Enrique Iglesias enjoys a spin on the water with girlfriend Anna Kournikova

Double date: The couple were joined by Enrique's half sister Ana Boyer and her tennis player boyfriend FernandoVerdasco

Meanwhile Enrique, 39, was perfectly coordinated with his better half in a white T shirt and blue jeans.

The Hero hit maker, Anna and Ana the daughter of Enrique's socialite mother Isabel Preysler and her third husband,replique arpel and van cleef, Spanish finance minister Miguel Boyer all wore matching baseball caps.

At one point, the foursome stopped the boat and decided to take a dip in the crystal clear turquoise water.

Home sweet home: Enrique and Anna live at a nearby $26million mansion, and park the speedboat at a pier right outside

The luxury home even has a tennis court for Anna, and Enrique's trusty speedboat sits right out front at his pier perfect for days out like this.

While the two stars have been dating for a very long time,van cleef and arple replique, it's unclear if Anna has finally met her boyfriend's famous father Julio.

Enrique told Billboard last April that they were yet to be introduced, explaining: 'The last 14 years,imitation van cleef joaillerie, 15 years of my life have flown by. And that's the only way I can truly explain it. There's no reason why it's not his fault, and it's not my fault.'

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Former Marilyn Manson drummer Chris Vrenna heads on tour with KingDoom

Chris Vrenna spent decades working with some of the biggest names in rock music,imitation oyster perpetual datejust rolex, mostly within the confines of a major label system that no longer exists.

"Man, I miss the '90s sometimes," Vrenna said with a laugh. "But you can sit around and bitch about it, or you can figure out a way to tackle what music is today."

Today's marketplace is defined by its lack of definition which isn't necessarily a bad thing, Vrenna said. With the old music biz business model now a thing of the past, he's happy to work on projects that interest him, independent or otherwise. Industrial leaning Edmonton group KingDoom fits the bill perfectly.

Vrenna, 46,imitation rolex datejust 2, will put his considerable drum talent on display beginning Monday in Victoria when KingDoom steps out on its first national tour.

He has been rehearsing with KingDoom for the past week, which is good news for everyone involved, the drummer admitted.

"The last time I played live was in Paris at the end of Marilyn Manson's tour on Dec. 22, 2009," he said.

"I've been in the studio the last two years, so it will be nice to get out, that's for sure."

The involvement of Vrenna has done a lot to sell the tour thus far. The Pennsylvania native co founded Nine Inch Nails, recorded and toured with Marilyn Manson, toured with Smashing Pumpkins and remixed U2. He even joined a reconstituted Guns 'N Roses, albeit briefly.

There are plenty of projects Vrenna could be working on, including the forthcoming KingDoom album he has been writing with singer Lex Justice.

But touring with KingDoom presented him with a unique opportunity: playing electronic drums beside and with KingDoom drummer Greg Ross, who will be playing acoustic drums during their set.

"We'll be performing the programmed elements that I did on the album live with two drummers. Truthfully, that's something I've never done in my entire career."

Vrenna has compiled an impressive list of achievements in his career. In addition to winning a Grammy Award as a member of Nine Inch Nails, which he joined in 1988, he spent nearly a decade as a key member of Marilyn Manson's band.

He also assembled a list of credits as a producer, mixer and engineer that includes recordings by David Bowie, Metallica, Hole, Nelly Furtado and Meat Loaf, among others.

Vrenna met the members of KingDoom through a shared friendship with the late Bill Kennedy, an engineer who worked with Vrenna and Nine Inch Nails. Kennedy brought Vrenna to Edmonton to work on drum programming for KingDoom's debut, and the relationship blossomed.

"Touring is so hard, with the amount of travel and set up and performing. If I didn't love these guys, I probably wouldn't do it," Vrenna said. "You've got to have fun."

Vancouver's HMP Recordings is helping to facilitate the new tour first model Vrenna is big on these days. HMP offers complete label services, such as management, grant writing, radio tracking and publicity, for acts who have yet to break out on a national level. Tickets for both events are $20.

That's the way artists should be thinking about their careers today, Vrenna said. Too many are waiting for fame to come to them, when they should be grabbing it for themselves.

"The way we did it with Nine Inch Nails back in 1989 was to get in a van, drive around America and play clubs,rolex datejust oyster imitation," he said.

"We met fans, then we built a fan base, and when that fan base became loyal,rolex oyster perpetual datejust stainless steel imitation, they bought our records and went to see us live. That's kind of the way it has to go back to.

Dutch fall out of love with windmills

Towering over the waves of the North Sea like an army of giants, blades whipping through the wind, the turbines were the country's best hope to curb carbon emissions and meet growing demand for electricity.

The 36 turbines each one the height of a 30 storey building produce enough electricity to meet the needs of more than 100,000 households each year.

But five years later the green future looks a long way off. Faced with the need to cut its budget deficit, the Dutch government says offshore wind power is too expensive and that it cannot afford to subsidize the entire cost of 18 cents per kilowatt hour some 4.5 billion euros last year.

The government now plans to transfer the financial burden to households and industrial consumers in order to secure the funds for wind power and try to attract private sector investment.

It will start billing consumers and companies in January 2013 and simultaneously launch a system under which investors will be able to apply to participate in renewable energy projects.

But the new billing system will reap only a third of what was previously available to the industry in subsidies the government forecasts 1.5 billion euros every year while the pricing scale of the investment plan makes it more likely that interested parties will choose less expensive technologies than wind.

The outlook for Dutch wind projects seems bleak.

COUNTRY OF WINDMILLS

For centuries, the Netherlands has harnessed wind power, using windmills to drain water from low lying marsh and turn it into arable land.

Now however, one of the most densely populated countries in Europe with 489 people per square kilometer (0.6 miles) compared to 356 in Belgium or 192 in Luxembourg is falling out of love with its iconic technology.

Arguments over the high cost and maintenance of sea based turbines, as well as complaints from residents about unsightly land based models, have brought the Dutch to an impasse.

Offshore wind farms produce more electricity than onshore ones but it costs twice as much as onshore wind power due to the higher cost of materials, more expensive drilling methods, and more complex maintenance.

Wind turbines in the sea need to be more robust to withstand strong winds and salt water; their maintenance some miles away from the coast requires special equipment and transportation.

Drilling the seabed is more expensive as it requires a specialized workforce and equipment. Then there's the additional cost of connecting the offshore farms to the grid.

Onshore, wind turbines face local resistance.

In 1994, a group of entrepreneurial farmers around the Dutch town of Urk got together and decided to build the country's largest onshore wind farm with 86 wind turbines nearby. Maxime Verhagen, then minister for economy, innovation and agriculture, said this would be enough to supply 900,000 people.

The project has since been adapted to meet changes in legislation and 20 years after it was launched, construction may finally start this year and be completed in 2014. The only thing holding up the project now is a lawsuit filed by local residents. They say the 30 meter high wind turbines will spoil their views.

"If we have wind turbines here this old picture will be destroyed," said the mayor, Jaap Kroon. "We are also concerned about the safety and noise."

Ironically Urk itself used to be an island until windmills were used to drain the surrounding land and connect it to the mainland,imitation rolex datejust perpetual oyster. The Dutch Wind Energy Association says about half the country's onshore wind projects such as the one in Urk are disputed.

"People don't want big wind turbines in their backyards," said Kasper Wallet,imitation rolex oyster perpetual datejust stainless steel, an energy consultant. "They think it will impact the value of their property."Renewable energy meets just four percent of the Netherlands' total energy consumption. That makes the country's target for its share to rise 14 percent by 2020 challenging enough.

"We have come to the conclusion that the most likely targets with the current policy to be reached will be in the range of 8 to 12 percent," said Paul van den Oosterkamp, manager of the Energy Research Center of the Netherlands (ECN), an independent institute for renewable energy.

Under the government's new system aimed at attracting private sector involvement, known as SDE+, investors will be able to apply in four phases to participate in renewable energy projects, with government subsidies set between 9 and 15 cents per kilowatt hour of produced electricity they produce.

A spokeswoman for the ministry of economic affairs,rolex datejust lady imitation, agriculture and innovation said this would not cover the current subsidy cost of offshore wind projects.

"Some technologies like offshore wind, tidal and wave energy and solar are on average more expensive than the SDE+ maximum cost price," said Esther Benschop in an email to Reuters.

Dutch power firms say wind remains key to meeting green energy targets but is still too expensive for them to manage alone,imitation datejust rolex oyster perpetual.

Frailty and type of death among older adults in China

Main outcome measures Type of death, categorised as being bedridden for fewer than 30 days with or without suffering and being bedridden for 30 or more days with or without suffering.Results Multinomial analyses showed that higher levels of frailty significantly increased the relative risk ratios of mortality for all types of death. Of those with the highest levels of frailty, men were most likely to experience 30 or more bedridden days with suffering before death (relative risk ratio 8.70, 95% confidence interval 6.31 to 12.00) and women 30 or more bedridden days with no suffering (11.53, 17.84 to 16.96). Regardless of frailty, centenarians and nonagenarians were most likely to experience fewer than 30 bedridden days with no suffering, whereas those aged 65 79 and 80 89 were more likely to experience fewer than 30 bedridden days with suffering. Adjusting for compositional differences had little impact on the link between frailty and type of death for both sexes and age groups.Conclusions The association between frailty and type of death differs by sex and age. Health scholars and clinical practitioners should consider age and sex differences in frailty to develop more effective measures to reduce preventable suffering before death.IntroductionHuman frailty is a universal feature of the ageing process that signals the progression and accumulation of physical, psychological, and social deficits in older adults.1 2 3 4 5 Evidence from clinical studies suggests that frailty is a valid and reliable proxy of biological age (as opposed to chronological age), which provides a robust measure of the balance between health assets and deficits across a variety of dimensions.3 4 5 6 7 8 9 10 11 12 Accordingly, there is increasing awareness that quantifying levels of frailty, termed a "frailty index," is important for identifying differences in ageing in a population and as a numerical tool for monitoring individual susceptibility to disease and death.11 13 14 15 16 17 18 19 Empirical studies of frailty on a national level are, however, limited.Health scholars and practitioners widely agree that promoting healthy longevity is accomplished with not only advances in age but through healthier survival and an improved quality of death.20 21 22 To date, research on the quality and type of death is primarily limited to cross sectional and non representative studies in clinical settings. Drawing from this research, consensus is growing that the extent of suffering (pain and discomfort) and number of bedridden days are basic dimensions underlying the quality of death in late life.20 23 24 25 26 27 28 In the United States it is estimated that end of life care utilises nearly one eighth of all healthcare expenditures and about one third of Medicare expenditures.29 In developing countries such as China, however, most health care occurs at home nearly 20% of the world's oldest old live in China and less than 2% of elderly people live in institutions.30 31 The degree to which this increasingly frail population dies peacefully or experiences prolonged degeneration before death is unknown.We carried out a prospective cohort analysis of the association between frailty and type of death among older adults (65 years) in China. Using data from the 2002 and 2005 waves of the Chinese longitudinal healthy longevity survey, the largest nationally representative sample of older adults in China, we examined the impact of frailty on type of death among people aged 65 to 109 and investigated whether differences in mortality varied by sex and age.MethodsThe Chinese longitudinal healthy longevity survey is a nationwide survey of one of the largest samples of people in the oldest old age group (80 years) in the world. Extensive questionnaires were used to collect information on personal characteristics, family and household characteristics, lifestyle and diet, psychological characteristics, economic resources, social support, and a myriad physical and cognitive health conditions. The survey began interviewing older adults with informed consent in 1998 from half of the counties and cities selected in 22 provinces in China. The major aim of the study was to collect a comparable sample of male and female octogenarians, nonagenarians, and centenarians. Follow up interviews of the original sample and newly added samples including adults aged 65 and older to replenish participants who had died or were lost to follow up were carried out in 2000, 2002, and 2005. The details of the sampling design, response rates, attrition, and systematic assessments of data quality across numerous measures in the survey are described elsewhere.32 33 34The current analyses utilise data from the 2002 and 2005 waves of the survey. In the 2002 wave 15919 participants aged 65 109 were interviewed. The oversampling of older adults provided data on 4845 participants aged 65 79, 3747 nonagenarians, and 3088 centenarians. Of the 15919 interviewees in 2002, 8090 adults (50.8%) were reinterviewed in 2005 and 5627 (35.3%) died before follow up in 2005. The remaining 2202 adults (13.8%) were lost to follow up and were ultimately dropped from the present study, leaving an analytical sample of 13717 participants.Outcome measureAs with most large scale studies, the Chinese longitudinal healthy longevity survey has limited qualitative measures to fully assess type of death. To overcome this shortcoming we integrated an objective indicator of physical failure with a subjective indicator of suffering before death to develop several categorisations of type of death between the 2002 and 2005 surveys.23 25 Firstly, we dichotomised separate variables into participants who were bedridden for fewer than 30 days before death and those who were bedridden for 30 or more days before death. Testing other cut off points for duration of being bedridden did not improve explanatory power.Secondly, we dichotomised the subjective painfulness of death on the basis of an evaluation of the decedents' next of kin (peaceful v non peaceful) reported in the 2005 survey. Most elderly people in China reside in the community,31 which provides the unique opportunity for next of kin to report on the participant's suffering immediately before death. Although both measures were ascertained from next of kin, research shows that surrogate responses from family members and others are appropriate for obtaining reliable information on the health status and quality of death among older adults.35 36Finally, we grouped the two assessments of the participants' last month of life to categorise the deaths as follows: less than 30 bedridden days with suffering, less than 30 bedridden days with no suffering,rolex datejust oyster imitation, 30 or more bedridden days with suffering, or 30 or more bedridden days with no suffering. The reference category in the multinomial regression models was survival over the three years.Frailty index and confounding risksFrailty is a physiological state of non specific vulnerability to stressors resulting from decreased physiological reserves and the deregulation of multiple physiological systems associated with advancing age.1 3 4 6 7 8 10 37 Conceptually, frailty is not just an association with specific diseases or disabilities but rather a systemic manifestation of physical and cognitive deficits, including the signs, symptoms, illnesses, and impairments that accumulate over the life course.8 37Empirically, a variety of methods have been used to quantify frailty, although the most common applications are the phenotypic approach and the frailty index.38 39 The phenotypic approach defines frailty on the basis of several items, such as weight loss, exhaustion,oyster perpetual datejust imitation, weakness, slowness, or low physical activity, and considers any three conditions as an indication of frailty.5 Alternatively, a frailty index focuses less on the specific deficits of people and more on the cumulative number of health deficiencies.8 15 Despite the similarities between these approaches, the choice of measurement is often dictated by the clinical outcome under investigation. Accordingly, recent research shows that frailty indices are more applicable for studying mortality than are phenotypic methods.8 38 39 In practice, most studies compute a frailty index as the proportion of cumulative health deficits to all possible deficits for a given individual.17Following earlier research, we constructed a frailty index using 39 variables that included objective, subjective, and proxy reports of cognitive functioning, disability,rolex datejust ii imitation, auditory and visual ability, depression, heart rhythm, and numerous chronic diseases (details available on request). Each item was assigned a value of 1 in the presence of a deficit (otherwise 0), and a value of 2 was assigned for people with two or more serious conditions that led to admission to hospital or a period of confinement in bed.13 We then constructed a frailty index by summarising all deficits and dividing by the total number of possible deficits.Although studies have shown that a frailty index does not require the same number or type of items to estimate accurate proportions of frailty levels,38 the items comprising our index are similar to those used in studies from Canada,15 the United States,8 and Hong Kong.13 We tested the validity and sensitivity of the frailty index by analysing several indices on the basis of differing combinations of variables. These results showed that as long as we included variables characterising each of the major domains of health (activities of daily living, instrumental activities of daily living, chronic illnesses, and cognitive functioning), the pattern of frailty with age remained consistent. In the Chinese longitudinal healthy longevity survey, levels of frailty increased exponentially from ages 65 to 100 and then levelled off (results not shown); therefore we split the frailty index into fourths for men and for women to account for non linear relations between levels of frailty and type of death.To obtain robust estimates we also adjusted analyses for several previously identified confounding factors.40 Various coding strategies were assessed for each measure and the results were similar; therefore, we dichotomised all of the confounding variables (except age). Measures of demographic background included age categorisations of 65 79 (reference group), 80 89, 90 99, and 100 and older, people from non Han ethnic minorities, and those living in urban areas. Measures of socioeconomic status included education (any formal education), primary lifetime occupation as a white collar worker, economic independence (primary financial source from own work or pension),imitation mens rolex oyster perpetual datejust watch, family in good economic standing (self rated as rich compared with other families in the community), and being in receipt of adequate drugs for any illnesses. Social contact and support measures included current marital status, close proximity to children (coresiding with biological or adopted children, including a spouse's child, or having one or more biological children living in the same village or street block), and religious activity almost every day or sometimes. Measures for health practices included exercising on a regular basis and having ever smoked in the past five years.Statistical analysisWe computed sample distributions of the study variables separately by sex and level of frailty. To test differences in the distributions of frailty for dichotomous variables we used Kendall's tests and for categorical variables Pearson's 2 tests. Multinomial logistic regression models were used to estimate the relative risk ratios and 95% confidence intervals associated with levels of frailty and the four types of death. We used two sets of nested regression models to adjust for the confounding risk factors. The first set of analyses tested the effects of frailty by sex while adjusting for basic personal information (age, ethnicity, and urban residence). In the second set of analyses we included the additional confounding variables for socioeconomic status, social contact and support, and health practices. We then computed the predicted proportions of the types of death (among decedents) across age and frailty for men and for women.All analyses were done using Stata version 10.1. Overall, few data were missing for study variables (41 Research shows that including variables related to sample selection produces unbiased estimates in the absence of weights42 and our preliminary analyses showed that the pattern of findings was consistent with those based on weighted data. Therefore we did not use weighted data in the regression analyses.ResultsTables 1 and 2 present the sample distributions of the study variables by sex and level of frailty. Among those in the lowest fourth (least frail) for frailty, 84.9% of men and 86.1% of women survived to 2005 compared with just over 25% of men and women in the highest fourth (most frail) for frailty. Among decedents, about 25% of men and women had fewer than 30 bedridden days before death, although women were less likely than men to suffer before death. A greater proportion of women than men had 30 or more bedridden days either with or without suffering before death. Those with the most frailty had the highest rates for all types of death. Men with the most frailty were more likely to suffer before death (17.9% withTable 1 Characteristics of men in 2002 wave of Chinese longitudinal healthy longevity survey by level of frailty. Values are percentages of participants unless stated otherwiseView this table:View popupView inlineAlthough men had a slightly younger age distribution (and death rates) than women, both sexes exhibited commensurate increases in age across levels of frailty. Similar proportions of men and women were from ethnic minority groups (about 6%) and lived in urban areas (about 43%); however, men and women from ethnic minority groups were less frail than those of Han ethnicity. There was no trivariate difference between sex, frailty, and urban residence. At nearly all levels of frailty men had higher socioeconomic status, were more likely to be married, took regular exercise, and had smoked in the past five years compared with women. Women were more likely to live close to their children and engage in religious activities compared with men. For both sexes, socioeconomic status, social contacts and support, and exercise declined across levels of frailty. Conversely, the proportion of participants who smoked was lower for men and women with higher levels of frailty.For both sexes the proportion of participants who did not suffer before death increased with age and the proportion who suffered decreased with age (figs 1 and 2). Across levels of frailty, the most pronounced patterns were the precipitous declines in the numbers of participants who experienced fewer than 30 bedridden days with suffering and increases in the number of participants who experienced 30 or more bedridden days with no suffering, particularly among women. Consistent with tables 1 and 2, the plotted probabilities also indicated that women were more likely to experience no suffering before death compared with men.Fig 1 proportion of type of death among deceased sample by age and sex in 2002 and 2005 waves of Chinese longitudinal healthy longevity survey

Fans Should Be Happy Now

Van Gaal believes a desire to beat the traffic was one of the determining factors that led to many supporters leaving Saturday's FA Cup third round tie early, rather than their frustration at the quality of performance.

United have regularly been criticised for their style of play this season and some fans left Old Trafford early on Saturday night, before the hosts escaped with a 1 0 win from a low key tie against Sheffield United, thanks to an injury time penalty.

But Van Gaal said he is just happy that following a terrible December run his team had followed up the Premier League victory over Swansea with another success.

"You can be very negative, but we are in the next round," said Van Gaal. "We have won two matches in a row, out of a very bad period, so you have to be happy as a fan of Manchester United.

"I think that you always have to take into account how your opponent is playing and our opponent [Sheffield United] was defending with 10 players behind the ball.

"We have won two times in a row and maybe it shall give us a boost, you never know."

When asked to account for the mass exodus, Van Gaal added: "They are not thinking that we would score, I think, and maybe also because of the traffic that they leave the stadium a few minutes early. There are many reasons to leave a stadium at the last minute.

"Me, as a manager, when I was looking at matches to analyse our opponent,van cleef and arpel knock off necklace, I have done that. In the beginning of my years as a manager, then I would leave the stadium five minutes before the end. You never know what is the reason.

"I think the fans have supported our team. It is not an easy time now,van cleef and arpels fake butterfly necklace, so I think the fans were there also. How many stadiums were like our stadium full,clover necklace replica van cleef, I think?

"You can mention how they leave, but you can also mention how they come to the stadium to watch this FA Cup match."

Shots from United were scarce on Saturday and Van Gaal said he could understand the sarcastic jeers that greeted a second half effort from Memphis Depay.

"Yes, I can understand that because it was a fact that we were not shooting too much or were not able to shoot at the goal so much," said Van Gaal. "That they were ironic, I can imagine. Because it was our first shot after 20 minutes."

United great Paul Scholes was critical of Saturday's display and claimed that even Van Gaal and the players had looked bored during the game.

But Van Gaal refused to be drawn into a war of words and said: "What do I have to do now? React to Paul Scholes? Do you want that?"

United will now bid for a third win in a row at Newcastle on Tuesday night and Van Gaal said: "Now we are playing away, it's also different, and Newcastle United is playing very well, I think.

"I see their game against Arsenal [a 1 0 loss] and they played very well, but they didn't win and that's the most important thing in football. I don't hope that they win against us, we have to beat them."

However,van cleef arpel knock off necklace, United will be without midfielder Bastian Schweinsteiger, who was injured on Saturday and would have been taken off, had Van Gaal not already used all of his substitutes.

evaluation of a device using heterochromatic flicker photometry

Macular pigment optical density measurements: evaluation of a device using heterochromatic flicker photometry

R de Kinkelder1,2, R L P van der Veen3, F D Verbaak1,van cleef copy necklace,4, D J Faber1,4, T G van Leeuwen1,5 and T T J M Berendschot3Received 21 June 2010; Revised 17 September 2010; Accepted 17 September 2010; Published online 5 November 2010.

Top of pageAbstractPurpose Accurate assessment of the amount of macular pigment (MPOD) is necessary to investigate the role of carotenoids and their assumed protective functions. High repeatability and reliability are important to monitor patients in studies investigating the influence of diet and supplements on MPOD. We evaluated the Macuscope (Macuvision Europe Ltd., Lapworth, Solihull, UK), a recently introduced device for measuring MPOD using the technique of heterochromatic flicker photometry (HFP). We determined agreement with another HFP device (QuantifEye; MPS 9000 series: Tinsley Precision Instruments Ltd., Croydon, Essex, UK) and a fundus reflectance method.

Methods The right eyes of 23 healthy subjects (mean age 33.9 years) were measured. We determined agreement with QuantifEye and correlation with a fundus reflectance method. Repeatability of QuantifEye was assessed in 20 other healthy subjects (mean age 32.1 years). Repeatability was also compared with measurements by a fundus reflectance method in 10 subjects.

Results We found low agreement between test and retest measurements with Macuscope. The average difference and the limits of agreement were We found high agreement between test and retest measurements of QuantifEye ( and the fundus reflectance method ( MPOD data obtained by Macuscope and QuantifEye showed poor agreement: For Macuscope and the fundus reflectance method, the correlation coefficient was r (P A significant correlation of r (P was found between QuantifEye and the fundus reflectance method. Carotenoids cannot be synthesized by the human body and are only available through diet.15 Hence, the amount of MP depends on the amount of lutein and (meso)zeaxanthin rich foods we ingest, and can be further influenced by the intake of nutritional supplements containing lutein and (meso)zeaxanthin.2, 16, 17

Accurate assessment of the amount of MP, expressed as MP optical density (MPOD), is therefore necessary to investigate the role of carotenoids and their assumed protective functions. High repeatability and reliability are especially important to monitor patients in studies investigating the influence of diet and nutritional (lutein and (meso)zeaxanthin) supplements, or disease processes on MPOD. Methods to determine MPOD should yield reproducible results accompanied by reliable uncertainty estimates, even when operated by non professional or untrained staff. Reproducibility is hampered when the method is applied in older patients, who may suffer from hazy ocular media, compromised physical skills, and early degeneration of the retina.

The most frequently used technique to asses MPOD is heterochromatic flicker photometry (HFP). Different devices using this technique have been validated to produce reproducible and reliable results in healthy research populations of different ages and patients with signs of early AMD.18, 19, 20 HFP setups are relatively inexpensive and easy to use, even for untrained staff. Furthermore, measurements can be performed through an undilated pupil, and are generally not influenced by changes in the ocular media, such as cataracts.

This was performed to evaluate the repeatability and reliability of a recently introduced device using HFP; Macuscope (Macuvision Europe Ltd., Lapworth, Solihull, UK). To this end, we tested the Macuscope against a second device based on HFP (Quantifeye, Tinsley Precision Instruments Ltd., Croydon, Essex, UK) and fundus reflectometry (MP reflectometer (MPR)), two established techniques for measuring MPOD. Special emphasis was put on the agreement between measurements using the Macuscope and the two established devices, and on repeatability between Macuscope measurements within our population. Separate studies showed weak repeatability, however, Macuscope was never tested against other HFP devices or methods.21, 22

Top of pageMaterials and methodsWe investigated the right eyes of 23 healthy subjects without ocular pathology, clear ocular media and a BCVA of at least 1.0. Mean age of the subjects was 34 years. To evaluate the ability of Macuscope to determine the MPOD, we compared the results with another commercially available device that uses psychophysical testing based on HFP, that is, QuantifEye.18, 23 The third method used to determine MPOD was a fundus reflectance technique, used in the MPR.24

MPOD was measured in healthy subjects without any ocular pathology, recruited from the University of Maastricht and the University Eye Clinic Maastricht. Study participants underwent all measurements consecutively on one day following the same protocol, that is, first measurement on the Macuscope, followed by the QuantifEye, followed by the Macuscope (repeatability measurement). The MPR method was the final measurement, because the high intensity of the used light could cause a temporal saturation of the photoreceptors that could influence the result of the other tests. The measurements were scheduled on one day between 0900 and 1500 hours, and were always performed by the same trained operator. When a subject was done with the first Macuscope test, another subject started his Macuscope measurement. Test series did not take longer than 30 per subject to avoid loss of concentration due to fatigue. The test results were only taken into account after a subset of successful pre test measurements,van cleef replica clover necklace, and were performed conform the manual. Repeatability measurements for QuantifEye were done on another day at the Academic Medical Center on 20 healthy subjects. Mean age of these subjects was 32 years. Repeatability data for MPR have already been published by van de Kraats et al,24 and are used in this study. All successful measurements were included for statistical analysis. All research adhered to the tenets of the Declaration of Helsinki. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during this research.

Heterochromatic flicker photometryBoth the QuantifEye and Macuscope are based on the principle of HFP for measuring MPOD. Flicker is generated by alternating light of two different wavelengths, blue light, which is absorbed by MP, and green light, which is not absorbed by the MP. Because of the pre receptorial location of the MP in the retina, incident light first passes through and is attenuated by the MP (peak absorption at 460 before reaching the photoreceptors. MP has its peak concentration foveally or just parafoveally, and decreases rapidly with eccentricity. Therefore, these setups always use a central (peak MPOD) and peripheral (low or zero MPOD) measurement point, to subtract these values and obtain an individual MPOD value for each different subject. The peripheral measurement is hereby used as a reference point for the central measurement,van cleef necklace knock off wholesale, to correct for the flicker sensitivity of each individual. Using HFP, subjects have to be instructed to fixate a stimulus and indicate when flicker is minimized (Macuscope) or when flicker is first observed (QuantifEye).

The MPOD value is derived by taking the logarithm of the ratio between blue and green luminance measured centrally and peripherally, as is displayed inequation (1):

Here Lbc and Lgc are the luminances of the blue and green light, respectively, during the central measurement and Lbp and Lgp the luminances of blue and green light, respectively, during the peripheral measurements.

MPOD values were determined after training of the subject. For the Macuscope, one or two pre tests were completed depending on how fast the subject comprehended the course of action. For the QuantifEye, the pre test function in the software was used for training of the subject.

MacuscopeMacuscope uses a conventional HFP approach, in which an operator adjusts a (green blue luminance ratio until no or minimal flicker is observed by the subject. Minimal flicker represents a matching of the brightness of both wavelengths. During a measurement, as also described by Hagen et al,21 firstly the subject has to fixate at a disc shaped stimulus of 1.5 in order to measure foveally. A crosshair centred on the stimulus should facilitate central fixation. The presented stimulus alternates between the blue ( 465 and the green ( 530 light, at a fixed frequency of 20 After that, the subject has to fixate one of the crosshairs placed 8 on either side of the central stimulus. Flicker frequency here is changed to 30 and is also fixed. As the crosshair in the centre needs to be in focus, the operator is able to adjust for spherical corrections. The operator then adjusts the luminance of the blue light, and the subject has to verbally indicate when minimal flicker is observed at the centre of the blue disc. The luminescence ratio is then stored. For parafoveal testing of the right eye, the right crosshair is fixated. Before the testing, subjects received verbal instructions on how to perform the test and are given time to make themselves familiar with the task and the machine. When the point of minimal flicker could not be clearly indicated, foveal and parafoveal measurements were repeated. Subjects were reminded of the instructions of the task throughout the test.

QuantifEyeQuantifEye uses a method, in which the user indicates when flicker is first observed. The test consists of two stages. The overall sensitivity of the user to flicker is determined first, and the luminance contrast of the two lights (green and blue) is normalized for that particular subject. Subsequently, during the actual measurement, the subject starts by fixating the central stimulus. The frequency of the blue ( 465 and green ( 530 light of the stimulus is ramped down from above the critical flicker fusion frequency (CFF), for a series of different luminance ratios of the two lights. The subject views the stimulus and presses a button when flicker appears. Each luminance ratio, therefore, generates a certain temporal frequency at which flicker is detected, and directly creates a point on the graph in the software of QuantifEye, as measurements go on. During this sequence, the trained operator can immediately determine if the measurement has been performed well. Each individual will show a luminance ratio for which they are least perceptive, at the lowest detectable flicker frequency. This represents the minimum in the distinct V shaped curve created and easily allows the operator to determine what the luminance ratio is at the minimum flicker frequency. The same sequence is then repeated for eccentric fixation (6 eccentricity). The difference between the minima of determined luminance ratios obtained from central and peripheral viewing determines the MPOD, equation (1). For a detailed description of this technique see van der Veen et al.18

MP reflectometerThe essentials of MPR24 are summarized as follows. The image of the filament of a 30 W halogen lamp is relayed to the pupil plane of the eye. The intensity of the light entering the eye is 1.04 107 Troland. A spot with a diameter of 1 centred on the fovea is illuminated, and the light that reflects from this spot is measured. An image of the retinal spot is focused on an optical fibre that has a mask on its tip to define a diameter spot of 1 at the retinal plane. To keep instrument stray light to a minimum, the detection channel does not overlap with the illumination system. Chin rest and temple pads are used to help maintain head position. MPOD is determined by a full spectral analysis of the reflected light. In brief, the incoming light is assumed to reflect at the inner limiting membrane, at the infoldings in cone outer segments and at the sclera. Using known spectral characteristics of the different absorbers within the eye (lens, MP, melanin, blood), the densities of the pigments and percent reflectance at the interfaces are optimized to fit the measured data at all wavelengths.25, 26 For a detailed discussion of this analysis see Berendschot et al.27, 28

StatisticsThe SPSS statistical software package (Version 15.0.1.1, Release 15.0.1; SPSS Inc., Chicago, IL, USA) was used for data analysis. To evaluate the repeatability, we generated a Bland plot, in which the difference between two measurements in one individual is plotted vs the average of these two measurements,van cleef alhambra knock off necklace, for all individuals. The same analysis was used to evaluate the measurements between the two HFP methods. We also determined relative differences, that is, the differences of two values divided by their mean value. Pearson's correlation tests were used to quantify the linear association of determining MPOD between HFP methods and MPR measurement. MPR determines an MPOD averaged over a 1 field using the reflectance method, whereas with HFP the MPOD is assessed using psycho physical testing. Consequently, as these methods use different analysis methods, a Bland graph is not suitable, and it is more appropriate to use Pearson's correlation tests. Low agreement was found between the test retest measurements done with Macuscope. Using Bland graphs, we determined the average difference between two measurements with Macuscope to be (Figure 1a). The limits of agreement, defined as the average difference plus or minus two times the standard deviation of the differences, were Mean relative difference was 32.2 In this figure two, data points were outside the limits of agreement. We found no reason, however, to exclude these two data points from our analysis. The difference between the first measurement and the second measurement was plotted vs the average of both measurements. Mean of all differences and limits of agreement are displayed. (a) Macuscope. (b) QuantifEye. (c) MPR.

Full figure and legend (99K)

Figure 1 also shows test retest data for QuantifEye and MPR. The limits of agreement for QuantifEye were (Figure 1b).

Full figure and legend (48K)

Figure 3 displays correlation coefficients between Macuscope and MPR measurements, and between QuantifEye and MPR measurements. For first Macuscope measurements and MPR measurements the correlation coefficient was r (P displayed in the upper panel. A significant correlation of r (P was found between the QuantifEye and the MPR, displayed in the lower panel.

es mejor que los adolescentes entren tarde al colegio

acaba de recomendar que todas las escuelas de ese pas que tienen alumnos de entre 10 y 18 aos retrasen el horario de entrada hasta las 08.30 o ms tarde.

La ms reciente investigacin al respecto, realizada por la Universidad de Minesota, resalta los beneficios de cambiar el horario, tras una investigacin en tres estados de EE. UU., que abarc ocho escuelas y reuni datos de ms de 9.000 estudiantes.

los adolescentes que entran ms tarde al colegio registran mejores calificaciones, les va mejor en las pruebas. se est repensando el horario de las escuelas, la mayora de las cuales empiezan a las 07:15, porque hay cada vez ms evidencia de los beneficios, y esto est causando mucho debate".

El estudio encontr que "los adolescentes que entran ms tarde al colegio registran mejores calificaciones, les va mejor en las pruebas. Tambin mostraron evidencias de menos depresin y uso de drogas,van cleef replica alhambra necklace, alcohol y tabaco".

Pero adems, la investigacin seal que hay menos accidentes automovilsticos que involucren a adolescentes, porque stos estn por lo general ms alerta.

Las razonesLos expertos sealan que los adolescentes tienen un ciclo de sueo diferente al de los adultos y de los nios menores de diez aos.

"Los estudios mdicos sealan que el cerebro del adolescente registra cambios que llevan a que no pueda dormirse hasta despus de las 11 de la noche y los lleva a despertarse a alrededor de las ocho de la maana. Esto tiene que ver con el cambio de las hormonas",van cleef necklace knock off alhambra, dijo Kyla Wahlstrom.

Por eso cuando los adolescentes estn en la escuela antes de las ocho de la maana, "su cerebro an no ha despertado", y no es inusual que se duerman en los asientos.

Los cientficos sealan que los ciclos de sueo se retrasan hasta dos horas con la llegada de la adolescencia y que lo ideal es que duerman entre nueve y nueve horas y cuarto.

A las ocho de la maana los adolescentes estn an en la fase de sueo ms profundo, e interrumpirlo en ese momento les causa somnolencia durante horas.

Esto no slo resulta en calificaciones bajas, sino que "cuando sufren falta de sueo, son ms proclives a problemas de depresin, consumo de alcohol y de tabaco y a ser vctimas de accidentes automovilsticos", explic la doctora Wahlstrom. es la ms influyente organizacin que se ha sumado hasta ahora a esta recomendacin.

Judith Owens, una de las autoras del comunidado de esa entidad seal que "los beneficios demostrados hasta ahora son generalizados e incluyen mejora en el desempeo acadmico, en la salud, en el estado de nimo e incluso en la seguridad".

An ms tardeEn el Reino Unido, los expertos han ido an ms lejos.

Russell Foster,van cleef arpels fake necklace, de la universidad de Oxford, quien particip en un piloto al respecto, seala que empezar a las 10 de la maana sera an ms recomendable.

"Cualquier horario es mejor que las ocho de la maana. Empezar a las 08:30 har una diferencia, pero comenzar a las 10:00 sera an mucho mejor", dijo Russell a la revista britnica New Scientist al ser cuestionado sobre la recomendacin de la Academia estadounidense de pediatra.

Cualquier horario es mejor que las ocho de la maana. como en otros pases como el Reino Unido,van cleef & arpels fake necklace, hay mucha resistencia a acoger el cambio de horario.

Una de las razones es la dificultad de combinar un nuevo horario con la jornada laboral de los padres.

Segn la doctora Wahlstrom la resistencia tiene que ver con muchos factores como por ejemplo la organizacin del cuidado de los nios, cmo afecta al horario de los autobuses que recogen a los estudiantes, y la renuencia del personal de las escuelas que tendran que terminar ms tarde.

Pese a esto, an organismos del Estado se estn planteando en Estados Unidos una revisin del horario, aunque las autoridades han enfatizado que la decisin debe realizarse a nivel local.

La evidencia mdica sobre cmo funciona el cerebro de los adolescentes parece cada vez ms convincente. Pero no est claro que las escuelas y el resto de la sociedad estn listos para ajustarse al reloj biolgico de los adolescentes.

Family thought news of man killed in S TMpore crash was a scam

JOHOR BARU: The family members of a Malaysian who was killed in a road accident in Singapore initially did not believe the tragic news.

Instead, they thought it was a scam to get money from them.

However, their lives came crashing down when it was confirmed that Loke Whay Mam,van cleef fleurette necklace fake, 50,van cleef pink necklace fake, was killed along with another Malaysian Lim Chun Hong,van cleef necklace butterfly fake, 34, in the island republic.

A van ploughed into nine Malaysian motorcyclists,copy clover necklace van cleef, including the two victims, during an accident along Bukit Timah Expressway in Singapore at 3.50pm on Saturday.

Loke son Qi Yuan said the family was still in shock after getting confirmation from the Singapore traffic police.

are all devastated. My father worked as a tile layer there, said the 21 year old technician when met at Tiong Hua Memorial Park in Jalan Ulu Air Molek here yesterday.

Qi Yuan, who also works in Singapore, described his father as a loving and caring father.

Tragic commute: Emergency personnel securing the site of the fatal accident along Bukit Timah Expressway in Singapore. The Straits Times/Asia News Networt

Loke wife was too distraught to be interviewed.

It is learnt that the other victim, Lim, would be brought to his hometown in Kahang, Kluang, for burial.

Out of the seven injured Malaysians taken to hospital, six are still warded while another has been allowed to go home.

It is learnt that the accident occurred when the nine motorcyclists were taking shelter under a flyover due to heavy rain.

It is believed that all those involved were workers commuting between Singapore and Malaysia daily.

Malaysian High Commissioner to Singapore Datuk Ilango Karuppannan said his officers had gotten in touch and informed all the Malaysian families soon after the accident.

Fifty great heroes

1) Howard Elphinstone, Victoria Cross

Lieutenant Howard Elphinstone, whose courage on the battlefield was matched by his charm as a courtier, was awarded the VC for bravery in the Crimean War. Even en route to the war zone, he was involved in the courageous rescue of four drunken sailors from the sea.

Elphinstone had landed at Balaclava, aged 24, in September 1854 and was twice mentioned in dispatches for his courage later that year. It was, however, for gallantry during the assault on Sebastopol that Elphinstone received his VC.

During daylight on June 18, 1855, Anglo French forces had conducted a sustained assault on the Redan fort but they had been repelled by the Russians. That night, under cover of darkness, Elphinstone commanded a group of volunteers who searched for scaling ladders and other vital equipment left behind after the abortive attack. It was a hugely dangerous assignment into no man However, the group brought back much of the equipment and some 20 wounded and vulnerable soldiers.

Later, in the final assault on Sebastopol, Elphinstone was his seemingly lifeless body was taken from the battlefield and placed with a mound of corpses awaiting burial. Yet his servant,van necklace fake, who had been searching for him, recognised his boots and dragged him from the pile. It was then discovered that he was unconscious rather than dead after being struck in the head by a shell splinter. He received urgent medical treatment and made a good recovery, although he never recovered the sight in his right eye.

Elphinstone, who later rose to the rank of major general and was knighted, became a royal courtier who was so admired by Queen Victoria and the Prince Consort that he mentored their third son, Prince Arthur.

2) Everard Phillipps, Victoria Cross

Ensign Everard Phillipps was awarded the VC for bravery during the Indian Mutiny an award that was controversial for two reasons.

First, it was one of six awarded posthumously by Edward VII and, second, its authenticity was later questioned by none other than Hancocks, the official makers of the decoration.

This query makes the decoration the only VC that I have collected.

Phillipps, a keen sportsman and devout Roman Catholic, was commissioned ensign in the Bengal Army in 1854, arriving in India later the same year.

He narrowly escaped death during the mutiny at Meerut in 1857 before becoming involved in attempts to retake Delhi from the rebels. From May to September 1857,van cleef magic alhambra necklace fake, Phillipps was at the forefront of ferocious battles, being wounded in action on three occasions.

On September 18, Phillipps was shot and killed during street fighting. At the time, it was impossible to be awarded a VC posthumously but Phillipps gallant deeds were noted in the London Gazette, where it was recognised that he would have been recommended for the VC had he survived. Eventually, his VC was announced in 1907 fully 50 years after his act of bravery by which time new guidelines made it possible to be awarded a posthumous VC.

Until relatively recently, it was believed that the VC awarded to Phillipps, who served with the Corps of Royal Engineers, and to five other pre Boer War heroes, had been given to their families at about the same time. However, subsequent research was prompted by the proposed sale of my Phillipps VC at auction, when it became apparent that the box for his decoration was different from the other 1907 decorations.

It emerged that the Phillipps family had a personal connection with Queen Victoria and that my Phillips VC was probably presented in the 1870s, perhaps because the Queen felt guilty that his bravery had never been recognised. The official VC issued in 1907 is still in the hands of Phillipps descendants.

3) William McDonell, Victoria Cross

William McDonell is one of very few civilians to have been awarded the VC. As a member of the Bengal Civil Service, he was involved in trying to quell the Indian Mutiny as the rebellion spread in 1857. In July of that year, the British were determined that the city of Arrah should not fall because the entire Bihar region might then be seized. McDonell was sent to guide a steamer carrying a military force to the city.

On July 29, a force of more than 400 men marched on Arrah House, but they were ambushed by rebel forces. McDonell was fearless in battle, during which he was wounded. Outnumbered, the British force had to retreat to the River Sone, where McDonell helped the soldiers into small boats so that they could reach the safety of their steamer. It was only when McDonell and his comrades got into the final boat under heavy fire that they discovered the rebels had removed the oars and tied the rudder to the side.

With the 35 men in the boat unwilling to get out to cut the rudder free, the injured McDonell braved the fire himself. Miraculously, he was uninjured by a hail of bullets. A Royal Warrant of 1858 extended the eligibility of the VC to civilians who were under the orders of an officer and McDonell was eventually awarded the decoration in February 1860.

His original VC was stolen during his time in India, when he served as a judge. However, McDonell was later issued with an official replacement and it is this that is now in my medal collection.

4) Charles Gough, Victoria Cross

Charles Gough and his brother, Hugh, are one of only four pairs of siblings to have been awarded the VC. Furthermore, he and his son, John, are one of only three fathers and sons to have been awarded the decoration. As a family, they are unique because no other family has been awarded three VCs.

Charles Gough was born in India but was brought up in Co Tipperary. However, aged 16, he returned to India. Major Gough, a cavalry officer, was awarded his VC for four separate incidents from August 1857 to February 1858 while serving in the Indian Army. It was on August 15, 1857, that he saved the life of his brother after the latter had been injured. He also killed two of the enemy in battle. Three days later, he led a cavalry charge in which he cut down two of the enemy sowars (Indian cavalrymen),how much is van cleef and arpels clover necklace fake, one of them after prolonged hand to hand combat.

In a further act of bravery on January 27, 1858, he lost his sword in fierce combat during which he attacked one of the enemy leaders and pierced him with his weapon. Afterwards, Gough was forced to defend himself with his revolver, shooting two of the enemy. Finally, during another battle on February 23, 1858, Gough went to the aid of a comrade and killed the man attacker before afterwards cutting down another of the enemy in the same gallant manner

His VC was announced in October 1859. Gough later served in the Afghanistan Campaign of 1878 9 where he was twice mentioned in dispatches. In 1881, Gough was knighted for his services in Afghanistan and 10 years later he was promoted to general.

5) Evelyn Wood, Victoria Cross

Evelyn Wood earned himself an unwanted reputation as most accident and sickness prone officer in the British Army yet he was also one of the bravest.

Wood had served first in the Royal Navy as a teenager during the Crimean War, taking part in the ill fated attack on the Redan fort in 1855. Wood had learnt an early lesson that there is little room for sentimentality in war. When looking at the Russian positions through a telescope that he was resting on the head of a sailor, an enemy shell took the man head clean off. Wood was stunned, but another sailor shouted: the hell are you looking at? Is he dead? Take the carcase away. Ain he dead? Take him to the doctor. Wood was hit and doctors wanted to amputate an arm,van cleef mini necklace fake, but he persuaded them to save it.

During a distinguished military career, Wood suffered many medical ailments. he also had many mishaps: he was badly battered riding a giraffe for a bet, and broke his nose and elbow when his horse ran into a tree.

Former Giants lineman Rich Seubert named head football coach at Watchung Hills

Watchung Hills has a new football coach, and he just so happens to be a Super Bowl champion.

Rich Seubert, a former New York Giants offensive lineman who helped the team win Super Bowl XLII against the New England Patriots,copy van cleef clover necklace sale, has been named the next head coach at Watchung Hills, athletic director Chris Van Vliet confirmed to NJ Advance Media on Tuesday.

"We did have some qualified candidates and we went through a pretty intense interview process for a couple of weeks," Van Vliet said. "But one common theme emerged from our committee that Richie Seubert was the best candidate for our program moving forward. We're really happy to have someone of his caliber take over our program."

Seubert, a Wisconsin native, played with the Giants from 2001 to 2010 and spent time all over the offensive line,copy van cleef and arpels vintage alhambra necklace, even techinically lining up as a tight end at times. He's well known for overcoming a leg injury many thought would be career ending when he broke his tibia, fibula and ankle in 2003.

The team's third coach in as many seasons, Seubert replaces Mike Katz who coached one season for the Warriors and led them to a 4 6 record. Seubert served as an line coach under Katz after previously coaching at Mission College Prep in California.

"He wants to do this. This is not something where we had to go out and recruit him or do any convincing," Van Vliet said. "This is a guy who is in town,van cleef and arpels four leaf clover necklace fake, his kids are here,copy necklace van cleef arpels, he's here for the long haul, we think, at least he's communicated that to us. That really made the decision that much easier when you have someone with his pedigree saying that he wants to do this and that he's passionate."