text:
This adorable looking Happy Hopperz green dino will provide the little one with lots of healthy fun. The hopper has ears and horns for the little one to grip. The hopping experience provides a great aerobic workout, strengthening their core muscles, increasing balance control and developing co-ordination skills. The dino can inflate and deflate in a matter of seconds and folds compactly for easy transportation. The rewarding ride can be easily stored in a bag so can be taken everywhere, from the grandparent's house, to the park or even on holiday.
Catalogue Number: 622-0495
- A bright inflatable 'bounce on' toy
- Super fun and great exercise for young children
- Come in a variety of colours and animal designs
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Product Details
Product specifications
Additional Information
What's in the Box
1 x Happy Hopperz plus pump to inflate
Power Source
Battery only
Batteries Included
Battery Type
Number Of Batteries Required
Maximum Weight Of Child (kg)
Product Height
47.0 Centimetre
Product Width
55.0 Centimetre
Product Depth
24.0 Centimetre
Product Weight
1.9 Kilogram
Age Range
3-4 years
Key Information
Animal ride-on
Suitable Age From
Suitable from 3 years
Appropriate Age Warning
Not suitable for children under 36 months
Prizes and Awards Won
Loved by Parents Best Activity Toy 3-6yrs Gold, Best Outdoor Toy 3-6yrs Gold, Best Toy Design Bronze
Minimal assembly required
Frame Material
Time To Assemble (mins)


text:
Friday, July 1st • 10 a.m. • UFO Museum North Library •
Lecture – Debunking the UFO Debunkers
Saturday, July 2nd • 10 a.m. • UFO Museum North Library •
Lecture – A New Approach to Man's Place in the Universe
Saturday, July 2nd • 6 p.m. • Convention Center Exhibit Hall •
Panel Discussion – The Roswell Report Part 1
Sunday, July 3rd • 5 p.m. • UFO Museum North Library •
Panel Discussion – The Roswell Report Part 2
Stanton T. Friedman, Nuclear Physicist-Author-Lecturer Stanton T. Friedman received his BSc. and MSc. Degrees in physics from the University of Chicago in 1955 and 1956. He was employed for 14 years as a nuclear physicist by such companies as GE, GM, Westinghouse Astronuclear Laboratory, TRW Systems, Aerojet General Nucleonics, and McDonnell-Douglas Astronautics working in such highly advanced, classified, eventually cancelled programs as nuclear aircraft, fission and fusion rockets, and various compact nuclear power-plants for space and terrestrial applications. He became interested in UFOs in 1958, and since 1967 has lectured about them at more than 600 colleges and 100 professional groups in all 50 U.S. states, all 10 Canadian provinces and 18 other countries in addition to various nuclear consulting efforts. He has only had 11 hecklers of which 2 were drunk. He has published more than 100 UFO papers and has appeared on hundreds of radio and TV programs including on Larry King in 1997, 2007 and twice in 2008, and many documentaries. He is the original civilian investigator of the Roswell Incident and co-authored "Crash at Corona: The Definitive Study of the RoswellIncident". TOP SECRET/MAJIC his controversial book about the Majestic 12 group, established in 1947 to deal with alien technology, was published in 1996 and went through 6 printings. An expanded new edition was published in 2005. Stan was presented with a Lifetime UFO Achievement Award in Leeds, England, in 2002, by UFO Magazine of the UK. He is co-author with Kathleen Marden (Betty Hill's niece) of a book in 2007: "Captured! The Betty and Barney Hill UFO Experience". The City of Fredericton, New Brunswick, Canada, declared August 27, 2007, Stanton Friedman Day. His book "Flying Saucers and Science" was published in June, 2008, and is in its 4th printing. His newest book "Science Was Wrong: Startling Truths about Cures, Theories, and Inventions 'They' Declared Impossible" with Kathleen Marden, was published in June, 2010. On July 2, 2010, he was inducted into the Roswell, New Mexico, UFO Hall of Fame for his long term investigative efforts on that important case. He and Marden have completed a new book for 2016 "Fact Fiction and Flying Saucers". Both TOP SECRET/MAJIC and "Captured! The Betty and Barney Hill UFO Experience" have been optioned for movies by Stellar Productions of Hollywood. He has provided written testimony to Congressional Hearings, appeared twice at the UN, and been a pioneer in many aspects of ufology including Roswell, Majestic 12, The Betty Hill-Marjorie Fish star map work, analysis of the Delphos, Kansas, physical trace case, crashed saucers, flying saucer technology, and challenges to the S.E.T.I. (Silly Effort To Investigate) cultists. He has spoken at more MUFON Symposia than anyone else.

subset: commoncrawl


text:
SBH South Beach Hotel, Miami Beach
- Free continental breakfast and WiFi
Main amenities
- 51 smoke-free guestrooms
- Near the beach
- 2 restaurants
- Outdoor pool
- Health club
- Beach sun loungers
- Valet parking
- Business center
- Childcare
- 24-hour front desk
- Air conditioning
- Daily housekeeping
For families
- Free cribs/infant beds
- Babysitting or childcare
- Babysitting or childcare (surcharge)
- Connecting/adjoining rooms available
- Private bathroom
- Premium TV channels
What's around
- In Mid Beach
- Lincoln Road Mall (0.8 mi / 1.3 km)
- Art Deco Welcome Center (1.2 mi / 2 km)
- Lummus Park Beach (1.3 mi / 2.1 km)
- Bass Museum of Art (0.1 mi / 0.2 km)
- Miami City Ballet (0.2 mi / 0.3 km)
SBH South Beach Hotel, Miami Beachfrom €191
- Junior Suite, Two Full Beds
- Standard Room, 2 Double Beds
- Junior Suite, One King Bed
- Standard Room, 1 King Bed
- Superior Room, 1 King Bed
- Standard Room
More great choices
At a glance
Key facts
Hotel size
- This hotel has 51 rooms
- This hotel is arranged over 2 floors
- Check-in time 4 PM-midnight
- Check-out time is 11 AM
Required at check in
- Credit card deposit required
- Government-issued photo ID required
- Minimum check-in age is 21
Travelling with others
- Children (12 years old and younger) stay free when occupying the parent or guardian's room, using existing bedding
- Babysitting/childcare *
- Pets not allowed (service animals welcome)
- Free WiFi in public areas
- Free WiFi in rooms
- Valet parking *
Other information
- Smoke-free property
Nearby Four Star Miami Beach hotels
In the hotel
- Free continental breakfast daily
- 2 restaurants
- Bar/lounge
- Coffee shop/café
- Poolside bar
- Room service (during limited hours)
- Beach sun loungers
- Beach towels
- Outdoor pool
- Free pool cabanas
- Health club
- Spa tub
- Pool sun loungers
- Business center
- Computer station
- 24-hour front desk
- Concierge services
- Tours/ticket assistance
- Dry cleaning/laundry service
- Hair salon
- Luggage storage
- Multilingual staff
- Porter/bellhop
- Number of buildings/towers - 1
- Year Built 1939
- Elevator/lift
- Safe-deposit box at front desk
- Garden
- Television in common areas
- Accessible bathroom
- In-room accessibility
- Roll-in shower
In the room
- Air conditioning
- Minibar
- Espresso maker
- Bathrobes
- Slippers
- Iron/ironing board
- Down comforter
- Blackout drapes/curtains
- Turndown service
- Premium bedding
- Pillowtop mattress
- Private bathroom
- Rainfall showerhead
- Shower only
- Designer toiletries
- Hair dryer
- 37-inch plasma TV
- Premium TV channels
- IPod docking station
- Desk
- Free WiFi
- Free local calls
- Daily housekeeping
- In-room safe
- Connecting/adjoining rooms available
Top Miami Beach hotels
Recently reviewed hotels in Miami Beach
- Ramada Plaza Marco Polo Beach ResortFrom
"We had a great stay at this property, the room was outdated but we had all we needed(great to have a kitchenette,especially when you have kids!) and above all the view was amazing…"Dec 28, 2016
- The National Hotel, An Oceanfront ResortFrom
"Great staff reception and specially concierge Natalya Garus (lead concierge) everything made easy by her wonderful assistance "Dec 16, 2016
- Kimpton Surfcomber HotelFrom
"Great location, very close to Ocean Drive (5 mins walk), beach access with free sun chairs & towels."Oct 14, 2016
- Hotel VictorFrom
"Perfect 2 night stay right in the centre of south beach."Aug 9, 2016
Nearby hotels
Recommended hotels
Special features
DiningOrange Blossom - This restaurant specializes in American cuisine and serves breakfast, brunch, lunch, and dinner. Guests can enjoy drinks at the bar. Happy hour is offered. Open daily.
On Site
- Health club
- Spa tub
- Personal motorized watercraft on site
- Bicycle rentals nearby
- Golf lessons available nearby
- Golfing nearby
- Kayaking nearby
- Parasailing nearby
- Sailing nearby
- Scooter/moped rentals nearby
- Snorkeling nearby
- Surfing/boogie boarding nearby
- Water skiing nearby
- Windsurfing nearby
SBH South Beach Hotel, Miami Beach's small print
Also known as
- Hotel SBH
- South Beach Hotel Miami
- SBH Hotel
- SBH South
- SBH South Beach
- SBH South Beach Hotel
- SBH South Hotel
- SBH South Beach Hotel Miami Beach
- SBH South Beach Miami Beach
- Hotel South Beach
The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
Noise-free guestrooms cannot be guaranteed.
The name on the credit card used at check-in to pay for incidentals must be the primary name on the guestroom reservation.
Mandatory fees
You'll be asked to pay the following charges at check in or check out:
Deposit: USD 75.00 per night
- Resort fee: USD 25.08 per accommodation, per night
Resort fee inclusions:
- Pool access
- Beach access
- Beach loungers
- Beach towels
- Fitness center access
- Partner property pool access
- Business center/computer access
- Internet access (may be limited)
- Phone calls (may be limited)
- In-room safe
- Additional inclusions
Inclusions may be listed elsewhere on the page as free or for a surcharge.
Optional extras
Valet parking costs USD 40.00 per night with in/out privileges
Parking is available nearby and costs USD 4.00 per hour
Babysitting/childcare is available for an extra charge
We have included all charges provided to us by this hotel. However, charges can vary, for example, based on length of stay or the room you book.
Recent reviews
Good 3.7 /5 from 566 reviews
The room was to small
The SBH hotel has great amenities! You can use the connecting hotel's rooftop pool, free breakfast, attached restaurant, and free beach chairs without paying higher rates to stay at that hotel. It is one block from the beach too!
Very disappointed with this hotel choice. It looks better on pictures than in real life. Decor is tired. The reception is shared by two hotels and it feels odd. It has absolutely no service! Housekeeping cleaned rooms late afternoon and everything in the room costs money to use, even the safe deposit box. Rooms are small. I personally will not stay here again and wont recommend it to anyone that is looking for comfort.
Great location in the center of Miami Beach, on the northern end of South Beach. Pool is salt water and is located on the top floor of the adjacent sister hotel. It is smaller than the photo makes it seem. Free breakfast is one serving of pancakes or waffles and a beverage, so don't choose this hotel based on that. Also, they charge ahead of time for incidentals and then refund the difference, if there is any. Be aware of this before you choose this hotel. I haven't experienced this before. The rooms were clean, but sparsely appointed, and the hallways had old, dingy and stained carpeting--not a good first impression. There are a lot of hotels in the area to choose from. I expected a little more for the money.
If he t was the middle of the night on Christmas Eve my wife and I would have tried to find a different hotel. Our Ac was broke and no maintenance was on site.
Is the description of this hotel not correct? Tell us


text:
For the purposes of applying the bidirectional algorithm to a paragraph-level container containing a unicode-bidi:isolate element like <bdi>, the isolate element is supposed to be treated like a neutral character.
Thus, in
a <bdi dir=rtl>א</bdi> b
 (try it at data:text/html,%3Cdiv%20dir%3Drtl%3Ea%20%3Cbdi%20dir%3Drtl%3E%26%23x05D0%3B%3C%2Fbdi%3E%20b%3C%2Fdiv%3E), the result is supposed to be displayed as
a א b
because the a and the b should form an LTR run with the whitespace and the <bdi> (i.e. neutral) between them. Instead, the result in 11.0a1 is instead:
In other words, while the directional run is formed (note that the spaces are laid out LTR, the part before the <bdi> is displayed where the part after the <bdi> belongs and vice-versa. The proper display is only achieved when the <bdi> gets dir=ltr (which certainly should not affect the display of the content around the <bdi>).
I am attaching a test case being submitted to the HTML5 test suite in which this was discovered, as well as two more test cases that are also failing probably due to the same bug.
Created attachment 583449 [details]
test case (being submitted to HTML5 test suite)
Created attachment 583450 [details]
a more complicated test case (nested <bdi>s) - may be related
Created attachment 583451 [details]
a more complicated test case (wrapped <bdi>) - may be related
Created attachment 587958 [details] [diff] [review]
w-i-p patch
This patch fixes the testcases attached here. It does NOT fix all the testcases in unicode-bidi-isolate-basic.html and unicode-bidi-isolate-aharon.html from bug 706194. I'll attach samples of failing tests.
Created attachment 587960 [details]
Tests from bug 710694
I have created a separate bug, https://bugzilla.mozilla.org/show_bug.cgi?id=717811, that was exposed by the test case from bug 706194. Actually, it turns out that it was also exposed by other tests we are submitting to the W3C's HTML5 tests suite, which I have attached to 717811. I don't know how I overlooked them failing.
(In reply to Simon Montagu from comment #4)
> Created attachment 587958 [details] [diff] [review]
> w-i-p patch
> This patch fixes the testcases attached here. It does NOT fix all the
> testcases in unicode-bidi-isolate-basic.html and
> unicode-bidi-isolate-aharon.html from bug 706194. I'll attach samples of
> failing tests.
Is this patch ready for review? Can anyone review it? This bug makes <bdi> almost impossible to use :-(
I was holding off on review request because fixing the remaining issues might require a complete rewrite of the patch. Aharon, do you think this is worth checking in in spite of that?
IMO, it's worthwhile, unless the full fix is really around the corner.
Comment on attachment 587958 [details] [diff] [review]
w-i-p patch
Review of attachment 587958 [details] [diff] [review]:
This looks good overall, but I'm not too comfortable reviewing the nsBidiPresUtils.cpp parts. Simon, can you please ask someone else to take a look at those changes as well? Thanks!
Comment on attachment 587958 [details] [diff] [review]
w-i-p patch
Rob, can you take a look when you have time?
Can you summarize the changes, preferably in the patch log message?
Created attachment 605543 [details] [diff] [review]
Patch with changes summarized in checkin comment
Comment on attachment 605543 [details] [diff] [review]
Patch with changes summarized in checkin comment
Review of attachment 605543 [details] [diff] [review]:
::: layout/base/nsBidiPresUtils.cpp
@@ +415,5 @@
> }
> static nsresult
> +SplitInlineAncestors(nsIFrame* aFrame,
> + bool splitBefore)
Might as well fix indent while you're here.
Better rename this parameter to something more meangingful, and something starting with 'a'. It would also be good if this was an enum {BEFORE, AFTER} instead of a bool. Actually though, why not just pass the frame to split after directly as the parameter here?
@@ +433,5 @@
> if (NS_FAILED(rv)) {
> return rv;
> }
> // Split the child list after |frame|.
"before or after"
@@ +865,5 @@
> child = parent;
> parent = child->GetParent();
> }
> if (parent && IsBidiSplittable(parent))
> + SplitInlineAncestorsAfter(child);
{} around the if body, while you're here
@@ +1209,3 @@
> }
> +nsBidiLevel
> +nsBidiPresUtils::GetFrameEmbeddingLevel(nsIFrame* aFrame)
need blank line
Created attachment 607330 [details] [diff] [review]
Addressed comments
and tests:


text:
How Much Does Vinegar Cost?
Vinegar is a liquid consisting of about five to 20 percent acetic acid, water, trace chemicals and sometimes some flavoring. Vinegar can be used as a cooking ingredient, in pickling or even as a cleaning product.
How much is it?
- The cost of vinegar will depend on the type of vinegar you purchase, the brand, quantity and where it's being purchased. On average, a bottle of vinegar will cost anywhere from $2 to as much as $11 depending on the volume.
- The most common type of vinegar that you can purchase is the white distilled vinegar. This type of vinegar usually comes from cane. Larger purchases that come in 4 gallon plastic containers can cost anywhere from $2 to $9. For instance, Heinz Distilled White Vinegar retails for $1.50 to $3 per bottle.
- Apple cider vinegar, which should be approved by USDA, is raw and unfiltered. The price for a 16 ounce cider vinegar can range from $2 to $4.
- Vinegar that has different flavors, such as balsamic vinegar or ume plum vinegar, can cost $2 to $11 depending on the volume of vinegar per bottle.
What is going to be included?
- Aside from the natural flavors produced from fermenting vinegars, there are companies that add flavorings to it to enhance its taste and to match it with the food to which it is being added.
- Vinegars are also used to make vinaigrettes; these are a combination of vinegar, oil and herbs that is commonly used as salad dressing.
- Aside from rice, strawberries and cane, vinegar can also come from other sources such as plums and apples. The vinegar is then poured into bottles that make it easier to dispense.
Tips to know:
- Vinegar possesses strong flavor qualities and it should be added to a dish sparingly; if the recipe you are using calls for vingear, follow the amount precisely. Vinegar can be added to other liquid ingredients such as oil to make different types of sauces or dressings.
- Since vinegar is fermented, you can stock it in your pantry for a long time and it will not go bad since it is naturally preserved.
How can I save money?
- Vinegar is not an expensive ingredient, but you can still save money when you buy from a store that sells it at a low price. You should do product comparison among different stores to make sure that you are getting the best deal.
- Many name brand vinegars will offer coupons on their official websites or even through social media outlets such as Facebook and Twitter.
Advertising Disclosure: This content may include referral links. Please read our disclosure policy for more info.
Average Reported Cost: $0
0 %
0 %
Less Expensive $1 $1.5K $3K $5K $6.5K More Expensive $8k


text:
Effects of etomidate on complications related to intubation and on mortality in septic shock patients treated with hydrocortisone: a propensity score analysis
DOI: 10.1186/cc11871
© Jung et al.; licensee BioMed Central Ltd. 2012
Received: 28 May 2012
Accepted: 12 November 2012
Published: 21 November 2012
Endotracheal intubation in the ICU is associated with a high incidence of complications. Etomidate use is debated in septic shock because it increases the risk of critical illness-related corticosteroid insufficiency, which may impact outcome. We hypothesized that hydrocortisone, administered in all septic shock cases in our ICU, may counteract some negative effects of etomidate.
The aim of our study was to compare septic shock patients who received etomidate versus another induction drug both for short-term safety and for long-term outcomes.
A single-center observational study was carried out in septic shock patients, treated with hydrocortisone and intubated within the first 48 hours of septic shock. Co-primary end points were life-threatening complications incidence occurring within the first hour after intubation and mortality during the ICU stay. Statistical analyses included unmatched and matched cohorts using a propensity score analysis. P < 0.05 was considered significant.
Sixty patients in the etomidate cohort and 42 patients in the non-etomidate cohort were included. Critical illness-related corticosteroid insufficiency was 79% in the etomidate cohort and 52% in the non-etomidate cohort (P = 0.01). After intubation, life-threatening complications occurred in 36% of the patients whatever the cohort. After adjustment with propensity score analysis, etomidate was a protective factor for death in the ICU both in unmatched (hazard ratio, 0.33 (0.15 to 0.75); P < 0.01)) and matched cohorts (hazard ratio, 0.33 (0.112 to 0.988); P = 0.04).
In septic shock patients treated with hydrocortisone, etomidate did not decrease life-threatening complications following intubation, but when associated with hydrocortisone it also did not impair outcome.
Endotracheal intubation, one of the most commonly performed procedures in the ICU [1–3], is associated with a high incidence of early onset life-threatening complications (25 to 39%) because of the precarious hemodynamic and respiratory status of those patients [1, 2, 4]. To limit intubation-related life-threatening complications, bundle therapy including hemodynamically well-tolerated anesthetics such as etomidate has been suggested in the ICU [1, 5] and is widely used in prehospital or emergency room environments [6, 7]. In critically ill patients, the use of etomidate has been challenged because it inhibits adrenocortical steroid synthesis by reversibly blocking the 11β-hydroxylase enzyme action [8–10] for at least 24 hours after a single bolus [9, 11]. This inhibition is associated with a risk of reversible failure of the adrenal axis, which can lead to critical illness-related corticosteroid insufficiency (CIRCI) [12]. Because CIRCI is associated with an increased mortality in septic shock patients [8, 13–15], etomidate use is controversial in this setting [16–19]. Moreover, some studies suggest a link between etomidate and poor outcome [11, 13, 14, 20–22] but others failed to confirm this link [6, 23–25].
To limit the potential consequences of etomidate on the adrenal axis, hydrocortisone administration may be of interest. To our knowledge, only one randomized controlled clinical trial, performed in nonseptic critically ill patients, failed to demonstrate any benefit to counteract etomidate's side effect using a short course (48 hours) of hydrocortisone treatment [10]. In our ICU, the anesthesia bundle for intubation strongly recommends the use of a rapid sequence induction [5] and our septic shock bundle therapy includes hydrocortisone for all septic shock patients after a cosyntropin test as is frequently observed and suggested in France [15, 26, 27]. In our operating room, no local bundle is purposed, although ketamine and etomidate are suggested for critically ill patients. Because of its potential protective effect on intubation safety [3–5, 7], due to its cardiovascular properties, and its deleterious impact on adrenal gland physiology [8, 28], etomidate may have contrasting impact on the incidence of life-threatening complications occurring within 1 hour after intubation and on the long-term outcome in septic shock patients.
The present study was aimed at assessing the short-term safety and the long-term outcomes of septic patients treated with etomidate versus another induction drug for intubation. We designed the present propensity-score-driven study to evaluate, in septic shock patients, first the incidence of immediate life-threatening complications after intubation and second the long-term outcome according to the hypnotic used. The propensity score allowed us to match patients according to their probably to receive etomidate or not and to adjust for confounding factors in the present observational study.
Materials and methods
Study setting and patients
A cohort, observational study was performed in an adult ICU of a university hospital from June 2006 until December 2009. Data were extracted from prospective studies conducted in our ICU and previous databases [1, 2, 5, 15, 26]. The study was approved by the local ethics committee (Comité de Gestion et d'Organisation de l'Anesthésie Réanimation, Montpellier University Hospital) and, in accordance with French law, informed consent was waived. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines [29].
Etomidate blocks cortisol synthesis primarily by inhibiting the activity of 11β-hydroxylase for at least 24 to 48 hours [10, 30]. Therefore, to describe the potential impact of etomidate on early and late outcome in septic shock patients, consecutive patients were eligible if they had received an induction agent for endotracheal intubation within the first 48 hours of septic shock onset. Patients were treated according to international guidelines for management of severe sepsis and septic shock [31] but all received hydrocortisone [15]. Exclusion criteria included pregnancy, age < 18 years, moribund patients, immunosuppression, and long-term or short-term corticosteroid treatment within the past 4 weeks. A cosyntropin stimulation test with 250 μg cosyntropin was performed in all septic shock patients. A 50 mg intravenous bolus of hydrocortisone was then administered every 6 hours, beginning within the first 12 hours of septic shock, for at least 5 days, tapered and stopped in 5 days according to the reversal of shock. Patients were grouped as those having received etomidate for intubation (etomidate cohort) versus those subjects having received another hypnotic (non-etomidate cohort).
Septic shock was defined by evidence of infection and a systemic response to infection, in addition to systolic blood pressure < 90 mmHg, despite adequate fluid replacement, or a need for vasopressors for at least 1 hour, according to the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee criteria [32]. Nonresponse to the cosyntropin stimulation test using an immunoradiology assay (SP2100; Beckmancoulter SAS, Roissy, France) was defined by a delta cortisol (60 minutes after 250 μg cosyntropin) < 9 μg/dl [15, 26, 28]. CIRCI was defined by a delta cortisol (60 minutes after 250 μg cosyntropin) < 9 μg/dl or a baseline plasma cortisol level < 10 μg/l [12].
Data collection
A standardized data collection instrument and guidance tool was developed for data collection. Record review and data extraction were performed by a single investigator (NC) and regular meetings were conducted to address any problems encountered during the data collection phase according to the recommendations that have been published to minimize validity threats in chart review studies [33]. Upon ICU admission, the baseline characteristics and the main variables obtained before intubation were recorded either by a nurse (from June 2006 to Jan 2009) or by computer-driven software plugged to the monitor, which recorded automatically all the variables.
At the time of intubation, clinical data including reason for intubation, interventions including sedative agent used, need for and doses of vasopressors were recorded. During the intubation procedure, drug administration and the difficulty to intubate rate (defined by three or more attempts at laryngoscopy to place the endotracheal tube into the trachea and/or > 10 minutes using conventional laryngoscopy and/or the need for another operator) [5] were documented. Within the first hour after intubation we recorded the short-term life-threatening complications that occurred, defined as previously reported [2, 5]: cardiac arrest, severe cardiovascular collapse (defined as systolic blood pressure < 65 mmHg recorded at least once and/or < 90 mmHg that lasted 30 minutes despite 500 to 1,000 ml fluid loading and/or requiring introduction of vasoactive support) and severe hypoxia (defined as a decrease in SpO2 level < 80% during attempts). Patients who already presented a cardiovascular collapse after fluid loading or who were severely hypoxemic (SpO2 < 80%) after preoxygenation by noninvasive positive-pressure ventilation were not considered to have had an intubation-related complication, but rather to have presented a life-threatening condition requiring an emergency endotracheal intubation.
During the ICU stay, we documented the results for basal plasma cortisol and that after the cosyntropin test, as well as total amounts and durations of hydrocortisone and vasopressor treatments from day 0 to day 5. Outcome data include the duration of shock, length of mechanical ventilation, nosocomial infection incidence, ICU and hospital lengths of stay, and day-28 mortality.
Statistical analysis
We had sufficient resources to review 102 patients in total. Descriptive data of quantitative variables were summarized as the mean ± standard deviation or median with interquartile range, according to the normality of the distribution, assessed with the Shapiro-Wilk test and compared with the Mann-Whitney or t test. Categorical data were expressed as the number and percentage and were compared with a chi-square analysis.
Using two statistical methods, we assessed the occurrence of short-term life-threatening complications and the long-term outcomes according to the administration of etomidate versus another hypnotic drug. First, unadjusted differences between patients receiving etomidate or not were compared using logistic regression after calibration with the Hosmer-Lemeshow wellness-of-fit test. Furthermore, long-term survival was assessed by a Cox regression in which we included all variables associated with P < 0.20 in the univariate analysis. A stepwise procedure then allowed the final multivariate model to be obtained.
Second, since patients were not randomly assigned to etomidate or other hypnotic in this observational study, we developed a propensity score using all variables associated with P < 0.20 in the univariate analysis. The propensity score is defined as a subject's probability of receiving a specific treatment (for example, etomidate) conditional on the observed covariates, and thus controls for selection bias in observational studies [34]. For the coupling process, optimal one-to-one nearest neighbor matching was used. When needed, patients already matched were replaced by the closest one in the in the propensity score. P < 0.05 was considered significant. Statistical analysis was performed by an independent statistician (NM), with R software (version 2.10.1).
Population characteristics
Baseline characteristics of the 102 studied patients
All patients (n= 102)
Etomidate cohort (n= 60)
Non-etomidate cohort (n= 42)
P value
Age (years)
69 (58 to 75)
71 (62 to 72)
68 (56 to 73)
Male gender
72 (71)
44 (73)
28 (67)
Body mass index (kg/m2)
25 (23 to 30)
25 (23 to 29)
26 (24 to 32)
SAPS II upon ICU admission
48 (40 to 63)
52 (42 to 65)
46 (34 to 58)
SOFA score upon ICU admission
8 (6 to 12)
10 (7 to 13)
8 (6 to 11)
Previous disease
43 (42)
26 (43)
17 (41)
Coronary artery disease
22 (22)
14 (23)
8 (19)
Congestive heart failure
29 (28)
17 (27)
12 (29)
Neurological disease
20 (20)
11 (18)
9 (21)
Chronic obstructive pulmonary disease
18 (18)
10 (17)
8 (19)
Diabetes mellitus
20 (20)
10 (17)
10 (24)
41 (40)
26 (43)
15 (36)
Liver cirrhosis
22 (21)
14 (23)
8 (19)
Admitting diagnosis group
42 (41)
27 (45)
15 (36)
Emergency surgery
45 (44)
23 (38)
22 (52)
Elective surgery
15 (15)
10 (17)
5 (12)
Time from infection diagnostic to surgery (hours)
8 (4 to 24)
8 (5 to 24)
8 (4 to 24)
> 0.99
Source of sepsis
33 (32)
21 (35)
12 (29)
54 (53)
25 (42)
29 (69)
15 (15)
14 (23)
1 (2)
Appropriateness of initial antibiotic therapy
68/89 (76)
39/52 (75)
29/37 (78)
Main variables obtained before intubation
Systolic blood pressure < 90 mmHg
15 (45)
7 (29)
SpO2 below 80%
6 (10)
5 (15)
1 (4)
Lactatemia (mmol/l)
2.5 (1.1 to 4.7)
2.5 (1.1 to 5.3)
2.3 (1.4 to 4.1)
Vasopressors use
21 (21)
16 (27)
5 (12)
Myorelaxant use to facilitate intubation
97 (98)
57 (95)
40 (98)
We first evaluated the association of hypnotics, intubation-related life-threatening complications and outcome in unmatched cohorts.
Intubation procedure and intubation-related complications
Comparison of main variables obtained before intubation according to occurrence of a short-term life-threatening complication
Univariate analysis
Multivariate analysis
No life-threatening complications following intubation ( n = 65)
Life-threatening complications following intubation ( n = 37)
P value
Odds ratio (95% CI)
P value
SAPS II upon ICU admission
48 (37 to 59)
54 (44 to 70)
< 0.01
1.04 (0.99 to 1.08)
SOFA score upon ICU admission
8 (6 to 12)
8 (6 to 11)
Main variables obtained before intubation
Lactatemia (mmol/l)
2.6 (1.1 to 4.9)
2.2 (1.5 to 3.9)
Vasopressors use
19 (29)
2 (6)
< 0.01
0.11 (0.01 to 0.93)
Lowest systolic blood pressure recorded within 30 minutes before intubation (mmHg)
89 (80 to 120)
100 (90 to 122)
1.01 (0.99 to 1.03)
Drug used to facilitate intubation
35 (53)
25 (69)
31 (47)
11 (31)
0.60 (0.18 to 2.03)
62 (95)
35 (97)
Critical illness-related corticosteroid insufficiency and hydrocortisone treatment
Patients were compared according to the hypnotic they received to facilitate intubation. The cosyntropin test was performed within 24 hours after intubation in 85% of the patients, and after the first 24 hours in 15% of the population but always before the first dose of hydrocortisone. Hydrocortisone treatment was started 540 (300 to 1,125) minutes after intubation. The basal plasma cortisol concentration was significantly lower (19 (14 to 35) μg/dl versus 31 (17 to 45) μg/dl; P = 0.04) and the percentage of nonresponders to the cosyntropin stimulation test was significantly higher (79% vs. 52%; P = 0.01) in the etomidate cohort compared with the non-etomidate cohort. CIRCI was also significantly more frequently observed in the etomidate cohort compared with the non-etomidate cohort (79% vs. 59%; P = 0.04). In the etomidate cohort, the cumulative hydrocortisone dose was significantly higher (1,250 (650 to 1,650) mg vs. 750 (350 to 1,150) mg; P = 0.02) and the duration of treatment was significantly longer (168 (96 to 216) hours vs. 96 (48 to 162) hours; P = 0.01) than in the non-etomidate cohort.
Reversal of shock
Norepinephrine was administered within 12 hours after intubation in 100% of the patients without significant difference between cohorts. Patients in the etomidate cohort needed a higher cumulative dose of norepinephrine during their ICU stay compared with patients anesthetized with another hypnotic (95 (39 to 203) mg vs. 58 (30 to 97) mg from day 0 to day 5; P = 0.02). The duration of norepinephrine treatment was not different between cohorts (58 (37 to 94) hours in the etomidate cohort vs. 48 (25 to 81) hours in the non-etomidate cohort; P = 0.20).
ICU length of stay and complications
Long-term outcome according to the hypnotic used to facilitate intubation
Etomidate cohort (n= 60)
Non-etomidate cohort (n= 42)
P value
Number of nosocomial infections
38 (100)
22 (100)
20 (53)
10 (45)
Urinary tract infections
10 (26)
7 (32)
> 0.99
Central venous catheter-related infections
8 (21)
5 (23)
Length of mechanical ventilation (days)
5 (2 to 14.8)
5 (1 to 7)
ICU length of stay (days)
12 (6 to 22)
9 (4 to 13)
Hospital length of stay (days)
32 (22 to 50)
29 (19 to 45)
Mortality at day 28
17 (28)
14 (33)
Comparison of main variables before intubation and cosyntropin test results between day-28 survivors and nonsurvivors
Multivariate analysis
Survivors ( n = 66)
Nonsurvivors ( n = 36)
P value
Hazard ratio (95% CI)
P value
SAPS II upon ICU admission
45 (37 to 55)
60 (47 to 71)
< 0.01
1.04 (1.01 to 1.06)
< 0.01
SOFA score upon ICU admission
8 (5 to 11)
11 (8 to 13)
1.01 (0.89 to 1.16)
Main variables obtained before intubation
Vasopressor use
10 (15)
11 (31)
> 0.99
Drug used to facilitate intubation
41 (62)
19 (53)
0.33 (0.12 to 0.90)
25 (38)
17 (47)
62 (94)
35 (97)
Basal cortisol plasma level (μg/dl)
20 (14 to 40)
33 (19 to 49)
0.99 (0.96 to 1.03)
Cortisol plasma level after ACTH test (μg/dl)
31 (18 to 44)
35 (21 to 48)
Cosyntropin test responders
21/59 (36)
4/22 (19)
The results of our study show that, first, intubation in septic shock patients was associated with a 36% rate of short-term life-threatening complications and that this rate was independent of the hypnotic used to facilitate the procedure. Second, to our surprise, in unmatched cohorts and after matching using a propensity score analysis, the administration of a single dose of etomidate in septic shock patients treated with hydrocortisone was associated with a lower risk of day-28 mortality (Table 3).
Potential confounding factors of the study must be addressed. First, this study was a single-center observational study in which the hypnotic used for induction of anesthesia was not randomized. Second, this was a small study subject to unmeasured or residual confounding (for example, patient heterogeneity, heterogeneity for intubation indication, protocol deviation), which is a limitation. The propensity score, however, is a tool to increase the accuracy of results in cohort studies [37, 38]. Moreover, external validity of observational studies may be higher than for randomized controlled trials. Third, because of the study design, we cannot provide detailed explanations about the protective mechanisms of etomidate on long-term outcomes.
In the present study, the hypnotic used to facilitate intubation in critically ill patients was mainly etomidate to limit the risk of cardiovascular collapse that may occur after intubation [5]. Propofol or pentobarbital represented 20% of the administered hypnotics (Table 2), mainly in the operating room for urgent surgery. The difficult intubation rate was high (near 10%), which is above the usual rate in the operating room but is similar to the rate reported in the few studies existing in this field [2, 5]. To facilitate intubation, almost all of the patients received a myorelaxant agent (Table 1), mostly succinylcholine, as recommended by our local protocol. Interestingly, the short-term life-threatening complications that occurred within 1 hour after intubation concerned 36% of the patients. This rate is similar to that in the literature [2, 4] and above the rate we reported after the implementation of a care bundle in nonselected critically ill patients [5]. The discrepancy between the present study and our previous results [5] may be explained by the severity of the patients in the present study, all of them intubated with cardiovascular instability related to sepsis. In the multivariate analysis, the sole factor associated with short-term outcome was the administration, prior to intubation, of norepinephrine (Table 2). Norepinephrine administration before intubation may be protective by both limiting the risk of severe cardiovascular collapse following sympatholysis induced by the hypnotic and the detrimental effect of thoracic positive pressure on venous return. In our unit, norepinephrine prior to induction is suggested for diastolic blood pressure < 45 to 50 mmHg [5].
In the present study, we assessed the short-term life-threatening complication rate, but also the long-term effect of hypnotics on outcome. Patients intubated with etomidate were more likely to present CIRCI (Table 4) and needed a longer hydrocortisone treatment and a higher total amount of hydrocortisone. One bolus of etomidate impairs cortisol secretion [8, 9, 39, 40] by the inhibition, for at least 24 to 48 hours, of 11β-hydroxylase, the enzyme that converts 11β-deoxycortisol to cortisol in critically ill patients [8, 10, 21]. The higher rate of CIRCI when patients received etomidate may explain the higher cumulative dose of hydrocortisone because, in the present study, hydrocortisone was tapered and stopped according to the reversal of shock. CIRCI is associated with increased morbidity and mortality in septic shock patients [8, 13, 14, 22]. However, despite a higher rate of CIRCI, we showed that etomidate was a protective factor for mortality in both unmatched and matched cohorts (Figure 2).
Our study provides new data on the effect of etomidate in septic shock. In a post-hoc analysis of a multiple-center trial designed to evaluate the impact of hydrocortisone treatment in septic shock patients, the authors reported an increased death rate in patients that had been intubated with etomidate compared with other hypnotics [28]. In contradiction, this increase was not statistically significant after adjustment in a multivariate analysis [21]. Furthermore, Cuthbertson and colleagues showed that administration of etomidate was associated with increased mortality, but in only one of two multiple regression models [20]. Despite higher severity of illness scores in patients intubated with etomidate compared with patients intubated with another hypnotic (Table 1), our study demonstrated a protective effect of etomidate on day-28 mortality using Cox regression. This effect was confirmed after matching (Figure 2).
The consequences of etomidate on long-term outcomes in the present study must be discussed in light of the co-administration of hydrocortisone. In the present study, hydrocortisone treatment was started within the first 12 hours after etomidate administration, earlier than in other studies [28]. To date, studies have failed to demonstrate an improved outcome when supplementing etomidate treatment with corticosteroids [10, 22, 24] and hydrocortisone is not recommended in every patient presenting septic shock but is suggested in those refractory to fluid challenge and dependent on high-dose vasopressors [12]. However, because the inhibition of cortisol synthesis due to etomidate is immediate, hydrocortisone must be administered immediately after an etomidate bolus to counter its effects on steroid synthesis [20]. Evaluating the role of hydrocortisone in patients who received etomidate may thus be interesting. To explain the impact of etomidate, it has also been reported that ketamine - which was the main drug used in the non-etomidate cohort - may have an anti-inflammatory effect in experimental sepsis models [41, 42]. Whether this anti-inflammatory effect may exacerbate late sepsis-induced immunosuppression, however, is unknown.
We have reported that etomidate use for intubation in septic shock patients treated with hydrocortisone did not prevent short-term life-threatening complications following intubation despite its cardiovascular tolerance profile. Our study also suggests that patients co-treated with etomidate and hydrocortisone might not be associated with a worse outcome than another hypnotic used to facilitate intubation. Future randomized controlled studies should be performed to confirm this result and to evaluate early hydrocortisone treatment in septic shock patients who received etomidate.
Key messages
In septic shock patients treated with hydrocortisone, despite its cardiovascular tolerance, etomidate was not associated with a decrease of life-threatening complications following intubation in comparison with other hypnotics.
Etomidate was associated with a longer period of shock and higher cumulative dose of hydrocortisone than patients intubated with another hypnotic.
Interestingly, patients treated with etomidate and hydrocortisone presented a lower risk of day-28 mortality, both in unmatched and matched cohorts and multivariate analysis.
critical illness-related corticosteroid insufficiency.
The authors are grateful to Patrick McSweeny for his technical support.
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Mozart: The 'Haydn' Quartets
By (author) John Irving
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Mozart: The 'Haydn' Quartets by John Irving
Book DescriptionThe six string quartets dedicated to his friend Joseph Haydn represent a turning point in Mozart's compositional development. In addition to providing a full synopsis of each quartet this book examines the music in relation to Mozart's earlier quartets, considers the genesis of the six 'Haydn' quartets through close examination of the autograph revisions and looks at contemporary eighteenth-century analytical models. John Irving also charts the reception of the quartets, drawing upon a broad range of sources: Mozart's letters and diary entries, early newspaper reports, harmony/compositional textbooks, contemporary criticism and early biographies.
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Book DetailsISBN: 9780521585613
(216mm x 138mm x 7mm)
Pages: 116
Imprint: Cambridge University Press
Publisher: Cambridge University Press
Publish Date: 8-Jan-1998
Country of Publication: United Kingdom
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Forum Rules
Woot, happy birthday!
Would anyone like to hit them with a clue bat? Bill, Hillary & Barack all encouraged the same policies Trump is doing.
I gather from this that the libs find it acceptable to catch and release illegal immigrants who commit crimes but they are OK with locking up citizens who commit crimes?
Stupidity and arrogance...
What have we become? Answer: A nation that respects itself enough to insist that those who come here do so through legal means. The US is one of the most generous nations on earth. There...
Happy Birthday to Canada.


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Current time:0:00Total duration:6:45
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Riemann approximation introduction
Approximating the area under a curve using some rectangles. This is called a "Riemann sum". Created by Sal Khan.
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Area's largest. More than 125 booths. This 80-year-old building has a lot of character, with a "down-home" atmosphere and friendly southern smiles.
Tennessee Vacation eGuide
The 2016 eGuide gives you instant access to Tennessee's irresistible attractions and destinations. Peruse venues online, then put in your order to get a free guide delivered to your doorstep.


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DENVER - Novell Inc. on Oct. 22 filed a petition for rehearing en banc of a 10th Circuit U.S. Court of Appeals ruling that Novell failed to present evidence sufficient for a jury to find that Microsoft Corp. unlawfully used its dominant position in the personal computing operating-systems market to monopolize the word-processing and spreadsheet applications markets when it withdrew access to its namespace extensions (Novell, Inc. v. Microsoft Corporation, No. 12-4143, 10th Cir.).
NEW YORK - A software company failed to allege facts demonstrating that insurers' requiring the use of a rival estimating software was anything more than parallel conduct, the Second Circuit U.S. Court of Appeals ruled Oct. 18 in an unpublished order affirming the dismissal of antitrust and trademark infringement claims (Vedder Software Group Ltd. v. Insurance Services Office, Inc., et al., No. 13-1267, 2nd Cir.; 2013 U.S. App. LEXIS 21118).
SACRAMENTO, Calif. - A man's claim that General Motors LLC knowingly sold vehicles with defective steering components then replaced those parts with equally defective replacements supports a claim under all three prongs of the California unfair competition law (UCL), a federal judge held Oct. 16 (Chris Aguilar, et al. v. General Motors LLC, No. 13-437, E.D. Calif.; 2013 U.S. Dist. LEXIS 149108).
WASHINGTON, D.C. - Attorneys for the U.S. Department of Justice (DOJ), US Airways Group Inc. and American Airlines Inc. on Oct. 17 filed a joint proposed procedural order for the upcoming antitrust trial on the DOJ's claims that the proposed merger of the two airlines violates federal law. The proposed order calls for closing arguments to be held Jan. 6 (United States of America v. US Airways Group Inc., et al., No. 13-01236, D. D.C.).
SACRAMENTO, Calif. - Claims that a health insurer misrepresented its power to authorize and provide coverage for treatment form the basis for a California unfair competition law (UCL) unlawful-prong claim, but because the provider is neither a consumer nor a competitor, its unfair-prong claim fails, a federal judge held Oct. 15 (Centre for Neuro Skills v. Blue Cross of California dba Anthem Blue Cross, et al., No. 13-743, E.D. Calif.; 2013 U.S. Dist. LEXIS 148432).
DAYTON, Ohio - Non-party Community Insurance Co., doing business as Anthem Blue Cross and Blue Shield (Anthem), must produce certain documents regarding its deliberations not to contract with a medical center in the medical center's lawsuit claiming that it was denied contracts with managed care providers as a result of a purported conspiracy involving other hospitals to exclude the medical center from the marketplace in violation of federal antitrust law, a federal judge in Ohio ruled Oct. 16 (The Medical Center at Elizabeth Place, LLC v. Premier Health Partners, et al., No. 3:12-cv-26, S.D. Ohio; 2013 U.S. Dist. LEXIS 148839).
LOS ANGELES - A California appeals court on Oct. 15 denied a petition for rehearing, leaving stand a ruling that "substantially identical" food labeling laws are not "identical" to federal law and cannot avoid preemption, according to the court's docket (Mary L. Simpson v. The Kroger Corp., et al., No. B242405, Calif. App., 2nd Dist.).
MARSHALL, Texas - Becton, Dickinson & Co. (BD) on Oct. 11 moved for judgment as a matter of law or, alternatively, a new trial following a federal jury in Texas' $133,508,014 damage award in favor of Retractable Technologies Inc.(RTI) on its claim of attempted monopolization of the market for safety syringes through deceptive practices (Retractable Technologies, Inc., et al. v. Becton Dickinson & Company, No. 2:08-cv-16, E.D. Texas).
SAN FRANCISCO - A federal judge in California on Oct. 10 declined General Mills Inc.'s request to stay three cases challenging the advertising of "natural" products, saying primary jurisdiction did not apply (Judith Janney, et al. v. General Mills, Gabriel Rojas v. General Mills Inc., Sean Bohac v. General Mills Inc., Nos. 12-03919, 12-5099, 12-5280, N.D. Calif.; 2013 U.S. Dist. LEXIS 147024, 2013 U.S. Dist. LEXIS 147019, 2013 U.S. Dist. LEXIS 147530).
SAN JOSE, Calif. - Exemption from antitrust regulation dooms a California unfair competition law (UCL) action challenging Major League Baseball's role in preventing a franchise from moving to San Jose, a federal judge held Oct. 11 (City of San Jose; City of San Jose as successor agency to the Redevelopment Agency of the City of San Jose, et al. v. Office of the Commissioner of Baseball, et al., No. 13-02787, N.D. Calif.).
WASHINGTON, D.C. - The special master overseeing discovery in the U.S. Department of Justice's (DOJ) action seeking an injunction to prevent the proposed merger of American Airlines Inc. and US Airways Group Inc. recommended Oct. 10 that certain discovery requests be denied (United States of America, et al. v. US Airways Group Inc., et al., No. 13-01236, D. D.C.).
WASHINGTON, D.C. - The special master appointed to handle discovery requests in the antitrust lawsuit filed by the U.S. Department of Justice (DOJ) against US Airways Group Inc., and bankrupt American Airlines Inc. on Oct. 10 issued a report saying that the airlines should not be permitted to compel discovery into third-party interviews conducted by the DOJ leading up to its filing of the lawsuit (United States of America v. US Airways Group Inc., et al., No. 13-01236, D. D.C.).
LOS ANGELES - Substantial evidence supports a judge's California unfair competition law (UCL) verdict that a used car retailer agreed to pay off a consumer's previous loan without intending to follow through, an appeals panel held Oct. 9 (Ismeal Bermudo Jr. v. Farhad Tahmassebi, et al., No. B240892, Calif. App., 2nd Dist.; 2013 Cal. App. Unpub. LEXIS 7191).
DENVER - A domestic partner who is not legally married to a health plan participant lacks standing to assert a claim for benefits under the Employee Retirement Income Security Act and, therefore, the health care provider who was assigned the domestic partner's rights also lacks standing, the 10th Circuit U.S. Court of Appeals ruled Oct. 9 in an unpublished opinion (Denver Health and Hospital Authority v. Beverage Distributors Company, LLC, et al., No. 12-1355, 10th Cir.; 2013 U.S. App. LEXIS 20537).
SAN JOSE, Calif. - An animal rights activist's allegations that circus employees' harassment necessitated longer recordings and forced her to purchase additional memory cards satisfies the California unfair competition law (UCL) injury standard, a federal judge held Oct. 4 (Shannon Campbell and Mark Ennis v. Feld Entertainment Inc., James Dennis, Matthew Gillett, Mike Stuart, David Bailey, DOES 1 through 20, Nos. 12-4233, 13-0233, N.D. Calif.; 2013 U.S. Dist. LEXIS 145495).
NEW YORK - Publishers Simon & Schuster Inc. and Holtzbrinck Publishers LLC d/b/a Macmillan on Oct. 4 filed notices of appeal, joining Apple Inc., in appealing to the Second Circuit U.S. Court of Appeals a final order requiring Apple to modify its existing agreements with five publishers and submit to an external monitor following a ruling that Apple conspired with the publishers to fix prices of electronic books (United States of America v. Apple Inc., et al., No. 12 Civ. 2826, S.D. N.Y.; State of Texas, et al. v. Penguin Group $(USA$) Inc., et al., No. 12 Civ. 3394, S.D. N.Y.).
WASHINGTON, D.C. - The Transport Workers Union (TWU) on Oct. 7 moved in the U.S. District Court for the District of Columbia for permission to intervene in the antitrust lawsuit filed by the U.S. Department of Justice (DOJ) against bankrupt American Airlines Inc. and US Airways Group Inc. (United States of America v. US Airways Group Inc., et al., No. 13-01236, D. D.C.).
SAN FRANCISCO - An expired Federal Rule of Civil Procedure 68 offer does not moot claims, even if the offer fully compensates the plaintiff for her misrepresentation claims, a Ninth Circuit U.S. Court of Appeals panel held Oct. 4 (Emily Diaz, et al. v. First American Home Buyers Protection Corp., No. 11-57239, 9th Cir.).
WASHINGTON, D.C. - The U.S. Supreme Court denied review on Oct. 7 of several antitrust cases involving issues related to price-fixing agreements and immunity from antitrust laws.
WASHINGTON, D.C. - The U.S. Supreme Court on Oct. 7 denied review of the Ninth Circuit U.S. Court of Appeals' ruling that automated teller machine cardholders did not have standing to proceed with their antitrust challenges to the fixed interchange fee that a card-issuing bank pays to the ATM owner and the foreign ATM fee that the cardholder pays to his bank when the cardholder uses ATMs owned by other institutions (In re: ATM Fee Antitrust Litigation, Pamela Brennan, et al. v. Concord EFS, Inc., et al., No. 13-63, U.S. Sup.).
LOS ANGELES - A California appeals panel on Oct. 4 found that a woman's putative class claims alleging unfair competition, false advertising and related claims against Skype Inc., over its claims of "unlimited" calling plans, were adequately alleged, reversing and remanding a lower court's dismissal (Melissa Chapman, et al. v. Skype Inc., No. B241398, Calif. App., 2nd. Dist.; 2013 Cal. App. LEXIS 794).
NEW YORK - A federal judge in New York on Oct. 3 granted a preliminary injunction to five retailers who sued the New York attorney general and other officials challenging the constitutionality of Section 518 of the New York General Business Law, which prohibits sellers from imposing credit card "swipe fees," saying the "virtually incomprehensible distinction between what a vendor can and cannot tell its customers offends the First Amendment $(to the U.S. Constitution$) and renders section 518 unconstitutional" (Expressions Hair Design, et al. v. Eric R. Schneiderman, et al., No. 13-3775, S.D. N.Y.; 2013 U.S. Dist. LEXIS 143415).
DALLAS - Texas Attorney General Greg Abbott on Oct. 1 announced that his office had reached a settlement with American Airlines Inc. regarding its proposed merger with US Airways Group Inc. and was dropping out of the lawsuit filed by the U.S. Department of Justice (DOJ), which opposes the merger on grounds that it violates federal antitrust law (United States of America v. US Airways Group Inc., et al., No. 13-01236, D. D.C.).
OAKLAND, Calif. - Electronic Arts Inc. (EA) and Collegiate Licensing Co. (CLC) announced Sept. 26 that they reached a settlement with former and current student athletes who claim that the National Collegiate Athletic Association (NCAA), EA and CLC violated Section 1 of the Sherman Act by agreeing to fix at zero the amount of compensation the athletes were allowed to receive under NCAA rules for the use of their names, images and likenesses in products or media (In Re NCAA Student-Athlete Name & Likeness Licensing Litigation, No. 09-1967, N.D. Calif.).
RIVERSIDE, Calif. - A woman does not allege that a car sales company deceived her into an automobile contract or that she paid more as a result of the contract, a California appeals court held Sept. 25 (Tiffini Harrelson v. CarMax Auto Superstores California LLC, No. E054435, Calif. App., 4th Dist., Div. 2; 2013 Cal. App. Unpub. LEXIS 6912).


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When Bonnie Greer was coming of age in the 1960s , the controversial African-American writer-campaigner, Langston Hughes was unfashionable. He had testified before the House of Un-American Activities Committee, and reassured the committee that "race relations had improved in America", that it was a better place to be than the USSR.
The statement led Black America to cast him out of their minds and hearts. Greer does not sidestep his failings and contradictions but brings a depth and tenderness to her re-construction of a figure who is increasingly recognised as the father of black consciousness and whose poetry shaped an era and a community.
- More about:
- History
- Neil LaBute
- Soviet Union


text: The New Teenage Mutant Ninja Turtles Movie Fails In Every Possible WayCharlie Jane Anders8/08/14 12:00pm1.1K69EditPromoteGo to permalinkIt's not enough to say that the Teenage Mutant Ninja Turtles reboot is kind of a lousy movie. You want to be able to draw some kind of lesson from its crapness, or at least pick through the debris for some hint of what it could have been. To that end, here are all the ways that TMNT 2014 fails.


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MOONSHOT Energy uses a 2,000+bottle capacity reefer (refrigerated) truck wrapped with MOONSHOT Premium Craft Energy Drink branding. Both the principal owners in addition to employees will distribute approximately 500-1,000 bottles per place to shoppers entering and away from Austin Texas stores. MOON SHOT is surely an eminently drinkable energy drink and is also intended to be enjoyed, so shoppers would be inspired to take one home and drink it at their leisure. There may be you don't need to rush and gulp down a MOONSHOT inside a parking area together might with typical odd tasting energy drinks. With a "caffeine drinker", MOONSHOT is a simple sell. This is a true craft energy drink in a non-craft price. The caliber of MOONSHOT's ingredients is undeniable to anybody who has had the opportunity to compare it's taste to competing artificial canned energy drinks. Cheap in equals cheap out. Quality in equals quality out. - moonshot austin texas
Both the principal owners of MOONSHOT Premium Craft Energy are native Austinites and are currently in talks with distributors and various bars/restaurants (having just "launched" 2 weeks ago). Through the month of March, MOONSHOT will be in locations all around Austin and possibly through the entire Texas. Our plan's to ramp up promotions at bars/restaurants inside the same neighborhood of each and every MOON SHOT Energy drink launch and communicate directly with local patrons how the MOONSHOT craft energy drink they may be enjoying inside their neighborhood bar/restaurant will soon be around inside their neighborhood stores. Additionally, notifications will probably be created for each store launch on the website and social networking.
Being local, March in Austin = SXSW. With the reefer truck and our downtown location + some branded pedicabs, we are going to give away as much as 20,000 bottles of MOONSHOT craft energy drinks up and down Downtown Austin through the 10 days of SXSW. Because of this promotion, each bottle will have a noticeable label/tag stating their availability at select geographic area stores.
By heavily promoting MOONSHOT energy drinks at SXSW in Austin, we might get more traffic at local suppliers and also gain a foothold for a future MOONSHOT rollout nationally. For us, there is no better demographic to target than 24x7 tweeting energy drink-craving SXSW'ers who often want a natural and premium craft energy substitute for artificial and economical energy drinks. - moonshot austin texas


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Thecus N5550 5-Bay Home NAS Review
The Thecus N5550 5-bay server is powered by the mighty Intel Atom D2700 processor and has 2GB of DDR3 to make sure building an array and transferring data is done quickly. It also features link aggregation, SuperSpeed USB 3.0, HDMI video out and a ton of other features. Read on to find out more about this NAS and to see if it is right for your home or small business!


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North America's Premier Network of Private Practice Optometrists
Vision Source is a network of independent optometrists located throughout the United States. Together, our members are dedicated to providing advanced eye care and unmatched personal care.
February 16, 2017
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text: Magic Spinning Egg Shell Uploaded 08/16/2012 What madness is this? Share Video REPLAY VIDEO Magic Spinning Egg Shell NEXT VIDEO WTF Can You guess what langauge he is singing? and the subtitle? RELATED MEDIA Shell Game Exposed Cool Baseball Bat Trick The Best Sign Spinner You Will Ever See Shell Party Fail 48 Inch Firework Shell Fired Off In Japan Incredible Footage Of A Hermit Crab Tricking Out Her Shell Jar Never Stops Spinning On Frozen Lake Spinning Shit In MMA Boobs Popping Egg Rifle Spinning Giant Spinning Top Snake Eats an Egg Microwave Egg Experiment An Egg Underwater! Line Judge Lays Egg How To Peel an Egg Like a Boss Cutting Open a Fertile Shark Egg Girl Firing A Glock Takes A Hot Shell To The Boob Can Magic Trick Octopus Using Coconut Shells Autoplay On Next Video Share Tweet Stumble Email Pin It Embed: Use old embed code Use new embed code Tags: spinning cool awesome eggshell weird strange magic egg NEXT VIDEO WTF Can You guess what langauge he is singing? and the subtitle? 1 Comments Login to Comment


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|keywords like terrorism
|attached to Officials: NSA's PRISM Targets Email Addresses, Not Keywords
|Perfect time to switch
|attached to Winamp Shutting Down On December 20
|All security experts..
|attached to McAfee Claims Successful Insulin Pump Attack
|attached to Upscaling Retro 8-Bit Pixel Art To Vector Graphics
|attached to Windows XP SP3 Causing Router Crashes
|Layer 8
|attached to Network Warrior
|Not multiple cable lines...
|attached to Comcast CEO Shows Off Superfast Modem
|M3DS Simply
|attached to Mass Market DS Homebrew Cart Released
|Re:solution for everyone else
|attached to SETI Finally Finds Something
|New Tom Tom Commercial
|attached to TomTom Admits Satnav Device Infected With Virus
|obligatory quote
|attached to Vista's Limited Symlinks
|attached to First look at new Battlestar Galactica Episodes
|attached to Michael Robertson Says Root is Safe
|attached to Microsoft Drops Windows XP for Itanium
|Re:A must download
|attached to TheOpenCD 2.0 Released
|Re:Uh, I start X
|attached to Poll: First Program You Start After Boot?
|death of the digicam?
|attached to 7 Megapixel Camera Phone
|Re:Ahhh, IRC
|Now's a good time... for SSL
|attached to CIA Researching Automated IRC Spying
|switched from opera to firefox
|attached to Opera Facing Losses While Firefox Usage Grows
|attached to Retailers Deploy Databases Against Customers
|Re:Dr. Evil
|attached to Itty Bitty SCSI Hard Drive Arrives
|attached to Intel Scraps Plan For 4 Ghz P4 Chip
|attached to Will VoIP Kill the PBX?
Adding features does not necessarily increase functionality -- it just makes the manuals thicker.


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USA GA tracked traffic to webstie
This project was awarded to onlineshine for $159 USD.Get free quotes for a project like this
Project Budget$30 - $50 USD
Total Bids11
Project Description
I am looking for someone to get me a high amount of traffic from REAL USA unique people. I want it to be able to be tracked by google analytic and if it is done good and meets all the requirements it will be a long term job! I am looking for someone who can start ASAP. Below are the requirements:
1. Real unique USA traffic that will be tracked by google analytics.
2. Good work will lead to long term work relationship
send me pm with :
1. the first word is Turtle
2. How much traffic you can get me in a month
3. When you can start
if you do not contain these three things your bid will be ignored
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- Forbes
- The New York Times
- Time
- Wall Street Journal
- Times Online


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It's been seen by millions around the globe, and now Philadelphia audiences get to relive the magic of the music of Buddy Holly, the brilliant musician who changed the face of popular music and paved the way for the next generation of rock 'n' rollers.
It's been seen by millions around the globe, and now Philadelphia audiences get to relive the magic of the music of Buddy Holly, the brilliant musician who changed the face of popular music and paved the way for the next generation of rock 'n' rollers.With Christopher Sutton in the title role, Buddy — The Buddy Holly Story continues at the Walnut Street Theatre through July 15.The story follows the superstar's meteoric rise to fame, from his humble country music roots to the top of the record charts, to his untimely death in a plane crash in 1959.Sutton is no newcomer to the role of Buddy Holly. A three-time Barrymore award nominee for Blood Brothers and Singing in the Rain, he won the award for The Buddy Holly Story in 1999."And it feels so good to be back," Sutton said. "I've done the role in several other theaters since playing it at the Walnut, but this production really captures my heart."In fact, Sutton added, acting in general captured his heart ever since he was a little boy. "I always loved reading, and when I discovered and read Shakespeare as a kid it made me want to become an actor. I liked the chameleon aspect of acting, and this show at the Walnut allows me to do just that."Although Holly's music became popular in the '50s, and Sutton admitted to just being in his mid-30s today, he nevertheless grew up with the music of that era — thanks to his parents who had all Holly's records and played them all the time at home."I still love the music, and so do audiences, which I think is one reason why they keep coming back to see the show," Sutton said. "There's truth and honesty in the show, and a joy in the music you can't help but love and react to." In the audience, Sutton added, "we have 12 year olds who never heard of Buddy Holly, and 90 year olds who will never forget him. They'll all be dancing in the aisles once they hear such classic favorites as Peggy Sue, Oh Boy, Maybe Baby, That'll Be The Day, La Bamba and others."Sutton, himself a musician as well as an actor, is a great admirer of Holly's music and his life's story. "I think Holly was way beyond his years as far as the music he wrote. The songs are almost like poetry, and so powerful that you wouldn't think someone so young could have written them."And even at the time he was writing and performing, Sutton added, "Holly was so idolized by so many that even the Beatles took their name because they admired Holly and the Crickets so much."In this show, Sutton will be acting, singing and dancing, as well as joining other actors on stage making music. There is no orchestra pit in this show. Rather, Sutton said, "when you hear the music of Buddy Holly and the Crickets, it's just me playing the guitar, another actor on the bass, and another on the drums."Over the years, Sutton has won several other awards, and appeared in many shows, including the national tour of Monty Python's Spamalot, I Love You, You're Perfect, Now Change, Me and My Girl, Carousel and others."Of course I have favorite roles, but I will say this one is right up there on my list, mainly because Holly was a real person and I find doing roles like that very interesting and a lot of fun," Sutton said.For times and ticket information, call 215-574-3550.
By Rita CharlestonFor the TimesGrowing up in the rough neighborhood of Bedford-Stuyvesant, and enduring a tough childhood wouldn't lead many men to comedy. But in the case of Tracy Morgan, it did."I was always a funny kid," said Morgan, 43, who is set to take the stage at the Keswick Theatre on Saturday. "I think comedy was always in me, so I don't think I picked it. I think it picked me."Really, said one of the stars of NBC's Emmy- and Golden Globe Award-winning 30 Rock, "I couldn't see myself doing anything else in life. Sure, everybody has a rough beginning, and I did too. I'm not Paris Hilton and I wasn't born with a silver spoon in my mouth. But I'm all right. I'm far away from those early days. I'm a grown man now. You live and you learn. Life is complicated, but we try."And Morgan certainly did try. Spurred on by a good friend to try comedy, Morgan began doing stand-up, building his act on the difficult situations he'd dealt with in his life. It was during one of those stand-up performances that Saturday Night Live's Lorne Michaels saw Morgan and decided to audition him for the popular TV show.Morgan's humor landed him a spot on the show and he stayed for seven years before moving on to other things. In 2003, Morgan left SNL to headline his own show on NBC, a sitcom called The Tracy Morgan Show. Although the show didn't last long, Morgan was able to turn his talents to other pursuits, landing significant roles in a handful of feature films.And in 2006, Morgan found his niche on 30 Rock, the sitcom created by fellow SNL alumna Tina Fey. A longtime friend and admirer of Morgan's, Fey wrote the character of Tracy Jordan specifically for Morgan. "Tina came to SNL three years after me and we always had a good time working together," Morgan said. "We are professionals and we work well together. There's a chemistry there that's always been there."In 2009, Morgan received his first Emmy nomination for his role in 30 Rock in the Supporting Actor category. He's also been nominated for a Supporting Actor NAACP Image Award, and has won the Screen Actors Guild Award for "Outstanding Performance in an Ensemble in a Comedy Series."Among the other heights he reached in 2009 was the release of his book, I Am The New Black, a compilation of anecdotes and some of the more serious moments that shaped him and his career."I wanted to tell my own story rather than have someone else tell it," Morgan explained. "I've never been the kind of person who asks 'why?' but rather, 'why not?' I'm somebody who came from the ghetto and learned how to make it. Somebody had to, so why not me?"Morgan has also been heard lending his voice to the animated film RIO, tackled a role in the drama The Son Of No One, and rounded out his list of great comedic achievements with his first HBO special, Black & Blue.And when he takes the stage at the Keswick, he said he hopes his audience will realize that his stand-up is unlike what they see him do on television."When I get on stage," Morgan said, "I just want to spread my love and do it live. What I do on TV is for TV. But this will be live entertainment. It's straight up, with no chaser. Sometimes, when people come to comedy shows they come expecting to see what they see on TV. But this is live. This is life. This is the real stand-up. This is the real me."For show times and ticket information, call 215-572-7650.


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Red Sox president and CEO Larry Lucchino insists that despite a dismal season, there's more reason for optimism than many in Boston may think. In his weekly appearance on WEEI's "Dennis & Callahan" show Thursday, Lucchino pointed to the potential of several of the team's young players, including Ryan Lavarnway ("He's hit everywhere he has been... at every level."), Jose Iglesias ("seeing how quick his hands are is kind of fun... he's only 22 years old, so I wouldn't write him off quite yet"), and four players in the minor-league system he calls "the killer B's" -- Jackie Bradley Jr., Xander Bogaerts, Matt Barnes and Bryce Brentz.
"Those four guys represent the cream of the crop, and project to be outstanding major league baseball players," he said.
Lucchino said the Red Sox plan to take a more aggressive approach in the future in advancing their prospects, and agreed it's possible that some of them will see playing time in Boston next season, especially outfielder Bradley, 22, who finished with an OBP of .430 in 128 games for Single-A Salem and Double-A Portland.
"I think that is possible," Lucchino said. "Maybe not at the start of the season, but at some point during the year. ... I do think we have taken a very conservative approach historically to the advancement of players in our minor-league system. I think that's just an undeniable fact and I hope as we focus more on scouting and player development in the next few years that will change, that there will be a presumption for slightly more rapid growth."
Lucchino clearly disagreed with manager Bobby Valentine's remark last week that this is Boston's weakest September lineup in history. "I think that was a bit of hyperbole, to be sure," he said.
"I understand what he was talking about in terms of injuries and in terms of the fact that we had our Triple-A team playing until Tuesday night. So I understand where he's coming from, and he's clarified that," he added.
As far as next year's roster, Lucchino said the team hopes to bring back productive outfielder and fan favorite Cody Ross.
"We love Cody Ross. He is someone that I think was one of Ben Cherington's best offseason acquisitions. And when we saw him in spring training, several of us predicted that he would be a very popular player because of his style, personality and power, and he has proven to be just that. So yeah, we'd love to have Cody Ross come back and play with us in future years. We're in the beginning stages of that process."
On whether less-popular but talented pitcher Alfredo Aceves will be back in Boston, Lucchino wouldn't commit.
"He's a valuable pitcher. His track record over the course of his major league career has been impressive," Lucchino acknowledged, adding that his role next season is "a decision that will be made next spring by whatever team he is with."
Lucchino did admit that there was discussion of suspending Aceves (a second time) after he appeared to show up manager Bobby Valentine last Wednesday after being taken out of the game in the sixth against the Yankees. He noted that there were some union concerns.
"There was discussion about it, but the decision was made that it was not necessary," he said.