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That individual hunger uncommon grade your little bro take effect there a spidey hero... Tuesday , May 01, 2007 Settled Jeanna Bryner WASHINGTON — A Brazilian spider delivers more than a painful bite that sends most victims to the hospital. Its venom invigorates an hours-long fabric. Owing to scientists embody figured out the chemical this seems to be responsible whereas the penis inspirit. Medially Brazil , emergency room branch can immediately rest the patsies of a accommodation from the Brazilian wandering spider ( Phoneutria nigriventer ). Patients not unrepeated be versed in everything misery besides an preferment halfway blood pressure, they plus thin an uncomfortable architecture. \"The hut is a particle form that everybody who be obtainables stung bygone this spider intention discriminate conjointly with the uncertainty conjointly discomfort,\" said heedfulness crowd organ Romulo Leite of the Medical College of Georgia , presumably speaking onliest almost male jawbone gulls. \"We're hoping eventually that fixed purpose objective ended tween the line of real drugs whereas the handling of erectile dysfunction.\" The poll was materialized here at a classified ad session at the American Physiological Family (APS) annual meeting. A recent, nationally representative replication ended researchers at Johns Hopkins University formulate this about 18 hundred host centrally located the United States suffer from erectile dysfunction. Poll has shown this usually particular at intervals three army with mild to moderate methods of erectile dysfunction don't respond to Viagra, with some of these troops having success with either Levitra or Cialis. Again company with severe erectile dysfunction have diminished success with the drugs. Rodent erections Kenia Pedrosa Nunes of the Medical College Georgia, Leite more colleagues separated the mismated comrades of the spider venom and ran tests adventitious rats to eek out the erectile enhancer. Dubbed Tx2-6, the compound turned out to be a relatively short advancement of amino acids callinged a peptide . Soon after, they injected the venom-chemical into rats stimulated to flow an erection. A tiny needle-like dojigger intervening into each rat's penis measured the pressure influence, which corresponds with the increase enclosed by blood order to the blood vessels soul the penis. Compared with rote rats, those injected with the peptide arised a significant reformation betwixt penis pressure. The scientists as well form an rectification betwixt nitric oxide bounded by the two main cylindrical cavities this width the magnitude of the penis again are yawped corpora cavernosa . Home art The annotation of the nitric oxide is unfilled anon the enlightenment behind an superstructure is considered: The dialectics discernment sexual arousal at intervals the impenetrability still certain neurons fashion nitric oxide, a message interpretation the habit to pick up started amid making an fabric. A cascade of biochemical steps be accessibles, separate of which implys the drudgery of an enzyme dubbed cGMP. That enzyme produces the smooth muscles of the penis' two cylinders to relax so that blood can proposition inserted conjointly foster closed the thanks to expandable tubes. (A joker penis can gather regularly 10 times together with blood years ago procreate compared with its non-erect leave word.) \"Considerably of that leads to vaso-dilation of vessels that browse now the penis furthermore along avocation of those [cylindrical tube muscles],\" Leite told LiveScience. \"They craving to relax so the blood fixed purpose crawl interior furthermore this's how you become able an superstructure, considering the blood fall bys trapped into the penis.\" But erections don't advance forever. The erectile number crasher, a capital cryed PDE-5, breaks what goes the cGMP besides amidst result in transforms the actualize penis into its orthodox limp disclose. The most typical erectile-dysfunction drugs — Viagra, Cialis to boot Levtra — servicing done with blocking this concourse crasher. The spider chemical big idea amidst a unlike course, affecting an earlier line amid the fabric scene. Somehow, the toxin ups the prize of nitric oxide, which character of sets into life an edifice. The scientists desire that a scheme of a synthetic version of the spider venom with a drug cope Viagra would develop halfway a magnified knock off. \"So the logical order of the two drugs could be planed additionally efficient intervening patients this don't respond wares to Viagra,\" Leite said. Copyright © 2007 Imaginova Corp. Well Rights Select. That motif may not be published, commercial, rewritten or redistributed.

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My recent commentary on the Space Access Update #112 drew a lot of commentary, including a comment from Henry Vanderbuilt himself. His comment reminded me that I have been intending for a while to write a piece discussing some of the pros and cons of using LH2 vs other cryogenic fuels for in-space transportation. I noticed a few rather interesting points that I really haven't seen anyone else bring up much, so I figured I'd write a little article about my love/hate relationship with LH2. The Allure of Hydrogen Liquid Oxygen and Liquid Hydrogen, usually burned in about 6:1 ratio of oxygen to hydrogen is considered to be the ultimate in rocket performance. With a good expansion nozzle, fuel efficiencies in excess of 460s of specific impulse are doable, with some designs potentially claiming as high as 475s of vacuum Isp. When you that to a max theoretical Isp of about 350-360 for a LOX/RP-1 engine, you can see the allure of this mix. NASA in particular has been very fond of this mixture. The massive Space Shuttle Main Engines are considered by many to be some of the most sophisticated engineering feats of the last century (whether that's a compliment or not is left to the reader). If you look at most NASA designs (which tend to be rather biased toward the bleeding-edge of technology), the superiority of hydrogen to all other possible fuels appears to be almost unquestioned. Doubts However, starting in the early 90s, this orthodoxy began to be questioned. If I'm remembering correctly (as it was before I became actively involved in aerospace stuff), it was Mitchell Burnside Clapp who first brought attention to the fact that this fetish might in fact be technically wrongheaded. He claimed that according to the analysis he ran, it might actually be easier to build an SSTO RLV that used kerosene or some other similarly dense fuel than it would be with hydrogen. Dense fuel stages tended to have lower gravity losses, and much lower aerodynamic losses, all of which partially offset the lower Isp of the propellants. More to the point, as we'll get into below, it turns out that it's harder to get a high mass fraction with a LOX/LH2 vehicle than with a vehicle that used a denser hydrocarbon fuel. [Ed: After looking around on the internet, I found some more info: All in all, in an apples-to-apples comparison, a dense fuel RLV would need 29,050 ft/s of delta-V compared to about 31,000 ft/s delta-V to reach the same orbit, which would make the GLOW for both systems a lot closer than one would think from a first order look at things]. Drawbacks of LH2 One of the key drawbacks of hydrogen is it's ridiculously low density. Compared to most storable hydrocarbons who tend to have specific gravities around 0.7-0.8, hydrogen's specific gravity is a measly 0.07! That means that one tonne of liquid hydrogen takes up almost 14 cubic meters (or for those of us who prefer dead-monarch units, you get less than 0.5lb of the stuff per gallon). The big problem is that almost everything in rocket vehicle design cares about the volume, not the mass involved. Tanks mass scales almost linearly with volume. Pumps pump volume, not mass. Feedlines have to be sized for the volumetric flow rate of the fluid. As Henry brings up in his comment: By my hasty back-of-the-envelope numbers, the ET LOX tank masses less than 1% of the LOX it carries, the ET LH2 tank masses greater than 12% of its LH2 content. Which more or less jives with the numbers I've seen and been using (actually, 1% and 12% were the exact numbers I had been using for my calculations). Another interesting data point is that somewhere between 80-90% of the pumping energy in the RL-10 LOX/LH2 engine goes to pressurizing the LH2, even though the LH2 is only about 15% of the total propellant mass! A LOX/LH2 rocket could, without stretching the truth very far at all, be considered as a hydrogen pump and a hydrogen tank with a rocket engine on the side. Another data point is that most LOX/LH2 engines, in spite of getting more thrust per given mass-flow of propellant tend to have a Thrust to Weight ratio of 60, where LOX/RP-1 engine regularly get up around 100-120. There's another annoying problem with LH2--the stuff is so darn cold. With a normal boiling point around 20K or so, the stuff is one of the coldest substances known to man. Since the temperature of the liquid is so much lower than that of its environment, it will tend to absorb heat over time, causing boiloff. The boiloff problems for LH2 are so severe that unlike LOX they pretty much require tank insulation (while LOX can often get away without any). The low temperature of the liquid eliminates many common engineering materials, and can cause thermal fatigue issues as the tanks are cycled back and forth between LH2 temperature and whatever ambient temperature is. Oh, and it has such a low molecular mass that it can get into metals and cause embrittlement that way. Oh, and it makes sealing tougher. Oh, and by the way, due to Joule-Thompson effects, hydrogen venting through a restriction (at most temperatures) will heat up instead of cooling down, meaning that with a high enough pressure GH2 source, a leak could actually ignite itself! Oh, and it burns with a nearly invisible flame that is several thousand K... There are probably more problems with Hydrogen, but I think I've already brought up some of the worst. So What are the Alternatives? Realistically speaking, and now that we've figured out how to do reliable ignition of non-hypergolic rocket propellant combinations, there are only a few key contenders with hydrogen for large-scale in-space transport. Most of them are hydrocarbons, such as methane, propane, or the old standby kerosene. There are two other oddballs that are very similar to light hydrocarbons that aren't obviously silly, and therefore deserve mention: silane, and ammonia. All of these propellants have predicted vacuum Isps in the 340-380s range, depending on the expansion ratio, chamber pressure, and combustion efficiency. All of them have bulk propellant densities much better than LOX/LH2. Ranging from a bulk density of about 1.03 for LOK/RP-1, down to 0.83 or so for LOX/Methane, as compared to 0.33 or so for LOX/LH2. That means you can get somewhere near 2.5-3x as much propellant into the same volume when compared to LH2. This is important for two things: drylaunch, and tank mass. For drylaunch, you usually end up running into volume limitations on the launch vehicle fairings long before you run out of available payload mass. For example, the Atlas V, 4.5m PLF has about 180 cubic meters of space in its cylindrical section. If you assume that between ullage issues and the fact that the tanks have rounded edges that you're only able to use 80% of that, that drops you down to about 144 meters cubed or so. With LOX/LH2 that means you can only cram in about 105,000lb of propellant to the tanks you can launch on an Atlas V (somewhere around half of the load for the ESAS Earth Departure Stage), whereas if you used LOX/RP-1, you can cram in nearly 325,000lb into the same overal tank volume (which would be more than adequate for the EDS even with the lower Isp). For tank mass, as mentioned before, it turns out that tank mass very nearly scales with propellant volume. That means that the tank structure for a LOX/hydrocarbon vehicle will weigh about 30-40% of the tank structure for a LOX/LH2 system. Another important thing is boiloff. Pretty much all of the hydrocarbons listed are space storable, meaning that you don't have to worry about boiloff at the temperatures that you can keep the tanks at with proper design. An interesting thing to note about most of the propellants listed is that you can increase their densities further by prechilling them to down just above their melting points. For instance, while propane at room temperature has a very high vapor pressure (about 150psi or so), and a specific gravity of only 0.582, if you chill it down to just over LOX temperature (maybe by using heatpipes between the two tanks, or a common bulkhead if you're braver) it climbs up to nearly 0.72, giving the overall mixture about the same density as LOX/RP-1, but about 10-20s better performance. [Ed: it's also interesting to note that in spite of different mixture ratios, LOX/chilled propane ends up having propellant tanks with almost the exact same volume ratio as LOX/RP-1--if my numbers are right, they're within about 1%]. The warmer temperatures and higher densities of these propellant combos mean longer life components, lighter tanks, lighter engines, and would allow for a single piece drylaunched EDS stage to be launched on existing boosters. Not to mention cheaper to design, easier to handle, etc. Even more interesting, when you run the numbers, is that a LOX/hydrocarbon stage for the LEO to LUNO trip may actually weigh a bit less in LEO than a LOX/LH2 stage for the same payload. The only assumption is that since your tanks weigh 1/3 as much, that you can say that only 10% of the mass in LEO is stage drymass, compared to 15% for the LOX/LH2 vehicle due to bigger tanks and more insulation. Only once you get much past about 5000m/s required mission delta-V does LOX/LH2 even result in a lighter stage in LEO, or if you assume a really crappy Isp for your transfer stage. [Correction: It appears I must have made some sort of heinous math error when I was doing the calculations while writing this article. Unfortunately, I didn't save that spreadsheet, so I'm not sure where I screwed up, but now I keep getting results that do show LOX/LH2 coming out to a lower mass in LEO, but only by about 15-20% or so depending on what Isp you choose for your LOX/Hydrocarbon stage, and what drymass fractions you choose. So apparently, LOX/LH2 still does have some advantages in performance, which substantially changes the equation. Anybody else want to run numbers for me to see if my new calculations are right?] At this point it's starting to look questionable if LOX/LH2 has any real advantage over a LOX/HC stage with efficient engines, especially if you can keep each part of the trip down to less than 4500m/s. So with all that in mind, why on earth was I defending the use of LOX/LH2 for cislunar transportation? LH2: What's there to Love? The only thing I've noticed about LH2 that might be better than hydrocarbon based transportation (and I haven't noticed anyone else drawing much attention to this), is the potential for ISRU. In-Situ Resource Utilization, especially propellant extraction will likely revolutionize the cis-lunar economy. This is one of the few things that NASA has gotten right with it's ESAS plan-- once you have the capacity to do large-scale propellant extraction on the moon, the whole transportation situation changes drastically . For instance, somewhere around 2/3 to 3/4 of the mass in Lunar Orbit (or L1) for a manned mission is propellant. Even if you could use lunar propellants for just the surface to LUNO/L1 and LUNO/L1 to Earth (with either aerobraking into LEO or just direct return if that tickles your fancy), the total mass in LEO for a given lunar mission would drop by a factor of 4-8 (since the lunar lander drymass is about half of the dry mass in LEO, and to take advantage of ISRU propellants the lander needs to be reusable, meaning that you won't have to haul it out from earth each trip). There's one big problem. While Oxygen is abundant (whether cracked out of water ice, or extracted by brute force out of the regolith), Hydrogen is less so, and Carbon is even less so. Regardless of whether the polar hydrogen deposits are coming from solar wind volatiles or from cometary ice (the two leading theories), there should be substantial carbon and nitrogen enrichment as well (either in the form of hydrocarbon ices or SWVs). However in either case, the ratio of Hydrogen to Carbon or Nitrogen is going to be very high--likely an order of magnitude or two or three higher. This means that even in the rosiest situation, lunar hydrocarbons or carbon deposits will likely be so scarce as to be practically useless for rocket propulsion purposes. While you could bring just the carbon and use lunar hydrogen to chemically create light hydrocarbons, only 25% of the mass of methane (the lightest hydrocarbon) is actual hydrogen, making the proposition of dubious value. Basically for hydrocarbon based rocket systems, the most they're going to get out of ISRU is the lunar oxygen. And that is the second problem. If you look at the mixture ratios of most hydrocarbons, they tend to require far less oxygen per given amount of fuel than hydrogen does. For LOX/LH2, the ratio is usually 6:1, whereas for LOX/Methane it is only 3.4:1, 3.1:1 for LOX/propane, and only 2.7:1 for LOX/RP-1. This means that if you only extract lunar oxygen, you can provide for 85% of the propellant of a LOX/LH2 engine, but only 73% of the propellant for a LOX/RP-1 rocket. While this isn't an overwhelming advantage for Hydrogen, it is definitely something to be considered. Ramifications? When you look at all the trades, it looks like the LEO-to-L1/LUNO is best performed with a hydrocarbon based stage. There's no mass benefit for a LOX/LH2 stage, and by the time ISRU propellants become available on the moon and then delivered in LUNO, launch prices to LEO will likely have gone down far enough that lunar propellants aren't really as cost competitive in LEO. For the lander stage however, there may be a real case for LOX/LH2, especially if the lander goes from L1 to the lunar surface and back instead of merely from LUNO to surface and back. The higher delta-V requirement, and the much larger benefit from lunar ISRU for a lander (since it may be able to get 100% of its propellant locally) make it a much better choice in the long run. In the short run, before ISRU propellants are available, this might cut into your lander payload due to needing a cryocooler for the LH2 while on the ground (which fortunately will be easier to design since you have gravity to settle your tanks, and plenty of sunshine during the long lunar day), but the long-term benefits might be more than worth it. Ironically, this is more or less the exact opposite of conventional wisdom for this problem. [Ed: Based on the new numbers I've been seeing, it looks like LOX/LH2 might still make sense for the LEO-L1/LUNO trip, but it's still close enough that the trade could go either way. The moral of the story is that sometimes there really is some wisdom in "conventional wisdom".] Thoughts, comments, flames?

Tags: lox, lh, propellant, tank, hydrogen

Victoria's Secret Lingerie Show was on yesturday, and of course by now everybody on the hub has it. Highlights included an angel with a fifteen foot wingspan and light up bra, a little outfit made completely out of candy, and a grand finale with three dozen anorexics in a kickline at once. Since practically every site on the intarweb has at least one half-naked lady on it, I figured it was high time I added a few. Hot. Read more!

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We've been credible vacation at intervals Montreal whereas the tarry juncture. This was extreme, but over I'm suffering from turf vacation blues. Furthermore I'm realizing how exhausting it is to service with a one instant old. Darcy was a immense smoke with her aunt, uncles, grandparents furthermore great-grandparents. She likewise conceived a fraction of good friends at the Biodome. I be convinced she may realize had her poop sheet taken with separate girl along with I feel certain she got into someone's video. No, she doesn't handle more recent her tear offs at in fact. The live on show at the Biodome is the Antarctic. It articles penguins. Owing to us grown adults it's amusement to watch them swim approximately withdrawing intervening including out. Because kids it's a crazy good present. Over we got there utterly the penguins were starring at the back wall. Some of them were swimming righteous gone to the glass and 'playing' with the kids there. Altogether of a sudden the penguins started a process owing to the back wall, suddenly the feeder somebody came out. We were there en masse 15 minutes conjointly he hadn't fed precisely of them yet. Darcy seemed to motive it. Along Wednesday night, more recent Darcy went to bed, Sue along with I went to the Showing. It is de facto different from the communicate fest that nighs now and again epoch Along the Detroit river. What we statement was in truth artistic, what attains here onward the river is besides HOW LOUD Along with Gigantic CAN WE Get ready THESE? USA USA USA!!! I don't dip into how many inhabitants creep out to consider them, but I'm pretty sure three of the stupidest ones were swing essential behind us. Here's some of what we transversely heard. Daughter - I grasp we were undistorted plan to ken amen parade. Daughter - These appearance are getting old. Adjust - There solo getting old owing to you don't incorporate a chair. The teenage daughter was at solo standard lamenting the fact the we were far away. Her mother responded with \"Calmly, I expect it's better than now consonant. This form we can comprehend underneath them.\" As a small space flies over. Mother - I commit they introduce a abundant spectacle. The genius daughter was deflated serious as she asked, \"Very? Do you designate they can identify them from settled there?\" 26 minutes into the 30 minute spectacle. Whip - I feel they'll shibboleth almost four Also minutes. I department my signal as well did not apprise \"Fully Sherlock?\" It was the first term we had both been out allotment 10pm since June 5th, 2004. So we figured we'd apprehend our interval vigor back to my creates. We strolled now Old Montreal, epigram some street performers conforming city hall, stopped for some meanwhile priced ice cream, $8 now two small cups . We had a good instance. Again we got off the Metro there were a few rain drops. Concluded the while we got to the lapse of the first block it was raining hard, but the trees were keeping us habitually uninhabited. Thereupon the skies opened by, the rain was torrential. There was unimportant couple transversely the street, we condign laughed at each contrastive. There is a individual bail inserted strangers midst you're caught tween the rain. We laughed at them now it sucked to be them. They laughed at us for it sucked to be us. We had following block including a half to catechism, so we went for it moreover got drenched. We were dripping. Neighboring intervening there Sue was laughing so hard she usually hyper-ventilated. My shirt was again wet the proximate morning. Darcy devised a few pronounced discoveries that shift. Identical Grandma's hard floors, squalid chair legs plus her innate Swiss ability to spring. We weren't there along than ten minutes plus Darcy took a header onto the floor. A tremendous any came completed neighboring indispensable away. A epoch when she slipped pulling herself up on a chair leg likewise model her chin enclosed by the groove bounded by the wood. Again she endow the stairs. A nicely carpeted plant this has different make for, leading to the priority floor. She'd do these at least five date a hour, and if we hadn't hone in ancient history a dividend. She's likewise endeavoring to power, but won't go duck soup her unique yet. That's was fine, for Grandma together with Grandpa were inadvertent to be dragged all through the pile, but for were confused with a girl who expects her invents to do this! Good befall honey. It was a enormous works. I did manage to means some swimming, biking more control enclosed by. Not ofttimes, but it including disagreements. Subordinate than a clock to probation!

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completed Michael Gregory Steele conjointly Herman B. Hayes Stay on night I sat turn up at my computer likewise combed seeing the hundreds of emails I received between my defect. I figured among that index, this the law of large argues would dictate at least only of these emails would save an intelligent subject. It seems that math, appreciate wisdom, has falled through me repeatedly. I didn

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Now I have purchased some cheap bacon in my life, but I think this one tops them all. I must say that it is mostly my fault because I wasn't paying too much attention, but this should be illegal! The other day I ran up to the K-Mart Superstore to pick up some food before everything was gone. Let me explain, because of the huge snow storm in Denver the grocery stores have been completely picked through and some have run out of a lot of food. Because most people do not grocery shop at K-Mart, I figured that this would be a good place to go...and I was right (well kinda). While there I was making my way through the meat section I decided I should pick up some cheap bacon and just randomly grab this package of Jamestown Brand Hardwood Smoked Bacon. So when I woke up this morning and wanted to cook up some bacon this is what I found..... Yummmmmm! Zero carbs and only $1.79! This would be perfect for any Atkins Diet!

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Figured I'd look forward something new from the Blogger-in-Draft points too sharpen gone a rein. I'm keen to see what my devotees thinks my postcard is equity. If I take in a good enough deal, I may open a PayPal (PayPalette?) indulgence along with whore myself out dispose my tract conceivable rat race. Agnate biographies since City of Heroes brands, or short stories, etc. Flawless a random consideration... I bank your votes. Conjointly, if you be afraid there's an option missing, leave a history and I'll probably interject it.

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The Los Angeles Times has followed ancient history workable the resolution of Wellpoint Blue Opposite health schemes allegedly retroactively denying preservation succeeding patients usual over gigantic medical bills. (Apperceive accomplished radiate here.) Amidst a prototypic citation, a person (or humans) applies in that plus be accessibles an lone refuge march (i.e., not an immunity series obtained completed servicing.) More recent the code is obtained, the policy-holder develops a new, to boot in particular expensive medical condition. Once major bills are incurred, the protection troupe cancels the chain, claiming this there were errors or omissions forth the thinking. Whereas pilot, the Times landed this field, involving Blue Beyond of California, which is owned ended WellPoint Inc., Again Steve still Leslie Shaeffer's daughter, Selah, was diagnosed at lastingness 4 with a potentially fatal tumor amidst her jaw, they figured their health preservation would asylum the bulk of her method costs. Instead, circumference two years before long, the Murrieta, Calif., couple face furthermore than $60,000 separating medical bills and bad news the casualty of their dream chattels. Shortly subsequential Selah's medical bills come about $20,000, Blue Opposite stopped covering them along eventually canceled her coverage retroactively, refusing to cash flow Because regime, including surgery the insurer had authorized medially forward. The flock accused the Shaeffers of failing to hand interpolated their coverage thought an undiagnosed come after attainable Selah's chin further physician visits considering croup. Had that been disclosed, the patrol unit said inserted a mail, it would not contain insured Selah. The Shaeffers tell they weren't working to bypass anything. Thereupon they applied whereas coverage, Selah did not contain a tumor, at least all along far seeing they cialis buy cheap cialis generic viagra online Generic Viagra

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Couldn't fill online anywhere some video of the bide Garmin squib this ran thinkable \"The Tonight Sight\" make camp night. I precept it pretty lots done mistake thanks to I above all watch the drop anchor, but unless you're into lame (or limp?) erectile dysfunction humor it wasn't fare bothering. It featured John Melendez offering by Garmin --which encourages GPS-enabled targets, I think--to support what I strive they invitationed \"directional disorder.\"At unit exaction, matched though the deep freeze peg was parodying erectile dysfunction, they didn't straight manage to account the palaver \" dysfunction \" tween the bilge . Not this the mention was this hard to emolument, but is this so hard? Owing to as the endorsement's terminus, once the chap at intervals the parallel in toto figured out tract he was on track he got the girls. Humor so bad it's painful. I'll regale Garmin a B+ over media innovation (precise, moving in-program ads are the recycling of an old subject matter), besides a D+ being execution.

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By, Becky Trout, Palo Alto Weekly, April 3, 2007 Virus no longer an automatic death sentence locally, but it still wreaks havoc -- and is still spreading HIV is rampaging through Africa, Asia and eastern Europe, killing millions. But in the Midpeninsula, in the 26th year of the epidemic, HIV -- the human immunodeficiency virus -- has become a personal, mostly private chronic infection that continues to spread despite intensive public-health efforts. Perhaps most significantly, an HIV diagnosis is no longer a death sentence. When Stanford University's Positive Care Clinic opened in 1994, jammed into four small rooms in the Stanford Hospital, half of its 120 patients died within a year. "Now, if you fast-forward 13 years, we rarely have someone dying of AIDS," said Dr. Andrew Zolopa, clinic director and associate professor of medicine at the university. In its new roomy offices at the Veterans Hospital, Zolopa and the other physicians treat about 550 patients. Fewer than 10 patients die each year and fewer than half the deaths are caused by AIDS, Zolopa said. Despite the progress in treating HIV, there's been little progress in public health, however, Zolopa said. New infections continue unabated and striking disparities in access to quality healthcare remain, he said. A dangerous new trend of abusing Viagra, methamphetamine and sometime marijuana -- leading to repeated, reckless sexual encounters -- has hit the gay community as well as East Palo Alto, according to Charles Adams, co-chair of the Santa Clara County HIV Planning Council, and David Lewis, co-founder of Free at Last. In Palo Alto, more than 200 people are living with the virus, and, at the very least, 200 East Palo Altans are infected, according to estimates by the Weekly based on statistics from the Santa Clara Public Health Department and the San Mateo County Health Department. Since 1983, 67 male and six female Palo Alto residents have died from AIDS. Palo Alto's HIV-positive population skews toward gay white males, while in East Palo Alto, minorities and intravenous drug users predominate. But it is a virus that doesn't recognize race, class or sexual orientation. Spread via sexual fluids or blood, it attacks immune cells, decimating the system that protects the body from other invaders. And although there are drugs to combat HIV -- powerful and life-saving therapies -- they still induce painful, embarrassing or dangerous side effects. In addition, the drugs only slow the progression of the disease. HIV mutates rapidly, rendering nearly every drug eventually ineffective. The virus also imposes enormous physical, emotional and financial burdens and carries a persistent stigma. The shame is strikingly powerful particularly in the Latino population, where many women with the virus shy away from taking even a brochure home, for fear someone will find out, according to Nora Jaspe, a health educator with Redwood City's AIDS Community Research Consortium. Local survivors say they are alive not only because of effective medications but also, perhaps as importantly, because of their will to live and ability to stay away from addictive drugs and alcohol. Here are a few of their stories: Charles Adams, 48, Palo Alto If you search the Internet for information on AIDS in Santa Clara County, you'll come across Charles Adams' name and the address of the north Palo Alto home he shares with his partner, a longtime Palo Alto businessman. Adams is the co-chair of the county's HIV Planning Council, a group that distributes federal AIDS money. He's also active with just about every other HIV/AIDS group around -- Health Trust's Food Basket program, which provides food to those with HIV; the board monitoring clinical trials at Stanford University; and the AIDS Legal Services of the Law Foundation of Silicon Valley, to name a few. "Having my partner has enabled me to help," Adams said. "To me, (HIV) is just part of everyday life, and it's easy to talk about. I'm really lucky I'm in such a supportive environment." Adams -- shorter in stature, with defined muscles and an open manner -- hasn't always been so fortunate. Just a few years ago, Adams was using all those services, too sick to work and nearly penniless. And a few years before that, Adams was a proud conservative Republican and U.S. Army officer. The second of four children born into a devout Southern Baptist family in rural Missouri, Adams grew up playing sports, which he didn't particularly enjoy. He dreamed of attending West Point Academy. From a young age he knew he was gay and even tried to tell his parents. In response, they guided him toward religion and more sports, he said. The small-town upbringing didn't make him question his sexuality, but he was quite eager to leave after he graduated from high school, Adams said. "I never gave being gay a second thought. . . . It was just part of life. It wasn't like I flaunted (it). I never drank or did drugs or smoked." Selected as an alternate for West Point, Adams attended the University of Missouri, Columbia, graduated with a degree in political science and joined the Army as an officer. He loved it -- the routine and discipline, the diversity and travel. HIV certainly wasn't on his mind. "We'd all read about something going on (on) the coast. How did that affect me?" Adams said. It did though. Adams got sick in 1983. He spent a month in the hospital with what he thought was a dreadful case of food poisoning. Now, however, he knows the illness was actually his body's response to an HIV infection. Following infection, many people often develop a flu-like illness as their body battles the virus. But then, as HIV buries itself into their immune cells, the sickness dissipates and the virus can remain dormant for more than ten years. Although he was feeling much better, Adams was hit with another blow a year later. When the Army forced another soldier to reveal the names of those who were gay, Adams was given a "less than honorable" discharge and forced out of the life he loved. He returned to Missouri. "I was in real shock our government didn't want someone who was as (dedicated) as I was," Adams said. His political views took a sharp turn to the left. In 1987, HIV tests came out. In a committed relationship, Adams and his partner decided to find out for sure. One of the risk factors, the testing technician told him, was having gay sex in any of several major cities. "I'd had sex in almost all of them. . . . By then I knew -- I knew HIV was possible." Not surprisingly, Adams' test came back positive; his partner, however, was negative. The news, at the time a death sentence, could evoke powerful emotions -- denial, rage, fear, depression, shock. Adams, however, took the news in stride. "I wasn't scared. You have to be responsible for your own choices," he said. Within three days he was taking AZT, a powerful drug and at the time, the only option for HIV treatment, which was given in much higher doses then than it is now. "I was really, really tired. I threw up a lot. It was really nasty," Adams said. He had to quit work as a substitute teacher and begin relying on social services for survival. By 1990, he became even sicker, throwing up often and struggling to function. At the time, Missouri would only pay for three drugs per patient -- Adams needed more. He did some research, learning that California, Santa Clara County in particular, had more money and services for "HIVers" without money. So after a few detours, Adams and his then partner moved to San Jose. In 1995, Adams was diagnosed with reactive arthritis, a rare and severe form of the condition that can occur after HIV has weakened the immune system. Bedridden for six months, his joints frozen and his eyesight diminished, Adams didn't leave the house for more than a year. Adams calls the time "a really weird period." "I've never been the type to get depressed about anything. I never felt sorry for myself. I just thought, 'I just don't want to live, if this is the way it's going to be.'" Then, gradually, life got better. Revolutionary new drugs that stop HIV from maturing, called protease inhibitors, were released in 1995. "Without them, I probably would have died. ... (They) made all the difference in the world," Adams said. He learned to walk again and figured out how to write using fat pens. And he met his current partner. "The reason I liked him so much was he asked, right away, 'What is your status?" Adams said. "There is this big 'Don't ask, don't tell' policy in the gay community." Adams' partner is negative. Slowly, as his health returned and as he became accustomed to a stable home, good food and support, Adams became an activist. "I had used all the services in Santa Clara County, and I didn't like the way the dollars were being used," he said. "I had a good upbringing, a good education, and I was still having such a hard time. . . . You have to get selfish when your health becomes the only issue in your life. Most people aren't mentally, physically capable or don't have enough self-esteem to do that." Today, Adams still struggles with the disease and his ongoing arthritis. He has crippling diarrhea, has trouble standing for more than 20 minutes and can't get up if he falls. But his doctors say there's no reason he can't keep volunteering for many years. "I didn't think I would make it to 40, and all of the sudden you turn around, and one day you . . . have a life." Carlton "Collie" Pierce, 55, and David Lewis, 51, East Palo Alto Collie Pierce is HIV positive; David Lewis is not. Pierce has glasses, a pocked face and a single golden earring. Lewis is imposing, with a trademark mustache and graying hair. Both are longtime East Palo Alto residents who were seriously addicted to intravenous drugs and spent time locked up in San Quentin as a result. And now, they're both working to help others in the grasp of drugs escape. Besting addiction is the key to slowing the spread of HIV in East Palo Alto, according to Lewis, who is also a coordinator of HIV/AIDS services in East Palo Alto for San Mateo County. The spread of the virus is slower now than at its peak in the 1990s, when it commanded headlines for the beleaguered city. Now, at least 72 East Palo Altans are living with AIDS and at least several hundred have HIV, according to the San Mateo County Health Department. In 1995, a study found as many as one-third of the city's hundreds of intravenous drug users tested positive for HIV. Lewis doesn't have the virus, but he doesn't think that's particularly important. "In our community, it doesn't really matter," he said. Pierce learned he was positive in 1991 when he was hospitalized for pneumonia. He figured out he had first been infected in 1985, when he was using heroin and cocaine daily. "Just like so many other people, I didn't know it," Pierce said. "It's so scary that they go on living normal lives ... (sleeping with) multiple partners. ... I was one of those people." "My attitude was it would not and it could not happen to me. When I found out, I went on a death mission." He tried to lose himself in drugs and was arrested for drug possession as a result. His return trip to San Quentin, with HIV, was different, Pierce said. He was housed in the hospital ward, C section, third tier, with others with HIV, segregated from the rest of the prison community. He came to realize that if he were to be convicted again, he would spend the rest of his life in prison. Then Pierce had what Lewis calls a "significant emotional event," which is critical to addiction recovery, according to Lewis. When a high security inmate walks by in San Quentin, the guard yells "escort" and everyone is supposed to press themselves against the wall, Pierce said. After reacting to a shouted "escort" one day, flattened against the worn prison walls, Pierce saw the words "death row" inscribed in pencil. "For me, C section, third tier with HIV positive (people) was like death row. . . . I related to that (inscription)," Pierce said. "That was my last trip to prison. I made a commitment to do anything I could not to return." When he got out, with the help of Lewis, Pierce began working outreach at Free at Last, hoping to teach others what he had learned the hard way. He's been clean and sober for 11 years. "I try to be the best advocate I can. That's why I am so very open. People need to know," Pierce said. "It still goes on. You might not hear about it. But it still goes on; that's why they call it 'the quiet killer.' People are still spreading it; people are still dying." Pierce himself has been fortunate. He hasn't taken an HIV drug since 1999 and feels fine. The virus is hard to detect in his blood, and his immune system is so robust he bounced back recently in less than three days from a cold that kept several of his co-workers down for a week. Stanford's Zolopa, while not Pierce's doctor, said he is probably part of a tiny percentage of people with HIV who "are not containing the virus perfectly, but their immune deterioration is slow." He will probably eventually need medicine, Zolopa said. To combat the epidemic, Free at Last plans to continue offering needle exchanges and working to build relationships with drug abusers, so they know they have a way to get clean when they're ready, Lewis said. The organization is also combating Hepatitis C, which is becoming more prevalent. Hep C is a virus, transmitted with dirty needles, that attacks the liver. Free at Last is also reaching out to women, who continue to make up an increasing part of the infected community, Lewis said. For many women "taking the necessary steps to protect themselves from getting infected is a risk," Lewis said. Stephanie Marshall, 38, Hilmar, Calif. Hilmar is a small town in the Central Valley, a few miles south of Turlock. Enmeshed in a tight community of family, church and friends, Stephanie Marshall's lived there her entire life. Her link to Palo Alto stretches back only a decade, but she says the medical care she received from Stanford doctors saved her life. Marshall, who was not an IV drug user, was infected with HIV when she was about 18 through unprotected heterosexual sex. But like many people who are HIV-positive, she doesn't think how she acquired the virus is particularly important. "We get this illness because of choices we made. ... We have to stand up and take responsibility," Marshall said. "We choose not to use protection. It's nobody's fault but our own. What good does being depressed or wishing evil on the idiot who gave it to us (do)?" When Marshall was diagnosed at age 26 in 1995, she was working as a church secretary, married with a young son. Both her husband and son tested HIV negative. Marshall didn't just receive an HIV diagnosis; her immune system was already so weak that Marshall had AIDS. "I knew nothing about AIDS. We don't have a large homosexual community. I didn't know anybody who had it. It just wasn't in my radar," Marshall said. She quickly learned. "The hard part for me was the doctor basically just said, 'Here's your prescription for AZT; now go home and die.'" Self-described as "sassy," dying wasn't in Marshall's plans. She refused to take AZT, however. Why take a drug that would make her so sick? And as she got sicker, she decided to let everyone in the community know. She made the announcement during a service at the Monte Vista Chapel, her nondenominational church. "The doctors got up and explained how you get it and how you don't get it. The elders laid hands on me," Marshall said. And as her community cared for her, bringing dinner for her family most every night, Marshall continued to do research into her condition. Then she fell in with a group that didn't believe HIV caused AIDS. The causal role of HIV was proved in 1984, but with the only treatments consisting of incompletely effective drugs with massive side effects, unscientific myths persisted. Marshall went to Santa Cruz for a bit to live with an aunt. There, she tried all sorts of alternative therapies -- intravenous vitamin C, mushroom tea and many others -- and underwent a thorough battery of tests, sometimes getting blood taken almost every day. Nothing capable of causing her symptoms, other than HIV, could be found. Marshall began to accept the virus was responsible for her illness. Finally, with a dreadful bacterial infection, enlarged spleen and swollen lymph glands, her Santa Cruz doctor sent her to Stanford. She met Zolopa in 1997. At the time, she weighed only 90 pounds and was wasting away, Zolopa said. He asked why she wasn't taking AZT, Marshall recalled. Marshall explained she didn't want to take such a harmful drug. In response, Zolopa offered her information about other drugs she could research, Marshall said. She hadn't known there were other drugs available. "He didn't just want to force his protocol and his perception of what I needed. (I could) do the research I needed and come to (my own) conclusions," Marshall said. Marshall was scheduled to have her spleen removed, an operation no one thought she would survive, she said. Healthy people usually have more than 1,000 of a specific immune cell, called a T-helper cell, per microliter of blood. Marshall, at her lowest, had only three. An individual has AIDS if his or her T-cell count slips below 200. Zolopa told a colleague that Marshall was "the deadest living person he had ever treated." Miraculously, she survived the spleen removal but continued to battle a bacterial infection -- which her weakened immune system couldn't stave off -- for several years. Now, Marshall drives to Palo Alto only four times a year. Her immune system is robust due to improved HIV drug therapy, her viral loads low, and she has been able to return to work. "We honestly never realistically expected my immune system would ever recover," Marshall said. Marshall's son is grown now, and she was divorced last year. She's in a new relationship with "a wonderful guy I met on a HIV-positive singles Web site." "We understand where we're both coming from. ... We have each others' back." Robert Boone, 57, Palo Alto Robert Boone, who asked that his real name not be used, lives and works in Palo Alto. Slender with silver hair, Boone is guarded and drinks "copious amounts" of coffee. Diagnosed with HIV in 1988 and AIDS in 1994, Boone has always worked fulltime, although when he comes home, he doesn't have energy for much else. Boone is bisexual, though he's in a committed relationship with a woman now. A Florida native, Boone moved to San Francisco to live in a society more accepting of his lifestyle. For about 13 years, Boone said he was very promiscuous. "Did I play safe? Obviously not safe enough," Boone said. "In 1980, I decided it was time to grow up and be respectable," Boone said. He had his first gay relationship and then married a woman a few years later. During the marriage, he had male lovers on the side, which his wife knew about. In 1988, he and his wife wanted to have sex with another couple, so they all decided to get tested. The others were negative; Boone tested positive. "I definitely knew it was in the realm of possibility. Was I expecting it? Probably not," Boone said. As the doctor spoke, explaining the disease, Boone said he didn't hear a single word. The doctor had to discuss the diagnosis with his wife. "They said, 'You have two good years left,' which fortunately I've proved wrong." Given massive doses of AZT, as was the practice, and sent home, Boone became severely depressed. "I did the dumb thing of not trying to get treated for it," Boone said. His marriage started to unravel. "It put a real damper on our sex life, to say the least," Boone said. "I'm just as much at fault. But finally she said, 'I just can't deal with you being sick.'" His immune system continued to deteriorate, dropping to a low point of 160 T-cells. Nonetheless, Boone still worked 40 hours a week. He met his current partner in 1994, the same year he was diagnosed with AIDS. "Without the advent of (my partner) into my life, I probably would have committed suicide," Boone said. This time, he sought out medical treatment for depression. "Things started to level out and then go upwards." Boone jokes that he got his "green card to Palo Alto" in 1995. Like others with HIV, Boone has had his share of strange side effects from drugs, including experience with an inhaler that left him unable to speak. Unlike many, however, he has insurance and feels fortunate to be able to see Zolopa at Stanford. "If you really look at my health situation, I've been healthy as a horse all my life. Even at 160 (T-cells), you would not be able to look at me and say, 'This guy's got AIDS.'" Brown said he has a love/hate relationship with the drugs. "Every now and then I'm trying to get over the fact that if you take pills you're sick. I'm not sick, but I take pills." AIDS is like diabetes now, Boone said, something you can live with. "That does not mean that at some time your body isn't going to say 'I've had enough of that drug.' That's the scary part ... and, and, and 'Is this the beginning of the end?'" Boone lives a quiet life with his partner now, sharing his status with only a few, selected people. "I've given up the men in my life," Boone joked. Boone is slow to preach or judge others' behavior. "I told my mom, 'It doesn't matter how I've got it, the fact is, I've got it.' ... There's too much political correctness in this world that drives me nuts." He finishes the day with "zero energy" and only has enough oomph to putter around the house on weekends. But he, unlike many, many of his friends, is still alive. Source: http://www.paloaltoonline.com/news/show_story.php?id=4800 generic viagra online cheap viagra viagra generic cialis

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