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LH_
Member for 0 years
This looks interesting...I wish to join this rp...may I reserve a place? I'm writing my char as 'descriptive' as possible...I'll submit my char soon
EDIT: err...I have a question...well, several questions:
Can our chars have special abilities? Like controlling the elements? Flying or stuffs like that?
and when you say races? What kinds of races?
blackwolf
Member for 1 years
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This catalog cover provided by J.C. Penny, shows the February, 2012 catalog. Penney said Wednesday, Jan. 25, 2012, that it is getting rid of the hundreds of sales it offers each year in favor of a simpler approach to pricing. On Feb. 1, the retailer is rolling out a three-tiered strategy that offers ?Every Day? low pricing daily, ?Monthly Value? discounts on select merchandise each month and clearance deals called ?Best Price? during the first and the third Friday of each month when many shoppers get paid. (AP Photo/J.C. Penney)
This catalog cover provided by J.C. Penny, shows the February, 2012 catalog. Penney said Wednesday, Jan. 25, 2012, that it is getting rid of the hundreds of sales it offers each year in favor of a simpler approach to pricing. On Feb. 1, the retailer is rolling out a three-tiered strategy that offers ?Every Day? low pricing daily, ?Monthly Value? discounts on select merchandise each month and clearance deals called ?Best Price? during the first and the third Friday of each month when many shoppers get paid. (AP Photo/J.C. Penney)
NEW YORK (AP) ? J.C. Penney is permanently marking down all of its merchandise by at least 40 percent so shoppers will no longer have to wait for a sale to get the lowest prices in its stores.
Penney said Wednesday that it is getting rid of the hundreds of sales it offers each year in favor of a simpler approach to pricing. On Feb. 1, the retailer is rolling out a three-tiered strategy that offers "Every Day" low pricing daily, "Monthly Value" discounts on select merchandise each month and clearance deals called "Best Price" during the first and the third Friday of each month when many shoppers get paid.
The plan, the first major move by former Apple executive Ron Johnson since he became Penney's CEO in November, is similar to Wal-Mart's iconic everyday low pricing strategy. The difference is that Penney's goal isn't to undercut competitors, but rather to offer customers more predictable pricing.
"Pricing is actually a pretty simple and straight forward thing," Johnson told the Associated Press during an interview ahead of the announcement. "Customers will not pay literally a penny more than the true value of the product."
Penney's plan comes as stores are struggling to wean Americans off of the profit-busting bargains that they have come to expect in the weak economy. The move is risky, though, because shoppers who love to bargain-hunt may be turned off by the absence of sales.
"The big question on investors' minds will be: 'How customers will react to a single price point versus a perceived discount under the old strategy?'" says Citi Investment Research analyst Deborah L. Weinswig.
Here's how Penney's pricing strategy will work:
? Sale prices become everyday prices. The company will use sales data from last year to slash prices on all merchandise at least 40 percent or lower than the previous year's prices. So, a woman's St. John's Bay blouse regularly priced at $14.99 could have the "Every Day" price of $7.
? Fewer sales. The retailer will pick items to go on sale each month for a "Monthly Value." For instance, in February, it might be jewelry for Valentine's Day and in December it could be Christmas decorations. Items that don't sell well would go on clearance and be tagged "Best Price," signaling to customers that's the cheapest price.
? New tags. The retailer used to pile stickers on price tags to indicate each time an item was marked down. But now each time an item gets a new price, it gets a new tag too. A red tag indicates an "Every Day" price, a white tag a "Monthly Value" and a blue tag a "Best Price."
? Simpler pricing. Penney will use whole figures when pricing items. In other words, you won't see jeans with a price tag of $19.99, but rather $19 or $20.
? New advertising. There will be an ad that shows shoppers screaming "No" to discounts as they look in their mailboxes, a pile of coupons and big sales signs. Talk show host Ellen DeGeneres will be the new spokeswoman for the chain. And a 96-page colorful catalog that highlights "Monthly Value" items will be mailed each month to 14 million customers, along with other promotional efforts.
The strategy, unveiled at Penney's investor meeting on Wednesday, comes as the retailer tries to turn around its business. Heavy discounting has hurt department stores like Penney. The group generates an average of about $200 per square foot, less than half the $550 or $600 stores like Victoria's Secret and Lululemon generate per square foot, according to John Bemis, head of Jones Lang LaSalle Inc.'s retail leasing team.
But Penney has been a laggard even among department stores as its core middle-class customers have been among the hardest hit by the weak economy. It's also failed to attract a younger, hip customer despite its efforts to add brands like Mary Kate and Ashley Olsen teen clothing collection. And its stores are described by some in the industry as "boring."
For the first nine months of fiscal 2011, Penney's revenue at stores opened at least a year ? an indicator of a retailer's health ? rose 0.9 percent, while competitors like Macy's Inc. rose 5.4 percent, and Kohl's was up 1.1 percent. Penney posted a loss in the third quarter and cut its fourth-quarter earnings outlook after a disappointing holiday season when it had to heavily discount to attract consumers. Penney's gross profit margin has shrunk for six straight quarters.
The pricing strategy caps months of speculation about what Penney's future might look like under the leadership of Johnson, a former Target Corp executive and the mastermind behind the success at Apple Inc.'s stores.
Johnson, who joined the company's board in August, has begun to put his stamp on the retailer. He has tapped former colleagues at Apple and Target to join him at Penney. That includes Target's top marketing executive Michael Francis to be Penney's president.
Because of the success Johnson has had turning Apple stores into hip places to hang out and shop, many industry watchers were waiting with bated breath to see what he'd do in Penney's stores. In December, Penney announced that it will have homemaker doyenne Martha Stewart develop mini-shops starting next year.
And during Wednesday's meeting, Penney executives outlined plans to transform its stores by 2014. That will include Main Street, a series of 80 to 100 brand shops similar to the Sephora cosmetics ones it has in stores to replace the dozens of racks common in department stores. It also plans to open areas in all stores called Town Square, a place that will offer services and expert advice.
But perhaps the biggest challenge for Johnson and his management team will be to sell shoppers on its new pricing. For years, Penney, like many other stores, has artificially propped up ticketed prices even as costs have come down slightly over the past decade. The intent: to make it look like shoppers are getting great discounts.
Penney has been an especially big promoter. Last year, the company, which offered 590 sales events last year, had about 72 percent of its revenue come from merchandise that was discounted by 50 percent or more.
That's more than double the industry average. According to an estimate by management consultant firm A.T. Kearney, a typical retailer sells between 40 and 45 percent of its inventory at a promotional price, up from 15 to 20 percent 10 years ago.
The increased discounting has been a vicious cycle that only feeds into shoppers' insatiable appetite for bigger and better discounts. In fact, whereas it took 38 percent off to get shoppers to buy 10 years ago, it now takes discounts of 60 percent, Johnson says.
At Penney, the regular price on an item that costs $10 to make rose 43 percent, from $28 in 2002 to $40 in 2011. But because of all of its sales and other promotions, what it actually ended up selling for rose only 15 cents, from $15.80 to $15.95 during that same period.
"I have been struck by the extraordinary amount of promotional activity, which to me, didn't feel like it was appropriate for a department store," Johnson says. "My instinct was that it wasn't a good thing. Once you start to promote, the only way to beat a promotion was to make it bigger."
Walter Loeb, a New York-based retail consultant, says Penney's new pricing strategy is "visionary" and revolutionary."
But Charles Grom, a retail analyst at J.P. Morgan, says it will be difficult for Johnson to change shoppers' buying habits. Macy's, for example, cut back on coupons a few years ago, only being forced to ramp it back up after seeing sales suffer.
"Shopper fatigue has been building for several years," Grom says. "He has a lot of wood to chop."
DORAL, Fla. ? Republican Newt Gingrich says Mitt Romney's call for self-deportation of illegal immigrants is an "Obama-level" fantasy that is inhumane to long-established families living in America.
The former House speaker ridiculed that part of Romney's immigration policy during a forum Wednesday with the Spanish-language network Univision. Gingrich laughed at the idea and said it wouldn't work.
Romney said during a recent debate that he favors what he calls "self-deportation" over policies that require the federal government to round up illegal immigrants and send them back to their home countries.
Gingrich says Romney's proposal reflects a candidate who lives, in his words, "in a world of Swiss bank accounts and Cayman Island accounts." That was a jab at Romney's wealth.
Romney was taping his own segment with Univision later Wednesday.
There is a lot that goes into making a house green, and we don?t mean just slapping a coat of paint on it. Building an energy efficient home is hard enough, let alone maintaining a home that doesn?t harm the environment by wasting resources and over consuming energy. Little things like switching off the lights and adjusting the thermostat go a long way in conserving energy, but it isn?t always easy, and it can be difficult fiddling with all of that on a day to day basis. Enter the Southern California Institute of Architecture (SCI-Arch) and California Institute of Technology (Caltech) and their easy-to-use CHIP Solar House, a cutting-edge solar home you control with a wave of your hands and the help of Xbox Kinect.
CHIP, which stands for Compact, Hyper-Insulated Prototype Solar House utilizes an Xbox Kinect as its means of control. Tasks like turning off the lights or turning down the thermostat can now be accessed through gesture controls. Wave your arm or flick your wrist, it doesn?t matter. CHIP was designed to make maintaining an energy neutral home as streamlined as possible. The house even features a 3-D camera that can go a step further by tracking your movements and auto-switching off a light when you leave a room. Who said being green wasn?t easy?
Of course besides being unique on the inside, the CHIP Solar House also carries with it a distinct look with its insulation stretched around the exterior of the house (resembling the material found on the inside of a padded cell). The house measures 750-square feet and took over two years, more than 100 students, and $1 million to build?however according to SCI-Arch and Caltech, the house could be replicated for as little as $300,000. So while being green might be easy, it isn?t exactly cheap.?
This article was originally posted on Digital Trends
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WASHINGTON ? Strong backing from conservative and religious voters and people fretting about the uncertain economy fueled Newt Gingrich's victory Saturday in South Carolina's Republican presidential primary, an exit poll of voters showed Saturday.
The figures also showed that for the first time, the former House speaker had grabbed two constituencies that his chief rival, Mitt Romney, has captured in the year's two previous GOP contests in Iowa and New Hampshire. By slight margins, he bested Romney among voters looking for someone to defeat President Barack Obama this November, and those who considered the economy the top issue in deciding which candidate to back.
Gingrich benefited most from the campaign's final, tumultuous week, the figures showed. Just over half said they'd chosen a candidate in the last few days, and they backed Gingrich over Romney, the former Massachusetts governor, by 2-1. By a slightly stronger margin, the roughly two-thirds who said campaign debates were an important factor also supported Gingrich. There were two GOP debates in South Carolina during the past week.
In the last days of the campaign, Romney stumbled badly when asked repeatedly whether he will release his income tax returns. Gingrich endured an allegation by one of his two former wives, Marianne, that he had asked permission for an open marriage while he was having an affair with his current wife, Callista.
That accusation seemed to take only a slight toll on Gingrich. Gingrich got less than 10 percent support from people who said what they most wanted in a candidate was strong moral character, but these voters were less than 1 in 5 of those who showed up Saturday at the polls.
In addition, Gingrich did slightly better than Romney among women, and polled a bit more strongly among married than unmarried women.
Gingrich won healthy margins among the state's conservatives, who comprise more than 6 in 10 voters in the state. While that was bad news for Romney, it was even more damaging to Rick Santorum, the former Pennsylvania senator who has been dueling with Gingrich to become the GOP's conservative champion and alternative to Romney.
Gingrich won among conservatives and tea party supporters by nearly 2-1 over Romney. Santorum was slightly behind.
Illustrating the sweep of Gingrich's victory over Romney, Gingrich triumphed among all age groups. The only income group that Romney won was people making above $200,000 a year ? 1 in 20 of those who voted Saturday.
Nearly two-thirds of voters Saturday said they are born again or evangelical Christians, and they backed Gingrich over Romney by 2-1 also.
More telling, 6 in 10 voters said it was important that their candidate share their religious beliefs. Nearly half of such voters backed Gingrich, while only around 1 in 5 chose Romney or Santorum.
About 8 in 10 voters said they were very worried about the direction of the country's economy, and they picked Gingrich over Romney by about a 4-3 edge.
Romney's earlier career heading Bain Capital, a venture capital firm, clearly wounded his prospects. During much of the campaign, Gingrich and others accused Romney and his company of killing jobs in the companies they bought and restructured.
Those blows showed on Saturday. According to the exit polls, Gingrich and Romney broke about even among the 6 in 10 voters who said they had a positive view of Romney's activities at Bain. But among those who viewed Romney's work negatively, half picked Gingrich and almost none backed Romney.
Underscoring how poorly Romney fared in South Carolina, only about 4 in 10 voters Saturday said they could enthusiastically back Romney should he eventually win the GOP nomination.
The survey was conducted for AP and the television networks by Edison Research as voters left their polling places at 35 randomly selected sites in South Carolina. The survey involved interviews with 2,381 voters and has a margin of sampling error of plus or minus 3 percentage points.
___
Associated Press global polling director Trevor Tompson contributed to this report.
GREENVILLE, S.C. ? Mitt Romney says he will attend the next GOP presidential debates in Florida, which is next up on the election calendar.
After last weekend's two debates in South Carolina, advisers to the former Massachusetts governor had said the candidate hadn't committed to any more campaign debates.
But Romney said Saturday, on the day when South Carolinians are voting in their state's GOP primary, that he will be at the Tampa debate, and advisers say he also will participate in the Jacksonville debate on Thursday.
His commitment to the debate might be a sign that he doesn't think he will do as well as first thought in South Carolina against rival Newt Gingrich and will need to continue the fight in Florida.
The Florida primary is Jan. 31.
THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.
Mitt Romney is heading into primary day conceding that he'll win some and lose some.
Romney on Friday acknowledged the contest here is "neck-and-neck" and said he expects to lose "some primaries" to rival Newt Gingrich, the former House speaker.
As voters head to the polls Saturday, Romney and Gingrich both planned to appear at the same breakfast restaurant in the morning. Both campaigns refused to change their schedules Friday night, potentially setting up a face-off between the two men ahead of the polls closing.
The past week has been an abrupt reversal of fortune for the former Massachusetts governor, who landed here last Wednesday after a big victory in New Hampshire and what was then a narrow win in Iowa.
But this week the Iowa GOP reversed his win there after problems with the vote count, and he's been dogged by questions about releasing his tax returns. And instead of emerging from South Carolina with three wins and a seeming lock on the GOP nomination, Romney and his team are now acknowledging they could lose here. That would leave the putative front-runner with just one early state win heading into Florida's Jan. 31 primary.
Romney's campaign planned at least two campaign stops Saturday ahead of polls closing. He planned to visit his campaign headquarters and Tommy's Country Ham House, where Gingrich also planned to stop. Romney was to end the day in Columbia, the state capital.
STATE COLLEGE, Pa. ? Penn State's Board of Trustees elected banking executive Karen Peetz to lead the embattled board and help the school negotiate the aftermath of a nightmarish child sex abuse scandal involving a former assistant football coach.
The trustees picked Peetz to be president of the 32-member board in a voice vote Friday. She is vice chairman of The Bank of New York Mellon. The trustees also elected farm owner Keith Masser as the vice chair. Like Peetz, he was unopposed.
They're replacing Steve Garban and John Surma, respectively, who guided the board in the two tumultuous months since Jerry Sandusky was charged with dozens of counts of child sex abuse. They decided not to run for another yearlong term as board officers.
Under Garban and Surma's watch, the board ousted football coach Joe Paterno and promised to uncover the truth behind the Sandusky case and Penn State officials' involvement in it through an internal investigation.
In recent weeks, the trustees have felt increasing heat from some former alumni and players critical of how Paterno's firing was handled, and what's been seen as a lack of openness on the board.
"The first thing I want to say to the entire Penn State community is that we have been through a very difficult experience together. We have tried to do the right thing," Peetz said. "All of us, including the board, with the wisdom of hindsight could have done things differently."
She said the board agreed it would focus on three themes ... "the first is change, the second is reform and the third is transparency."
Sandusky, a longtime defensive coordinator who helped Paterno win two national titles, is out on bail and awaiting trial after denying charges that he abused 10 boys over 15 years.
The scandal resulting from his arrest Nov. 5 has had wide-ranging implications going beyond Paterno and the storied football program.
Since Sandusky was charged, the university has cited its status as a state-related university ? along with Temple, Pitt and Lincoln ? in denying requests by The Associated Press for documents related to a 1998 investigation into Sandusky that began when a woman complained he had showered with her son, a copy of his severance agreement and emails among top administrators about Sandusky.
Some state lawmakers have called for a change in the commonwealth's three-year-old open records law to get rid of an exemption that allows Penn State and the other state-related universities to keep their operations out of the public eye while receiving taxpayer money.
"We have to decide, the board has to decide, whether they're going to be a public entity that receives public funds or a private entity," said Gov. Tom Corbett, who also is a trustee. "But it is something that is incumbent on the board in the next few weeks and months that the decision has to be made."
The board is also undertaking its own investigation into the case. Ken Frazier, the trustee overseeing the effort, said results of the probe may now not come until next fall ? if then. Frazier added there was no "artificial timetable" ? he wants to give investigators ample time for thorough questioning.
Trustees have tabbed former FBI director Louis Freeh as their lead investigator. Frazier maintained Freeh, who has an office on campus, had free rein over the investigation and would not be beholden to pressures from the board or other university administrators.
Peetz also reiterated that the university "will find a way to make sure Penn State helps the victims of this tragedy.
"Immediately, we will reach out to the victims we know of and seek to pay for their abuse-related health costs, to pay for related counseling that they've had to have to date and pay for counseling going forward related to abuse," she said. School President Rodney Erickson declined to give a range about how much it might cost.
General counsel Cynthia Baldwin said the university has been served legal notice that it was the subject of a second civil complaint related to the Sandusky case, though the lawsuit had not been filed. The first known civil suit was filed in late November.
The departures of Garban and Surma from leadership positions had nothing to do with the investigation, Frazier said. Garban had decided in November to step aside as the chairman, citing his past ties to the university and as a former football player.
Surma, an executive at U.S. Steel, said the duties of the board during the scandal increasingly took much time away from his job.
The board also approved five recommendations from Freeh, including a strengthening of school policies for programs involving minors; prompt reporting of allegations of abuse; and increased security measures within the athletic department.
It was the trustees' first meeting since the chaotic week in November after Sandusky was charged, when Paterno was dumped and former school president Graham Spanier also was pushed out.
The meeting, in the ballroom of a campus hotel, drew a larger-than-normal crowd of at least 200 people, including a couple of candidates hoping to win election to the board this spring. Former Penn State running back Franco Harris, a vocal critic of the administration and a Paterno supporter, also attended and held a question-and-answer session afterward attended by about 100 people.
They listened to Harris and another critic, prominent donor and alumni Anthony Lubrano, air their grievances about the firing of Paterno and the way Penn State's Board of Trustees functions. There were several white poster boards propped up in the front of the room with famous Joe Paterno quotes.
The crowd was very receptive to the duo, nodding their heads with each points and, at times, erupting into applause.
"It's going to take people like you, here in this room, spreading the word," Harris told the crowd. "It's not a Penn State sex scandal, it's not a Penn State football sex scandal, it's not a Joe Paterno sex scandal. It's a Jerry Sandusky sex scandal. And what the board did was wrong."
The trustees have said Paterno was ousted in part because he had a moral obligation to pass on to police a 2002 allegation that was relayed to him by a graduate assistant. Paterno told his superiors at the university about the accusation, and authorities have said the coach is not a target of their criminal investigation.
"We still have respect and gratitude for coach Paterno's legacy and for his many contributions to Penn State," Peetz said, "and to (fired school President Graham) Spanier for his years of dedicated service and leadership."
She said they intended to honor Paterno at a future date, though the timing was uncertain given Paterno is being treated for lung cancer.
COLUMBIA, S.C. ? Former House Speaker Newt Gingrich took a giant step Saturday toward becoming the Republican alternative to Mitt Romney that tea partyers and social conservatives have been seeking for months.
Gingrich's come-from-behind win in the South Carolina primary snatches away the quick and easy way for the GOP to pick its presidential nominee. Only days ago, it seemed that party activists would settle for Romney, the former Massachusetts governor who stirs few passions but who has the looks, money, experience and discipline to make a solid case against President Barack Obama in November.
Now, the party cannot avoid a wrenching and perhaps lengthy nomination fight. It can cast its lot with the establishment's cool embodiment of competence, forged in corporate board rooms, or with the anger-venting champion of in-your-face conservatism and grandiose ideas.
It's soul-searching time for Republicans. It might not be pretty.
Romney still might win the nomination, of course. He carries several advantages into Florida and beyond, and party insiders still consider him the front-runner. And it's conceivable that former Pennsylvania Sen. Rick Santorum can battle back and take the anti-Romney title from Gingrich. After all, he bested Gingrich in Iowa and New Hampshire.
But Santorum's third-place finish in South Carolina will doubtlessly prompt some conservative leaders to urge him to step aside and back Gingrich, as Texas Gov. Rick Perry did Thursday.
Even if Santorum revives his campaign in Florida, the fundamental intraparty debate will be the same. Voters associate Gingrich and Santorum with social issues such as abortion, and with unyielding fealty to conservative ideals. That's in contrast to Romney's flexibility and past embraces of legalized abortion, gun control and gay rights.
Texas Rep. Ron Paul will stay in the race, but he factors only tangentially in such discussions. His fans are largely a mix of libertarians, isolationists and pacifists, many of whom will abandon the GOP nominee if it's not the Texas congressman.
Strategically, Romney maintains a big edge in money and organization. He faces a dilemma, however. Gingrich resuscitated his struggling campaign in this state with combative debate performances featuring near-contempt for Obama and the news media. Romney likely would love to choke off that supply by drastically reducing the number of debates.
Ducking Gingrich after losing to him in South Carolina would suggest panic or fear, however, and all four candidates are scheduled to debate Monday in Florida.
Gingrich is benefitting "from the inherent animosity and mistrust GOP primary voters have with mainstream media," said Republican strategist Terry Holt. "Their first instinct is to rebel, and that's what they did. The question is whether he can sustain that anger and build it into a legitimate challenge to the frontrunner."
Gingrich tried to stoke that anger with his victory speech Saturday. He referred repeatedly to "elites" in Washington and New York who don't understand or care about working-class Americans. He decried "the growing anti-religious bigotry of our elites."
Gingrich made $3.1 million in 2010, but he nonetheless is tapping middle-class resentment in ways reminiscent of Sarah Palin. "I articulate the deepest-held values in the American people," he said.
Despite their contrasting personalities, Romney and Gingrich don't differ greatly on policy. Both call for lower taxes, less regulation, ending "Obamacare" and a robust military. They promise to cut spending and increase jobs without offering many details of how they would do so in a divided nation and Congress.
Romney vs. Gingrich in some ways mirrors the Democrats' 2008 choice between Obama and Hillary Rodham Clinton, which turned mostly on questions of personality, style and biography. The Republicans' choice, however, will plumb deeper veins of emotion and ideology.
Romney appeals to Republicans who want a competent, even-tempered nominee with a track record in business and finance. His backers are willing to overlook his past support of abortion rights and his seeming tone-deafness on money matters ? even if it feeds caricatures of him as a tycoon.
Until Saturday, GOP polls had shown Romney easily ahead on the question of who would be Obama's toughest challenger. South Carolina exit polls, however, showed Gingrich with an edge among those who said it was most important that their candidate be able to beat Obama.
Romney will try to regain that advantage in Florida, which votes Jan. 31. It's not clear what strategies will work. In his concession speech Saturday, Romney said Obama has attacked free enterprise and "we cannot defeat that president with a candidate who has joined that very assault on free enterprise."
He was alluding to Gingrich's past criticisms of Romney's record running Bain Capital, a private equity firm. But Gingrich and a friendly super PAC dropped their references to Bain days ago.
Romney hinted at another approach. "Our party can't be led to victory by someone who also has never run a business and never led a state," he said. Gingrich's background didn't seem to bother South Carolina's Republicans, however.
What they've done is steer the primary contest into more emotional, and possibly dangerous, waters. They rewarded a candidate who gave voice to their resentment of the news media, federal bureaucrats and what they see as undeserving welfare recipients and a socialist-leaning president.
Two South Carolina debate moments crystalized Gingrich's rise. Both involved an open disdain for journalists, whether feigned or not.
In Myrtle Beach on Monday, the Martin Luther King holiday, Gingrich acidly told Fox News' Juan Williams that he would teach poor people how to find jobs, and that Obama has put more Americans on food stamps than any other president. Gingrich repeated the food stamp lines in his speech Saturday night.
At Thursday's debate in North Charleston, Gingrich excoriated CNN's John King for raising an ex-wife's claim that Gingrich once asked for an "open marriage," to accommodate his mistress.
Conservatives inside the hall and out seemed to love the tongue-lashing. The details of Marianne Gingrich's allegations, which Gingrich denied almost as an afterthought, seemed to matter much less to voters. That's remarkable in a state whose GOP electorate is nearly two-thirds evangelicals.
Mike McKenna, a Republican strategist, said Gingrich seems to be drawing many people, including tea party activists, who are fairly new to politics. They don't know or care much about Gingrich's legacy of leading the 1994 Republican revolution in Congress, or his subsequently lucrative career as a writer and speaker that sometimes veered from conservative orthodoxies, McKenna said.
Instead, he thinks these voters are reacting emotionally to someone they hope "can take the fight to the president, to the media, to whomever. They are not particularly concerned about what kind of president he will be."
Therein, of course, is the potential peril of a Gingrich candidacy. Along with his verbal fireworks he carries baggage that might give Democrats more to exploit than do Romney's policy flip-flops and record at Bain.
Gingrich's impressive South Carolina victory will force Republicans in Florida and other states to make a hot-or-cool choice.
They can pick the data-driven Harvard MBA grad who smoothed out the Winter Olympics and now runs a by-the-numbers nationwide campaign. Or they can pick the pugnacious firebrand who didn't manage to get his name on the Virginia primary ballot but who wows an angry electorate that can't wait to lay into Obama in debates next fall.
___
EDITOR'S NOTE: Charles Babington covers politics for The Associated Press.
>>few days ago showed
mitt romney
with a wide lead in
south carolina
, but the
romney
campaign sensing a change in the winds has been trying to tamp down expectations as it ratchets up its attacks on
newt gingrich
.
peter alexander
has that end of the story. good evening to you.
>> reporter: lester, good morning to you. and roomy took the afternoon off, in fact, to relax and he took his family to the movies today. regardless of what happens here this evening, governor
romney
's advisers say he's in this for the long haul. for the
romney
campaign, proudly meticulous about every detail, that visit to tommy's country hamhouse featured an oversight that summed up a week's worth of stumbles.
>>we came here.
>> reporter: the crowd couldn't hear the candidate because his campaign didn't bring its own microphone. all week
romney
who is largely focused on attacking
president obama
--
>>repeal obamacare --
>> reporter: has struggled to fend off jabs from his rivals.
newt gingrich
and santorum and sidetracked about his personal wealth and wavering answers about whether he'd release his tax returns.
>>maybe. i'll take a look at what the -- what our documents are.
>> reporter: saturday morning
romney
tried to slow gingrich's momentum, and talking about the contract he signed with
freddie mac
.
>>this is a big issue, got the washington insiders, talking about
freddie mac
. let's see what the report was to
freddie mac
. what advice he gave them.
>> reporter: the
romney
campaign levelled this sarcastic attack, wishing again dprigingrich a happy anniversary. part of the increasing nasty campaign that has some voters turned off.
>>even got carolina to answer some. just hanging up. we're not listening to the messages.
>> reporter: still as
romney
looks to lower expectations here, his advisers are already touting their head start in florida.
>>we have a long way to go. come join us in florida. then in nevada and michigan and colorado.
>> reporter: but first,
romney
appears to have a few chores. today, his son tweeted this photo. showing the former governor doing laundry. and the next time we expect to see all four of the
republican presidential candidates
together, lester, is monday night in tampa. that of course is nbc news's
presidential debate
.
Of all of Russia's opposition leaders, none have posed a bigger threat to the government of Prime Minister Vladimir Putin than the blogger and activist Alexei Navalny. A lawyer by training and a nationalist by conviction, Navalny, 35, has been at the forefront of the demonstrations that shook awake the Russian body politic last month, bringing tens of thousands of protesters onto the streets of Moscow for the first time since the fall of the Soviet Union. A few days after the third and biggest demonstration on Dec. 24, when Navalny addressed a crowd of 100,000 people in Moscow, TIME's Simon Shuster caught up with him at a courthouse, where he was arguing a case for greater transparency at Russia's largest oil company, Rosneft. He drove back to his office afterward, where he runs a small legal firm, to continue discussing his plans for toppling Putin's government.
Before the recent wave of opposition protests, you were best known as an activist against corruption. But you've said that you had your eye on politics the whole time. How are these two aspects of your work connected? I've always seen my campaigns against corruption as political work of a purer form than what opposition leaders usually do. All they do is hold roundtables and release political statements, which is all well and good. But there are concrete things that need to get done in order to achieve the basic goal of every opposition politician. That goal is to replace the people in power by putting pressure on the regime. One way to do that is to release political statements and appear on the radio. Another way is to file lawsuits against corrupt state corporations. I take the second approach. And it's very important to carry this through to the end, because my political work needs to always have new substance to it. Everyone needs to understand that my work addresses existing problems, and one of the crucial problems in Russia today is corruption. (See photos of massive protests in Moscow.)
Many observers have been quick to compare last month's demonstrations to the Arab Spring. Is this the way you envision it? Will Moscow have a revolution like the one on Kiev's Maidan Square in 2004? The one on Tahrir Square in Cairo last year? Or something else? What we need is a peaceful scenario. Both Maidan and Tahrir were peaceful. Maidan was absolutely peaceful, Tahrir saw some unrest but was still peaceful on the whole. At this point, the authorities need to understand that they can prevent a Maidan by meeting our demands. If they don't, then we will continue to see peaceful protests in the streets. This is nothing new. Gandhi did it in his day, as did Martin Luther King. It's a time-tested method. The people come out onto the streets. They don't go fighting anyone or burning cars. They just stand there. Humanity has this historical experience of fighting injustice and tyranny. The way to proceed is by using this experience.
Who or what finally brought Russians out onto the streets after years of political apathy? The mood of defiance brought them out. This is impossible to organize or orchestrate. I can't organize it because the people don't listen to me. When I worked at Yabloko [a liberal political party, where Navalny was an activist between 2002 and '07], we would try to organize a rally and 500 people showed up. But now there is a wave rising. Some people can claim to stand at the cusp of this wave, and yes, they can stand at the podium and address the crowds. But they didn't make this wave. Putin was the one who made this revolution. By falsifying the elections [on Dec. 4], Putin brought these people onto the streets. If he hadn't rigged the [parliamentary vote on Dec. 4] in Moscow, nothing would have happened. But no, they tried to bust through at the joint and ended up insulting so many people that there was a backlash. The people went into the streets. This is a natural reaction for any person. This has been happening for hundreds and thousands of years. They came out and said, 'That's it. No. We don't want this anymore. We want to do things differently.'
See photos of protests and counterprotests in Russia.
The Kremlin has started offering concessions in response to the protests. For one, it has proposed a law making it easier to register political parties. You've said that you want to create a party of your own. What will be the structure of this party and its political priorities? Our goal is to make a party that is massive, effective and cheap. The last point is not the least important. We just don't have any money. We need to use new technologies, first of all the Internet, for the practical functions of the party, like a reconstituted Facebook. Many people call it Democracy 2.0. I'm a lobbyist and fanatic of this system. It should allow people to register online and verify their identities through a bank card or by some other means, and then let them take part in [the party's] decisionmaking, voting and so on. This gives a guarantee that everyone votes, that there is no vote rigging, that everything is open and there is legitimacy. This does not mean that the party is virtual and not real. In the present day, the split between the virtual and real worlds is irrelevant. The protest on Bolotnaya Square [on Dec. 10], was it real or virtual? Yes, it was organized by virtual means, on Facebook. But I think it was more than real enough. (Read "Occupy the Kremlin: Russia's Election Lets Loose Public Rage.")
But half of the Russian population does not have Internet access. Would your party just ignore them? Every party looks for its own constituency. I can rely on people in big cities, where there is plenty of Internet penetration. Of course, I would like to attract people from villages, but I don't have money for that. What we do have already is a pool of millions of people we can reach through the Internet. We can reach them efficiently and on a daily basis. Sure, I would love to go talk to every grandma who lives in some village in the Ryazam region, but I don't have that possibility. You can only reach such people through television, but we don't control the television channels. So it's pointless to even talk about.
Nationalism has always been at the core of your politics. You have called for tight control of immigration, for the right to bear arms, and you have said that the Movement Against Illegal Immigration, a group banned last year for extremism and hate speech, is "as harmless as the girl scouts." Will your party represent these values? Will it be a nationalist party? Consistency for me is everything. I am not ready to back away from my views. With age, everyone forms certain core principles, and I have a basic stand on the main issues. I only see one problem with my views. Maybe I didn't explain them clearly enough. That means I will keep explaining them, because people aren't afraid of my views. They are afraid of the word nationalism. (Read "Russia: The Revolution Will Be Tweeted and Facebooked and YouTubed.")
By necessity, we have no other way to refer to these views but as nationalism. The problem is that people associate this word with some abstract nationalist menace. But when people talk about the nationalism of Navalny, we're talking about very simple things. I support limits on illegal immigration, including through visa requirements for visitors from Central Asia. When you enter the U.S., you need to give fingerprints. Yes? Yes. Did the U.S. build a wall on the border with Mexico? Yes, it did. And Obama voted for that wall. So how is my position on immigration more nationalistic than even the Democrats in the U.S.? Few American politicians would step out in support of visa-free travel with all of Latin America. But we have a visa-free system with Central Asia. And when it comes to arms control, yes, I think that arms should be more accessible to our citizens. At home I have two rifles, and do I go shooting people out my window? No. We have hundreds of thousands of hunting weapons in circulation, and the number of crimes committed with legally registered guns is minimal, microscopic.
But any crook in the country knows where to buy a gun. You go to Chechnya and buy an automatic for 3,000 rubles. This agenda is not even part of the radical right. It is a standard position, often held for instance in the U.S. mainstream. I wouldn't say this is a populist position at all. More likely the majority of citizens would not support it. And when it comes to the [Movement Against Illegal Immigration], I'm not saying they're sweet guys. I'm saying they are all different. They are marginals because they have been pushed underground. But if they are the ones talking about illegal immigration, our goal is to make sure illegal immigration is not only discussed in the radical underground, but in the political mainstream. Our goal is to bring this discussion out of the context of beating the crap out of the all the immigrants and into the framework of imposing visas, ensuring that [immigrants] have insurance, ensuring they are paid a minimum wage, and everything else that exist in other countries.
See TIME's Russia covers.
The movement you are helping to lead poses a serious threat to the people in power. Moreover, you have said that you want to put Putin and his circle on trial if they are deposed. If push comes to shove, they could respond with force to defend their authority. Are you ready for bloodshed if that's the direction it goes? Do I want bloodshed? No, I don't. But am I ready for the possibility that force will be used against us? Yes, I am ready. Any politician who fights with our corrupt regime needs to be ready for that. If he's not ready, he's got no place here. The battle here has certain terms. [The state] opened a criminal case against me a year and a half ago. I knew this would happen, and it happened. I knew they could arrest me for 15 days at a protest, and they did [on Dec. 5]. But that's part of life. We are in a political situation where a person can be put in jail for nothing. So that's what we're fighting against. And the fact is, you shouldn't go walking in the woods if you're afraid of the wolves. (See how corruption and abuse of power are threatening Russia's economy.)
But in your speeches to the crowds last month, you took a very provocative tone, as if to goad the authorities. You said from the podium that you would "chew through the throats of those animals," referring to Putin's United Russia party, which you call "the party of crooks and thieves." You said that the protesters are ready to "take the Kremlin now." Why do you say this if you want a peaceful scenario? I say this because it's true -- we can take the Kremlin now. But we're not going to because we're a peaceful people. We simply have to demonstrate our strength. Everything we're doing amounts to nothing without posing a potential threat. These people who gathered are totally peaceful, they don't want a fight. But potentially, if their rights are ignored, they can do a lot. And that threat is the driving force of reform. If [the authorities] understand that people are gathering just to make political demands, to take part in flash mobs and take pictures with each other, they'll say, 'Big deal. So a few thousand of them got together and took pictures arm-in-arm.' But who's afraid of them? Nobody. So we need to make clear that these people came out because the government doesn't work anymore. They demand change and they will continue to demand it. We need to make clear that there is a palpable threat. It exists. We can take the Kremlin now.
Your favorite political weapon has always been the Internet. Why did you choose this approach? Well, this all came out of necessity. It wasn't that we were so tricky that we came up with the Internet. It's that the Internet is all we have. The only difference is some politicians were inclined to evolution, and others weren't. Those [others] couldn't adapt to the Internet. They kept saying, 'We demand access to television. Give us one hour of airtime, and we'll change everything.' But anything less than television wasn't good enough for them. I had a different approach. I understood that I'll never be on television. Nobody will give me airtime. I have no money. I have no oligarch friends, and don't have any particular desire to make oligarch friends. So the only thing I had to count on were my concrete abilities, like the North Korean motto: Rely only on yourself. And I developed my own methods. I did what I could. I started filing lawsuits [against state corporations] and telling people about it online. This all looked marginal and funny. But with time my audience grew. And now my blog has more readers than most newspapers have. There are 1.5 million unique views on my blog per month. It just grew over time. And it grew mostly because of the fact that there is no freedom of information. People don't get free and objective information. So they go to find it on the Internet. If the things I write in my blog were to be said on television and written about in the broadsheets, then nobody would need me or the Internet. But you can't say these things on television, so when I began saying them on the Internet, I had a sort of exclusive. And when people went online to find some information, they came to hear my exclusive. This was the only free place for discussion and information available. (See the top 10 Twitter controversies.)
Still, this online community has stayed online until only the past month or so, when they started attending street protests en masse. You have explained this shift as something called the 76-82 effect, referring to the Russians born, like yourself, between 1976 and 1982. Can you explain this theory? This is the Moscow baby boom. And it has come of age. Actually, the name 76-82 comes from an insanely popular community on Livejournal [Russia's most popular blogging site], called 76-82, where people write about memories that they share with people from this generation. Things like, I don't know, chewing gum, movies, the Communist youth camps of a very particular sort, at the end of the Soviet Union, in the late '70s and '80s, where the kids were still technically [Communist Young] Pioneers, but nobody really believed in the [Soviet] system anymore. There are tons of these people. They are the biggest generation of working-age Russians, and they got stuck somewhere between the Soviet Union and modern-day Russia.
They are now taking up more and more positions in society and have developed firm political views. A huge number of these people have now had the opportunity to travel, to go to the Czech Republic, to Germany, wherever, and to realize that we could live this way too. So they start asking themselves, Why can't we live like they do? What's the reason? There is no objective reason. On the contrary, there are reasons why we should live even better. But we don't. People don't like this. So for this generation, the anti-American and anti-Western rhetoric doesn't work nearly as well as for the rest. The main thing that Putin and his gang maniacally use to fight the opposition is that we are all some kind of American-funded monsters. But people understand that this is a load of crap. Sure, Americans have their interests. But the people of this generation, they understand that our existence is not defined as a conflict between East and West.
Read "Twenty Years After Independence, Russia Is in No Mood to Party."
Some pundits, supporters and even random people on the street have started calling you Russia's next President. How do you react to this kind of excitement around you? Is it justified? When the opposition parties were voted out of the State Duma [Russia's lower house of parliament] in the 2003 elections, it created a situation where it was impossible to judge who is popular. This process of comparing pricks at the ballot box is usually done, in a healthy society, through elections. But we haven't had competitive elections in Russia in years. Since 2003 I've watched various attempts to choose some opposition leader who can pose a challenge to Putin. But they couldn't choose one, because there is no mechanism. They use subjective criteria. They say, 'Well, I used to be a minister. I used to be a Prime Minister. I'm loved by the intellectuals.' But this is pointless. I've long said that we need to hold some kind of primaries, where the opposition leaders can decide who among them really has the mandate of the people. At the same time, a lot of [other opposition leaders] don't like the Navalny cult of personality. There's a lot of buzz around me right now, mostly because the political playing field has been stomped flat over the past 10 years. I don't like that myself, because it's impossible to always be this Internet hero. Everyone loving you can change quickly into everyone demanding that you make miracles, and when you don't, their love quickly turns to hate. (See photos of a country house in the former Soviet Union.)
Your oratory style has not done a lot to ease the concerns of many in the liberal opposition that you are a right-wing fanatic. Why do you continue to speak that way every time you take the stage? I don't know if I even have an oratory style. It's more like loud screaming into a microphone. I never studied it, and that's the only way I know how to do it. But it's true, suddenly [the pundit] Maxim Sokolov goes writing that this is how Hitler addressed the crowd. Well, what can I say? I know some people got scared. Sure, I screamed loud. I got too emotional, but what can I say? I really hate the people in power. I hate them with every fiber of my being. That's what drives me in almost everything I do. And I don't see any need to hide that. So I scream.
The 'Amsterdam of the Middle East,' Tel Aviv has miles of urban cycling paths and a new bike-share program.
? A local, slice-of-life story from a Monitor correspondent.
Skip to next paragraph
Back in the 1990s, Tel Aviv?s bicycles were pushed to the margins of the urban landscape, which lacked bike lanes or bike racks.
In the past decade, however, Israel?s cosmopolitan capital has reimagined itself as an Amsterdam of the Middle East with miles of bike paths on sidewalks, boulevards, and in the streets.
With its generally flat terrain and temperate climate, Tel Aviv is an ideal city to navigate on two wheels. The network, marked with bicycle stencils, runs the length of the city?s Mediterranean seacoast, reaches down leafy historical avenues, and sweeps through the commercial center. The city also inaugurated a bike rental system, the Tel-O-Fun, with some 150 rental stations throughout the city. Usage has exceeded expectations, and the distinctive green and gray bikes with upright seating have become ubiquitous. A leading enthusiast is Tel Aviv Mayor Ron Huldai, who test-drove one of the Tel-O-Fun bikes and christened a bike traffic light.
Let?s be clear: Tel Aviv is no Amsterdam ? most of the bike lanes are on sidewalks. On trendy Rothschild Boulevard, the cyclists must dodge cafe tables, and on Ibn Gavirol, the bike path is interrupted by trees, benches, and building columns. But in a country where the volatile Israeli driver dominates the roads, some of that turf is being retaken by cyclists.
Think you know the Middle East? Take our geography quiz.
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Non-invasive measurements of tricuspid valve anatomy can predict severity of valve leakagePublic release date: 18-Jan-2012 [ | E-mail | Share ]
Contact: Abby Robinson abby@innovate.gatech.edu 404-385-3364 Georgia Institute of Technology Research News
An estimated 1.6 million Americans suffer moderate to severe leakage through their tricuspid valves, which are complex structures that allow blood to flow from the heart's upper right chamber to the ventricle. If left untreated, severe leakage can affect an individual's quality of life and can even lead to death.
A new study finds that the anatomy of the heart's tricuspid valve can be used to predict the severity of leakage in the valve, which is a condition called tricuspid regurgitation. The study, conducted by researchers from the Georgia Institute of Technology and Emory University, found that pulmonary arterial pressure, the size of the valve opening and papillary muscle position measurements could be used to predict the severity of an individual's tricuspid regurgitation.
"By being able to identify and measure an individual's particular tricuspid valve anatomical features that we have shown are correlated with increased leakage, clinicians should be able to better target their repair efforts and create more durable repairs," said Ajit Yoganathan, Regents' professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.
The study was published in the January issue of the journal Circulation: Cardiovascular Imaging. Funding for this work was provided by the American Heart Association and a donation from Tom and Shirley Gurley.
Yoganathan and recent Coulter Department doctoral graduate Erin Spinner teamed with Stamatios Lerakis, a professor of medicine (cardiology), radiology and imaging sciences at Emory University, to non-invasively collect 3-D echocardiograms from 64 individuals who exhibited assorted grades of tricuspid leakage. Subjects included 20 individuals with "trace," 13 with "mild," 17 with "moderate" and 14 with "severe" tricuspid regurgitation. The subjects with "mild" to "severe" leakage exhibited a mix of isolated right, isolated left, and both right and left ventricle dilation.
From the 3-D echocardiography images of the heart they collected, the researchers measured (1) the area of the annulus, which is the fibrous ring that surrounds the tricuspid valve opening; (2) the distance between the annulus and the three right ventricle papillary muscles, which keep the valve shut when the ventricle contracts; and (3) the position of the papillary muscles with respect to the center of the annulus. The clinicians also measured pulmonary arterial pressure using standard clinical methods and assessed the grade of tricuspid regurgitation from "trace" to "severe" with color Doppler imaging.
In collaboration with Emir Veledar, an assistant professor and statistician in the Rollins School of Public Health at Emory University, the researchers found statistical differences between individuals with ventricular dilation and the control subjects in the parameters of pulmonary arterial pressure, annulus area and papillary muscle displacement. They also found that all three factors were correlated with the grade of tricuspid regurgitation.
"This study's use of advanced cardiovascular imaging, and more specifically 3-D echocardiography, provided new insight into the pathophysiology of tricuspid regurgitation and a good understanding as to why current surgical treatments for tricuspid regurgitation are not good enough," explained Lerakis. "I believe this study will change the focus and direction of future surgical therapies for tricuspid regurgitation only to make them better and more durable."
Based on the findings of this study, said Lerakis, future surgical therapies should not only be focused on the tricuspid annulus, but on the entire tricuspid valve apparatus, including the tricuspid valve papillary muscles and their three-dimensional location within the apparatus.
Individuals in the study with left ventricle dilation exhibited significant displacement of one of the papillary muscles and patients with both ventricles dilated had significant displacement of two papillary muscles. Subjects with right ventricle dilation showed significant displacement of all three papillary muscles.
The researchers also found that patients with a dilated right ventricle were more likely to have a dilated annulus and exhibited the highest pulmonary arterial pressures and highest levels of tricuspid regurgitation. However, not all patients with a dilated right ventricle had significant increases in annulus area, providing evidence that the right ventricle may become dilated without the annulus being affected.
"We think an increase in pulmonary arterial pressure caused geometric changes in the ventricle, which resulted in alterations to the annulus and papillary muscles," explained Yoganathan. "The combination of displacement of all three papillary muscles and annular dilatation may account for the patients with isolated right ventricle dilatation having the largest percentage of severe tricuspid regurgitation."
Knowing which parameters are responsible for significant tricuspid regurgitation and having a non-invasive imaging technique to measure these parameters should help clinicians target repairs to the specific cause of an individual's tricuspid leakage, according to Yoganathan.
In future studies, the researchers plan to study papillary muscle displacements in individuals with specific diseases to see if different disease manifestations exhibit different characteristics.
"Although it has long been accepted that pulmonary hypertension may result in tricuspid regurgitation, this study is one of the first to provide a clinical correlation between the two," said Yoganathan, who is also the Wallace H. Coulter Distinguished Faculty Chair in Biomedical Engineering. "We want to know whether treating an individual's pulmonary hypertension, and thus decreasing one's pulmonary arterial pressure, can reverse the geometric changes that are causing tricuspid regurgitation and return the annulus and papillary muscles to their original positions."
###
Emory University sonographers Jason Higginson, Maria Pernetz and Sharon Howell also contributed to the study.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Non-invasive measurements of tricuspid valve anatomy can predict severity of valve leakagePublic release date: 18-Jan-2012 [ | E-mail | Share ]
Contact: Abby Robinson abby@innovate.gatech.edu 404-385-3364 Georgia Institute of Technology Research News
An estimated 1.6 million Americans suffer moderate to severe leakage through their tricuspid valves, which are complex structures that allow blood to flow from the heart's upper right chamber to the ventricle. If left untreated, severe leakage can affect an individual's quality of life and can even lead to death.
A new study finds that the anatomy of the heart's tricuspid valve can be used to predict the severity of leakage in the valve, which is a condition called tricuspid regurgitation. The study, conducted by researchers from the Georgia Institute of Technology and Emory University, found that pulmonary arterial pressure, the size of the valve opening and papillary muscle position measurements could be used to predict the severity of an individual's tricuspid regurgitation.
"By being able to identify and measure an individual's particular tricuspid valve anatomical features that we have shown are correlated with increased leakage, clinicians should be able to better target their repair efforts and create more durable repairs," said Ajit Yoganathan, Regents' professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.
The study was published in the January issue of the journal Circulation: Cardiovascular Imaging. Funding for this work was provided by the American Heart Association and a donation from Tom and Shirley Gurley.
Yoganathan and recent Coulter Department doctoral graduate Erin Spinner teamed with Stamatios Lerakis, a professor of medicine (cardiology), radiology and imaging sciences at Emory University, to non-invasively collect 3-D echocardiograms from 64 individuals who exhibited assorted grades of tricuspid leakage. Subjects included 20 individuals with "trace," 13 with "mild," 17 with "moderate" and 14 with "severe" tricuspid regurgitation. The subjects with "mild" to "severe" leakage exhibited a mix of isolated right, isolated left, and both right and left ventricle dilation.
From the 3-D echocardiography images of the heart they collected, the researchers measured (1) the area of the annulus, which is the fibrous ring that surrounds the tricuspid valve opening; (2) the distance between the annulus and the three right ventricle papillary muscles, which keep the valve shut when the ventricle contracts; and (3) the position of the papillary muscles with respect to the center of the annulus. The clinicians also measured pulmonary arterial pressure using standard clinical methods and assessed the grade of tricuspid regurgitation from "trace" to "severe" with color Doppler imaging.
In collaboration with Emir Veledar, an assistant professor and statistician in the Rollins School of Public Health at Emory University, the researchers found statistical differences between individuals with ventricular dilation and the control subjects in the parameters of pulmonary arterial pressure, annulus area and papillary muscle displacement. They also found that all three factors were correlated with the grade of tricuspid regurgitation.
"This study's use of advanced cardiovascular imaging, and more specifically 3-D echocardiography, provided new insight into the pathophysiology of tricuspid regurgitation and a good understanding as to why current surgical treatments for tricuspid regurgitation are not good enough," explained Lerakis. "I believe this study will change the focus and direction of future surgical therapies for tricuspid regurgitation only to make them better and more durable."
Based on the findings of this study, said Lerakis, future surgical therapies should not only be focused on the tricuspid annulus, but on the entire tricuspid valve apparatus, including the tricuspid valve papillary muscles and their three-dimensional location within the apparatus.
Individuals in the study with left ventricle dilation exhibited significant displacement of one of the papillary muscles and patients with both ventricles dilated had significant displacement of two papillary muscles. Subjects with right ventricle dilation showed significant displacement of all three papillary muscles.
The researchers also found that patients with a dilated right ventricle were more likely to have a dilated annulus and exhibited the highest pulmonary arterial pressures and highest levels of tricuspid regurgitation. However, not all patients with a dilated right ventricle had significant increases in annulus area, providing evidence that the right ventricle may become dilated without the annulus being affected.
"We think an increase in pulmonary arterial pressure caused geometric changes in the ventricle, which resulted in alterations to the annulus and papillary muscles," explained Yoganathan. "The combination of displacement of all three papillary muscles and annular dilatation may account for the patients with isolated right ventricle dilatation having the largest percentage of severe tricuspid regurgitation."
Knowing which parameters are responsible for significant tricuspid regurgitation and having a non-invasive imaging technique to measure these parameters should help clinicians target repairs to the specific cause of an individual's tricuspid leakage, according to Yoganathan.
In future studies, the researchers plan to study papillary muscle displacements in individuals with specific diseases to see if different disease manifestations exhibit different characteristics.
"Although it has long been accepted that pulmonary hypertension may result in tricuspid regurgitation, this study is one of the first to provide a clinical correlation between the two," said Yoganathan, who is also the Wallace H. Coulter Distinguished Faculty Chair in Biomedical Engineering. "We want to know whether treating an individual's pulmonary hypertension, and thus decreasing one's pulmonary arterial pressure, can reverse the geometric changes that are causing tricuspid regurgitation and return the annulus and papillary muscles to their original positions."
###
Emory University sonographers Jason Higginson, Maria Pernetz and Sharon Howell also contributed to the study.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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Public release date: 18-Jan-2012
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