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Spice Cake
More From Oxmoor House
- 1/2 teaspoon ground nutmeg
- 1/2 teaspoon ground cinnamon
- 1/2 teaspoon ground cloves
- 1/2 teaspoon ground all spice
- For a spice cake variation, add 1/2 teaspoon ground nutmeg, 1/2 teaspoon ground cinnamon, 1/2 teaspoon ground cloves, and 1/2 teaspoon ground all spice to flour mixture.
My Notes
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Spice Cake Recipe at a Glance
- COURSE: Cakes/Frostings
- CONVENIENCE: Entertaining, Family, Kid-Friendly, Make-Ahead
- CUISINE: American
- MAIN INGREDIENT: Rice/Grains
- DIETARY CONSIDERATION: Meatless
- COOKING METHOD: Bake
- OCCASION: Autumn
- PUBLICATION: Oxmoor House
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do you see this
So i bought these because im like "OH MY GOD CAKE IN DARK CHOCOLATE WHAT CAN BE BETTER" From the very start I questioned the weight of the little package, it was too heavy for a cake, but I gave them the benefit of doubt. BUT THEN. THEN I took a bite. WHAT GREETED ME WAS NOT THE MOIST DELICIOUSNESS I HAD ANTICIPATED BUT THE WORST THING I COULD'VE IMAGINED: A CHEWY SALTY CARAMEL INSIDE. I HATE CARAMEL. I WANTED RED VELVET CAKE. THIS HORROR IS NOT WHAT I SIGNED UP FOR. HOW DARE YOU RUSSELL STOVER. HOW DARE YOU. YOU HAVE NEVER BEEN SUCH A DISAPPOINTMENT. I AM SO ANGRY. YOU ARE NOTHING BUT A MANUFACTURER OF CHOCOLATE LIES.
also may i add that is is probably a huge danger for customers with allergies


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Last season, Earl Clark made the most of his time in Los Angeles filling in for the injured Dwight Howard and Pau Gasol.
The fourteenth overall pick in the 2009 NBA Draft struggled for playing time during his first three season, where were split between Phoenix and Orlando. However, acquired alongside Dwight in the trade to Los Angeles, Clark found a home on the Lakers. He's also found a home in Cleveland, as according to Sean Deveney of The Sporting News, Clark has signed a two year deal worth $9 million dollars with the Cavaliers.
Source tells Sporting News that Lakers F Earl Clark has signed a 2 yr deal w the Cavaliers for $9 million
While a few teams expressed interest in Clark, including the Lakers, none showed more desire for the former Louisville product than that of Cleveland Cavaliers who heavily courted the athletic power forward.
It's a bit of an odd signing given the Cavaliers selected power forward Anthony Bennett with the number one overall selection this year and also have Tristan Thompson on their roster, but it was a no-brainer for Clark who wouldn't have received an offer close to that elsewhere.
Tags: Cleveland Cavaliers Earl Clark Los Angeles Lakers NBA Free Agency


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this is a blog. sometimes fandom. sometimes art. sometimes personal. always me.
- My Art - My Face -
Felt it was time for a change of icon. The photo is from my trip to the mountains to go snowboarding with my brother for New Years.
Oh look that's me
Reference photos I took for my self portrait final :) This is really fun.
Fred Astaire
Fred Astaire


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Former Geto Boy Willie D, aka William Dennis, has been sentenced to a year and a day in federal prison on wire fraud charges, the U.S. Attorney's office for the Southern District of Texas announced today. Judge Gray Miller also ordered Willie D to pay nearly $200,000 in restitution to the buy ... More >>
2009 was definitely a year, we'll say that much.
Above is some video from B L A C K I E's performance Monday night at New Orleans' Dragon's Den, the first show of his mini-tour. The feedback-loving local rapper visits Baltimore Friday and Brooklyn's Afro!!Punk!!Fest!! Sunday. Rocks Off has heard through the proverbial grapevine that there's a Mic ... More >>
Okay, imagine you're a third overall draft pick, and two years into your football career, you've lost your job as starting quarterback to an aging, recovering alcoholic, racist retread. You're teetering on the brink of being labeled one of the biggest busts in recent football history. What's more, ... More >>
It took a little longer than Rocks Off expected, but it appears "prison city playaz" Huntzville's hammer-cocking song "Backpack Fulla Gunz" is finally ruffling some feathers. The protégés of Geto Boy Willie D appeared on Fox 26's morning news program Friday to perform the (anti-)school-shooting tr ... More >>
Hard to believe it's been 20 years since gangsta rap went overground with N.W.A.'s Straight Outta Compton. Through Dr Dre and Snoop Dogg to Tupac and Eminem, it launched most of hip-hop's biggest stars for a good decade, but these days even artists like T.I. and Lil Wayne have sacrificed serious str ... More >>
The Geto Boys showed the nation hip-hop with real staying power
Reagan Hamilton goes into Texas jails and tells inmates they better stay in touch with their kids. Her sadly powerful message has sparked some successes. Too bad they don't include her own father.


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LUBBOCK, Texas (AP) - A hospital spokesman says Texas Tech coach Billy Gillispie has been discharged from the hospital after a six-day stay amid an investigation into alleged player mistreatment.
University Medical Center spokesman Eric Finley says Gillispie left the hospital sometime after 3 p.m. Thursday. Messages were left seeking comment from Gillispie and athletic director Kirby Hocutt.
Hocutt has said the university is investigating allegations that Gillispie mistreated players.
Gillispie called 911 on Friday morning, just hours before he was set to meet with Hocutt to discuss what the AD had heard from players on Aug. 29.
(Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)
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TWD: Vanilla Chiffon Roll
I have always wanted to make a "Swiss roll" - you see them in the cake shop windows, these creations of rolled up cake - all nice and symmetrical and so inviting. So even though I have just come back from a couple of trips abroad and have just started a new job, I cleared out part of my weekend and got to work.
How did this turn out for me? The mousse turned out great and I really liked the addition of nuts in it - it gave it another dimension. The cake? Well, I baked a full sized one on my first attempt and it broke up on me when I tried maneuvering it around (Note: this is what happens when you don't read the instructions properly). So the next day I attempted half the recipe for the cake portion. I followed the instructions to a "t" and got it all rolled up. "Yay!" for perseverance.
The end result? I found the cake a little too moist. I pulled the cake out from the oven when the sides started to shrink away from the jelly pan so am not sure whether I should have baked it longer…. With some time in the fridge when everything had hardened up, the cake was passable but not what I have seen in the cake shop windows.
For more successful attempts, check out the rest of the TWD bakers sites.


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It's been a few years since the last drop between Oakley and skateboarding team rider Eric Koston, but it was worth the wait. A new set of shades will be releasing July 1 and we now present a full look here. The collection consists of the Plaintiff, which is an aviator style sunglass, the Holbrook and of course, the classic Frogskins. Each pair features a brown tortoise print and they come with matching bronze colored lenses and matching sunglass bag. These will be available at Oakley.com and select retailers.
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Excellent, tender biscuit. Prepped the basil and cheese earlier in the day, combined, and chilled in the fridge. Same with the butter, cut into bits and put back in the fridge to re-harden. Oterhwise made to recipe. When I took them out of the oven, brushed the tops with probably less than 1tsp of melted butter, made a lovely finish.
Purple Basil Parmesan Biscuits
carolfitz Posted: 09/22/09
ConniePhx Posted: 09/01/09
I made this just as the recipe called for, except that I didn't have purple basil -- used the standard sweet Italian basil. The biscuits were very light and flavorful, and paired well with grilled chicken and a green salad. We served Berry Peach Cobbler with Sugared Almonds for dessert, and everyone was very full after the meal, and also very complimentary.
threesailors Posted: 07/22/09
I prepared this recipe exactly as recipe states. It is outstanding! The texture of the biscuit is fine and flaky. The purple basil was straight from my garden creating a fresh and flavorful biscuit. Butter needs to be very cold and do not overwork the dough. Served biscuits with Sesame Ginger marinated Salmon filet on a cedar plank and roasted asparagus. Mmmm!!
aetcas Posted: 11/21/10
I substituted the basil for 1 tsp. of ground black pepper (wanted to make the Pepper Parmesan Biscuits but didn't have buttermilk) and it was so delicious. Looking forward to trying it with basil.
JacquelineT Posted: 06/07/10
I forgot to add the Parmesan, measured 2/3 cups purple basil not chopped before chopping it, but it still came out pretty good....just a tad salty, will put less next time. Otherwise, well worth making again! :o)
EvilCookieFairy Posted: 02/07/11
The biscuit texture was really nice. Can't say i liked the basil in it though. It was way too strong for ME. Well, i guess you try everything at least once!


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Devens - Local Information, Resources & Photos
Devens - Searchable Map, Aerial Photos & Driving Directions
Devens is a community or populated place (Class Code U5) located in Worcester County at latitude 42.5447 and longitude -71.6132. (Devens Panoramio Photos). The elevation is 266 feet. Devens appears on the Ayer U.S. Geological Survey Map. Worcester County is in the Eastern time zone (GMT -5). Observes DST? Yes. Current Time. | Devens, MA ZIP Code Maps | Devens local area photos
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Worcester County: Cities & Towns | ZIP Codes | Schools | Features (airports, churches, hospitals, etc.)
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I write fanfictions about One Direction because they are the sexiest little shits I know :) If you want an imagine inbox me and I will give you one :D I don't mind other famous people soo don't worry. One Direction I HeyBombShell I Austin Mahone I Justin Bieber sometimes I @_lights is amazing. I just kindove met her one day and we just clicked. Our conversations make me laugh all the time and shes just over all flawless..Im also in a lot of her stories soo you should mabey you know check them out ;) I used to have some kind of schedule on here what happened? I don't know.. enjoy my terrible fanfic like writing and I hope you enjoy me in your company :D BYEEEEEEEEEEE btw fan for a unicorn ride and a cookie :*
Pretend (One Direction ) [ON HOLD]
Upcoming poop that I call fanfics :)
The Sunflower Affect. (Ed Sheeran)
Lost [One Direction/Ed Sheeran]
Its Just A Game (One Direction Fanfic) [ON HOLD]
Crash And Burn (One Direction) [ALSO ON HOLD]
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Niall Horan Criminal Affair (one direction/Janoskians fanfic)


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Mick LaSalle
Chronicle film critic Mick LaSalle tells you what he really thinks
Monthly Archive for January, 2012
Reader Appreciation Day Pictures
Well, you made it easy for me. Instead of loading in photos all day, I got exactly six pictures. One was a joke, and in another case, the person changed their mind. So that left four. But you know what? Four is OK. I'm happy that you're here reading this. Sending a picture of what's […] [Read More]
Blooper Reel from THE ARTIST
Have you seen this? From ALLOCINE, the French cinema web site. So charming: [Read More]
Reader Appreciation Day is Tuesday
Well, you have multiplied exponentially in the last two months, and so the time has come to appreciate you, the reader. In what is partly a steal from Andrew Sullivan, who is my favorite political blogger, I'd like to see where you are reading this blog. So send me a JPEG of your environment — […] [Read More]
Oscar Predictions — the Early Handicapping
I'm going to be doing my usual Oscar predicting in the Pink section, within a few weeks, but here I'll give you my initial impression of the field and who will win. For years, people used to ask me who was going to win the Oscars, and I'd always guess on the basis of what […] [Read More]
Terilyn Joe Writes to Peter Hartlaub
Peter Hartlaub in The Big Event has been running a series on Bay Area TV legends, and the other day he got a very friendly message — and the picture (at left) — from Terilyn Joe, formerly of KGO TV news. Some people were surprised at the friendliness of her response. But I worked with […] [Read More]
The 95 or So Best Comedies Before 1960
In our last look at comedy, we were guessing to some extent. MAYBE we were talking about films that would stand the test of time, but maybe we weren't. It takes about thirty years to know. By now, ANNIE HALL is safe. MANHATTAN is in the pantheon. But for the moment, FUNNY PEOPLE is just […] [Read More]
What Were You Drinking? The Glenrothes and Other Favorites
It has become a cliche to ask — to ask ME — to ask MOI – in comments sections, "What were you smoking, when you . . . " And I always think that's kinda dumb. Why say the same thing that every other person says, when you could be asking, "What were you drinking?" […] [Read More]
John Stanley at Books, Inc.
John Stanley, who wrote for the Chronicle for over 30 years, has released a new book that re-works his old interviews, mixing them with current insights. THE GANG THAT SHOT UP HOLLYWOOD concentrates on the crime and action stars he interviewed and, in some cases, befriended. John is a great guy, and he's going to […] [Read More]
The 100 Best Comedies Since 1960
The Golden Globes have separate categories that honor comedy — actually they group musicals and comedies together, probably because at one point in the Globes history (the 1950s), there were lots of musicals and few comedies. I don't know how I feel about ghettoizing comedy in a separate category, and yet I know that without […] [Read More]
Ricky Gervais, A Day Later
Last night, Ricky Gervais hosted the Golden Globes, after weeks of anticipation. Based on his performance last year — and the way in which the show was advertised — it was expected that Gervais would slash and burn his way through the proceedings, insulting every star in the audience and every presenter who dared share […] [Read More]
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Arizona > Phoenix Yellow Pages > Health and Wellness > Health Care Centers > Nursing Homes Phoenix
Ridgecrest Healthcare
(602) 456-2979
16640 N 38th St, Phoenix, AZ| Map
Ridgecrest Healthcare, a full-service skilled nursing facility, is conveniently located one block south of Bell Road next to Paradise Valley Hospital. - Ridgecrest Healthcare, a full-service skilled nursing facility. Our specialties include rehabilit... More>
A Place For Mom
See the Best Senior Care Options in the Phoenix Area.
Paradise Valley Loving Care
(602) 992-8942
3324 E Oraibi Dr, Phoenix, AZ| Map
Our Home Suporting Wellness, ?Providing residents with a balanced lifestyle. Our trained & certif... More>
Concerns: Elder Care Homes
Life Care Center At South Mountain
(602) 243-2780
8008 S Jesse Owens Pkwy, Phoenix, AZ| Map
Arizona State Veterans Home
(602) 248-1550
4141 N 3 St, Phoenix, AZ| Map
Christian Care Nursing Center
(602) 861-3241
11812 N 19 Av, Phoenix, AZ| Map
The Springs at North Mountain
(602) 997-6224
350 E Eva St, Phoenix, AZ| Map
The Springs at North Mountain is a spirited senior living community. We are conveniently located ... More>
El Dorado Vista
(602) 264-7802
Service Area:
Phoenix, AZ
Foothills Health and Rehabilitation Center
(480) 759-0358
15810 S 42nd Street, Phoenix, AZ| Map
Life Care Center Of Paradise Valley
(602) 867-0212
4065 E Bell Rd, Phoenix, AZ| Map
Paradise Valley Retirement Community
(602) 992-0710
11645 N 25 Pl Phoenix, Phoenix, AZ| Map
Arizona Grand Senior Living Community
(602) 954-9178
4602 N 24th St, Phoenix, AZ| Map
Welcome! For 35 years, Arizona Grand Senior Living Community, formerly known as Arizona Easter... More>
Home Instead Senior Care
(602) 588-7725
2412 West Greenway Road, Phoenix, AZ| Map
Home is where quality of life is enhanced without the stress of interrupted routines and changes ... More>
Arizona State Government
(602) 248-1550
4141 N 3rd St, Phoenix, AZ| Map
Life Care Center of Paradise Valley
(602) 867-0212
4065 E Bell Rd Phoenix, Phoenix, AZ| Map
Ridgecrest Healthcare of Paradise Valley
(602) 482-6671
16640 N 38 St, Phoenix, AZ| Map
Ridgecrest Healthcare, a full-service skilled nursing facility. Our specialties include rehabili... More>
Sunshine Village
(602) 765-7400
2606 E Greenway Pkwy, Phoenix, AZ| Map
The Terraces
(602) 906-4024
Terraces Skilled Nursing Center The
(602) 371-4106
Sonoran Rehabilitation And Care Center
(602) 264-3824
4202 N 20th Ave, Phoenix, AZ| Map
Arcadia Estate Assisted Living
(480) 717-1100
5825 East Indian School Rd, Phoenix, AZ| Map
Welcome to Arcadia Estate Assisted Living! Arcadia Estate Assisted Living is located in Phoeni... More>
Baptist Village
(602) 569-0508
20802 N Cave Creek Rd, Phoenix, AZ| Map
ABRC is called by God to care for elders with a compassionate heart. To help them recognize the v... More>
Phoenix Mountain Nursing Center
(602) 996-5200
13232 N Tatum Blvd, Phoenix, AZ| Map
Est 1979. Rehabilitation Therapy Services, Alzheimer's Secured Care, Respite and Hospice Care, N... More>
Kivel Campus Of Care
(602) 956-3110
3550 E Pinchot Ave, Phoenix, AZ| Map
Beatitudes Campus - Health Care Center
(602) 995-6133
1616 W Glendale Av, Phoenix, AZ| Map
The Terraces
(602) 371-4106
Maryland Gardens Care Center
(602) 265-7484
31 W Maryland Ave, Phoenix, AZ| Map
Maryland Gardens is a 100 bed skilled nursing facility (nursing home) and assisted living facilit... More>
Kivel Care Center
(602) 956-3110
3020 N 36 St Phoenix AZ, Phoenix, AZ| Map
Capri Care Center
(602) 944-1574
1501 E Orangewood, Phoenix, AZ| Map
The Stratford
(602) 841-2500
1739 W Myrtle, Phoenix, AZ| Map
Three monthly rental options, stratford court for independant and assisted living. Stratford Squa... More>
Ahwatukee Adult Care III
(480) 705-7262
5135 E Half Moon Dr, Phoenix, AZ| Map
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Westminster Village
(866) 986-2757
12000 N 90 St
Scottsdale, AZ 85260
Scottsdale, AZ 85260
Live Life With Peace Of Mind.
Sun West Choice Healthcare & Rehab
(623) 349-4933
14002 Meeker Blvd
Sun City West, AZ 85375
Sun City West, AZ 85375
Dedicated, reliable & consistent service since 1985.
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Dr. Marc H. Nudelman, DO
Pediatrics, Medical Care Group
- 701 Biesterfield Rd
Elk Grove Village, IL 60007
- Within miles of
- 1 Office Location
- Email a Friend
- (847) 228-0460
Dr. Marc H. Nudelman has been practicing medicine for 24 years. Dr. Nudelman graduated from the University of Illinois, Chicago College of Medicine in 1990. He practices medicine in Elk Grove Village, IL and specializes in Pediatrics. Dr. Nudelman is affiliated with Northwest Community Hospital, Saint Alexius Medical Center and Alexian Brothers Medical Center.
Gender: Male
Years in Practice: 24 Years
Languages Spoken: English
Medical School: University of Illinois, Chicago College of Medicine
Graduation Date: 1990
Hospital Affiliations: Northwest Community Hospital, Saint Alexius Medical Center, Alexian Brothers Medical Center
Specialties: Pediatrics
©2005-2014 WebMD, LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.


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- Kathryn Hoban
- Ann Arbor, MI
- United States
Legislative Aide - Michigan Senate, National Society of Collegiate Scholars
This conversation is closed.
Optimism and Pessimism: The Impact of Outlook on Outcome
Do you consider yourself an optimist or a pessimist?
What do you think are the drawbacks and benefits of each?
To what extent do you think your outlook impacts your actions?
Tali Sharot talks about the blame that optimists and pessimists place on either themselves or other factors. To what extent do you blame internal or external factors regarding your success or failure?
Showing single comment thread. View the full conversation.
May 18 2012: I consider myself both an optimist and a pessimist.
The "drawbacks" are non-existent, its "benefits" of each are synergised and amplified if you are both at the same time.
This is much evident in Edward de Bono's Six Hats, he states that whatever decision we make, it is ultimately an emotional one. And in order to sooth and direct the emotions successfully and adequately, one must be aware of the facts, the dangers (pessimism) & the possibilities (optimism).
My general outlook would be "Happy Go Lucky", "nonchalance" and "readiness/preparedness".
I'd show nonchalance towards one's anger, sadness, disappointment or the likes.
I'd go about doing whatever I can so that when (s)he comes round,
I'd be there to ask what needs to be done or any help needed to move forward, together.
I connect with people this way, one person at a time, it keeps me happy all the time.
Waking up every morning, staring into the sky smiling, and to everyone I meet.
Sometimes, when I think that this is too good to be true, I label myself pessimistic.
So, am I an optimist or a pessimist? I'm a pessimistic optimist.
Showing single comment thread. View the full conversation.


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BBM officially no longer just a "blackberry thing"
BlackBerry has started the rollout of its popular BlackBerry Messenger (BBM) service for Android and iOS users across the world, the company announced.
The service will be made available in a phased manner as about six million people have pre-registered for the app, and the company wants to ensure a "smooth roll out" it said. Interested users need to download BBM, install the app, and enter their email addresses. They will then be "placed in a line". As soon as they reach the front of the queue, they will receive an email notification and can start using the service.
"We want to make sure that the end user has the right experience," said Mike Al Mefleh, director of Product Management, Middle East at BlackBerry, speaking on the sidelines of the Gitex exhibition in Dubai.
There is no stipulated timeframe for the process at the moment, he said.
"It depends on the number of people who have registered and are in line ahead of you. We are delivering the service to hundreds and thousands of people and now millions have shown interest and excitement for this," said Al Mefleh.
"We are only doing the staging in the introductory period – in the future the download will be immediate."
Features include BBM Chat with the standard 'delivered and read' updates, file sharing and BBM Groups. BBM will continue to only use PINs to protect personal information, the company said.
"BBM has always been strong and people have confidence in us. It was not launched as an app, but was part of developing the platform itself. So flexibility and security have been taken into account," said Al Mefleh.
But with cross-platform messaging services such as WhatsApp steadily gaining traction, how will BBM compete and gain a stronghold in the wider market?
"People wanted BBM and that's why we have introduced it," stated Al Mefleh.
"The service offers immediacy, and maintains your privacy and security – so nobody needs your phone number, they only require access to your PIN. Nobody knows if you are offline, online or the last time you were online. Those are very important elements.
"Also, in terms of features, we provide grouping, avatar, profile and we have talked about introducing new BBM channels including video and voice. There is still a lot still to come. It is a solid networking application."
Currently, the majority of BBM customers use BBM an average of 90 minutes per day and collectively send and receive more than 10 billion messages each day.
The service already enjoys popularity in the Middle East, added Al Mefleh.
"BBM has always been great in the Middle East. We think penetration rate on an average stands at 98 per cent across the region, at 99 per cent in Saudi Arabia and at 97 per cent in Kuwait. That's why we see a lot of excitement over BBM going cross platform."
Top Headlines
- The 'ironic' struggle for Turkey's internet freedom
- Forget the iphone 6 for a second and pay attention to Apple and the 'smartwatch revolution'
- A piece of cake? Egypt's 'baseeta' e-service for completing government documents gains popularity despite legality concerns
- When will the iphone 6 come to the Middle East?
- Filters vs. proxies: the tug of war between Iranian authorities and online browsers
- BlackBerry offline in Europe, Mideast and Africa
- Not good enough? UAE operators cancel BBM service
- Will the new Blackberry be sweet?
- Nimbuzz Supports Arabic Language to Give Java Handset Users More Mobile Freedom in Middle East and Africa
- Growing trend: Middle East consumers use mobile phones as wireless PC


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These are a fun addition to my family's dinner table! This may sound weird, and I am usually not an odd combo kind of eater, but try dipping your sandwiches in maple syrup! It is actually quite good! While I was making these I felt compelled to try the syrup & talked myself out of it 3 or 4 times. But when it was time to actually dig in, I decided to go for it--and I liked it! I'd say the taste combination of the waffle, salty ham & syrup is similar to a good Monte Cristo served with strawberry jam--yummy.
Grilled Ham and Cheese Waffle Sandwiches
Photo: Antonis Achilleos
Yield: Makes 4 servings
More From Real Simple
Recipe Time
Prep Time:
Other: 10 Minutes
Nutritional Information
Amount per serving
- Calcium: 360.88mg
- Calories: 439.26
- Calories from fat: 5%
- Carbohydrate: 28.49g
- Cholesterol: 100.91mg
- Fat: 26.79g
- Fiber: 1.52g
- Iron: 3.6mg
- Protein: 21.35mg
- Saturated fat: 14.12g
- Sodium: 1465.58mg
- 8 frozen toaster waffles
- 1 tablespoon Dijon mustard (optional)
- 1/2 pound sliced deli ham
- 1/4 pound Cheddar, thinly sliced
- 4 tablespoons unsalted butter
- Place 4 of the waffles on a work surface. Spread one side of each with the mustard (if using). Top with the ham, cheese, and the remaining waffles. Spread the top of each sandwich with 1/2 tablespoon of the butter. Melt the remaining butter in a large nonstick skillet over medium heat. Place the sandwiches in the skillet, buttered-side up. Cook, pressing occasionally with the back of a spatula, until the cheese melts and the waffles are golden, 3 to 4 minutes on each side.
My Notes
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Grilled Ham and Cheese Waffle Sandwiches Recipe at a Glance
- COURSE: Breakfast/Brunch, Sandwiches
- CONVENIENCE: Quick/Easy
- MAIN INGREDIENT: Cheese, Pork
- PUBLICATION: Real Simple
More Recipes Like This
Dijon Croque MonsieurCooking Light
Grilled Ham-and-Cheese Sandwiches with Strawberry-Shallot JamSouthern Living
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Photo: Jumping Jack Longland, E3 5c © Si Litchfield
View all 3 photos or Submit a new photo of this climb.
E3, really? I mean, I'll take it, but there's plenty of harder HVS...Longsufferingropeholder - Lead O/S - 27/Sep/14 with nick ferro
MrBIond - 2nd - 18/Jul/14 with Ed Teale
Loved it. Spicy top out too!mrteale - Lead O/S - 18/Jul/14 with MrBlond
Hidden - 2nd O/S - 01/Dec/13
Nice litle route. Looking at the pictures on here I could have got more gear in higher up to protect the moves through the top roof. Didn't feel like I needed it though, otherwise I'd have looked a bit harder! Had one look at it first to suss it out, rested, then went for it and was fine.shed_hed - Lead O/S - 01/Dec/13 with Andy Winter
Started up neb buttress direct, then up the crux of auricle then on to this. Climbed clean but not onsight, I've done all the other stuff on the buttress and seconded the E3 before.
deacondeacon - Lead - 08/Aug/13
First E3. Soft touch but good top out.Hardcore Pat - Lead O/S - 14/Jul/13 with Timtim McTim
Had previously led Auricle (in 2010)DavidR - Lead O/S - 29/Jun/13 with Holly Adamthwaite
Nick Sillem - Lead O/S - 2013
jwpil - Lead O/S - 21/Jul/12 with Deacon
Andy Peak 1 - Lead - 19/Jun/12
Rich Kirby - Lead O/S - 12/May/12 with Ruth
Had previously led Auricle.ianjfsutcliffe - TR β - 04/May/12 with Courty, Coatesy
melonmike - 2nd O/S - 06/Mar/12 with Jack Metcalfe
pie_eater_pete - Lead O/S - 28/Oct/11
drysori - Lead - 15/Oct/11 with Jesamine
Sebastien Gastaud - 2nd - 02/Oct/11 with Tim Selvage
tigertim - Lead - 02/Oct/11 with Sebastien Gastaud
Hidden - Lead O/S - 12/Mar/11
mwatson - 2011
Exciting, E2?mark20 - Lead O/S - 17/Oct/10
Fell of the start of the roof after faffing with gear and not committing. Rock to the face was my punishment.bigdrew - Lead dnf - 17/Oct/10 with Mark R
Gazleah - Lead O/S - 05/Oct/10 with paul jones, tom ireson
willsm11 - 2nd dog - 30/Aug/10 with Twisty
Found Auricle reach hard. Jumping Jack L finish is easier but must have been very bold and committing to lead. Look at the top first to see where to head to to finishharold walmsley - 2nd O/S - 29/Jun/10 with Colin Struthers
Hidden - Lead O/S - 19/Jun/10
keefe - 15/May/10 with Tansy
Hidden - Lead O/S - 17/Apr/10
Hidden - Lead O/S - 13/Apr/09
Hidden - 2009
wolverine - Sep/07 with John Nightingale
Pythonist - 2nd O/S - 23/Aug/07 with DaveDJ
Joe Dove - 2nd - 05/May/07 with kev
Brown - Lead O/S - 18/Apr/07 with John
Two ticks for the price of one - did this as the finish of Auricle. Whole pitch is probably only worth hard E1 5b but great quality. JJL - easiest E3 in peak? (easier than flying butress for sure)Ram MkiV - Lead O/S - 29/Jun/06 with Tom anfd Mike
had an interesting 14m fall from the top moves. yummybeanfingers - Lead dnf - 29/Apr/06 with ginger dan
dannyboy83 - Lead O/S - Apr/06 with Ben Harper
Hidden - 2002
Billg - Lead O/S - 24/Apr/99 with Phil McAllistair
Hidden - TR - 10/Oct/93
shark - Lead - 09/May/87 with Phill Dickens
Users with this climb on their wishlist are:
Oddjob, Owen W-G, climberchristy, theomoore, Hidden, PanzerHanzler


text:
which model netgear NAS do you have little-miss ?
Eugh, can someone tell me how to install the second drive in my Netgear NAS. I've installed it and expected something magical to happen....but it didnt. Not that i can see anyway...
which model netgear NAS do you have little-miss ?
if its a duo then it just automatically mirrors drive 1 to drive to unless you do a factory reset and within the first 10 or so mins tell it to stripe it
Little-Miss (6th September 2010)
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text:
Good Karma
Beach shacks with character
What we say:
All the bungalows have great character and share the same facilities and aspect towards the ocean, but some are larger than others and therefore command a higher price. It's the proximity to the ocean and the coral right offshore that is so attractive about these bungalows. You can roll out of bed, put some flippers on and be in the ocean within 30 seconds. The huts are made out of bamboo as is the floor covering, bed, chairs, furniture -- everything that can be made from bamboo is. The bedding is brightly covered and there is a mosquito net in some, but not all the rooms. The grounds of Good Karma are a jungle with tropical plants and trees lining the maze of pathways and providing much needed relief from the scorching Amed sun. Relaxing on the daybed attached to each bungalow seems to be the second most popular activity here -- the first is snorkelling. These are great beach shacks in a tiny village which means we recommend having some form of transport to get around.
Make a reservation online now
Contact details:Jalan Raya Selang. T: (081) 337 531 133
What we were quoted
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|Standard - Single
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|Deluxe- Double
Added to Travelfish on: 2nd November, 2010
Last visited or updated on: 17th September, 2013
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text:
Favorite line from Parks and Recreation:
"Damn it, Jerry!" - Tom Haverford
"Damn it, Jerry!" - Tom Haverford
If I get the internship. @_@
But my mom's pushing for it. So hopefully.
But then if I go there, I'm gonna be the one missing all the hangouts cuz I'm gonna be interning.
Are the guys gonna watch you become a "Catholic man"? Lol.
I agree.
That is all.
1. Scrubs
I wonder what I should do. xD
How crazy were you going earlier? xD


text:
Earth Balance Almond Butter Included In Recall
Earth Balance is voluntarily recalling its 16 oz. jars of almond butter because of a possible health risk.
Suspect Arrested In Niwot Bank Robbery Case
The FBI now has a man in custody accused of robbing a bank in Niwot.
Strong Wind Leaves Tens Of Thousands Without Power
Wind is blamed for causing power outages Wednesday afternoon in Boulder County.
ASU Swimmer From Niwot Dies In Pool On Campus
A former Arizona State University swimmer is dead after drowning in a pool on the university campus.
Fire Chief Threatens Multi-Million Dollar Lawsuit
The former chief of the Fairmount Fire Protection District has filed a legal notice that he may sue his former employer for $5 million.
Crocs Gives Layoff Notices To 22 Employees
Niwot-based Crocs Inc. has given layoff notices to 22 employees.


text:
If you're traveling in or out of Grand Rapids, Michigan via Gerald R. Ford International Airport, you may notice a couple of large dioramas I recently shot for Spectrum Health on display in the concourse.
I must say they're looking pretty tasty all backlit and such.
Next >>>
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text:
Troy-bilt TB130 vs. Lawn-Boy 10730
Hi all,
My old Murray with B&S died so I've been looking around for a new mower.
I've narrowed it down to these two mowers and would like your inputs on which one to get.
Troy-Bilt TB130
Lawn-Boy 10730
These two fit my price range and I can pick one up today. $249 for TB130 $239 for 10730
It would be used to mow my yard which isnt that big. I just can't decide which would be a better buy and which would be more reliable. The troy-bilt only comes with a 2 year warranty and the Lawn-boy comes with 2 year warranty + 3 year true start warranty.
Which engine is more reliable? the Honda GCV160 or the Kohler XT6? and which is cheaper to repair should something go wrong?
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For 2015, 10 years after its introduction, the Toyota Yaris is getting its second restyling with revised looks inside and out, a quieter cabin, a fuel-efficient engine, and all the versatility that comes with the three- and five-door versions. The U.S.-spec Yaris debuted in 2005 with lots of spunk and clever packing wrapped in an inexpensive sub-compact. Offered in both the three-door and five-door hatchback styles, the Yaris filled a niche near at the bottom of Toyota's lineup. Refreshed in 2011, the Yaris continued its mission largely unchanged, save for a more modern design. Now for 2015, Toyota is improving the Yaris with more refinement and a better driving experience, while still retaining its superb value proposition. Starting at just $14,485, the Yaris makes a great city car or a sweet first car for a teenager. Its 1.5-liter inline four-cylinder will keep curious teens out of trouble with Johnny Law, while the expansive cargo area and decent back seat might land them in trouble with mom and dad.
Toyota has resolved a few of the complaints that plagued the previous-generation Yaris, namely the NHV levels inside the cabin. More sound insulation and more premium interior materials help push the Yaris' feel upmarket, while it still keeps its low price point. With three trim models and two body lengths to chose from, the Yaris is a pretty customizable hatchback .
With the updated features and added benefits, Toyota may see the Yaris climb back up the sales charts to the level of its glory days in 2008 when sales of the hatch topped 100,000 units. Selling only 21,343 units in 2013, the Yaris was apparently in desperate need of a makeover. Let's see what Toyota has done to turn up the heat.
Click past the jump to read more about the 2015 Toyota Yaris.


text:
A 23-year-old woman was found dead inside an East Tulsa apartment, Friday afternoon.
According to homicide investigators, Ashley Brizendine was found not breathing inside an apartment. Emergency responders attempted to resuscitate Brizendine, but she could not be revived.
Inside the apartment were two toddlers, an infant and the suspect.
23-year-old Brian Harris was questioned and further investigation revealed enough probable cause to arrest him for first-degree murder.
According to Harris' booking report, Harris stated "...that he and Brizendine got into an altercation and things went too far."
Harris told detectives that he and the victim were in a physical fight when he grabbed her by the shirt and they both fell to the floor. Harris pinned Brizendine's arms to the floor and that he grabbed her by the neck and strangled her.
According to the report, Harris saw that Brizendine was unresponsive and attempted CPR.
Brizendine and Harris shared the apartment with their three children.
Harris was booked on first-degree murder charges.
Evangelist Franklin Graham prayed on a sidewalk outside the Pentagon Thursday after his invitation to a prayer service inside was withdrawn because of comments that insulted people of other religions. More>>
P.O. Box 8 Tulsa, OK 74101-0008
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text:
This apartment is in the Hellman neighborhood in Long Beach. Nearby parks include Douglas MacArthur Park, Carroll Parks and Rose Park.
Hellman Long Beach CA has a Walk Score of 77 out of 100. This location is Very Walkable so most errands can be accomplished on foot.
Nearby schools include Lincoln Elementary School, Burbank Elementary School and Burbank Child Development Center.
The closest grocery stores are KMP Market, norgate and 562 Discount Med.
Nearby coffee shops include Choices Cafe, The Flea Espresso Bar and Portfolio Coffee House LLC. There are 48 restaurants within a 15 minute walk including Sunrise Donuts, Zizinia and Bai-Plu.
Hellman Long Beach CA is near California State University - Long Beach.
There are minimal bike lanes and the terrain is flat as a pancake. Hellman Long Beach CA is bikeable, there is some bike infrastructure.
We are proudly offering for rent this 2 bedroom 1 bath apartment in the City of located close to the Traffic Pacific Coast. The apartment is approximately square feet with 2 bedrooms, 1 bathroom, a balcony, stove, onsite laundry room, and 2 gated parking spaces. The property has new exterior paint, For other available listings in your area, feel free to check our. at.


text:
e-Learning and Medical Education
Advertisement: Preregister now for the Medicine 2.0 Congress
|Download PDF
Original Paper
Effectiveness of YouTube as a Source of Medical Information on Heart Transplantation
He-Ming Chen1,2*, MS; Zhong-Kai Hu3,4*, PhD; Xiao-Lin Zheng3,4, PhD; Zhao-Shun Yuan1, MS; Zhao-Bin Xu1, MD; Ling-Qing Yuan5, MD; Vinicio A De Jesus Perez6, MD; Ke Yuan6, PhD; Mark Orcholski6, BSc; Xiao-Bo Liao1,6, MD
1Division of Cardiothoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
2Complex Carbohydrate Research Center, University of Georgia, Athens, GA, United States
3College of Computer Science, Zhejiang University, Hangzhou, China
4Division of Medical Informatics, Stanford University Medical Center, Stanford, CA, United States
5Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China
6Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Stanford, CA, United States
*these authors contributed equally
Division of Cardiothoracic Surgery
The Second Xiangya Hospital
Central South University
139# Renmin Road
Changsha, 410011
Phone: 86 0731 85295102
Fax: 86 0731 85292133
ABSTRACTBackground: In this digital era, there is a growing tendency to use the popular Internet site YouTube as a new electronic-learning (e-learning) means for continuing medical education. Heart transplantation (HTx) remains the most viable option for patients with end-stage heart failure or severe coronary artery disease. There are plenty of freely accessible YouTube videos providing medical information about HTx.
Objective: The aim of the present study is to determine the effectiveness of YouTube as an e-learning source on HTx.
Methods: In order to carry out this study, YouTube was searched for videos uploaded containing surgical-related information using the four keywords: (1) "heart transplantation", (2) "cardiac transplantation", (3) "heart transplantation operation", and (4) "cardiac transplantation operation". Only videos in English (with comments or subtitles in English language) were included. Two experienced cardiac surgeons watched each video (N=1800) and classified them as useful, misleading, or recipients videos based on the HTx-relevant information. The kappa statistic was used to measure interobserver variability. Data was analyzed according to six types of YouTube characteristics including "total viewership", "duration", "source", "days since upload", "scores" given by the viewers, and specialized information contents of the videos.
Results: A total of 342/1800 (19.00%) videos had relevant information about HTx. Of these 342 videos, 215 (62.8%) videos had useful information about specialized knowledge, 7/342 (2.0%) were found to be misleading, and 120/342 (35.1%) only concerned recipients' individual issues. Useful videos had 56.09% of total viewership share (2,175,845/3,878,890), whereas misleading had 35.47% (1,375,673/3,878,890). Independent user channel videos accounted for a smaller proportion (19% in total numbers) but might have a wider impact on Web viewers, with the highest mean views/day (mean 39, SD 107) among four kinds of channels to distribute HTx-related information.
Conclusions: YouTube videos on HTx benefit medical professionals by providing a substantial amount of information. However, it is a time-consuming course to find high-quality videos. More authoritative videos by trusted sources should be posted for dissemination of reliable information. With an improvement of ranking system and content providers in future, YouTube, as a freely accessible outlet, will help to meet the huge informational needs of medical staffs and promote medical education on HTx.
(Interact J Med Res 2013;2(2):e28)
heart transplantation; Internet; medical informatics; online videos; YouTube; e-learning
Heart transplantation (HTx) is still the gold standard in the treatment of end-stage heart failure for appropriate candidates [1]. Since the first successful human-to-human HTx was performed in 1967, the survival quality and life span of HTx recipients have improved tremendously [2]. Between 1982 and 2009, there were 97,911 cases of HTx in the world, according to the Registry report of the International Society for Heart and Lung Transplantation (ISHLT) [3]. Along with the evolving development in patient selection, surgical techniques, perioperative care, and clinical follow-up, the outcomes of HTx have improved over the past four decades [1]. The overall survival rates after HTx show inspiring results from the data of ISHLT: five-year overall survival rates were 62.49-68.94%, ten-year 47.53-52.08%, and fifteen-year 29.63-37.05% [4]. Furthermore, the quality of life of HTx recipients is excellent. For instance, if including housewife recipients, approximately 90% of the adult recipients returned to their job following HTx in Japan [5]. Nevertheless, the volumes of HTx recently slowly declined, largely due to a critical organ donor shortage, and there were approximately 2200 cases yearly in the United States [6,7]. Therefore, the shortage of live surgical cases has led to reduced opportunities to witness this major operation, especially for medical students and trainee doctors.
At present, the Internet has become the largest and most up-to-date source for medical information worldwide [8]. In North America alone, 74% of adults use the Internet daily, and 80% of all users search for health-related information [9-11]. Acquiring and sharing medical information via the Internet offers extraordinary electronic-learning (e-learning) possibilities and has gradually changed the learning habits of medical professionals. When questions about health care arise, physicians increasingly turn to the Internet, which has changed the way medical students learn, communicate, and share specialized information, rather than to journals and textbooks [12,13]. Major search engines, such as Google, are often the first place physicians go for information [13-15]. Since 2005, YouTube has become the third most visited site on the Internet, after Facebook and Google [9,16]. Presently, there are over 4 billion hours of video being watched per month on YouTube, with 72 hours of video uploaded per minute, triple the statistical outcome in 2010 [17,18]. Therefore, the YouTube website is currently the leading audiovisual information center of medically relevant videos [13]. Numerous individuals, organizations, hospitals, and academic institutions from around the world have uploaded plenty of freely accessible medical videos onto the YouTube website. Moreover, the new generation of medical professionals is inclined to use social networks, online communities, and multiple media to learn specialized knowledge, because these means possess a nature of immediacy and parallelism when presenting information [19]. Currently, 94% of medical students actively participate in social media applications, compared to 79% of residents and 42% of physicians [19,20].
Some scholars have evaluated YouTube as a source of medical information on H1N1 influenza, papillomavirus vaccination, prostate cancer, and kidney stone [21-24]. However, until now, little is known about the characteristics of existing YouTube videos focusing on HTx. To our knowledge, there is no investigation to have examined the quality of videos related to HTx on YouTube. In this study, our aim is to assess the overall situation of specialized medical information in HTx-related YouTube videos.
Determination of HTx-Related Videos
This trial was conducted as a cross-sectional analysis. The website YouTube (YouTube, LLC, San Bruno, CA) was searched according to "relevance" priority for the following keywords: "heart transplantation", "cardiac transplantation", "heart transplantation operation", and "cardiac transplantation operation." All the videos containing relevant information about HTx before February 01, 2013 were included in this study. The total number of videos that appeared in the searching was 6930. However, 95% of people conducting an online search will watch no further than the first 60 videos of output, and most researchers for similar studies on YouTube videos usually chose the first 200 to 300 videos as their data sources [24-26]. Thus, we viewed and analyzed the first 1800/6930 (25.97%) videos (600 in 3750 "heart transplantation", 600 in 1200 "cardiac transplantation", 300 in 770 "heart transplantation operation", and 300 in 1210 "cardiac transplantation operation"), on the assumption that no medical practitioner would go beyond the first 300 to 600 videos even for a serious e-learning goal. English language (comments or subtitles) in the video was a prerequisite for inclusion. Among all the videos, those meeting this inclusive criterion were further viewed. Data evaluation was independently conducted by two experienced cardiac surgeons (H-M Chen and X-B Liao) blind to each other. After discarding all the videos that were either duplicated, which have partially or completely identical content with shorter durations (part or whole, 647/1800, 35.94%), or completely irrelevant with medical knowledge (811/1800, 45.05% such as the names of some songs or electronic games), all the videos containing specialized medical information on HTx (342/1800, 19.00%, such as surgical lectures or live broadcasts) were classified from the aspect of information and knowledge as useful, misleading, and recipients videos (Figure 1). This classifying methodology of our study was conducted in accordance with the observations of Sood et al [24,27,28].
First, the video was grouped under the "useful" category if it contained scientifically correct information about any aspect of HTx such as donor procurement, surgical techniques, perioperative management, rejection control, clinical follow-up, new technologies, or the issues about medical humanities (eg, history of HTx, appealing for organ donation, etc). Second, the video was categorized as "misleading" if it contained scientifically incorrect or unproven information for now (eg, self-healing from serious heart failure by the help of the God rather than medical service; asserting that mechanical circulatory support is currently a practical alternative to HTx, but without convincing proof existing in the literature; oversight during the delivery and preservation of cardiac graft; and dissemination for abandoning HTx in end-stage heart failure patients). Finally, if the video described recipients' personal experience rather than medical information of HTx per se (eg, for raising donation, expressing gratitude, advertising hospitals, etc), it was called a "recipients video."
In case the investigators' designation was not identical, the video was reevaluated with both surgeons and a united assessment was conducted. The kappa statistic was used to measure interinvestigator variability.
[view this figure]
|Figure 1. A graphic display of the classifying process of HTx-related videos.
Basic Communicative Analyses of HTx-Related Videos
Videos were categorized according to the "source" into four groups: namely, hospital/university channel (H/UC), independent user channel (IUC), medical dotcom channel (MDC), and news agency channel (NAC) [21,24]. These four categories were determined after watching all the videos and were chosen on the basis of the primary themes that emerged. Data were analyzed according to six kinds of YouTube characteristics that include (1) "total viewership", (2) "duration", (3) "source", (4) "days since upload", (5) "scores" given by the viewers, and (6) specialized information contents of the videos. To begin with the evaluation process, first, the "scores" of videos were used to describe the general evaluation of each video, which were determined by subtracting the total number of "dislikes" from the total number of "likes" designated by antecedent viewers at the statistical point in time. In our opinion, the higher positive value of "scores" may mean higher recognition of antecedent viewers and more attractive to new viewers.
Data were analyzed with SPSS version 19.0 (SPSS Inc) and presented as mean (SD). When more than two groups of means were compared (eg, mean "duration", mean number of "days since upload", and mean "scores" for four source groups), data were analyzed for statistical significance using a one-way analysis of variance (ANOVA) followed by a Tukey comparison of all groups. Before running the analysis, data were checked to determine if they met the assumptions of ANOVA (homogeneity of variances and data were sampled from the Gaussian distribution). P value less than .05 was considered statistically significant.
Top 10 YouTube Videos After Searching With the Term "Heart Transplantation"
After the first-step search with four key terms, the vast majority of the output consisted of nonmedical or minute-medical videos without meaningful and specialized information (such as live but shaking or silent videos of less than 10 seconds). For example, a YouTube search for the term "heart transplantation" returned 3750 videos, and the top 10 outcomes sorted by relevance are provided in Table 1. Observably, the first four videos and the last three videos are useful for medical professionals. However, three intermediate videos (ranked 5th, 6th, and 7th) are all the advertisements of an electronic game named "Surgeon Simulator 2013." In short, 3 days after uploading, the number of their "total viewership" accounted for 291,760/1,069,235 (27.28%) of the number of whole "total viewership" of these 10 videos. Furthermore, the "scores" of these 3 videos, which are completely uncorrelated with HTx, unexpectedly showed high value (1003, 394, and 2469, respectively).
Classification of HTx-Related Videos
Of all the YouTube videos that were viewed, 342/1800 (19.00%) videos were classified into three groups containing medical information on HTx (total duration, 2373.8 minutes). Details for the inclusion of these videos are shown in Figure 1. The kappa coefficient of agreement on classification of videos between two surgeons was .89, which is usually in the "almost perfect" agreement range (.81-.99) [39]. The classification of these HTx-relevant videos based on their usefulness with details of other characteristics is given in Table 2. The mean duration of 342 videos was 6.94 minutes (SD 11.59, range 0.5-93), the mean scores of them showed 18.77 (SD 99.69, range 42 to 1148), and the mean viewers/day (since the date videos being uploaded)" were 15.95 (SD 67.14, range 0.02-785.30).
The majority of the useful videos were mainly posted by strong reputation such as H/UC (88/214, 41.1%) and NAC (64/214, 29.9%) (Table 2). For example, the "batsonhospital" channel provided the third ranked video in Table 1, which documented a success story about the fourth pediatric HTx in the Batson Children's Hospital at the University of Mississippi Medical Center (see Multimedia Appendix 1). On the contrary, IUC delivered a majority of the misleading videos (5/6, 83%) and recipients videos (45/126, 35.7%). Detailed analysis of useful videos is shown in Table 3. Videos uploaded by H/UC occupied the vast proportion both in numbers (88/214, 41.1%) and total duration in minutes (657.05/1723.7, 38.12%) among all videos. No statistically significant difference was noted in the mean "duration" (P=.55), mean "days since upload" (P=.25), and mean "scores" (P=.28) among useful videos based on "source" by ANOVA. However, useful IUC (40/214, 18.7%) videos had significantly higher mean "viewers/day" than H/UC videos (P=.006) and NAC videos (P=.046).
Communicative Analyses of Useful and Misleading Videos
Useful videos were also analyzed based on the medical information they delivered. All useful videos contained HTx-related information on at least one or more of the following aspects: (1) live demonstration of HTx, (2) brief introduction of surgeries, (3) release of new technologies, (4) scholar viewpoints by experts, or (5) medical humanities. For example, videos were categorized as "medical humanities" if the main message of the videos portrayed the history of HTx or brainstormed on the issue of organ donation after brain death. Content analysis of useful videos with respect to the above five aspects is presented in Table 4. The annual number of useful HTx-related videos shows an uptrend since 2007, especially with a growth spurt in 2012 (Figure 2).
Compared with useful videos, the misleading videos demonstrated the following characteristic: fewer numbers, shorter total and mean "duration", but higher mean "scores" and mean "viewers/day" (Table 2). These results suggest that the misleading videos might have a more influence on audience compared to useful videos. However, because the data of misleading videos presented a non-Gaussian distribution with a small number of samples (just 6 videos), we did not further analyze these data.
[view this table]
|Table 1. A summary of the top ten videos ranked by their "relevance"a resulting from a YouTube search for "heart transplantation" (HTx) on February 01, 2013.
[view this table]
|Table 2. Detailed characteristics of different categories of YouTube videos with relevant information on HTx.
[view this table]
|Table 3. Detailed characteristics of "useful videos" on YouTube uploaded by different sources.
[view this table]
|Table 4. Detailed content analysis of "useful videos" from five aspects.
[view this figure]
|Figure 2. The annual numbers of useful HTx-related videos.
Principal Results
With the rise in popularity of the website YouTube, there is now another route by which medical professionals can learn the specialized knowledge. YouTube enables physicians and institutions with strong reputation to upload multimedia clips of medical knowledge on their channels. For instance, in Table 1, the fourth top video relevant to HTx (see Multimedia Appendix 2) had a high total viewership, which encompassed a live HTx operation with a panel discussion at the Montefiore-Einstein Heart Center, on September 19, 2007. This webcast-featured video portioned the scene of HTx as well as detailed descriptions of surgical techniques. The "scores" (1003 on February 1, 2013) of this video were very high, and it has won a lot of commendableness from physicians and patients, such as "Praise the doctors doing the surgery and teaching new doctors. Praise the experts that designed the tools..." (see Figure 3, comment from a YouTube user named "airborne101st45").
YouTube videos provide us an effective way to actively engage with our worldwide colleagues, by subscribing and responding to high-quality clips from the respected individual surgeons. Although there is no information available on how many of the viewers of these videos were medical personnel, it is obvious that those high-quality videos can be used by medical staff and can improve the learning outcomes of physicians. For instance, in the live implantation video of a left ventricular assist device (LVAD, Heartmate II) as a bridge to HTx (see Multimedia Appendix 3), Dr Arie Blitz brought clarity and "even made laymen to understand the patients by seeing these procedures" (appraisement from a YouTube user named "Pat Stewart", see Figure 4). After reviewing utterly specialized questions, such as why not performing a transapical aortic valve combined with LVAD implantation, Dr Arie Blitz always gave counterparts prompt and active responses (Figure 5).
However, our study demonstrated that the majority of HTx-related videos were easily available yet often without expertise information. Considering all the videos that were uploaded before February 1, 2013, YouTube had nearly 7000 videos by searching the keywords about HTx, yet only 342 of the 1800 (19.00%) videos were actually related. Furthermore, in about 40 hours of coverage of these videos, only 72.61% of them contained useful specialized information about this challenging surgery. At present, many reliable academic institutions, such as ISHLT, have not exerted their positive and dominant impacts to increase the signal-to-noise ratio of HTx-related YouTube videos, through uploading their high-quality videos for viewing by people. For example, the American Association for Thoracic Surgery (AATS) has been registered as an organizational user (AATSVideos) on November 7, 2012. However, there were only 21 videos as open resources, which contain nothing about HTx. Interestingly, the striking "Watch AATS Video" sign always stays at the top of AATS website, and there are five links to the Cardiothoracic Surgery Network (CTSNet), which deposited 159 authoritative videos of cardiac surgeries until April 12, 2013. Therefore, even with a newest video titled "Left Ventricular Aneurysm Resection and LVAD Implantation Through Median Sternotomy" (Multimedia Appendix 4) on CTSNet, there was no HTx-related video in AATSVideos Channel. On April 12, 2013, the number of subscribers of "AATSVideos" Channel was still five, and two of the five guys were the authors (X-B Liao and H-M Chen) of this paper. Therefore, with the accumulation of a lot of unrelated videos, there is an exigent need to upload reliable, high-quality HTx-related videos, by professional medical educators, institutions, and organizations.
In addition to the lack of goal-oriented contents from authoritative organizations and trustworthy individuals, there is a real risk of dissemination of misleading information by YouTube. In our study, we found that the maximum-weight misleading video (see Multimedia Appendix 5) accounted for 88.27% (1,214,312/1,375,673) of total viewership, and it arouse a significant support with a "scores" number of 272 (345 "likes"; 73 "dislikes"). The video was uploaded on November 11, 2008 and featured one 13-year-old British girl who claimed to refuse HTx. Her option was obviously irrational and unscientific, thus inevitably, it would negatively affect some viewers. Paradoxically, "She changed her decision when her situation worsened, she underwent the surgery at the Great Ormond City Hospital" (see Figure 6, comment from a YouTube user named "Sorgutentarer"). Nevertheless, this video is still online. Today, content generation is no longer limited to the health care professionals; Web 2.0 services and platforms have empowered patients to create and interact videos with various forms of patient-generated content [40]. Therefore, it is understandable that the emergence of quality-without-assurance videos prompts skepticism and worries along with the obvious information overload.
[view this figure]
|Figure 3. A screenshot of the commendable from Web viewers (on April 12, 2013).
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|Figure 4. A screenshot of the comments from Web viewers (on April 12, 2013).
[view this figure]
|Figure 5. A screenshot of the utterly specialized BiVAD-related discussions (on April 12, 2013).
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|Figure 6. A screenshot of the comments from web viewers about the misleading video (on April 12, 2013).
Optimizing Directions
Given the problems above, two measures can be implemented by YouTube to improve its functionality with a more efficient way of providing high-quality medical videos. First, a professional community targeting at medical education can be built to inspire specialized videos uploading and consumption, just as iTunes U. Since introduced in 2007, Apple's iTunes U courses (more than 2500) on a variety of topics have topped a billion downloads, and these courses are contributed by over 2400 educational institutions including universities, colleges, K-12 schools, and districts [40]. As the most advantageous online video provider, YouTube can take use of its incomparably competitive edge to encourage physicians, hospitals, and institutions to upload more instructional videos. Besides, this professional community will bring about specialized ranking outputs by separating e-learning-oriented viewers from common ones just for recreational needs. Based on the specialized community, searching experiences of the users can be optimized and remembered by mining social network characteristics [41], such as an expert assessment model that can strength weight of user rating in ranking factors [42]. Video providers can be scored based on their specialty approbation, and their score can be taken into account and reflected in the ranking system. Moreover, graphical model can be used in social community and medical experts can be distinguished from amateurs [43,44]. Thus more accurate recommendation of relevant videos can be given. Fernandez-Luque et al used a link-based analysis based on a metric called "HealthTrust" to acquire diabetes content from YouTube [45]. Their result indicated that social network analysis could be used to identify trustworthy multimedia in health communities.
Second, more precise and personalized lists of video after searching on YouTube should be provided. When a medical practitioner wants to access HTx-related videos, the most common way is to input keywords (eg, "heart transplantation"), wait for automatic operation embedded in the YouTube search tool, and then look over the videos according to the search result list in sequence. The purposes of viewers for viewing the videos are different, in which some physicians want to look for similar experience as reference for their clinical decision-making or operative skills, and other trainees wish to look up correct and useful information just as learning materials. Though out of different purposes, they don't expect to be distracted by irrelevant, even misleading information. To meet professional requirements with the least disturbance, YouTube ranking system should be refined and improved.
In the current YouTube ranking system, there are two comprehensive aspects of ranking factors: (1) "content", which is out of the video self-characteristics, such as correlation between search keywords, video title, and description, and (2) "engagement", which is contributed by viewer interaction in YouTube social community. There are 12 different detailed factors that are used to determine rank of each video (Table 5) [46]. With the help of these factors, YouTube not only explores the correlation between search keywords and candidate videos but also takes popularity of videos into account. However, the ranking system is mainly based on the relationship of viewership or hits, although YouTube has updated its algorithm with video-discovery features, such as "time watched" [47].
In the present study, it was found that the "scores" of three advertisement videos of "Surgeon Simulator 2013", an electronic game, were unexpectedly high. However, they were completely uncorrelated with HTx (Table 1). On the other hand, the results of this study showed that IUC videos had significantly higher mean "viewers/day" than H/UC and NAC videos. This phenomenon reflected that viewers are more interested in personal experiences about HTx rather than in professional conferences or didactic lectures, irrespective of authenticity or authority of multimedia materials. Thereupon, this ranking system is still focusing on the popularity of videos, not exactly the accuracy and correlation between videos' contents and searching keywords.
It is required to take deeper use of social network relationship among viewers. Users' historical viewing records can be regarded as personal profile, so system can supply personalized search results according to each user's preference, by using techniques in recommendation system [41], such as collaborating filter and opinion mining [48]. For instance, for a user whose historical viewing records include plenty of cardiac surgery videos, if he/she searches HTx, there is a great possibility that the desired videos are specialized materials for e-learning, other than personal experience sharing just as a recipient. Furthermore, it may benefit the ranking effect to mine literal information generated by viewers via using natural language processing (NLP) techniques, because it can strengthen the correlation between videos and search keywords [49]. So far, superficial literal features on video have been focused on YouTube ranking system; however, there is no evidence that showed that the comments generated by viewers have been noticed enough as they deserved. Most comments contain viewers' affection response to these videos; therefore, comments can be used to adjust video rating as a feedback. To date, researches on how to efficiently retrieve medical-related videos from YouTube are still few in number. Commonly, collocations in the context are much more informative than frequent phrases [50,51]. Thus, it is probably a suitable means to extract content-related video by NLP-discovered phrases rather than keywords [52,53].
[view this table]
|Table 5. YouTube ranking factors.a
Study Limitations
First, our study was confined to the content analysis of HTx-related videos retrieved on February 01, 2013. This cross-sectional observation is like a snapshot of information distribution, but the actual source from YouTube is swiftly expanding as one never-ending documentary. Second, our classification method was subjective. However, the kappa coefficient demonstrated fairly high agreement between two cardiac surgeons. We did not extrapolate the percentage of "useful" and "misleading" videos in our dataset to all the HTx-related YouTube videos. Furthermore, our analysis of the comments and the social interactions of viewers and uploaders was based on pure observation without a solid methodological approach. The "scores" are based on "likes" or "dislikes", and it may not be an excellent indication of viewer preferences or video quality on medical contents. Third, non-English language video clips were excluded, which included some valuable videos, such as many French language HTx-related videos. Fourth, we did not revalidate the results in other networking platforms, such as Baidu or Facebook. Finally, this study was limited to a direct search on YouTube, so we might have missed some valuable surgical videos that could be viewed at other available health information websites.
This study demonstrates a panoramic view of HTx-related videos on YouTube until February 1, 2013. The results of this study showed that YouTube benefits medical professionals by providing a substantial amount of specialized information. However, casting YouTube to find HTx-related videos is currently inefficient. As more young medical trainees are eagerly participating in social media and e-learning activities, it is reasonable to promote and optimize the dissemination of free and valuable medical videos via YouTube. It is clear from the results of this study that the quality of surgical specialized information in YouTube videos is very heterogeneous and the process of e-learning is not without pitfalls. The reasons include that (1) the content of most videos often lacks institutional or peer quality control, thus the specialized information shared may be not accurate; (2) finding informative and trustworthy targets is hampered by the vast amount of seemingly relevant videos via current ranking system. To solve these problems, we are expecting changes in two aspects. First, more authoritative videos by trusted sources should be posted. Second, ranking system based on present YouTube algorithm may be evolved by adding some elements like peer review, social network analysis, or NLP techniques. With the endeavors of professional individuals, academic institutions, and e-learning communities, YouTube, the leading video streaming websites, will help to meet huge informational needs of medical staffs and promote medical education on HTx.
This research was partly supported by The National Natural Science Foundation of China, under grants (No. 30900622, 81270962, and 81070159). The work of X-B Liao was sponsored by CJ Huang Medical Fellowship of Stanford University. The authors are grateful to Dr Mark Nicolls and Dr Rosen Glenn for providing superb academic environment in postdocs' free accessing to knowledge. Furthermore, the authors got excellent guidance from Dr Dipanjan Banerjee and Jodi Halpern.
Authors' Contributions
The authors XBL, HMC, XLZ, and VADJP were involved in the study design; XBL, HMC, ZBX, ZSY, KY, and MO participated in the data collection; XBL, HMC, ZKH, LQY, XLZ, and VADJP participated in the discussion and interpretation of the results; and XBL, HMC, ZKH, and VADJP led the manuscript drafting. All authors have read and approved the final manuscript.
Conflicts of Interest
None declared.
Multimedia Appendix 1
The Revived Heart Transplant Program at Batson Children's Hospital builds on a 20-year legacy.[MP4 File (MP4 Video), 109MB]
Multimedia Appendix 2
The heart transplant procedure from Montefiore-Einstein, NYC.[MP4 File (MP4 Video), 135MB]
Multimedia Appendix 3
Example of a high-quality surgical educational video "Heartmate II LVAD Implantation. Arie Blitz, MD" uploaded by "Arie Blitz" channel. It was originally from the YouTube website, reproduced under Creative Commons Attribution License.[FLV File, 93MB]
Multimedia Appendix 4
A newest video titled "Left Ventricular Aneurysm Resection and LVAD Implantation Through Median Sternotomy" available on the website of CTSNet; however, it cannot be accessed from "AATSVideos" Channel. It was reproduced under Creative Commons Attribution License.[MP3 File, 5MB]
Multimedia Appendix 5
The maximum-weight misleading video "13-year-old British girl" uploaded by "uniquerocks" Channel. It was from originally from the YouTube website, reproduced under Creative Commons Attribution License.[MP4 File (MP4 Video), 3MB]
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|AATS: American Association of Thoracic Surgery
|ANOVA: one-way analysis of variance
|CTSNet: Cardiothoracic Surgery Network
|HTx: heart transplantation
|H/UC: hospital/university channel
|ISHLT: International Society for Heart and Lung Transplantation
|IUC: independent user channel
|LVAD: left ventricular assist device
|MDC: medical dotcom channel
|NAC: news agency channel
|NLP: natural language processing
|Edited by G Eysenbach; submitted 15.04.13; peer-reviewed by DM Liou, L Fernandez-Luque, R Thackeray; comments to author 10.05.13; revised version received 14.07.13; accepted 08.10.13; published 21.11.13
Please cite as:
Chen HM, Hu ZK, Zheng XL, Yuan ZS, Xu ZB, Yuan LQ, Perez VADeJ, Yuan Ke, Orcholski M, Liao XB
Effectiveness of YouTube as a Source of Medical Information on Heart Transplantation
Interact J Med Res 2013;2(2):e28
URL: http://www.i-jmr.org/2013/2/e28/
doi: 10.2196/ijmr.2669
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Copyright©He-Ming Chen, Zhong-Kai Hu, Xiao-Lin Zheng, Zhao-Shun Yuan, Zhao-Bin Xu, Ling-Qing Yuan, Vinicio A De Jesus Perez, Ke Yuan, Mark Orcholski, Xiao-Bo Liao. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 21.11.2013.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Interactive Journal of Medical Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.i-jmr.org/, as well as this copyright and license information must be included.


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I am not a girly-girl. Much to my mother's chagrin I was a tomboy as a child, more likely to be mucking around in the dirt than playing dress up. I haven't gotten much better as an adult but, after six years in Kentucky, a little bit of Southern femininity has rubbed off on me. Now I rarely leave the house without some makeup on and at least once a month I head to the salon to get my nails done.
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Photo: Fab Fatale via Pinterest
I used to think of nail art as being either really childish or kind of trashy. But celebrity manicurists have helped to create classy new styles that copy fashion trends and are still wearable in everyday life. For example, I love how Fab Fatale layered Deborah Lippmann's Boom Boom Pow, made with 24k gold dust and chunky glitter, over a subtle nude shade to give it a bit of bling. I think this could be my gateway polish to going a little more glam.
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For even more texture, fashionistas are turning to the Ciaté Caviar Manicure, for which tiny beads of colour are applied to a basecoat. This was originally created for a magazine cover shoot and it doesn't last very long, so it would be best for special occasions. I must admit, I'm intrigued by the look but I think that having textured nails would drive me crazy.
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Another fashion trend that has been used in everything from clothing to hair colour is the ombré effect, a subtle gradation of colour from light to dark. The easiest way to do this with a manicure is to pick five shades of one colour and paint one on each nail from lightest to darkest. If you are going to go this route, it's best to pick colours that you really like so that you can wear them individually. Another way to achieve this effect is to buy one polish along with a bottle of white; simply pour the varnish into five small containers and add increasing amounts of the white to create custom gradations.
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Neon has made a big comeback this year. I'm old enough to have worn it the first time it was in, so I'm not going there now. But I might try Refinery 29's Neon Splatter Manicure, which manages to incorporate the bright hues without being overwhelming.
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I'm a little obsessed with text art so I was over the moon when I saw this Newspaper Transfer Manicure on If It's Hip It's Here. I'm really horrible at applying my own polish, hence my trips to the salon, but this is so cool I might have to bust out tools.
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If you are also a little challenged in the nail polish application department, you might want to start with nail decals. Companies like Nail Fraud offer dozens of patterns. Styles range from subdued to show-stopping, so there really is something for everyone. Their biggest advantage? They take only a few minutes to apply and there is no drying time!
Photo: Nail Side
The secret to keeping nail art looking cool is to keep your nails short and file them in a slightly rounded shape. So this weekend, take some time for yourself; grab your favourite polish and create some art!


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"True Blood" Episode 410 Recap: "Burning Down the House"
After getting the crap beaten out of him by Marcus and his goons, Tommy is bleeding out on the front seat of Alcide's van. Then, because of the whole skinwalker thing, he starts barfing blood and writhing in pain.
Alcide is trying to figure out where to take him for help, but Tommy says it's too late for that. He just wants to go "home," meaning Merlotte's.
At Merlotte's, Sam speeds into the parking lot and runs inside. I'm not sure if Alcide called him, or he sensed a disturbance in the Force, or merely freaked out because he'd left his iron turned on, but for whatever reason, he's ditched his camping-sex trip with Luna and rushed home.
He and Alcide help a bloody Tommy onto the pool table. Sam is trying to figure out how to help him, but Tommy again says it's too late. He takes about 15 more minutes to die, and there's some nice acting here and the brothers forgive each other, and then he kicks the bucket.
It's a testament to how well done this sequence is that even though I never really cared for this character, I am a bit sad to see him go this way.
Afterward, Sam vows to Alcide that Marcus is a dead man, and Alcide happily drives him over to Marcus' place to kill him off. A lot of stuff with Alcide has been really out of character lately. I don't think he would so eagerly have backed Marcus up last week, and I'm not sure he'd so eagerly help Sam now confront him. Wouldn't be be more the peacekeeping type? Or at least the "let's see Marcus dealt with by the proper werewolf authorities" type?
Anyway, they go to Marcus' garage, but Marcus isn't there. Instead, it's one of his goons who helped beat Tommy, and Sam decides to use him as a practice punching bag before the real thing.
Where is Marcus, you wonder? Why offering loving consolation to that tender, delicate flower, Debbie Pelt. The two of them are getting high on his sofa, and she's bitching about how Alcide didn't come home the night before. Then she tells Marcus that Alcide won't give her the one thing she wants most – a child – and she sort of puts herself in position to illustrate what a child-bearing Debbie Pelt might look like.
Marcus responds by happily groping her, and all I can think is just how high is she? Because anybody that would trade an Alcide for this guy is seriously off their gourd. I'm officially downgrading him from hot-skeevy to just plain skeevy. Heck, he's more than skeevy. He's Skeevy Plus.
WTF Rating: 3
Tommy's death aside, like so much else this episode, this seems like a mere precursor to a bigger battle that's about to come. But in all the Sam/Alcide/Marcus battling, I just hope we find time for Debbie to find her way back to Sookie.


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Faith's Faculty:Qualified and Experienced
Many factors contribute to a successful college experience, but none is more significant than the faculty members. Faith's faculty members offer a balance of academic qualification and extensive ministry and professional experience.
Faith faculty members are academically qualified. More than two-thirds of Faith's faculty members have an earned doctorate.
Faith faculty members have extensive ministry and professional experience. Dr. Robert Domokos, the head of our Pastoral Training Department, has over 30 years of ministry experience as a pastor and interim pastor. Mr. Mark Lounsbrough, the head of our Missions Department, had almost 20 years of field experience in Brazil before coming to Faith to teach. Dr. Paul Hartog, co-chair of the Bible and Theology Department, has written a major book for Oxford University Press.
This balance of practical field experience as well as academic excellence not only sets Faith apart from other institutions, but it also plays a vital role in the overall preparation of the students. This balance will equip you for a successful life of service to Christ as a pastor, missionary, Sunday School teacher, husband, businessman, mother, Christian school teacher, lawyer, or whatever vocation God calls you to!
The Presidential Search Committee is pleased to share that we are engaged with a possible candidate for the office of president. Read More
Faith is pleased to announce the appointment of Jack and Lindsie Arneson to the Athletic Department. Read More
Terry Waltersdorf, Faith's dining services director, was recently honored for his outstanding work in the college food service industry. Read More
Central Baptist Theological Seminary recently honored Drs. George and Myron Houghton with honorary doctorates. Read More
The Faith Alumni Association honored Sandi Nihart and John Javaux with Alumnus of the Year awards. Read More
Pat Duer, Sally McFarling, David Stout, and Melody Mains honored with service awards. Read More