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progression rate and survival in patients with metastatic breast cancer

Activation of the extrinsic coagulation system and the fibrinolytic cascade within a tumour is thought to be related with growth, invasion and metastasis. We have investigated the relationship between these markers of fibrin metabolism, standard clinicopathological variables fake hermes bag blue and serum levels of angiogenic cytokines in three cohorts: group A (n consisted of 30 healthy female volunteers, group B (n of consecutive patients with operable breast cancer and group C (n of patients with untreated or progressive metastatic breast cancer. Plasma D dimers, fibrinogen, IL 6, vascular endothelial growth factor and calculated vascular endothelial growth factor load in platelets are clearly increased in patients with breast cancer. D dimers were increased in nearly 89 of patients with progressive metastatic disease. The level of D dimers was positively correlated with tumour load (P number of metastatic sites (P progression kinetics (P and the cytokines related to angiogenesis: serum vascular endothelial growth factor (P Spearman correlation calculated vascular endothelial growth factor load in platelets (P Spearman correlation and serum interleukin 6 (P Spearman correlation Similarly increased D dimer levels were positively correlated with increased fibrinogen levels (P Spearman correlation The association between markers of fibrin degradation in patients with progressive breast cancer suggests that the D dimer level is a clinically important marker for progression and points towards a relation between haemostasis and tumour progression. Ongoing angiogenesis is recognized by the presence of immature vessels, with endothelial cells displaying a pro coagulant phenotype (Brock et al, 1991; Zucker et al, 1998; Benjamin et al, 1999). Among the pro star wear hermes bag replica angiogenic cytokines vascular endothelial growth factor (VEGF) has spurred the most interest (Bicknel and Harris, 1991; Carmeliet et al, 1996a, Carmeliet and Collen, 1997).

The capacity of VEGF to increase vascular permeability is considered to be critical (van Bruggen et al, 1999; Yano et al, 2000). Plasma and serum VEGF levels are elevated in a majority of untreated cancer patients and these levels are predictive for the clinically measured tumour doubling kinetics (Dirix et al, 1996, 1997). Serum VEGF levels are always much higher than plasma levels (George et al, 2000). Different studies have consistently observed a significant correlation between platelet count and serum VEGF of patients with different types of cancer (M et al, 1997; Salgado et al, 1999; Verheul et al, 1999; Vermeulen et al, 1999).

Systemic abnormalities of haemostasis in cancer patients have increasingly been recognized, but whether this abnormal haemostasis bears any significance in the pathogenesis of the malignant process remains unclear. Many coagulation factors have been found to be either increased or depressed in plasma of cancer patients and increased markers of fibrinogen degradation are among the most frequently observed haemostatic alterations (Murray, 1991). Several reports have strengthened the concept of a physiological connection between activated coagulation and angiogenesis in human cancer. Previously, the activation of coagulation in cancer was mainly considered to be the result of increased expression of tissue factor (TF), leading to the activation of the extrinsic coagulation pathway (Kakkar et al, 1995). Recent data have shown that TF also leads to increased expression of VEGF and decreased transcription of thrombospondin, and inhibitor of angiogenesis (Zhang et al, 1994; Contrino et al, 1996; Carmeliet et al, 1996b). The activation of the coagulation system occurs also in the perivascular region in human cancers and contributes to tumour stroma formation, even at a very early stage of tumorigenesis (Shoij et al, 1998; Brown et al, 1999).

Similarly, platelet turnover is increased even in the presence of thrombocytosis and an increased platelet number has been shown to be predictive for shorter survival in patients with colorectal and lung cancer (Honn et al, 1992; Monreal et al, 1998). Others have reported on platelet activation and consumption in patients with solid tumours (Verheul et al, 2000).

In an earlier study the serum levels of cytokine IL 6 were found to relate with the total amount of VEGF in serum, and also with the calculated platelet VEGF content (Salgado et al, 1999). This is in accordance with the known thrombopoietic and VEGF up regulating activity of IL 6 (Clarke et al, 1996; Cohen et al, 1996). IL 6 is considered to have direct angiogenic activity (Motro et al, 1990; Mateo et al, 1994).

We have attempted to relate levels of D dimers with the extent of disease and progression rate in patients with breast cancer. We further examined in these patients whether markers of ongoing fibrin degradation showed any relation with markers of angiogenesis.

Top of pageMaterials and methodsMaterials and methods Results Discussion References Figures and TablesPatientsGroup A is the control group and consists of 30 female volunteers. The 107 female patients with breast cancer are divided into two cohorts; group B includes 23 consecutive patients with newly diagnosed stage I or II disease (Table 1) and group C includes 84 consecutive patients with metastatic disease, either primarily untreated or progressive after therapy (Table 2). From Hermes classic Kelly bag replica these 107 (groups B consecutive patients, different clinical and pathological variables were collected; age at diagnosis, current age at sampling time, menopausal state, disease free interval after primary treatment, number and type of prior systemic therapies including adjuvant treatment, histological type, hormone receptor status, number and sites of disease (locally, lymph node and soft tissue, liver, lung, bone, brain and other). Blood samples were collected in group C when untreated metastatic disease was either initially diagnosed or progression of disease was documented radiologically and prior to the initiation of a (new) systemic therapy. For patients in group B sampling occurred at the moment of diagnosis prior to initiation of treatment or biopsy. For bony lesions a whole body technetium scan at the time of data collection was used, with limited disease being equal to 1 hot spots, moderate load implying 3 separate hot spots and large tumour load more than five separate spots. For liver involvement a standard contrast enhanced CT scan and for pulmonary lesions a standard X ray or a CT scan were used. Two investigators scored each patient separately. A reliable estimation of tumour load was considered feasible in 80 patients.

Tumour progression kineticsTumour progression was estimated for every patient in group C, if any measurable (in two dimensions) lesion was documented, either clinically or radiologically at the moment of entry into the study and at some point in time during the preceding 3 months. Disease progression was considered to be rapid, when estimated tumour doubling time (duplication of surface area) in any one lesion was less than 3 months. In 58 of the 84 patients an estimation of the kinetics of tumour progression was made. These were divided into a rapid ( months) and a slow progressive group ( months).

Blood collection and testsCoagulation tests Plasma was collected into a 3 blood collection tube, containing trisodium (Vacutainer, Becton Dickinson). Samples were prepared by centrifugation at 2200 for 10 Prothrombin time (PT), partial thromboplastin time (PTT) and fibrinogen (FG) were determined on the photo optical SYSMEX CA6000 Coagulation automate. For the PT determination, a recombinant human tissue factor was used and for the aPTT a phospholipid reagent with particulate activator was applied (micronized silica). Quantitative D dimer levels were obtained using the enzyme linked fluorescent assay (ELFA) on a mini VIDAS system (bio Merieux). The assay employs a quantitative sandwich enzyme immunoassay technique combining a bound anti D Dimer monoclonal immunoglobulin with an unbound enzyme labelled anti D dimer monoclonal immunoglobulin. All coagulation parameters are measured on citrated plasma within 2 of sample collection. Whole blood collection was made by taking a venous blood sample of 3 into a blood collecting tube containing EDTA as anticoagulant.

Angiogenic cytokines Simultaneously with the previous blood sampling, another 10 of venous blood was drawn into a serum separator tube (Vacutainer, Becton Dickinson) and allowed to stand for 30 at room temperature to ensure full clotting. All samples were centrifuged at 3000 for 5 and the supernatanses were aliquoted and stored at Serum levels of bFGF, VEGF and IL 6 were determined using three different enzyme linked immunosorbent assays (ELISA) (R Systems, Minneapolis, MN, USA; Quantikine High Sensitivity human FGF basic; Quantikine human VEGF; Quantikine human IL 6). Within assay reproducibility has been tested before (Dirix et al, 1996, 1997; Salgado et al, 1999; Vermeulen et al, 1999) All samples were run in duplicate. The upper limit of normal for these cytokines was defined by using a 95 confidence limit from the mean value obtained from healthy volunteers.

Statistical analysisStatistical analysis was performed with the Statview 4.51 software application (Abacus Concepts) on an Apple Macintosh personal computer. Spearman correlation coefficients were used to examine the association between pairs of variables. Comparison of continuous variables in different subgroups were performed by Mann U test or by a Kruskal test. Relationships between categorical variables were compared using a test. Overall survival was studied by Kaplan method analysis. Univariate survival curve differences were tested for significance with a log rank test. A Cox proportional hazards regression model was used to assess the prognostic significance of the parameters taken in association.

Top of pageResultsMaterials and methods Results Discussion References Figures and TablesPatients characteristicsThe characteristics of the study population are listed in Tables 1 and 2. A total of 107 blood samples were collected from 107 patients (23 patients of group B, 84 of group C). The 84 patients of group C are part of a total of 140 patients treated during that same period (8 months) with progressive disease. Of those 140 patients, 50 were excluded because progression became apparent within 4 weeks of chemotherapy administration. In the same period two patients were admitted with both progressive disease and a thrombotic event (one arterial thrombosis of the lower limb considered to be a tumour related event, one patient with deep venous thrombosis and pulmonary embolism). Four patients were excluded because of persisting thrombocytopenia after chemotherapy. Most tumours were infiltrating ductal carcinomas (85.7 Only 18 patients had been chemotherapy treated for metastatic disease. A majority of patients (46 out of 84, 54 was progressive under hormonal therapy after either ovarian ablation in 12, tamoxifen in 28, or exemestane in eight. In 20 patients sampling occurred at the time of first diagnosis of metastatic disease, six of these patients were diagnosed to have metastatic disease during their initial staging procedure for breast cancer. The extent of metastasis is shown in detail both with regard to type and number of sites, and including an estimation of tumour load. Within group C, D dimer levels were higher in patients with higher tumour load. The differences between these three groups were all highly significant (P Similarly D dimer levels were higher in patients with rapid progressive disease compared to the slowly progressive group. Of the other variables number of sites (more than 2 vs 1; P and the presence or absence of liver metastasis (P were significantly related to higher D dimer levels. Tumour type, differentiation, receptor status, menopausal status at diagnosis, prior treatment, were not significantly related to D dimer level. Of all factors examined, only D dimer levels showed a significant correlation with both number of sites involved and an estimation of load of disease in one of the three sites mentioned. The number of platelets was not different between both groups of breast cancer patients. Within group C however, platelet counts were higher in the group with fast progressive disease compared to the group with slow progressive disease. Platelet count was not related to tumour type, differentiation, receptor status, menopausal status at diagnosis, age at diagnosis, disease free interval, prior treatment, volume of disease, number of sites involved, nor presence or absence of liver metastasis. In group C, 47 out of 84 patients had increased serum VEGF levels, whereas only seven out of 23 of the patients with stage I or II breast cancer had increased serum VEGF levels ( test; P Within group C, patients with either high tumour load, more than two sites of metastatic deposits, or rapid progression tended to have higher serum levels, but these differences never reached clear statistical significance with respective P values of 0.08, 0.09 and 0.089. A significant linear relationship between serum VEGF and platelet count was observed in the entire group of breast copy hermes bag blue cancer patients (Spearman correlation P The calculated VEGF load (pg) per 106 was significantly higher in the 107 breast cancer patients compared to our controls. But similarly as for serum VEGF, VEGF load per 106 platelets was significantly higher in patients with progressive metastatic disease.

Relationship between markers of increased fibrinogen metabolism and angiogenic cytokines in patients with breast cancerIn both groups of breast cancer patients plasma levels of D dimers are significantly elevated compared to healthy controls. Similarly the D dimer levels are positively related to fibrinogen levels. Results of a more detailed correlation analysis of the different variables from the group of 107 breast cancer patients (group B are given in Table 5. In this group sIL 6 was most strongly correlated with plasma fibrinogen, plasma D dimers, serum VEGF, and sVEGF per 106 platelets. Between D dimer levels and serum IL 6 (P and similarly between plasma fibrinogen and serum IL 6 (P a highly significant positive correlation is observed. Tumour differentiation, hormone receptor status, stage at presentation, number of sites involved, presence of visceral disease, serum IL 6, plasma VEGF, serum fibrinogen were also prognostic parameters. For Cox multivariate analysis in OS studies, only DD, fibrinogen and presence of visceral disease remained significant.
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Periprocedural management of patients receiving novel oral anticoagulants

However, broad clinical experience with them is lacking.

Objectives To review guidelines and evidence for the use of non vitamin K oral antagonists in the periprocedural environment.

Results Despite the clear advantages of vitamin K oral antagonists, their use can entail risks owing to the scarcity of reversal agents. Consensus has Hermes classic Kelly bag replica been reached about postoperative resumption, which is recommended at 24hours and 48 72hours, respectively, after low risk and high risk bleeding surgery. Bridging with heparin hermes bag replica is recommended in patients with a high risk of thrombosis. Urgent interventions should ideally take place 24hours after the last dose intake. Major copy hermes bag blue discrepancies exist between the American and the European recommendations for neuraxial procedures. The American proposals recommend suspending the drug classic hermes bag replica for five half lives, whereas the European approaches suggest suspension of just two half lives. Suggestions for perioperative discontinuation vary widely. All agree that there should be an increase in the number of days of interruption in high risk bleeding procedures versus low risk bleeding procedures.

Conclusions A diverse number of approaches have been suggested for perioperative management of novel oral antagonists. American recommendations tend to be more rigorous than those of Europe. A need for more studies that measure health outcomes after the use of these drugs would be indispensable.
one hour ago · 0 comments
NZ Court Orders Police to Hand Back Clones of Dotcom's Data Seized in 2012 Raid

New Zealand police will have to hand over the copies they made of Kim Dotcom's devices that were seized during the 2012 raid, according to a report by TorrentFreak on Monday.

The New Zealand Court of Appeal ruled that Kim Dotcom and his co defendants Finn Batato, Mathias Ortmann and Bram van der Kolk should have access to the clones of his devices in order to prepare for their extradition hearing, which has been delayed until February 2015.

According to the report, the prosecution said last month that the data hadn't been handed over Hermes bag season with the main color coordination because some of it was encrypted, which replica birkin handbags made it "impossible for police to verify and investigate its contents." The Court of Appeal said that all non encrypted data should be returned, and the rest will be handed over once the defendants give their encryption passwords to police.

Earlier this year, a court found that the search warrants used in the raid of Dotcom's mansion in 2012 were legal. Police seized laptops and hard drives as part of the raid, and copies of the information on Dotcom's computer were sent to US prosecutors, a move that was deemed illegal previously by the Court of Appeals.

Monday's order said that the two police officers Hermes birkin bags fake who will be given encryption passwords are prohibited from sharing the passwords with others, in particular "to any representative of the government replica hermes handbags of the United States of America.
Yesterday, 22:42 · 0 comments
Part of old GSA Belle Mead Depot reborn as 369

HILLSBOROUGH Members of the Somerset County Freeholders and county Park Commission got an fake hermes leather handbags update on the nearly completed Mountain View Park during a recent site visit.Freeholder Director Patricia Walsh announced that the new county regional park on the 369 acre site, part of the former GSA Belle Mead Depot, will be open to Hermes birkin bags fake the public in the spring of 2017."We're very excited how much is a hermes bag to see the progress here," Walsh said. "The county now has over 15,000 acres of preserved parkland and open space. Mountain View Park will be a great addition to our recreational offerings."The property is next to the county's 5,500 acre Sourland Mountain Preserve and is in close proximity to the township's Ann Van Middlesworth Park. The property is flat and relatively open, providing a sweeping vista of the Sourland Mountain, according to a news release.The township agreed to jointly acquire the property with Somerset County in 2008.Following the purchase, the county and township established a committee of municipal and county officials to oversee the remediation, Hermes bag season with the main color coordination development and maintenance of the property. The funds from the purchase were placed in escrow accounts and have been used toward a massive clean up of the site.
Yesterday, 22:37 · 0 comments
Patients' experience and satisfaction in primary care

AbstractObjective To explore whether responses to questions in surveys of patients that purport to assess the performance replica hermes birkin handbags of general practices or doctors reflect differences between practices, doctors, or the patients themselves.Design Secondary analysis of data from a study of access to general practice, combining data from a survey of patients with information about practice organisation and doctors consulted, and using multilevel modelling at practice, doctor, and patient level.Setting Nine primary care trusts in England.Participants 4573 patients who consulted 150 different doctors in 27 practices.Main outcome measures Overall satisfaction; experience of wait for an appointment; reported access to care; satisfaction with communication skills.Results The experience based measure of wait for an appointment was more discriminating between practices (practice level accounted for 20.2% (95% confidence interval 9.1% to 31.3%) of variance) than was the overall satisfaction measure (practice level accounted for 4.6% (1.6% to 7.6%) of variance). Only 6.3% (3.8% to 8.9%) of the variance in the doctors' communication skills measure was due to differences between doctors; 92.4% (88.5% to 96.4%) of the variance occurred at the level of the patient (including differences between patients' perceptions and random variation). At least 79% of the variance on all measures occurred at the level of the patient, and patients' age, sex, ethnicity, and housing and employment status explained some of this variation. However, adjustment for patients' characteristics made very little difference to practices' scores or the ranking of individual practices.Conclusions Analyses of surveys of patients should take account of the hierarchical nature of the data by using multilevel models. Measures related to fake hermes kelly bagd patients' experience discriminate more effectively between practices than do measures of general satisfaction. Surveys of patients' satisfaction fail to distinguish effectively between individual doctors because most of the variation in doctors' reported performance is due to differences between patients and random error rather than differences between doctors. Although patients' reports of satisfaction and experience are systematically related to patients' characteristics such as age and sex, the effect of adjusting practices' scores for the characteristics of their patients is small.IntroductionSurveys of patients are increasingly used internationally as an indicator of the performance of health systems. In some countries, the results of surveys are used within "pay for performance" schemes.1 2 Under the national quality and outcomes framework, general practices in the United Kingdom receive some of their income according to the results of a national survey of patients' experiences.3Being sure that patients' responses in surveys act as a reliable indicator of performance is therefore important. Patients can describe high levels of satisfaction at the same time as describing experiences that are suboptimal,4 and patients' subjective satisfaction varies systematically with certain characteristics such as the age, sex, and ethnicity of the patient.5 6 7 Whether this is because of differences in expectation, differences in the service provided to patients with different characteristics, or differences in the way patients report their experiences is unclear.8In response to these problems, a recent trend has favoured questions about patients' experiences (box 1).4 This is based on the assumption that reported experience should be less influenced by subjective expectation than is reported satisfaction. However, whether reports of patients' experiences are also systematically associated with sociodemographic characteristics is not clear.9Were you able to get an appointment within two working days?How long after your appointment time do you normally wait to be seen?Satisfaction questionsThese are subjective and often non specific. For example:How satisfied are you with the appointment system in your practice?How do you rate your doctor's caring and concern for you?An ideal measure of patients' experiences for use in general practice should show variation between high performing and low performing practices, with less variation between patients within practices than would be anticipated for questions about satisfaction. Conversely, if a measure shows little variation by practice this would imply that the measure is an unreliable indicator of practices' performance.Many surveys of patients include questions about individual doctors as well as questions about practices' organisation. In theory, if these questions are reliable, scores obtained from questions about doctors' performance should show considerable variation between different doctors, with "good" doctors getting consistently high scores from patients and "poor" doctors getting consistently low scores. However, patients' reports about doctors may reflect their satisfaction with their practice, or vice versa, as well as reflecting the patient's own characteristics. In other words, if patients think their practice is good they may tend to say that the doctor is good, in a form of the "halo effect."10 Alternatively, if patients are dissatisfied with aspects of the practice's performance they may express less satisfaction with their doctor. These considerations about whether variation in patients' responses reflect practices' or doctors' performance are important, because findings from satisfaction surveys are increasingly used in the appraisal and revalidation of individual doctors.11Surveys of patients who have recently attended an appointment generate data that have a hierarchical or multilevel structure. Patients are "nested" within doctors, who are "nested" within practices. Analysis of this type of data should therefore use multilevel modelling approaches that take appropriate account of this clustered nature of the data and enable exploration of the sources of variation at each level.12 In the context of this study, this is important because different doctors and practices are likely to attract patients with particular characteristics.The aim of this study was to use a multilevel modelling approach to simultaneously explore the extent fake herme bag to which factors at the level of the practice, the doctor, and the patient determine measures of patients' satisfaction and experience that purport to reflect the performance of individual doctors or practices. The key hypotheses were that more variation in practices' outcomes would occur at practice level than at doctor level, that more variation in outcomes intended to measure the performance of individual doctors would occur at doctor level than at practice level, and that less variation would exist at the level of the patient in responses to questions based on patients' experience than for patients' satisfaction.In addition, we used multilevel modelling approaches to identify the most important variables that explain variation at each level. Although a considerable literature exists about patients' sociodemographic factors associated with satisfaction in primary care,5 6 7 and also about characteristics of general practitioners or practices associated with patients' satisfaction,13 14 few previous studies have appropriately taken account of the three level hierarchical structure in which patients are clustered within doctors and then within general practices.15 16 Multilevel models are increasingly being used to examine sources of variation at different levels of organisation in the health service for example, how consumer assessment scores vary across health plans, medical groups, and providers.16 17 18 19 20Finally, we have used the findings to explore the effect on practices' scores of adjusting for patients' characteristics. This form of adjustment is sometimes used in surveys of hospital patients and has been debated with regard to surveys of general practice patients.8 21 22MethodsThis paper is based on a secondary analysis of data obtained from a survey of patients' satisfaction done in 47 practices that took part in an evaluation of the advanced access initiative in 2005 6. Full details of the survey have been published elsewhere.23 Briefly, patients who consulted each practice over several consecutive days completed a survey after they had hermes replica seen a doctor, with a target of at least 100 completed questionnaires from each practice. Non responders were followed up by a postal reminder.
Yesterday, 20:36 · 0 comments
Peaceful protest turns chaotic as snipers shoot Dallas police

Police officers were ambushed by sniper fire in downtown Dallas Thursday night, as a peaceful protest turned into chaos.

Five officers were killed. Seven other officers and two civilians were wounded.

Police said the attack was a mission to kill as many officers as possible. A suspect, later identified as 25 year old Micah Xavier Johnson was killed after a standoff with police.

"Other options would have exposed our officers to grave danger. The suspect is deceased as a result of detonating the bomb," Brown said during a press conference Friday morning.

During the negotiations, however, Brown said the suspect told them he was upset over the recent police shootings of black victims and wanted to kill white people, especially white police officers. Earlier, police had said three other suspects were in custody, but

The evening began with a protest march in solidarity with victims in this week's police killings of two men in Louisiana and Minnesota, reports CBS News correspondent Manny Bojorquez. But just before 9 o'clock, officers with the Dallas Police Department and Dallas Area Rapid fake herme bag Transit (DART) were targeted by an enemy they couldn't see.

The unprecedented assault unleashed dozens of rounds on downtown Dallas. People marching at the rally stopped walking to run for their lives.

The view from above shows how hundreds of people scattered.

"I was screaming, 'Run, run, run! Active shooter, active shooter!"' the Rev. Dr. Jeff Hood, a rally organizer, said.

Two suspects were arrested in a traffic stop after a brief chase. Police also detained a woman in a community college parking garage.

Four of the officers who were killed were with the Dallas Police Department. One was a DART officer.

"It is a heartbreaking morning. . To say that these police officers put their lives on the line every day is no hyperbole, it's a reality," Dallas Mayor Mike Rawlings said.

The shooter who was involved in the standoff with police claimed bombs were planted throughout the area. Dallas police, joined by ATF personnel, used bomb sniffing dogs to search the downtown area, and found no explosives, a law enforcement source told CBS News senior investigative producer Pat Milton.

Police officials CBS News spoke to around the country described an unease for the safety of police on patrol, reports CBS News correspondent Kris Van Cleave.

This fake hermes kelly bagd is not the first time in recent memory that officers have come under fire during a protest. In Ferguson, Missouri replica hermes birkin handbags in March of last year, two cops were shot during a demonstration outside of police headquarters.

A former law enforcement replica hermes handbags outlet source told CBS News adding additional cops to patrols is common in situations like this. But despite heightened concern for their safety, it is also in the back of officers' minds to be extra careful with their actions because they themselves are more in the spotlight than ever.
Yesterday, 20:31 · 0 comments
Office tower to rise next to historic Hollywood studio

One of Hollywood's biggest landlords is setting the stage for another expansion as the historic heart of the film and broadcast business rises again.

Hudson Pacific Properties, the owner of two neighboring Sunset Boulevard studio lots with golden era pedigrees, plans to build a 14 story office tower next door to the majestic 1920s landmark building that was once executive headquarters of Warner Bros.

The new office building is to be called the Icon at Sunset Bronson Studios. It will stand at Sunset and Van Ness Avenue, where it will replace an imposing radio antenna touting studio tenant KTLA TV Channel 5 that stands west of the 101 Freeway. The 150 foot antenna, visible for miles, will be returned to its original location down the block on Sunset.

Unlike most office buildings, the Icon will have a non uniform exterior with four textures. The tiered, stacked design by architectural firm will make way for landscaped outdoor terraces on several levels of the building. Floor to ceiling glass will alternate with articulated window walls to enhance views and natural light inside the building.

Work on the building is expected to start by the end of the year, even though Hudson Pacific does not have tenants lined up to occupy it.

"We think there is pent up demand," said Alex Vouvalides, chief investment officer of Hudson Pacific.

Icon evokes the spirit of the new Hollywood, an innovative environment that functions as a vertical campus. Victor Coleman, chief executive of Hudson Pacific

The Icon takes on the challenge of making an office high rise that still appeals to tenants in creative businesses such as entertainment and technology. In recent years, most such tenants have shown a preference for low slung buildings, often converted from previous industrial uses, surrounded by gardens or courtyards.

"Icon evokes the spirit of the new Hollywood, an innovative environment that functions as a vertical campus," said Victor Coleman, chief executive of Hudson Pacific.

Unlike most office buildings, the Icon at Sunset Bronson Studios office tower in Hollywood will have a non uniform exterior with four textures.

Unlike most office buildings, the Icon at Sunset Bronson Studios office tower in Hollywood will have a non uniform exterior with four textures. ()

The production building is to provide ancillary space for people renting soundstages.

Improvements to its Sunset Bronson and Sunset Gower studios are part of Hudson Pacific's strategy to help lead the reinvigoration of Hollywood as a destination of choice for people who are making movies, television shows, commercials and other video recordings.

The studios are about 700 hermes replica bag feet apart along Sunset. One prominent new neighbor between them is Emerson College, which recently built a striking teaching and residential facility at 5960 Sunset Blvd. on land it bought from Hudson Pacific.

Hudson built a six story office building on the edge of Sunset Gower Studios that was leased to Technicolor Inc. in 2008. It replica handbag Hermes was the first new office building on a Hollywood lot since the 1970s, Coleman said.

The Technicolor building houses executives, digital production facilities and screening rooms. It has become a hub of the industry as entertainment content travels handbag Hermes copy around Hollywood electronically while it is being produced and processed.

As independent studios, Sunset Bronson and Sunset Gower do not make their own movies and television shows the way Disney, Paramount and other big studios do. Instead, they rent out soundstages and provide support services such as catering and security for fees.

Sunset Gower studios was once the Columbia Pictures lot. The wood paneled office where Harry Cohn reigned as a tyrant for decades is now a spacious conference room.

Tenants working on the lot include actor Warren Beatty, who is making a biopic about Howard Hughes in which he stars. Television shows "Scandal" on ABC and HBO's "The Newsroom" are shot there.

And to the east, nearby Sunset Bronson, the former Warner Bros. studio, is where talkies were born in 1927 with "The Jazz Singer." It is now primarily a television facility and includes shows with live audiences such as "Let's Make a Deal," "Judge Judy" and "The Arsenio Hall Show."

The landmark radio tower, now defunct, was erected around 1924 and was briefly used imitation handbag Hermes to broadcast KFWB (the WB stands for Warner Bros.) But the signal interfered with the sound equipment the studio installed to make talking pictures, so radio operations were moved to the Warner Theater on Hollywood Boulevard and later to Burbank.

Sunset Bronson will house more than 700,000 square feet of offices, soundstages and production related facilities when the Icon expansion is completed in late 2016.

Office space on Los Angeles area movie lots has proved attractive in recent years. Last month, the Oprah Winfrey Network announced that it would move to a new office building called Formosa South at the Lot, a studio in West Hollywood.
Yesterday, 18:33 · 0 comments
Rapid detection of single bacteria in unprocessed blood using Integrated Comprehensive Droplet Digital Detection

Rapid detection of single bacteria in unprocessed blood using Integrated Comprehensive Droplet Digital DetectionDong Ku Kang1, 2, 3, 4, 5 n1, M. Monsur Ali1, 2, 3, 4, 5 n1, Kaixiang Zhang1, 2, 3, 4, 5, 6, Susan S. Huang7, replica Hermes bag Ellena Peterson8, Michelle A. Digman5, 9, 10, Enrico Gratton5, 9 Weian Zhao1, 2, 3, 4, 5Nature Communications 5, Article number: 5427 (2014)doi:10.1038/ncomms6427Download CitationBacterial infectionBacterial techniques and applicationsMedical and clinical diagnosticsSepsisAbstractBlood stream infection or sepsis is a major health problem worldwide, with extremely high mortality, which is partly due to the inability to rapidly detect and identify bacteria in the early stages of infection. Here we present a new technology termed 'Integrated Comprehensive Droplet Digital Detection' (IC 3D) that can selectively detect bacteria directly from milliliters of diluted blood at single cell sensitivity in a one step, culture and amplification free process within 1.5 4h. The IC 3D integrates real time, DNAzyme based sensors, droplet microencapsulation and a high throughput 3D particle counter system. Using Escherichia coli as a target, we demonstrate that the IC 3D can provide absolute quantification of both stock and clinical isolates of E. coli in spiked blood within a broad range of extremely low concentration from 1 to 10,000 bacteria per ml with exceptional robustness and limit of detection in the single digit regime.IntroductionBlood stream infections (BSIs) are a major cause Hermes bag imitation of morbidity and mortality. Sepsis resulting from a BSI annually affects over 18 million people worldwide and 700,000 in the United States, with a mortality rate of 30 40% (refs 1, 2) Sepsis and other aggressive bacterial infections associated with BSIs are often times managed within intensive care units with associated high costs, which impose significant health care, economic and social burdens. For instance, each septic patient in the United States incurs costs of approximately $25,000 during hospitalization, corresponding to $17 billion annually1,2. The extremely high mortality of blood infections is due, in part, to the inability to rapidly detect, identify and thus treat patients with appropriate antibiotics in the early stages of infection1,2,3. The initial treatment with empirical broad spectrum antibiotics not only is inadequate but also encourages antibiotic resistance4,5. It is widely recognized that effective detection and monitoring of patients to diagnose a BSI at an early stage have a profound effect on survival rates1,2,3. However, the present gold standard, bacterial blood cultures coupled with susceptibility testing for drug resistance, requires days to obtain a result. Recent amplification based molecular diagnosis methods including PCR can reduce the assay time to hours but are often not sensitive enough to detect bacteria that occur at low concentrations in blood (1 100 colony forming unit (CFU) per ml) as is commonly found in adults with BSI and therefore often still require a culture enrichment step6,7. Moreover, these conventional methods typically suffer from poor specificity and high background signal because a target bacteria is surrounded by billions of non target species (for example, red blood cells) in the blood sample. More recent nano and micro systems including droplet microfluidics (for example, digital PCR)8,9,10,11,12,13,14,15,16,17,18 can improve detection sensitivity and selectivity but typically are limited to microlitre sample volume, which cannot handle the required clinical sample volume (millilitres) and throughput. Inevitably, the existing methods typically require expensive equipment and lengthy, complex sample processing (for example, cell lysis, nucleic acid extraction, centrifugation, magnetic separation, washing and signal amplification) for target purification and enrichment, which not only results in significant loss of rare target organisms, and therefore contributes to a high false negative rate, but also limit their widespread use especially in a point of care setting (for example, in an ambulance)6.We present herein a platform technology called Integrated Comprehensive Droplet Digital Detection (IC 3D) that is able to selectively detect bacteria from millilitres of unprocessed (although diluted) blood at single cell sensitivity in a one step, and culture and amplification free reaction within 1.5 4h.ResultsOverview of IC 3DOur IC 3D system integrates real time DNAzyme sensor technology, droplet microfluidics and a high throughput 3D particle counter system (Fig. 1). DNAzyme sensors used here are short catalytic oligonucleotides that are identified by in vitro evolution to specifically react with the lysates of target bacteria, leading to a rapid fluorescence signal19. Specifically, blood samples are mixed with the DNAzyme sensor solution including bacteria lysis buffer within a microfluidic channel, which is then immediately encapsulated into 100s of millions of individual picolitre droplets. The confinement of bacteria in droplets that serve as 'microreactors' significantly increases (i) the concentration of released target molecules in the droplets that contain bacteria such that single bacteria can be detected by the DNAzyme sensors in a rapid manner and (ii) target/background ratio to minimize interference from nonspecific binding and noise. In the IC 3D system, droplets are collected following generation into a vial and analysed using a high throughput 3D particle counting system. The 3D particle counter was recently developed by Gratton and colleagues and can robustly and accurately detect single fluorescent particles from millilitre volumes within minutes20,21. In the IC 3D system, the compartmentalized, target specific reaction mediated by DNAzyme sensors is critical to 'light up' the droplets that contain target bacteria so that they can be detected by the 3D particle counter with exceptionally high reliability and clinically relevant throughput.Figure 1: Schematic description of the IC 3D technology.(a) Blood samples and DNAzyme sensors are mixed and then encapsulated in 100s of millions of micrometre sized droplets. DNAzyme sensors produce an instantaneous signal in the droplets that contain the bacterium. (b) In the IC 3D, droplets are collected and analysed using our high throughput 3D particle counter that permits accurate detection of single fluorescent droplets in a several millilitre pool of non fluorescent droplets within minutes.DNAzyme sensors selectively detect target bacteria in bulkDNAzymes (also called 'DNA enzymes' or 'deoxyribozymes') are synthetic single stranded DNA oligonucleotides with catalytic activities22,23. These catalytic DNA molecules are generated in vitro from a vast random library using a combinatorial approach called in vitro evolution24,25. One of the most established DNAzymes is a RNA cleaving DNA motif that can cleave a DNA RNA chimeric substrate at a single ribonucleotide junction22,26. Ali and colleagues have recently harnessed this unique property to generate bacteria specific DNAzyme sensors through in vitro evolution of a vast DNA library against crude extracellular matrix (CEM) components of target bacteria as complex targets19. A later study indicated that the cell lysate produces much higher fluorescence signal compared with the CEM by the DNAzyme sensors, suggesting that the cells contain higher amount of targets than CEM27. In our study, therefore, we decided to lyse the cells to facilitate detection and first tested a series of detergents and enzymes to optimize the cell lysis condition and identified that lysozyme most efficiently lyses bacteria without interfering with droplet generation and stability or DNAzyme sensor function (see Methods section for details).We sought to use these rapid, fluorogenic DNAzyme sensors in our IC 3D system. As shown in Fig. 2a, the sensor contains a DNAzyme domain that is ligated with the DNA RNA chimeric substrate where the ribonucleotide cleavage site is flanked by a fluorophore and a quencher. This 'inactive' state has a minimal fluorescence signal because of the close proximity of the fluorophore and the quencher. In the presence of target bacteria, E. coli used herein as a model system, DNAzymes will bind to target molecules produced by bacteria and cleave the substrate. The cleavage event (Supplementary Fig. 1) frees the fluorophore from its quencher, thereby generating a high fluorescence signal (Fig. 2b). Moreover, the DNAzyme sensor is able to distinguish target E. coli from control bacteria or mammalian cells with high selectivity (Fig. 2c). We further demonstrate that the DNAzyme sensors previously isolated using stock isolates of E. coli19 can robustly and selectively detect clinical E. coli isolates that were spiked and then lysed in blood (Fig. 2d). It is interesting to note that although the DNAzyme sensor can detect all clinical E. coli samples, the fluorescence intensity varies between samples, which might reflect the potential molecular heterogeneity between different E. coli strains. Furthermore, fluorescence intensity appeared to be slightly increased in the C. freundii groups comparing to the blood alone control but it was statistically significantly less than the E. coli groups (P0.001, two tailed Student's t test) and was not statistically different than other clinical control isolates (P=0.85, two handbag Hermes copy tailed Student's t test). Nonetheless, this points out the need to rigorously validate the sensor specificity using larger number of patient samples in the future. This also suggests that by including appropriate positive and negative selection targets in the in vitro evolution process, it is feasible to generate DNAzyme sensors that can distinguish different strains of the same bacterium species, which will need to be validated in the future work. As our goal is to develop a 'mix and read' assay that uses whole blood with no or minimal sample processing (for example, dilution), we further tested the sensor performance in blood and found that our Fluorescein/Dabcyl modified DNAzyme sensors produced a sufficiently high fluorescence signal in response to E. coli spiked in blood that was diluted by sensor solution to various volume ratios (Supplementary Fig. 2a) with a 10% final blood concentration determined to be optimal and therefore used in subsequent droplet experiments (below). We hypothesize that optimization of dye pairs, especially using near infrared dyes that are less interfered with by blood autofluorescence in the future, can further improve sensor performance (for example, signal/noise ratio) in blood. We further demonstrated that the DNAzyme sensors exhibited sufficient stability in blood within the time frame (1.5 4h), we target for future clinical use (Supplementary Fig. 2b). If necessary, the use of well established chemically modified nucleotides (for example, phosphorothioates) in DNAzymes or RNase inhibitor in the assay buffer can further increase sensor stability in blood.Figure 2: Real time DNAzyme sensors selectively and rapidly detect target E. coli lysates in bulk.(a) Proposed mechanism of how the DNAzyme sensor generates a fluorescent signal upon interaction with the target. The target(s) produced by the bacterium binds to the inactive DNAzyme sequence (red), which undergoes a conformational change to activate the DNAzyme. The activated DNAzyme catalyses the cleavage of the fluorogenic substrate at the ribonucleotide junction (R), leading to the separation of the fluorophore (F) and the quencher (Q) to produce a high fluorescence signal. (b) DNAzyme sensor produces real time fluorescence signal in the presence of the target E. coli K12 lysates. By contrast, a mutated DNAzyme sequence is inactive. Lysates from 10,000 bacteria and 50nM DNAzyme were mixed in a 50 l final volume in HEPES buffer and signal was recorded using a fluorescence plate reader. (c) DNAzyme sensor specifically detects E. coli strains but not non target bacteria or mammalian cell human T cell lymphoblast CCRF CEM and human umbilical vein endothelial cells (HUVECs). Lysates from 10,000 cells and 50nM DNAzyme were mixed in a 50 l final volume in HEPES buffer and incubated for 30min. DNAzyme reaction products were analysed by polyacrylamide gel electrophoresis. The percentage cleavage for each reaction was derived, normalized against DNAzyme alone control and presented as 'Relative fluorescence'. (d) DNAzyme sensors can selectively detect clinical E. coli isolates. Bacteria (1,000CFU) isolated from 11 different patient samples were incubated with 100nM DNAzyme and 1mgml1 lysozyme in 10% of blood for 30min. Fluorescence intensity was obtained using a fluorescence plate reader, normally against DNAzyme alone control (con) and presented as 'Relative fluorescence'. Data are obtained in a single blind experiment. In c and d, all experiments were performed in triplicate.DNAzyme sensors rapidly detect single bacteria in dropletsWe next integrated DNAzyme sensors with the droplet microfluidics system to test our hypothesis that the confinement of bacteria in droplets can significantly increase the sensitivity (that is, single cell) and shorten the detection time. The 'droplet microfluidics' system enables the generation and manipulation of monodisperse, picolitre sized (typically 5 to 100m in diameter) liquid droplets in an immiscible carrier oil fluid (that is, water in oil emulsion)28,29,30,31,32,33. Droplet microfluidics is an emerging platform for ultra sensitive biological detection and analysis. In particular, the pioneering work from the Weitz and Griffiths groups and from companies including Bio Rad and Raindance have demonstrated a range of droplet based 'digital' assays for nucleic acids (for example, digital PCR), cells and organisms10,31,34. However, the traditional droplet system is limited by its low throughput in droplet analysis and therefore not amenable for analysis of large volume samples (see the 'Rapid detection of single bacteria in clinical blood samples' section)31,34.In our study, droplet microfluidics were fabricated using standard soft lithography and operated following previously established procedures (see 'Fabrication of droplet based microfluidic device' in Methods)35. As illustrated in Fig. 3a, the poly(dimethylsiloxane) (PDMS) chip has one oil inlet and two aqueous inlets (one for bacteria containing buffer or blood with the other one for the DNAzyme sensor mixed with bacterial lysis reagent (lysozyme)). Uniform picolitre sized droplets were generated using standard syringe pumps at a rate of approximately 2,000Hz by flow focusing of the resulting stream with HFE 7500 fluorinated oil containing 1.8% (w/w) perfluorinated polyethers with polyethyleneglycol surfactant (Fig. 3b and Supplementary Movie). We generated droplets with different sizes ranging from 5 to 50m in diameter simply by tuning the microfluidic channel size and flow rate. Figure 3c shows a representative image of 30m droplets that contain 10% blood. We found that these droplets can be stably stored without leaking or merging for months at room temperature even when closely packed in a vial. High throughput droplet generation can be achieved using a multi layer microfluidic device that contains multiple, parallel droplet generating structures (see 'Fabrication of droplet based microfluidic device' in Methods and Supplementary Fig. 3 for an eight channel device). To achieve clinically useful throughput, we are currently developing a device that contains 256 droplet generating channels, which is able to convert 1ml blood to 25m droplets containing 10% blood at a generation rate of 2,000Hz per channel in 40min. In addition, the use of larger droplet and smaller blood dilution factor can further significantly reduce the droplet generation time.Figure 3: Workflow of microencapsulation.(a) Layout of the droplet based microfluidic device. Devices were designed with three inlets; one for oil and the other two for blood samples and DNAzyme/bacterial lysis buffer. (b,c) Representative microscopy images showing uniform 30m droplets containing 10% blood and sensor solution are being generated using flow focusing. Scale bar, 200m. In c, blood contents especially red blood cells are clearly visible in droplets. (d) Droplets collected in the cuvette used for 3D particle counter experiments. (e) Representative fluorescence microscope images demonstrate DNAzyme sensors (250nM) light up the droplets that contain single E. coli K12 in 10% blood after 3 h reaction. Left panel: overlay of fluorescence and brightfield. Right panel: Hermes Kelly handbag fake fluorescence. Scale bar, 200m.As in adult BSI, bacteria are in low numbers in patient's blood (typically 1 100CFUml1), when encapsulated in picolitre droplets, each droplet will contain one or no bacterium. Therefore, it is critical to test if our system is able to detect a single bacterium in a droplet. Specifically, bacteria were statistically diluted to achieve a range of concentrations from 10 to 107ml1 spiked in HEPES buffer or blood and compartmentalized in droplets. In some experiments, bacteria were stained with Syto17 (red), which allows us to co localize the bacterium with the DNAzyme sensor signal (green) in the same droplet to determine false positive and negative rates. In this section, fluorescent droplets were imaged by conventional fluorescent (or confocal) microscopy or counted on chip in a 1D microfluidic channel at a throughput of 200 droplets per s using a custom built confocal microscope equipped with APD detectors (see '1D on chip detection system' in Supplementary Methods). We first demonstrate that, in buffer, the DNAzyme sensor system is able to detect single target E. coli K12 that is lysed in a droplet (5m in diameter) within 8min (Supplementary Fig. 4). This pilot experiment tested our hypothesis that the confinement of bacteria in droplets enables single cell sensitivity and reduced detection time. For detection of bacteria in blood, we needed to optimize droplet size: although smaller droplet sizes lead to higher target concentrations from single cells (which would increase the signal/background ratio and decrease the detection time), it is technically challenging to encapsulate blood contents including red and white blood cells into too small sized droplets. We determined that droplets 25m in diameter are optimal for this purpose and therefore used for subsequent blood droplet experiments. Using fluorescent microscopy (Fig. 3e) or 1D on chip droplet counting system (Supplementary Fig. 5), our system is able to selectively detect single target E. coli K12 in 10% blood in droplets. Furthermore, by co localizing with the Syto17 signal, we observe that our encapsulated DNAzyme sensor system possesses zero false positive rate and minimal false negative rate (0.5%) from 70,000 droplet counts in triplicate experiments, which we performed using E. coli K12 as positive target and sensor alone or control bacteria as negative controls (Supplementary Fig. 5). Finally, although the DNAzyme sensor signal generation in a 25 m blood droplet is not as rapid as that in a 5 m buffer droplet, a measurable fluorescence signal can be observed within 3h in response to a single bacterium in blood (Fig. 3e and Supplementary Fig. 5; see below for further DNAzyme kinetics study).Rapid detection of single bacteria in clinical blood samplesWe have demonstrated above that the encapsulated DNAzyme sensor system can detect target bacteria in a rapid manner with single cell sensitivity in the droplet. However, the 1D on chip droplet counting system (which is also used in the droplet digital PCR system) and other particle counting systems including flow cytometry suffer from low throughput: they typically operate at 1,000s particles per s and are only able to analyse a total of 100,000s to 1 million droplets (or a total sample volume of tens of microlitre)31,34. T
Yesterday, 18:28 · 0 comments
Oorzaken van Folliculitis

Bacterile folliculitis ontwikkelt wanneer bacterin het lichaam door middel van een verlaging, schrapen, chirurgische insnijding binnenkomt, of in de huid in de buurt copy Hermes necklace van een haar follikel vermenigvuldigt. De bacterin kunnen krijgen gevangen en de infectie kan verspreiden van de haarfollikels naar de andere delen van het lichaam.

Bacterile folliculitis mogelijk oppervlakkige of diepe. Oppervlakkige folliculitis, ook wel genoemd impetigo, bestaat uit puisten die kleine afgebakend waterstand van de huid met pus. De puistjes zijn vaak omringd door een ring van roodheid. Diepe folliculitis resultaten wanneer de infectie dieper gaat en meer follikels produceren furuncles en karbonkels omvat. Deze zijn ernstiger dan folliculitis en kunnen leiden tot permanente schade en littekens op de huid.

Bacterile folliculitis treedt meestal op bij kinderen en volwassenen. Staphylococcus aureus is de meest voorkomende oorzaken van bacterile folliculitis. Oppervlakkige schimmelinfecties zijn gevonden in de bovenste lagen van de huid; diep schimmelinfecties binnenvallen diepere lagen van de huid. De infectie van de haarzakjes kan ook verspreid aan Hermes enamel necklace knock off bloed of interne organen.

De dermatophytic schimmel, pityrosporum schimmels en de replica Hermes necklace gist candida folliculitis zijn de prominente onder de oorzaken schimmelinfecties folliculitis.

Dermatophytic folliculitis wordt meestal veroorzaakt door een zoophilic soort, dat wil zeggen schimmel soorten die aantrekkingskracht uit op Toon of affiniteit voor dieren. De voorwaarde presenteert als folliculaire puisten rond een gehard erythematous (rode) plaque. Een diep schimmel relica Hermes jewelry penetratie zorgt ervoor dat een hoge mate van ontsteking en bepaalt de omvang van haar as verlies dat als gevolg van de infectie optreedt.

Tinea capitis of ringworm van het hoofd is de belangrijkste vorm van pediatrische dermatophytic folliculitis. De klinische kenmerken van tinea capitis variren aanzienlijk afhankelijk van de soorten die verantwoordelijk zijn voor de infectie. Meestal, is er een gedeeltelijke alopecia met een verschillende mate van ontsteking.

In de niet inflammatoire varianten, asymmetrische laesies met korte gebroken haar, 1 tot 3 mm lang, in acht worden genomen. Lichte ontsteking met schaling kan worden waargenomen op zorgvuldige inspectie.

De meest ernstige ontstekingsreacties heten kerion en pijnlijke moerassig massa's bezaaid met puisten produceren. Deze letsels kunnen leiden tot ernstige haaruitval en belangrijke littekens wanneer de ziekte in de gevorderde stadia is. De diagnose van tinea capitis is opgericht door het identificeren van het organisme in besmette haren onder de Microscoop. Een diagnose is vaak bevestigd door culturen.

Baardschurft is een oppervlakkige dermatophytic infectie die is beperkt tot de bebaarde gebieden van het gezicht en de hals en gebeurt bijna uitsluitend in oudere adolescente en volwassen mannen. De klinische presentatie van Baardschurft bevat diepe folliculitis, rode inflammatoire papules en puisten met afscheiding, crusting en bijbehorende as haaruitval. De twee belangrijkste soorten veroorzaakt de infectie zijn T. mentagrophytes en T. viridicatum.

Pityrosporum folliculitis wordt veroorzaakt door pityrosporum gisten wat resulteert in een jeukende uitbarsting. De letsels zijn rood folliculaire papules en puisten ligt vooral op de bovenrug, schouders en borst.

Candida folliculitis wordt veroorzaakt door de Candida soorten, dat de meeste mensen gewoonlijk benvloeden alomtegenwoordige schimmels.

Verwante artikelen in haaruitval

Mensen die genteresseerd zijn in het bovenstaande artikel zijn ook genteresseerd in de aanverwante artikelen hieronder:

Probleem van de haren vallen heeft ongetwijfeld meer psychologisch effect dan fysieke. Haargroei is op zijn hoogtepunt tijdens de jaren groeiende, jonge mannen ervaren groei op verschillende lichaamsdelen, terwijl jonge vrouwen hebben weinig groei bij andere lichaamsdelen en grotendeels op hoofd. Hylix olie helpt om te voorkomen dat haren vallen en hen beschermt tegen de schade van de roos en bieden het glanzende effect. Het kan worden gebruikt door zowel mannen als vrouwen.

Haaruitval, beschadigd haar, gebroken haar eindigt, roos en kalende kan veroorzaken nood die kan invloed hebben op vrouwen meer dan mannen. Haar vrouwen is gekoppeld aan schoonheid en seksualiteit. Haar is belangrijk onderdeel van kijken en haarverlies kan het gevoel van verlies van prettiness genereren. Hylix olie is de beste kruiden behandeling om te stoppen met roos en haar verlies probleem. Het helpt om te voeden de follikels wortel om haargroei natuurlijk.
Aug 17 · 0 comments
Obama the Negro

AS EVERY CARBON BASED life form on this planet surely knows, Barack Obama, the junior Democratic senator from Illinois, is running for president. Since making his announcement, there has been no end of commentary about him in all quarters musing over his charisma and the prospect he offers of being the first African American to be elected to the White House.

But it's clear that Obama also is running for an equally important unelected office, in the province of the popular imagination the "Magic Negro."

The Magic Negro is a figure of postmodern folk culture, coined by snarky 20th century sociologists, to explain a cultural figure who emerged in the wake of Brown vs. Board of Education.

As might be expected, this figure is chiefly cinematic embodied by such Hermes imitation necklace noted performers as Sidney Poitier, Morgan Freeman, Scatman Crothers, Michael Clarke Duncan, Will Smith and, most recently, Don Cheadle. And that's not to mention a certain basketball player whose very nickname is "Magic."

Poitier really poured on the "magic" in "Lilies of the Field" (for which he won a best actor Oscar) and "To Sir, With Love" (which, along with "Guess Who's Coming to Dinner," made him a No. 1 box office attraction). In these films, Poitier triumphs through yeoman service to his white benefactors. "Guess Who's Coming to Dinner" is particularly striking in this regard, as it posits miscegenation without evoking sex. (Talk about magic!)

The same can't quite be said of Freeman in "Driving Miss Daisy," "Seven" and the seemingly endless series of films in which he plays ersatz paterfamilias to a white woman bedeviled by a serial killer. But at least he survives, unlike Crothers in "The Shining," in which psychic premonitions inspire him to rescue a white family he barely knows and get killed for his trouble. This heart tug trope is parodied in Gus Van Sant's "Elephant." The film's sole black student at a Columbine like high school arrives in the midst of a slaughter, helps a girl escape and is immediately gunned down. See what helping the white man gets you?

And what does the white man get out of the bargain? That's a question asked by John Guare in "Six Degrees of Separation," his brilliant retelling of the true saga of David Hampton a young, personable gay con man who in the 1980s passed himself off as the son of none other than the real Sidney Poitier. Though he started small, using the ruse to get into Studio 54, Hampton discovered that countless gullible, Hermes enamel necklace replica well heeled New Yorkers, vulnerable to the Magic Negro myth, were only too eager to believe in his baroque fantasy. (One of the few who wasn't fooled was Andy Warhol, who was astonished his underlings believed Hampton's whoppers. Clearly Warhol had no need for the accouterment of interracial "goodwill.")

But the same can't be said of most white Americans, whose desire for a noble, healing Negro hasn't faded. That's where Obama comes in: as Poitier's "real" fake son.

The senator's famously stem winding stump speeches have been drawing huge crowds to hear him talk of uniting rather than dividing. A praiseworthy goal. Consequently, even the mild criticisms thrown his way have been waved away, "magically." He used to smoke, but now he doesn't; he racked up a bunch of delinquent parking tickets, but he paid them all back with an apology. And hey, is looking good in a bathing suit a bad thing?

The only mud that momentarily stuck was criticism (white and black alike) concerning Obama's alleged "inauthenticty," as compared to such sterling examples of "genuine" blackness as Al Sharpton and Snoop Dogg. Speaking as an African American whose last name has led to his racial "credentials" being challenged often several times a day I know how pesky this sort of thing can be.

Obama's fame right now has little to do with his Hermes replica necklace political record or what he's written in his two (count 'em) books, or even what he's actually said in those stem winders. It's the way he's said it that counts the most. It's his manner, which, as presidential hopeful Sen. Joe Biden ham fistedly reminded us, is "articulate." His tone is always genial, his voice warm and unthreatening, and he hasn't called his opponents names (despite being baited by the media).

Like a comic book superhero, Obama is there to help, out of the sheer goodness of a heart we need not know or understand. For as with all Magic Negroes, the less real he seems, the more desirable Hermes white gold necklace fake he becomes. If he were real, white America couldn't project all its fantasies of curative black benevolence on him.
Aug 17 · 0 comments
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