text:
Monthly 25-hydroxyvitamin D level changes in the 25-hydroxyvitamin D quartiles. Black bars indicate 25-hydroxyvitamin D quartile 1 (lowest levels); light gray bars, quartile 4 (highest levels). To convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496.
Kaplan-Meier plots of all-cause and cardiovascular mortality in the 25-hydroxyvitamin D quartiles (Q). Log-rank test indicated a significant difference across all 25-hydroxyvitamin D quartiles (P < .001). Multivariate-adjusted hazard ratios for patients in the lower two 25-hydroxyvitamin D quartiles (median, 7.6 and 13.3 ng/mL) were higher for all-cause mortality (hazard ratio, 2.08; 95% confidence interval, 1.60-2.70; and hazard ratio, 1.53; 95% confidence interval, 1.17-2.01; respectively) and for cardiovascular mortality (hazard ratio, 2.22; 95% confidence interval, 1.57-3.13; and hazard ratio, 1.82; 95% confidence interval, 1.29-2.58; respectively) compared with patients in the highest 25-hydroxyvitamin D quartile (median, 28.4 ng/mL). To convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496.
Cox proportional hazards regression model ratios (including 95% confidence intervals [CI]) for cardiovascular mortality are shown for 25-hydroxyvitamin D (A) and 1,25-dihydroxyvitamin D (B) quartiles (Q) for the following 3 different statistical models (M): (1) M1 (unadjusted), (2) M2 (adjusted for age, sex, body mass index, and physical activity level), and (3) M3 (variables of M2 plus active smokers, diabetes mellitus, albumin level, cystatin C level, triglyceride level, N-terminal pro-BNP level, systolic and diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol levels, and the use of statins, aspirin, β-blockers, bronchodilators, and angiotensin-converting enzyme inhibitors).
Multivariate-adjusted (covariates as in model 3 of Figure 3) hazard ratios for all-cause mortality in patients categorized by Charlson Comorbidity Index (A), New York Heart Association functional class (B), and physical activity level (C). Q1 indicates patients in the lowest 25-hydroxyvitamin D quartile; Q4, patients in the highest 25-hydroxyvitamin D quartile. *P < .05. †P < .01. ‡P < .005. §P < .001 compared with the reference group.
Univariate correlation analysis. A, Distribution profile for both serum vitamin D levels among patients assigned to different 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles. Although patients with concomitantly high (column H) or concomitantly low (column L) levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were frequent, the overall correlation between the 2 endogenous D vitamins was weak (r = 0.32, P < .001). B, Effects on mortality rates when 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were considered concomitantly. Patients of column H (both high) showed the lowest and those of column L (both low) the highest mortality rates during the study period.
The 25-hydroxyvitamin D (A) and 1,25-dihydroxyvitamin D (B) patient quartiles and corresponding effects on multivariate-adjusted hazard ratios (covariates as in model 3 of Figure 3) for all-cause mortality according to patients' coronary artery disease (CAD) status as determined by coronary angiography at baseline. CAD ≥ 50% indicates patients with significant CAD; patients without significant CAD are presented as 2 categories (<50% or by the most stringent criteria of <20% narrowing of ≥1 of 15 coronary artery segments evaluated). * P < .05. †P < .01. ‡P < .005. §P < .001 compared with the reference group.
Baseline Characteristics According to 25-Hydroxyvitamin D Quartiles
Hazard Ratios (HR) for All-Cause Mortality According to 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D Quartiles
Associations of 25-Hydroxyvitamin D Quartiles With Cardiovascular Risk Markersa
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Dobnig H, Pilz S, Scharnagl H, et al. Independent Association of Low Serum 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D Levels With All-Cause and Cardiovascular Mortality. Arch Intern Med. 2008;168(12):1340–1349. doi:10.1001/archinte.168.12.1340
Independent Association of Low Serum 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D Levels With All-Cause and Cardiovascular Mortality
Harald Dobnig, MD; Stefan Pilz, MD; Hubert Scharnagl, PhD; et al Wilfried Renner, PhD; Ursula Seelhorst, MA; Britta Wellnitz, LLD; Jürgen Kinkeldei, DEng; Bernhard O. Boehm, MD; Gisela Weihrauch, MSc; Winfried Maerz, MD
Author Affiliations: Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine (Dr Dobnig), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (Drs Scharnagl, Renner, and Maerz and Ms Weihrauch), Medical University of Graz, Graz, Austria; and Department of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Heidelberg (Dr Pilz), LURIC Study Nonprofit LLC, Freiburg (Ms Seelhorst and Dr Wellnitz), Synlab Center of Laboratory Diagnostics Stuttgart, Leinfelden-Echterdingen (Dr Kinkeldei), Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Ulm, Ulm (Dr Boehm), and Synlab Center of Laboratory Diagnostics Heidelberg, Eppelheim (Dr Maerz), Germany.
Background In cross-sectional studies, low serum levels of 25-hydroxyvitamin D are associated with higher prevalence of cardiovascular risk factors and disease. This study aimed to determine whether endogenous 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are related to all-cause and cardiovascular mortality.
Methods Prospective cohort study of 3258 consecutive male and female patients (mean [SD] age, 62 [10] years) scheduled for coronary angiography at a single tertiary center. We formed quartiles according to 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels within each month of blood drawings. The main outcome measures were all-cause and cardiovascular deaths.
Results During a median follow-up period of 7.7 years, 737 patients (22.6%) died, including 463 deaths from cardiovascular causes. Multivariate-adjusted hazard ratios (HRs) for patients in the lower two 25-hydroxyvitamin D quartiles (median, 7.6 and 13.3 ng/mL [to convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496]) were higher for all-cause mortality (HR, 2.08; 95% confidence interval [CI], 1.60-2.70; and HR, 1.53; 95% CI, 1.17-2.01; respectively) and for cardiovascular mortality (HR, 2.22; 95% CI, 1.57-3.13; and HR, 1.82; 95% CI, 1.29-2.58; respectively) compared with patients in the highest 25-hydroxyvitamin D quartile (median, 28.4 ng/mL). Similar results were obtained for patients in the lowest 1,25-dihydroxyvitamin D quartile. These effects were independent of coronary artery disease, physical activity level, Charlson Comorbidity Index, variables of mineral metabolism, and New York Heart Association functional class. Low 25-hydroxyvitamin D levels were significantly correlated with variables of inflammation (C-reactive protein and interleukin 6 levels), oxidative burden (serum phospholipid and glutathione levels), and cell adhesion (vascular cell adhesion molecule 1 and intercellular adhesion molecule 1 levels).
Conclusions Low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are independently associated with all-cause and cardiovascular mortality. A causal relationship has yet to be proved by intervention trials using vitamin D.
Studies1,2 have demonstrated that low levels of vitamin D represent a problem of global dimension. A recent Workshop Consensus for Vitamin D Nutritional Guidelines3 estimated that about 50% and 60% of the older populations in North America and the rest of the world, respectively, do not have satisfactory vitamin D status. The consensus further concluded that the situation is similar in younger subjects. Reasons for this remain unclear but are likely related to factors such as urbanization, demographic shifts, decreased outdoor activity, air pollution and global dimming, and decreases in the cutaneous production of vitamin D with age. The amount of vitamin D from dietary sources is generally viewed as too insignificant in many regions of the world to have an effect on vitamin D status at the population level.3
The minimum desirable serum level of 25-hydroxyvitamin D has been suggested to be 20 to 30 ng/mL (to convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496) according to the consensus conference3 and to a study4 in which the analysis was expanded to cover potential beneficial effects of vitamin D for multiple health outcomes. Low levels of 25-hydroxyvitamin D are clearly related to compromised bone mineral density,5 to falls6 and fractures,7 and to diminished lower extremity function. In addition to higher incidences of cancer8 and immune dysfunction,9 low levels of 25-hydroxyvitamin D have been recently linked to the presence of cardiovascular disease,10,11 hypertension,12 and the metabolic syndrome.13 Results of recent nationwide investigations showed an association of low 25-hydroxyvitamin D levels with important cardiovascular risk factors11,14 and further supported the findings of preclinical and clinical investigations that demonstrated positive effects of vitamin D and its analogues on fibrinolysis, blood lipids, thrombogenicity, endothelial regeneration, and smooth muscle cell growth.15 Together, these findings strongly suggest that 25-hydroxyvitamin D has beneficial effects, some involving the cardiovascular system, that are independent of calcium metabolism.
The mediator of these effects is thought to be 1,25-dihydroxyvitamin D, produced by the kidney, by extrarenal tissues (such as the vasculature), and by immune and gastrointestinal cells that express 1α-hydroxylase, which converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D.16 Locally produced 1,25-dihydroxyvitamin D may act in an autocrine or a paracrine manner via activation of the vitamin D receptor, which is found in many different cell types throughout the body.16 Because the serum level of 25-hydroxyvitamin D is roughly 1000-fold higher and the affinity for vitamin D receptor 100-fold lower compared with 1,25-dihydroxyvitamin D, direct effects of 25-hydroxyvitamin D on gene transcription or activation by intracellular mitochondrial 1α-hydroxylase may be operative.17 Therefore, low circulating levels of 25-hydroxyvitamin D could in theory damage target tissues in the following 2 ways: (1) by low substrate availability for renal and extrarenal 1α-hydroxylase and decreased local intracellular conversion to 1,25-dihydroxyvitamin D and (2) by a diminished direct effect on vitamin D receptor activation.
Apart from intervention studies18-20 in hemodialysis patients demonstrating decreased mortality associated with calcitriol treatment, as well as a recent prospective cohort study21 that found an association between mortality and elevated parathyroid hormone (PTH) levels but not between mortality and 25-hydroxyvitamin D level, there are no large longitudinal studies addressing associations of endogenous serum vitamin D levels with overall and cardiovascular mortality. To focus on this research question, we followed up a large cohort of patients referred for coronary angiography who underwent detailed baseline examinations. This allowed us to adjust our analysis for possible confounders of the association between vitamin D levels and mortality.
The Ludwigshafen Risk and Cardiovascular Health (LURIC) study22 is a prospective cohort trial designed to evaluate the effect of genetic polymorphisms and plasma biomarkers on cardiovascular health. Patients were recruited between July 1, 1997, and January 14, 2000, at the Herzzentrum Ludwigshafen (Cardiac Center Ludwigshafen) in southwest Germany (49° 29 minutes north latitude). The rationale and design of this study, baseline characteristics of the population, and definitions used for diagnosis of diabetes mellitus and hypertension have been published previously.22 In brief, our study population comprised 3316 patients of white race/ethnicity referred for coronary angiography in a tertiary care medical center. Serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were determined in 3258 patients (98.3% of the entire study population; mean [SD] age, 62 [10] years), and the analysis was restricted to this group. Study participants had to demonstrate a stable clinical condition except for acute coronary syndrome. Exclusion criteria were any acute illness other than acute coronary syndrome, any predominant noncardiac chronic disease, and a history of malignant neoplasm(s) within the past 5 years. Seventy-eight patients (2.4%) reported taking vitamin supplements on a regular basis, which usually contained B complex vitamins or vitamin D3. Because 25-hydroxyvitamin D levels (mean [SD], 22.1 [11.3] ng/mL) were only slightly higher in users of vitamin D preparations compared with the remaining cohort (mean [SD], 17.2 [9.1] ng/mL) and because age, PTH levels, and 1,25-dihydroxyvitamin D levels did not differ significantly, we decided to include these patients in the present analysis. Written informed consent was obtained from each participant, and the study was approved by the institutional review board at the Ärztekammer Rheinland-Pfalz (Medical Association of Rheinland-Pfalz).
Coronary angiography was commonly indicated because of clinical symptoms or results of noninvasive tests that suggested myocardial ischemia. Coronary artery disease (CAD) was defined as the presence of at least 50% stenosis of at least 1 of 15 segments of the 3 major coronary arteries, based on maximal luminal narrowing. We used the Charlson Comorbidity Index, which has been shown to be a valid and reliable instrument to assess comborbidity,23 to form 3 groups of patients with 0 score points (group 0), 1 score point (group 1), and 2 or more score points (group 2). A questionnaire with a scoring system ranging from 1 to 11 was used to classify the mean physical activity levels, and study participants were grouped into the following 3 categories of physical activity: below average (score, 1-3), average (score, 4-7), and above average (score, ≥8).
A fasting venous blood sample was obtained in the morning before coronary angiography. Selected variables were measured after samples were snap frozen and stored at −80°C. A summary of methods and test kits used for variables relevant to this study has been published.22 The estimated glomerular filtration rate was calculated according to the 4-variable model of the Modification of Diet in Renal Disease study.24
Serum levels of 25-hydroxyvitamin D were assayed on a weekly basis using a radioimmunoassay (DiaSorin SA, Antony, France) with intra-assay and interassay coefficients of variation of 8.6% and 9.2%, respectively. In a random sample of 100 study participants, 25-hydroxyvitamin D level was also determined using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with isotopic-labeled internal standard and 2 fragment mass to charge ratios of 401.4 to 382.2 (quantifier) and 401.4 to 365.3 (qualifier). Another fragment (mass to charge ratio, 413.5 to 395.4) was used to monitor 25-hydroxyvitamin D2 level, but none could be detected in any of the samples. A highly significant correlation was noted between 25-hydroxyvitamin D levels obtained by radioimmunoassay and by LC-MS/MS (r = 0.875, P < .001). Levels of 1,25-dihydroxyvitamin D (Nichols Institute Diagnostika GmbH, Bad Nauheim, Germany) were measured by radioimmunoassay on a multicrystal counter (Berthold LB2014, DiaSorin SA). Intra-assay and interassay coefficients of variation were below 10% for all described laboratory procedures.
Information on mortality was obtained from local registries. We used death certificates to classify the deceased into those who died from cardiovascular vs noncardiovascular causes. This classification was done independently by 2 experienced clinicians who were blinded to any data on the study participants except the already-mentioned information that was required to classify the causes of death. In the event of disagreement or uncertainty concerning the cause of death, the decision was made by one of us who is a principal investigator of the LURIC study (W.M.). Eighteen patients could not be contacted for follow-up, and for 23 of the deceased we had insufficient information to classify the cause of death. The latter study participants were included in the analysis of all-cause mortality but were excluded from any statistical procedure regarding cardiovascular mortality.
Because serum vitamin D levels fluctuate by month throughout the year, we decided for the purpose of this analysis not to use absolute vitamin D levels but instead to categorize individual patients' 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels into quartiles that were obtained on the basis of 202 to 358 vitamin D measurements of study patients each month. To address other possibilities of 25-hydroxyvitamin D categorization and to allow for comparisons with the quartile-based approach already mentioned, these results are also briefly mentioned in the "Comment" section.
Baseline characteristics of the 25-hydroxyvitamin D groups are given as percentages for categorical data and as medians with interquartile ranges for continuous variables. Comparisons between groups were performed using the χ2 test for categorical data and using analysis of variance and analysis of covariance with P for trend and adjustments as indicated for continuous data. If appropriate, continuous variables were logarithmically transformed before use in parametric procedures. Kaplan-Meier curves followed by log-rank test were used to evaluate differences in overall and cardiovascular mortality for 25-hydroxyvitamin D categories. Hazard ratios with 95% confidence intervals (CIs) for all-cause and cardiovascular mortality were calculated using Cox proportional hazards regression models. Hazard ratios for 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D categories were calculated by comparing the data with those of the highest 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles, respectively. We adjusted for several possible confounders in the Cox proportional hazards regression model by using different models that included important clinical variables, cardiovascular risk factors, or factors related to calcium metabolism. The backward stepwise logistic regression selection method was used, and the results of the final step are given. We tested for plausible interactions between the covariates by adding product terms to our models, and we tested for colinearity. Further assumptions underlying the Cox proportional hazards regression model were evaluated by log minus log survival and partial (Schönfeld) residuals vs survival time plots and were found valid. All statistical tests were 2-sided, and statistical significance was defined as P < .05. All data were analyzed using commercially available statistical software (SPSS 15.0; SPSS Inc, Chicago, Illinois).
Mortality rates
After a median follow-up of 7.7 years, 737 persons (22.6% of the study population at baseline) had died. Of these, 463 deaths (62.8%) were from cardiovascular causes, 251 (34.1%) were from noncardiovascular causes, and 23 (3.1%) could not be classified because of insufficient data about the cause of death. Among patients with angiographic CAD, 319 deaths occurred from cardiovascular causes and 148 deaths from noncardiovascular causes.
25-hydroxyvitamin d levels
Significant seasonal changes in serum 25-hydroxyvitamin D levels were found, with the lowest and highest levels appearing in March (mean [SD], 12.0 [6.8] ng/mL) and in August (mean [SD], 22.7 [9.6] ng/mL) (P < .001, analysis of variance), corresponding to an 89% difference in the mean levels. When patients were grouped into different 25-hydroxyvitamin D categories (0-10, >10-20, >20-25, >25-30, and >30 ng/mL), PTH levels began to rise significantly with the category of greater than 20 to 25 ng/mL. Respective increases in PTH levels averaged 3 pg/mL (to convert PTH levels to nanograms per liter, multiply by 1.0) (for the >20-25 ng/mL category), 5 pg/mL (for the >10-20 ng/mL category), and 12 pg/mL (for the 0-10 ng/mL category). Because 25-hydroxyvitamin D levels vary with the month of the year, the range of 25-hydroxyvitamin D quartiles fluctuates as well (Figure 1).
Baseline characteristics according to 25-hydroxyvitamin D quartiles are summarized in Table 1. On average, patients in the lowest 25-hydroxyvitamin D quartile were older, were more likely to be female, and had more comorbidities. The mean serum PTH levels were 36% higher and the 1,25-dihydroxyvitamin D levels 31% lower among patients in the lowest 25-hydroxyvitamin D quartile compared with those in the highest quartile. Differences in corrected serum calcium and phosphate levels were absent or small.
Kaplan-Meier curve analysis followed by log-rank test showed that risk for all-cause and cardiovascular mortality increases significantly (P < .001) across 25-hydroxyvitamin D quartiles (Figure 2). Hazard ratios (with 95% CIs) for all-cause mortality (Table 2) and for cardiovascular mortality (Figure 3) among 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles are given for 3 different statistical models that include traditional cardiovascular risk factors or other variables directly or indirectly correlated with vitamin D metabolism. After adjustment for the respective other serum vitamin D level, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D associations with all-cause and cardiovascular mortality remained significant.
We performed a multivariate-adjusted subgroup analysis (based on covariates of model 3, described in the legend to Figure 3) for all-cause mortality among patients in different Charlson Comorbidity Index, New York Heart Association functional class, and physical activity level categories. These results are shown in Figure 4.
Correlation of 25-hydroxyvitamin d levels with 1,25-dihydroxyvitamin d levels
Univariate correlation analysis between 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels was weak (r = 0.36, P < .001) even after adjustment for cystatin C levels (r = 0.32, P < .001). Patients in a given 25-hydroxyvitamin D category could have 1,25-dihydroxyvitamin D serum levels ranging from low to high (Figure 5A). Patients' concurrent assignment to both vitamin D quartiles suggests a synergistic increase in all-cause mortality within a respective 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D quartile with declining levels of the respective other vitamin D level (Figure 5B).
Mortality risk in patients without significant cad
We split the results of multivariate-adjusted Cox proportional hazards regression models by different categories of angiographic CAD. A total of 2190 patients (67.3%) had significant CAD (≥50% stenosis). Six hundred ninety-three patients had virtually no CAD (<20% stenosis). Even in patients with CAD of less than 50% stenosis or less than 20% stenosis, there was a gradual increase in all-cause mortality for all lower 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D quartiles (Figure 6).
Cardiovascular risk markers
We performed multivariate-adjusted comparisons among 25-hydroxyvitamin D quartiles for biological markers potentially linked to cardiovascular risk (Table 3). In addition, multiple linear regression analyses were performed for 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels, which were found to be correlated with the following log values (significant for all 25-hydroxyvitamin D correlations and for most 1,25-dihydroxyvitamin D correlations): glutathione, interleukin 6, phospholipids, C-reactive protein, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1, with standard β coefficients of 0.10 to 0.20 (P < .001 for all) after adjustments for age, sex, body mass index, and physical activity level and of 0.05 to 0.10 after additional multivariate adjustments. The direction of these correlations pointed toward an increase in cardiovascular risk at low vitamin D levels. Variables available for all patients (C-reactive protein and phospholipid levels) were also added to multivariate Cox proportional hazards regression models and were found not to significantly affect the vitamin D mortality relationship.
This study demonstrates that 25-hydroxyvitamin D levels that are in the lower 50% of the vitamin D range of our study population have a hazard ratio (HR) of 1.53 to 2.08 for all-cause mortality after adjustment for traditional cardiovascular risk factors. In subgroup analysis, the relationship of low 25-hydroxyvitamin D levels to mortality was consistent regardless of comorbidity, physical activity level, or New York Heart Association functional class. We could also exclude that variables known to be vitamin D dependent such as serum PTH, calcium, or phosphate level were driving confounders in the association between mortality and serum vitamin D levels. Therefore, a low 25-hydroxyvitamin D level can be considered a strong risk indicator for all-cause mortality in women and in men.
For this analysis, a retrospective classification of all individual 25-hydroxyvitamin D levels into quartiles was performed on the basis of 202 to 358 measurements of 25-hydroxyvitamin D levels each month. A patient belonging to the lowest monthly quartile could have 25-hydroxyvitamin D values ranging from 1.9 to 15.3 ng/mL depending on the season of the year. Although in theory such an approach of quartile-based monthly cutoffs seems logical and appealing, we reached similar results when absolute serum 25-hydroxyvitamin D levels were considered.
However, the cutoff discriminating vitamin D insufficiency and sufficiency is still a matter of debate, and there is likely a "gray area" of overlap between these 2 entities. A cutoff value of 20 ng/mL for normal 25-hydroxyvitamin D levels may be considered a more conservative threshold value because vitamin D levels below that have clearly been shown to be associated with increases in serum PTH levels,25 decreases in physical performance,26 and diminished lower extremity function.27 Using such a vitamin D classification, we calculated multivariate-adjusted HRs for all-cause mortality of 2.13 (95% CI, 1.70-2.68) for patients with vitamin D deficiency (≤10 ng/mL) and 1.33 (95% CI, 1.07-1.65) for patients with vitamin D insufficiency (>10-20 ng/mL), values that are close to the HRs obtained using the quartile-based approach. If vitamin D deficiency is defined as 20 ng/mL or less and vitamin D insufficiency as greater than 20 to 30 ng/mL or less and is compared with values greater than 30 ng/mL, the adjusted HRs for all-cause mortality were 2.34 (95% CI, 1.48-3.39) for patients with vitamin D deficiency and 1.54 (95% CI, 0.99-2.41) for patients with vitamin D insufficiency. Using yet another approach, we expressed 25-hydroxyvitamin D levels as percentiles within the respective month. Here, the adjusted HRs for all-cause mortality among patients having hydroxyvitamin D values in the lowest 25-hydroxyvitamin D quartile became even higher compared with those among patients having 25-hydroxyvitamin D values above the 10th percentile (adjusted HR, 4.91; 95% CI, 3.33-7.20; and adjusted HR, 3.04; 95% CI, 1.95-4.75). Therefore, it cannot be excluded that risk gradients become even steeper when outcomes are compared with 25-hydroxyvitamin D levels well above those seen in our study population.
At first glance, the percentage of patients with low 25-hydroxyvitamin D values seems unexpectedly high in the present study. Roughly two-thirds had serum levels below 20 ng/mL. However, our mean value of 17.3 ng/mL compares well with values reported from other large trials performed in middle European countries such as France, Italy, and Germany.28-30
Another important aspect supporting our conclusions is that, similar to low 25-hydroxyvitamin D levels, low 1,25-dihydroxyvitamin D levels were associated with increased HRs for mortality, despite a weak correlation between the 2 (r = 0.36). This leads to the conclusion that 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels may yield similar but independent biologic effects. This is also in line with our finding that, when both variables are considered concomitantly, a synergistic effect on mortality risk seems evident (Figure 5B).
What are the major determinants of circulating 1,25-dihydroxyvitamin D levels? By multiple regression analysis with relevant variables included and with serum 1,25-dihydroxyvitamin D level set as the dependent variable, 25-hydroxyvitamin D levels (partial R2 = 9.6%) and renal function (partial R2 = 7.3% for log cystatin C) constituted the 2 most important independent predictors in the model, yielding an overall R2 of 24%. We were unable to find an independent association with age, despite a study31 demonstrating such an effect on 1,25-dihydroxyvitamin D production after infusion of PTH fragment 1-34. Consequently, availability of 25-hydroxyvitamin D substrate and renal function account for a small explainable proportion of 1,25-dihydroxyvitamin D serum levels. The question remains whether extrarenal production of 1,25-dihydroxyvitamin D contributes, at least in part, to the circulating pool of 1,25-dihydroxyvitamin D in individuals with normal renal function.
Another interesting aspect of the present study is that the association of vitamin D levels with mortality can be compared between patients with and without CAD. Low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were associated with significant increases in all-cause mortality but were consistently higher in patients without significant CAD. We conclude from these data that low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels seem to be important mediators of mortality even when there is little or no indication of overt vascular disease.
A limitation of our study is that we are unable to decide whether the association between low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels and mortality is causal or not. However, there are a few indications pointing to a possible link. Elevated C-reactive protein and interleukin 6 levels in patients with lower 25-hydroxyvitamin D levels suggests that 25-hydroxyvitamin D has anti-inflammatory properties. Similar relationships have been reported by others.32,33 Together with the effects related to oxidative stress and increased cell adhesion that we found, low levels of vitamin D may detrimentally affect vascular biologic function in multiple ways. Other mechanisms whereby low vitamin D levels may be associated with mortality include effects on matrix metalloproteinases,32,34 which were shown to affect plaque production and stability, increased susceptibility to arterial calcification,35,36 or an increase in renin messenger RNA expression.37
Further limitations of our study are related to 25-hydroxyvitamin D level determination and possibly race/ethnicity and changes of serum 25-hydroxyvitamin D levels over time. For measurements of 25-hydroxyvitamin D serum levels, we used a commercial radioimmunoassay that was validated against an LC-MS/MS as a reference method in a patient subgroup. The correlation between the 2 methods was strong (r = 0.87). We have further confidence in our vitamin D measurements because the annual variation in 25-hydroxyvitamin D level and the rise in serum PTH levels in patients with vitamin D insufficiency were similar, as expected,25 and because there was a graded biological effect with decreasing 25-hydroxyvitamin D levels. Serum 25-hydroxyvitamin D levels in a given individual seem to be constant over time. Among 100 healthy older individuals participating in a fall prevention study performed at 2 centers, we found a high correlation between two 25-hydroxyvitamin D levels that were 12 months apart (r = 0.758, P < .001; H.D., unpublished data, 2004), suggesting low intraindividual variation over time. The results of this study may further apply only to white race/ethnicity; despite low 25-hydroxyvitamin D levels in African Americans, little or no correlation to cardiovascular disease was reported.11
In conclusion, this prospective cohort study demonstrates for the first time, to our knowledge, that low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are associated with increased risk in all-cause and cardiovascular mortality compared with patients with higher serum vitamin D levels. Both vitamins seem to have synergistic biologic action that is largely independent of each other. Apart from the proved effects that vitamin D has on bone metabolism and neuromuscular function, appropriate serum levels (that may also be higher than in the present investigation) are associated with a decrease in mortality. Although not proved, it seems possible that at least part of this effect may be due to lowering of a risk profile promoting atherosclerosis and preventing cardiovascular end points. Based on the findings of this study, a serum 25-hydroxyvitamin D level of 20 ng/mL or higher may be advised for maintaining general health.
Correspondence: Harald Dobnig, MD, Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria (harald.dobnig@meduni-graz.at).
Accepted for Publication: January 27, 2008.
Author Contributions: Dr Dobnig had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Boehm and Maerz. Acquisition of data: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, Boehm, Weihrauch, and Maerz. Analysis and interpretation of the data: Dobnig, Pilz, Renner, and Maerz. Drafting of the manuscript: Dobnig, Pilz, and Maerz. Critical revision of the manuscript for important intellectual content: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, Boehm, and Weihrauch. Statistical analysis: Dobnig and Pilz. Obtained funding: Boehm and Maerz. Administrative, technical, or material support: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, and Weihrauch. Study supervision: Maerz.
Funding/Support: The LURIC study has received unrestricted grants from Sanofi-Aventis, Roche, Dade Behring, and AstraZeneca.
Additional Contributions: The German registration offices and local public health departments assisted with the study. Eugenia Lamont and Günter J. Krejs, MD, critically reviewed the manuscript, and Andrea Groselj-Strele, MSc, provided statistical advice. We thank the participants of the LURIC study, the LURIC study team, and the laboratory staff at the Ludwigshafen General Hospital, the University of Freiburg, and the University of Ulm.


text:
Sounds of things
Sounds of a fluid that conforms to the shape of its container but retains a constant volume independent of pressure.
Splash, splatter
The sound of a liquid colliding with a hard surface.
Sounds made by a liquid-saturated material being squeezed.
The sound of liquid falling in drops.
The sound of liquid being transferred in a steady stream.
Fill (with liquid)
The sound of a container being filled with liquid.
The sound of a liquid being transferred in a scatter or jet of droplets.
Pump (liquid)
The sound of a liquid being drawn or poured with a pump.
The sound of moving an implement through a fluid substance.
The sound of a liquid that is reaching the temperature at which it transitions to a vapor, resulting in bubbles emerging at the surface.

redpajama_set_name: RedPajamaCommonCrawl


text:
DMA's release 'Beautiful Stranger' MTV Unplugged cover
MTV Unplugged album out June 14th
DMA's today release their MTV Unplugged version of Madonna's Beautiful Stranger. The single will be part of their MTV Unplugged live album which is set for release on June 14th. Watch and listen to Beautiful Stranger below.
The MTV Unplugged session was filmed last October at Memo Music Hall, Melbourne and follows on from the trio's second album For Now, which was released last year to critical acclaim. The full tracklisting and artwork for MTV Unplugged (live) can be found here.
Main songwriter Johnny Took comments:
It was the most fun I've had in awhile, just rearranging the songs and hearing them in a different light. To be able to do this is a bit of a dream come true.
Over the past few months, the band have been busy touring with Liam Gallagher, Richard Ashcroft, The Kooks and Kasabian and have played their own sold out headline shows across Europe, the UK, the US and Australia. This summer, the Aussie band will appear at several festivals across the UK, including Isle of Wight and TRNSMT festivals. All dates and ticket links can be found here.
MTV Unplugged (live is available on CD and limited edition vinyl from the band's webstore.
Video: DMA's – Beautiful Stranger (MTV Unplugged)
DMA's
Watch DMA's cover Cher's 'Believe'
Published: 31 October 201612:53 Updated: 13 November 201713:41
The Sherlocks add dates with DMA's and Rat Boy + new video
Published: 9 March 201715:34 Updated: 13 November 201713:41
DMA's share video for 'Time & Money' + Madonna cover
Previous Previous post: Beach Baby share new single 'Lovin' Feeling'
Next Next post: The Night Café announce debut album '0151', stream new music
DMA's tour dates & tickets


text:
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7-RT202: Is There a Moral Imperative for Development Researchers to Act as Advocates?
Thursday, 08/July/2021:
Session Chair: Adinda Ceelen, International Institute of Social Studies, Netherlands, The
Session Chair: Prof. Arjun Singh Bedi, Erasmus University Rotterdam, Netherlands, The
Session Abstract
Our understanding of international development is rapidly changing. We are dealing with multiple systemic crises such as climate change, the COVID-19 pandemic and growing inequality. Meanwhile the decolonization debate and shifting communication landscapes present fundamental challenges to the role of researchers and how they communicate knowledge.
This event will zoom in on the topic of development research and communication within the context of transformation processes and change. It will dive into the topic of scholar-activism and impact-oriented research. Our multi-stakeholder panelists will share key insights from different stakeholder and disciplinary perspectives on the topic of research communication and knowledge exchange, before we dive into a group discussion on practical challenges, good practices and lessons learned.
The session will be chaired by Prof. Arjun Bedi (Deputy Rector Research Affairs, ISS).
This roundtable is convened by Adinda Ceelen (Knowledge Broker & Research Communications Advisor, ISS) and Chris Jordan (Communications and Impact Manager, Global Development Institute-UMAN) who co-convene the EADI Working Group on Research Communication.
Confirmed speakers:
Prof. Dirk-Jan Koch - Chief Science Officer at the Netherlands Ministry of Foreign Affairs
Speaking on the policy-academia nexus within which development researchers sometimes find themselves in the role of advocates. He will also touch upon existing feedback loops between research and policy-making and ways forward.
Prof. Adriano Nuvunga - Executive Director of the Center for Democracy and Development, Mozambique
Speaking on the practitioner-academia nexus to discuss how researchers can contribute to the work of NGOs and vice versa. Drawing on lessons from the practitioner arena to learn how NGOs communicate and advocate their work.
Dr. Kristen Cheney - Associate Professor in Children and Youth Studies at the ISS
Engaging in research for advocacy and change such that research can be designed and shared to bring about changes in policy and practice. She will also address some of the key skills, methods and approaches that are needed.
Dr. Lata Narayanaswamy - Associate Professor in the Politics of Global Development, University of Leeds
Sharing lessons for development research communication from the decolonization debate and how to be mindful when speaking about "knowledge transfer" within this context.
Dr. Tobias Denskus - Associate Professor in Development Studies at Malmo University
Sharing expert insights and perspectives on digital communication and how to use Twitter in the policy arena.
No contributions were assigned to this session.
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Maurizio Sarri says Chelsea must solve their mental problems following the 6-0 battering at the hands of Manchester City on Sunday.
The Blues were hammered from the opening moments in the loss to the reigning Premier League title contenders with Raheem Sterling after just four minutes.
By the 25th minute, it was 4-0, and Chelsea never got close to showing enough fight to turn the tide.
Sarri has begrudged his side's mental fortitude previously in his first season in charge of the club, but bouncing back from the Man City loss may prove the team's biggest test yet.
"In my opinion, the last game was not a problem of motivation. We were not able to react to the first difficulty during the match because, in the first four or five minutes, we started well," he said.
"Then, after the first goal, we were not able to react. So the problem is different. But it's always a mind problem, a mental problem, so we need to solve them."
"I think that, sometimes, as the match in Tottenham in the Premier League [showed], we had not the right approach to the match, the right determination," Sarri added.
"This match, in my opinion, was different. We had very good training during the week. We arrived at the match with the right level of motivation. Then we conceded a goal after five minutes and were not able to do anything."
Sarri added that the players and coaching staff met for an hour the day after the match in an effort to clear the air following the defeat.
In the days since, Chelsea have looked to mentally move on from the loss, something Sarri says hasn't been totally simple.
Now, they'll face a difficult road, starting with Thursday's Europa League clash with Malmo.
After that comes an FA Cup meeting with Manchester United, the return leg against Malmo before meeting Manchester City again in the Carabao Cup final.
"Not too easy, of course. But I think, after a match like in Manchester City, it's normal," Sarri said.
"It's not easy to play tomorrow [against Malmo] after a 6-0, but we have to play and we have to play well. We want to win.
"We know that it will be not really very easy because we have to play against a very good team, I think. They are compact, they are solid.
"They have usually a very good defensive phase, so it won't be easy. But we want to win and react immediately."


text:
Collective Sigh
"Two things are infinite: the universe and human stupidity; and I'm not sure about the universe." - Albert Einstein
Bush to unveil super-flu plan on Tuesday
Curses - trumped again by The Onion -
// posted by andante @ 6:01 PM
The stages of Halloween
I. Infant to @ twelve - intense anticipation of spooky times to come and lots of candy.
II. Indulgent young adult - passing out candy to trick-or-treaters.
III. Grumpy old fogey - turning out lights and eating candy yourself.
I've reached Stage III myself. Actually, there are very few Stage I's on our street these days, so I'm joined by most of my neighbors in Stage III.
But what Halloween would be complete without visiting a "Hallelujah House" or another similarly named spectacle?
We have a wide assortment of them around here, from churches disguising their Revivals For The Youth as "harvest festivals", to knock-offs of the one-and-only Landover Baptist Hellhouse.
Enter door number two at your own risk....The Demoncrat Room
In Room number 2 you will experience the horrors of life under the extreme liberal agenda! Your guns will be taken away! Your children will be taught that homosexurals are human! You will pay taxes while lazy good-for-nothing negroes eat fried chicken and watermelon and watch color TV all day while you have to work! Boodists, Cathylicks and other satanists will go unpunished and will walk the streets like they own them! See for yourself what blasphemy will occur if the Clinton/Gore liberal feminazis are not stopped!
On-site Republican voter registration is required; minimum registration is two states. Prizes will be given to the individual(s) who manage to register in all fifty states, "Puerto Rico and all U.S. holdings and territories." Participants will have to dodge the Al Gore monster as he tries to chop off your hands when you register to vote! While the evil Gore aims for your hands, the liberal demoncrat Lieberman will aim lower, trying to perform a circumcision. If you fail to dodge the demons and register in two states, you will be evicted from Hellhouse!
Clean house
Michael is right - Libby never should have had the opportunity to resign.
Scooter Libby should never have been allowed to resign: Cheney should have fired his ass as soon as Fitzgerald stopped reading the indictment.
If the administration was ever really serious about "restoring integrity", Libby's butt would have been out the door as soon as it became apparent he would face indictment.
That goes double for "Official A(sshole)".
There's no denying the Bush administration has been like the worst kind of evangelical missionaries; so certain of their twisted worldview they were willing to jeopardize the security of the country and utter disdain for the law of the land.
// posted by andante @ 10:37 PM
If I'm hearing this discussion on CNN correctly, two Republican talking-points are emerging. Number one - blame Joe Wilson. As Paul Begala pointed out, this is what got the Bushies in trouble in the first place.
But Joe diGenova is pushing a goody - the CIA is at fault for not providing better protection for Plame's cover.
Amazing.....Republicans are worried the CIA can't protect itself from Republicans?
We still don't know who told Novakula about Plame.
The saga continues.....
The ONION tells all
Bush To Nominate Next Person Who Walks Through Door
October 27, 2005 | Issue 41•43
WASHINGTON, DC—After Harriet Miers withdrew her nomination for the Supreme Court Thursday, President Bush announced that he will nominate the next person who walks through his door. "I assure the American people that the next person who enters my field of vision will be a highly qualified candidate of unimpeachable character, with a solid record, and—what's more—a good heart," Bush said. As of press time, 17 people were waiting outside the door, including the president's daughter Jenna, and special prosecutor Patrick Fitzgerald.
// posted by andante @ 9:35 AM
I'm dreaming of a bankrupt Christmas
....again.
Mr. Andante has a big family, and they refuse to consider drawing names for gifts. So, once again I'm knitting and crocheting and shopping at the Dollar Store and Goodwill.
Googling around for gift ideas, I came up with a few not-too-expensive things for those who are oh-so-hard at gift-giving time. Most of them are out of my price range, which ranges anywhere from "free" to $10.00, but I thought I'd share.
For about $54.00 plus shipping, why not delight that persnickity gift recipient with a title?
When you book a table in a restaurant or check in to a hotel, imagine how much better service would you receive if you were the Lord / Lady of Glencairn? The person who receives this gift pack will be the proud owner of a square foot of the Glencairn Estate located in Caithness in the far North East of Scotland and therefore become the Laird / Lady of Glencairn.
If a square foot of Glencairn Estate sounds a bit too cheap, you might go for acreage - on the moon.
Here's your chance to own 1 acre of the Moon, and have the certificate to prove it.
You will be the envy of your friends with this unique and novel property. If you are a first time buyer this is also the ideal way to get on to the property ladder!
And who couldn't use a belly button brush?
Intensively designed and developed by NASA (ahem, honest) costing the tax paying citizens of America billions of dollars, the hi-tech design has left many people speechless. If you're anything like me you'll be thinking "how did mankind survive so long without this essential grooming tool?" and "why on God's sweet earth have we had to wait so long for this wondrous brush?" Of course, if you are thinking along those lines you probably need more medication than I'm currently taking and belly button fluff is probably the last thing on your troubled mind.
And from Gadgetstorm, an update on the ever-popular Eight Ball - The Decision Maker
Press the button on this gorgeous paperweight to have your questions answered by the blue flashing light - is it random, or controlled by some higher power?
The Cat End Towel Holder is interesing -
But if you're really stuck on a gift for that cranky Republican acqaintance, you can't beat the Not your day t-shirt, which reads -
"I can only please one person each day. Today is not your day. Tomorrow doesn't look good either".
May your Fitzmas be merry and bright!
Down home Carolina cooking - Halloween edition
Stuck for a good old blood & guts recipe?
I still think Halloween was more fun when you just threw on a white sheet, cut two eye-holes, and hit the street with a shopping bag. But for those with gory aspirations:
From our local FAUX affiliate, WGHP-TV:
Classic horror movies depend on blood and gore to terrify. And this time of year is all about scary costumes and masks. But, if you really want to frighten your friends, you can steal some tricks from the experts. But you don't have to travel to Hollywood for make-up tips. We talked to a make-up artist at the North Carolina School of the Arts. Michael Meyer says, blood is one of the easiest props to make. You can buy all of the ingredients at the grocery store. Combine 2/3 cup corn syrup and 1/3 cup chocolate syrup. When it's mixed together, add a tablespoon of red food coloring. Then, add one tiny drop of blue food coloring. You can apply it to your skin with a popsicle stick.
To make fake skin for a realistic "scarred or torn look" use these materials, also available at your grocery store: Combine 3/4 oz of plain gelatin, 1/2 oz of water, 1 1/2 ounces of glycerin* and 1 1/2 ounces of sorbitol*. *Both are available at your pharmacy. Microwave the mixture for about 5 seconds, or until it dissolves. Remember, don't let the liquid boil! To make it flesh colored, add in a little cake makeup, then microwave again for 5 seconds. You can then apply it to your skin, but be sure it's not so hot it burns.
Buh-bye, Harriet
I'm almost sorry to see Harriet go so soon.
Surely someone so inarticulate in her written responses and so ineffectual in the one-on-ones with legislators would have provided endless fun at televised hearings.
So, let's play multiple choice:
A. Miers' nomination was a deliberate attempt to distract the media from other White House woes.
B. Miers' nomination was supposed to be a bone thrown to the religious right so that a more moderate nominee would emerge.
C. Miers' nomination was a deliberate sandbagging; most anyone else would look competent in comparison.
D. Miers' nomination was a genuine attempt by the Greatest Governor Ever to reward his bestest friend for her personal loyalty and Americans would, of course, trust him blindly.
Correct answer? I suspect all of the above.
Obviously, as Hotline reports - "One Bush aide acknowledged that Miers vetting had been rushed and left out much of what's been discovered by the press since the announcement."
They never learn, do they?
Extreme chutzpah, without the humor
TPM reports -
"New York Times reporter Judith Miller has begun discussing her future employment options with the newspaper, including the possibility of a severance package, a lawyer familiar with the matter, said yesterday."
Remember the definition of "chutzpah"? - a person who kills his parents and pleads for the court's mercy on the ground of being an orphan.
As the one who supplied the music for the War Drum Symphony, she should be in jail. But I'm sure she'll find employment at the Moonie Times or Wall Street Journal.
Better yet, here.
I love sports as much as most sports fans, but what's wrong here?
Nationals' Expected '05 Profit Is $20 Million
D.C. Seizes 16 Owners' Property for Stadium
The District government filed court papers yesterday to seize $84 million worth of property from 16 owners in Southeast, giving them 90 days to leave and make way for a baseball stadium.
Could the owners - I don't know, maybe use some of that $20 million to buy their own land and build their own stadium.... or make renovations to RFK?
Next time Joe Six-Pack starts raging between innings against black single mothers getting food stamps, one might remind him of corporate sports welfare.
Melanie has more.
Source: No announcement in CIA leak probe today
The federal grand jury investigating the leak of a CIA operative's identity could hand up charges as early as today, but Special Counsel Patrick Fitzgerald is not expected to make any public announcements Wednesday, one source with knowledge of the probe told CNN.
I have a relative whose Christmas day tradition is to cook up a huge Christmas brunch and invite the entire family.
According to this tradition, their three little boys have to wait until brunch is over and the last slow-eater has finished the last crumb before opening presents - which is often pushing 12:00 noon.
Damn, I know just how those little boys must feel.
// posted by andante @ 11:40 AM
'Twas the night before Fitzmas?
Lots of speculation that Fitzgerald will lay the cards on the table tomorrow.
What a time for my eyeballs to start acting up.
It's a bit difficult to read, therefore hard to cruise around the blogosphere dropping comments here & there, or posting here.
If anyone knows anything about corneal dystrophy, I'd sure like to hear your thoughts.
Texas crude ain't always oil
George Will:
Miers's advocates tried the incense defense: Miers is pious. But that is irrelevant to her aptitude for constitutional reasoning. The crude people who crudely invoked it probably were sending a crude signal to conservatives who, the invokers evidently believe, are so crudely obsessed with abortion that they have an anti-constitutional willingness to overturn Roe v. Wade with an unreasoned act of judicial willfulness as raw as the 1973 decision itself.
That would be George W. Bush -
"Part of Harriet Miers' life is her religion," President Bush said.
Mosquitoesque
If you read the WaPo Scooter Libby profile all the way to the end, you'll know exactly how the Bush administration regards the country's security:
"Cheney and Scooter play chess on several different levels," (Mary) Matalin says. "That's how their minds work. It's not about what's right in front of him. They look at things in the sweep of history.
"The Wilson thing was almost mosquitoesque."
'Calm' not being the right word - more like waiting for various axes to fall. Tense, expectant.
Wilma chews up the Yucatan, the Florida Keys are under a hurricane watch. Where will the storm strike next, and at what strength?
Patrick Fitzgerald is wrapping up his investigation into l'affaire Plame - are indictments imminent? I suppose starting up a treason investigation website could mean an announcement that everyone who appeared before the grand jury is as pure as the driven snow and no further action is needed.
Will Dubya yank his bestest friend's SCOTUS nomination - the hapless Harriet?
If they didn't understand before, I'm sure the Bushies are now comprehending the meaning of the phrase "cat on a hot tin roof".
Best case scenario for BushCo - all three happen at once; the SCLM will go for the hurricane every time.
Impatient AND shrill
How rude and impatient can you get?
Marty Bahamonde, a FEMA regional director, told a Senate panel investigating the government's response to the disaster that he gave regular updates to people in contact with then-FEMA Director Michael Brown as early as August 28, one day before Katrina made landfall.
In most cases, he was met with silence. In an August 29 phone call to Brown informing him that the first levee had broke, Bahamonde said he received a polite thank you from Brown, who said he would check with the White House.
In e-mails to various FEMA officials, including one to Brown, Bahamonde described a chaotic situation at the Superdome, where many of the evacuees were sheltered. Bahamonde e-mailed FEMA officials and noted also that local officials were asking for toilet paper, a sign that supplies were lacking at the shelter.
"Issues developing at the Superdome. The medical staff at the dome says they will run out of oxygen in about two hours and are looking for alternative oxygen," Bahamonde wrote in an e-mail to regional director David Passey in a call at 4:46 p.m. CT on August 28.
Bahamonde said he was stunned that FEMA officials responded by continuing to send truckloads of evacuees to the Superdome for two more days even though they knew supplies were in short supply.
"I thought it amazing," he said. "I believed at the time and still do today, that I was confirming the worst-case scenario that everyone had always talked about regarding New Orleans."
Later, on Aug. 31, Bahamonde frantically e-mailed Brown to tell him that thousands are evacuees were gathering in the streets with no food or water and that "estimates are many will die within hours."
"Sir, I know that you know the situation is past critical," Bahamonde wrote.
Less than three hours later, however, Brown's press secretary wrote colleagues to complain that the FEMA director needed more time to eat dinner at a Baton Rouge restaurant that evening. "He needs much more that (sic) 20 or 30 minutes," wrote Brown aide Sharon Worthy.
"We now have traffic to encounter to go to and from a location of his choise (sic), followed by wait service from the restaurant staff, eating, etc. Thank you."
The nerve of this guy, trying to interrupt Michael Brown during his dinner!
Note to those in Wilma's path - please schedule your rescue and recovery needs during hours that will not interfere with normal meal or sleeping hours.
Psssst....need a sensible national energy policy?
Here's a good start -
Gaston schools join biodiesel bandwagon
Fuel from cooking oil costs 60 cents per gallon
Gaston County is the first school district in the state to use recycled vegetable oil and produce its own biodiesel fuel. School officials are collecting the slick substance from school cafeterias and restaurants such as The Shrimp Boat and China King's Buffet, and are looking for more donors.
Superintendent Ed Sadler said school officials will produce about 12,000 gallons of biodiesel fuel this year and save $30,000. The school system expects to produce up to 60,000 gallons in the future and save about $150,000 annually, following a nationwide trend of using alternative fuel to save money and cut down on toxic emissions.
Saving money, protecting the environment, and using less fossil fuel?
Sounds like a winner to me.
Conservative backlash
Good piece in Salon by Sidney Blumenthal, and here's the money quote:
Members of the public support conservative presidents so long as they leave the liberal programs that benefit them alone.
Yeah, mon.
I always think of my aunt; a cradle-to-grave Republican, and the icy stare she gave me when I suggested she give up her Social Security and Medicare.
Running of the Worms
It's FAIR and FESTIVAL season in North Carolina, with all sorts of events planned throughout the state.
There have been the inevitable glitches, but none quite so catastrophic as the annual State Fair in Raleigh.
The bad news for the State Fair - nearly half the rides were shut down by safety inspectors, resulting in attendance figures lowered by nearly 20,000.
The good news - the safety inspectors were doing their jobs.
But the usual fun was had by all at the annual Wooly Worm Festival in Banner Elk, located deep in the beautiful High Country mountains.
Forget the Kentucky Derby, the Breeder's Cup, or NASCAR - the Wooly Worm races not only provide excitement and a big (?) purse, but a winter weather prediction:
Niko Wins 28th Annual Running of the Worms
Banner Elk, NC - Lori Parada's woolly worm, Niko, won the championship race and took home the purse of $1,070 at the World Famous Woolly Worm Festival on Saturday, October 15, 2005.
As tradition holds Niko was carefully examined and his colors interpreted to provide the 2005-2006 Winter Forecast.
The Winter Forecast
Week 1: Cold and snowy
Week 5: Severe cold and light snow
Weeks 6-11: Normal cold, No snow
Weeks 12-13: Cold and light snow
Lori Parada, from Ocala, Florida, obtained the winning worm from a young person near the entrance gate who said they sold winning worms.
When asked what will she do with the $1,070 grand prize winning? "I have five children. I can find something to do with the money!"
I'd advise Lori to head back down to Florida and stock up on hurricane supplies.
Happy news, for a change
My cousin's boy is on his way home from Iraq, alive and physically whole.
Debriefing at Ft. Bragg, then (hopefully) home by Thanksgiving.
Would that all families were so lucky....
Have you felt Disgust Overload recently?
Yeah - me, too. The outrages keep coming, and there's no comment I can add.
This one isn't as high-fallutin' as the hijinks at the NYTimes, or the forthcoming civil war in Iraq, or the treason in the White House, but disgusting just the same:
Long Island principal cancels prom
WHAT?...I thought. Cancelling these poor kid's prom? A landmark event in one's high school years?
Then I read on...
Students putting down $10,000 to rent a party house in the Hamptons.
Pre-prom cocktail parties followed by a trip to the dance in a liquor-loaded limo.
Fathers chartering a boat for their children's late-night "booze cruise."
Enough was enough, (Principal) Hoagland said. So the principal of Kellenberg Memorial High School canceled the spring prom in a 2,000-word letter to parents this fall.
Good for him.
And boo-frickin'-hoo for the spoiled kids and their overindulgent parents who are protesting the decision.
These are the same kind of kids who will go off to an exotic locale for spring or summer break and get themselves murdered or raped or stagger drunkenly off a pier or whatever. Then their parents will hire expensive PR, lawyers, and detectives to harass the local gendarmes into finding their over-indulged darlings who should have never been there in the first place.
And we can't help but note this is a Roman Catholic school - a 'faith-based' alternative to public education with an annual tuition of $6,025. I wonder how many kids from the slums have vouchers to attend?
Fortunately, not all the parents and students are miffed by the decision:
Hoagland said in an interview that parents, who pay $6,025 in annual tuition, have expressed appreciation for his stern stand.
"For some, it [the letter] was an eye-opener," he said. "Others feel relieved that the pressure is off of them."
Chris Laine, a senior from Rockville Centre, said the cancellation was "unfortunate, but you can't really argue with the facts they present. ... It's just what it's evolved into. It's not what it was 20, 30 or 40 years ago. It's turned into something it wasn't originally intended to be."
Besides, Laine noted, the senior class still has a four-day trip to Disney World scheduled for April.
Note to the cable news folks - that's a hot news tip if I ever heard one. Mark that down on your April through October schedule for another missing white woman alert.
A Polling Free-Fall Among Blacks
In what may turn out to be one of the biggest free-falls in the history of presidential polling, President Bush's job-approval rating among African Americans has dropped to 2 percent, according to a new NBC/Wall Street Journal poll.
A few months after the 9/11 terrorist attacks, the NBC/Wall Street Journal poll found Bush's approval rating among blacks at 51 percent. As recently as six months ago, it was at 19 percent.
All those photo-ops hugging little black kids for naught. At this point, I truly believe I could out-poll Bush among African-Americans.
And two percent? Hasn't that reached the point where you don't give percentages, you can start naming names?
Must be Condi, Thomas Sowell, Armstrong Williams, and Alphonso Jackson. You might even stretch it to their next-of-kin.
President Addresses U.S. Troops in Iraq in Video Teleconference
...and at the end, he says:
May God bless you all in your work and when you get back to the states, you know, if I'm hanging around, come by and say hello.
Correct me if I'm wrong, but in the constitutionally-correct way of things, shouldn't Bush be figuring he'll be 'hanging around' until 2008?
Is he planning to bless these folks with a very-extended extension?
Or is he planning on going somewhere?
The Army has a problem:
Opinion surveys indicate that daily reports of soldiers dying in Iraq have dampened young people's interest in joining the military, prompting the Army to try new ways to make the war work in its favor.
I don't know; perhaps if young people thought there was a noble cause, a sensible plan for victory, and coherent exit strategy, and some body armor to go along with it all?
Pre-Halloween scary stuff
Have you ever opened your e-mail's inbox, read the subject line and felt the hair on the back of your neck stand up?
From: Tom Matzzie, MoveOn.org Political Action
Date: Wednesday, October 12, 2005 1:31 PM
To: Andante
Subject: Flu Pandemic: Our lives are in this man's hands
We've all heard the terrible warnings about the risk of an influenza pandemic from an avian flu virus. But the Bush administration official in charge of making sure America is ready has no experience related to his job—he's a political appointee. And, a botched response could affect millions of Americans.
Stewart Simonson is the Bush administration's point man for a flu pandemic but he has no public health management experience. He got his job because he is a close associate of former Health & Human Services Secretary Tommy Thompson.
That's scary enough, but what it boils down to is this - our lives are in THIS man's hands -
....and that goes beyond scary.
Theodore Roosevelt Heller, RIP
Theodore Roosevelt Heller, 88, loving father of Charles (Joann) Heller; dear brother of the late Sonya (the late Jack) Steinberg. Ted was discharged from the U.S. Army during WWII due to service related injuries, and then forced his way back into the Illinois National Guard insisting no one tells him when to serve his country. Graveside services Tuesday 11 a.m. at Waldheim Jewish Cemetery (Ziditshover section), 1700 S. Harlem Ave., Chicago. In lieu of flowers, please send acerbic letters to Republicans. Arrangements by Chicago Jewish Funerals, Douglas MacIsaac, funeral director 847-229-8822.
Will do, Mr. Heller.
Peace, land, and bread
Lenin's promise of "Peace, Land, and Bread" was the blueprint for bringing communism to the world.
These days, Lenin must be smiling somewhere....
No peace - Iraq's insurgency appears to take the upper hand
Precious little land - Creating Homeless in Iraq
Bread? You must be kidding! - Children 'starving' in new Iraq
Looks like Bush is setting up a new boogey-man, a necessity for getting Republican votes.
That's not a legacy, it's a crime.
All guts, a little glory
It seems like I've spent the last week cleaning up my own messes, undoing my own mistakes, and generally untangling my own screw-ups. And it's been raining since Thursday.
It can get you down a bit, this continual blunder mending (and the gray skies). So, I find it useful to relive some of those moments when things went a bit more successfully and the sun shone brightly on my world.
Have you ever had a moment when you nailed it? You ruled? You rocked? A time when maybe you weren't the king of the world, but at least felt like you were the king of your world?
And best of all, had witnesses who applauded enthusiastically?
I'm not talking Pulitzer prize-winning moments, just a personal triumph that put a huge grin on your face and reverberates even today.
I've had a couple of shining moments; here's my favorite.
Back when I was at the top of my form as a classically-trained soprano who would sing anywhere and everywhere I was asked (including a few times I wasn't asked), I auditioned for some solo work in a community chorus performance of Handel's Messiah. As a personal challenge, and because I'm stubborn, I chose Thus saith the Lord of hosts and But who may abide the day of his coming?.
This recitative and aria are generally performed by a bass, but in Handel's day were performed by whatever voice was available. Besides, I was working on my flexibility and lower range, and the aria presented quite a challenge. We would have a small string ensemble and harpsichord for the performance, and I was determined to do at least some rough justice to the music.
I won the part, and started working furiously on mastering the two pieces.
Our church choir was doing a Christmas music program consisting of many different styles of music that year, and the director asked me to do the above two pieces at that performance. We would only have piano accompaniment, but it gave a chance to perform the pieces in front of an audience that was friendly and supportive. The audience for the community chorus program would be much more discriminating.
When the time came, I stepped in front of the audience in the church, and nodded to the pianist to signal I was ready.
The accompanist was frantically shuffling through a stack of music, trying to find his copy of The Messiah. It's a rather thick score, and hard to miss - he had apparently left it in the choir rehearsal room.
The rehearsal room was more than a few hops, skips, and jumps from the sanctuary and it would have taken a good five minutes for him to scramble back there, find the music, and return to the piano. In the meantime, there would be a rather uncomfortable lull in the program.
I took a deep breath and handed him my music.
Could I do it from memory? I'd worked hard on it; I'd heard the music performed all my life. I cleared my mind of doubts and let it rip.
I nailed it. I triumphed...I soared. I never missed a note, word, or beat. The final measures gave me a chance to spin into my higher range before cascading back down to the gutsy lower levels.
I could feel myself literally glowing with happiness as the choir, then the audience rose to their feet to give me a standing ovation. The choir director walked over to me and kissed my hand.
Yeah, I did it again with the community chorus - with music, this time. I got a lot of congratulations and a good review from the local paper's music critter, er - critic.
But nothing has ever surpassed that moment when I trusted my own memory, intellect, and training - and they came through for me.
I feel better already.
Care to share a triumphant moment in comments?
It ain't working
The occupation of Iraq isn't working for many reasons.
Carl succinctly outlines the three most likely suspects, which basically boil down to 1) culture, 2) culture, and 3) culture.
Go read.
My new hard drive arrived yesterday and is whirring away happily while I try to restore all my 'stuff'.
As usual, I ran into unexpected problems and spent most of the afternoon and well into the night with the procedure.
So, did anything else happen yesterday?
What we have here is a misinterpretation of God's word
"President Bush said to all of us: 'I'm driven with a mission from God. God would tell me, "George, go and fight those terrorists in Afghanistan." And I did, and then God would tell me, "George, go and end the tyranny in Iraq …" And I did. And now, again, I feel God's words coming to me, "Go get the Palestinians their state and get the Israelis their security, and get peace in the Middle East." And by God I'm gonna do it.'"
Prime Minister Mazen recounts how President Bush told him: "I have a moral and religious obligation. So I will get you a Palestinian state." (link)
Are you wondering what went wrong in Afghanistan and Iraq, George, even though God spoke to you on the subject?
What is it about the word "you" that you don't understand?
God meant YOU, George - you personally. Report to the nearest recruiting center and do your duty.
So I'm reading about the 13-foot Burmese python that burst after trying to swallow a six-foot alligator whole, and my stupid cat brushes up against my leg.
The keyboard doesn't appreciate hot coffee, and neither does the cat.
Serves him right.
Come on, Tammy!
Tropical Storm Tammy to bring rain to N.C.
Tropical Storm Tammy formed just off Florida's east coast Wednesday and was expected to bring rain to North Carolina by Thursday.
It's not often we welcome a tropical weather system, but we are 11-1/2 inches below normal and getting very thirsty.
I've enjoyed the respite from mowing the yard, but enough is enough.
"CITY OF GREENSBORO DECLARES "STAGE III WATER SHORTAGE DANGER"
In response to an increasingly serious drought situation, Greensboro City Manager Ed Kitchen declared today (Monday) that Stage III water restrictions will go into effect beginning at 1:00pm Tuesday, December 8. Stage III restrictions are more stringent than the current Stage II restrictions and prohibit any watering or sprinkling of any lawn, grass, shrubbery, trees or flowers. Vegetable gardens may only be watered by hand held hose, container or drip irrigation system, and any nonessential use of water for commercial or public use is unlawful."
As the news-guy said on the local news last night, "Time to shower with a friend".
I wonder if he has a job today.
Ruh-roh
I fail to see what the military can do about a flu pandemic, as Bush has suggested.
What are they going to do? Shoot all the birds before the virus makes the jump to humans?
Too late...it may have already done so.
Recent research isn't encouraging...
Deadly 1918 Epidemic Linked to Bird Flu, Scientists Say
Two teams of federal and university scientists announced today that they had resurrected the 1918 influenza virus, the cause of one of history's most deadly epidemics, and had found that unlike the viruses that caused more recent flu pandemics of 1957 and 1968, the 1918 virus was actually a bird flu that jumped directly to humans.
The work, being published in the journals Nature and Science, involved getting the complete genetic sequence of the 1918 virus, using techniques of molecular biology to synthesize it, and then using it to infect mice and human lung cells in a specially equipped, secure lab at the Centers for Disease Control and Prevention in Atlanta.
"This is huge, huge, huge," said John Oxford, a professor of virology at St. Bartholmew's and the Royal London Hospital, who was not part of the research team. "It's a huge breakthrough to be able to put a searchlight on a virus that killed 50 million people. I can't think of anything bigger that's happened in virology for many years."
The 1918 flu showed how terrible that disease could be. It had been "like a dark angel hovering over us," Dr. Oxford said. The virus spread and killed with terrifying speed, preferentially striking the young and the healthy. Alfred C. Crosby, author of "America's Forgotten Pandemic: The Influenza of 1918," wrote that it "killed more humans than any other disease in a similar duration in the history of the world."
Living back in the sticks, we're not sure what killed my maternal grandfather. But it seems quite likely he was one of those 50-million-plus fatalities.
If Bush wants assistance from the military, the best thing he could do is stop this insanity in Iraq so researchers will have the money to find a vaccine and cure.
I'm a commie!
Wanda made me do it -
You are a
Social Liberal
(63% permissive)
and an...
Economic Liberal
You are best described as a:
Socialist
Link: The Politics Test on Ok Cupid
Also: The OkCupid Dating Persona Test
FEMA - the gift that keeps on giving
Housing promises to evacuees fall short
FEMA pulling funding for hotel stipends as more shelters close
Two weeks before President Bush's mid-October goal for moving Hurricane Katrina victims out of shelters, more than 100,000 people still reside in such makeshift housing, and 400,000 more are in hotel rooms costing up to $100 a night.
Housing options promised by the federal government a month ago have largely failed to materialize. Cruise ships and trailer parks have so far proved in large part to be unworkable, while an American Red Cross program -- paid for by the federal government -- that allows storm victims to stay in motels or hotels is scheduled to expire Oct. 15. It is projected to cost the Federal Emergency Management Agency as much as $168 million.
Finding housing for a large, displaced population is proving to be a nightmare for the Bushies. All their "privatizing" alternatives are floundering, from vouchers to 'faith-based' shelters, to ignoring the problem and hoping it will go away.
Kiss that evacuee vote goodbye.
And make no mistake...this will happen again; if not tomorrow, perhaps a year or a decade from now.
There will be more hurricanes, wildfires, earthquakes - who knows what Mother Nature has in store for us? Who knows what bin Laden has in store for us?
The only thing we know for certain is the Bush administration doesn't have a clue how to deal with disaster, be it natural or man-made.
I wonder how long it will take before BushCo concedes that FDR had the right idea for putting large numbers of the unemployed to work and at the same time improving the infrastructure and environment?
Unemployed and even unskilled workers combined with the expertise of military engineers, organizations like Habitat For Humanity and the Friends Disaster Service could construct homes, schools, parks, streets, sidewalks, playgrounds, clinics - you name it. They build quickly, efficiently, inexpensively, and with quality. And they could probably do it a hundred times over, all over the Katrina- and Rita-devastated area.
Don't hold your breath - we'll have to wait for the next Democratic president and Democratically-controlled Congress for that kind of thinking.
Meanwhile a city of RVs awaits families in Louisiana, which as everyone knows is exactly what the South needs - more trailer parks and more tornado bulls-eyes.
The Federal Emergency Management Agency once envisioned "cities" of 500 to 600 RVs scattered across the South to house evacuees uprooted from their homes by Katrina. But those plans have bogged down as FEMA has tried to make its way through a maze of bureaucratic hurdles to lease land, comply with local zoning laws and overcome local opposition to "FEMA cities" within their borders.
In search of temporary housing immediately after the hurricane, FEMA officials went on a $1.5 billion spending spree, buying out entire dealerships of recreational vehicles and signing contracts for more than $500 million with one manufacturer of mobile homes. But the plan to create "cities" of 500 to 600 RVs across the South has run into major logistical and political problems.
Policymakers say that warehousing tens of thousands of people in trailer park communities until New Orleans and other cities are rebuilt could lead to the creation of dysfunctional "FEMAvilles," as residents of past encampments have called them. Democrats go further, warning that they may become known as "Bushvilles," just as Depression-era shantytowns were called "Hoovervilles."
Bushvilles, indeed. My partisan political side welcomes communities of Bushvilles scattered around the Red States.
But these are people; people with families who can't be cooped up in RV's for very long without going completely stir-crazy. It's certainly possible for one or two people to live comfortably in an RV or even a small single-wide trailer, but keep in mind when an advertisement says "sleeps eight!" it actually means sleeps "sleeps eight if you put three very good friends in a shortened double bed, three more in a pull-out sofa, and two in a twin bed".
Senator Paul Sarbanes sums it up -
"The scope of this disaster calls for changes in how we think about disaster assistance," Sarbanes wrote the White House. "Hundreds of thousands of people may need housing assistance for 18 months or even longer. We cannot rely on FEMA, an emergency response agency, to provide on-going housing assistance to this large number of families," he said.
We definitely need new thinking from this adminstration. All they've given us for five years is stinkin' thinkin'.
Six Democratic War Vets Seek House Seats
Lawyer Patrick Murphy and five other veterans of the Iraq war are asking questions about President Bush's policies in Iraq as part of their broader Democratic campaigns to win congressional seats in next year's elections.
Given their experience in Iraq, the six Democrats in Pennsylvania, North Carolina, Maryland and Virginia say they are eminently qualified to pose the tough questions. Their reservations mirror public opinion, with an increasing number of Americans expressing concern about the mission and favoring a timetable for withdrawal of U.S. troops.
Nice to read of this. Now, where are the headlines about Republican war vets seeking office?
Hmmm?
Monday, Monday
...can't trust that day.
My Monday has started off with a bang. I turned on the computer, and it informed me 'Hard drive detects imminent failure'.
This can't be good.
I suppose I could use the Future Under Bush Administration Regulations (FUBAR) system and hope the hard drive will fix itself while I tell everyone what a great job I'm doing and let the blank CD-R's sit idly on the shelf.
When the hard drive fails, I could take it to CompUSA and borrow a lot of money to pay some geeky teenager to get it back in running order. Of course, the hard drive would be blank - all the data lost.
Or I could prepare for the imminent disaster by making backup CD's, make a note of all the plug-ins, programs, etc. that I consider indispensable, and handle it myself for free- just as I've always done.
Wow, what a concept.
At it again, this time in Waveland
The Seabees, last seen here putting FEMA to shame by building quick,temporary housing for pennies have also come to the rescue of abused children in Waveland, Mississippi:
For nearly a decade, the private nonprofit shelter in Waveland has cared for children who have been beaten, starved, burned, raped or lived through some other atrocity.
Hope Haven is a temporary stop as children wait for a spot in the state's crowded foster care system.
Hurricane Katrina's storm surge swallowed the backyard playground and shoved about 7 feet of water through the small home, forcing the children, from teenagers to infants, to look for a new start - again.
However, a group of Navy Seabees from Port Hueneme, Calif., is working to restore Hope Haven, hoping the children will soon be able to come back.
"My troops know that abused children lived here," said Chief Charlie Luna. "They know that this will be a nice place for them to come back to, when we're done."
Director Terry Latham estimates the shelter sustained more than $100,000 in damage.
"We lost everything inside the shelter, and in our storage and activity buildings," he said. "We just got a new van through grant money, and we lost that."
Shortly after the storm plowed through Waveland, Latham - a retired Navy chief - was covered in mud when he saw the green trucks rolling through the debris-choked street.
"They were looking for Hope Haven," he said. "I would have danced naked in the street to get them to stop."
The 17 members of NMCB-4 are working 12-hour days to install new sheetrock and tile.
Latham decided the $3,000 estimate from a local company to repair the privacy fence was too much, so the Seabees picked up the pieces and put the old one back together.
"The children who lived here have no other place to go," Sgt. 1st Class Tia Potter said. "For me, it's very important to put this place back together again."
The Seabees should finish their work sometime next week, and Latham said he hopes Hope Haven will be operating again in about 60 days.
Dubya has half a right idea when he considers a military role in disaster response.
The first responders should always be local and state; after all, they know the territory and resources best. But the military, with their equipment, knowledge, and manpower are best equipped to carry out many tasks.
FEMA - if it's managed correctly - should deploy their people to assess needs and develop the capacity to communicate those needs to the appropriate agency. It requires a bit more than a web site, toll-free telephone number, and friends in high places.
(with apologies to Bryan and the Air Force engineers; I'm sure they're working hard also, and promise to post any articles I find!)
Give, dammit!
Liberal Blogs for Hurricane Relief
Noah's Wish
Friends Disaster Service
ACORN (Association of Community Organizations for Reform Now)
North State Blogs
Essential Andante Facts
**I am a white, middle-aged, Southern Belle Don'€™t-Wannabe. Watch me and my hooped-skirt give new meaning to the act of "€œmooning"
**I don'€™t suffer trolls wisely or at all. I have a delete€ button, and I'€™m not afraid to use it
**According to "€œBelief-O-Matic"€, I am 100% Liberal Quaker and 98% Neo-Pagan. What'€™s with that?
**I believe The South Shall Rise Again. And white, middle-aged women shall lead them.
**"For the poor shall never cease out of the land: therefore I command thee, saying, Thou shalt open thine hand wide unto thy brother, to thy poor, and to thy needy, in thy land." (Deuteronomy 15:11 (KJV)
**Can't we all get along?
Never mess with a woman brave enough to put up her third grade picture
Bankruptcy Bill Sell-Outs
Joe Biden, Delaware
Robert Byrd, West Virginia
Tom Carper, Delaware***
Kent Conrad, North Dakota***
Herb Kohl, Wisconsin
Tim Johnson, South Dakota
Mary Landrieu, Louisiana
Joe Lieberman, Connecticut***
Blanche Lincoln, Arkansas
Bill Nelson, Florida
Ben Nelson, Nebraska***
Mark Pryor, Arkansas
Ken Salazar, Colorado
Debbie Stabenow, Michigan
*** Double trouble - member of TPM Fainthearted Faction
Correntewire
Current Terror Level !!!!


A girls tote bag with a sweet boho bunny wear flowers on her head, will make the cutest bag ever.
Our kids' personalised tote bag to keep their library books inside, as well as many other uses. Perfect to carry their favourite things, also an overnight bag, travel bag, or something to fill up with toys on a long trip in the car.
Child holding the bag is a 9 year old boy.