![]() How do I know how much to budget for each category? Then I use the chart to record our purchases and keep a running balance of what we’ve spent so that I always know how much we have left in our budget for the month. At the top I can list the category and amount of money we’ve budgeted for it. I created a tracking sheet (kind of like a checkbook register) and printed one out for each category. Everyone needs a little splurge every once in a while!) Fun money (You may want to give each member of your household a little bit of guilt-free fun money each month so they don’t get burnt out with being so strict about the budget.Some of our Budget Binder categories for tracking our expenses include: This can be as simple or as detailed as you want, but everything you buy during the month needs to fit into one of your categories. We break down our purchases into categories and budget a certain amount of money for each category. ![]() Monthly ExpensesĪfter the recurring expenses were taken care of, I needed a way to keep track of any purchases we make throughout the month. The small boxes on the right half of the page have the initials of each month at the top when a bill is paid, I can just check the box to keep track and I know I’m good for another month. You can also also use your bank statements to fill in the amount of each recurring bill (if it varies slightly each month, I usually write down what it is when the bill is on the higher end) and the day of the month it comes out of the account. ![]() If you don’t already have a list of your recurring payments, look back over your last few months of bank statements (most banks provide them online these days!) and write down each bill that you pay on a recurring basis. What if I don’t know what recurring payments I have?
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Patients were required to have bone marrow plasma cells 10% or greater and measurable disease defined as serum monoclonal protein level greater than 10 g/L, urine monoclonal protein level greater than or equal to 200 mg/24 hours, or measurable soft tissue plasmacytoma that had not been radiated. Patients were eligible to enter the study if they had previously untreated symptomatic multiple myeloma. Informed consent was provided according to the Declaration of Helsinki. The goal of this phase 2 clinical trial was to determine the response rate and toxicity of Rev/Dex in patients with previously untreated, newly diagnosed multiple myeloma. Thus, lenalidomide (Rev)/Dex may be a safer and more effective alternative to Thal/Dex in newly diagnosed myeloma. 15, 17, 18 Responses were observed even in patients in whom thalidomide treatment had previously failed. 15, 16 It has also shown significant activity in relapsed and refractory myeloma alone and in combination with dexamethasone, with fewer nonhematologic side effects compared with thalidomide. Lenalidomide (CC-5013) is an analog of thalidomide that has demonstrated significantly more potent preclinical activity compared with thalidomide. 14 However, grade III or greater nonhematologic toxicities were significantly higher with Thal/Dex compared with dexamethasone alone, 68% versus 43%, respectively. 12, 13 In a recent randomized trial conducted by the Eastern Cooperative Oncology Group (ECOG), the response rate with Thal/Dex was significantly higher compared with dexamethasone alone, 58% versus 42%, respectively ( P =. 9 - 12 Response rates with Thal/Dex range between 64% and 76%, which are comparable to or better than those obtained with VAD. 8 Recently the combination of thalidomide plus dexamethasone (Thal/Dex) has emerged as an alternative to VAD in newly diagnosed myeloma based on three phase 2 clinical trials and a case-control study. 2, 6, 7 However, VAD had several disadvantages, including the need for an intravenous indwelling catheter, which predisposes patients to catheter-related sepsis and thrombosis most of the activity of VAD was from the high-dose dexamethasone component. Vincristine, doxorubicin, and dexamethasone (VAD) was typically used as pretransplantation induction therapy for patients who were considered candidates for stem-cell transplantation. 4, 5 Patients eligible for stem-cell transplantation should avoid alkylator-based induction therapy to enable an adequate and safe stem-cell harvest early in the disease course. Recently, autologous stem cell transplantation has been shown to be effective in the treatment of multiple myeloma in 2 randomized clinical trials. 3 Response rates with this therapy are approximately 50%, and median survival is approximately 3 years. 1, 2 For many years, melphalan and prednisone had remained the standard therapy for this disease. ![]() Multiple myeloma is a malignant plasma-cell proliferative disorder that accounts for over 11 000 deaths each year in the United States. Rev/Dex is a highly active regimen with manageable side effects in the treatment of newly diagnosed myeloma. Fortyseven percent of patients experienced grade III or higher nonhematologic toxicity, most commonly fatigue (15%), muscle weakness (6%), anxiety (6%), pneumonitis (6%), and rash (6%). ![]() ![]() Of the 3 remaining patients not achieving an objective response, 2 had minor response (MR) and one had stable disease. Thirty-one of 34 patients achieved an objective response, including 2 (6%) achieving complete response (CR) and 11 (32%) meeting criteria for both very good partial response and near complete response, resulting in an overall objective response rate of 91%. Objective response was defined as a decrease in serum monoclonal protein level by 50% or greater and a decrease in urine M protein level by at least 90% or to a level less than 200 mg/24 hours, confirmed by 2 consecutive determinations at least 4 weeks apart. Dexamethasone was given orally 40 mg daily on days 1 to 4, 9 to 12, and 17 to 20 of each cycle. Lenalidomide was given orally 25 mg daily on days 1 to 21 of a 28-day cycle. We report the results of a phase 2 trial using lenalidomide plus dexamethasone (Rev/Dex) as initial therapy for myeloma. ![]() Delsin is a relatively likeable character with his enthusiasm and need to prove himself in the fight against the DUP (Department of Unified Protection), and the delight at discovering all the awesome things he can do is conveyed nicely through to the player. You can see where this is all going right from the tutorial mission that introduces the basic mechanics and the characters. We’ve got Delsin, the anarchist graffiti artist and street punk, who finds out he’s a Conduit, and there’s his sibling Reggie who’s a straight laced small town cop who’s spent his life looking out for his reckless kid brother. That said, I’ve seen this type of relationship story play out twice already, and whilst the heart of the inFAMOUS games is about the bond of brotherhood (and was very emotive, for me at least, in the ending of inFAMOUS 2), I was hoping for something a little different this time round. ![]() I like to see a game stick by its principles and being comfortable enough with itself to tell its tale in its own way. The tone and style of the story is very similar to the first two games, and laying it on the table now, it’s probably one of the things I’m most torn about. There’s no need to have played the previous games, inFAMOUS Second Son is a separate story of Delsin and his police officer brother Reggie as they discover Delsin’s powers and go on a quest to save their small town from pain and suffering. Since that’s happened, Conduit survivors (now known as Bio-Terrorists) have been hunted and imprisoned to keep the human population safe, though anyone who has the Conduit gene may exhibit abilities, X-Men style, as they grow older. To recap here: the world contains Conduits that are able to manipulate and bend elements to their will, Cole McGrath could control electricity and was the hero that saved the world from a menace known as The Beast, but wiped out the majority of Conduits in the world doing it. If you’ve played the other games you’ll have a decent idea of what this means for the game world, if you haven’t then you’ll be filled in pretty quickly with enough information to get you going. It must be one of the biggest issues for the developers, how to continue a franchise that has games with two distinct endings based on player choice? Sucker Punch have tackled this head on by picking the “good” ending from inFAMOUS 2 and building the scenario from there. I’ll admit to being a little concerned on how the series would continue considering the lead character seemingly ended things quite finally in the second game. Having played inFAMOUS 1, 2 and Festival of Blood several times (and cursed the horrible missing final blast shard from the first game on more than one occasion), I’ve been looking forward to Second Son since it was revealed. There’s no doubt that the game has received a lot of attention and has arrived in the middle of a game drought, so it’s pretty much guaranteed to sell well, but is it a worthy successor to the series that started on the PlayStation 3? Set 7 years after inFAMOUS 2 and with the world seemingly recovering from the events that transpired at the end of that game, Second Son starts a superhero story for a new generation, both in the game world and the hardware, in the form of not-so-reluctant hero Delsin Rowe. Sucker Punch Productions third inFAMOUS installment is the PlayStation 4 exclusive Second Son. ![]() When this occurred, once, Meta-Cooler won the first skirmish in the Instant Transmission dimension by grabbing Goku by the leg and slamming him through a mountain later, Goku entered it to save Vegeta from a crushing blow from Meta-Cooler, who had entered the dimension to surprise Vegeta. After this, there were times when both used it to fight when used by both at the same moment, it resulted in the two battling in the dimension that makes up Instant Transmission. Meta-Cooler states "that's quite a clever trick", and Goku responds "Yeah, it's called Instant Transmission", only to have Cooler blandly reply "I 's of one my favorite techniques" (in the original version, Cooler stated that he was surprised that Goku knew the move as well). He revealed it after Goku used it to dodge a Supernova. A Meta-Cooler is first seen using the technique during his fight with Goku on New Namek. Cooler's metal clone servants in the film Dragon Ball Z: The Return of Cooler also have the knowledge of Instant Transmission.This is stated only in the anime, as in the manga, King Kai was amazed by the existence of such an ability. King Kai mentions he could have taught Goku the technique in the Cell Games Saga when Goku visited him on his planet to find the location of the New Namek. ![]() Soba, a powerful Yardrat who appears in the video game Dragon Ball Z: Sagas.Yardrats, the inhabitants of Planet Yardrat, know this technique, as they taught it to Goku in the manga/anime and uses it in the computer game Dragon Ball Online.Goku learned the technique from the Yardrats sometime after the destruction of Namek and prior to his return to Earth in the Trunks Saga.Ī Yardrat about to use Instant Transmission in Dragon Ball Online.When Goku became a child in Dragon Ball GT, the ability to use this technique was greatly hindered to the point where he just randomly travels to places a short distance away however, as a Super Saiyan 4, he is able to use the ability to its full potential. However, the user cannot travel to an area they have never been to unless they can detect someone familiar to them to use as a homing beacon. It is revealed in the movie Dragon Ball Z: Broly - The Legendary Super Saiyan, that this move briefly moves the user into a pocket dimension which then allows them to move to any location instantly. Super Saiyan 4 Goku using Instant Transmission Goku uses two of his popular attacks with this technique, such as Instant Kamehameha and Instant Spirit Bomb. In the FUNimation Dub of the anime, Goku describes the technique as allowing him to move at the speed of light (specifically 186,282.397 miles per second), however, it occurs instantly as New Namek for example is light years away. Goku can even shift through realms, having no problem teleporting from Earth to the Sacred World of the Kais, and from there to New Namek. Throughout the rest of the series, Goku uses the technique often to travel around the universe. Instead, Goku simply demonstrated its ability to the fellow Z Fighters after his return by warping to Kame House and stealing Master Roshi's sunglasses in under a few seconds. Goku intended to use the technique to get to Earth before the rebuilt Frieza could harm anyone, but found it unnecessary because Future Trunks had already come to finish Frieza and his father off. The technique has many practical uses throughout the series. For example, at the end of Dragon Ball Z, Goku proclaimed to Dende that he could not travel to New Namek because their ki signature was too far away. Goku can take passengers along with him as long as they are touching him, but in the episode " Piccolo's Decision", it is revealed that this ability has limits, as Goku said he could not move the entire world's population in one trip.īecause Instant Transmission requires a ki signature to lock onto (whereas Instantaneous Movement does not), the successful performance of the technique is dependent on one's ability to detect them. Instant Transmission allows Goku and anyone that is in physical contact with him to instantly travel great distances (from meters to light-years, or even travel between the living world and Other World) just by concentrating on a particular individual's ki signature, and 'transmitting' or feeling that being's location. The Yardrats taught Instant Transmission to Goku during his time on their planet. |