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Groo (Generic Robot, Object-Oriented) and tt14m (Trash-Talking 14-year-old Moron) are two systems that use simple and computationally inexpensive artificial intelligence mechanisms to produce engaging character behavior for computer games, while remaining within the performance constraints of modern game development. Groo engages in intelligent tactical behavior in a first-person-shooter death-match game using a fairly simple and static behavior network, while tt14m uses simple text processing to attempt engagement in the social aspects of the game "Counter-Strike".
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Thomas Keller, Founder Of Thomas Keller Restaurant Group
Host Jessica Harris speaks with chef and restaurateur Thomas Keller, who bought The French Laundry, a restaurant in Napa Valley California, and turned it into one of the leading fine dining establishments in the world.
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The dangerously evolving Spanish banking problem should now ring alarm bells in the EU and the UK. It is time to recognize that the eurozone has a banking crisis that is bigger than the sovereign debt problem.
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I suppose it was too much to ask for Snooki to put in an appearance in court today. Maybe she couldn't find anyone to cover her shift at the Shirt Shack.
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UDWC stands for UTCH Davis/Weber Co-Operative and is an official co-op of the Utah Christian Home School Association. We are a homeschool co-op that meets weekly for 10 week fall and winter terms to provide group instruction in a variety of subjects. We are a parent participation co-op and not a drop off program. Our host campus is Mountain View Baptist Church in Layton city in Davis county. The church does not operate our co-op, it has offered the space as a ministry/out-reach. Our co-op is made up of families who attend a wide variety of area churches.
For more information, please select the "About" Menu Option.
UDWC is a Parent Participation co-op. Co-op leadership, in conjunction with course coordinators, determine the course schedule for the year. Parents of students enrolled in those courses teach material if it is a teaching rotation course. Additionally, UDWC leadership, in conjunction with course coordinators, determine the total number of helping slots needing coverage throughout the entire schedule and divide them among the participants. Therefore, some parents may serve as helpers in courses in addition to/other than those in which their students are enrolled.
We ask families who choose to participate in this co-op to commit to participation for the full year and regular attendance, missing only due to illness or emergency. We ask families in UDWC to make co-op attendance a priority and schedule family vacations, activities, and appointments on different days. If you cannot commit to regular attendance and participation for the full year, UDWC is not the right co-op for your family. UDWC is volunteer dependent and the short terms (10 weeks) mean that every week's materials are very important for students to master materials presented. In addition, withdrawals during the co-op year burden coordinators, teachers, and co-op families with the time-consuming responsibility of filling empty teaching and helping slots.
For more information select the "Co-op Philosophy" Menu Option.
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|Reviews for Barren
| tigger2025643119 chapter 1 . 1/14/2005
aw. gr8 story. poor hermione. well done luv tigger ~x~
| zafaran chapter 1 . 10/25/2004
If this is you trying angst, you did a *very* good job of it. :) Very nice job. Zafaran
| June chapter 1 . 10/23/2004
Wow ... very dark and serious. I'm glad Snape came in at the end. I know this is a one-shot, but in my mind's eternal hope for a somewhat happy ending, I can see Snape showing her respect by making her a Potions assistant/apprentice. After all, she still has her intelligence, etc. Or she could teach arithmancy or astronomy, or even Muggle Studies. And after the war, maybe SS-HG romance. OR, you could write a sequel!
| jen chapter 1 . 10/11/2004
Powerful and short. Wow.
Rosemary's Baby scared the hell out of me, by the way.
If Hermione loses her magic, is she able to brew potions?
| adxlunam chapter 1 . 9/16/2004
That was amazing. I simply adored it. Congratulations on a great piece of work. :)
| SeverusSnapeishot chapter 1 . 7/22/2004
I LOVED LOVED LOVED this story. The ending was the most brillent I've ever read. And I mean ever. You must write more stories like this. This is the best story I've ever read on fanfiction and I've read close to a millon. I just love to read and when a Harry Potter book isn't out I come here and I must tell you that you are a brillant writer!
| Droxy chapter 1 . 7/20/2004
How the heck did I ever miss this gem? Lovely angst. Perfectly written with imaginative twists on HP universe magic.
| lavender baby chapter 1 . 6/1/2004
wow. great one shot. it would have been interesting to see how hermione's life turned out after she took the potion. its a great story even if it is somewhat gruesome, but then again, thats part of what makes it great.
| Krstna chapter 1 . 5/23/2004
I like the idea that she made apotion to make her barren so that seh can't have children, its kinda sad but it was a good story
| concrete13rose chapter 1 . 5/9/2004
that was extremely powerful. one of the best & most emotional stories I've ver read. amazing!
xxoo anniePADFOOT
| midnight Tiger chapter 1 . 5/4/2004
wonderful! the writting is so ... strikingly beautiful. thanks for posting it! (still hoping for an update on Heart over mind, PLEASE?)
| Vampireguardian chapter 1 . 5/1/2004
I thought this was good even if it had angst in it. I liked how you had the ending.
| Aloe chapter 1 . 3/16/2004
I can see Herm doing this ... and I think she made the right decision.
Well-written fan fic that forces you to think ... I'm impressed :)
| dedbabydoll chapter 1 . 7/29/2003
WOAH. WOAH. 0-0 That was...amazing. The scene with the potion was possibly the most...I dunno, dead shock ever. Reminds me a bit of every time I get my period, actually. This is seriously the 2nd most angsty fic Ever, Their Destiny being #1. I am chilled, shocked & moved by this, as short as it was. The horror of Hermione's sacrifice & her pain put me into a quiet state of awe & reflection. Wow. It seems that her pain was a breif glance into the eternal suffering of those damned to Hell forever. Intense.
| HeavenStone chapter 1 . 5/19/2003
I like your angst. It's very good. This is one of the first angst-based stories I've read, and if half of them are this good, perhaps I'll read more. _


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my oldest son's father works 6 days a week for a tree company he refuses to pay child support, Child support mailed his employer paperwork to start garnishing his wages, but his employer failed to respond within the 60 day time period. I have proof he works 40+hrs a wk (his facebook page has pictures of him working & on the job working & the company he works for has there own facebook page.) There's been a "Montion of Contempt" I'm wondering should I bring said pictures and other stuff?
How should I go about his employer plain out refusing to cooperating? isn't what his employer doing fraud?
Divorce / Separation Lawyer
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Divorce / Separation Lawyer
If he works for the tree company and they were properly noticed via an income deduction order, they can be held in contempt for violating a Court Order. You should contact an attorney in your area to assist you.
The answering of this question is just friendly advise, and in no way legal advise, nor create an attorney-client relationship. For legal advise you should contact an attorney with detailed information about your situation, so he or she can better assist you.
Family Law Attorney
If he works for the tree company and it appears as though you have evidence that he does, the tree company must comply with it or be held in contempt of Court and they can be fined for each pay period they have refused to honor the income deduction order. Good Luck.
B. Elaine Jones, Esq.
Family Law Attorney
Yes you can file a motion for contempt against the employer, and subpoena them to court.. Contact my office for free consultation 727-446-7659
Divorce / Separation Lawyer
I assume by child support enforcement you are referring to DOR. I would contact them and advise of the information you have and the employer's non-compliance. Go forward with your Motion for Contempt by setting it for hearing and provide this inofrmation to the Judge. You ay also want to subpoena the employer to the hearing so they can explain to the judge why they are failing to deduct. It is not clear if an income deduction order exists. If not, ask the court to enter one. If the employer then fails to abide they too are incontempt of court.
All answers are based on limited facts provided and should not be relied upon unless there is an attorney/client agreement and I speak with you Personally.
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Community Ties
UP Foundation Supports School Technology
Posted November 15, 2013 07:00 AM CDT
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From left to right: Sylvia Harris; Drew Tessier, UP director-Public Affairs for Arkansas and Louisiana; Bob Turner, UP senior vice president-Corporate Relations; Patricia Schexnayder; Louisiana First Lady Supriya Jindal; St. James Parish President Timmy Roussel; Dr. Josephine Allen Oubre, and Joycelyn Accardo.
A Louisiana elementary school is taking interactive learning to a new level, thanks to a partnership between Union Pacific and Louisiana's Supriya Jindal Foundation.
Supporting the railroad's commitment to enrich the quality of life where employees live and work, the Union Pacific Foundation partnered with the foundation for the third consecutive year to purchase hands-on educational supplies fostering student success.
This year's "School Surprise" was awarded to Fifth Ward Elementary, a neighbor to Union Pacific's planned rail yard in St. Joseph, La., said Drew Tessier, director-Public Affairs for Arkansas and Louisiana.
"Union Pacific is proud to partner with the Supriya Jindal Foundation to make this award possible for our new neighbor," Tessier said. "Teachers have told us that these enrichment tools transform the way they teach. Our hope is that the award packages will provide the opportunity to make a lasting and positive difference in education."
Bob Turner, senior vice president-Corporate Relations, and Tessier joined Louisiana First Lady Supriya Jindal in awarding Fifth Ward's pre-kindergarten and kindergarten classrooms "center-related" tools, such as books for a reading center, and magnets and weather charts for a science center.
The school's library also received an interactive whiteboard package for all Fifth Ward students to enjoy, featuring a laptop, whiteboard with speaker system, and response system allowing students to actively participate in lessons.
More Stories
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Apr. 18, 2016 04:00 PM CDT
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Apr. 11, 2016 11:43 AM CDT
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Feb. 26, 2016 03:14 PM CDT
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Feb. 12, 2016 02:00 PM CDT
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Jan. 7, 2016 02:47 PM CDT
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Dec. 23, 2015 11:44 AM CDT
Houston Literacy Program Strives to Break Cycle of Poverty
Dec. 18, 2015 12:22 PM CDT
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Dec. 9, 2015 10:21 AM CDT
When the Railroad Comes to Town
Dec. 4, 2015 11:05 AM CDT
UP Delivers Huge Holiday Tradition
Nov. 23, 2015 03:58 AM CDT
Steel Giants Promise Safe Passage
Nov. 13, 2015 11:00 AM CDT
UP Steam Update: Making Parts for a Living Legend
Nov. 12, 2015 02:38 PM CDT
New Railport in Kinney County, Texas, Delivers Cerveza
Nov. 10, 2015 01:30 PM CDT
The Feel-Good Story that Keeps Giving
Oct. 30, 2015 03:40 PM CDT


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The hotel is just off the 101 and very convenient for going to SF, getting to the airport and generally going around this area. The room was pretty large, nice, very clean even including a little side table.
The staff were very friendly checking us in and helpful throughout the stay. When we stayed (March 2013) the technology was pretty bad, wifi juts non existent for most of one morning whiel we were trying to determine what to do, the television also had rotten reception. The staff was accommodating and with a little nudging comped us breakfast to make up for inconvenience which was a really nice way to deal with this inconvenience and left me feeling this was dealt with appropriately.
We ened up feeling we had a good experience and would consider staying here again.
- Official Description (provided by the hotel):
- The Holiday Inn & Suites San Mateo / San Francisco SFO is the newest and most modern hotel in the area. Conveniently located off US-101, we are situated among fine dining, world-renowned attractions, endless shopping possibilities and vast business opportunities. Our prime location places you within minutes from the San Francisco International Airport, Downtown San Francisco, Golden Gate Park, Monster Park, San Mateo Expo Center, Downtown San Mateo, AT&T Park, Half Moon Bay, East Bay, Pier 39, Alcatraz, Fisherman's Warf, Hillsdale Mall, Pacifica Beach, Golden Gate Bridge and is a short drive from Napa and Sonoma Valley which hosts some of the finest vineyards in the world. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Hotels.com, Booking.com, IHG, Expedia, Hotwire, TripOnline SA, Travelocity, Priceline and Odigeo so you can book your Holiday Inn San Mateo-San Francisco SFO reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Holiday Inn San Mateo-San Francisco Sfo Hotel San Mateo
- Quality Inn San Mateo
- San Mateo Quality Inn


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Tried my hands on a newly bought Wacom Bamboo tablet. I used an actual Nike shoe from the website and used pen tool in Illustrator to draw this out.
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text: AdChoices Terms of Use Privacy Policy Hide TOP 10 Top 10 Better Man Top 10: 2009 Personal Finance Resolutions Share Tweet 0 Shares 6. Make an emergency fund iStockphoto.com You've probably heard a lot about having an emergency fund. With the world economy teetering on the brink of disaster, many people are taking the important step of establishing an emergency fund. The fact of the matter, however, is that you'll be glad you have an emergency fund regardless of the economic climate. An emergency fund will allow you to resolve minor disasters without going into debt. Next Page TOP 10 9 8 7 6 5 4 3 2 1 Comments Share your opinion Your name More Like This Finance Tips Take Control Of Her Finances Read More Finance Tips The Debt Debate Is Happening Now Read More Power & Money News Trending News: Let A Millennial Teach You How To Retire At 40 Read More Finance Tips Five Credit Card Perks That Will Save You Thousands Of Dollars Per Year Read More Top 10 Power & Money Have You Been Paying For A Bunch Of Travel Stuff You Could Be Getting For Free? Read More Finance Tips Why You Need To Take Advantage Of Your Workplace Retirement Plan Read More Around the Web Special Features Guy Gear The Best Watches Under $500 Read More Special Feature The Ultimate Guide To Hooking Up Online Read More


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62 reviews | 4.4 out of 5
It's fast, smooth, gorgeous, and has windows 8! I especially like how it was pretty much set up for me already. I've hated getting a new machine in the past because of all the complicated set up, not in this case. I didn't have to call my son for help! I know I'm going to get compliments at my meetings.....great buy, zero complaints
I just got my new laptop and it is great!!! I had a hard time deciding what computer to get because I just wanted to get if for school. I had only had a desktop, but I wanted to be able to bring my computer with to school to be able to work on my homework in between classes and not to always have to run to the computer lab, so this semester I started looking for a computer and this one caught my eye and then I had a family member look for me because I have never ordered my own computer before and we both agreed on this computer. It was a reasonable price and when I got it in the mail it was a little bit bigger of a computer then I thought, but when I started to use it I learned that I love it!!! It is big enough so I don't have to squint at the computer. I would definitely recommend this computer to others. It is a great computer for a reasonable price and it has been a great investment for school!! Another bonus was that it came almost a week earlier then it was suppose to, so that was very exciting!
This computer is a gr8 value for the money. It runs very smooth for a windows operating system and meets or exceeds my expectations for all my computing and gaming needs in a unique ruby red case and large led screen that is sure to turn heads.
I purchased this computer on Walmart.com and I must say that I am thrilled with the purchase. First off walmart was great at delivering before the expected delivery date. Also, this computer is everything I needed and more. My old laptop died after 6 years of use, so I needed a new one. I found this one on sell and HP is a brand I thoroughly trust. I needed the computer for school, work, and to hold a ton of music. This comp has excellent speed and graphics and does everything I need it to. Windows 8 is a bit different to get used to, but sit down with it for a couple hours and it's no sweat....it is set up a bit like a smart phone with apps instead of just a normal windows system. I love this computer. I also purchased an Ape Case Jumbo Size case for it.....not specifically made for laptops but it has more than enough room to house the laptop and power cord, and is fully padded which s important to me. So happy!
This is a great laptop. I was unsure about Windows 8 at first. Took some time fooling with it to learn all the new stuff. Now, I really enjoy it. The 17" screen is awesome. I am very glad I bought this laptop. The Ruby Red color is a much needed change from all the black, gray, silver computers. It it definitely great to look at. I have not had any complaints so far with this laptop.
I love my new laptop. I will recommend it to everyone I know ! I could not be happier with it. buy, buy buy this product
If I understood how windows 8 works better I would absolutely love this laptop. It took me 2 days to figure out how to turn it off!!!!! But it runs beautifully and the screen size makes picture pop right out at you....I would Definitely purchase this again
This laptop boots up nearly as fast as my homemade pc running Linux. I not a big fan of windows and I'm sure not a fan of Windows 8. Compared to other window operating systems win8 is stupid. It has all these apps but most you have to pay for. When I come across one I delete it. It has windows office sample but it's expensive. It connects easily to wireless networks. My modem went down once and I finished a emai on a neighbors unsecured network. But as far as a computer goes this one is excellent and is very pretty in ruby red and as far as a operating system Microsoft is the 2 ton gorilla so you don't have much choice.
I purchased this laptop for my parents, who are elderly and found the Windows 8 very difficult
to use unfortunately as it is not at all straightforward or logical, in my opinion. I will probably return it, thanks to Walmart's good return policies. I have found the Walmart internet site and the way they operate very good.
Windows 8 would be much easier to use if I had a touch screen, so I kind of wish I knew this was not a touch screen. Touchpad is a bit sensitive, so it is a bit of a learning curve on bringing up the "charms" and learning a whole new Windows environment. All the apps are pre-loaded, so I wish I could have chosen the apps instead of them being pre-installed. Again, takes a bit of a learning curve to learn Windows 8. Also, you need to have a hotmail account to set it up. Love the laptop otherwise. Nice, big screen. Pretty color. Numeric keypad is included on this keyboard, so that takes a little getting use to as the qwerty is slightly more left than the laptop I was using that did not have the numeric keypad. I do appreciate the keypad though. It was tough to find where to go to upload the updates, but I eventually found it under the HP tools button on the launch bar. I'd recommend this product, but I would have found it more user friendly if it were Windows 7 or Vista, or if it had a touchscreen to manipulate the tiles and charms. I would say it was a good price for this laptop, but unfortunately, the Microsoft Office Suite is not included, so I will have to invest another $300 to purchase the software.
Having tried other companies computers, when it comes down to it, I've always used HP, Compaq, and Windows computers since they are dependable. My last PC's hard drive crashed (my fault), which is why I bought this laptop. Initially, by initially I mean the first couple of days, I was getting impatient and started regretting the purchase. But I had to keep reminding myself that with every new Windows computer, you have to download all the updates and it takes time. So after installing service packs and updates, the computer was ready to use. And its amazing. I've had it for almost a month, which I know is a little short of time, and it's really fantastic. My most favorite part about the computer is the loading and saving time. It is so fast. Editing programs open in seconds and videos that used to take 25 minutes to save now literally takes 2. Overall, I am greatly happy with this purchase and I still haven't been disappointed with a HP product. Being and student, website designer, and having a hobby of video editing, I need computers I can trust, which is why I only buy HP.
The laptop is fast and I haven't had any issues with the hardware. The only problem I've been having is Windows 8. I'm not a fan of the OS and, unfortunately, it's not one that people are going to have a choice in much longer.
Big screen for my wife to use also needs a large screen to read
I got this laptop to play World of Warcraft on, do my school work on and to do my actual work on. It does all of that plus so much more! The AMD in it is awesome, for gaming purposes, I can sit in Stormwind on Fair to High settings and still get approximately 30 frames per second. Out in World it gets upwards of 80 fps. Did the Sha in Kun Lai summit - dropped it down a little and was still averaging 20 FPS. The speakers on this beast are amazing. I didn't realize that when I got this thing, that the speakers were going to be that good, or the volume actually worth a dang. It came with Windows 8 which at the time, was a little of a draw back, but now I am used to it, and I love it on this machine. The track pad is dual touch so it makes a touch pad OS seem acceptable. The only complaint, and I think this is more on my end as I have left it plugged in all the time, the battery life isn't that great. Which again isn't a problem, as I am constantly plugged in. So all in all, if you are looking for a gaming laptop, that isn't expensive, right here! If you are looking for an Entertainment laptop at all right here!
I bought this laptop based on other reviews. I wanted to replace my 3 yr. old HP. Thank Goodness I didn't get rid of it because I keep having to go back to ol' faithfu anyway. The windows 8 is pretty but this I think I just got a bad one I don't know. It's too soon for it to hang, stall & freeze the way it does. I'll be returning this. My previous HP was dual core so maybe that it why this one seems so slow to me. I don't know but I'm every disappointed.
Windows 8 is hard to navigate.
This is my first time writing a review for anything. This stylish, ruby red computer is fantastic. I could not be happier with it. No problems setting anything up, especially wirelessly. RAM and HD space is enough for the small business person or home user/student. It is also a fantastic financial deal. In fact, the deal is so good I'm buying another one. I am recommending it to everyone I
know! Don't forget to purchase a 2-year service agreement.
Have no complaints with operating the computer but the case is made out of cheap plastic - flimsy and the edges are very rough. Almost like you can lift the top off the keyboard and where the cd goes in feels very very weak. I am very afraid that this computer will not last very long. Just very sad about the construction.....
It did not meet my expectations for what I was looking for in a Laptop
I received my HP laptop a couple of days ago as a gift to myself. It was mailed out to me in 2 days. I am still learning all the apps and Windows 8. So far I love the sleek style, color and light weight of the HP notebook. I gave my fiancé the Acer laptop which I purchased 6 months ago in August 2012 for my birthday. He was happy to received a new laptop until he saw my HP replacement. Now he wants one. I think I am going to enjoy my new HP laptop for many years to come. It will be used to get my degree online. And maybe start a home business. I hope it can withstand the duration. Thanks Wal-Mart for making the price affordable for me to purchase. My next purchase will be the matching cordless mouse. :-)


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"A very straightforward book based on systems thinking, an approach that views the corporation as an organic whole swimming in its environment rahter than as a conglomerate of disparate departments and functions." "With clarity and style, Ackoff has drawn a very simple map for the implementation of systems thinking in the corporation."--Stacy Hague, CIO
About the Author
Russell L. Ackoff is currently Chairman of Interact, an institute dedicated to education, consulting, and research, and Professor Emeritus of the Wharton School, University of Pennsylvania. Considered one of the most innovative and insightful management thinkers of the 20th century, he is also the author of the acclaimed The Democratic Corporation: A Radical Prescription for Recreating Corporate America and Rediscovering Success, published by Oxford University Press in 1994.


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LEAF Downtown, which returns on Saturday and Sunday, July 30-31, has a decidedly local focus.
Stepping up: Two new walking tours come to Asheville
Asheville Music Tours offers a stroll through downtown, highlighting the city's rich musical past, as well as celebrating its present day achievements. Meanwhile, in the River Arts District, Asheville Art Studio Tours leads guests through a series of workspaces and galleries while sharing tales of the area's former industrial days.


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Human Bites
- Author: Jeffrey Barrett, MD; Chief Editor: John L Brusch, MD, FACP more...
Approximately 10%-15% of human bite wounds become infected owing to multiple factors. The bacterial inoculum of human bite wounds contains as many as 100 million organisms per milliliter and is made up of as many as 190 different species. Many of these are anaerobes that flourish in the low redox environment of tartar that lies between human teeth or in areas of gingivitis. Most injuries due to human bites involve the hands. Hand wounds, regardless of the etiology, have a higher rate of infection than do those in other a locations. (See Pathophysiology and Etiology.)
Infections associated with human bites are often far advanced by the time they receive appropriate care. Patients often wait until infection is well established before seeking medical treatment. These wounds are frequently more extensive than estimated on initial examination by the inexperienced observer and are frequently managed inadequately. (See Prognosis, Presentation, Treatment, and Medication.)
Human bites have been shown to transmit hepatitis B, hepatitis C, herpes simplex virus (HSV), syphilis, tuberculosis, actinomycosis, and tetanus.
Evidence suggests that it is biologically possible, but quite unlikely, to transmit human immunodeficiency virus (HIV) through human bites. (See Pathophysiology, Presentation, and Workup.)
The goals of therapy are to minimize possible soft tissue deformity and to prevent or appropriately treat infection. Recognition of the high risk of infectious complications and early aggressive treatment are mandatory to prevent serious wound infection and its associated complications.[1, 2] (See Prognosis, Treatment, and Medication.)
Human bite wounds occur as 2 separate entities: clenched-fist injuries and occlusive bites.
Clenched-fist injury
Clenched-fist injuries are the most common and have the greater clinical significance. They occur as the closed fist strikes the teeth of another individual with sufficient force to create a small wound, usually 3-8 mm in length. The injury usually occurs over the dorsal surface of the third and fourth metacarpophalangeal (MCP) or proximal interphalangeal joints of the dominant hand. Because of the thinness of the skin in these areas, potential injuries include joint penetration, metacarpal fracture, and extensor tendon laceration. Injury to the digital nerve or artery is rare.
As the fingers extend following injury, the bacterial inoculum may be carried proximally with the extensor tendons. This makes adequate irrigation of the wound more difficult. These are the most serious human bite wounds, and they require the most aggressive treatment.
Occlusive bites
Occlusive bites occur when there is sufficient force to break the skin. Such injuries to the hand have a higher infection rate than similar bites to other parts of the body because of the thinness of the skin in this area.
When a finger is bitten, such as in a chomping-type injury, tendons and their overlying sheaths are in close proximity to the skin. The wound may appear to be a minor abrasion-type injury, but careful inspection is required to rule out deep injury.
Occlusive human bite wounds of the head and neck result in avulsion, laceration, and crushing of the tissues. Even so, when a tooth strikes the head, even a deep puncture wound may appear innocuous. However, deep, subgaleal, bacterial contamination is possible. This is especially true in young children who have relatively thin, soft scalp and forehead tissue.
Disease transmission
Regardless of the mechanism and anatomic location of the bite wound, the composition of the bacterial inoculum is the same. Cultures of human bite wounds are commonly polymicrobial in nature, and aerobes and anaerobes are represented almost equally. Beta-lactamase production occurs frequently. Commonly isolated aerobes include Eikenella corrodens and Staphylococcus, Streptococcus, and Corynebacterium species. Staphylococcus aureus is isolated in up to 30% of infected human bite wounds and is associated with some of the most severe infections.
E corrodens is a slow-growing, facultative, anaerobic, gram-negative bacillus. It is frequently associated with chronic infection and abscess formation. This pathogen is isolated in 30% of human bite wounds. Other commonly isolated anaerobes include Bacteroides, Fusobacteria, Prevotella, and Peptostreptococcus species.
In addition to the acute risk of localized infection, human bites pose the potential for the transmission of systemic infections, which can be life threatening. Hepatitis B transmission via human bites is well documented. In approximately 75% of patients with hepatitis B, the antigen is detectable in their saliva, and it is approximately 100 times more infectious than HIV.
Less likely is the transmission of HIV, although several cases in the literature suggest this as a mode of transmission.[3, 4] HIV is found in the saliva of affected patients, although at lower levels than in the blood. In addition, salivary inhibitors render the virus noninfective in most cases. As a result, the risk of transmission of HIV via human bites is exceedingly low.[5]
The causes of human bite wounds include the following:
Aggressive behavior, often in combination with alcohol (the cause of most clenched-fist injuries)
Rough sexual play or sexual assault
Domestic violence
Child abuse
Occupational injury to dental personnel
Seizure-related tongue lacerations
Nose biting (punishment for adultery in several cultures [6] )
Accidents during sporting events
Aggressive play of children in daycare centers
Self-inflicted wounds in persons who are emotionally disturbed or mentally handicapped - Lesch-Nyhan syndrome is an uncommon disorder that includes self-mutilation through biting
Institutionalized patients with poor impulse control create a high-risk environment for human bite wounds.
Occurrence in the United States
Human bites are ranked as the third leading cause of all bites seen in hospital emergency departments (after dog and cat bites), accounting for 3.6-23% of bite wounds. However, the true frequency is difficult to estimate because most human bites are probably unreported or patients fail to seek medical attention. Of those reported, approximately 60% occur in an upper extremity (most frequently the dominant one), while 15% occur in the head and neck region, most commonly the ears, nose, or lips. The remainder occur on the breasts, genitals, thighs, and other areas.
International occurrence
In a 4-year retrospective review in the United Kingdom, 421 (13%) human bites were identified out of 3136 case notes. The majority of those bitten were young males, with 44% of the males aged 16-25 years. The male-to-female ratio was 3:1.[7]
Sex- and age-related demographics
Clenched-fist infections are predominantly found in men, presumably owing to their more aggressive behavior. Occlusive bite wounds occur with equal frequency in males and females.
The peak incidence of human bites, including occlusive bites and clenched-fist injuries, occurs in individuals aged 10-34 years.
The prognosis is excellent in patients who promptly seek medical attention following injury. However, patients frequently present days to weeks after injury, when the infectious process is well established. Conversely, the severity of a human bite injury may initially be underestimated, especially by an inexperienced observer, resulting in a significant delay of appropriate therapy.
Morbidity of human bites is primarily related to the degree of permanent function and/or cosmetic impairment.
Bite infections of poorly vascularized structures, such as ear cartilage, are particularly difficult to cure. In particular, in ear infections, plastic surgery is often needed to achieve an acceptable cosmetic result.
The morbidity of human bites is also related to infection and its sequelae. Prior to the era of antibiotics, up to 20% of hand bites required amputation of a finger. While amputation is seldom required today, residual scarring may result in permanent functional and/or cosmetic impairment; complications include the following:
Cosmetic deformity resulting from wound contraction
Permanent hand disability secondary to stiffness and/or chronic pain
Infectious tenosynovitis
Septic arthritis
Abscess formation
Amputation (rare)
Transmission of disease (eg, hepatitis B or C, HIV) [4]
Necrotizing fasciitis
Occlusive bite injuries among toddlers placed in crowded daycare centers are usually superficial and rarely become infected.
Patient Education
Patients must clearly understand the signs and symptoms of wound infection that signal a need to return for immediate reevaluation. These include, but are not limited to, the following:
Decreased mobility
Patients must also clearly understand the importance of early and regular follow-up care for this seemingly minor injury, as well as the rationale for providing antibiotics and the importance of compliance with this recommendation.
Moreover, patients need to be informed of potential complications that may develop even with complete compliance with the care plan, and they should understand that wound revision for cosmetic or functional purposes may be desirable at a later date.
For patient education information, see the First Aid and Injuries Center and the Infections Center, as well as Human Bites and Tetanus.
Kennedy SA, Stoll LE, Lauder AS. Human and Other Mammalian Bite Injuries of the Hand: Evaluation and Management. J Am Acad Orthop Surg. 2015 Jan. 23 (1):47-57. [Medline].
Aziz H, Rhee P, Pandit V, Tang A, Gries L, Joseph B. The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. J Trauma Acute Care Surg. 2015 Mar. 78 (3):641-8. [Medline].
Khajotia RR, Lee E. Transmission of human immunodeficiency virus through saliva after a lip bite. Arch Intern Med. 1997 Sep 8. 157(16):1901. [Medline].
Vidmar L, Poljak M, Tomazic J, Seme K, Klavs I. Transmission of HIV-1 by human bite. Lancet. 1996 Jun 22. 347(9017):1762. [Medline].
Smoot EC, Choucino CM, Smoot MZ. Assessing risks of human immunodeficiency virus transmission by human bite injuries. Plast Reconstr Surg. 2006 Jun. 117(7):2538-9. [Medline].
Okimura JT, Norton SA. Jealousy and mutilation: nose-biting as retribution for adultery. Lancet. 1998 Dec 19-26. 352(9145):2010-1. [Medline].
Harrison M. A 4-year review of human bite injuries presenting to emergency medicine and proposed evidence-based guidelines. Injury. 2009 Aug. 40(8):826-30. [Medline].
Welbury RR, Murphy JM. The dental practitioner's role in protecting children from abuse. 3. Reporting and subsequent management of abuse. Br Dent J. 1998 Feb 14. 184(3):115-9. [Medline].
American Academy of Pediatrics Committee on Child Abuse and Neglect, American Academy of Pediatric Dentistry. Guideline on oral and dental aspects of child abuse and neglect. Pediatr Dent. 2005-2006. 27(7 Suppl):64-7. [Medline].
Freeman AJ, Senn DR, Arendt DM. Seven hundred seventy eight bite marks: analysis by anatomic location, victim and biter demographics, type of crime, and legal disposition. J Forensic Sci. 2005 Nov. 50(6):1436-43. [Medline].
Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis. 2014 Jul 15. 59 (2):147-59. [Medline].
Presutti RJ. Bite wounds. Early treatment and prophylaxis against infectious complications. Postgrad Med. 1997 Apr. 101(4):243-4, 246-52, 254. [Medline].
Kretsinger K, Broder KR, Cortese MM, et al. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR Recomm Rep. 2006 Dec 15. 55:1-37. [Medline].
Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005 Nov 15. 41(10):1373-406. [Medline].
Henry FP, Purcell EM, Eadie PA. The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon. Emerg Med J. 2007 Jul. 24 (7):455-8. [Medline].
Zubowicz VN, Gravier M. Management of early human bites of the hand: a prospective randomized study. Plast Reconstr Surg. 1991 Jul. 88(1):111-4. [Medline].
Baker MD, Moore SE. Human bites in children. A six-year experience. Am J Dis Child. 1987 Dec. 141(12):1285-90. [Medline].
Smith DK, Grohskopf LA, Black RJ, Auerbach JD, Veronese F, Struble KA, et al. Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services. MMWR Recomm Rep. 2005 Jan 21. 54:1-20. [Medline].
Ruskin JD, Laney TJ, Wendt SV, Markin RS. Treatment of mammalian bite wounds of the maxillofacial region. J Oral Maxillofac Surg. 1993 Feb. 51(2):174-6. [Medline].
Stucker FJ, Shaw GY, Boyd S, Shockley WW. Management of animal and human bites in the head and neck. Arch Otolaryngol Head Neck Surg. 1990 Jul. 116(7):789-93. [Medline].
Donkor P, Bankas DO. A study of primary closure of human bite injuries to the face. J Oral Maxillofac Surg. 1997 May. 55(5):479-81; discussion 481-2. [Medline].
Uchendu BO. Primary closure of human bite losses of the lip. Plast Reconstr Surg. 1992 Nov. 90(5):841-5. [Medline].
Menard P, Bertrand JC, Philippe B. [Reconstruction of the lip vermillion using a myo-mucosal advancement flap]. Rev Stomatol Chir Maxillofac. 1991. 92(1):18-21. [Medline].
Walton RL, Beahm EK, Brown RE, et al. Microsurgical replantation of the lip: a multi-institutional experience. Plast Reconstr Surg. 1998 Aug. 102(2):358-68. [Medline].
Godwin Y, Allison K, Waters R. Reconstruction of a large defect of the ear using a composite graft following a human bite injury. Br J Plast Surg. 1999 Mar. 52(2):152-4. [Medline].
Talan DA, Abrahamian FM, Moran GJ, Citron DM, Tan JO, Goldstein EJ. Clinical presentation and bacteriologic analysis of infected human bites in patients presenting to emergency departments. Clin Infect Dis. 2003 Dec 1. 37(11):1481-9. [Medline].
Goldstein EJ. Bites. Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009. chap 319.


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In the wake of a terrible tragedy such as the elementary school massacre in Newtown, Conn., people immediately grope for answers.
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