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Philadelphia Theatre Company presents
Prospect Theater Company's original production of
Making Micheaux
April 22nd – May 16th
Music by Alphonso Horne
Book & Lyrics by Jesse L. Kearney, Jr.
Directed by Jeffrey Page
Starring Aaron Marcullus
Alphonso Horne, Endea Owens, Mathis Picard, and TJ Reddick
Director of Photography Brian Bon
Chicago, 1918. Oscar Micheaux stands at a turning point in his life:
Facing down a world which denies him a place in the narrative, what path will he take?
This original jazz musical-on-film is inspired by the life of America's first major Black filmmaker, Oscar Micheaux.
Runtime 15 minutes
How to View:
2020-21 PTC Subscribers will gain automatic access to Making Micheaux on Thursday, April 22nd. It runs through May 16th.
Non-subscribers are asked to register to receive a link to view. Registration opens on Thursday, April 22nd.
Subscribers and those who register will receive a link and instructions for viewing.
Making Micheaux is FREE to all, but we are grateful for donations to support the work we do. Thank you!
If you need assistance please review our FAQs or contact our virtual box office 215-985-1400 (M-F 12-6pm EST) or by email.
MEET THE Creatives
JESSE L. KEARNEY, JR., Book and Lyrics
Jesse L. Kearney, Jr. (Book / Lyrics) is an award-winning playwright whose honors include the ASCAP Musical Theater Workshop and the Jonathan Larson Musical Theater Fellowship from the Dramatist Guild. He received commissions from City Lights Youth Theater to write librettos for Take Two: Hollywood Revue and Lights on Broadway, and has authored three one acts, Dinner For Two, O, Ye Of Little Faith, and Phantasmagoria–
collectively called The Dark Night Plays (Nightmares & Fantasies)–which were presented in Prospect's Dark Nights Series. His musical The Little Playhouse received a workshop in the Lincoln Center Director's Lab / American Living Room Series and he provided book and lyrics for the short musical The Lion In Love (music by Brian Feinstein), and the libretto for The Blind Man (music by Deborah Abramson, lyrics by Peter Mills). His songs have been featured in musical revues throughout NYC. Mr. Kearney is a co-founder and General Counsel of The STAGE Network, a media platform devoted to the performing arts. Education: J.D.: New York Law School, MFA: NYU's Musical Theater Writing Program, BA: Dartmouth College. Proud member of the Dramatist Guild.
ALPHONSO HORNE, Music
Alphonso Horne (Music / Trumpet) is a two-time Grammy nominated trumpeter named by Wynton Marsalis as one of the rising stars of the next generation. He has performed with many renowned artists including Marcus Roberts, Michael Feinstein, Rhiannon Giddens, Marilyn Maye, and Rihanna. On Broadway, he has performed in the orchestras of the Tony winning After Midnight and the Tony nominated Shuffle Along, and was the Music Director for Ziegfeld's Midnight Frolic. Horne leads an active career as a sideman, performing at world-class venues and jazz festivals, including Madison Square Garden (VMA Awards). Projects include playing with Sammy Miller and the Congregation (Ars Nova residency) and the Savannah Swing Central & Music Festival. He is the bandleader of an early jazz band, Gotham Kings, which performs at Jazz at Lincoln Center and Ginny's Supper Club in Harlem. He is producing his original show Mother Kofi: The Tale of an African Princess inspired by his family history and has appeared on "Saturday Night Live" and "The Late Show with Stephen Colbert" and in the film, BOLDEN. Education: Florida State University (BM), The Juilliard School (MM).
JEFFREY PAGE, Director
PTC's Resident Artist Jeffrey Page is an opera and theatre director of both classical and contemporary works. As director and choreographer, he spearheaded the Tokyo production of Memphis, which received four Yomiuri Award nominations, including Best Musical. The first African American to be named the Marcus Institute Fellow for Opera Directing at the Juilliard School, he has also been nominated for an Emmy Award, and won an MTV Video Music Award for his work with Beyoncé. His work was featured on Beyoncé's "The Formation World Tour," in her historic Coachella performance, and in two of her HBO specials. Page was the associate creative director for Mariah Carey's "Sweet, Sweet Fantasy" European Tour, and has been a featured choreographer on Fox's "So You Think You Can Dance."
As a performer, Page was in the original Broadway cast of Fela! and choreographed the Broadway musical Violet starring Sutton Foster. At the Barrington Theatre Company, Page won a Berkshire Theater Award for Joe Iconis' Broadway Bounty Hunter. In 2016, he established Movin' Legacy as an Indianapolis-based nonprofit organization dedicated to the ethnology and documentation of contemporary and traditional dance from Africa and the African diaspora. He holds a Master's of Fine Arts degree, (Theatre Directing) from Columbia University in New York City, and has been awarded the Chuck Davis Emerging Choreographer Fellowship from the Brooklyn Academy of Music.
This fall, Jeffrey joins Harvard University as a Lecturer in Theater, Dance and Media. Currently, he is preparing to choreograph and co-direct, with Diane Paulus, the upcoming Broadway production of 1776, after premiering at the American Repertory Theatre at Harvard University.
AARON MARCELLUS as Oscar Micheaux
Aaron Marcellus (Oscar Micheaux) is a singer, vocal coach, writer, musician, dancer, and actor from Atlanta who got his start in gospel music and has performed around the world. He has recorded albums and was voted top 24 on "American Idol" in 2011. After a world tour, Marcellus was featured in a ChapStick commercial, NBC's "Next Caller," and STOMP. Marcellus also hosts a burlesque show at Duane Park. He founded Surrender to Love, LLC, a foundation that supports arts programs and seeks to feed the hungry and Adventure Voice, a training program offering vocal classes for groups and individuals. He directs The Marcellus Music Ensemble, a new and powerful collection of voices that help to comprise the Marcellus Orchestra.
ALPHONSO HORNE on Trumpet
ENDEA OWENS on Bass
MATHIS PICARD on Piano
TJ REDDICK on Drums
Learn more about Making Micheaux with a post-screening discussion hosted by award-winning writer Kirsten Childs with the creative team.
Making Micheaux Program
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This is just a basic biscuit recipe using olive oil instead of butter. These go good with soup!
Mix all ingredients and stir until just mixed.
Drop by 1/4 cups onto baking sheet about two inches apart.
Bake for 15 – 18 minutes until bottom is golden brown and top is firm.
WOW! These were so fast to make and super tasty. Thank you for the recipe!


text:
An empty chair vs the risk of a crazy Trump crony
Geoff Kitney
A politically stupid choice as next US Ambassador to Australia would hurt public confidence in the relationship.
Photo: Chip Somodevilla/Getty
Published 26 Jun 2018 06:00 1 Comments
Almost two years have passed since the US was represented in Australia by a permanent ambassador. It is now conceivable that Australia will receive a Presidential visit before it gets an ambassador.
This is an unprecedented interregnum.
It is tempting to observe that this is a pretty shoddy way for the US to treat arguably its most loyal ally. At the very least, it is puzzling that the Trump administration does not recognise that Australia might quite reasonably feel it is being taken for granted – a sentiment perhaps reflected in the results of the 2018 Lowy Institute Poll which revealed the lowest ever level of trust in the US by Australians.
The most recent US Ambassador to Australia, John Berry, left the post in September 2016. That was just before the US Presidential election, so there was understandably a delay in the process of choosing his successor.
The Turnbull government has bitten its tongue about what could easily have been seen as a snub.
A year passed until, on 9 February 2018, the Trump administration announced that it intended to appoint top-ranking US military commander Admiral Harry Harris to fill the post. But on 24 April, days before he was due to appear before the US Congress for a confirmation hearing, the appointment was cancelled. Admiral Harris was to be reassigned as US Ambassador to South Korea.
No replacement was named. Instead, the acting ambassador since 2016, career diplomat James Carouso, was asked to continue warming the ambassador's seat.
The Turnbull government has bitten its tongue about what could easily have been seen as a snub, accepting that the decision to reassign Harris reasonably reflected the Trump administration's strategic priorities. However, privately there have been mumblings inside government about the failure of the US to quickly follow up with an alternative nomination for the Canberra post.
But this sentiment has been expressed with one important caveat: the government is just a little nervous about the Trump administration's second choice for Ambassador to Australia.
A former senior diplomat put it this way: maybe it would be better to leave things as they are rather than end up with a "crazy Trump crony".
There is a view at senior levels of the Australian Government that it would be quite happy to see Carouso promoted to fill the ambassador role than to have a controversial appointee. What makes ministers and senior officials nervous is the tendency of the Trump team to choose people for key diplomatic posts who seem to see themselves as political players rather than as diplomats.
In a clear reflection of the Trump administration's lack of regard for convention, several diplomatic appointees have been behaving most undiplomatically in their posts. These include Trump's picks for his ambassadors to two of the US's most important allies – Germany and the UK.
In Germany, US Ambassador Richard Grenell has caused outrage by publicly advocating partisan political positions, including declaring his intention to use his post to "empower" conservatives in Europe. A Trump devotee, Grenell has made a number of statements considered interferences in domestic German politics.
Similarly in London, Trump appointee Woody Johnson has intervened in the heated domestic debate about Brexit, urging the British Government to cast off Britain's "defeatist attitude", take inspiration from Trump's boldness, and get on with leaving the European Union.
The expectation in Canberra is that Trump will make his first presidential visit to Australia in November to coincide with the next APEC Leaders' Summit, to be held in Papua New Guinea on 17–18 November. Officials say they expect a new US Ambassador to be named well ahead of any visit to Australia.
Australian officials say that the initial appointment of Harris as US Ambassador to Australia is an encourgaing indication that the next ambassador will be "a serious appointee".
There is also a view in Canberra's diplomatic circles that the Trump administration has noted the Turnbull government's hard work to establish a good relationship with the US. Australia has backed the US when other Western nations have chosen to be critical of the Trump administration, most notably in relation to Israel and the Israeli government's hard-line security measures.
And where Australia has had different views to the US, on issues such as climate change and the Iran nuclear deal, it has expressed them in careful diplomatic language.
Critics complain that Australia has been too soft, putting pragmatism ahead of principle. The pressing need to keep the Trump administration committed to the Obama-era refugee swap deal, and the imperative to shelter Australia from US tariffs on steel and aluminium are said to have resulted in the Turnbull government pulling its punches, especially on protectionism and the Trump trade wars – issues on which Australia has a proud history of leadership and uncompromising advocacy.
But as on much else, Prime Minister Malcolm Turnbull's foreign policy agenda has proven to be significantly more conservative than had seemed likely before he won the prime ministership. In practice, Turnbull has adopted a much more pro-American agenda than anyone would have expected from his speeches and statements prior to winning the top job.
Government insiders say that, particularly on issues relating to the US and China and Australia's strategic interests, in office Turnbull has modified his views under the influence of the major Australian security agencies.
Given the extent to which the government has worked to demonstrate its strong commitment to the US alliance, at a time when the Trump administration has upended other US alliance relationships, it would be a gratuitous insult to appoint as US ambassador to Australia someone who is obviously a Trump crony or political activist.
While Australians continue to believe the US alliance is vital to Australia's security, the 2018 Lowy Institute Poll shows that public trust in the US is declining. The Trump factor is especially concerning, with less than a third of those polled saying they had confidence in the US President. A third of those polled said Australia should distance itself from the US under Trump.
The Poll figures suggest, therefore, that the Trump presidency is a negative for Australia–US relations. A politically stupid choice as the next US Ambassador to Australia would not be good for public confidence in the relationship, and a potential unwanted political headache for the Turnbull government.
Australia, Vietnam, the diaspora and generational change
The technology shock
Exceptional access: Australia's encryption laws
Emma Connors 16 May 2017 08:53
'This is an incredibly interesting but also challenging time for Australia's Vietnamese diaspora.'
Dougal Robinson 30 Mar 2017 16:35
Trump's legislative headaches no good for predictable foreign policy
If Trump can't get a handle on Washington's politics – not least the requirement to work with Congress – US foreign policy will suffer.
Malcolm Cook 11 Dec 2018 11:00
Separating the Philippine state from the church
Filipino Catholic voters separate the Church from the State and uphold this in political practice.

redpajama_set_name: RedPajamaCommonCrawl


Dear Zindagi Teaser 3 has Alia Bhatt falling in love with love and then falling out of it. Love. Breakup. Repeat. That's life's favorite cycle!Love. Breakup. Repeat. That's life's favorite cycle!, that's what the new teaser of 'Dear Zindagi' is all about. Watch the Dear Zindagi Teaser 3 and share your views in comments below!


"You can call it a miracle or a legend or whatever you want to. I just know that on that day, Brett Favre was larger than life."
- Gene Stallings, Alabama Coach, after Southern Mississippi's Brett Favre led the team to a comeback victory who - six weeks prior - had a near fatal car wreck in which he had 30" of is small intestines removed.
"It was about what I expected," Favre said. "It was probably worse every time I took the field ... but I considered it a good thing. It's better than saying nothing, I guess. I know what I did here. You can ask the teammates I played with here. ... I would venture to think all the guys I played with would speak positively about the way I carried myself. ... Although I wasn't expecting a standing ovation, I know what I've done and what I stand for."
As he went on he got a little emotional. I checked behind him during this interview to see if any Green Bay fans were still there cheering him. There were, thank goodness. He spent 16 years there being what the fans thought, was one of them. He was, he is. What he is not is one of the people that run the Packers franchise.
"I know how special these fans are," Favre said. "I think deep down inside I know how they feel. Packer fans cheer for Packers first. I know that. I hope that everyone in the stadium watching tonight said, 'That joker's on the other side, but he does play the way he's always played, with his passion and love of the game.' As long as I play, that's not going to change."
As I watched the post game interview on the field with Brett Favre I couldn't help but get a little into the moment. He was trying his best to get off his chest what he wanted to say to all the fans there in that tiny microphone in front of him. Even though he seemed to be searching for words, I think the words found him.
Green Bay ownership wanted to move on without him and insert the new young gun, and they did. I think Brett took on a two year journey to get to Minnesota (Green Bay's rival) and stick it to them. An he did. I know that revenge can sometimes be hollow. In this case I think only Favre knows if that's the case. I also think that the ownership of which he was exacting revenge on probably feels empty as well. Not because of the team loosing, but for the decisions they made two years ago. And the fans, for whom cheered him on for nearly a generation? I hope they are upset with themselves for booing him, but in fact, are feeling probably pretty empty as well for doing so.
From is roots in Kiln, Mississippi (pop. 2000) to is time as 7th string QB at Southern Miss (the only school to offer him a scholarship), to this first Packers pass (which he completed to himself), to his young days enjoying a beer or two, or his addiction to painkillers, to his two Super Bowls, through is wifes cancer, to the legendary game after his fathers death, to setting most all passing records including interceptions all through his 276 game start streak. His story is seemingly as rich as Davie Crockett or Daniel Boone. And like any other stubborn southerner, he refuses to quit or go quietly.
By beating the very group off people that said he was washed up twice this year... Brett did what he done set out to do.
Favre was born in Gulfport, Mississippi, and raised in the small town of Kiln. He is of French and Choctaw ancestry; one of his paternal grandparents was a Native American affiliated with the Choctaw. He was the second of four children and attended Hancock North Central High School where he played baseball and football. Favre started for the Hancock North Central baseball team as an eighth–grader and earned five varsity letters. He played quarterback, lineman, strong safety, placekicker and punter in a primarily option, run-oriented offense coached by his father, Irvin Favre.
Irvin Favre said he knew his son had a great arm but also knew that the school was blessed with good running backs. As a result, in the three years Brett was on the team, his father ran a run-oriented offense called the wishbone. Favre rarely threw more than five passes in a game.
After high school Southern Mississippi offered Favre a scholarship (the only one he received). Southern Miss wanted him to play defensive back but Favre wanted to play quarterback instead. Favre began his freshman year as the seventh–string quarterback and took over the starting position in the second half of the third game of the year against Tulane on September 19, 1987. Favre, despite suffering a hangover from the night before and vomiting during warm-ups, led the Golden Eagles to a come-from-behind victory with two touchdown passes.
In his junior season, Favre led the Golden Eagles to an upset of Florida State (then ranked sixth in the nation) on September 2, 1989. Favre capped a six-and-a-half-minute drive with the game–winning touchdown pass with 23 seconds remaining.
On July 14, 1990, before the start of Favre's senior year at Southern Miss, he was involved in a near-fatal car accident. When going around a bend a few tenths of a mile from his parents' house, Favre lost control of his car, which flipped three times and came to rest against a tree. It was only after one of his brothers smashed a car window with a golf club that Favre could be evacuated to the hospital. In the ambulance, his mother was sitting with him. "All I kept asking [her] was 'Will I be able to play football again?'" Favre recalled later. Doctors would later remove 30 inches (760 mm) of Favre's small intestine. Six weeks after this incident, on September 8, Favre led Southern Miss to a comeback victory over Alabama. Alabama coach Gene Stallings said, "You can call it a miracle or a legend or whatever you want to. I just know that on that day, Brett Favre was larger than life."


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Home Health & Fitness Most Romantic Movies Ever
Most Romantic Movies Ever
By Women Fitness Magazine -
Most Romantic Movies Ever : Looking for some romantic movies to watch tonight? These are great movies to watch with someone or on your own – they are sure to leave you feeling good, and knowing that love is always in the air!
1. Casablanca
Casablanca (1942) is the ultimate Hollywood romance. Set in Morocco in WW II, the ex-patriot owner of a bar, Rick, has to choose between Ilsa, the love of his life, or helping her husband in the Czech resistance against the Nazis. He's never stopped loving her, but he never expected to see her again. When she walks into his place, it's obvious she feels the same way, but her devotion to her husband's cause drives her most of all. European exiles and refugees from the ongoing war were extras or played minor roles. In a special moment of "dueling anthems" many of the actors were crying and someone observed that he realized they were real refugees.
The film has classic moments that are part of the English language: "Play it again, Sam," "Here's looking at you, kid," "We'll always have Paris," "Round up the usual suspects," "This is the beginning of a beautiful friendship." The film won three Academy Awards for Best Picture, Best Director, and Best Screenplay. It's become iconic and rated as one of the best films ever, but what gives it this power is the tension and chemistry between Rick, played by Humphrey Bogart, and Ilsa, played by Ingrid Bergman. It hasn't lost any of its power.
2. The Princess Bride
Photo: siblingcinema.com
A delight of a movie, a "fairy tale" about a sweet and beautiful young woman, Buttercup, and the one true love of her life, Westley. He must find her after they have been apart a long time and save her from evil events in the kingdom of Florin. It is partly tongue-in-cheek, with a frame story of Peter Falk reading it all as a story to his grandson, played by Fred Savage. Robin Wright is Buttercup, and Cary Elwes her great love, who always says to her "As you wish." Their love has to face Westley's capture by pirates and the abduction of Buttercup. A masked man in black figures in the movie, along with Inigo Montoya (Mandy Patinkin) who seeks revenge for his father's death and is famous for saying: "Hello. My name is Inigo Montoya. You killed my father; prepare to die!"
The film has a fantastical element set in a rural landscape filled with enemies and unexpected friends. Cameos by Billy Crystal, Wallace Shawn, Carol Kane, and Peter Cook bring great comedy. Rob Reiner directed it and it has become a cult classic, a joy to watch from start to finish.
3. Notting Hill
Photo: dailymail.co.uk
Notting Hill became the highest grossing British film released in 1999. Starring Hugh Grant and Julia Roberts, it also features a small part by a young Hugh Bonneville (the Lord Grantham of Downton Abbey fame). Grant plays a bookstore owner who finds a famous American actress in his shop. Though hapless as a lover, Grant discovers Julia is interested in him, and that his way of life enchants her because of its normality (despite odd moments that are in quintessential Hugh Grant style).
Great comic scenes are also provided by Rhys Ifans as Grant's Welsh roommate. The locale is the real and unique Notting Hill in the Royal Borough of Kensington. The two keep meeting up, but their relationship sets off a news frenzy that threatens to keep them apart. The film has a great screenplay and wonderful acting – not a wrong note anywhere, and plenty of laughter follows their evolving romance. The film won a BAFTA.
4. Moonstruck
Photo: dca.org.uk
Cher and Nicholas Cage are the romantic center of this wonderful comedy. Loretta Castorini (Cher) feels she must remarry and chooses a very average and unexciting man, Johnny. But then she meets Johnny's brother (Cage), who makes bread in a bakery. He's an exciting and passionate man and they fall totally in love. Knowing it is a mistake, certain they can't betray Johnny, they still can't stay away from each other. Meanwhile, her mother (Olivia Dukakis) is convinced her husband Cosmo is seeing another woman and tells Loretta to never trust a man. Johnny is having second thoughts about Loretta, too, but no one knows this. High energy, fabulous dialogue, a close Italian family, and a story to warm the heart. The movie was nominated for six Oscars, including Best Actress for Cher, who is dazzling in the role.
5. Sleepless In Seattle
Photo: wowthatscool.com
This Nora Ephron comedy stars Tom Hanks and Meg Ryan. The story focuses on Sam's (Tom Hanks) inability to get over grieving when his wife passes away. He moves to Seattle to escape memories. On Christmas Eve his young son Jonah, without Sam's knowledge, explains his dad's problem on a national radio talk show that is listened to by Annie (Meg Ryan). Annie is a journalist in Baltimore, already engaged to a man (Bill Pullman), but suddenly she finds herself falling in love with Sam, sight unseen. She writes to him proposing they meet, but their efforts keep running amuck and they don't seem able to get together at all. A pivotal and famous scene occurs at the Empire State Building. When the movie ends you want to watch it all over again…
Other actors include David Hyde Pierce of Frasier fame, Rosie O'Donnell, and Victor Garber from the TV show Alien. Rita Wilson, Tom Hanks' wife in real life, has a cameo role as Sam's good friend. A marvelous score is the undercurrent, including songs like "As Time Goes By" (from Casablanca!), "Stardust" by Nat King Cole, "Stand By Your Man" with Tammy Wynette, and "When I fall in love" with Celine Dion.
6. Amélie
Photo: blog.birichina.ca
Amélie is a romantic comedy about a girl (Audrey Tautou) who is fragile in health, at first, and lives most of the time in her imagination. She sees very little of other people and the outside world, but she dreams of love. As a young woman she ventures out to be a waitress in the center of Paris. When she finds a small box filled with someone's childhood mementos, she seeks to return it to its owner, who she must find. With an innate mischievous spirit, she begins to involve herself in the lives of people around her, befriending a shut-in, a hypochondriac, an unsuccessful writer, and others who cross her path. She becomes attached to the people she meets and falls in love with life. In time, she begins to discover that she can claim love for herself.
The film met with critical acclaim and many awards in Europe. It was nominated for five Academy Awards.
7. Under the Tuscan Sun
Photo: www.cinemanet.sk
A writer named Frances (Diane Lane) is devastated after her marriage ends when her husband leaves her for another woman. She takes a bus tour of Tuscany but she can't shake herself out of her despair and move on. Then on sudden impulse she gets off the bus when it stops to let sheep pass by on the road and buys a villa in the town of Cortona that is in need of much repair. She gradually assembles a very quirky crew of helpers that include a good friend from San Francisco who is pregnant, a married real estate agent who is her lover for a while, and Polish immigrants who are wandering through the town. Her home becomes a jewel in Tuscany, and along with it comes the love of her life.
With gorgeous scenery the movie is a real treat to watch, immersing us not only into its color and incredible beauty but into a lovely feeling of escape. One co-star is Sandra Oh from the "Gray's Anatomy" TV show. Diane Lane received a Golden Globe nomination as Best Performance by an actress.
8. Roman Holiday
Photo: filmbalaya.com
This is a captivating and utterly romantic caper that takes place one summer in Rome. Princess Anne (Audrey Hepburn), arriving in Rome from an unnamed country, is eager to be free of the confines of conventional court life. She escapes from her royal entourage during a visit to their embassy. She manages to get a ride in the back of a delivery truck, and no one knows where she is. Falling asleep on a park bench, she is discovered by Joe Bradley, an American newspaper reporter, played by Gregory Peck. He takes her back to his apartment where she sleeps on his sofa. The next morning Joe dashes off to cover the Princess Anne press conference, unaware who she really is. When he does discover her true identity, he sees it as a way get an exclusive interview, without her knowing. He and his cohort Eddie Albert, a news photographer, work out a plan. But then, instead, Joe discovers Anne's endearing ways have drawn him in and he begins to fall in love with her, and feels he must tell the princess the truth.
The film received an astonishing ten Academy Award nominations. In this, her first film, Audrey Hepburn won an Academy Award for Best Actress. The director William Wyler was already highly acclaimed for his direction of Ben-Hur and Funny Girl.
9. A Walk in the Clouds
Photo: phim.clip.vn
A Walk in the Clouds stars Keanu Reeves, Debra Messing, Giancarlo Giannini, and Anthony Quinn. More stunning scenery shows up in this romantic, warmhearted fantasy—this time in the wine country of the Napa Valley and Sonoma in Northern California. As a soldier returning from the war, Paul (Keanu) meets a young woman (Aitana Sánchez-Gijón) who is returning home from college and is very fearful of encountering her domineering father. She is pregnant and terrified. Paul offers to pretend to be her husband, and he goes with her to the vineyards her father owns, where the grape harvest has begun. In time, they fall in love, which threatens the family in a new way, but their passion gives them courage to forge a way together.
10. The Holiday
Photo: www.tribute.ca
This movie is too much fun! It stars Cameron Diaz, Kate Winslet, Jude Law and Jack Black. The comedy is constant and it is a first-rate feel-good experience. The premise is that two dissatisfied young women decide to exchange houses for a while – Amanda (Cameron Diaz) lives in Los Angeles and Iris (Kate Winslet) lives in Surrey in the U.K. Their homes are quintessential models of the ideal life (as only movies can make such things). Iris' cottage is as picturesque as the Cotswolds and the hacienda extravagance of Amanda's home in L.A. is lavish.
Initially both women are ecstatic and for Iris the California life is amazing, but Amanda gets bored in the small English village. She is almost ready to throw in the towel when she meets Iris' brother Graham (Jude Law). Everything shifts and she decides to wait and see a little longer.
Iris meets film composer Jack Black who becomes a love interest, but she also encounters her neighbor, a once famous screenwriter, now aged ninety. He helps her feel good about herself, and she helps him leave his hermit life and learn to walk without a cane so he can accept a celebration in his honor by the Screenwriter's Guild. Gradually for Amanda and Iris their new lives intertwine in ways that bring both friendship, joy, and love into their lives. The last scene is a delight.
Is there a special romantic movie you always enjoy watching that isn't on this list? By all means mention it in a comment if you have one to recommend to readers.
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When pizza, sandwiches, and baked goods are handed out for free at work, it may seem like a windfall. After all, who doesn't love free food? But you might want to think twice before accepting it.
A new study funded by the Centers for Disease Control and Prevention (CDC) and published in the Journal of the Academy of Nutrition and Dietetics has found that U.S. office workers take in, on average, an extra 1,291 calories per week from food consumed at work. Two-thirds of that comes from food obtained for free.
The study found that the 10 most commonly obtained foods in office settings are coffee, regular and diet soft drinks, sandwiches, tap water, tea, cookies or brownies, lettuce salad, French fries, and potato chips.
"These 10 foods accounted for 44 percent of the foods obtained at work. Additional foods also included among the most commonly purchased foods were tortilla and other chips, candy containing chocolate, and crackers. The most common foods acquired for free also included chicken."
When this office-sourced food was analyzed using a metric developed by the United States Department of Agriculture to measure nutritional quality on a scale of one to 100, the workplace fare scored an average of 48. The New Food Economy pointed out, "That's the same score as a Wendy's menu."
"Employers can offer appealing and healthy options in cafeterias, vending machines, and at meetings and social events. One way to do this is by incorporating food service guidelines and healthy meeting policies into worksite wellness efforts."
Until workplaces start offering amazing salad bars in place of vending machines, the responsibility lies on individuals' own shoulders to assess the true cost of eating whatever is up for grabs. So, the next time pizza's going around for a third time that week, remind yourself that it still comes at a price – that of your healthy – and ask whether that's worth paying.


For those of you who are still mulling over what to do this Halloween I have yet another activity for you to consider: The Habitit's Freak Show. Among the tricks and treats promised are $3.00 "bloody brain shots" and a $100 prize for "Best Costume". Weirdos are especially encouraged to attend. Check it out!


Robocalled spammer selling health insurance? Claimed I filled out a survey, hung up on them because I have insurance. Spam, spam, spam. Phone # likely spoofed too.
caller just hangs up without leaving a message!
Rings twice never leaves message.
I rec'd a 2 calls from this # within 45 min. Did not answer either one since I do not know anyone in Willington Delaware. However, they left a message that I was in serious trouble, I had 4 offenses against me, if I did not take action, they would send the local authorities to arrest me. I already knew it was a scam, so I called just to see what they would say. The represented themselves as the ??? Dept of the IRS. I hung up!
This is a phone number that is used by people doing a car ad scam. They will send you a check and of course want you to forward part of the money from Walmart to another Walmart. Do not cash this check or get involved with these people.
302 330-7503 is a 2004 Jeep Wrangler with 70k miles for $2k.
What do YOU think? Does ANYONE care foreign organized crime posts hundreds of the same fakes coast to coast on Craigs? Does not appear to be the case as Craigslist is now #1 for organized crime in America. MAGA!
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Sarapo, Northwest Face. A few brief moments under the west face of Siulá convinced Tom Sisson and me that we did not want to play Russian Roulette with our lives on that face. The snow-and-ice northwest face of Sarapo, a short way up the glacier, seemed fairly trivial in comparison. The best line would avoid the ice cliffs on one side and some rotten rock sections on the other. Though it looked short, it turned out to be one bivouac and 1500 feet to the ridge. There were interesting corniced and fluted sections on the ridge, but after that it was quite easy. Soft snow on the last 400 feet made the final section a tiring and time- consuming wallow. A windy bivouac near the summit and, in the morning, a spectacular view of the southern Huayhuash were our reward. We retraced our steps, at least knowing where they went in contrast to unending corniced ridges, that seemed to be the alternatives. One bivouac and several ice bollard rappels eventually returned us to the glacier. Our route differs from the Italians' by starting up the northwest face before joining the ridge they followed up from Sarapococha. We found much evidence of their fixed line on the corniced ridge section soon after we joined the ridge.


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The Free Library > Health > Health, general > Archives of Pathology & Laboratory Medicine > January 1, 2011
The Free Library > Date > 2011 > January > 1 > Archives of Pathology & Laboratory Medicine
Pathologic evaluation of axillary dissection specimens following unexpected identification of tumor within sentinel lymph nodes.
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MLA style: "Pathologic evaluation of axillary dissection specimens following unexpected identification of tumor within sentinel lymph nodes.." The Free Library. 2011 College of American Pathologists 20 Jan. 2022 https://www.thefreelibrary.com/Pathologic+evaluation+of+axillary+dissection+specimens+following...-a0330499520
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APA style: Pathologic evaluation of axillary dissection specimens following unexpected identification of tumor within sentinel lymph nodes.. (n.d.) >The Free Library. (2014). Retrieved Jan 20 2022 from https://www.thefreelibrary.com/Pathologic+evaluation+of+axillary+dissection+specimens+following...-a0330499520
For patients with breast cancer, the histologic status of the axillary lymph nodes remains among the most important of prognostic factors. Sentinel lymph node (SLN) biopsy has become the primary method to most accurately assess nodal metastasis, and completion axillary lymph node dissection (ALND) remains the standard treatment after identification of metastases. It is well known, however, that ALND carries multiple early and late morbidities for the patient, such as lymphedema, pain, and sensory loss. (1,2)) Moreover, the ALMANAC trial showed that overall patient-recorded quality of life and arm functioning scores were significantly better in patients who underwent SLN biopsy alone versus ALND. (3)
Examination of the axillary SLNs in breast cancer patients has become more complex, with serial hematoxylin-eosin (H&E) levels and cytokeratin (CK) immunohistochemistry (IHC) performed at many centers. This practice has not been standardized, and different protocols are used at various institutions. (4) These inconsistencies in methodology most likely contribute to differences in node positivity rates and, thus, stage of disease. (5) The American Society of Clinical Oncology Guideline Recommendations state that isolated tumor cells (ITCs) are currently of unknown clinical significance. (6,7) In light of these vagaries in practice patterns nationally, the need for ALND in patients with ITCs has become controversial.
Studies have found the incidence of positive non-sentinel lymph nodes (NSLNs) in patients who presented with ITCs in their SLNs to range from 7% to 19%. (8-18) Routine pathologic examination of the NSLNs has been found to show an incidence of micrometastasis (MM) and metastasis (MET) ranging from 8% to 45%. (11,15,17) Variables analyzed to understand whether they predict positive NSLNs have included tumor size, number of positive SLNs, number of SLNs examined, lymphovascular invasion, and tumor grade. (15,17,18,19) Collectively, these studies have shown mixed conclusions with no generally accepted nomogram developed to date.
The primary objective of the current study was to prospectively evaluate the incidence of NSLN involvement in invasive breast cancer patients whose SLNs were initially negative on frozen section (FS) but were later found to contain ITCs, MM, or MET. Additional objectives of this study were to assess identical pathologic methods on both the SLNs and the NSLNs and to identify relevant variables that could predict positive NSLNs.
Case Selection and Tissue Preparation
This study was approved by the institutional review board at Abbott Northwestern Hospital, Minneapolis, Minnesota. In the period between 2002 and 2007, all patients found to have a negative SLN by intraoperative FS, who were later found to have tumor involvement in their SLN by permanent section H&E levels or CK IHC, were invited to participate in this study (n = 116). A total of 2134 patients underwent an SLN procedure during this time resulting in a 5.4% false-negative rate of the FS SLN procedure during the study time. Consent for the study was obtained from all patients who are included in the final analysis (n = 103), and each of these patients underwent subsequent ALND.
The FS analysis involved sectioning the SLNs across their longitudinal axis in 3-mm sections. The SLNs were then frozen and 2 cryostat sections were obtained and stained for immediate intraoperative evaluation. Following routine overnight processing, 6 sections were obtained separated by at least 50 mm from all negative SLN cases and mounted on separate slides. Levels 1, 3, and 5 were stained by H&E, levels 2 and 4 were evaluated with IHC with antibodies to CK (a cocktail made from antibodies AE1/AE3, Dako, Carpinteria, California), MAK6 (Becton Dickinson, Franklin Lakes, New Jersey), and CAM 5.2 (Zymed, San Francisco, California) using standard automated procedures using a Dako immunostainer. A negative control level was also obtained between levels 2 and 3. The NSLNs were examined by H&E levels and CK IHC using identical techniques as applied to the SLNs, with exception of FS analysis, which was performed on the SLNs only.
Tissue Evaluation
The size of metastatic tumor within each lymph node was measured using an ocular-mounted micrometer. When multiple foci of metastatic tumor were present within a node, the size of the largest focus was recorded. Metastatic foci were classified using the approach detailed in the 7th edition AJCC Cancer Staging Manual (6) classifying the lesions depending on their size: ITCs ([greater than or equal to]0.2 mm, or nonconfluent or nearly confluent clusters of cells not exceeding 200 cells in a single histologic lymph node cross section), MM (.0.2 mm to [greater than or equal to]2 mm), MET (>2 mm).
The age of the patient, the size of the primary tumor in centimeters, number of involved SLNs and NSLNs, size and location of metastasis in SLNs and NSLNs, presence or absence of angiolymphatic invasion, tumor histologic type (invasive ductal, invasive lobular, other), tumor grade (I, II, III), estrogen receptor status (estrogen receptor-positive, estrogen receptornegative), and HER2 status (HER2+, HER2-) were also evaluated for each case. The type of diagnostic biopsy was recorded for each patient studied. Patient charts were reviewed to assess for lymphedema symptoms following ALND after a minimum of 3-years follow-up and up to 8 years. Univariate and multivariate logistic regression models were used to assess the potential relation between the various clinicopathologic parameters. P < .05 was considered statistically significant. The software used for analysis was SAS version 9.1 (SAS Institute, Cary, North Carolina).
One hundred sixteen patients were eligible for the study. Thirteen patients were excluded from the study: 8 because of retrospectively identified tumor within the SLN, which was inadvertently missed at time of FS; 3 due to no primary invasive tumor found in the breast specimen (in situ carcinoma only); 1 patient refused consent; and 1 patient transferred to another institution. One hundred and three patients, with the following SLN statuses, were included in this prospective analysis: ITCs (n = 46), MM (n = 46), or MET (n = 11). All of these patients underwent subsequent ALND.
Patient clinicopathologic characteristics are delineated in Table 1. Mean age was 53 years (range, 30-85 years). The average number of SLNs removed was 2.5 (range, 1-5 nodes). The average number of NSLNs removed was 12 (range, 2-35 nodes). Tumor size was less than or equal to 2 cm in most patients (58%). The tumor type in most patients was invasive ductal (76%). Half of the patients had a tumor grade II, while the remainder were split between I (22%) and III (28%). Angiolymphatic invasion was present in 71% of cases. HER2 status was negative in most patients (86%) and estrogen receptor status was positive in most patients (93%). Pathologic analysis identified metastasis in the SLNs detected only by CK IHC in 44 patients (43%). The remainder were identified by either H&E alone or combined with CK IHC.
Twenty-three of the 103 patients (23%) had at least one NSLN with ITCs, MM, or MET (Table 2). Of the patients with ITCs in their SLNs, only 2 of the 6 patients had a MM or MET in their NSLNs, which resulted in a change of their pathologic stage (pN0i+ to pN1). One patient with microinvasive tumor had an MM in her NSLN, which resulted in a classification change from stage IA, pT1mic pN0(i+), to stage 1B, pT1mic pN1mi. Another patient had an NSLN MET, which resulted in a stage change from stage IIA, pT2 pN0(i+), to stage IIB, pT2 pN1. In both patients, treatment management was changed due to the NSLN findings.
Fifteen of 46 patients (33%) with MM in SLNs had a positive NSLN; of those 13% were MM (n = 6) and 4% were MET (n = 2). Eleven patients had MET in their SLNs, 2 of which (18%) had additional MET in their NSLNs. This resulted in a pathologic stage modification in one of these patients due to an increase in the overall number of positive nodes (pT3 pN1 to pT3 pN2). Thirty-one patients developed lymphedema symptoms during the follow-up period of 3 to 8 years. No lymphedema symptoms were recorded in 68 patients, while 4 patients were unable to be evaluated due to lack of follow-up records.
Univariate analysis, aimed at enabling understanding of potential predictors of NSLN involvement by tumor, was performed on all variables included in Table 1, along with additional tumor characteristics--multifocality or multicentricity, location of tumor cells in SLNs (subcapsular sinus versus nodal parenchyma or both), and tumor cells identified only on CK IHC of the SLNs. Significant variables are included in Table 3. Patients with 2 or more positive SLNs were more likely to have a positive NSLN than those with only 1 positive SLN (P = .002). Patients with MM versus ITCs were more likely to have positive NSLNs (P = .03). Angiolymphatic invasion was also positively related to NSLN involvement (P = .04). The type of diagnostic biopsy (91 patients with core biopsy, 11 patients with excisional biopsy, 1 patient with fine-needle aspiration) had no relation to NSLN status. Other variables (tumor grade, histologic type, multifocality or multicentricity, patient age, hormone receptor and HER2 status, location of tumor cells in SLN [subcapsular sinus versus nodal parenchyma or both]), and tumor cells identified only on CK IHC of the SLN had no statistically significant relation to NSLN status.
Multivariate analysis was performed to more carefully understand the predictors of NSLN involvement by tumor when controlling for all other significant univariate factors. Patients with 2 or more positive SLNs were more likely to have a positive NSLN than those with only 1 positive SLN (50% versus 16%; P = .002).
Detailed pathologic examination of axillary SLNs with serial sectioning and H&E and CK IHC has resulted in increased rates of detection of MM and ITCs for breast cancer patients.4 In this study we evaluated 103 patients with negative SLNs at the time of intraoperative FS evaluation, whose nodes were subsequently reclassified with more detailed pathologic evaluation (permanent section H&E levels and CK IHC). Forty-three percent of cases had involved SLNs following evaluation with CK IHC and/or permanent section H&E levels; use of these methods has previously been shown to increase the sensitivity of SLN biopsy detection rates of metastatic disease. (4,17,20-22) In the present study, 13% of patients with
ITCs had additional findings (ITCs, MM, or MET) in their NSLNs, which correlates with previous published data showing rates ranging from 7% to 19%. (8-18) Only 4% of patients with ITCs in this study had a positive NSLN that resulted in a change of stage. The need for ALND in patients with ITCs has been debated due to the increased morbidity associated with ALND (1-3) and the unknown clinical significance of ITCs related to their effects on long-term survival. Results of recent studies reporting survival outcomes may be confounded by differences in adjuvant treatments used. (17,23,24) Colleoni et al (23) reported on 1959 patients, 1400 N0(i-) and 232 N0(i+)/N1mi. Patients with MM and ITCs, at 5-years follow-up, had similar survival to node-negative patients, although a significant number of patients with MM received chemotherapy. Chagpar et al, (24) in a retrospective review of 81 patients with a mean follow-up of 40.2 months, found no difference in overall or distant metastasis-free survival in patients with negative SLNs and micrometastatic disease. However, the management of 12% of these patients according to their protocol would have been modified due to the change in nodal status. A study from the Netherlands (25) showed decreased 5-year survival rates in 1851 patients with either MM or ITCs as compared with a node-negative cohort group (856 patients). However, there was a survival advantage in 995 patients with either MM or ITCs who did receive adjuvant therapy as compared with 856 patients with MM or ITCs who did not. Approximately 66% of the patients with MM or ITCs underwent lymph node dissection, and an additional 8% had axillary radiation. Thus, it is difficult to discern the benefit of the axillary dissection (and radiation) versus the adjuvant therapy. Cox et al (17) reviewed 2381 patients of which 2108 patients were N0(i-), 151 patients were N0(i+), and 122 patients were N1mi. This study found that the overall survival of the N0(i+) SLN patients who did not receive a complete ALND was significantly worse than those undergoing axillary dissection. Survival of N1mi patients who did and did not receive axillary dissection was not statistically significant. (17)
Significant univariate predictors of positive NSLNs in our present study included patients with 2 or more involved SLNs. These patients were more likely to have a positive NSLN than those with only 1 involved SLN. We also found that patients with angiolymphatic invasion were more likely to have positive NSLNs. The number of positive SLNs and the presence of angiolymphatic invasion have also been found to be important predictive variables in other studies. (26-28) We found that patients with MM versus ITCs were more likely to have positive NSLNs, again confirming other studies showing that the size of SLN metastases is one of the most powerful predictors for positive NSLNs. (4,11,21,26,28,29) In our analysis, size of primary tumor did not show a significant correlation with NSLN status, similar to other published literature, (26-28) although we note that there are some studies showing a significant relation between tumor size and NSLN status. (15,17,21,27,29) The multivariate predictor remaining after controlling for other factors was whether or not a patient had 2 or more involved sentinel nodes. An increased sample size may have yielded additional significant multivariate factors.
The use of CK IHC on NSLNs from axillary dissections did not add additional diagnostic or staging information, and this approach should be reserved for the evaluation of SLNs only. In our practice, we recommend ALND for patients with MM and MET. There is a need for additional standardization in the evaluation of SLNs and reporting of ITCs, as different protocols are in use at various institutions. (4) In our study, 4% of patients with ITCs had a positive NSLN that resulted in a change of stage, which could have potentially altered the plan of treatment. Thus, we consider ALND in patients with ITCs involving 2 or more SLNs and in those with angiolymphatic invasion associated with their tumor. Ultimately the factors determining a decision around ITCs and ALND should take into account the patient's entire clinical picture. The true clinical and biologic significance of ITCs remains unknown. We are prospectively following our study patients to assess the clinical significance of ITCs during a period of 5 years and hope to contribute to the additional research needed to reliably predict the status of the NSLNs.
We would like to acknowledge Kaitlyn Lillemoe, BA, Nilanjana Banerji, PhD, and Heather Britt, PhD, for their diligence and expertise.
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17. Cox CE, Kiluk JV, Riker AI, et al. Significance of sentinel lymph node micrometastases in human breast cancer. JAm Coll Surg. 2008;206(2):261-268.
18. Alran S, De Rycke Y, Fourchotte V, et al. Validation and limitations of use of a breast cancer nomogram predicting the likelihood of non-sentinel node involvement after positive sentinel node biopsy. Am Surg Oncol. 2007;14(8): 2195-2201.
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21. Turner RR, Ollila DW, Krasne DL, et al. Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg. 1997;226(3): 271-276.
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23. Colleoni M, Rotmensz N, Peruzzotti G, et al. Size of breast cancer metastases in axillary lymph nodes: clinical relevance of minimal lymph node involvement. J Clin Oncol. 2005;23(7):1379-1389.
24. Chagpar A, Middleton LP, Sahin AA, et al. Clinical outcome of patients with lymph node negative breast carcinoma who have sentinel lymph node micrometastases detected by immunohistochemistry. Cancer. 2005;103(8):1581 1586.
25. de Boer M, van Deurzen CH, Van Dijck JA, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med. 2009; 361(7):653-663.
26. Viale G, Maiorano E, Pruneri G, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241(2):319-325.
27. Hwang RF, Krishnamurthy S, Hunt KK, et al. Clinicopathologic factors predicting involvement of nonsentinel axillary nodes in women with breast cancer. Ann Surg Oncol. 2003;10(3):248-254.
28. Rahusen F, Torrenga H, van Diest P, et al. Predictive factors for metastatic involvement of nonsentinel nodes in patients with breast cancer. Arch Surg. 2001;136(9):1059-1063.
29. Reynolds C, Mick R, Donohue JH, et al. Sentinel lymph node biopsy with metastasis: can axillary dissection be avoided in some patients with breast cancer? J Clin Oncol. 1999;17(6):1720-1726. Pathologic Evaluation of Axillary Dissection Specimens Following Unexpected Identification of Tumor Within
Jessica Gutierrez, MD; Daniel Dunn, MD; Margit Bretzke, MD; Eric Johnson, MD; John O'Leary, MD; Diane Stoller, MD; Sally Fraki, RN; Leslie Diaz, MD ([dagger]); Tamera Lillemoe, MD
* Context.--Axillary lymph node dissection has been the standard of care after identification of a positive sentinel lymph node for breast cancer patients.
Objective.--To determine the likelihood of nonsentinel lymph node involvement for patients with negative sentinel node by frozen section, who are subsequently found to have tumor cells in the sentinel node by permanent section levels and/or cytokeratin immunohistochemistry.
Design.--One hundred three patients with invasive breast cancer exhibiting negative frozen section evaluation of their sentinel node, but later found to have isolated tumor cells (n = 46), micrometastasis (n = 46), or metastases (n = 11) in their sentinel node by permanent sections or immunohistochemistry, were enrolled in this prospective cohort study and underwent completion axillary dissection.
Results.--Six of 46 patients (13%) with isolated tumor cells in their sentinel node, 15 of 46 patients (33%) with micrometastasis in their sentinel node, and 2 of 11 patients (18%) with metastasis in their sentinel node had additional findings in the nonsentinel nodes. These findings resulted in a pathologic stage change in 2 patients. Predictors of positive nonsentinel nodes were 2 or more positive sentinel nodes (P = .002), sentinel nodes with micrometastasis versus isolated tumor cells (P = .03), and those with angiolymphatic invasion (P = .04).
Conclusions.--Our findings lend support to axillary node dissection for patients with micrometastasis or metastasis in their sentinel nodes. However, studies with clinical follow-up are needed to determine whether axillary node dissection is necessary for patients with isolated tumor cells in sentinel nodes.
(Arch Pathol Lab Med. 2011;135:131-134)
For patients with breast cancer, the histologic status of the axillary lymph nodes remains among the most important of prognostic factors. Sentinel lymph node (SLN) biopsy has become the primary method to most accurately assess nodal metastasis, and completion axillary lymph node dissection (ALND) remains the standard treatment after identification of metastases. It is well known, however, that ALND carries multiple early and late morbidities for the patient, such as lymphedema, pain, and sensory loss.1,2 Moreover, the ALMANAC trial showed that overall patient-recorded quality of life and arm functioning scores were significantly better in patients who underwent SLN biopsy alone versus ALND.3
Accepted for publication March 26, 2010. 3 Deceased.
From the Department of Surgery, University of Minnesota Medical Center, Fairview(DrGutierrez);and the Departments of Surgery (Drs Dunn, Bretzke, Johnson, O'Leary, and Stoller), Research (Ms Fraki), and Pathology (Drs Diazt and Lillemoe), Piper Breast Center, Virginia Piper Cancer Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.
The authors have no relevant financial interest in the products or companies described in this article.
Presented as a poster at the 30th Annual San Antonio Breast Cancer Symposium, San Antonio, Texas, December 13-16, 2007.
Reprints: Tamera Lillemoe, MD, Department of Pathology, Piper Breast Center, Virginia Piper Cancer Institute at Abbott Northwestern Hospital, 800 E 28th St, Minneapolis, MN 55407 (e-mail: tamera. lillemoe@allina.com).
Examination of the axillary SLNs in breast cancer patients has become more complex, with serial hematoxylin-eosin (H&E) levels and cytokeratin (CK) immunohistochemistry (IHC) performed at many centers. This practice has not been standardized, and different protocols are used at various institutions.4 These inconsistencies in methodology most likely contribute to differences in node positivity rates and, thus, stage of disease.5 The American Society of Clinical Oncology Guideline Recommendations state that isolated tumor cells (ITCs) are currently of unknown clinical significance.6,7 In light of these vagaries in practice patterns nationally, the need for ALND in patients with ITCs has become controversial.
Studies have found the incidence of positive nonsentinel lymph nodes (NSLNs) in patients who presented with ITCs in their SLNs to range from 7% to 19%.8-18 Routine pathologic examination of the NSLNs has been found to show an incidence of micrometastasis (MM) and metastasis (MET) ranging from 8% to 45%.11,15,17 Variables analyzed to understand whether they predict positive NSLNs have included tumor size, number of positive SLNs, number of SLNs examined, lymphovascular invasion, and tumor grade.15,17,18,19 Collectively, these studies have shown mixed conclusions with no generally accepted nomogram developed to date.
The primary objective of the current study was to prospectively evaluate the incidence of NSLN involve ment in invasive breast cancer patients whose SLNs were initially negative on frozen section (FS) but were later found to contain ITCs, MM, or MET. Additional objectives of this study were to assess identical pathologic methods on both the SLNs and the NSLNs and to identify relevant variables that could predict positive NSLNs.
The FS analysis involved sectioning the SLNs across their longitudinal axis in 3-mm sections. The SLNs were then frozen and 2 cryostat sections were obtained and stained for immediate intraoperative evaluation. Following routine overnight processing, 6 sections were obtained separated by at least 50 mm from all negative SLN cases and mounted on separate slides. Levels 1, 3, and 5 were stained by H&E, levels 2 and 4 were evaluated with IHC with antibodies to CK (a cocktail made from antibodies AE1/AE3, Dako, Carpinteria, California), MAK6 (Becton Dickinson, Franklin Lakes, New Jersey), and CAM 5.2 (Zymed, San Francisco, California) using standard automated procedures using a Dako immunostainer. A negative control level was also obtained between levels 2 and 3. The NSLNs were examined by H&E levels and CK IHC using identical techniques as applied to the SLNs, with exception of FS analysis, which was performed on
the SLNs only.
The size of metastatic tumor within each lymph node was measured using an ocular-mounted micrometer. When multiple foci of metastatic tumor were present within a node, the size of the largest focus was recorded. Metastatic foci were classified using the approach detailed in the 7th edition AJCC Cancer Staging Manual 6 classifying the lesions depending on their size: ITCs (#0.2 mm, or nonconfluent or nearly confluent clusters of cells not exceeding 200 cells in a single histologic lymph node cross section), MM (.0.2 mm to #2 mm), MET (>2 mm).
One hundred sixteen patients were eligible for the study. Thirteen patients were excluded from the study: 8
Table 1. Clinicopathologic Characteristics of 103 Patients With Involved Sentinel Lymph Nodes (SLNs) After Initial Negative Frozen Section
Abbreviation: NSLNs, nonsentinel lymph nodes.
because of retrospectively identified tumor within the SLN, which was inadvertently missed at time of FS; 3 due to no primary invasive tumor found in the breast specimen (in situ carcinoma only); 1 patient refused consent; and 1 patient transferred to another institution. One hundred and three patients, with the following SLN statuses, were included in this prospective analysis: ITCs (n = 46), MM (n = 46), or MET (n = 11). All of these patients underwent subsequent ALND.
Twenty-three of the 103 patients (23%) had at least one
NSLN with ITCs, MM, or MET (Table 2). Of the patients
with ITCs in their SLNs, only 2 of the 6 patients had a MM or MET in their NSLNs, which resulted in a change of their pathologic stage (pN0i+ to pN1). One patient with microinvasive tumor had an MM in her NSLN, which resulted in a classification change from stage IA, pT1mic pN0(i+), to stage 1B, pT1mic pN1mi. Another patient had an NSLN MET, which resulted in a stage change from stage IIA, pT2 pN0(i+), to stage IIB, pT2 pN1. In both patients, treatment management was changed due to the
NSLN findings.
Fifteen of 46 patients (33%) with MM in SLNs had a positive NSLN; of those 13% were MM (n = 6) and 4%
were MET (n = 2). Eleven patients had MET in their SLNs, 2 of which (18%) had additional MET in their NSLNs. This resulted in a pathologic stage modification in one of these patients due to an increase in the overall number of positive nodes (pT3 pN1 to pT3 pN2). Thirty-one patients developed lymphedema symptoms during the follow-up period of 3 to 8 years. No lymphedema symptoms were recorded in 68 patients, while 4 patients were unable to be evaluated due to lack of follow-up records.
Detailed pathologic examination of axillary SLNs with serial sectioning and H&E and CK IHC has resulted in increased rates of detection of MM and ITCs for breast cancer patients.4 In this study we evaluated 103 patients with negative SLNs at the time of intraoperative FS evaluation, whose nodes were subsequently reclassified with more detailed pathologic evaluation (permanent section H&E levels and CK IHC). Forty-three percent of cases had involved SLNs following evaluation with CK IHC and/or permanent section H&E levels; use of these methods has previously been shown to increase the sensitivity of SLN biopsy detection rates of metastatic disease.4,17,20-22 In the present study, 13% of patients with
ITCs had additional findings (ITCs, MM, or MET) in their
NSLNs, which correlates with previous published data showing rates ranging from 7% to 19%.8-18 Only 4% of patients with ITCs in this study had a positive NSLN that resulted in a change of stage. The need for ALND in patients with ITCs has been debated due to the increased morbidity associated with ALND1-3 and the unknown clinical significance of ITCs related to their effects on longterm survival. Results of recent studies reporting survival outcomes may be confounded by differences in adjuvant treatments used.17,23,24 Colleoni et al (23) reported on 1959 patients, 1400 N0(i-) and 232 N0(i+)/N1mi. Patients with MM and ITCs, at 5-years follow-up, had similar survival to node-negative patients, although a significant number of patients with MM received chemotherapy. Chagpar et al,24 in a retrospective review of 81 patients with a mean follow-up of 40.2 months, found no difference in overall or distant metastasis-free survival in patients with negative SLNs and micrometastatic disease. However, the management of 12% of these patients according to their protocol would have been modified due to the change in nodal status. A study from the Netherlands25 showed decreased 5-year survival rates in 1851 patients with either MM or ITCs as compared with a node-negative cohort group (856 patients). However, there was a survival advantage in 995 patients with either MM or ITCs who did receive adjuvant therapy as compared with 856 patients with MM or ITCs who did not. Approximately 66% of the patients with MM or ITCs underwent lymph node dissection, and an additional 8% had axillary radiation. Thus, it is difficult to discern the benefit of the axillary dissection (and radiation) versus the adjuvant therapy. Cox et al (17) reviewed 2381 patients of which 2108 patients were N0(i-), 151 patients were N0(i+), and 122 patients were N1mi. This study found that the overall survival of the N0(i+) SLN patients who did not receive a complete ALND was significantly worse than those undergoing axillary dissection. Survival of N1mi patients who did and did not receive axillary dissection was not statistically significant.17
Significant univariate predictors of positive NSLNs in our present study included patients with 2 or more involved SLNs. These patients were more likely to have a positive NSLN than those with only 1 involved SLN. We also found that patients with angiolymphatic invasion were more likely to have positive NSLNs. The number of positive SLNs and the presence of angiolymphatic invasion have also been found to be important predictive variables in other studies.26-28 We found that patients with MM versus ITCs were more likely to have positive NSLNs, again confirming other studies showing that the size of SLN metastases is one of the most powerful predictors for positive NSLNs.4,11,21,26,28,29 In our analysis, size of primary tumor did not show a significant correlation with NSLN status, similar to other published literature,26-28 although we note that there are some studies showing a significant relation between tumor size and NSLN status.15,17,21,27,29 The multivariate predictor remaining after controlling for other factors was whether or not a patient had 2 or more involved sentinel nodes. An increased sample size may have yielded additional significant multivariate factors.
The use of CK IHC on NSLNs from axillary dissections did not add additional diagnostic or staging information, and this approach should be reserved for the evaluation of SLNs only. In our practice, we recommend ALND for patients with MM and MET. There is a need for additional standardization in the evaluation of SLNs and reporting of ITCs, as different protocols are in use at various institutions.4 In our study, 4% of patients with ITCs had a positive NSLN that resulted in a change of stage, which could have potentially altered the plan of treatment. Thus, we consider ALND in patients with ITCs involving 2 or more SLNs and in those with angiolymphatic invasion associated with their tumor. Ultimately the factors determining a decision around ITCs and ALND should take into account the patient's entire clinical picture. The true clinical and biologic significance of ITCs remains unknown. We are prospectively following our study patients to assess the clinical significance of ITCs during a period of 5 years and hope to contribute to the additional research needed to reliably predict the status of the NSLNs.
(1.) Maunsell E, Brisson J, Deschenes L, et al. Arm problems and psychological distress after surgery for breast cancer. Can J Surg. 1993;36(4):315-320.
(2.) Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema. Am J Surg. 1999;177(3):184-187.
(3.) Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial. J Natl Cancer Inst. 2006;98(9):599-609.
(4.) Cserni G, Bianchi S, Boecker W, et al. Improving the reproducibility of diagnosing micrometastases and isolated tumor cells. Cancer. 2005;103(2):358-367.
(5.) Van der Heiden-van der Loo M, Bezemer PD, Hennipman A, et al. Introduction of sentinel node biopsy and stage migration of breast cancer. Eur J Surg Oncol. 2006;32(7):710-714.
(6.) Edge SB, Byrd DR, Compton CC, etal. AJCCCancerStagingManual. 7th ed. New York, NY: Springer;2009.
(7.) Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in earlystage breast cancer. J Clin Oncol. 2005;23(30):7703-7720.
(8.) Chu KU, Turner RR, Hansen NM, etal. Sentinel node metastasis in patients with breast carcinoma accurately predicts immunohistochemically detectable nonsentinel node metastasis. Ann Surg Oncol. 1999;6(8):756-761.
(9.) Mignotte H. Treilleux L, Faure C, et al. Axillary lymph node dissection for positive sentinel nodes in breast cancer patients. Eur J Surg Oncol. 2002;28(6): 623-626.
(10.) de Widt-Levert L, Tjan-Heijnen V, Bult P, et al. Stage migration in breast cancer: surgical decisions concerning isolated tumor cells and micro-metastases in the sentinel lymph node. Eur J Surg Oncol. 2003;29(3):216-220.
(11.) Dabbs DJ, Fung M, Landsittel D, et al. Sentinel lymph node micrometastasis as predictor of axillary tumor burden. Breast J. 2004;10(2):101-105.
(12.) Mazzorol G, Mastropasqua MG, Valentino S, et al. Breast cancer isolated tumor cell in axillary sentinel node and prevalence of additional non-sentinel node metastases. Presented at: 2004 Annual Meeting of the United States and Canadian Academy of Pathology;March 6-12, 2004;Vancouver, BC. Abstract 159.
(13.) McCready DR, Young WS, Ng AK, etal. Influence of the new AJCC breast cancer staging system on sentinel lymph node positivity and false-negative rates. J Natl Cancer Inst. 2004;96(11):873-875.
(14.) Menes TS, Tartter PI, Mizrachi H, et al. Breast cancer patients with pN0(i+) and pN1(mi) sentinel nodes have high rate of nonsentinel node metastases. J Am Coll Surg. 2005;200(3):323-327.
(15.) Houvenaeghel G, Nos C, Mignotte H, et al. Micrometastases in sentinel lymph node in a multicenter study: predictive factors of non-sentinel lymph node involvement. J Clin Oncol. 2006;24(12):1814-1822.
(16.) van Rijk MC, Peterse JL, Nieweg OE, et al. Additional axillary metastases and stage migration in breast cancer patients with micrometastases or submicrometastases in sentinel lymph nodes. Cancer. 2006;107(3):467-471.
(17.) Cox CE, Kiluk JV, Riker AI, et al. Significance of sentinel lymph node micrometastases in human breast cancer. JAm Coll Surg. 2008;206(2):261-268.
(18.) Alran S, De Rycke Y, Fourchotte V, et al. Validation and limitations of use of a breast cancer nomogram predicting the likelihood of non-sentinel node involvement after positive sentinel node biopsy. Am Surg Oncol. 2007;14(8): 2195-2201.
(19.) Singletary ES. Nanometastases in the sentinel node a surgeons dilemma. General Surgery News. March 2008:1-8.
(20.) Teng S, Dupont E, McCann C, et al. Do cytokeratin positive only sentinel lymph nodes warrant complete axillary lymph node dissection in patients with invasive breast cancer. Am Surgeon. 2000;66(6):574-578.
(21.) Turner RR, Ollila DW, Krasne DL, et al. Histopathologic validation of the sentinel lymph node hypothesis for breast carcinoma. Ann Surg. 1997;226(3): 271-276.
(22.) Cox C, Bass S, McCann C, et al. Lymphatic mapping and sentinel lymph node biopsy in patients with breast cancer. Annu Rev Med. 2000;51(1):525-542.
(23.) Colleoni M, Rotmensz N, Peruzzotti G, et al. Size of breast cancer metastases in axillary lymph nodes: clinical relevance of minimal lymph node involvement. J Clin Oncol. 2005;23(7):1379-1389.
(24.) Chagpar A, Middleton LP, Sahin AA, et al. Clinical outcome of patients with lymph node negative breast carcinoma who have sentinel lymph node micrometastases detected by immunohistochemistry. Cancer. 2005;103(8):1581-1586.
(25.) de Boer M, van Deurzen CH, Van Dijck JA, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med. 2009; 361(7):653-663.
(26.) Viale G, Maiorano E, Pruneri G, et al. Predicting the risk for additional axillary metastases in patients with breast carcinoma and positive sentinel lymph node biopsy. Ann Surg. 2005;241(2):319-325.
(27.) Hwang RF, Krishnamurthy S, Hunt KK, et al. Clinicopathologic factors predicting involvement of nonsentinel axillary nodes in women with breast cancer. Ann Surg Oncol. 2003;10(3):248-254.
(28.) Rahusen F, Torrenga H, van Diest P, et al. Predictive factors for metastatic involvement of nonsentinel nodes in patients with breast cancer. Arch Surg. 2001;136(9):1059-1063.
(29.) Reynolds C, Mick R, Donohue JH, et al. Sentinel lymph node biopsy with metastasis: can axillary dissection be avoided in some patients with breast cancer? J Clin Oncol. 1999;17(6):1720-1726.
Jessica Gutierrez, MD; Daniel Dunn, MD; Margit Bretzke, MD; Eric Johnson, MD; John O'Leary, MD; Diane Stoller, MD; Sally Fraki, RN; Leslie Diaz, MD3; Tamera Lillemoe, MD
Accepted for publication March 26, 2010.
([dagger]) Deceased.
Table 1. Clinicopathologic Characteristics of 103
Patients With Involved Sentinel Lymph Nodes (SLNs)
After Initial Negative Frozen Section
Characteristics No. (%)
Mean age, y (range) 53 (30-85)
Mean SLNs removed (range) 2.5 (1-5)
Mean NSLNs removed (range) 12 (2-35)
Tumor size, cm
[greater than or equal to]2 60 (58)
> 2 to [greater than or equal to]5 39 (38)
>5 4 (4)
Tumor type
Invasive ductal 78 (76)
Invasive lobular 19 (18)
Other types 6 (6)
Tumor grade
I 23 (22)
II 51 (50)
III 29 (28)
Angiolymphatic invasion
Present 73 (71)
Absent 28 (27)
Suspicious 2 (2)
Positive 12 (12)
Negative 89 (86)
Not evaluated 2 (2)
Estrogen receptor
Negative 7 (4)
Not evaluated 0
Table 2. Rate and Classification of Nonsentinel Lymph Node
(NSLN) Involvement Based on Size of Sentinel Lymph Node
(SLN) Metastases
Classification of
Positive NSLNs,
No. of Cases
SLN Classification No. of SLN No. of ITCs MM MET
Cases Positive
NSLNs (%)
ITCs ([greater than 46 6 (13) 4 1 1
or equal to] 0.2 mm and
no more than 200 cells)
MM (>0.2 mm to [greater 46 15 (33) 7 6 2
than or equal to]2 mm)
MET (>2 mm) 11 2 (18) 0 1 1
Abbreviations: ITCs, isolated tumor cells; MET, metastasis;
MM, micrometastasis.
Table 3. Univariate and Multivariate Statistical Analyses of
Clinicopathologic Variables for Patients With Nonsentinel
Lymph Node Metastasis
Clinicopathologic Variable Univariate Multivariate
(P Value) (P Value)
Number of positive SLNs (1 versus
[less than or equal to] 2) .002 (a) .002 (a)
Angiolymphatic invasion (present, .04 (a) .08
absent, suspicious)
Metastasis size (ITCs, MM, MET) .03 (a) .10
Tumor size ([greater than or .10 .07
equal to]2, > 2 to [greater than
or equal to] 5, >5 cm)
Abbreviations: ITCs, isolated tumor cells; MET, metastasis; MM,
micrometastasis; SLNs, sentinel lymph nodes.
(a) Statistically significant.
COPYRIGHT 2011 College of American Pathologists
Gutierrez, Jessica; Dunn, Daniel; Bretzke, Margit; Johnson, Eric; O'Leary, John; Stoller, Diane; Fra
Archives of Pathology & Laboratory Medicine
Clinical report
Adult testicular granulosa cell tumor: a review of the literature for clinicopathologic predictors of malignancy.
The impact of specially designed digital games-based learning in undergraduate pathology and medical education.


Subtitle: Baking Classic Sourdough bread using a sourdough starter and NO KNEAD methods.
Teresa loves teaching serious home bakers, how to bake sourdough bread! She worked at two different bakeries besides baking at home for over 40 years. Thirteen years ago, she built a business (Northwest Sourdough) around teaching others how to bake real sourdough at home. She published a four volume book called, "Discovering Sourdough," and another baking book, "Make Your Own Sourdough Starter." Teresa also published her memoir titled: "Reach for Joy," under the pseudonym, TL Reys.
Learn to a Start A SUCCESSFUL Restaurant Without making costly mistakes that cause 80% of Restaurants to fail.
Target audience: This course is suited to anyone with basic baking/kitchen skill. It is often easier for a person who has never baked to learn sourdough baking. Beginners will enjoy the satisfaction of baking real bread and professionals will have fun with a refresher.
Requirements: The materials and equipment you will need are covered in the course, so jump in and let's get started!


text:
#ifndef TRAJVIDEOMAKER_H
#define TRAJVIDEOMAKER_H

#include <avogadro/glwidget.h>

namespace Avogadro {

class Animation;

  class TrajVideoMaker
  {
  public:
    //! Constructor
        TrajVideoMaker();
    //! Destructor
    virtual ~TrajVideoMaker();

    static void makeVideo(GLWidget *widget, Animation *animation,
                          const QString& workDirectory,
                          const QString& videoFileName);

  private:
    static double getAspectRatio(GLWidget* widget);
    static bool runPovRay(QString directory, QString povFileName);

    template <class QStringIterator>
    static void runMencoder(QString pngFileDirectory, QString videoFileName,
               QStringIterator startPngFiles, QStringIterator endPngFiles);

  };
}
#endif

redpajama_set_name: RedPajamaGithub


text:
with LITTLE MAN
Sunday, September 16, 2018 at 7:00pm
Pitchfork praised the songs for striking "a balance between meaty vintage metal and crisp, stoner-rock melodies." NME said it ticked "the requisite boxes for all great rock & roll" and called it "utterly, utterly thrilling," and Q Magazine called it "immense fun." When it was released in 2005, Wolfmother's eponymous debut was exactly what rock & roll needed: a meaty, beaty, big and bouncy genre resuscitator that not only broke through to the mainstream, but broke big.
Read more about WOLFMOTHER
Rock band Little Man, who's fronted by Chris Perricelli, continues to be a strong live act and an amazingly diverse recording artist of the Twin Cities. Classic Rock, Garage Rock, Psychedelic Rock - think George Harrison meets Bowie meets Jack White.
Read more about LITTLE MAN


A New Reason to Take Sleep SeriouslyIs 30 minutes of exercise a day enough?
I've written about the dangers of sitting before. In that blog post, I talked about a study from the American Cancer Society that found a correlation between leisure time spent sitting and an increased risk of myeloma, breast, and ovarian cancers in women. Even then, this research was less of a piece of breakthrough and science and more of a confirmation of what the medical community has become to accept as fact: sitting is really bad for you.
In fact, some studies have gone as far as to compare the dangers of setting to the dangers of smoking.
While there might be some hyperbole here, smoking and sitting do have a few key things in common: smoking and sitting can both become deeply ingrained habits that persist for decade after decade in an individual's life, and they both have far-reaching health consequences. The takeaway from this body of research is that activity matters throughout your day, so you should adopt Habits of Health that promote movement in both big and small ways. A workout at the end of your workday will not undo the damage of sitting for the entirety of a 10 hour workday.
These health consequences, unfortunately, are not limited to adults. Just like you wouldn't want your son or daughter to take up smoking, you should be just as concerned about how much time your children spend sitting.
A recent study published in Experimental Physiology (that was picked up by the New York Times) found that children who had just one session of inactivity began to experience changes in blood flow and arteries. These same physical changes are consistent with indicators of adult cardiovascular problems.
The research into how sitting affects children is still quite limited compared to the volume of research that has been done on adults, but these findings are not surprising given what we already know about the dangers of inactivity. From a Habits of Health perspective, prolonged periods of inactivity may be more dangerous for children in terms of the behavioral patterns it reinforces. If you play those habits out over a lifetime of inactivity, the culmination is likely incredibly serious health problems.
For the older generations, a childhood spent in front of a screen or on a couch is far from our own personal experiences. For us, inactivity began to take hold as we transitioned into adulthood. We went from spending our days playing sports and romping through the neighborhood to sitting at a desk in an office. For younger generations, the path is from a childhood spent in a chair to an adulthood spent in a chair.
As the above study indicates, the consequences for inactivity might begin almost immediately. Just as we see the value of adopting Habits of Health in our adult lives, we should be helping our children to adopt Habits of Health that set them up for a lifetime of vibrant health. Should we toss out the televisions and video game systems? Maybe not, but we should be looking to model and impart Habits of Health for and to our children.
So get up and move with the whole family!


text:
VERSION >= v"0.4.0-dev+6521" && __precompile__()

module Color

warn("Color is deprecated, please use Colors instead. See https://github.com/JuliaGraphics/Colors.jl")

using FixedPointNumbers, Compat

typealias Fractional Union(FloatingPoint, FixedPoint)

import Base: ==, convert, eltype, hex, isless, linspace, show, typemin, typemax, writemime

if VERSION < v"0.4.0-dev+3275"
    import Base.Graphics: set_source, set_source_rgb, GraphicsContext
else
    import Graphics: set_source, set_source_rgb, GraphicsContext
end

export ColorValue, color,
       ColourValue,
       AlphaColorValue, AbstractAlphaColorValue, AbstractRGB,
       RGB, HSV, HSL, XYZ, xyY, Lab, LAB, Luv, LUV, LCHab, LCHuv, DIN99, DIN99d, DIN99o, LMS, RGB24,
       RGBA, HSVA, HSLA, XYZA, xyYA, LabA, LuvA, LCHabA, LCHuvA, DIN99A, DIN99dA, DIN99oA, LMSA, ARGB32,
       rgba, hsva, hsla, xyza, xyYa, laba, luva, lchaba, lchuva, din99a, din99da, din99oa, lmsa, argb32,
       colortype, weighted_color_mean, hex,
       protanopic, deuteranopic, tritanopic,
       distinguishable_colors,
       colordiff, DE_2000, DE_94, DE_JPC79, DE_CMC, DE_BFD, DE_AB, DE_DIN99, DE_DIN99d, DE_DIN99o,
       MSC, sequential_palette, diverging_palette, colormap,
       colormatch, CIE1931_CMF, CIE1964_CMF, CIE1931J_CMF, CIE1931JV_CMF

# The core; every other include will need these type definitions
include("colorspaces.jl")

# Early utilities
include("utilities.jl")

# Include other module components
include("conversions.jl")
include("algorithms.jl")
include("parse.jl")
include("differences.jl")
include("colormaps.jl")
include("display.jl")
include("colormatch.jl")

@deprecate RGBA32 ARGB32
@deprecate rgba32 argb32

end # module


IKON Services has joined the Carlton Football Club in actively participating 16 Days of Activism, a global campaign raising awareness around violence against women. The international initiative runs from Friday 25 November until Saturday 10 December, symbolically beginning on the International Day for the Elimination of Violence against Women, and finishing on International Human Rights Day. There are fewer issues more pressing than stamping out violence against women and children and as such we share this message with the hope that we can do our bit to influence community values and raise awareness.


Special Delivery | Special Delivery music and information online.
It has been a busy summer for Special Delivery! Since our last post, we have been at a Ladies Retreat at the Baptist Church in Minot, ND; Our Savior's Lutheran Church in Rolla, ND; the Polk County Fair in Fertile, MN; and dodged a tornado in McClusky, ND!
Thanks to all the fantastic groups who performed and to those who were able to stop by the park and listen!
Special Delivery was honored to sing at North Dakota House of Representatives Memorial Service on March 23rd. This service recognized past representatives who have died since the last session.
We also sang at the Governor's Prayer Breakfast on March 25th. The Governor's Prayer Breakfast is a State version of the National Prayer Breakfast held annually in Washington, D.C. The National Prayer Breakfast was inaugurated in 1953 by members of the United States Senate and House of Representatives as a time of dedication of themselves and our nation to God.
State Prayer Breakfasts are now held in nearly every State of the Union.
Greetings friends! Yes, we are still here in spite of the fact that we have been so removed from cyberspace. We really mean to keep our website current but that, as you well know, has not been the case. A number of factors have entered into that result, but suffice it to say, this is the beginning of a huge attempt at actually doing so.
I could not do justice to the events that we've participated in since our last update so I won't try to catch up on each one. I can say that each event has been just as special to us as the next whether or not we specifically comment on it here! We appreciate every opportunity we have had to share gospel music.
Just a few events we will try to touch on soon: Floyd Gospel Sing & Church of Christ (Nashua,IA) – just last weekend: Int'l Country Gospel Music Fest at the Peace Gardens in mid August: 10th Annual Gospel Extravaganza in the Cando City Park – Aug. 8.
Our schedule has been very slow this past year for various reasons but we are still singing, working on new material, and ready and anxious to come and sing for your special event!
Pastor Rodney Johnson once again opened the doors to Special Delivery. We were honored to worship at Our Saviors Free Lutheran Church in Stanley ND. They have welcomed us with open arms for many years every time we are in the area. It is such a blessing to return to this awesome church family when we have the opportunity. Kathy Ellingson was Catherine's college roommate and it is always fun to reminisce and meet new friends through her kindness. We thank everyone there for their continued prayers and support.
Fort Buford came to life as the 6th Infantry Regiment Association had reenactment on the parade ground. Special Delivery sang at their 9 a.m. outdoor Sunday Service.
Naomi is employed with AIM (Adventures in Missions). She also ministers thru KABU radio station on Sunday afternoons. KABU gave Special Delivery the wonderful opportunity of singing praise and worship on live radio August 9th. This was a very SPECIAL day for us and one we will always remember.
It was an honor for Special Delivery to return to Peace Lutheran Church in Devils Lake.
It brought back wonderful memories as it was the first church we performed using our sound equipment.
Our Sound Tech, Ron Anfinson, has become an experienced sound man who is now being requested by many music groups and organizations in the surrounding communities.
Our group has been together for 17 years and we are very grateful for the financial and prayer support we have always received from the people of Peace Lutheran.
We had a wonderful day in the park on Sunday! The weather started out a little chilly with a few rain drops while we set up the equipment, but by the afternoon it turned out to be a nice day!
Special Delivery took part in the 10:00 Lutheran Church Service in the park with Pastor Bonnie Weaver. We enjoyed the food and fellowship after the service.
At 1:00 Special Delivery started out the sing with a few songs,and Chuck introduced each group before they took the stage.
These few pictures will give you an idea on how much fun we had!