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Hyperfunctioning nodules of the thyroid are thought to only rarely harbor thyroid cancer, and thus are infrequently biopsied. Here, we present the case of a patient with a hyperfunctioning thyroid nodule harboring thyroid carcinoma and, using MEDLINE literature searches, set out to determine the prevalence of and characteristics of malignant “hot” nodules as a group. Historical, biochemical and radiologic characteristics of the case subjects and their nodules were compared to those in cases of benign hyperfunctioning nodules. A literature review of surgical patients with solitary hyperfunctioning thyroid nodules managed by thyroid resection revealed an estimated 3.1% prevalence of malignancy. A separate literature search uncovered 76 cases of reported malignant hot thyroid nodules, besides the present case. Of these, 78% were female and mean age at time of diagnosis was 47 years. Mean nodule size was 4.13 ± 1.68 cm. Laboratory assessment revealed T3 elevation in 76.5%, T4 elevation in 51.9%, and subclinical hyperthyroidism in 13% of patients. Histological diagnosis was papillary thyroid carcinoma (PTC) in 57.1%, follicular thyroid carcinoma (FTC) in 36.4%, and Hurthle cell carcinoma in 7.8% of patients. Thus, hot thyroid nodules harbor a low but non-trivial rate of malignancy. Compared to individuals with benign hyperfunctioning thyroid nodules, those with malignant hyperfunctioning nodules are younger and more predominantly female. Also, FTC and Hurthle cell carcinoma are found more frequently in hot nodules than in general. We were unable to find any specific characteristics that could be used to distinguish between malignant and benign hot nodules.
Thyroid nodules are frequently-encountered entities in clinical practice, occurring with a prevalence of 4% by palpation , 33% to 68% by ultrasound examination [2,3], and 50% on autopsy series . While approximately 95% of thyroid nodules are benign, certain historical, laboratory, and sonographic features raise the suspicion for malignancy . As the initial step for evaluation of a thyroid nodule is measurement of serum thyroid stimulating hormone (TSH) [6,7], it is not uncommon for patients with a solitary thyroid nodule to be diagnosed with hyperthyroidism. In this setting, the thyroid nodule may represent a solitary hyperfunctioning thyroid nodule in an otherwise normal thyroid gland or it may represent a hyperfunctioning or nonfunctioning nodule occurring within a toxic multinodular goiter, within a Graves’ disease or destructive thyroiditis milieu, or in an individual with a less common cause of thyrotoxicosis . Thyroid scintigraphy employs radioiodine (123I, 131I) or technetium-99m-(99mTc) pertechnetate in order to differentiate these diagnostic possibilities. The distinction is important, because hyperfunctioning nodules – also referred to as “autonomous,” “autonomously-functioning,” or “hot” nodules – are thought to only rarely harbor malignancy, such that fine needle aspiration (FNA) is not traditionally indicated in this circumstance . Per the 2009 revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer, “Since hyperfunctioning nodules rarely harbor malignancy, if one is found that corresponds to the nodule in question, no cytologic evaluation is necessary” .
Here, we present the case of a woman with subclinical hyperthyroidism due to a hyperfunctioning thyroid nodule who was diagnosed with minimally-invasive follicular carcinoma after surgical resection. We also include our findings from a formal literature review on this topic, in which the historical, laboratory, and radiological features of similarly-documented cases were scrutinized to determine if there are features that differentiate hyperfunctioning thyroid carcinomas from solitary toxic adenomas. The results of a separate literature review aimed at estimating the prevalence of thyroid cancer within hot thyroid nodules are also presented. Our goal is to call attention to the fact that hyperfunctioning thyroid carcinomas are well-described in the literature (and also likely underreported), challenging the commonly-held notion that the hot thyroid nodule is very unlikely to be cancerous.
A MEDLINE literature search of English-language studies published between 1950 and January 2012 with the terms, “thyroid cancer, hyperthyroidism, surgery,” “thyroid cancer, hyperfunctioning nodule, surgery,” and “thyroid cancer, hot nodule, surgery,” was performed to determine the reported prevalence of thyroid carcinoma in patients undergoing resection of solitary hyperfunctioning thyroid nodules. Another literature search, using the terms, “hyperfunctioning thyroid carcinoma,” “toxic adenoma, thyroid carcinoma,” and “hot nodule, thyroid carcinoma” was performed using MEDLINE and by reviewing the citations of relevant articles in order to collect data on reported cases of patients with a solitary thyroid nodule found to harbor thyroid carcinoma. Case series were included provided that at least some demographic and clinical details of individual subjects were described. A third MEDLINE literature search, using the terms “hot nodule,” “hyperfunctioning thyroid nodule,” and “autonomous thyroid nodules,” was performed to establish the demographic characteristics and nodule sizes of subjects with solitary hyperfunctioning thyroid nodules. In this third group, the available studies analyzed the group of hyperfunctioning nodules en masse and did not make a distinction between hyperfunctioning nodules that were benign and those that may have been malignant. Therefore, while the aggregate data from these studies most likely involved predominantly benign cases, a small number of malignant cases also may have been included. For this reason, we will subsequently refer to this group as “predominantly-benign” hyperfunctioning (or hot) nodules.
Weighted averages of data were calculated by assigning a “weight” to each study (based on the number of subjects in the study divided by the total number of subjects for all studies), multiplying each weight by the subject mean in the corresponding study, and then taking the sum of these products.
A 29-year-old teacher was referred to her local endocrinologist to evaluate a palpable left thyroid nodule. While she did not report thyrotoxic symptoms at that time, she was found to have a suppressed TSH. Thyroid scintigraphy revealed a hyperfunctioning left-sided thyroid nodule, and ultrasonography revealed it to be 2.4 cm in greatest dimension, isoechoic, and in the left lower lobe. A follow-up ultrasound one year later revealed an essentially unchanged nodule measuring 2.5 cm.
The patient presented to our institution the next year, at which time she endorsed tremors, anxiety, insomnia, and oligomenorrhea. She denied local compressive symptoms, history of radiation exposure, or family history of thyroid malignancy. Her only medication was a daily multivitamin. Her weight was 106 kg with a height of 1.7 m, blood pressure of 117/73 mmHg, and heart rate of 79 beats per minute. A 1.5 cm, firm, slightly tender nodule was palpated in the left lower lobe of the thyroid; it moved with swallowing. There was no evidence of cervical lymphadenopathy or thyroid bruit. The patient had a slight, fine tremor of the hands with normal biceps deep-tendon reflexes bilaterally.
Thyroid function tests revealed a suppressed TSH (0.005 mcIU/mL, normal 0.4 - 4.5 mcIU/mL) but normal free T4 (1.1 ng/dL, normal 0.9 - 1.8 ng/dL) and free T3 (3.5 pg/mL, normal 2.3 - 4.2 pg/mL). Thyroid peroxidase antibody testing was negative (0.4 IU/mL, normal < 9 IU/mL), as were thyroglobulin antibody (< 20 IU/mL) and thyroid stimulating immunoglobulin (< 1.0) testing. Thyroid ultrasound revealed a 2.6 × 2.7 × 2.6 cm predominantly solid, isoechoic left lower lobe nodule with internal hypervascularity within a slightly enlarged but otherwise normal-appearing thyroid gland (Figure1A and B). 123I thyroid scintigraphy revealed a left lower lobe hyperfunctioning nodule with 24-hour uptake of 27% (Figure1C).
After discussing with the patient the benefits and risks of radioiodine ablation versus surgical resection (left hemithyroidectomy), she elected for the latter, citing the reduced risk of permanent hypothyroidism as her main deciding factor. Histologic evaluation of the surgical specimen revealed a solitary, circumscribed, and well-encapsulated tumor measuring 2.5 × 2.5 × 2.2 cm without lymphovascular invasion or extra-thyroidal extension (Figure1D). A focus was identified where the tumor penetrated and budded through the well-defined fibrous capsule, giving the diagnosis of minimally-invasive follicular thyroid carcinoma (Figure1E) in the setting of background lymphocytic thyroiditis. Given the pathologic diagnosis, lobectomy was felt to be sufficient, and neither completion thyroidectomy nor radioactive iodine ablation was pursued in this patient. Molecular testing was performed on the surgical specimen for BRAF and KRAS mutations, both of which were negative. At her 6-month follow up appointment, the patient was symptomatically and biochemically euthyroid on low-dose levothyroxine replacement and showed no evidence of cancer recurrence.
In order to place the current case report in context, we have attempted to establish the prevalence of malignancy within hot thyroid nodules. This involved a literature search for surgical case series of solitary hyperfunctioning nodules managed by thyroid resection. A total of 14 relevant case series were uncovered. The earliest we found was from 1967 and included 79 hot nodules that underwent surgical resection; none of those cases were found to harbor thyroid carcinoma. Among the 14 case series, carcinoma rates of intranodular carcinoma ranging from 0 – 12.5% were noted, with a weighted total of 3.1% (Table1). Of note, some of those case series also included cases in which thyroid carcinoma occurred outside of the hot nodule; however for the purposes of our review, such extranodular cases were not included in our estimated prevalence determination.
We next sought to establish historical and/or clinical features that may help to differentiate malignant, hyperfunctioning thyroid nodules from benign, toxic adenomas, especially since hyperfunctioning thyroid carcinoma is generally an ex post facto diagnosis. Using the search criteria listed in the Methods Section, we discovered 76 cases (in addition to the current case) of malignant hot thyroid nodules, in which autonomy was highly suggested by both biochemical parameters of hyperthyroidism and scintigraphic evidence of increased radioiodine or labeled technetium uptake. All possibly-relevant features of the 77 cases were extracted and are displayed in Table2, and a further analysis of these features appears in Table3. An additional 27 cases with scintigraphic evidence suggestive of nodular autonomy but with normal thyroid function tests, absent thyroid function testing, or uninterpretable laboratory results (e.g., patients already on levothyroxine therapy at time of laboratory collection) were also found in the literature search (Table4); these cases were excluded from subsequent analyses since autonomy seemed less certain.
We compared age at diagnosis and female: male ratio of individuals with malignant, hyperfunctioning thyroid nodules to those with benign, toxic adenomas. Data on the latter group was compiled from a separate literature search which identified several surgical case series of predominantly-benign hot nodules, as described in the Methods section (Table5). Subjects with malignant hot nodules were younger at the time of diagnosis than those listed in multiple case series of predominantly-benign hot nodules [47.0 vs. 57.6 years, respectively (Tables3 and and5)].5)]. Additionally, a greater percentage of subjects with malignant hot nodule were female as compared to those with predominantly-benign hot nodules [3.53:1 vs. 1.65:1 female to male ratio, respectively (Tables3 and and55)].
The sizes of the malignant hot nodules (Table2) and predominantly-benign hot thyroid nodules are compared in Figure2A. Of note, the clinical use of ultrasonography began in the late 1960s, so that the sizes listed in the early case reports of malignant hot nodule were estimated by palpation. We include tumors that were noted to encompass the entirety of the hot nodule as well as microcarcinomas embedded within a larger hot nodule. The actual size of the tumor within the thyroid nodule determined by pathological review was occasionally provided in the literature and is listed in Tables2 and and4.4. The mean nodule size among the subjects with thyroid carcinoma was 4.13 ± 1.68 cm, which closely approximates the mean size of the predominantly-benign hyperfunctioning nodules.
The majority of subjects with a malignant hot nodule demonstrated elevation of triiodothyronine (76.5%), whereas closer to half of the subjects had elevation of thyroxine (51.9%) (Table3). Note that these percentages represent the number of subjects with an elevated thyroid hormone level (total and/or free value, depending on the particular study) divided by the total number of subjects with a hyperfunctioning thyroid nodule. Far fewer subjects had subclinical hyperthyroidism (13%) (Table3). In comparison, with the exception of 3 studies, similar data on the biochemical profiles of subjects with benign, toxic adenoma in the collected case series were only sparsely included. In a study of 35 subjects with toxic adenoma, Hamburger found 16 with elevations in both T3 and T4 levels, 16 with elevations of only T3, 3 with isolated T4 excess, and 7 with subclinical hyperthyroidism . In a study of 63 patients with solitary toxic adenoma, Langer found that mean free T3 level was significantly higher (8.8 ± 3.5 pg/mL, normal range 4 – 6.8 pg/mL) than mean free T4 level (16.9 ± 6.6 pg/mL, normal range 7 – 17.5 pg/mL) . Blum evaluated 35 patients with solitary autonomous thyroid nodule and found that 65% had elevated T3 levels, 54 % had elevated T4 levels, and 31% were biochemically euthyroid . Thus, hypersecretion of T3 appears to be a common factor among both benign and malignant hyperfunctioning thyroid nodules. Of interest, a greater prevalence of frank biochemical hyperthyroidism can be seen in patients with malignant hyperfunctioning thyroid nodules who have larger nodules (Figure2B).
We next turned our attention to high-risk historical features and suspicious sonographic features to determine if these were present in cases of malignant hot nodule (Table3). These features are described in Cooper et al.  and are listed in the Tables2 and and33 legend. None of the 77 subjects with malignant hot nodules was noted to have high-risk historical features. Eleven subjects (36.7%) had suspicious features on ultrasonography, which is likely an underestimate, as some of the more newly-recognized high-risk sonographic features (e.g., taller than wide on transverse view) were not utilized in the earlier published reports. It was difficult to assess cases for nodule growth as a risk factor for malignancy, since the vast majority of the subjects were referred to surgery for immediate resection. However in seven cases, nodules were noted to grow over time. While an increase in nodule size is an indication for biopsy, the specificity of this finding for malignancy is limited, as 9-89% of benign nodules have been shown to grow over time depending on which definition for significant growth is used [21,73,77,79].
The majority of malignant hot nodules were proven to be PTC (57.1%), and of these, 18.2% were the follicular variant of PTC (FVPTC). Follicular thyroid carcinoma (as seen in our patient) comprised 36.4% of cases, while Hurthle cell carcinoma was found in 7.8% of samples. By comparison, in the U.S. National Cancer Data Base (1985–1995), which includes histologic information on all thyroid nodules as a group, the prevalence of PTC was approximately 85%, FTC was 10%, and Hurthle cell carcinoma was nearly 3% . Thus, there does seem to be a higher prevalence of both FTC and Hurthle cell carcinoma in the hyperfunctioning thyroid carcinoma cases.
Of note, within the 77 identified cases of malignant hot nodule, only 23 subjects received FNA of their thyroid nodule prior to resection. FNA enabled a pre-operative diagnosis of thyroid carcinoma in 43.5% of cases. However, 30.4% of subjects undergoing FNA were erroneously characterized as having benign lesions, and 17.4% of samples were nondiagnostic. Of the subjects with false negative biopsies, surgical pathology eventually revealed PTC in 3 cases (one of these was FVPTC), FTC in 1 case, and Hurthle cell carcinoma in 3 cases. Tumor size was given in only 3 instances of false negative biopsies. Two of these were of subcentimetric PTC, and it is presumed that small size was likely a chief factor leading to misdiagnosis. However, the other was a 3 cm nodule comprised wholly of Hurthle cell carcinoma.
To our knowledge, the current data set is the largest and most detailed to date of patients with malignant hot thyroid nodule. In that regard, this study complements the informative and excellent 2012 review by Pazaitou-Panayiotou and colleagues examining the association of thyroid carcinoma with a broader spectrum of hyperthyroid states, including Graves’ disease and toxic multinodular goiter in addition to hyperfunctioning thyroid nodule . Of note, although it was not the focus of the Pazaitou-Panayiotou et al. review to perform a detailed analysis of the historical and clinical features of malignant hot nodule cases, as we did here, Pazaitou-Panayiotou and colleagues did include an evaluation of thyroid carcinoma prevalence. The reported percentages of thyroid carcinoma in their collected case series of patients with hot nodules, which overlapped but did not mirror exactly those case series evaluated here and which also included some cases of thyroid carcinoma occurring in extranodular thyroid tissue, ranged between 2.5 – 12.0%. This corresponds to a weighted average of 6.9% and thus is similar to the 3.1% prevalence estimated here. In its discussion of thyroid carcinoma in patients with hyperfunctioning nodules, the Pazaitou-Panayiotou et al. review also included several other important commentaries. For instance, they draw attention to two studies suggestive of a higher prevalence of thyroid carcinoma in hot nodules occurring in children [82,83], though the latter study included children from an iodine-deficient region. In addition, they discuss several reports in which activating mutations of the TSH receptor gene were identified within malignant hot nodules .
There are several noteworthy discussion points and implications to the findings presented here. The first relates to the prevalence of malignancy within solitary hot nodules. As mentioned, in the available surgical case series that addressed this topic, a varied prevalence was noted, ranging from 0 – 12.5%, with a weighted average of 3.1%. Only a minority of the patients who underwent surgery in those series did so because of concerning findings from FNA, and as such, we do not believe that the data set is biased towards cases in which a post-operative diagnosis of malignancy was expected. We realize that this collection of case series includes only a small fraction of the total number of solitary hot nodules that have occurred, and also that the vast majority of malignant hot nodules likely have gone unreported. Furthermore, it is likely that malignancy goes undiagnosed in many cases of hot nodules treated with radioiodine, especially those harboring microcarcinomas. Despite these limitations, we do believe there are sufficient numbers of cases included among the collected 14 surgical case series of subjects to cite the 3.1% figure as being a fair and representative estimate of malignancy prevalence amongst solitary hyperfunctioning nodules. While this 3.1% prevalence figure is low – and in fact is lower than the estimated 5 - 15% prevalence of malignancy among all thyroid nodules  – it is not trivial. Thus, the possibility of malignancy within a hot nodule must not be overlooked by a managing clinician, particularly if management other than surgical resection is chosen.
Another important discussion point regards the limitations resulting from the retrospective nature of this analysis, including incomplete data and differing methodology used in many of the collected case reports and case series of malignant hot nodule. While some of the primary sources were meticulous in their case descriptions, others included less-thorough descriptions. For example, tumor size was frequently not reported, and thus it was unclear if a PTC tumor was simply an incidental microcarcinoma embedded within a larger hot nodule or a large, follicular variant of PTC comprising the entirety of the nodule. While we have included some cases in which the malignancy was a microcarcinoma and thus of uncertain clinical significance , these cases are clearly in the minority (only 8 of the 77 reported tumors were less than one centimeter in size). Other factors affecting the data set are the evolution of technology and our understanding of risk factors for thyroid carcinoma. For instance, thyroid ultrasound began clinical use in the late 1960s, and prior to this, nodule size was estimated by palpation. Earlier reports would not have commented on some of the suspicious sonographic features recognized today. Additionally, the radioimmunoassays used to measure TSH have undergone many generations of refinement over the past several decades, and thus the presence and degree of hyperthyroidism may have been underestimated in earlier studies.
Also worth discussing are the differential prevalences of thyroid carcinoma histologic subtype found in hot nodules as compared to nodules as a group. As mentioned, there was a much higher prevalence of both FTC and Hurthle cell carcinoma in hot nodules (36.4% and 7.8%, respectively) as compared to in all nodules (10% and nearly 3%, respectively). Additionally, a substantial percentage of the PTC cases found in hot nodules were the follicular variant. This may have bearing on the current algorithm for evaluation of patients with thyroid nodules as recommended in the 2009 thyroid nodule and thyroid carcinoma management guidelines . In particular, for those nodules found by biopsy to have follicular neoplasm by histology, the guidelines recommend consideration be made for performing an 123I thyroid scan, if not already done, especially if the serum TSH is in the low-normal range; if the nodule is found to be hyperfunctioning, it can then be followed . However, the high prevalence of both FTC and FVPTC reported for malignant hot nodules suggests that a biopsy diagnosis of follicular neoplasm within a hot nodule may not be as reassuring as previously thought. Also of interest, in a 2009 study, Sundaraiya and colleagues reported a case of metastatic FTC occurring in the setting of thyrotoxicosis, in which high-grade extrathyroidal uptake of technetium-99m-pertechnetate was observed; in a literature search, they found 74 other cases of thyrotoxicosis resulting from well-differentiated thyroid cancer metastatic lesions, most of which demonstrated histologic evidence of FTC .
As a final point of discussion, since none of the historical, biochemical or radiologic characteristics that were assessed seems to predict malignancy in the collected cases of hot nodules, one might ask if there is any utility in biopsying hot nodules. Such would be a shift from the current thyroid nodule management guidelines which views an increased nodular radiotracer uptake pattern as a reassuring characteristic from a cancer perspective . Given the estimated 3.1% prevalence of malignancy within hot nodules, and also taking into account the difficulty in predicting whether a particular hot nodule is malignant, we recommend that hot nodules that are not treated surgically (as is an option to manage the hyperthyroidism) be considered for biopsy if high-risk historical and/or suspicious sonographic features are present or if these nodules grow over time, just as is currently recommended for nodules that are not hyperfunctioning . This should also include previously hyperfunctioning nodules treated with radioiodine, although the known occurrence of dystrophic calcification and cystic degeneration as sequelae of radioiodine ablation should be taken into account when assessing their sonographic features . Future prospective studies could help determine if biopsying at the time of diagnosis all hot nodules with suspicious sonographic characteristics and/or associated high-risk historical features versus biopsying hot nodules only if the initial sonographic characteristics worsen over time would result in better outcomes.
The authors declare that they have no competing interests.
SM performed the literature review and drafted the manuscript. DM provided the radiology images and participated in drafting/revising the manuscript. LP provided the pathology images and participated in drafting/revising the manuscript. SW helped to provide the surgery perspective and edited the manuscript. JZ assisted with the literature review and drafting of the manuscript. All authors read and approved the final manuscript.
The authors would like to acknowledge Jeffrey R. Garber, M.D. for helpful discussions. We also acknowledge the support of the Diana and Richard C. Strauss Professorship in Biomedical Research and the Mr. and Mrs. Bruce G. Brookshire Professorship in Medicine at UTSW Medical Center.

domain: medical


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WEEKENDS from Friday 10pm to Monday 5am the Monacacy Bridge from Dickerson (Montgomery County MD) will be closed!!
Please choose alternate route.
If coming from the south, take 270 North to exit 26 (Buckeystown/Urbana) Route 80. Take 80 west to a left onto Park Mills Road.
From Leesburg area, use 15 North to Route 28 in Point of Rocks. Do not take White's Ferry!

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Walmart is making a push to bolster iPhone sales and get more shoppers in its store during the final lead up to Christmas. Starting this Saturday and running for an entire month, Walmart will knock $70 off the 16GB iPhone 6 and 6 Plus contract prices, and $50 off the 16GB 5s, according to BGR. Sam’s Club, the members-only warehouse store, will have the same deal as Walmart but $2 less.
These are the best price we’ve seen on Apple’s flagship iPhones since Black Friday when Sam’s Club dropped its price below $100.
Today’s report doesn’t make note of discounts for any other models. However, Target is currently including a free $50 gift card with all iPhone 6 capacities.
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domain: health


A Taco Bell at 1125 Tiffin Ave. in Findlay was robbed at 10:28 a.m. today.
A white female entered the restaurant and demanded money from an employee while brandishing a black handgun, police said.
The employee complied and the suspect left the restaurant on foot before getting into a silver, four-door vehicle.
Nobody was hurt during the robbery and no shots were fired.
The vehicle left in an unknown direction on Tiffin Avenue, police said.
The suspect was approximately five feet tall with a thin build and wore a camouflage coat, jeans and boots. Her face was also partially covered, police said.
The incident is still under investigation, police said.
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DIGITAL FOR PLANET WEBINAR – SUSTAINABLE NEXT GENERATION INTERNET HORIZON EUROPE
April 14, 2021 @ 2:00 pm – 4:00 pm
The Sustainable Next Generation Internet Horizon Europe webinar aims to gather researchers, innovators and policy makers that across a number of communities are at work to ensure the transition toward a green and sustainable internet that is resilient and inclusive.
THE MAIN OBJECTIVE IS TO IDENTIFY RESEARCH AND INNOVATION CHALLENGES AND OPPORTUNITIES IN VIEW OF THE UPCOMING HORIZON EUROPE CALLS.
With the increasing dependence on the internet for many professional and private aspects of our lives, as exacerbated by the Covid-19 pandemic, there is a clear need to transition towards a safer, more resilient and better sustainable internet. When focusing on environmental aspects, the internet already uses 9% of global energy, a total that by some of the most extreme estimates could go up to as much as 23% of global greenhouse emissions by 2030.
Next generation internet technologies, from core to access networks, from the physical to the application layer, must become greener, both in the way they are developed and in the way they are deployed. Reducing the CO2 footprint of the internet, requires public and private organisations, as well as individuals, to become aware of the environmental impact social media, online advertising, and online streaming, to mention some, are already having. All stakeholders must be engaged in redefining the way we use and consume internet technologies to ensure the twin green digital transition will sustain and grow our economy and society in a sustainable way.
The Sustainable Next Generation Internet Horizon Europe webinar is gathering top experts from public authorities, industry and academia to present and discuss how energy-efficient technologies, mechanisms, and policies must be put in place at several levels to ensure a safe, resilient and sustainable Internet.
Relevant Horizon Europe initiatives will be presented, as well as concrete activities planned by the Digital for Planet – D4P Sustainable Next Generation Internet Working Group, in preparation of upcoming Horizon Europe Calls.


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Jr Little Kickers Spring Indoor (3 and 4 year olds)
DOUBLE-BLIND CONTROLLED TRIAL OF ?-HYDROXYBUTYRATE ...
administration, it can increase bronchial secretion. Therefore, other agents . ?- Hydroxybutyrate (GHB) is a neurotransmitter that occurs naturally in the . GHB has no effect on respiratory function, but it may lead to a slight increase in . Cash, C. D. (1994) Gamma-hydroxybutyrate: an overview of the pros and cons for it .
Spring Rec Indoor 2012
Gamma hydroxybutyrate (ghb): Report of a mass intoxication and ...
Gamma hydroxybutyrate has been implicated in an increasing . an adequate respiratory drive. Two of . suctioning for increased secretions or emesis. Particu - .
Physostigmine for gamma-hydroxybutyrate ... - Informa Healthcare
Keywords: Gamma hydroxybutyrate, Physostigmine, Gamma butyrolactone, 1,4 . (with difficulty due to friable epiglottic mucosa, with bloody secretions suctioned). . Complications included hypotension (BP = 40/20) and pulmonary infiltrates.
Try-Out Evaluations for 2013 Travel Teams
Cases Journal | Full text | Gamma-hydroxybutyrate withdrawal ...
Gamma-hydroxybutyrate withdrawal syndrome: a case report . Pulse oximetry showed an oxygen saturation of 97%, while her respiratory rate was . and lead to diminished clearance of secretions of her upper airway, resulting in hypoxia, .
Summer Travel 2012: Player Openings
Gamma-Hydroxybutyric acid: Facts, Discussion Forum, and ...
GHB, sodium oxybate) or potassium gamma-hydroxybutyrate (K.GHB). . life- threatening depression of the central nervous system and respiratory system. . In medicine, aspiration is the entry of secretions or foreign material into the trachea .
MYSA Fall State Champions: U11 Girls C2/Fall State Runners Up: U12 Boys C1
Congratulations to the gamma hydroxy butyrate pulmonary secretions Scream U11 C2 Girls (Coach Driste) who won the MYSA Fall State Tournament
Congratulations also to the Blaine Venom U12 C1 Boys (Coach MacDonald) who finished MYSA Fall State Runners Up
MYSA Fall League Champions
The brain converts this derivative of metabolic fat to gamma-hydroxybutyrate, . Pulmonary: Pharyngeal and pulmonary secretions increase causing cough, .
OATHS AWARD - 4 gamma hydroxy butyrate pulmonary secretions SC teams receive the OATHS Award
DATE RAPE DRUGS - Community Intervention Centre | Trauma ...
Substances related with sexual assaults include Gamma-hydroxybutyrate (GHB), . coma, moderate bradycardia, and cardiac and respiratory depression can occur. . increased salivary and bronchial secretions, bradycardia (lowers the heart .
Physostigmine for gamma-hydroxybutyrate coma: Inefficacy ...
Keywords Gamma hydroxybutyrate; Physostigmine; Gamma butyrolactone; 1,4 butanediol; antidote. Introduction . mal sinus rhythm, P = 60, BP = 106/64, respiratory rate (RR) = . due to friable epiglottic mucosa, with bloody secretions .
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Gamma hydroxybutyrate intoxication: The Gold Coast experience
surrounding the emergence of gamma hydroxybutyrate (GHB) as a drug of abuse , . One patient (7%) had a respiratory arrest. . Purulent secretions via ETT.
MLS Launches New Kidsí Website
Halothane treatment in life-threatening asthma
Respiratory failure: PaO 2 < 70 mmHg (without O2-therapy);. PaCO 2 > 50 mmHg . 4. . upon respiratory secretions, nor does it cause laryn- geal irritation. . gamma-hydroxy-butyrate et sodium bromure de pancuronium. Anesth Analg R6an .


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Couple won't make wedding guests choose between nuptials, LSU game
BATON ROUGE - It's common knowledge that football fans or people with friends for football fans plan big events when LSU is out of town or has a bye-week.
So, When SEC officials announced Tiger Stadium would be hosting the South Carolina Gamecocks this weekend, some people scrambled to change their prepared plans or make accommodations. A number of events have been canceled or moved. But a wedding, isn't exactly something that can change easily.
Truly Haute Event Planner Rachel Henry says her schedule fills up as soon a the football schedule is announced.
"Everybody wants the bye-week," she said. "If they have to settle for an away game they will or a non-conference game so we book those up pretty quickly."
Now that an away game has turned into a home game, some couples with weddings this weekend are learning the hard way, while others are going with the flow.
Melissa Walker and Blake Flemming are the latter couple. While picking that perfect day in October did have something to do with an LSU away-game, they're not letting the change of venue and game time impact them.
"I mean, I'm from Baton Rouge. I get it," said Walker. Her groom echoing, "We know to schedule our weddings whenever they're away."
The couple says so far, their guest list has not changed and all their family and friends plan to attend Saturday. Yet, there's still that lure of being in Tiger Stadium for the 2:30 p.m. kickoff.
"There are some people that want to try to sneak into the LSU game at least for maybe a half and get here on time," said Flemming. To which his bride said, "Yeah, all the groomsmen want to go to the game and want that to be the day-of activity."
Walker knows there might be a TV around while the groomsmen get ready.
While there will be changes around the city, Henry says accommodations have been made and vendors should be prepared. She's had to plan a wedding on an LSU home game before.
"The challenges are real," she said. "The vendors are going to be duplicating with any tailgating event... we have to really plan around that."
Football is something not to be taken lightly in Louisiana. Then again, neither should a wedding.
Desktop NewsClick to open Continuous News in a sidebar that updates in real-time.
Tiger fans storm the court after upset win against No. 17 Kentucky
Ascension Parish student heading to national welding competition
Louisiana Senator Bill Cassidy says he is against sending national guard troops...
In response to deadly car jacking, Louisiana lawmaker proposes bill increasing penalties
Crews on Amite River clearing decades of debris


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Warning, the amount of bullish energy coming from this post may be infectious. Simply put, the price of bitcoin is about to explode and the world isn't ready. Even for the most bullish of us who feel we got into bitcoin early; are in-fact also not ready as well. Although we are much better off than the person who hasn't began investing into bitcoin yet.
Let's travel back to February when bitcoin reached a new all-time high in the $60,000 price range. Bitcoin holders were feeling a high like no other, and we were sure that bitcoin would soon go up to 100k. But it didn't, and it dropped all the way down to 28k. This was caused by an onslaught of FUD thrown at bitcoin at an unprecedented pace. Throughout out this time I remained bullish. There were people that claimed the bull market was finished at the very least, and perhaps that bitcoin was finished for good. That it would never overcome the obstacles set in front of it, never returning to the 60k price level. It was a bearish time. Do you remember how you felt during this time? But now we are rising back up, and have defeated a large majority of that FUD. Which means we are much stronger, and prepared for this next run. The China FUD has come to an end. We have lived through constant Binance FUD, the US government enacting regulations, the mining hash rate collapsing, China banning mining and the list goes on and on. But as just mentioned, we have moved past each issue.
The second time is always sweeter than the first. All of those new hands in bitcoin, that panicked and sold off during the FUD, and swore off bitcoin. They are already coming back, they will run back even fast when bitcoin reaches 50k, and 60k.
Something that most people don't consider is that perhaps the largest news story in bitcoin's history came out during this bearish period. The news of El Salvador making bitcoin legal tender in their country. While this did make the price of bitcoin go up slightly, it was quickly brought back down by all the FUD that was happening during that time. I have no doubts that if that same news story happened, but instead during that bullish time period in February, we would have seen the price of bitcoin go very close to 100k if not more.
Go to cryptocurrency message boards, twitter posts and the like around the internet. You may run across comments saying that bitcoin is an old technology, that is extremely slow and expensive to use. That it can never become a payment method that everyday people will use. There are two things that these people need to understand that they clearly do not. In order for bitcoin to become extremely successful, it doesn't have to do either of those two things mentioned above. Just being an extremely great way to preserve your wealth and overtaking gold would push the price of bitcoin to over 500k. Not to mention if it absorbs bond and debt markets. Just those things alone would make bitcoin go to unprecedented levels. And then you go to point two. These people are uninformed. Bitcoin has made great strides within the last year and has matured greatly. This has been due to the development of Lightning, bitcoin's layer 2 chain. Lightning's transactions are instant and cost just one satoshi, which is about 1/100th of a cent. Practically free. This is what will propel bitcoin to be a method used for everyday transactions. It will be very similar to having both a checking and savings account at a bank. Your savings account is your money that you will keep in bitcoin. This is the money you're saving for the long-term that you're not intending to sell. While you keep a smaller amount of money in your checking account that you use for everyday transactions, being your Lightning. Once people begin to catch on to this fact, it is game-over for nearly half of all cryptocurrency coins out there, with their main purpose being that it is either faster or cheaper than bitcoin.
When bitcoin reaches a price of 100k there will be rush towards it, and when the prices goes over 200k they will all-out sprint. Not by the public, but by corporations and potentially countries. Unfortunately there are far too many people out there who just have no interest in their finances, or learning about how money works. These people will be the last one to enter the market. They won't enter until they are forced to do so.
Now keep in mind, many analysts have claimed that these type of prices could come before the end of the year. Which all leads me to my question, have you done enough to be ready? The days having a semi-cheap bitcoin are nearly at a close. In a few months when bitcoin is at a 150k, we will look back to the summer when bitcoin was at 28k, and we will be filled with regrets for not buying as much as we could. Unfortunately humans are often controlled by emotions of the here and now. Not remembering their initial vision and all thinking about the long game. Even to this day bitcoin is cheap. You can buy 0.01 BTC for around $460. But when bitcoin goes to 150k or 200k, that same bitcoin purchase will cost you $1,500 to $2,000. Now let's get to my favorite part to think about; the passive income. If you went all-out, and put in the work to grow your bitcoin passive income will become quite significant. For example, my passive bitcoin would grow to be more than I make with my full-time job.
People aren't ready, are you?
Have you done everything possible to accumulate as much bitcoin as you possibly could during this time? How are you earning a passive income with your bitcoin?
As always, thank you for reading!

domain: finance


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*And by "Saturn," I mean "the Multiverse."
I hate the Multiverse. I hate it with the burning passion of the infinite suns that light its pitch-black skies. I want DC to play home to one Earth. Just one. Not two, not five, certainly not X, and not Infinity.
I know when it first started, too. It started with Who's Who Volume IV. I didn't own the comic until recently, but someone I knew in 3rd grade, knowing I was a comic fan, brought it to class a couple of times, and I absorbed its wealth of information. This was my first exposure to the Calculator and Calendar Man! My first glimpse at Captain Marvel! My first look at Changeling! And, sadly, my first induction into the world of the DC Multiverse.
"Why are there two Catwoman entries?" wondered my nine-year-old brain. "When did Catwoman and Batman get married? They had a kid? Catwoman's dead?"
I didn't understand the concept of Earth-2, and to be fair, I really didn't have much context for it. That would have been 1992-93, and I didn't start actively reading DC until December of '92 (though I have the sneaking suspicion that Who's Who crossed my path in the Spring of '93). But I have since encountered plenty of material on the various Earths, and I feel very secure in my utter hatred for their existence.
I don't like the idea that there could be more than one of Superman in a fight. More than one of Batman seems like overkill, especially given the existence of Nightwing, Oracle, and Robin. The Batman family of Multiple Earths could potentially include Batman-1, Batman-2, Robin III/V-1 (since Tim is the 3rd and 5th Robin), Robin-2, Nightwing, Huntress-1, Huntress-2, Catwoman-1, Catwoman-2, Batgirl II-1, Oracle, Bat-Girl-2, and Bat-Woman-2. Superman's family? Superman-1, Superman-2, Supergirl III-1, Power Girl, Superboy-1, Superboy-Prime, Krypto-1, Krypto-2, Steel I, and Steel II. Four of them are each nigh-omnipotent.
I don't like splitting up the universe and the dynasties. The best thing about the original Crisis is that it gave us a generational DCU. Superman wasn't the first, last, and best Superhero, he just kicked off the modern age. There was a whole generation of heroes before him, and there's a new generation coming after. That's one of the things that makes the DCU so unique: it's all about family and pantheons and legacies. That wouldn't be the case if each generation operated on a different Earth.
When Hypertime came along, I had a similar reaction, until Superboy's "Hypertension" storyline and the Flash's "Dark Flash" arc proved to me that it could work. Hypertension established that crossing barriers in Hypertime was really freaking dangerous, and took a hell of a lot of power. It wasn't something that every super-speed schmoe or human vibrator could do on his or her own.
Sidenote: The Human Vibrator will soon show up as arch-nemesis to the Birds of Prey.
"Dark Flash" established the more important point that crossing Hypertime barriers was dangerous to the universe. It caused other Hypertime anomalies to leak through and build up until something got corrected, or until whole universes ate each other.
Hypertime also makes more sense in a quantum fashion, where every choice spawns multiple new tributary universes, and there isn't necessarily a single "right" one.
But Hypertime won me over through underuse and hyperregulation, so it wouldn't become the trick-of-the-week parallel universe MacGuffin.
You want to know the biggest reason, though? I hate explaining it to people. I'm a bit of a DC history buff, and people know that, so I get questions. Especially about Superman. And more often than not, the answer to those questions starts with "yeah, originally, before they restarted his history in '86." Which inevitably leads to a convoluted answer to their original question, as it was in pre-Crisis and as it is now.
So, when a friend of mine starts discussing a story she read some time ago where Batman and Catwoman got married, and asks for further info on that, I have togo into the whole history of Earth-2, what makes it different from Earth-1, and all that.
Explaining DC history post-Crisis is hard, but it's not nearly as hard as trying to explain pre-Crisis stuff, or things that bridge the gap. I don't like doing it. It's prohibitively confusing to newcomers and non-fanboys.
Meanwhile, the heroic dynasties add to the mythoses. They give characters legacies and history. They give the universe cohesion and a rich tapestry of history. They make sidekicks make sense.
I want DC to stay the universe of families and dynasties, not the universe of redundant characters, superfluous worlds, and one-sided battles.
Tuesday, February 14, 2006
*And by "Saturn," I mean "the Multiverse."
So apparently they're killing the Invisible Woman. Because, you know, she hasn't been through enough with spending years as the most useless member of her team, having several life-threatening pregnancies, one of which resulted in a miscarriage, and being the object of lust for an Atlantean and the megalomaniac in the iron mask. That's not even counting the whole "Malice" split personality thing, where she becomes an evil dominatrix.
The first time I followed Fantastic Four was around the same time that they decided to kill off Reed and Dr. Doom. It was also around the same time that they gave Sue that hideous die-cut costume (sorry for stealing the image, Marionette).
The next time I got into Fantastic Four was around the same time that they decided to give Doom armor made of human flesh, then kill him again.
After killing him, they decided to kill the Thing. And they killed Galactus too. Everyone got better, except Galactus and maybe Doom.
That was just a year or two ago, now they're killing off Sue. I guess Johnny's the only one who hasn't yet had a trip in a pine box. Maybe that's the big event of 2007.
I just wish that Marvel would stop killing off major characters for no reason, only to bring them back and assert "dead is dead, starting now." Especially when those characters have young children (even though Franklin's been four or five for fifteen years). The Fantastic Four is a family, stop making it a family plot.
Goodbye, Sue. See you in a year or two.
Thursday, February 09, 2006
I think it was Jon who clued me into the inherent impossibilities of Superman wearing his costume under his street clothes, but I can't for the life of me find the post where he mentioned it.
Anyway, my ultra-cool Superman 13" doll (yes, doll. Action figures don't typically come with a change of clothes) finally arrived, and I can now personally attest to the wardrobe difficulties that must plague Superman on a daily basis. Perhaps he stores his cape in a pocket someplace. Perhaps he keeps his belt and boots in a desk drawer. But there is no way that that man can wear a jumpsuit, briefs, a belt, a cape, and a pair of boots underneath socks, pants, a tucked-in shirt, the undershirt he'd require to keep that big red 'S' from showing through his white shirt, a belt, socks, and a pair of wingtips. It's simply not possible.
My theory? He wears the skintight shirt, possibly pants, possibly briefs (I'm not quite willing to concede that the pants and briefs are separate items) under his clothes. His boots are similar to Spider-Man's (no hard sole), and he keeps them folded up in a pocket or something. The belt's trickier, but the cape is folded up (through a method he learned from Barry Allen) in the buckle.
The figure itself is pretty cool. There are parts of the head sculpt that I'm not too keen on, and the coloring on his face makes him look a little sickly, and I can't figure out how the heck his feet are supposed to fit into his Clark-shoes (or, for that matter, how he's supposed to fit into his boxers). But overall? Freakin' awesome. He even comes with a copy of the Invasion! Daily Planet issue (the full-sized version of which I picked up at a recent comic sale).
And being able to strip Superman naked has already led to countless minutes of way-too-funny homoeroticism.
Wednesday, February 08, 2006
Okay, so the Super-Skrull has all the powers of the Fantastic Four, plus the regular Skrull shape-shifting abilities, right?
So, isn't Mr. Fantastic's power pretty redundant? Skrulls can already stretch; does Mr. Fantastic just give the guy more stretchability?
And I imagine the Thing's powers give him strength, but does he need to be rocky to use that (or any invulnerability he may gain from Ben's powers)? Since he's a shapeshifter, can't he just turn the rock into normal-looking skin and retain the powers?
Or is the Super-Skrull somehow lacking in the shapeshifting department?
I'm not a Marvel Zombie, really. Not anymore. I can't say why for certain; I guess I just like my heroes a little more iconic and primary-colored than Marvel typically offers. Sure, I love Spider-Man as much as anyone, but most Marvel comics just don't draw me in the way they did when I was younger.
That doesn't mean I don't still love some Marvel characters, and it certainly doesn't mean I don't have ideas. Thus starts a new feature here at the Fortress: Marvel Comics I'd Write for Free. I'm sure a DC version will pop up eventually.
So, the first Marvel comic I'd write for free is...
I don't know much about Mr. Wendell Vaughn, Protector of the Universe. I've read maybe three issues of his title, and I think I've seen him in a half-dozen appearances altogether. But, man, look at that costume! That's one of the best costumes in comics, period. I've read more about Wendell than I've ever seen him in comics, and he really intrigues me. It'd be easy to write him off as the Marvel Universe Green Lantern, but he seems more than that. He's the Protector of the Universe; he alone has a jurisdiction that, in DC, is now patrolled by 7200+ space policemen.
And yet, he seems like such a nice, down-to-Earth, happy-go-lucky fellow.
So here's my proposal for a Quasar series: superheroic space opera meets Robert Kirkman or Dan Slott. "Green Lantern Team-Up," if you will. Wendell Vaughn is like Spider-Man without the bouts of depression and insecurity; Kyle Rayner without the vanity, brashness, and arrogance. He's always smiling, always helpful, and always friendly; the kind of guy you'd absolutely hate if he wasn't so damn likable. With his Quantum Bands and his fantastic costume, he patrols the spaceways, getting involved in every sort and scale of cosmic pandemonium.
I'd want to ape the Kirkman/Slott style of fun one-issue stories, building pieces of some greater story arc. Quasar would naturally be facing various moral and ethical dilemmas, the "scratch the surface to find social relevance" sort of sci-fi that seems sorely lacking these days.
But my favorite part of this idea would be the Earth trips. To close off each arc (i.e., once per trade), Quasar would make a trip back to Earth (since most of his action would take place in outer space). He'd inevitably get involved in some crazy brouhaha, face the running joke that the Avengers roster is totally different from the last time he visited, and he'd cap off the trip with chili dogs with Spider-Man.
Cosmic adventure. Superheroic fun. Hilarious action. Chili dogs. And I'd do it for free.
Why is Green Arrow's sidekick named Speedy? Shouldn't Speedy, by any logic whatsoever, be the Flash's sidekick? Don't get me wrong, I much prefer Kid Flash, but "Speedy" has very little to do with arrows. Has the name ever been explained?
Same with Toro. How did the original Human Torch end up with a sidekick named Toro? Toro should have been a Contest of Champions Hispanic bull-themed hero, not a kid who spontaneously combusts. "Toro" has absolutely nothing to do, as far as I can think of, with being on fire.
Bucky doesn't appear to have buck teeth, nor does he typically ride horseback. Why did Crimson Avenger have Wing? Shouldn't Wing have been Hawkman's sidekick? How lame must it have been to charge into battle saying "You'll never stop TNT and his trusty sidekick, Dan!"?
Robin has been explained (and makes at least some greater sense in light of Kane's initial idea for a "Bird-Man" character). Batgirl, Supergirl, Bulletgirl, Wonder Girl, Kid Flash, Aqualad, etc. all make immediate sense. What the heck is up with the rest of the sidekick brigade?
Saturday, February 04, 2006
This seems like a good time to use the "below the fold" spoiler warning.
I really liked Jade, too. At least she and Kyle got one last team-up.
Ragnell predicted Jade's death way back in November. In the comments section of that post, I made the following prediction:
Kyle used his powers as Ion (ugh) to recharge Jade's abilities.
Jade dies, and Kyle is somehow unable to save her (loses his ring, loses charge, something). However, in death, she passes her powers on to him. He leaves the Corps, feeling both that he has failed them and that they have failed him (the tragedy that Marz talked about), and tries to rebuild his life on Earth. When he was starting out as GL, Alex's death hovered over him constantly. Now, every time he uses his new powers, he is reminded of Jade and his failure to save her. Alan Scott won't speak to him, and Obsidian wants his head on a platter. All this, and more, as Kyle Rayner tries to make a new name for himself...and that name is "Ion."
Much like my prediction about Catwoman's impending kittens, and much unlike my prediction about Despero's role behind Checkmate, this one came true in style. I knew she was gone as soon as she started talking about being "together" with Kyle there.
Granted, it doesn't look like Kyle's leaving the Corps (quite the opposite, in fact), nor does it look like he's destined for Earth or that Alan harbors any ill will toward him, but I called that pretty well, didn't I?
Of course, major props go to Ragnell for predicting the whole shebang in the first place.
Hey, anyone else remember that Jade was raped? Me either. Well, she was molested as a child, at least. Add another one to the morbid list.
Originally I was going to end the post here, but I figured I ought to talk a little about Jade first. I liked Jade. I thought she was a cool character, long before I ever read a comic where she was a regular character. I liked her old Infinity, Inc. costume, and I don't think she's had a costume since then that was nearly as good looking. She was an example of power internalization done well (her brother's powers, less so). She made a good love interest for Kyle, right from the first time I picked up a Kyle GL comic (because it had Jade nekkid and Obsidian on the cover, and that combines far too many of my favorite things). I thought it was stupid when they started giving her plant powers, and I knew she'd be getting her abilities back 'round the time of Ion. I fully expect her to be alive again within five years.
I'll miss Jade 'til then.
Friday, February 03, 2006
Anniversaries are important to comics. So important, in fact, that we make up anniversaries in order to celebrate them.
Case in point: when I started up a subscription to Amazing Spider-Man, the second issue I received was #365, Spider-Man's 30th Anniversary issue. It had been 30 years, to the month, since his debut in Amazing Fantasy #15. The event was commemorated with an extra-sized issue (which made me promptly fall in love with Mark Bagley and the Lizard) that had a holographic cover, re-enacting the cover scene from Amazing Fantasy #15 in stunning rainbow-colored 3-D.
Ten issues later, the book celebrated another anniversary of sorts: the #375th issue. It was doubly special, because it also marked the 30th Anniversary, to the month, of the publication of Amazing Spider-Man #1, the first issue of Spider-Man's first ongoing series. Venom guest-starred, Peter's parents "returned," and the event was commemorated with a shiny semi-holographic cover of some sort.
This is not all that uncommon. Comic books like to celebrate. #1 issues are, naturally, big deals. Any issue that ends in More than one zero is, as well, cause for celebration. Major year dates (any character's XXth anniversary, naturally) and issue number multiples of #25 are nearly always significant. ASM had only fifteen issues prior to that 30th Anniversary bash released #350, an extra-sized issue in which Erik Larsen departed as artist, and a bunch of people did pin-ups in the back. Also, I believe Dr. Doom was involved, and Uncle Ben showed up as a concussion-induced hallucination of Peter's.
In other words, #375 being the anniversary of ASM #1 wouldn't have mattered, they would have celebrated anyway. It just gave them the excuse to use a holographic cover twice in the same year.
These days, it's so difficult for a comic to gain a foothold that even 10th, 12th, 20th, and 24th issues are being celebrated. Part of this, naturally, comes from the "writing for the trade" trend, which would suggest that issue #10 or #12 is probably the end of a major story arc. There's a certain sadness in this, but it has led, at least in part, to the end of the holo-cover-every-week syndrome that plagued the '90s. And, of course, one could make the case that celebratory issues have greater meaning now, since most comics today don't make those impressive double-zero milestones.
Of course, if they'd stop ending and restarting long-running series, that problem wouldn't be so significant. After all, are Amazing Spider-Man or Fantastic Four selling any less now that they've returned to their original numbering schemes? I'd be willing to bet that the 500th issue extravaganzas of those series would have far outsold another #33 or something. The last few weeks have seen the final issue of The Flash and the death throes of Wonder Woman and JLA, the former two series well into the 200-issue range. We know that both of them are receiving relaunches in the near future, as is JLA, which has around 125 issues under its belt. Superman is being cancelled, only to (according to rumor) be replaced with Superman: Confidential, another #1 to add to the pile.
I started my Superman subscriptions (yep, I still receive Superman comics via mail) in 1992. Since then, I've seen one new quarterly series (Superman: The Man of Tomorrow), two new Maxi-Series (Superman: Metropolis and Superman: Birthcrap), countless mini-series and one-shots (Hunter/Prey, Doomsday Wars, Day of Doom, Superman Red/Superman Blue, Superman Forever, Superman: Legacy, Save the Planet, etc.), one new (semi-)regular ongoing series (Superman/Batman), and now the cancellation of two regular series (Superman: The Man of Steel and Superman). I know the subscribers make up a pretty small chunk of comics buyers, but does DC realize how much it screws up the math to try to split up the remaining issues of one series among the other three? Sigh, it's a pain in the butt. I think, once my subscriptions finally run out, I have at least one extra issue of Action coming. Of course, the cancellation of Superman might even that problem out, if "Superman: Confidential" doesn't take its place in my mailbox.
Anyway, the point is that there's the perception that #1 issues sell better than higher issues; that large numbers intimidate people. Poppycock, I say. Honestly, did the high numbers prevent people from picking up "Hush"? I say thee nay.
Of course, not every comic can have Jeph Loeb and Jim Lee working on it (thank goodness for small miracles) to boost sales. I can't speak to the factual truth of that perception, so I'll let it go, but I sure like seeing #500 more than #1. Everyone gets a #1.
I own a bunch of these anniversary issues, from various series. Like I said, there's one every 25 issues almost guaranteed. Typically those issues contain major changes that are eventually undone, or are the culmination of major storylines, which usually restore some sort of status quo. Off the top of my head...
Action Comics #600: Superman and Wonder Woman kiss, ending any chance of their eventual relationship up until Kingdom Come.
Superman #75: Killed Superman. He got better. Came in a black polybag with all sorts of goodies.
Adventures of Superman #500: Superman and Pa Kent meet in the afterlife during Pa's near-death experience. Also introduced the four wannabe Supermen. Came in a black polybag, the cover had some sort of inexplicable plastic clingy thingy.
Superman #82 and Adventures of Superman #505: Not anniversaries, but respectively contained the end of the Reign of the Supermen storyline and the restoration of Superman's costume and status quo. The former had a chromium cover, the latter a holo-foil one. All hot on the heels of that polybagged AoS issue. If that's not a little excessive, I don't know what is.
Superman #100: Kicked off the "Death of Clark Kent" story, where Superman gave up his civilian identity due to the machinations of the Green Go--er, Conduit, a villain who was really kind of wasted.
Action Comics #700: somewhere in the "Fall of Metropolis" storyline. Metropolis fell down. It got rebuilt. Repeatedly.
Superman #200: Mercifully ended Stephen Seagle's reign of terror on the title, killed Cir-El, caused the greatest sigh of relief ever breathed by Superman fans, right up until Chuck Austen left the book.
Superman: The Man of Steel #100: Introduced Superman's second post-Crisis Fortress of Solitude; started a tradition of Mark Schultz being the only writer to understand that Fortress.
Wonder Woman #100: Killed Artemis, restored Diana as Wonder Woman, got her to give up the half-jacket and bicycle shorts.
Flash #100: Killed the Flash, introduced the Speed Force (which lasted what, 125 issues? That's quite the status quo alteration).
Flash #200: Brought Wally's kids back, answered the question of the new Capt. Boomerang's parentage.
So, what are your favorite anniversary issues? What changes managed to stick around? What was undone within a year?

domain: entertainment


text:
This product is currently Unavailable
Young bee keepers can hone their fine motor skills with this colourful beehive toy. Use finger and thumb or the tweezers to grab the bee and put it into the corresponding colour hive. It's a great way to learn colours and encourage turn-taking when playing with a friend.
Suitable for 3+ Years
Size: each hive measures 5 x 5.7 x 4.5 cm
Material: Planwood/Rubber wood
Care: wipe clean
About The Brand
Plan Toys are the original eco toy maker leading the way in sustainable manufacturing and quality wooden toys to stimulate young children. The aspect that drew us to Plan Toys was that they use rubber wood from trees that no longer produce latex and would otherwise be burnt, some toys are made from 'eco Plan Wood' which is made from another waste product, the roots of the rubber trees.
This sustainable wood source is then kiln dried without the use of chemicals, glued together with Plan Toy's own e-zero formaldehyde free glue and dyed with water based dyes to create a wonderful selection of eco friendly wooden toys. Using waste products from production to fuel their factory, along with solar energy, keeping their impact on the environment as minimal as possible.

domain: hobby


[TCML] quench times again
list at future-technologies.co.uk
Wed Nov 21 18:08:16 MST 2007
>>I was looking at http://www.richieburnett.co.uk/wavefrms.html real
>>looking at the discharge waveforms. The spark has arced to ground and
>>all the voltage even before it gets to the first notch. So if the coil
>>on the first ring up cycle then all the RSG times and notches are
>>meaningless really ?
> Yes, you are correct.
So is this the same for sparks in air ? Looking at the waveforms the corona
discharge is not pulling enough power to kill the input waveform.. well not
by much anyway...
More information about the Tesla


text:
Restaurant Tolerated a Sexually Hostile Work Environment, Federal Agency Charged
LITTLE ROCK, Ark. - Pei Wei Asian Diner, LLC, doing business as Pei Wei Fresh Kitchen in Little Rock, will pay $300,000 to former employees as part of a settlement of a sexual harassment and constructive discharge lawsuit brought by the U.S. Equal Employment Opportunity Commission (EEOC), the federal agency announced today.
According to the EEOC's lawsuit, the company failed to take action in response to severe and pervasive sexual harassment by the restaurant's general manager after teens and other young female employees complained about the abuse.
Sexual harassment violates Title VII of the Civil Rights Act of 1964. The EEOC filed suit in U.S. District Court for the Eastern District of Arkansas, Western Division (now referred to as the Eastern District of Arkansas, Central Division), Civil Action No. 4:19-cv-718, after first attempting to reach a pre-litigation settlement through its conciliation process.
Under the three-year consent decree settling the suit, in addition to the monetary payment, Pei Wei will revise its written policy prohibiting sexual harassment. The company must revise its procedures to ensure that all complaints receive prompt attention by upper management and are thoroughly investigated. Pei Wei must disseminate a copy of its policies and procedures to all employees and will conduct training at its Little Rock location.
"Young women are especially vulnerable to sexual harassment by an older manager," said Faye A. Williams, regional attorney of the EEOC's Memphis District Office, which has jurisdiction over Arkansas, Tennessee, and portions of Mississippi. "Title VII ensures that employees can work in an environment free of sexual harassment. The EEOC continues to take sexual harassment complaints very seriously."
Pamela Dixon, lead attorney on the case, added, "The EEOC appreciates the fact that Pei Wei moved quickly to resolve this matter without protracted litigation and agreed to put measures in place to ensure similar conduct would not be repeated."
Delner Franklin-Thomas, district director of the Memphis District Office, encouraged employers to "regularly monitor their workplaces to ensure that employees are not subjected to sexual harassment and that all employees are aware of the avenues by which to complain."
The original complainant in this lawsuit was also represented by Chad Green of Green & Gillespie in North Little Rock.
Learn more about this lawsuit on the U.S. Equal Employment Opportunity Commission website. The EEOC advances opportunity in the workplace by enforcing federal laws prohibiting employment discrimination. More information is available at www.eeoc.gov.

domain: law


text:
August 16 2016
Sometimes you can be surrounded by a large group of happy people having fun who want to hang out with you yet, you still feel alone. Sometimes something as simple as getting out of bed feels so overwhelming and exhausting it is enough to make you just want to crawl back into bed and stay there all day, maybe even all week. Sometimes you really don’t want to get ready for school or work or anything at all because that would mean having to go out of your room and deal with life which to some seems like just another part of a daily routine, but for you it means having to get out of bed, and getting ready for the weight of the world to crush you into oblivion. While the world will not actually crush you into oblivion, when you have depression, it can certainly feel like it.
Depression is categorized as a mental disorder that is caused by a combination of genetics, chemical imbalance, environment and psychological factors. It is important to also include any potential major life changes (relationship ending, death of a loved one, loss of job), medication, drug abuse, other health problems, even the changing of seasons as factors for depression as well. We at Naturiste are not professionals at diagnosing depression; however it is known that if you can identify with a few if not all of the following symptoms and this seems to just not go away, you may possibly suffer from depression:
- Frequent feelings of hopelessness and helplessness
- Loss of interest in friends and activities you typically enjoy
- Feeling drained of energy all the time
- Notable change in sleeping and eating habits (sleeping much more or less, eating much more or less)
- Difficulty concentrating on tasks
- Consistent negative thoughts and difficulty getting rid of them
- Increased irritability and restlessness
- Engaging in reckless behaviour such as reckless driving, excessive drug and alcohol consumption, getting into fights etc.
- Unexplained aches and pains
- Suicidal thoughts and tendencies*
* If you feel you may be a potential danger to yourself please try to call a suicide prevention line like 1-866-277-3553. You have so much more to live for than you think you do, you do not need to hurt or kill yourself to escape the negativity that you feel.
One of the many reasons why people suffer from depression is a chemical imbalance, to be more specific, someone who is suffering from depression will likely have lower than average serotonin and dopamine levels in their brain. Serotonin helps to regulate appetite, sleep and mood and it also inhibits pain, low levels of serotonin have been linked to those who suffer from depression and suicidal thoughts. Dopamine plays a role in how someone perceives reality; lack of dopamine has been linked to psychosis. It is also the brain chemical that gives the brain and body gratification, the same feeling when people abuse drugs which is why those who suffer from clinical depression are more likely to abuse substances than those who do not suffer from it.
Antidepressants can be very useful, sometimes even crucial to help with someone’s depression and no one should be ashamed for needing them; unfortunately it can be difficult sometimes to find the right one that works for you without any unwanted side effects. Many people have been trying to find natural alternatives or complimentary natural supplements that help with depression along with finding healthy lifestyle choices. Finding a good therapist is a very worthwhile option, it is good to have an unbiased person who has no former opinion of you try to help. Having a professional to talk to can help you get to some of the underlying reasons of finding out why certain things may trigger your depression. Bottling up your emotions is a sure way to make you feel far more depressed and very lonely. Foods rich in iron, vitamin B6, natural fats, protein and riboflavin will help boost serotonin and dopamine in your brain, combined with physical activity such as hiking, yoga, swimming, biking, basically anything that can be both meditative and physically exerting will help to regulate dopamine and serotonin levels. As for natural supplements to take, 5-htp, rhodiola, omega-3’s and Saint John’s wort are all very good options as either natural compliments or alternatives to pharmaceutical antidepressants. One thing, however, that is really important, even if it seems impossible, try to love yourself. You are loved, you are not a burden to anybody, you matter and you can pull through this.

domain: psychology


WXYZ-TV WEB TEAM & ASSOCIATED PRESS — A United States Marine with Michigan ties is now facing charges along with two others in connection to the January 6, 2021, Capitol riots.
According to court documents unsealed on January 19, the investigation into Dodge Dale Hellonen began when fellow Marine Micah Coomer allegedly posted photographs from inside the U.S. Capitol Building on January 6 to social media.
Investigators were reportedly able to identify Coomer, Hellonen, who is said to be based at Camp Lejeune and has a Michigan driver's license, and Joshua Abate, another Marine, from video footage taken that day.
It is alleged that Coomer, Abate and Hellonen unlawfully entered the Capitol Building. The criminal complaint says all three of the men were captured on surveillance video throughout the Capitol Building using their cell phones to take pictures, videos and answer calls.
The men spent about 52 minutes inside the Capitol, authorities say. At one point while in the rotunda, they put a red “Make American Great Again” hat on a statue to take pictures with it, according to court papers. Hellonen was carrying a “Don’t Tread on Me” flag, authorities said.
No defense lawyers for the men were listed in the court docket, so it was not immediately clear whether they have attorneys to comment on their behalf.
Their service records show they are all active-duty Marines. Maj. Kevin Stephensen, a spokesman for the Marine Corps, said it is aware of the allegations and “is fully cooperating with appropriate authorities in support of the investigation.”
Hellonen, Coomer and Abate are facing the following charges: Knowingly Entering or Remaining in any Restricted Building or Grounds Without Lawful Authority, Disorderly and Disruptive Conduct in a Restricted Building or Grounds, Disorderly Conduct in a Capitol Building; and Parading, Demonstrating, or Picketing in a Capitol Building.
Nearly 1,000 people have been charged so far in the riot and the tally increases by the week. Almost 500 people have pleaded guilty to riot-related charges and more than three dozen have been convicted at trial.
View the Statement of Facts below:
The Associated Press contributed to this report.


Iran, the world’s most prolific executioner after China, has hanged a woman and four men for murder in defiance of mounting criticism from human rights groups.
One of those executed in Tehran’s notorious Evin prison had killed a five-year-old boy while robbing his home. The woman was put to death for killing her husband after discovering he wanted to marry another woman, a government daily reported Thursday.
Wednesday's hangings brought to 232 the number executions in Iran this year, compared to 317 in 2007, according to Amnesty International figures. China, a far more populous country, carried out 407 death sentences last year.
Human rights groups and European governments have criticized Iran for an increase in the number of hangings since authorities launched a clampdown on “immoral behaviour” in July.
Of particular concern is the number of youths facing execution for crimes they committed as children which has reached “crisis levels," Amnesty International told The Times. There are “at least 132 juvenile offenders known to be on death row, although the true number could be much higher,” the organization said.
Human rights groups accuse Iran of resorting excessively to the death penalty while Tehran counters that it is an effective deterrent used only after a thorough judicial process.
Iran’s national police chief, Esmaeil Ahmadi-Moqaddam, claimed at the weekend that the number of violent crimes, including murder, kidnap and armed robbery, had fallen by 50 percent over the past two years.
Much crime is drug-related as Iran battles heavily-armed traffickers from neighboring Afghanistan, Europe’s main supplier of heroin. Youth unemployment is another factor: many emigrate but some who cannot turn to drugs and crime.
The harsh political climate fostered under Mahmoud Ahmadinejad, the country's hardline president, also contributes to the high execution rate, analysts said.
“He’s a throwback to the early days of the (1979) Islamic Revolution and so you get the hardline social attitudes that go with the enforcement of Sharia law,” Michael Axworthy, an Iran analyst at the Institute of Arab and Islamic Studies at Exeter University, told The Times.
Capital offenses in Iran include murder, rape, armed robbery, drug trafficking, adultery, treason and espionage.


text:
In most programs when a 6-foot-5, five-star receiver with great hands and speed arrives on campus it doesn't take long for him to crack the starting lineup.
Subscribe today to read the full article and get everything Rivals has to offer.
- Member-only message boards
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domain: sports


Weighing just 3.7 lb and able to hold up to 30.9 lb, the GC269TB2 can extend from a minimum height of 16.7" up to 64.6". The 5-section legs are secured with twist locks and can be independently adjusted in both height and leg angle. The legs reverse-fold around an optional ball head to help maintain the compact folded length of 16.5.The B2 Double Action Ball Head has a dual-action design featuring separate knobs for the panning adjustment and ball movement. It can hold up to 44 lb, and weighs just 1 lb. The quick-release clamp is Arca-type compatible, and a QR plate is included with the head.
One of the tripod's legs can be detached and paired with the center column to produce a full-size monopod. The Quick Flip 90° center column can quickly go from vertical to horizontal without the use of any tools. Twist locks with rubberized locking grips, combined with anti-rotation legs, enable fast and fumble-free set-up, plus weather and dust-resistance. The GC269TB2 is equipped with interchangeable screw-in rubber feet and stainless steel spiked feet.A thick layer of closed-cell nitrile butadiene rubber (NBR) provides a comfortable grip when carrying your tripod. A removable ballast hook can be screwed into the bottom of the center column, allowing you to hang additional weight from the tripod for increased stability. An included durable case with a shoulder strap provides protection and transport for your tripod. With the center column in the horizontal orientation and the addition of one or two GoCouplers, you can mount one or two cameras, a digital workstation, or a slider to the tripod. 30.9 lb (14 kg).
Tripod: 64.6" (164 cm) Monopod: 67.5" (171.5 cm). Maximum Height w/o Column Extended. 16.7 (42.5 cm). 3.7 lb (1.9 kg).
60.7 (154.2 cm). 2.7 lb (1.2 kg).Benro GC269TB2 GoTravel Carbon Fiber Tripod with B2 Ball Head. Carrying Case with Shoulder Strap. The product serial number must match the serial number in our database. We maintains serial number tracking. Once we receive and inspect the product we will credit your account. Please allow 5-7 days for a credit to appear on your account. Replacement: We will send a product replacement after the authorized return has completed our receiving/inspection process. Please allow for additional processing time after holidays. The item "Benro GC269TB2 GoTravel Carbon Fiber Tripod with B2 Ball Head Photographic" is in sale since Saturday, June 3, 2017.
This item is in the category "Cameras & Photo\Tripods & Supports\Tripods & Monopods". The seller is "tikalexpress" and is located in New York. This item can be shipped to United States, Canada, United Kingdom, Denmark, Romania, Slovakia, Bulgaria, Czech republic, Finland, Hungary, Latvia, Lithuania, Malta, Estonia, Australia, Greece, Portugal, Cyprus, Slovenia, Japan, China, Sweden, South Korea, Indonesia, Taiwan, Thailand, Belgium, France, Hong Kong, Ireland, Netherlands, Poland, Spain, Italy, Germany, Austria, Israel, Mexico, New Zealand, Singapore, Switzerland, Norway, Saudi arabia, Ukraine, United arab emirates, Qatar, Kuwait, Bahrain, Croatia, Malaysia, Chile, Colombia, Costa rica, Panama, Trinidad and tobago, Guatemala, Honduras, Jamaica, Philippines.