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Hotels in South Miami
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- Most bookedCountry Inn & Suites Miami Kendall
202 people looked at this hotel in the last hour
Most recent review
"Hotel staff were very helpful and pleasant and room was clean. It was a great location with plenty of shopping and restaurants in walking distance. The only negative is there were not enough seats for breakfast for the large crowd every morning but one the week we stayed. We would definitely s..."
A Traveller, Jan 2017, US
149 people looked at this hotel in the last hour
Most recent review
"The hotel staff is very friendly, the hotel is very well located and the breakfast menu is very good, plus it has a shuttle service to the hotel which helps a lot to the tourist."
P, Jan 2017, US
103 people looked at this hotel in the last hour
Most recent review
"Needs to have free Wi-Fi. Enjoyed the latin entertainment"
A Traveller, Jan 2017, US
85 people looked at this hotel in the last hour
Most recent review
"I absolutely love this place and I have never been to Miami before and the people there we're amazing they were very friendly. Very romantic setting. Absolutely love their remodel. Their food was good and so were the drinks. Coffee was delicious. when I go back to Miami Aloft is where I will go."
A Traveller, Jan 2017, US
74 people looked at this hotel in the last hour
Most recent review
"Room was clean, bed was comfortable and clean. Bathroom was clean as well. Room had no smell of smoke. Smelled fresh. When I first arrived I had a room near maintenance I was told. Soon as I arrived at front desk the clerk stated to the other staff she couldn't put me there because it not OK. (Ma..."
A Traveller, Jan 2017, US
67 people looked at this hotel in the last hour
Most recent review
"We wanted a central location to Key West and the Miami area beaches - so this was perfect for our needs. Close to shopping with a Publix Grocery Store within walking distance. GREAT breakfasts every morning!!"
P, Jan 2017, US
60 people looked at this hotel in the last hour
Most recent review
"Loved the location, the staff, the lobby and the look. Rooms were very clean and comfortable. Bathroom showed signs of heavy wear, waiting for a remodeling, but it was very clean and the house cleaning staff were real nice. We could hear lots of noise from a couple having fun above us... all t..."
F, Jan 2017, US
59 people looked at this hotel in the last hour
Most recent review
"Non eventful everything was very good A/c unit was not clean but once i brought it to their attention it was promptly dealt with I have actually extended my stat by 5 days"
l, Jan 2017, US
42 people looked at this hotel in the last hour
Most recent review
"great location very clean staff really nice lots of shopping near by...."
A Traveller, Oct 2016, US
38 people looked at this hotel in the last hour
Most recent review
"Was a good hotel. Clean and comfortable. The breakfast was very good. They had a fairly large selection. However, the hot tub was not very hot. The regular pool felt warmer than the hot tub did. "
A Traveller, Jan 2017, US
What you should know about South Miami
Are you looking for a cheap South Miami hotel, a 5 star South Miami hotel or a family friendly South Miami hotel? You just landed in the best site to find the best deals and offers on the most amazing accommodations for your stay.
When you search for hotels near South Miami with Hotels.com, you need to first check our online map and see the distance you will be from South Miami, Florida.
Our maps are based on hotel search and display areas and neighborhoods of each hotel so you can see how close you are from South Miami and refine your search within Miami or Florida based on closest public transportation, restaurants and entertainment so you can easily get around the city. All the hotels details page show an option for free or paid onsite parking.
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One of the new features on Hotels.com guest reviews is that also show reviews from Expedia for South Miami hotels and the TripAdvisor South Miami hotels reviews so you can make sure that you checking with a reliable source. See the review scores on our Miami hotel information pages.
Make the most out of your family vacation when you book your accommodation with Hotels.com – book your hotel near South Miami, Miami after reviewing the facilities and amenities listed for each hotel.
After booking your hotel near South Miami, expect to receive your reservation confirmation in the mail in less than 10 minutes. The confirmation email contains more information on all nearby attractions, local directions and weather forecast, so you can better plan the days during your trip.
After getting the best hotel rates you can still save more by winning 1 free night! That's right, book 10 nights in any hotel near South Miami, Miami and after you sign up for the Welcome Rewards program, you are eligible hotel you receive 1 night free*
The best hotel deals are here: We have South Miami hotel deals, South Miami last minute deals and offers to get you the cheapest South Miami hotel with our lowest price guarantee.
Miami travel guides
Shopping in Miami - Style, Substance, and Smokes
Miami's reputation as the playground of the rich and famous makes it the ideal spot for upscale desi...
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It's such a cliché to say that a destination has "something for everyone," but it's a pretty forthri...
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Spend significant time around Milan Lucic and it's clear that he cannot mask his joy. The earnest look comes over his face and his tough exterior dissolves into his genuine good-guy demeanor.
He bore that expression when, after a morning skate during a losing skid, he talked about returning to Staples Center for the first time Thursday.
"It'll be cool," Lucic said. "It'll be a lot of fun. I had a lot of fun last year being in L.A. and being a King. Even before I was a King, I always had a lot of fun going into the Staples Center … those are the games that you circle on the calendar."
Lucic only spent one season with the Kings but he thoroughly enjoyed it...

subset: commoncrawl


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While reliability is important to every company, the NYSE requires uninterrupted availability, as it is the worlds largest stock exchange, with 2,750 companies listed and a total market capitalization of more than $17.8 trillion. Since 2002, the average number of shares traded has risen from approximately 1 billion a day to 1.6 billion. Thirty years ago, trade volumes averaged 16 million daily. Today, brokers collectively send and receive an average of 75,000 messages a day, up 200 percent in the last two years. The system has already replaced human ticket runners on the exchange floor. The trade communication goes from a brokers wireless handheld device, and bounces through the various internal systems to the end customer. Part of the role of technology at the NYSE is to handle growing volumes with same number of people. The exchange is processing trades today with the same number of people who handled one-tenth the number of transactions 30 years ago.A team of more than 50 IBM researchers, software designers and financial industry experts from around the world has been working with the Exchange on custom technologies, engineering methods and testing procedures aimed at helping establish the NYSE as a state-of-the-art example of "extreme availability." Some of the pioneering technologies and processes emerging from the NYSE project are expected to spill into IBMs work with other customers with similar requirements and commercialized in IBMs software products. Check out eWEEK.coms for the latest news, views and analysis on financial applications and services for the enterprise and small businesses.
As the Exchange moves to a higher percentage of automatic execution, when the hybrid market becomes a reality, higher performance is a must. Rolling out early next year, IBM has created application software on the handheld that allows a broker to create a trading strategy, such as a tapered strategy, with one set of interactions. Implementing this strategy would have taken five or six orders in the past. There are 10 strategies built into the handheld device now. Burkhardt says, "This will become extremely valuable to the brokers and to their institutional customers going forward."
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Pearse Road Guesthouse
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A misty morning in Buncrana
... aged women in a bathing suit gingerly picking her way down to the water. I really couldn't believe that she was going in, as the day was still very chilly and it was anyone's guess what temperature the water was. But she did! So much for the Polar Bears in Melbourne, they had nothing on this lady. Moreover, she was still swimming about when we walked back that way about half an hour later!
One of the lovely touches on the walk was a ...
Local History Tour with Tony
... purposes. The construction of it was very unique, and I hope to recreate a scaled down version when I come home.
After Grianan Ailigh, we made an unscheduled stop at a museum called "The Old Church Museum". It was a very nice, interactive museum, even featuring a thatched-roof building out front in which a history lesson was given by a Druid woman via projector - just like Princess Leia in Star Wars when she was pleading with Obi ...
To Belfast for a Day
... Murals made me feel really sad.
Dinner at the Quayside again and here I am writing yet another post. What I have seen of Ireland so far is all I thought it would be. Clusters of quaint rough cast houses. Green fields. Friendly locals. Am so looking forward to getting further south and experiencing music in the pubs. In the meantime will have to be satisfied with a couple of CD's I have purchased to get the feet ...
Leaving the hostel I headed north, aiming to go round the Inishowen peninsula. Within a few miles I was buried in Muff, but passed straight through to stop in Moville, a small fishing village with great views across to Northern Ireland. Though by now I was further north than the north most point of NI. My inner bingo caller enjoyed the car park holding 'two fat ladies-large ice creams' and I and the bingo caller ...
50 Shades of Green
... boys and their sister Joan) and the head of the household, rosy cheeked Mr. Doran. Joan served Cajun chicken with goats cheese (so much cheese... was I ever excited!!) and Mr. Doran poured us generous glasses of red wine while entertaining us with all of his stories (of his family, his travels and the antics of his best friend, Bonnie the Retriever). After dinner (and a delicious hot shower) it was off to the pub. Now, everytime we went out in Belfast, we ...


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Season 2 of the Overtime podcast is here! Listen to the first episode with Meg Robichaud now.
This drawing was an attempt to articulate the moment of discovery and was the first piece of work I completed which featured a significant focus on shading technique in addition to the inclusion of an environment.
Having seen a worked up rough in my studio, Musician Ian M. Hale requested a final rendition of this scene for his Loss EP.
You can find out more about Ian M. Hale's music over at www.IanMHale.com
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Listen to free music by Megan & Liz
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- Description
All solid Pine wood construction, finished in a weathered golden-brown hue with subtle wire brushing and varying natural distressing. The bed offers a sleigh headboard and a footboard - both featuring lateral slats. The cases have generous storage with framed inset drawers and framed sides, all supported with robust leg posts. Drawer boxes are dovetailed and fully finished with wooden center glides for smooth function. The metal bin pull hardware nicely accents the wood finish.Includes
1 California King Bed, 1 Night Stand, 1 Dresser and 1 MirrorDimensions
Chest(B658-46) is not included. But sold separately upon you required.
California King Bed,
Inside depth 73.25"
Rail to floor 5.75"
Inches: 65.75" W x 18.25" D x 43.25" H
Drawer interior (6) 29.50" x 14.00" x 5.75"
Inches: 43" W x 1.5" D x 32.5" H
Night Stand(B658-92)
Inches: 25.25" W x 17.25" D x 29.5" H
Drawer interior 15.38" x 13.25" x 8.38"
More from this collection: Trudell
- Additional Information
Additional Information
SKU 12008613 MPN B658-58-56-94-31-36-92 GTIN N/A Brand Signature Design Collection Trudell Assemble Length N/A Assemble Width N/A Assemble Height N/A Assembly Required Yes Material Wood Finish Brown Sizes N/A Bed Styles N/A Shipping Time 1-2 Weeks Free Shipping No
- Reviews


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Pyrolux 4.7L Food Warmer - Stainless Steel11433
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The Pyrolux 4.7L Food Warmer - Stainless Steel is made to keep your food at the temperature you want. Whether there's a family gathering or a picnic, this handy food warmer is the kitchen partner you can confidently rely on to make every occasion a bit more spectacular.
Key Features
- The Pyrolux 4.7L Food Warmer - Stainless Steel has a high quality stainless steel finish and a portable handle design.
- The inner container is insulated to keep your food the temperature you want it to be.
- Its tight locking system ensures that your food stays intact when transporting it from one place to another.
|Food Warmers
If you feel your product has failed a Consumer Guarantee (as defined by Australian Consumer Law) then don't worry you can easily return it to your local Harvey Norman store. We'll even pay for the postage if you live in an area where there is no store. Our returns policy covers any purchased item (conditions apply).
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New Era has enlisted venerable all-weather fabric brand GORE-TEX for a series of New York Yankees caps that harness the waterproof, yet breathable, nature of the fabric. Presented in a variety of colors with slight GORE-TEX metal badge branding, the result is a traditional summer staple that has been reworked to accommodate upcoming blustery conditions. Keep an eye out for the collaborative caps at select New Era institutions this fall.


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Deep Lane, Crediton, Devon, EX17
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Added On: 2014-08-20 02:50:30 • Views: 536 • Duration: 05:30
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hbo Six Seasons Planned For HBO's American Gods Adaptation
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Hotfrog INDIA provides information regarding Isot. Isot provides Medical College services. Contact them on 0522 2495187 or by visiting them on their website http://www.isot.co.in.
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Telephone & Addresses
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James Kittrell
07601 Hackensack NJ
James Kittrell
70637 Dry Creek LA
James Kittrell (Age: 30)
27855 Murfreesboro NC
James Kittrell, 46, Alexander City, Sunny Level Cutoff
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Network Profiles
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LinkedIn: James Kittrell | LinkedIn
Sehen Sie sich das berufliche Profil von James Kittrell (Deutschland) auf LinkedIn an. LinkedIn ist das weltweit größte professionelle Netzwerk, das Fach- und ...
James Kittrell |MaxPreps
James Kittrell's high school sports timeline. MaxPreps has events and updates about James Kittrell while he was playing football at Joplin High School dating...
Valor awards for James Lee Kittrell
James Kittrell was captured during the Korean War and interned as a Prisoner of War. He was not among those returned at the wars end, and is listed as Missing ...
Business Profiles
(1 - 4 from 9
patentbuddy: James M Kittrell
INTERNATIONAL PAPER COMPANY, Mobile, AL, US
patentbuddy: James R Kittrell
KSE, INC., Amherst, MA, US
James Thatcher Kittrell Lawyer Profile on Martindale.com
James Thatcher Kittrell Profile by Martindale-Hubbell. Find James Thatcher Kittrell contact information, experience and credentials, peer review ratings etc.
James Kittrell - Previous Manager for James G. Kitrell Jr., LLC
View James G Kittrell's profile for company associations, background information, and partnerships. Search our database of over 100 million company and...
Private Homepages
James Kittrell Glanton (November 25, 1950 - April 2, …
James Kittrell Glanton Memorial Website. Honor your dearest with a memorial website where you can create photo albums, family tree, memorial video, light a memorial ...
(1 - 4 from 17
classmates: James Kittrell
Commerce High School, Yonkers, NY, 2001-2005
classmates: James Kittrell
Arkansas City High School, Arkansas City, KS, 1954-1958
classmates: James Kittrell
Meadville Area High School, Meadville, PA, 1967-1971
classmates: James Kittrell
Highland Springs High School, Highland Springs, VA, 1962-1966
Bad news
(1 - 4 from 78
legacy.com: James Kittrell
James C. Kittrell CHESAPEAKE - James C. "DuFunny" Kittrell, 81, of the 2600 block of Harvard Drive passed away Jan. 15, 2011. He was predeceased by two sons, Sherman L. Kittrell
legacy.com: James Kittrell
LEXINGTON - Kittrell, James, 80, died November 1, 2011. Milward Funeral Directors, Broadway
legacy.com: James Kittrell
In Loving Memory of Its been a year today but it seems like yesterday. We miss you. Love, Betty, Linda, Frederick, and family.
findagrave: Kittrell, Dr James Bates "Bob"
12/30/1916 - 03/4/2011, Texarkana (Bowie County, Texas)
(1 - 4 from 21
James Kittrell (1776 - d.) - Genealogy
Genealogy for James Kittrell (1776 - d.) on Geni with over 140 million profiles of ancestors and living relatives. Page updated July 23, 2014.
Samuel James Kittrell Jr. (deceased) - Genealogy
Genealogy for Samuel James Kittrell Jr. (deceased) family tree on Geni, with over 140 million profiles of ancestors and living relatives.
James Kittrell McGregor (deceased) - Genealogy
Genealogy for James Kittrell McGregor (deceased) on Geni with over 140 million profiles of ancestors and living relatives. Page updated July ...
Descendants of Samuel James Kittrell
Five generations of Samuel James Kittrell's children.
Books & Literature
(1 - 4 from 9
Environmental considerations of selected energy conserving...
... Refining: Mr. R. Peter Stickles, Principal Investigator Mr. Edward Interess Mr. Stephen A. Reber Dr. James Kittrell (consultant) Dr. Leigh Short (consultant) Pulp ...
Marriages of Granville County, North Carolina, 1753-1868 - Brent...
Marriages of Granville County contains abstracts of all marriage bonds issued in Granville County between 1753 and 1868--some 8,000 bonds, mentioning a total...
Montgomery Co, TN - Google Books
James Kittrell. the fourth child, wounded and captured also Feb. 1 6. I X62. at Fort Donelson. was able to recover from his wounds. On Aug. 21. 1X34. Solomon ...
Report by the Committee on Motor Vehicle Emissions - National...
... Materials and Electronic Control Group, Texas Instruments, Inc. (Attleboro, MA) JAMES KITTRELL, Associate Professor, Department of Chemical Engineering, ...
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(1 - 4 from 5
09-7178 - James Kittrell v. Gene Johnson
09-7178 - James Kittrell v. Gene Johnson. Download Files. Descriptive Metadata, MODS. Authenticity Metadata, PREMIS. All Format & Metadata Files, ZIP file ...
Dadeville Cemetery - USGenWeb Archives
Cemeteries Dadeville Cemetery ... ND Alice S. Cleveland 1932 - ND Larry James Kittrell Aug. 7, 1966 Aug ...
James Kittrell v. Gene Johnson, No. 09-7178 (4th Cir. 2010) :: Justia
James Kittrell v. Gene Johnson, No. 09-7178 (4th Cir. 2010) case opinion from the U.S. Court of Appeals for the Fourth Circuit.
A-B - USGenWeb Archives - census wills deeds genealogy
... james kittrell, rebecca 2 jan 1842 brannum, lucinda morrow, jesse v. 28 feb 1835 brannum, luvisey chandler, samuel 15 jun 1842 brashare, lorane ...
PEOPLE v. KITTRELL | Leagle.com
Lawyer, Attorney, Counsel, Law Firm, & then The People of the State of New York, Appellant, v. James Kittrell and Keith Miller, Respondents On March 18, 1978,...
Video & Audio
James Kittrell - YouTube
James Kittrell - YouTube
Creep- Radiohead (cover) James Kittrell - YouTube
My 1st uploaded singing video ever!!! Just first verse and chorus of the song, hope you enjoy!!! Comment with future covers for me to do any style!!!
James Kittrell - Alive (original song) - YouTube
My buddy James wrote this awesome song! Great worship music
(1 - 4 from 8
James Kittrell DBA Kitts Mini Mart in Kinston, NC 28501-4937 - (252)...
James Kittrell DBA Kitts Mini Mart's products, services, reviews, address, phone number, driving directions, hours of operation and more. Located in Kinston,...
John Guerieri III
HENRIETTA â John Guerieri III, 53, of Henrietta, died Saturday, Nov. 2, 2013.
No New Deaths in Oklahoma, but the Fires Cut a Grim Path ...
"We've got reports that this is the worst drought since 1956," said Judge James Kittrell of Montague County, whose jurisdiction includes ...
James Kittrell Of Benton County, Oregon On Fri Apr 11, 2014 | Western...
James Clavis Kittrell, aka James Kittrell, was arrested or detained on Fri Apr 11, 2014 by Benton County Sheriff's Office | Benton County, Oregon Regional News...
Reports & Statements
(1 - 4 from 6
pinterest.com: James Kittrell on Pinterest
See what James Kittrell (jameskittrell) has discovered on Pinterest, the world's biggest collection of everybody's favorite things.
Wildfires Continue Burning in Three States : NPR
Traci Weaver, a spokeswoman for the Texas Forest Service, talks about the grass fires that threaten large areas of her state. Firefighters anticipate another...
James Kittrell - Discussion on Topix
James Kittrell. Posted in the Carthage Forum. Leave a Comment Track Replies. Comments. 1 - 1 of 1 Comments Last updated Mar 15, 2013 ...
James Kittrell, Dvm, Watkinsville GA
James Kittrell, Dvm is an equine vet in Watkinsville, GA. Get information about James Kittrell, Dvm, including contact information and directions to the...
(1 - 20 from 28
JAMES KITTRELL | LinkedIn
View JAMES KITTRELL's professional profile on LinkedIn. LinkedIn is the world's largest business network, helping professionals like JAMES KITTRELL ...
James Kittrell Dba Kitts Mini Mart - Convenience Stores - Kinston,...
Information about James Kittrell Dba Kitts Mini Mart located in Kinston 28501-4937, NC. Business is Convenience Stores.
Diane Getz & James Kittrell - Wedding Registry
Diane Getz and James Kittrell from Cherryvale, KS have registered at for their wedding on June 29, 2013. Browse all their registries in one list.
Brian James Kittrell | Free Listening on SoundCloud
Listen to Brian James Kittrell | SoundCloud is an audio platform that lets you listen to what you love and share the sounds you create.. 8 Tracks. 13...
Diane Getz and James Kittrell exchange vows | Times News Online
Diane J. Getz, daughter of Mr. and Mrs. George Kattner Sr. of Jim Thorpe, and the late Dennis Getz of Hazleton, and James Kittrell, son of Jerry and Nancy...
JAMES KITTRELL - people search, genealogy, find deceased relatives...
JAMES KITTRELL - people search, genealogy, find deceased relatives and locate ancestors
James Kittrell Criminal Record & Mugshot
James Kittrell Mugshot Picture and Arrest Report for Lincoln County Jails.
Michael James Kittrell | Payson Roundup - Payson, AZ
Michael James Kittrell, 24, died in Chandler Jan. 6, 2005.
James Kittrell (@hoteluardon) • Instagram photos and videos
James Kittrell. 0 posts; 0 followers; 0 following. ... 0 posts; 0 followers; 0 following. Follow. James Kittrell. This user has no photos. Log in · Privacy · Terms.
James Kittrell (@rastamane365) • Instagram photos and videos
James Kittrell. 18 posts; 45 followers; 75 following. Musician/Skater Single 4 life Catie Beth is my bestie!!!
Liskow & Lewis - Kittrell James T.
James T. Kittrell • Associate, Houston (713) 651-2950 • mobile (214) 274-7520 • fax (713) 651-2850 email@example.com Mr. Kittrell is an associate in the ...
James Kittrell 802-442-3678 Shaftsbury White Pages
James Kittrell 802-442-3678
In Memory of Dr. James B. Kittrell -- TEXARKANA FUNERAL HOME, New...
This is the permanent online memorial and Life Legacy for Dr. James B. Kittrell. Please join us in Loving, Sharing and Memorializing, through stories, photos,...
UK Career Statistics and Bio for James Kittrell
Obituary - Death Takes Mr. Kittrell, Lexington Leader (May 16, 1966) Services for James B. Kitrell, of 306 South Hanover Avenue, will be conducted at 3 p.m. Tuesday ...
James Kittrell 303-838-8045 Conifer White Pages
James Kittrell 303-838-8045
James W Kittrell 301-863-2442 Great Mills White Pages
James Kittrell 301-863-2442
CSFBL: Player: James Kittrell
Computer Simulated Fantasy Baseball League - Create and manage your own baseball franchise and compete against others over the Web.
0086 Another Irritating Bank Story | Affordable Real Estate...
You guys know I feel that banks are a last resort! Well, let me tell you one more story if you haven't gotten the point they are more likely to tell you No,...
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Auto repair services
Catalytic Combustion of Waste Halogenated Solvents - James Kittrell
A novel preparation method has been adapted to a catalyst for oxidation of halogens in dilute air streams. This procedure produces a highly active...
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Internal Medicine Clinic Website
This project received 52 bids from talented freelancers with an average bid price of $604 USD.Get free quotes for a project like this
Project Budget$250 - $800 USD
Total Bids52
Project Description
We are looking for a simple, patient-oriented website for our internal medicine private practice. Features for the website should include easy navigation bars for information regarding treatments, office facts, doctor's qualifications; we also would like to optimize search engine ranking in whatever way you know. On a website for another one of my businesses, I maintain a blog through which I post relevant articles with keywords relating to my business, and this achieves quite a significant search engine boost. If this is how you would like to approach that, that's fine. If you have better ideas, please let me know. The primary focus will be user friendliness, our community is largely rural, so bells-and-whistles are less important than clean design, website ease, and excellent presentation. I would like this job done fairly expeditiously as well. Contact me with ideas if you have them. This should be a very straightforward job, and I would like to keep it that way as much as possible.
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Nah i believe it should be - 1 life or - pill
My Anti weapons are Deiter, and Nahi...
i like the concept, of a - power, and - damage ability, it would never be very strong, but it would be affective.
it'd likely never exceed -2 which would be -2 power, -2 damage.
heres a nifty idea.
Ability = Transfer affect.
this would transfer any affect from you to them, or them to you depending.
so if you had poison, and they had +1 pill per round, the affect would transfer giving you +1 pill, and them poison
I like Chaos. in fact, perhaps Chaos would be a good name for the ability
Ability = opp ability
Ability = opp bonus (ir any)
How about Ability=Opp Ability or Ability=OppBonus?
Ability switch
when this card is played the opponents card fights for you and your card fights for the opponent, pills used will not be transfered between players
(for when your opponent has a few more high power cards then you)


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19425 Surnames | 123641 Records | 2644 Reunions
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Photo #77027
Last Name: Ahrens
First Name : Cora
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Date: 1901-1920
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Comments: Cora Ahrens (Nee: ) | IA United States | 1901-1920 | Comments: Cora at the far left. Students at Iowa State Teacher's College. This photo was taken at the depot just before Jane [Little] went away to Storm (?) Lake to debate.
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Nutbush was made famous in the 1973 Ike and Tina Turner hit, "Nutbush City Limits." It was the last hit single produced by the duo.
Welcome to the heart of a true cotton community. Notice the still-operating cotton gin and visit the Nutbush Country Store with a sign proudly declaring it the "Birthplace of Tina Turner." When settlers first arrived here, they found an abundance of hazelnut trees that had to be cleared so homes could be erected. This reminded them of a village in North Carolina called Nutbush, so they gave their settlement the same name.
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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Electronic health records are coming to a sports arena near you. A hospital in New Jersey is providing emergency medical services at a stadium that hosts the local major league soccer team. If a person is hurt, they can go to the first aid station, where a team of doctors will treat them. When a person is transported to a hospital, doctors are able to treat them more quickly because they already have the patient's medical record from the stadium and are notified of any medications that were already administered.
Photos of the amazing, moving, important and amusing things happening in the federal community.
A daily update of important moments in the history of the U.S. government.


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Named in celebration of Peavey's first 40 years, the 6505 Series is the undisputed go-to guitar amplifier for scores of rock, hardcore and metal bands for their raw tone, relentless power and road-proven reliability. The 6505 is still the unquestionable choice for an ever-expanding list of endorsers.
6505® Series amps feature five 12AX7 preamp tubes and four 6L6GC power amp tubes, with presence and resonance controls and three-band EQ for taming their notorious tone.
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|Width Packed: 12.25"(31.115 cm)
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- Peavey Electronics - 6505+ 112 Combo
- Chimaira - 6505 Amplifiers 2011
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- Ted Nugent Interview
- 6505 MH (Espanol)


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Wrangler advice
I am interested in getting a new 2012 wrangler but I was hoping for some advice first.
A lot of times that I tell someone that I am looking at a jeep wrangler I get some horror stories about how rough, loud, and uncomfortable they are. However with the new revised interior in 2011 the jeep looks as if it can be a quiet and comfortable ride.
Basically I am just looking for people's opinions on the 2011 wrangler as far as comfort. Has it come a long way? Is it loud with the soft top? How would it compare to a grand Cherokee for example? I just feel as if I'm missing something. If the wrangler was as comfortable as a cherokee for example (which I think the 2011's look like they are) why wouldn't everyone just get a wrangler. It can do so many more things.
Thanks for the help guys. You got a great forum here.
I'd go test drive a 2011 and see what you think.
In my opinion, my 2010 is great. Very comfortable to drive for hours at a time. Soft top is quiet enough that I can have cell phone conversations.
Is it like a Lexus? Of course not. But does it doesn't beat you up and leave you exhausted either.
The Wrangler has come a very long way in terms of comfort and quietness. It is not quite on par with the Grand Cherokee though. Take a 2011 with the soft top for a test ride and see for yourself. If possible take it on the highway. I was supprised how quiet my 2010 was, compared to the 1990 I used to have.
the wrangler is a off road jeep and rides like one, the grand Cherokee is a suv and a very nice one that has nice smooth highway tires and air rid suspention, if your looking for comfort i dont hink you'll find it in a JK or JKU. sorry to bust your bubble,
Coming from a 2006 tj to a 2011 JKU I was extremely surprised with the difference. The ride was much smoother and the soft top was much much more quiet. Can you hear road noise? Yes. Do I have to raise my voice to talk? Not at all.
Are there other vehicles out there that are almost or just as capable off road as the jeep that are more comfortable and quiet? Absolutely. But try and take those doors and tops off!!
I came from a g35 coupe and expected the jeep to be very loud. I am extremely impressed with how quiet the ride is in my jk. (although mine is stock suspension and tires)
It does not ride like the Cherokee. It is loud and rough and perfect! Drive one and you'll understand. The only thing that changed in 2011 was the interior. Different dash and steering wheel.
We took mine on a 2.5hr road trip topless last weekend... :) It was awesome, but conversation is nearly impossible, so don't buy one if you like to talk while you're driving on the highway topless....
I came from a 2wd Ram quad cab, I have a 2 door Wrangler hardtop now. The seats in the Jeep are not as comfortable as the Ram's, but not uncomfortable by any means. The suspension feels about the same as the truck did, softer in front with more travel but more firm in the rear. The biggest difference is the wheelbase which took some time to get used to, still want to do a three point turn to park at the store just to make sure I remember how. Road noise is worst when the freedom tops are off and back half on, then with top on and windows down. I drove an hour with top off on the freeway at 75 mph and just had to raise my voice a bit but was pleasant drive. The biggest difference is a Wrangler is just FUN to drive in so many ways.:dance:
Highway noise is louder than a GC, with the hard or soft top, but it is within reason, and well worth the tradeoff of a removable top and doors.
The hard top is quieter than the soft top, too, so if you can swing the dual top option in your budget, you'll like having both.
I have no problem talking hands free on the blue tooth voice connect, with a lift kit and big tires.
LaTuFu, remember not all people are the same size, im 6-1, 320 pounds . so my jku is just an ok vehicle, and i do love it. i made my statement on my size, my legs are cramped , my size 13.5 feet are cramped, my ass kills me after 4 hours. BUT i still love the jeep.
My only other Jeep was a 94 Grand Cherokee. Our new JKU hard top rides and drives as well as our old ZJ, and the interior is almost as nice. I was shocked at how well the JKU drives and handles and the interior blew me away. It's light years ahead of the old CJ's and YJ's!
I agree with the comments above. I have a 2 door Rubi which is my daily driver, and I find the ride to be pretty comfortable. I also drive my mom's Lexus SUV from time to time, and I would say it is a night and day difference from the Wrangler. I'd put the Grand Cherokee in a similar category as the Lexus.
The SUV accelerates like a car, handles road bumps like a car, and is quiet like a car. On the other hand the Wrangler does not accelerate quickly, shakes and bounces over very bumpy roads, and is not as quiet. All of this is relative though, and I have no problem whatsoever driving the Wrangler every day and even taking it on longer road trips. The fun factor of the Wrangler more than compensates for the sacrifices in road manners.
I like to be giggled as I go down the road. No other car that I have driven gives me the same feeling as my jeep. I can't quite describe it but it somehow adds to the fun of driving it. Stiffer than a passenger car or SUV, but not as firm as my YJ. The YJ is like a buck board compared to the JK and REALLY excites me to drive it. Especially with the top and doors off. But, I can see that as a daily driver the YJ may wear on you. Point being is that you won't really know how you will feel about it until you get in and drive one. Be a pest at the dealer and drive it a whole bunch until you get a feeling for it. That should help drive your decision.
the wife and I test drove both a hardtop and softop 2011 before making the call to wait & buy a 2012.
Took them both on the same drive, and up to 65 mph. We both thought there were pretty quiet. Easy to have conversation, even with someone in the back seat. I didnt really notice any difference between the soft and hard tops, except there was a wind whistling comming from the top rt front corner of the softtop. The salesman said the top probrably wasnt seated right, so I suspect that could be adjusted out.
I own a BMW E46 3 series, and a Duramax. They wont ride like the beamer, but in all honesty its not much louder than my car. I was suprised, when we did the test drive.. The last jeep i was in was an older CJ, 15 years ago, and that thing was noisy and rode like cr@p. The new ones are far and above a better riding vehicle, based off my 30 minute ride in one..
You want loud and uncomfortable, drive my 89 YJ. The 10 Rubi we have is like driving an old American luxury car compared to that. Do a test drive and you'll see.
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With the Fair Work Commission's long-awaited decision on weekend penalty rates handed down, a fierce political fight is reignited between Labor and the Coalition.
The Territory Government resists calls to have an independent watchdog investigate the three NT utilities corporations at the centre of a multi-million-dollar staffing blowout.
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The Lalaloopsies Puzzle (24 pcs)
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Intel Says No MeeGo Handsets Until 2011
Nokia has no comment.
Forbes reports that a mobile device with MeeGo natively installed won't ship until the first half of 2011. Doug Fisher, Vice President of Intel's Software and Solutions Group and General Manager of Intel's System Software Division said in a recent interview that a MeeGo-powered device might debut at a large trade show in early 2011, quelling any rumors that an official MeeGo phone might make a debut at this year's inaugural MeeGo Conference in Dublin.
MeeGo tablets are also scheduled to appear in 2011, save the German-made WeTab by Neofonie, which is available for preorder now and slated to launch later this year.
Intel's development partner Nokia has stayed silent on the delay, which isn't entirely surprising considering the recent shakeups in management. Recently, MeeGo Device VP Ari Jaaksi left the company for undisclosed reasons.
Still Fisher is confident in the operating system's road map. Saying that MeeGo has been hitting its dates, some of them early. Later this month MeeGo 1.1 will become available, which includes additional telephony and touch support for tablets and smartphones.
Currently, Nokia is the only company onboard to produce MeeGo devices. But Intel is currently in talks with other OEMs.
Issue 28: GIMP Handbook 4th Ed./Special Editions
Buy this issue as a PDF
Munich Plans to Ditch Linux and Go Back to Windows
A major setback for the Linux desktop.
Linux Kernel 4.10 Comes with New Security Features
Improved support for GPU in virtualization.
OpenSUSE Site Hacked
News site for the openSUSE community falls victim to a Wordpress exploit.
LibreOffice Goes Online with 5.3 Release
The source code is available online.
Microsoft Brings Clear Linux OS to Azure
One out of three virtual machines on Microsoft Azure Cloud run Linux.
ASUS Announces a Single-Board Computer
The form factor of the board makes it a drop-in replacement for Raspberry Pi.
Red Hat Releases RHEL 6.9 Beta
Makes it easier for customers to move workloads into container-centric applications.
SUSE Working on a New Operating System Called MicroOS
SUSE's answer to container-centric operating systems.
Biggest Kernel Release Ever
Linux 4.9 is the biggest release in terms of number of commits.
CentOS Linux 7 (1611) Released
The latest version of the official RHEL clone is here.


text:
Mark Bass, lawyer, listed under "Lawyers" category, is located at 521 5th Ave New York NY, 10175 and can be reached by 2124905678 phone number. Mark Bass has currently 0 reviews.This business profile is not yet claimed, and if you are the owner, claim your business profile for free. If you are not the owner you can invite this business to join by email or by phone.Browse all Lawyers in New York NY. Discover census data for New York, NY.
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Hiking, Biking and Fall Colors. Open for Relaxation Year Round.(15 Reviews)
The owner has been emailed.
To book this property, you need to complete your booking through checkout on the VRBO website. We can't protect your payment if we don't know you've booked through us. Learn more
This listing was first published here in 2014.
Date last modified - Thursday, February 23, 2017


text: Item is not available Find Another One Others Looked At... Smith & Wesson M&P40 .40 S&W Crimson Tra... SELLER: Ammo And Arms 1 $629.99 SMITH & WESSON 5906 9mm, STainless 5-14r... SELLER: pilot07 1 $429.99 Smith & Wesson PC Model 986 9mm 2.5" 7rd... SELLER: Ammo And Arms 1 $949.99 S&W 1911 PRO SERIES .45 ACP 5" 8RD N.I.B... SELLER: LAUGHLIN'S 1 $1,376.99 Smith and Wesson 4536, with original box... SELLER: Ti4500 0 $1,650.00 PAIR OF RARE SMITH AND WESSON 39-2 9MM W... SELLER: Iron SIte Gun Shop 1 $1,100.00 Guns Pistols Smith Wesson Pistols Autos Steel Frame . Mid Range Wad Cutter Target w mags | 640 | 39 | Lc | 281.2623ms 52-2 .38 Mid-Range Wad Cutter, 5" Target w/5 mags For Sale from Perkiomen Gunworks | Positive feedback: 99% View | Verified Seller | 3186 Completed Sales View Sellers Items This item is no longer available. /UserImages/6195/981534427 1891373.jpg /UserImages/6195/981534427 1891374.jpg /UserImages/6195/981534427 1891375.jpg /UserImages/6195/981534427 1891376.jpg Description Shipping and Payment More Info S&W M-52-2 Semi-Auto .38 Mid-Range Wadcutter Target, 5 inch bbl, single action, target sights, S&W wood grips w/logo, serial TAK5054 dates gun about 1985. Comes with non-original box (correct but not serial numbered to the gun) and 5 mags. Also includes a set of white plastic grips w/S&W logo-never used, take down tool and manual with the 5 correct mags. Would rate gun at 96-98% overall condition showing light usage – see photos. Excellent good clean shooter. +S&H of $30.00 to your local FFL dealer for transfer. To pay on line - go to - find item - put in your cart and check-out. All transactions will be charged a +2% maintenance fee. We will receive notice of your payment automatically. Then all we will need is for you to have your local transfer dealer fax, email or mail their FFL license copy to ship firearm. OR: To pay via mail with NO extra fees – email us and follow these directions: To commit to gun we need your full name, address and phone #. This will only be used to hold gun until your paperwork arrives. Will confirm back sale if you are the FIRST we hear from with this information. We offer 3-day inspection but Layaway payments, Special Order deposits, S&H and Credit Card fees are Non-Refundable. We have a 10% return fee if item is as ad states and you wish to return anyway. TAK5054 10063 Additional charges for special guns or heavier items will be stated in description or other text. Over night and hardcase shipping quoted. Our listed price is for Check or Money order, all on line payments are subject to a +2% maintenance fee. Layaway payments, Special Order deposits, S&H and Credit Card fees are Non-Refundable. We have a 10% return fee if item is as ad states and you wish to return anyway. Our web site: www.perkiomengunworks.com Trades Accepted: Trade plus cash deals are considered - email us with details - photos would be a plus.We never do "Even" trades. All on line payments are subject to a +2% maintenance fee.Layaway payments, Special Order deposits, S&H and Credit Card fees are Non-Refundable. We have a 10% return fee if item is as ad states and you wish to return anyway. Our web site: www.perkiomengunworks.com Browning and Kimber Direct Dealer with access to ten major distributors for most firearms. Visit our web site: www.perkiomengunworks.com Located in central Tennessee – we are open BY APPOINTMENT ONLY. Our GunsAmerica sales count is well over 2640 guns with many repeat customers - we would be happy to have you as a customer too!! Email is the best way to contact us right off one of our ads. We must be first come first served to be fair.Email committing to buy with your full name, address and phone # will hold the gun for you if you are the first to commit. A confirmation reply will be back to you ASAP with instructions and our full address. Our phone # is listed for those wishing to call. Condition: Used, Minor Wear Caliber: .38 (other) Location: TN Share Item Item #: 981534427 Stock No.: 10063 This item is no longer available. Price: (Price reflects 3% cash discount.) This Seller Accepts Online Payment Shipping: $30.00 (or Arrange local transfer) Accepted Payment Methods: Returns: 3 Days Perkiomen Gunworks Seller Since: Feb. 2000 Seller Level: Trusted Seller This seller is an FFL City: Sparta State: TN Your Recently Viewed Items


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How Ellie Goulding's "Lights" Sloowwllly Became A Monster Hit
The dance-pop tune went from U.K. bonus track to U.S. smash over the course of nearly two years.
Ellie Goulding's "Lights" has been kicking around for nearly two years now, but finally became a big crossover hit in the United States this summer. The song was expected to knock Carly Rae Jepsen's summer pop anthem "Call Me Maybe" off the top of the Billboard Hot 100 this week, but as it turns out, Flo Rida's "Whistle" is taking that honor instead. Regardless of whether Goulding makes it to Number One, it's pretty amazing that she's camped out at Number Two on the U.S. pop chart with a song that's been out for such a long time. Here's a timeline of how Goulding pulled it off.
February 26th 2010: Ellie Goulding released her debut album Lights in her native United Kingdom, but despite the title, the record does not include the song of the same name.
November 29th 2010: Lights is reissued as Bright Lights, and "Lights" made its debut as one of six bonus tracks tacked on to the original 10-track album. Sales for the album jumped up in the U.K., thanks in large part to it now including her popular cover of Elton John's "Your Song."
January 20th 2011: The video for "Lights" is released on Goulding's YouTube channel. It was going to be the first single from the Bright Lights reissue, but the label opted to push "Your Song" instead.
March 8th 2011: The album is released as Lights in the United States, with a different running order that places "Lights" as the album's lead-off track.
March 13th 2011: "Lights" is released as Goulding's sixth single in the United Kingdom. The song ended up doing okay in the U.K. market, but it's still not as popular as her other singles over there.
April 29th 2011: Goulding performed at a private dinner for Prince William and Kate Middleton following their wedding earlier that day. She didn't sing "Lights," but this gig went a long way toward boosting the singer's profile.
May 7th 2011: Goulding performed "Lights" and "Your Song" on Saturday Night Live. This was the singer's first major U.S. television appearance (Tina Fey, incidentally, was the host).
July 14th 2011: The video for the Bassnectar remix of "Lights" hit YouTube. There are dozens of EDM remixes of the song, but Bassnectar's is the most popular.
January 18th 2012: Goulding sang "Lights" on Late Show with David Letterman.
February 15th 2012: News broke that Goulding is romantically involved with dubstep superstar Skrillex, prompting widespread gossip media coverage.
March 27th 2012: "Lights" was certified gold by the RIAA for digital single sales.
April 11th 2012: Goulding performed "Lights" with a string section on The Ellen DeGeneres Show.
May 2nd 2102: The digital single for "Lights" was certified platinum by the RIAA.
July 16th 2012: "Lights" was certified double-platinum.
August 9th 2012: Goulding released the lyrics video for "Anything Could Happen," the first single from her next album Halcyon, which is coming out in October.
August 13th 2012: "Lights" hits Number One on Billboard's On-Demand Songs chart, which measures plays on streaming services such as Spotify.
August 15th 2012: Flo Rida's "Whistle" ends Carly Rae Jepsen's long reign at the top of the Billboard Hot 100, while Goulding holds firm at Number Two. As a consolation, she has hit Number One on the Radio Songs chart.
- Trump has named H.R. McMaster as his new National Security Adviser, replacing Michael Flynn, who resigned last week.
- Russian ambassador to the UN Vitaly Churkin has died after suffering from cardiac arrest this morning, a day before his 65th birthday.
- Senator Ron Wyden will soon introduce legislation requiring warrants before phones can be searched at the US border.
- A girl's best friend showed up to her date in a fake mustache to spy on her and it is the definition of friendship goals 😎


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Video from KrancLife's first ever "Downtown Sunday Sessions" this past weekend. Freestyle BMX riders are welcomed to join them this Sunday (1/21) between 1:30pm - 8pm in downtown Miami.
And while we're highlighting BMX check out this excellent edit from Atmosphere Bikes "5 on 5" contest this past December. Video courtesy of Creative Duet.


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The odds ratios (ORs) or the weighted mean differences (WMDs) and 95% confidence intervals (CIs) comparing the effects of hypothermia vs normothermia with the outcome variables Glasgow Outcome Scale score (A), intracranial pressure (B), pneumonia (C), cardiac arrhythmia (D), prothrombin time (E), and partial thromboplastin time (F). With regard to sample size, n indicates the number of subjects who were positive for the outcome; N, the total number of subjects in the group.
Harris OA, Colford, Jr JM, Good MC, Matz PG. The Role of Hypothermia in the Management of Severe Brain InjuryA Meta-analysis. Arch Neurol. 2002;59(7):1077-1083. doi:10.1001/archneur.59.7.1077
© 2017
Hypothermia is utilized in the management of severe traumatic brain injury despite the lack of unequivocal evidence supporting its use. Because of its widespread use, the effects of hypothermia are a concern.
To determine the effectiveness of hypothermia in the management of severe brain injury.
Data Sources
Two investigators working independently abstracted data in a blinded fashion from studies identified using multiple literature databases, including MEDLINE, Ovid, PubMed, the Cochrane Database of Systematic Reviews, EMBASE, and the abstract center for the American Association of Neurological Surgery and the Congress of Neurological Surgery, as well as the bibliographies of these articles. Additionally, experts in the field of hypothermia and neurotrauma provided additional references.
Study Selection
Seven studies met predetermined inclusion criteria: (1) the study was a randomized clinical trial comparing the efficacy of hypothermia vs normothermia in patients with posttraumatic head injury, (2) only subjects aged 10 years or older were included in the study, and (3) relative risks (odds ratios [ORs], cumulative incidence, or incidence density measures) and 95% confidence intervals (CIs) or weighted mean differences and 95% CIs could be calculated from the data presented in the article. These criteria were applied in a blinded fashion by 2 independent investigators.
Data Extraction
No single outcome variable was evaluated in all studies. The following outcome variables were assessed: intracranial pressure, Glasgow Outcome Scale score, pneumonia, cardiac arrhythmia, prothrombin time, and partial thromboplastin time. Either ORs or weighted mean differences (when the data provided did not permit calculation of an OR) comparing the effects of hypothermia vs normothermia were calculated from the data provided.
Data Synthesis
The weighted mean difference (hypothermia − normothermia) for intracranial pressure was −2.98 mm Hg (95% CI, –7.58 to 1.61; P = .2). The OR (hypothermia vs normothermia) for Glasgow Outcome Scale score was 0.61 (95% CI, 0.26-1.46; P = .3). The OR for pneumonia was 2.05 (95% CI, 0.79-5.32; P = .14). The OR for cardiac arrhythmia was 1.27 (95% CI, 0.38-4.25; P = .7). The weighted mean difference for prothrombin time was 0.02 seconds (95% CI, –0.07 to 0.10; P = .7). The weighted mean difference for partial thromboplastin time was 2.22 seconds (95% CI, 1.73-2.71; P<.001).
This meta-analysis of randomized controlled trials suggests that hypothermia is not beneficial in the management of severe head injury. However, because hypothermia continues to be used to treat these injuries, additional studies are justified and urgently needed.
TRAUMA AFFECTS an estimated 1.9 million persons annually in the United States and accounts for approximately 1% of all injuries and annual visits to emergency departments.1 In addition, traumatic brain injury accounts for 40% of all deaths from acute injuries. Of those surviving, 200 000 patients require hospitalization each year and often are permanently disabled. An additional 1.74 million persons suffer mild traumatic brain injury.1 The direct costs of traumatic brain injury in the United States are estimated at $4 billion annually, with indirect costs estimated at 10 times that amount.2 Although prevention has been the main focus of efforts to address the incidence of primary traumatic brain injury, efforts to address secondary injury have been quite varied. One of the oldest such modalities used is hypothermia.
Defined simply as body temperature significantly below 37°C, hypothermia has long been used for cerebral protection in the management of traumatic brain injury.3 Although the beneficial effects of hypothermia in head injury were reportedly observed by Hippocrates,4 the first reported clinical application of hypothermia was performed by Fay in 1938.3,5 The procedure was limited to the terminally ill, who were subjected to temperatures of approximately 80°F (27°C). His results are noteworthy for tumor shrinkage and their palliative effect, specifically pain relief associated with metastatic cancer.3,6 His work led to widespread application of the procedure in neurosurgery and cardiothoracic surgery, where deep hypothermia (15°C-22°C) demonstrated an effective method of neuroprotection.7
Deep hypothermia, however, led to significant secondary complications, including cardiac arrhythmia; inhibition of coagulation cascade enzymes, predisposing patients to hemorrhage; and systemic complications, such as infection.7- 14 In addition, it demanded significant use of hospital resources.7,9,15- 17 Milder degrees of hypothermia were later studied in an attempt to address the complications posed by cooling to deeper temperatures. At 30°C to 35°C, hypothermia was found to "offer significant neuroprotection in both global and focal models."7(p36), 15,18- 24 In addition, the milder temperatures were safer and less expensive to induce and maintain.7,8,22,24 These results led to the implementation of mild to moderate hypothermia in various clinical settings. The principal purpose of this meta-analysis is to investigate the hypothesis that induced hypothermia improves outcomes in patients with severe brain injuries when compared with normothermia.
In the field of traumatic brain injury, several clinical studies have sought to establish hypothermia as a treatment modality. The results of early studies suggesting the benefits of hypothermia were met with significant scrutiny because of their lack of randomization and the heterogeneous subject populations. The generalizability of the data was thus limited, and the efficacy of the procedure remained in question. More recent studies have responded to these criticisms. These studies include several single-center trials and 1 multicenter trial, with various outcomes of interest. As a result, it has been difficult to fully assess the efficacy of induced hypothermia and, thus, endorse the procedure as beneficial in the management of traumatic brain injuries.
The medical literature published since 1966 was searched in all languages using electronic databases. The initial search included the MEDLINE, Ovid, and PubMed databases. The commands used in these searches were "hypothermia and head injury," "hypothermia and brain injury," "hypothermia and trauma," and "hypothermia and neurosurgery." The Cochrane Database of Systematic Reviews, EMBASE, and the abstract center for the American Association of Neurological Surgery and the Congress of Neurological Surgeons were searched using the same keywords. Additional references from any year of publication were retrieved from the bibliographies of the relevant articles reviewed and from experts in the field of hypothermia and/or neurotrauma: Gary K. Steinberg, MD, PhD; Donald Marison, MD; Alois Zauner, MD; and one of us (P.G.M.).
Studies with titles or abstracts discussing hypothermia or the management of head injuries or trauma were retrieved. Any original randomized controlled trial investigating hypothermia as an exposure was submitted for further review with all references to author names, journal titles, and funding sources removed. All pertinent articles were reviewed, and the resulting studies were analyzed independently by 2 of us (O.A.H. and M.C.G.). The following inclusion criteria were applied: (1) the study was a randomized clinical trial comparing the efficacy of hypothermia vs normothermia in patients with posttraumatic head injury; (2) only subjects 10 years or older were included (established to exclude very young pediatric patients in whom the pathophysiologic effects of trauma are believed to be different5); and (3) relative risks (odds ratios [ORs], cumulative incidence, or incidence density measures) and 95% confidence intervals (CIs) or weighted mean differences and 95% CIs could be calculated from the data presented in the article. When multiple publications reported information from the same study subjects, only the publication with the most recent analysis of data was included.
The following data were abstracted from the eligible studies in a blinded fashion, using a standard data form (with the abstractors blinded to journal and author names): classification of head injury (Glasgow Coma Scale score), category of hypothermia (mild or moderate), ages of subjects, initiation and duration of hypothermia, extent of blinding, and the various outcomes studied. Several variables were assessed in the studies included in the meta-analysis. Because no single variable was available for evaluation in every study, the decision was made to evaluate the more frequently used and clinically relevant variables25: Glasgow Outcome Scale score, intracranial pressure, pneumonia, cardiac arrhythmia, prothrombin time, and partial thromboplastin time.
Relative risk estimates were not provided in any of the included studies. Thus, all estimates were calculated from the data provided. In the majority of the studies, 2 × 2 tables were reconstructed, and the appropriate estimates were calculated. When the means and SDs of outcome variables were given, this information was used directly to calculate weighted mean differences. Whenever possible, an OR was calculated and used in the summary calculations.
Summary relative risk estimates were then calculated as a weighted average of individual study results. Weightings and the summary estimate for each outcome were determined based on the random effects model (DerSimonian and Laird26). This model explicitly incorporates any heterogeneity of treatment effects across studies and provides a conservative compensation for heterogeneity by inflating the estimated variance (thus enlarging the estimated CIs). Summary estimates were compared using a z statistic. All summary measures of effect and associated CIs were calculated using the software package RevMan,27 developed by the Cochrane Collaboration for meta-analysis and systematic reviews. Heterogeneity was evaluated using the Mantel-Haenszel method, and the results were considered heterogeneous (ie, differences unlikely to be due to chance alone) if the P value was less than .2.28
Study quality was assessed and scored using 3 criteria highlighted by the scale by Jadad et al.29 The following items were used to measure the internal validity of each clinical trial: (1) concealment of treatment allocation, (2) randomization, (3) blinding of outcome assessment, and (4) handling of withdrawals and dropouts. All 7 trials scored points for randomization. None of the studies addressed blinding or gave a description of withdrawals and dropouts. However, given the critical nature of injury in both treatment and control groups, the loss of time introduced by blinding would have been clinically inappropriate. Furthermore, it may be inferred that no patient withdrew because of the clinical severity of injury. The likelihood of publication bias was addressed using funnel plots to compare relative outcome measure and sample size.
A total of 528 references (445 when duplicates were deleted) were retrieved from PubMed (n = 327), Ovid (n = 83), pre-MEDLINE (n = 4) and MEDLINE (n = 79), the abstract center for the American Association of Neurological Surgery and the Congress of Neurological Surgeons (n = 1), contacting experts (n = 5), and bibliographic review (n = 29). Fifty-four publications were submitted for blinded review. The blinded review excluded all but 9 studies because the studies did not contain original data or because they lacked information regarding hypothermia specific to the management of severe head injury. Another study was excluded because of redundancy in data reporting8 and another because it was a nonrandomized trial in which there was no control group.30 The final 7 studies are summarized in Table 1. Each study focused on several variables as outcomes of interest. Because no single variable was evaluated in every study, the more frequently reported and clinically relevant variables were chosen as the focus of this analysis.
Four of the 7 studies included in the meta-analysis assessed Glasgow Outcome Scale score as a variable of interest.11,31- 33 The summary estimate (OR, 0.61; 95% CI, 0.26-1.46; P = .3) demonstrated no statistically significant effect for hypothermia (Figure 1A). There was evidence of heterogeneity among these studies (P = .08).
Five studies assessed intracranial pressure as an outcome variable.11,32- 35 However, only 2 studies provided sufficient data to allow statistical analysis of this outcome. Using the random effects model, the weighted mean difference was –2.98 (95% CI, –7.58 to 1.61; P = .2; Figure 1B), suggesting that hypothermia had no benefit. There was evidence of heterogeneity among these studies (P<.001).
Three studies included pneumonia and cardiac arrhythmia as outcome variables.11,31,34 The summary estimate for the effect of hypothermia on pneumonia was OR, 2.05 (95% CI, 0.79-5.32; P = .14), suggesting that hypothermia had no benefit (Figure 1C). There was no evidence of heterogeneity among these studies (χ2 = 2.83; P = .24). The summary estimate data for the effect of hypothermia on cardiac arrhythmia (OR, 1.27; 95% CI, 0.38-4.25; P = .7) suggested that hypothermia had no benefit (Figure 1D). There was no evidence of heterogeneity among these studies (P = .23).
Three studies assessed prothrombin time and partial thromboplastin time.32,35,36 Only 2 of these studies provided sufficient data to allow statistical analysis. Using the random effects model, the weighted mean difference for prothrombin time was 0.02 (95% CI, –0.07 to 0.10; P = .7; Figure 1E). There was no evidence of heterogeneity among these studies (χ2 = 1.0; P = .32). For partial thromboplastin time, the weighted mean difference was 2.22 (95% CI, 1.73-2.71) with an overall effect (P<.001; Figure 1F). These results favored normothermia over hypothermia. There was no evidence of heterogeneity among these studies (χ2 = 0.62; P = .43).
The possibility of publication bias in the literature on hypothermia was assessed using a funnel plot.28 The studies that evaluated Glasgow Outcome Scale score and cardiac arrhythmia were chosen as representative because they included the largest subcategory of studies. Each of the funnel plots examines effect size vs sample size. These plots do not support the existence of publication bias in these studies.
Meta-analyses are relatively uncommon in the field of neurosurgery; fewer than 20 studies have been published in the last 10 years. Because this method of analysis is useful in the synthesis and evaluation of available data, we believe increased use will add greatly to the field. This meta-analysis is the first study evaluating the use of hypothermia in the management of severe brain injury.
We examined 5 clinically relevant outcome variables in the evaluation of the value of hypothermia in the management of patients with severe head injury: Glasgow Outcome Scale score, intracranial pressure, cardiac arrhythmia, pneumonia, prothrombin time, and partial thromboplastin time.25 Glasgow Outcome Scale score is widely recognized as a functional rating scale in neurosurgical trauma.37 The meta-analysis of Glasgow Outcome Scale score indicated a statistically significant risk associated with hypothermia (Figure 1B). Intracranial pressure was included in this meta-analysis because it is an integrated marker of cerebral edema, secondary injury, and deteriorating neurologic status.38 The meta-analysis of the effects of hypothermia on intracranial pressure did not suggest that hypothermia was beneficial for patients with severe head injury (Figure 1A).
The added morbidity of the systemic effects observed during the use of hypothermia is one criticism of its early use. We chose to examine cardiac arrhythmia and pneumonia as representatives of systemic effect because several studies included them as outcome variables. Neither of these meta-analyses suggested that hypothermia had any benefit (Figure 1D and Figure 1C).
Early studies involving deep hypothermia were plagued by concerns regarding coagulopathy and the resulting hemorrhage.39- 42 Subsequent research demonstrated a disruption in the extrinsic and intrinsic clotting pathways, fibrinolytic cascade, and platelet number and function.5,43,44 The results of current studies were reported to be without any clinically deleterious effect. We chose to look more closely at this issue and selected prothrombin time and partial thromboplastin time as markers for coagulation. There was no evidence that hypothermia affected prothrombin time, although our meta-analyses suggested that hypothermia is associated with a statistically significant risk of elevated partial thromboplastin time (Figure 1F).
There are several limitations inherent to the design of the individual studies included in the meta-analysis. Potential confounding factors, such as sex, age, mechanism of injury, time to initiation of hypothermia, duration of treatment, rate of rewarming, and ideal target temperature range, could introduce bias into the results.
There is a consensus that initiation of hypothermia in the treatment of traumatic brain injury should be done as soon as possible. Although the majority of the clinical trials (5 of 7) included in this meta-analysis initiated treatment in patients randomized to hypothermia within 6 hours postinjury (Table 1), there was no uniform protocol established to determine the ideal interval for humans. Further complicating the issue was the time to target temperature level, which varied considerably among trials. Of those reporting this parameter, the range was 8 to 15 hours postinjury. This differs significantly from the animal studies in which delay in treatment initiation demonstrated a decrease in potential benefit.42,43
The duration of hypothermia and the ideal rate of rewarming are controversial. The duration of treatment employed by the clinical trials included in the meta-analysis ranged from 24 hours to 14 days. Two of the 7 studies maintained hypothermia for 24 hours, 4 for 48 hours, and 1 for 3 to 14 days (Table 1). The rewarming schedule used in recent trials varied as well, ranging from 12 hours to 5 days. From these studies, the optimal length of therapy and rate of reversal remain uncertain.
The definition of the specific target temperature for hypothermia is another important potential source of bias. Although hypothermia is defined as temperature significantly below 37°C, there are many subcategories of hypothermia to be considered, and each is associated with its own benefits and complications.3 There are several classification schemes for hypothermia, ranging from mild to ultra-profound.5,44 Regardless of the classification scheme, among studies included in the meta-analysis, little distinction exists between mild (34°C-35°C) and moderate (32°C-33°C) hypothermia. Recent studies have been too few to determine whether any benefit exists between the subcategories of mild and moderate hypothermia.
Temperature determination was another source of potential bias. Available methods for assessing temperature included ventricular, bladder, rectal, and intravascular sites. Although there is evidence to suggest that the route of measurement was irrelevant,15,45 it must be noted that several methods were used to assess temperature in the studies included in the meta-analysis. The majority used a thermistor placed in the ventricle.
Patient age is an important factor in traumatic brain injury. Two of the studies included the specific age range of the patients, approximately 15 to 75 years. Two additional studies excluded only the very young, with an age inclusion criterion of 10 years or older. One study did not report specific ages but provided a mean age of 42.2 years for the hypothermia group and 40.6 years for the normothermia group. Average age provided little useful information because it did not exclude the possibility of either the very young or very old, 2 groups with different posttraumatic pathophysiological characteristics, being included. With regard to sex and mechanisms of injury, in all studies, the majority of patients were men, and the primary mechanism of injury was motor vehicle accident. This is consistent with previous studies outlining the demographics of trauma.1,2
The severity of neurologic impairment may act as a confounder and as such would be important to control. Thus, subcategorizing severe traumatic brain injury beyond a Glasgow Coma Scale score of 3 to 8 would be important because lower scores indicate a greater degree of neurologic impairment. Of the studies included in this meta-analysis, only 3 took this into account by using a block randomization scheme to balance the injury severity between hypothermia and normothermia groups. There was insufficient data to explore this issue further, specifically to determine if there was an excess of patients with lower Glasgow Coma Scale scores in either the hypothermia or normothermia groups, which could have influenced the summary estimates of effect.
There are several limitations inherent in all meta-analyses.28,45 Any biases present in the individual studies are not removed when a quantitative synthesis is performed. Thus, any summary estimate generated from a synthesis of studies represents an estimate of the association of interest (hypothermia and outcome variable) available from the literature. Both the availability of the literature and the studies presented may be biased. Many potential confounding variables of interest (time to target temperature, choice of specific target temperature, and duration of hypothermia) could not be thoroughly explored because of inconsistencies in reporting or lack of relevant information for subgroup analyses. Although every attempt was made to secure all published and unpublished studies in all languages, publication bias may never be totally excluded.
The meta-analysis of the existing literature does not support the use of hypothermia in the management of posttraumatic brain injury. We do not believe that the results of this meta-analysis should define the clinical use of hypothermia because of the limitations imposed by the low number of studies and the lack of consistent outcome measurement. However, because hypothermia is widely used and the results of this meta-analysis suggest that there may be no benefit to this treatment, a definitive and rigorously conducted randomized controlled trial is urgently needed.
Accepted for publication March 19, 2002.
Author contributions: Study concept and design (Drs Harris and Colford); acquisition of data (Drs Harris and Matz and Mr Good); analysis and interpretation of data (Drs Harris, Colford, and Matz and Mr Good); drafting of the manuscript (Drs Harris and Colford); critical revision of the manuscript for important intellectual content (Drs Harris, Colford, and Matz and Mr Good); statistical expertise (Drs Harris and Colford); administrative, technical, and material support (Drs Harris, Colford, and Matz and Mr Good); study supervision (Drs Harris, Colford, and Matz).
Corresponding author and reprints: Odette A. Harris, MD, MPH, Department of Neurosurgery, Stanford University Medical Center, 300 Pasteur Dr, Edwards Bldg, Second Floor, Stanford, CA 94305 (e-mail: email@example.com).


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Witty Musical "I Love You, You're Perfect, Now Change"
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Described as "Seinfeld set to music," I Love You, You're Perfect, Now Change is a playful musical about love in suburbia. The talented cast plays over 40 roles as it explores the ups and downs of different types of relationships. From single life to dating to marriage to the bitter end, I Love You, You're Perfect, Now Change covers the whole cycle with humor, emotion and insight. When it closed in 2008, the show's New York production had played 20 previews and 5,003 performances, making it the second longest-running musical in off-Broadway history.
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The last date listed for I Love You, You're Perfect, Now Change was Sunday July 27, 2014 / 2:00pm.
Currently at Fountain Hills Theater Mainstage
Cross-Dressing Comedy Caper: Leading Ladies by Ken Ludwig
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Two struggling Shakespearean actors are touring Amish country, performing in unappreciative Moose… More
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Book and Lyrics by Joe DiPietro
Music by Jimmy Roberts
Presented through special arrangement with Rodgers & Hammerstein


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- John Hodgeman (The PC from the latest Apple ads) who makes his living with fake trivia and appearances on The Daily Show. Brief and snark-a-licious.
- Charles Stross, my all-time favoritest science fiction writer (I own and have read seven of his books: Accelerando, Singularity Sky, Iron Sunrise, Family Trade, The Hidden Family, The Clan Corporate, and Glasshouse, and I have two more, The Jennifer Morgue and Missile Gap, on pre-order). It's an MP3 file, so close the office door and bust out the headphones.
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Jay Garmon has a vast and terrifying knowledge of all things obscure, obtuse, and irrelevant. One day, he hopes to write science fiction, but for now he'll settle for something stranger — amusing and abusing IT pros. Read his full profile. You can also follow him on his personal blog.


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Download Drivers for FREE from the Web's largest Driver Database. Since 1996, experts recommend DriverGuide to fix PC problems fast. No Software to Buy - No Scan ...A library of over 250,000 device drivers, firmware, BIOS and utilities for WindowsDownload driver for free and fix your PC. This site offers the biggest collection of new and old free Windows drivers. We have printer drivers, laptop drivers ...In computing, a device driver (commonly referred to as a driver) is a computer program that operates or controls a particular type of device that is attached to a ...Free Device Drivers Scan and Driver Downloads. Update all Official Windows Drivers and Devices Driversupdate.orgDriver Magician is device driver backup, restoration, update and removal software for WindowsDownload Recommended PC Drivers - Windows 8, Windows 7, XP and Vista Drivers - Free Drivers Scan & Updates from Drivers.com - The Trusted Driver Download SiteKeep your system up-to-date and out of trouble. TechSpot's library of driver downloads includes the latest graphics card drivers, printers, networking, audio, chipset ...10/17/2012 The package provides the installation files for Microsoft Hardware Bluetooth Device Driver version 126.96.36.199 In order to manually update your driver ...The most downloaded Drivers software, including Realtek High Definition Audio Codec (Windows Vista / Windows 7 / Windows 8 32-bit), WLan Driver 802.11n Rel. …
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