv medications. resistance to raltegravir is not well understood. with combination therapy ( taking more than one antiretroviral drug at the same time ), hiv mutates much


activity against hiv that already has resistance to several other hiv medications. resistance to raltegravir is not well understood. with combination therapy ( taking more than one antiretroviral drug at the same time ), hiv mutates much more slowly. resistance takes longer to develop. it is very important to take antiretroviral medications according to instructions, on schedule, and not to skip or reduce doses. sometimes, if you develop resistance to one drug, you will also have resistance to other antiretroviral drugs. this is called " cross - resistance ". because raltegravir is in a new class of antiretroviral drugs, it seems to have almost no cross resistance with antiretroviral drugs in older classes. raltegravir may be taken with or without food. it is provided as 400 mg tablets. the adult dosage of raltegravir is 400 mg twice daily. there is also a 300 mg chewable tablet that is taken twice daily. raltegravir may also be used by children. dosage for children less than 12 years old is based on their weight. merck studied a once - daily dose of 800 mg. this dose was less effective at controlling hiv than the approved twice a day dosage. the difference in effectiveness was greater in patients who started with viral loads over 100, 000. in human studies, the most common side effects in people taking raltegravir were diarrhea, nausea, and headache. reports from people using raltegravir also include rash and depression. in rare cases, skin rash can be severe and life - threatening. contact your health care provider immediately if you develop a serious rash while taking raltegravir. raltegravir has been studied to see if it interacts with other drugs. rifampin, used to treat tuberculosis ( see fact sheet 518 ) decreases blood levels of raltegravir. a higher dose of raltegravir must be used. raltegravir has not been studied with all medicines, over - the - counter drugs or vitamin or herbal supplements. be sure your doctor knows about all medications and supplements that you are taking. raltegravir is the first drug in a new class, integrase inhibitors. it stops hiv from inserting its genetic code into an infected cell. this prevents the virus from making new copies of hiv. raltegravir helps control hiv, even when it


article reproduced courtesy of the guardian environment network ' sustainable ' palm oil campaign banned by asa 9th september, 2009 advertorial claimed that controversial oil business was ' green answer ' and was important to alleviating poverty a press campaign making environmental claims about the controversial product malaysian palm oil, including that it is " sustainable ", has been banned as misleading by the advertising regulator. palm oil, which is used in a third of all groceries, has been at the centre of an environmental debate over its role in the destruction of rainforest in areas such as south - east asia. the press campaign, run by the malaysian palm oil council ( mpoc ), made a number of claims, including that the product was the " green answer " and that palm oil is the " only product able to sustainably and efficiently meet a larger portion of the world ' s increasing demand for oil crop - based consumer goods, foodstuffs and biofuels ". mpoc also argued that the palm oil business had played an important role in the " alleviation of poverty, especially among rural populations ". the advertorial went on to claim that criticism of malaysia ' s palm oil industry – including " rampant deforestation and unsound environmental practices " – amounted to " protectionist agendas " not based on scientific fact or evidence. environmental group friends of the earth, and two members of the public, complained to the advertising standards authority ( asa ) that a number of the claims made by mpoc were misleading and could not be proven. the asa said that a palm oil company sustainability certification scheme, through a body called the roundtable on sustainable palm oil ( rspo ), and the certification of biofuels in general, was " still the subject of debate ". therefore making a claim that palm oil could be wholly sustainable, which cannot be substantiated, was deemed to be misleading. the asa also said that mpoc ' s attack on its detractors was likely to mislead. this was because mpoc could not prove that the production of palm oil did not, in fact, lead to deforestation or environmental damage. mpoc ' s assertion about helping to alleviate poverty was also misleading according to the asa, as there was " not a consensus on the economic impact of palm oil on local communities ". the asa said that some research had shown that biofuel production causes adverse social impacts including rising food prices and has a major short - term impact on the poor. the asa ruled that the ad should not be shown again.


researchers in kerala to use modern techniques for dna analysis alison is not aware of her white cousin housed in a rescue centre at puducherry. she, however, is on chattering terms with the grey striped version of her species scurrying about in a cage near hers in the laboratory of the department of zoology, university of kerala, here. ever since she was captured from the outskirts of the city in 2008, the black squirrel, named after a united kingdom - based scientist who helped identify the animal, has been the subject of intense scientific curiosity. following up on preliminary investigations that have confirmed the black and white animals to be variants of the indian striped palm squirrel, researchers here have launched a mission to decipher the genetic causes of the colour change. the multi - institutional project will use modern techniques for dna analysis. efforts are focussed on identifying the chromosome responsible for the genetic mutation in the grey squirrel, and the resultant colour change. “ apparently, one of the genes in the animal acted as a switch to activate the change in pigmentation, ” explains oommen v. oommen, council of scientific and industrial research emeritus scientist, who heads the project. while the research team has black and grey squirrels in its possession, the scientists have collected blood and hair samples of the white variant from puducherry where the animal is kept in a rescue centre operated by the forest department. unlike the united kingdom, the united states and canada where the black squirrel has attained sizeable populations, there have been no reports of the mutant versions being sighted anywhere else in india. “ we had earlier carried out gene sequencing to establish that the black squirrel is a variant of funambulus palmarum [ indian three - striped palm squirrel ]. that work will have to be repeated to ascertain the mutation responsible for melanisation [ black pigmentation ], ” says dr. oommen. “ our attempt is to understand the basic science behind the colour change, what it is that throws the switch. the project could have far reaching implications for mankind. it would perhaps obviate the need to use bleaching creams for a fair skin or have a sunbath for a tan. ” the sequencing programmes are expected to generate meaningful data in the next two months. the team includes dr. sanal george, rajiv gandhi centre for biotechnology ; dr. dileep kumar, anaswara krishnan and dr. achuth sankar s. nair ; department of computational biology and bioinformatics ; k.


includes dr. sanal george, rajiv gandhi centre for biotechnology ; dr. dileep kumar, anaswara krishnan and dr. achuth sankar s. nair ; department of computational biology and bioinformatics ; k. ramachandran and a. s. vijayasree, department of zoology, university of kerala ; dr. divya, central university, kasaragode ; dr. helen mcrobie, east anglia university, cambridge ; dr. m. a. akbarsha, bharatidasan university ; dr. anil kumar, deputy conservator of forests, puducherry ; and dr. jacob alexander, veterinary surgeon, thiruvananthapuram zoo. this is not the first time dr. oommen and his team have been on the trail of animals exhibiting abnormal colour characteristics. the scientists have already lined up their next project, to carry out gene sequencing of a hen that changes colour. belonging to a small - time farmer near here, the bird has acquired a celebrity status for its ability to change from black to white and back without shedding feathers. “ unlike the squirrel, the switch seems to be active throughout the life of the bird, ” says dr. oommen.


physicians, demographers, and epidemiologists often approach family planning as an issue of comparative risk and effectiveness of various contraceptive methods. but as the statistician christopher tietze ( 1908 — 84 ) wrote in the 1950s, any contraceptive approach succeeds only if it is “ use - effective ” — one which individual women ( and men ) find appropriate for use within their own lives. this idea, of course, has very different connotations in the developed countries of the world, where contraceptives are marketed products, and in developing countries, where they are often made available through government population control programmes. let us consider a few historical instances from the usa in the mid - 20th century that cast some light on the way women responded to using contraceptives. in the late 1950s, tietze, then at the national committee for maternal health ( ncmh ) in new york, was working to improve the scientific legitimacy of contraception, both within us medical practice and for implementation in global population control programmes. with his ally mary calderone at the planned parenthood federation of america, he embarked on a research study to compare diaphragms, planned parenthood ' s medically endorsed method of choice, with what they called “ simple methods ” — spermicidal creams, jellies, and foam products. tietze and calderone suspected that many women found these products, which were widely marketed not only through physicians but also available at pharmacies and even five - and - dime stores, easier to use than the diaphragm, and therefore more “ use - effective ”. calderone lamented at one point that they could not gather data on condoms, also a simple, widely available method, but one that at the time was inaccessible to clinic - based research, since virtually all condoms were purchased by men in retail outlets. planned parenthood ' s 3 - year simple - method study and a concurrent project at the cleveland clinic had similar results. although spermicides seemed to be effective when used consistently, tietze found it impossible to draw significant conclusions, since more than 60 % of the women who took part dropped out of the study within 18 months. although each woman was allowed to choose her own method when enrolled, many would not use it regularly or even adhere to a single method or product for more than a few months ; all failed the use - effectiveness test. tietze noted ruefully that “ consistent use of one method was often not compatible with their pattern of life as evidenced by the frequent comment that they


to a single method or product for more than a few months ; all failed the use - effectiveness test. tietze noted ruefully that “ consistent use of one method was often not compatible with their pattern of life as evidenced by the frequent comment that they liked variety ”. tietze had meanwhile begun working with frederick osborn and the population council on what promised to be a method less subject to user whim : the intrauterine device ( iud ). this inexpensive and apparently effective device, inserted and removed only by physicians, seemed to be an ideal solution for global population control. the cooperative statistical program ( csp ) designed by tietze evaluated five different iuds between 1963 and 1968. the final reports presented data on 31 767 women submitted by 33 researchers at 26 clinical sites. some 45 % of the participants dropped out before the study concluded, some because of personal choice, most for “ medical reasons ” ( other than expulsion ). tietze noted, however, that “ the distinction between medical and personal reasons was not always unequivocal ; doubtful cases were classified as medical. ” in order therefore to assess the contraceptive effectiveness of the iud, tietze developed a formula that assessed the experience of those who persisted, “ the more determined contraceptors ”, while excluding those who had not found the device as use - effective. in 1960, of course, the iud and all earlier methods of contraception were overtaken by the astonishing impact of the pill. tietze, calderone, osborn, and their colleagues had known that enovid ( conovid ), the first oral contraceptive ( a progestin - oestrogen compound ), was in development, but at an ncmh conference in 1958, had agreed that most women would probably not find a medication that altered their physiological cycles acceptable. this was clearly a misconception. the freedom and personal control that the pill put into the hands of women was life - altering for many. as loretta lynn sang in 1975, “ i ' m making up for all those years since i ' ve got the pill. ” oral contraceptives proved not to be an unmixed blessing. in november, 1961, the lancet reported the death from thrombosis of a young woman who was taking the pill ; in less than a year, the us food and drug administration ( fda ) had received reports of six such deaths and 20 other non - fatal cases. popular articles in newspapers and magazines began to ask, “ how safe is the birth


taking the pill ; in less than a year, the us food and drug administration ( fda ) had received reports of six such deaths and 20 other non - fatal cases. popular articles in newspapers and magazines began to ask, “ how safe is the birth control pill? ” several years of uncertainty and controversy followed, culminating in 1967, when martin vessey, richard doll, and their colleagues published their epidemiological findings in the british medical journal. they estimated the pill ' s mortality risk at one in 67 000 for women aged 34 years and younger and one in 25 000 for those aged 35 and older. the american journalist morton mintz, who had broken the thalidomide story in the usa, charged enovid ' s developers, gregory pincus and g d searle and company, with risking the lives of thousands of women, claiming erroneously that the pill had been tested on only 132 experimental subjects before fda approval. the feminist writer barbara seaman ' s better - evidenced, but impassioned, book, the doctors ' case against the pill, fuelled consumer and congressional concern, resulting in a series of hearings chaired by senator gaylord nelson in 1969, and the strengthening of the consumer warnings inserted in each packet of oral contraceptives sold. as elizabeth watkins has described, the debate over the pill and the nelson hearings galvanised feminist health activism in the usa and elsewhere. on the one hand, women still wanted an easy - to - use contraceptive that allowed them to control their own sexuality and reproductive choices ; on the other, some no longer fully trusted the medical profession to make decisions for them and they trusted the pharmaceutical industry even less. features in the popular magazines now shifted emphasis from discussing the risks of the pill to comparing and contrasting various contraceptive methods available and describing the “ lifestyle ” that each would best fit — in other words, assessing their use - effectiveness. as concerns focused on oral contraceptives in this period, the iud seemed to be a safer alternative to many women and physicians. in 1971, however, a h robins company introduced the dalkon shield, a tiny triangle - shaped iud with “ fins ” to prevent its expulsion ; the company claimed that the shield was 98 · 5 % effective in preventing pregnancy. over the next 3 years, some 3 · 7 million women chose to have this device inserted, including many young, single women, whom a h robins specifically targeted in its marketing. but within a year physicians reported cases of severe pelvic inflammatory disease, leading to miscarriage


some 3 · 7 million women chose to have this device inserted, including many young, single women, whom a h robins specifically targeted in its marketing. but within a year physicians reported cases of severe pelvic inflammatory disease, leading to miscarriage, birth defects, infertility, and even death. a h robins suspended sales in 1974 and stopped manufacture in 1976, with about 400 000 lawsuits in progress ; the company was forced into bankruptcy in 1986. the subsequent histories of oral contraceptives and the iud are telling. manufacturers of both types of product have undertaken extensive research and redesign efforts to address the identified risks and improve the safety profiles ; the current formulations on the market are relatively low - risk and well - publicised so that both physicians and consumers are able to make informed choices. many medical experts consider the newer iuds safer for long - term use than oral contraceptives. but while women have continued to find oral contraceptives use effective, in the usa at least iuds never seem to have fully regained the confidence of women after the 1970s. indeed, iuds became less available in the usa during the 1980s and 1990s, as manufacturers found the market too limited to invest their time and effort ; only two devices, the copper - t paragard and hormonal mirena, are currently available. in most parts of europe iuds are used by a higher proportion of women than in the usa, although they are still less popular than oral contraceptives. by contrast, in many asian and african countries, where it has often been endorsed by government programmes, iud use predominates. in 1990, the population council tried again with norplant, an implantable device that slowly released progesterone over 5 years, a method designed to combine the best features of the pill and the iud ; but women in developed countries disliked the erratic menstrual cycles they experienced with it. norplant disappeared from the us and uk markets by around 2000 and other new implant and injectable products have so far had only limited impact on patterns of use. watkins has explored the remarketing of the oral contraceptive as a “ lifestyle ” drug, one that may also relieve premenstrual mood changes, treat acne, and regulate menstruation. but popular writers have discussed the appropriate contraceptive for a given lifestyle since at least the 1970s. the ultimate message of much of this popular literature in western countries is that women who take the pill are characterised as young,


high - fructose corn syrup linked to type 2 diabetes high - fructose corn syrup ( hfcs ) in national food supplies around the world might help explain the rising rates of type 2 diabetes around the world, researchers at the university of southern california and the university of oxford report in the journal global public health. after studying 42 countries, researchers found that those that use hfcs in their food supply had a 20 percent higher prevalence of diabetes than those that did not use hfcs, suggesting an association with diabetes independent of total sugar intake and obesity levels. “ hfcs appears to pose a serious public health problem on a global scale, ” said principal study author michael i. goran, md, professor of preventive medicine, director of the childhood obesity research center, and co - director of the diabetes and obesity research institute at the keck school of medicine at usc in a release. “ the study adds to a growing body of scientific literature that indicates hfcs consumption may result in negative health consequences distinct from and more deleterious than natural sugar. ” not surprisingly, the united states topped the list with the most per - capita consumption of hfcs - 55 pounds per person, per year. the second highest was hungary, with an annual rate of 46 pounds per person per year. canada, slovakia bulgaria, belgium, argentina, korea, japan, and mexico also had high rates while germany, poland, greece, portugal, egypt, finland, and serbia were found to be among the lowest hfcs consumers. countries on the high end of the hfcs scale had an average type 2 diabetes rate of 8 percent, compared to 6. 7 percent in countries not using hfcs. researchers believe this link is driven by higher amounts of fructose in foods made with hfcs than in foods made with regular table sugar or glucose. some evidence suggests that the body metabolizes fructose differently from glucose, researchers say in the article, though this runs contrary to the positions of the american medical association and the academy of nutrition and dietetics, among other groups. the ama says hfcs is no worse for the body than glucose - containing table sugar - a claim that ’ s hard for some consumers to believe, as hfcs has been vilified for decades because of its suspected role in weight gain and metabolic syndrome. regardless, the take - home message is that consumers need to reduce the amount of all forms of sugar and sweeteners in their diets, says joan salge


vilified for decades because of its suspected role in weight gain and metabolic syndrome. regardless, the take - home message is that consumers need to reduce the amount of all forms of sugar and sweeteners in their diets, says joan salge blake, ms, rd, ldn, a spokesperson for the academy of nutrition and dietetics. “ honey, high - fructose corn syrup, corn syrup, sucrose, molasses - these are all sources of added sugars that we need to reduce in our diet, ” she says. “ sixty - five percent of americans are overweight, and getting rid of foods like these that are just empty calories can potentially help manage weight. ” for more diabetes news and information, follow @ diabetesfacts on twitter from the editors of @ everydayhealth. reprinted with permission from everydayhealth. com see wrong or incorrect information in a story. tell us here location, st | website. com national life videos - mob underboss says jimmy hoffa was " buried alive " at dig site in oakland township ( 2807 ) - attorney believes fbi shifting media location a good sign in search for jimmy hoffa ( 1839 ) - police blotter june 18 : apparent suicide committed at home ; woman dies of drug overdose ( 1414 ) - tucker cipriano pleads no contest to first - degree murder, will spend life in prison ( 1232 ) - car rams into pontiac building to avoid accident with video ( 1170 ) - residents concerned about independence township crosswalk they believe is dangerous ; road commission defends system ( 1032 ) - hoffa mystery wrapped up in detroit mafia lore ( 1025 ) - new backcourt leads lathrup over dragons ( 19 ) - mob underboss says jimmy hoffa was " buried alive " at dig site in oakland township ( 10 ) - ‘ anyone can be a father, but few are truly dads ’ ; oakland press readers honor their dads this father ’ s day ( 6 ) - macomb coroner accused of running ‘ tyrannical ’ regime at morgue ( 5 ) - appeal filed to split up former pistons owner bill davidson ' s charitable foundation ( 5 ) - oxford school district sends letter, names parent accused of spreading rumors about elementary school principal with letter ( 3 ) recent activity on facebook caren gittleman likes talking cats. she ' ll discuss everything about them, from acquiring a cat, differences in breeds, behaviors, health concerns, inside versus outside lifestyles, toys, food,


boffins simulate plasma - eating dusty ' life - forms ' dust to dust, etc physicists have discovered that charged particles of dust can form themselves into life - like structures that appear to be capable of reproducing and passing information along, behaviour reminiscent of life on earth. the researchers, ( led by v n tsytovich of the general physics institute, russian academy of science, in moscow, along with boffins from the max - planck institute for extraterrestrial physics in germany, and the university of sydney ) have developed a computer model to help them understand " the behaviour of complex mixtures of inorganic materials in a plasma ". although convention dictates that there would be very little organisation in a system of such particles, the researchers demonstrated that under the right conditions, order could emerge. as the plasma becomes polarised, the model shows microscopic strands of particles twisting into helical, or corkscrew structures. the simulation suggests that the dusty corkscrews have two stable configurations - a large spiral and a small spiral. each helix could contain various sequences of these two states, the researchers say, which raises the possibility that they could store information. the team reports that the structures can divide, form copies ( transmit their stored information information ), interact with neighbouring spirals, and even induce changes in other spirals. more speculatively, they suggest these changes could evolve as less stable structures break down. so, are there corkscrew - shaped dust - aliens floating about in interstellar space? gregor morfill of the max planck institute for extraterrestrial physics in germany is not prepared to go quite that far. he told new scientist : " it has a lot of the hallmarks for how we define life at present, but we have not simulated life. to us, they ' re just a special form of plasma crystal. " however, tsytovich is prepared to be a bit more flexible on his definition of what might constitute life, saying that the spirals " exhibit all the necessary properties to qualify them as candidates for inorganic living matter. they are autonomous, they reproduce, and they evolve ". the next step is to go hunting for a real environment where such structures could have emerged. morfill suggests that planetary rings would be the best place to start the search. the research is reported in the 14 august edition of the new journal of physics, and new scientist has a more extensive write up here. ® 2 : 7 and the lord god formed man of the dust of the ground,


is there a safe level of lead in children ’ s toys? perhaps not. recent studies suggest that the current standard for blood lead levels of 10 micrograms per deciliter of blood is too high. the cdc and the epa have both issue statements that no level of lead in the blood is safe, although the standard has not yet been lowered. dr. bruce lanphear, professor of pediatrics at cincinnati children ’ s hospital medical center said in an interview reported in the baltimore sun that a study he published last year showed that children older than 4 with lead levels as low as 2 micrograms per deciliter had a four fold risk of having attention - deficit hyperactivity disorder as compared to children older than 4 with lead levels less than 1 microgram per deciliter. other studies have shown similar results. for example, one study reported in the new england journal of medicine showed a significant drop in iq at levels below 10 ug / dl. blood lead levels correspond with the levels of lead in the individual ’ s environment. if no blood lead level is safe, then lead should be eliminated as much as possible from all sources. lead in children ’ s toys isn ’ t the only source of lead. lead in our houses is probably the biggest source of exposure. the u. s. department of housing and urban development estimates that 25 % of our nation ’ s housing contains significant lead based paint hazards. what is alarming is that the us didn ’ t regulate lead in paint until 1978 but the hazards of lead in paint were known much earlier. in 1904, j. lockhart gibson was one of the first english - speaking authors to link directly lead based paint to childhood lead poisoning. in 1905, he wrote, “ the use of lead paint within the reach of children should be prohibited by law. ” others made similar links in published literature, including 2 americans in 1914. kenneth blackfan and henry thomas reported a boy who died of lead poisoning after ingesting leaded paint on his crib railing. with this information, other countries banned or restricted lead in residential paints beginning in 1909 with france, belgium and austria to great britain, sweden and belgium in 1926, among many others. the us didn ’ t act, even in the face of mounting evidence, because of the strength of lobbying by the lead paint industry. in fact, the lead paint industry ’ s advertising in the first half of the 20th century aggressively promoted lead paint for interior use, and focused on children. some of the advertising pictures are just frightening –


| [ excerpt from the science of yoga, page 280 ] in yoga, the spinal column is referred to as brahma danda, which literally means " the walking stick of god. " this should give us an indication of the importance that the ancients attributed to this region of the body. spinal health is of paramount importance in yoga. the spine is seen as a vehicle through which the power of the universe may manifest in the human form. as well, it is through sushumna nadi, the central channel within the spinal column that the mysterious and powerful kundalini force raises from its dormant state at the base of the spine to the brahmarandhra, or psychic aperture at the crown of the head. it is the vertical nature of the human spine which aligns the mechanism of our central nervous system with the vertical energy flows of the universe and gives superior intelligence to the human beings. thus, in meditation it is of the utmost importance that one ' s spine be vertical and straight. as we have touched upon in an earlier lesson, it was precisely to enable the yogi to sit comfortably with a tall and straight spine that the asanas were primarily concerned with. even so today, the recurring theme throughout much of our hatha yoga practice revolves around the health, strength and flexibility of the spine. one cannot have good health without a healthy spine. note : this yoga article is an excerpt from the science of yoga, an online yoga training program with streaming yoga videos and 600 pages of step - by - step yoga instruction. " the science of yoga is a course worthy of leather binding and an honored place in the finest libraries in the world... it is indeed a masterful work. " dr. john michael christian learn more about the science of yoga course


moon light world map the map below shows where the moon is visible from the earth, depending on weather conditions and moon phases. the white dot symbolizes the position of the moon, and the yellow sun symbolizes the position of the sun. view day and night map - the bright part of the map shows where the moon is over the horizon on sunday, november 18, 2012 at 05 : 20 : 00 utc. - the sun ' s position is marked with this symbol :. at this location, the sun will be at its zenith ( directly overhead ) in relation to an observer. - the moon ' s position is marked with this symbol :. at this location, the moon will be at its zenith in relation to an observer. note that the symbol is not showing the current phase of the moon. fraction of moon illuminated : 25 % position of the moon on sunday, november 18, 2012 at 05 : 20 : 00 utc the moon is at its zenith at these coordinates : | latitude : | | 16° 26 ' | | south | | longitude : | | 159° 08 ' | | east | the ground speed of the movement is currently 428. 40 meters / second, 1542. 3 km / hour, 958. 3 miles / hour or 832. 7 knots. the table below shows the moon position compared to the time and date above : | time | | longitude difference | | latitude difference | | total | | 1 minute | | 0° 14 ' 26. 3 " | | 15. 97 mi | | west | | 0° 00 ' 08. 0 " | | 0. 15 mi | | north | | 15. 97 mi | | 1 hour | | 14° 26 ' 27. 2 " | | 958. 18 mi | | west | | 0° 08 ' 06. 3 " | | 9. 29 mi | | north | | 958. 56 mi | | 24 hours | | 12° 58 ' 45. 2 " | | 861. 23 mi | | east | | 3° 36 ' 39. 6 " | | 248. 28 mi | | north | | 903. 41 mi | locations with the moon near zenith the following table shows 10 locations with moon near zenith position in the sky. | honiara | | sun 4 : 20 pm | | 780 km | | 485 miles | | 421 nm | | n | | luganville | | sun 4 : 20 pm | | 867 km | | 539 miles | | 468 nm


| | sun 4 : 20 pm | | 780 km | | 485 miles | | 421 nm | | n | | luganville | | sun 4 : 20 pm | | 867 km | | 539 miles | | 468 nm | | e | | port vila | | sun 4 : 20 pm | | 988 km | | 614 miles | | 534 nm | | e | | noumea | | sun 4 : 20 pm | | 1004 km | | 624 miles | | 542 nm | | se | | brisbane | | sun 3 : 20 pm | | 1374 km | | 854 miles | | 742 nm | | ssw | | cairns | | sun 3 : 20 pm | | 1425 km | | 885 miles | | 769 nm | | w | | port moresby | | sun 3 : 20 pm | | 1508 km | | 937 miles | | 814 nm | | wnw | | yaren | | sun 5 : 20 pm | | 1956 km | | 1215 miles | | 1056 nm | | nne | | suva * | | sun 6 : 20 pm | | 2059 km | | 1280 miles | | 1112 nm | | e | | sydney * | | sun 4 : 20 pm | | 2087 km | | 1297 miles | | 1127 nm | | ssw | related time zone tools


chlorine manufacturers that still use a 19th - century technology have been largely overlooked in the national debate over whether the bush administration has become aggressive enough in combating mercury emissions, an international group said yesterday. oceana, a group formed three years ago to track worldwide efforts to protect the seas, said chlorine plants that don ' t use a more modern mercury - free technology spew twice the mercury of some coal - fired power plants and should share some blame for fish consumption advisories in the great lakes as well as advisories against eating too much tuna from oceans. there are far more power plants, though. the u. s. environmental protection agency estimates that power plants are responsible for about two - thirds of america ' s airborne mercury, a dangerous toxin that can cause problems with brain and nervous - system development among children. while oceana agrees the primary focus should be on power plants, it said chlorine makers should not be given a free pass if they have not converted to a mercury - free technology. ninety percent of the chlorine made in the united states is manufactured with the cleaner process. the other 10 percent is made by nine manufacturers that haven ' t embraced it, including ashta chemicals inc. of ashtabula, ohio, the group said. ashta is ohio ' s single - largest source of mercury emissions and the nation ' s fifth - largest mercury emitter. ohio, which has more coal - fired power plants than most states, is second only to texas in mercury emissions, u. s. epa records show. an ashta spokesman was not available yesterday. but zoe lipman of the national wildlife federation, a group often critical of state and federal regulators, praised the ohio environmental protection agency for negotiating improvements at ashta. in september, the agency announced a $ 1. 54 million settlement that will prevent the release of 1, 320 pounds of mercury annually from ashta. although not mercury - free technology, the improvements will be " an important step forward, " ms. lipman said. also yesterday, several groups claimed 12 of ohio ' s 21 largest power plants increased annual emissions of sulfur dioxide between 1995 and 2004 and eight of them increased their annual emissions of smog - forming nitrogen oxide during that period. but jack shaner, an ohio environmental council spokesman, noted that firstenergy corp. ' s coal - fired bay shore power plant in oregon posted reductions. contact tom henry at :


before... the parasitic infection toxoplasmosis is perhaps a pregnant catkeeper ' s greatest fear. it can result in miscarriage, stillbirth or such birth defects as blindness, deafness, hydrocephalus or epilepsy. since cats can become infected with the parasite by eating small mammals or birds, it is best to keep your cat indoors. now is not a good time to befriend strays, as they may already be infected. toxoplasmosis cysts are shed in the feces of infected animals. since cats often use gardens as litter boxes, wear gloves when gardening and when you are washing raw vegetables and fruits, handling raw meat or scrubbing food prep surfaces. you should also avoid rubbing your eyes until your hands have been washed. and do not eat or feed your cat raw or undercooked meat. to prevent any cysts that are passed in the feces from becoming infectious, scoop fecal matter at least twice a day. better yet, use your " delicate condition " to get your mate to handle the dirt detail. some cats resemble little old maids who cannot tolerate change. these are the cats most likely to be affected by a new baby, so use the entire pregnancy to slowly prepare them. play tapes of baby noises to acclimate your cat to the new sounds he ' s about to hear, or rub baby lotion on your hands before engaging in a pleasant activity with him to create positive associations with baby odors. set up nursery furniture as soon as possible, and allow him several weeks to investigate before you select surfaces to declare off limits — such as the changing table and crib — so that he can see there ' s nothing scary here. however, don ' t make it so comfortable that he ' ll want to nap on them. then, at least one month before the baby arrives, make the surfaces unwelcoming. cut sheets of cardboard to the size of the furniture surfaces and cover one side with double - sided adhesive / masking tape. cats tend to avoid sticky surfaces, and by the end of the month, he should steer clear of these sites. if the litter box has been kept in the soon - to - be nursery, begin several months ahead of time to move it a few inches a day to its new location. if the transition is made too quickly, your cat may return to soil in his old spot. covering that area with a solid object like a diaper pail or dresser may deter him. finally


it a few inches a day to its new location. if the transition is made too quickly, your cat may return to soil in his old spot. covering that area with a solid object like a diaper pail or dresser may deter him. finally, any cat care routines that will be shifted from new mother to mate after the baby arrives should actually be switched one to two months before the birth. these might include feedings, grooming, play sessions and sleep partners / locations. if these were always shared activities, the change will make little difference to the cat. if not, the cat will need time to adjust to the style and skills of the new caregiver.... and after birth when you first arrive home from the hospital, peacefully greet your cat in a quiet room without interruption. once you ' ve had a few minutes to reconnect, let in everyone else — mate, baby, grandparents, baby nurse and assorted well - wishers. unless your cat is extremely social, he will flee the hoopla and go into hiding. once things settle down, he will come tiptoeing back. place a used receiving blanket or piece of infantwear in a quiet area where the cat can investigate it. when nursing, allow the cat to approach and check things out. if he follows you into the nursery at naptime, make sure he doesn ' t jump into the crib. while there ' s certainly no truth to the myth that cats suck the air out of babies ' lungs, a newborn does not have the capacity to turn over or even move her head at first. a heat - seeking cat who chooses to cuddle up close to the baby ' s face could make it difficult for the child to breathe. close the door to the nursery when the baby is napping. if there is no door to close, either install a temporary screen door or hang mosquito netting over the crib to keep the cat out. these precautions also prevent the cat from urinating in the crib, something he may try if extremely stressed. with the baby safely at rest, now ' s the perfect time to grab a catnap with your favorite feline. jacque lynn schultz, cpdt aspca companion animal programs advisor national shelter outreach


babatunde osotimehin is united nations under - secretary - general and executive director of the united nations population fund. co - author sharon camp, is president and ceo of the guttmacher institute. the opinions expressed are their own. on july 11, at the london summit on family planning, leaders from 18 african countries made unprecedented commitments — financially and politically — to strengthen their family planning programs. the summit, sponsored by the british government and the bill and melinda gates foundation, with support from the united nations population fund ( unfpa ), focused attention on the ongoing lack of family planning services for millions of women in the developing world and garnered extraordinary global support and resources to enable 120 million more women to use contraceptives by 2020. the summit exceeded its target, raising pledges of $ 4. 6 billion over eight years. the call to action came not a moment too soon. in sub - saharan africa alone, approximately 53 million women have an unmet need for modern contraceptives, meaning they want to avoid pregnancy but are not using a modern method. a new study by the guttmacher institute and unfpa shows there has been minimal progress in addressing the contraceptive needs of african women during the past four years. what ’ s worse, in the 39 poorest countries in the region, the number of women with an unmet need has actually increased since 2008. among all sexually active women of reproductive age in sub - saharan africa, 42 percent want to avoid pregnancy but only 17 percent are using a modern contraceptive. across the continent, progress in meeting the demand for contraceptive services has been uneven. the situation of married women — who represent the bulk of women with contraceptive needs — is telling. between 2008 and 2012, the proportion of married women using modern contraceptives increased from 20 percent to 27 percent in east africa and from 54 percent to 58 percent in southern africa. however, in west africa and central africa, there was no progress during that time, and contraceptive use among married women remains low at 9 percent and 7 percent, respectively. not being able to plan their pregnancies can have devastating consequences for women. in 2012, more than 160, 000 are expected to die in sub - saharan africa from pregnancy - related causes — 62, 000 of them did not want to be pregnant in the first place, a sobering statistic. the benefits of improving and expanding family planning programs in sub - saharan africa would be dramatic : there would be 14 million fewer unintended pregnancies ; maternal


them did not want to be pregnant in the first place, a sobering statistic. the benefits of improving and expanding family planning programs in sub - saharan africa would be dramatic : there would be 14 million fewer unintended pregnancies ; maternal deaths would decline by 29 percent, saving the lives of 48, 000 women ; and infant deaths would drop by 555, 000 annually. plus, if women spaced their births by three years, which many would like to do, deaths among children aged five and under would drop significantly. so, what will it take to make these dramatic gains a reality? currently, approximately $ 381 million is spent each year on contraceptive care in sub - saharan africa. expanding coverage to all women who want to use family planning but lack access to contraceptive services would require an increase of $ 2. 3 billion. this sounds like a lot, but this investment is modest in relation to the remarkable returns it would achieve. what ’ s more, it would actually lower total health - related costs. every dollar invested in family planning services in sub - saharan africa saves $ 1. 30 on maternal and newborn health care — money that could be invested in other critical areas. in addition to improving public health, satisfying unmet need for modern contraceptives would bring a host of other benefits. enabling women to control their fertility and time their births means better chances for higher educational attainment, increased employment opportunities, and enhanced social and economic status. family savings and investment would rise, spurring economic growth and reducing poverty. these advances at the family level would in turn make social and economic development goals easier to achieve, benefiting society as a whole. evidence from ethiopia, malawi and rwanda shows that, with strong government commitment, significant gains can quickly be made in meeting women ’ s contraceptive needs. in rwanda, contraceptive use among married women increased from 9 percent in 2005 to 44 percent in 2010, a truly impressive achievement. if the commitments made at the london summit are realized, and similar ones follow, this kind of progress could potentially become the norm, not the exception. now it is up to all of africa ’ s leaders and the international community to do their part through a sustained commitment to improving the provision of contraceptive services. not only do women want to time and space their pregnancies to achieve healthier outcomes and better lives for themselves and their families, it is their human right to do so.


toadsuck, texas. toadsuck, originally called toadsuck saloon, later became part of collinsville in western grayson county. settlers arrived in the area in the late 1850s, and in 1869 a townsite was surveyed near toadsuck saloon, then located a half mile southeast of what is now the site of collinsville. the town of toadsuck took the name of the saloon. it may have been named by john jones, an early settler and mill owner, after the city of toadsuck, arkansas. according to legend, the name was originally a reference to men consuming liquor until they swelled up like toads. however, the word " suck " was also commonly used in the region as a term for a whirlpool in a river. hence, the town name may have simply meant " toad whirlpool. " in 1869 william ( alfalfa bill ) henry david murrayqv, who later became a notable oklahoma governor, was born in toadsuck. the texas and pacific line was built within three quarters of a mile of toadsuck in 1880, and by 1887 most of its businesses and residents had moved to the tracks. the railroad town was named collinsville when it was incorporated in the 1890s. ancestors and descendants : grayson county, texas ( sherman, texas : grayson county genealogical society, 1980 ). frank x. tolbert, " tolbert ' s texas " scrapbook, dolph briscoe center for american history, university of texas at austin. the following, adapted from the chicago manual of style, 15th edition, is the preferred citation for this article. lisa c. maxwell, " toadsuck, tx, " handbook of texas online ( http : / / www. tshaonline. org / handbook / online / articles / hvt74 ), accessed june 16, 2013. published by the texas state historical association.


united nations — funding for and attention to family planning has been declining for the past decade. at the same time, 200 million women still lack access to contraception, the largest youth generation ever is coming into its prime reproductive years and the women in poorest and least developed countries have the highest unmet need for family planning. that was the background for a meeting of technical experts convened this week by unfpa to discuss continuing inequities in family planning. it was one of three consultations organized to mark the 15th anniversary of the international conference on population and development and to identify remaining challenges and new directions for implementing its bold vision. while the opening session, “ the unfinished agenda, ” addressed ongoing hurdles to wider access to contraception, several of the key participants affirmed that in spite of the current financial crisis, this can be a time to re - energize the role of voluntary family planning in development. exercising the right to plan their pregnancies, a cornerstone of the icpd agenda, can be especially crucial to women who are young, impoverished or living far from health services that could ensure a safe delivery. yet these are the very people who disproportionately lack access to contraception, according to nuriye ortayli, a unfpa technical adviser. presenting data collected from demographic and health surveys, dr. ortayli demonstrated that while there has been a gradual leveling off of inequities in many middle - income countries, disparities remains high in much of sub - saharan africa, where more than 60 per cent of women who would like to avoid pregnancy lack access to appropriate means of contraception. “ unmet need for contraception is increasing fast in least developed countries, ” she said. stan bernstein, also of unfpa, described some of the reasons that family planning has fallen behind on the international agenda. in part, he said, family planning has been a victim of its early success in the 1990s. “ with so much early progress, it was thought that nothing new was needed, that the problem had been solved, ” he said. moreover, family planning was considered within the broader issue of reproductive health, and both, were downplayed in the initial framework for the millennium development goals, he noted. further, placing family planning solely in the context of health meant that it received “ a portion of a portion that is too small, ” he said. recent un estimates show that meeting icpd commitments for family planning will require $ 2 billion annually from donor


gonococcal infections, including urethritis, cervicitis, epididymitis, and proctitis, are a significant cause of morbidity among sexually active men and women. the treatment of these sexually transmitted infections ( stis ) has evolved over the years, mainly due to the emergence of antibiotic resistance. urogenital, anogenital, pharyngeal, and ocular gonococcal infections that are not associated with bacteremic or ascending spread of the pathogen to other organs are considered uncomplicated. this topic will address the treatment of these gonococcal infections, with a focus on urogenital infections. in 2012, the united states centers for disease control and prevention updated their guidelines on the treatment of neisseria gonorrhoeae. the information in this topic is largely consistent with those guidelines, as well as the 2010 sexually transmitted disease ( std ) treatment guidelines. the clinical manifestations and diagnosis of gonorrhea are discussed elsewhere. the treatment of complicated infections, such as disseminated gonococcal infection and pelvic inflammatory disease, is found elsewhere. ( see " epidemiology, pathogenesis, and clinical manifestations of neisseria gonorrhoeae infection " and " cutaneous manifestations of gonorrhea " and " diagnosis of gonococcal infections " and " disseminated gonococcal infection " and " treatment of pelvic inflammatory disease ", section on ' recommended regimens '. ) therapeutic principles — it is desirable for a therapeutic gonococcal regimen to : - be highly effective at all anatomic sites of infection - be well tolerated ( particularly in patients with recurrent infections ) - offer the feasibility of single - dose therapy at the point of care


the man without a face the unlikely rise of vladimir putin a chilling and unflinching portrait of one of the most fearsome figures in world politics. his early life has the ring of legend about it — the legend of a postwar thug. it starts in leningrad in 1952, just eight years after the end of the siege of leningrad. his parents, maria and vladimir putin, had survived the siege in the city. the elder vladimir putin had joined the army in the early days of the soviet - german war and had been wounded seriously in battle. these were the future president ’ s parents : a disabled man and a woman who had come very close to dying from starvation and who had lost her children ( a second son died in infancy several years before the war ). but by the measure of the postwar soviet union, the putins were lucky : they had each other. to have lived not only through the war but through the siege, and to still have your spouse — and your home — was, essentially, a miracle. because vladimir putin was catapulted to power from obscurity, and because he spent his entire adult life within the confines of a secret and secretive institution, he has been able to exercise greater control over what is known about him than almost any other modern politician — certainly more than any modern western politician. he has created his own - mythology of a child of post - siege leningrad, a mean, hungry, impoverished place that bred mean, hungry, ferocious children. one enters the building in which putin grew up through the courtyard. chunks of the handrail were missing, and the rest of the construction wobbled wildly. the putins lived on the top floor of the five - story building, and the journey up the dark stairs could be risky. three families shared a single gas stove and a sink stationed in the narrow hallway. the putins had the largest room in the shared apartment : around 20 square meters, or roughly 12 feet by 15 feet. by the standards of the time, this was an almost palatial abode. more incredibly, the putins also had a television set, a telephone, and a dacha ( a small house outside the city ). the elder vladimir putin worked as a skilled laborer at a train - car factory ; maria took backbreaking unskilled jobs ( night watchman, cleaning woman, loader ) that allowed her to spend time with her son. against the fine shades of postwar soviet poverty, the putins emerge as practically rich. education was not part of


backbreaking unskilled jobs ( night watchman, cleaning woman, loader ) that allowed her to spend time with her son. against the fine shades of postwar soviet poverty, the putins emerge as practically rich. education was not part of the younger putin ’ s idea of success ; he has placed a great emphasis on portraying himself as a thug, and in this he has had the cooperation of his childhood friends. by far the largest amount of authorized biographical information available about him concerns the many fistfights of his childhood and youth. putin, younger than the thugs he encountered and slight of build, apparently tried to hold his own with them. “ if anyone ever insulted him in any way, ” a friend recalled, “ volodya would immediately jump on the guy, scratch him, bite him, rip his hair out by the clump — do anything at all never to allow anyone to humiliate him in any way. ” putin ’ s friends recount a series of fighting stories, the same plot repeating itself year after year. “ we were in eighth grade when we were standing at a tram stop, waiting, ” recounted another friend. “ a tram pulled up, but it was not going where we needed to go. two huge drunken men got off and started trying to pick a fight with somebody. they were cursing and pushing people around. vovka calmly handed his bag over to me, and then i saw that he had just sent one of the men flying into a snowbank, face first. the second one turned around and started at volodya, screaming, ‘ what was that? ’ a couple of seconds later he knew exactly what it was, because he was lying there next to his buddy. that was just when our tram pulled up. if there is anything i can say about vovka, it ’ s that he never let bastards and rascals who insult people and bug them get away with it. ” at the age of 10 or 11, putin went looking for a place where he could learn skills to supplement his sheer will to fight. boxing proved too painful : he had his nose broken during one of his first training sessions. then he found sambo. sambo, an acronym for a russian phrase that translates as “ self - defense without weapons, ” is a soviet martial art, a hodgepodge of judo, karate, and folk wrestling moves. with its discipline, sambo became part of putin ’ s transformation from a grade - school thug into a goal - directed and hardworking


weapons, ” is a soviet martial art, a hodgepodge of judo, karate, and folk wrestling moves. with its discipline, sambo became part of putin ’ s transformation from a grade - school thug into a goal - directed and hardworking adolescent. it was also linked to what had become an overriding ambition : putin had apparently heard that the kgb expected new recruits to be skilled in hand - to - hand combat. “ imagine a boy who dreams of being a kgb officer when everyone else wants to be a cosmonaut, ” the journalist natalia gevorkyan said to me, trying to explain how odd putin ’ s passion seemed to her. i did not find it quite so farfetched : in the 1960s, soviet cultural authorities invested heavily in creating a romantic, even glamorous image of the secret police. when putin was 12, a novel called the shield and the sword became a bestseller. its protagonist was a soviet intelligence officer working in germany. when putin was 15, the novel was made into a wildly popular miniseries. forty - three years later, as prime minister, he would meet with 11 russian spies deported from the united states — and together, in a show of camaraderie and nostalgia, they would sing the theme song from the miniseries. “ when i was in ninth grade, i was influenced by films and books, and i developed a desire to work for the kgb, ” putin told a biographer. “ there is nothing special about that. ” the protestation raises the question : is there another explanation for putin ’ s single - minded passion? it seems there is, and putin has hidden it in plain sight, as the best spies do. we all want our children to grow up to be more successful versions of ourselves. vladimir putin was born to be a soviet spy. during world war ii, the elder putin had been assigned to troops who worked with the nkvd, as the soviet secret police was then called. the legend of his father ’ s daring escape from behind german lines with which the younger putin grew up is as likely to have been true as any other tale of miraculous survival and spontaneous heroism. it is not clear whether the elder putin had worked for the secret police before the war or continued to work for the nkvd afterward. it seems likely that he remained part of the so - called active reserve, a giant group of secret - police officers who held regular jobs while also informing for — and drawing a salary from — the kgb. this may explain why the putins lived so comparatively well


likely that he remained part of the so - called active reserve, a giant group of secret - police officers who held regular jobs while also informing for — and drawing a salary from — the kgb. this may explain why the putins lived so comparatively well : the dacha, the television set, and the telephone — especially the telephone. at the suggestion of a kgb recruiter, putin went to university, where he seems to have chiefly kept to himself. he kept his grades up and spent his free time training in judo ( his coach and teammates had traded in sambo for an olympic martial art ) and driving around in his car. putin was, more than likely, the only student at leningrad university who owned his own car. in the early 1970s a car in the soviet union was a rarity : it cost roughly as much as a dacha. the putins won the car, a late - model two - door with a motorcycle engine, in a lottery, and rather than take the money — which would have been enough to get them out of the communal apartment and into a separate flat in a newly constructed building — gave the car to their son. that they gave the younger putin this lavish gift, and that he accepted it, are further examples of the putins ’ extraordinarily doting relationship with their son, and perhaps of their incongruous riches. whatever the reason, putin ’ s relationship to money — extravagant and strikingly selfish for his social - context — - appears to have taken shape during his university years. soon after university putin achieved his dream of entering the kgb, and he seems to have made no secret of his work for it. he told the cellist sergei roldugin, who would become his best friend, almost as soon as the two met. roldugin, who had traveled abroad with his orchestra and had seen kgb handlers at work, says he was apprehensive and curious at once. “ once, i tried to get him to talk about some operation that had gone down, and i failed, ” he told putin ’ s official biographers. “ another time i said to him, ‘ i am a cellist, and that means i play the cello. i ’ ll never be a surgeon. what ’ s your job? i mean, i know you are an intelligence officer. but what does that mean? who are you? what can you do? ’ and he said, ‘ i am an expert in human relations. ’ that was the end of the conversation


job? i mean, i know you are an intelligence officer. but what does that mean? who are you? what can you do? ’ and he said, ‘ i am an expert in human relations. ’ that was the end of the conversation. he really thought he knew something about people... ” putin ’ s own descriptions of his romances paint him as a strikingly inept communicator. he had one significant relationship with a woman before meeting his future wife ; he left her at the altar. “ that ’ s how it happened, ” he told his biographers, explaining nothing. “ it was really hard. ” he was no more articulate on the subject of the woman he actually married — nor, it seems, was he successful at communicating his feelings to her during their courtship. they dated for more than three years — an extraordinarily long time by soviet or russian standards, and at a very advanced age : putin was almost 31 when they married. mrs. putin has gone on record saying it was by no means love at first sight, for at first sight putin seemed unremarkable and poorly dressed ; he has never said anything publicly about his love for her. her description of the day he finally proposed paints a picture of a profound failure to communicate. “ one evening we were sitting in his apartment, and he says, ‘ little friend, by now you know what i ’ m like. i am basically not a very convenient person. ’ and then he went on to describe himself : not a talker, can be pretty harsh, can hurt your feelings, and so on. not a good person to spend your life with. and he goes on. ‘ over the course of three and a half years you ’ ve probably made up your mind. ’ i realized we were probably breaking up. so i said, ‘ well, yes, i ’ ve made up my mind. ’ and he said, with doubt in his voice, ‘ really? ’ that ’ s when i knew we were definitely breaking up. ‘ in that case, ’ he said, ‘ i love you and i propose we get married on such and such a day. ’ and that was completely unexpected. ” they were married three months later. ludmila moved to leningrad to live with putin in the two rooms he shared with his parents. in the middle to late 1970s, when putin joined the kgb, it, like all soviet institutions, was undergoing a phase of extreme bloating. its growing number of directorate


leningrad to live with putin in the two rooms he shared with his parents. in the middle to late 1970s, when putin joined the kgb, it, like all soviet institutions, was undergoing a phase of extreme bloating. its growing number of directorates and departments were producing mountains of information that had no clear purpose, application, or meaning. an entire army of men and a few women spent their lives com - piling newspaper clippings, transcripts of tapped telephone conversations, reports of people followed and trivia learned. the internal ideology of the kgb, as of any police organization, rested on a clear concept of the enemy. but putin entered the service not only in the post - stalin era but also during one of the few brief periods of peace in soviet history. the only active enemies were the dissidents, a handful of brave souls who drew a disproportionate amount of kgb force. putin claims not to have taken part in anti - dissident work but has shown in interviews that he was thoroughly familiar with the way it was organized, probably because he was part of the group fighting the dissidents, as a former comrade ’ s memoir claimed. his break came in 1984, when he was sent to spy school in moscow. barring an unexpected disaster, putin knew that afterward he would be assigned to work in germany, but he was disappointed that it was to dresden. at the age of 33, putin, with ludmila — who was pregnant — and their 1 - year - old daughter, maria, traveled to his backwater assignment. this was the job for which he had worked and waited for 20 years, and he would not even be undercover. the putins, like five other russian families, were given an apartment in a large apartment block in a little stasi world : secret - police staff lived here, worked in a building a five - minute walk away, and sent their children to nursery school in the same compound. their job was to collect information about “ the enemy, ” which was the west, meaning west germany and, especially, united states military bases in west germany, which were hardly more accessible from dresden than they would have been from leningrad. putin and his colleagues were reduced mainly to collecting press clippings, thus contributing to the growing mountains of useless information produced by the kgb. the putins had a second daughter and named her ekaterina. putin drank beer and got fat. he stopped training, or exercising at all, and he gained more than 20 pounds — a