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The NYU Child Study Center just launched a new campaign called "Ransom Notes" to draw attention to childhood psychiatric disorder. This in-your-face approach has created a lot of controversy.
The Ransom Notes campaign is designed as a provocative wake up to create awareness and spark dialogue about the disorders. Twelve million American children and adolescents face daily battles with psychiatric disorders. Untreated, these children are at risk for academic failure, school dropout, substance abuse, suicide, unemployment, and imprisonment according to the NYU Child Study Center.
"Ransom Notes," the Child Study Center's most extensive public awareness campaign in its history, was produced pro bono by BBDO. Its public service ads appear in kiosks and bulletin spaces across New York City. The campaign features scrawled and typed communiqués as well as simulations of classic ransom notes, composed of words clipped from a newspaper.
Update 20/12: Ransom-Note Ads About Children's Health Are Canceled.
The Child Study Center at New York University said on Wednesday that it would halt an advertising campaign aimed at raising awareness of children's mental and neurological disorders after the effort drew a strongly negative reaction.
Read the story here.
NYU Child Study Center: "The idea behind the "Ransom Notes" is that, all too often, untreated psychiatric disorders are holding our children hostage. These disorders rob children of the ability to learn, make and keep friends and enjoy life.
But many people in a child's life, such as family members, professionals, friends and other caring adults, have a chance to intervene and help a child who is suffering needlessly."
In addition to depression, there are ominous threats concerning autism, obsessive-compulsive disorder, attention-deficit hyperactivity disorder, Asperger's syndrome and bulimia. The campaign's theme is that 12 million children "are held hostage by a psychiatric disorder."
"Children's mental disorders are truly the last great public health problem that has been left unaddressed," said Dr. Koplewicz, founder and director of the Child Study Center, "It's like with AIDS. Everyone needs to be concerned and informed."
In some quarters, however, the campaign has raised a lot of controversy. The Autistic Self Advocacy Network, a national grass-roots organization of children and adults, is circulating a petition asking the Child Study Center to end the campaign.
Kristina Chew, founder of Autism Vox, which has a link to the petition, says that "the reaction has been mostly outrage from parents of special-needs children, autistic adults, teachers, disability rights advocates and mental health professionals."
A lot of blogs have written the last days about the campaign, mostly negative. A list of links to articles can be found here.
Thanks for sending Arthur.
NYU Child Study Center
11 Comments
since when are ransom notes signed? doesn't that defeat the purpose? 🙂
meh, should be treating the source and not the symptoms
A truly heartless campaign, with only the thought of how lucrative a business selling drugs to children is. See http://www.cchr.org for further info.
Yeah, I think treating mental illness is alright and raising awareness is definitely a good thing.
My only issue with this campaign is that, by pointing out specific mental illnesses and their symptoms, it may be contributing to isolate the kids more completely.
I dunno, but I have a friend who suffers from a mild case of Asperger's syndrome and I think he'd feel sort of bad with his condition and its symptoms plastered all over billboards.
I'm in major support of this ad campaign. I am sixteen and have suffered with depression since I was fourteen, and possibly even long before that. People need to know—childhood and adolescent mental illness can be strikingly different from adult. It can ruin futures, not just the present.
Citizens Commision for Human Rights, also known as cchr.org IS A FRONT GROUP FOR THE CULT OF SCIENTOLOGY that claim 9/11 and the holocaust was caused by psychiatrists.
While people should always be skeptical about any drug new to the market, they should be just as skeptical of alternative "treatments". Such as auditing, and "medical" treatment involving isolation and large amounts vitamins and minerals which are not only ineffective but dangerous in high amounts.
Be honest with your children and yourselves about things that are worrying you and the red flags that appear with mental disorders. Often times the most effective way to prevent depression, ADD, and even some forms of autism is simply talking about it and going through different types of therapy like music, art.
Therapy is not just sitting in a room talking to someone. If you don't like the therapist, change them, if you don't like the type change it. Give yourself a choice.
Only then can you know what works for you and your kids. Salvation is not in a pill or in paranoia. It's in information and action.
While it is common for high-functioning individuals on the spectrum to win up with mental illnesses, Autism and Asperger Syndrome are not psychiatric disorders – they're developmental disorders. For a center for psychiatric research to make such a glaring mistake in an advertising campaign is very dangerous.
This is garbage. I have had aspergers syndrome ever since I was 2 and a half, and I'm doing pretty good. And my dad has depression, but he's not sad 24/7, just sometimes. To the a-holes who made these ad that make me and other people like me look bad. YOU ARE SCUM. That is all.
i completely disagree. i have suffered from depression since i was a child and this advertising raises awareness so people like me can get help when they need it instead of being a messed up 21 year old.
Very insightful,very true. What do we do?
I really like this ad campaign, I'v had bulimia for…I don't even remember how long, and depression. They are completely ok in my book to show how these disorders affect people(though I don't think Autism and Aspergers are psychiatric disorders). I personally wish they would show these where I live to raise awareness…


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Newegg.com - A great place to buy computers, computer parts, electronics, software, accessories, and DVDs online. With great prices, fast shipping, and top-rated customer service - once you know, you Newegg.
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This review is from: Thermaltake BlacX ST0005U External Hard Drive SATA Enclosure Docking Station 2.5" & 3.5" USB 2.0 & eSATA
Pros: Inexpensive.
Cons: No physical feedback that the drive is seated correctly when inserting drive.
Other Thoughts: Worked very well for 18 months, now the server can't see the drive without resetting. Have to do this every couple of days.
Time to try a different product since it only has a 12 month warranty.
This review is from: Linksys WUMC710 Wi-Fi Wireless AC1300 5GHz Universal Media Connector Bridge Adapter 802.11ac with 4-Port Switch
Pros: Automatically connected to the fastest WiFi connection available. In my case the 5GHz band using "N".
Cons: Seems to run a little warm.
Other Thoughts: A number of posts said the bridge would lose its connection if setting idea. So far I have not seen this issue. So maybe newer versions of firmware has fixed the issue. Here's hoping.
One thing I noticed, don't plug a wire into the bridge until after the setup and it will connect on the fist try. In my case I had it plugged into a receiver and the bridge didn't find the router. Once I unplugged the receiver and started over no problems.
This review is from: BYTECC AP-DPDVI-005 DisplayPort to DVI Cable Adapter 0.5ft (6") w/IC
Pros: Non powered cable works fine, cheap.
Cons: Not powered, most computers need a powered version for a 3 monitor display setup.
Other Thoughts: Wanted to run 3 monitors using 2 Displayports and 1 VGA with adapter. Didn't work, I have recently been told that a powered version of this adapter is needed. Great cable for the price if you don't' need this configuration.READ FULL REVIEW


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Magic Nails & Spa has been providing Tyler, TX, with premium manicure, pedicure, massage, and facial services since 2010. We know that you can't trust just anyone with your nails. Our family owned and operated salon has been providing top of the line manicure and pedicure services to our clients as well as body massage, facial, and other spa services. We offer all types of packages to accommodate all ages! Come by, sit back and relax with a complimentary glass of wine or a mimosa and let our team of experts take care of the rest! Now accepting appointments and walk-ins.
Manicures and pedicures are not just important for the appearance of your nails but are also good for their overall health. Getting manicures and pedicures regularly can keep your hands, feet and cuticles hydrated and provide relief to those who may experience carpel tunnel and arthritis. The massage that comes with the manicure and pedicure can even help with blood flow and circulation. If you want healthy looking nails and skin as well as joint relief, come in to Magic Nail Spa in Tyler, TX and let us pamper you! We have many different manicure and pedicure packages to accommodate everyone.
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Mrs. Kwan (Character)
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- The Cat in the Hat (2003) Played by Amy Hill
... aka "Dr. Seuss' The Cat in the Hat" - USA (complete title)
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[Sally, Conrad and Mrs. Kwan are watching TV. It shows a scene of Taiwanese Parliament Members fighting]
Conrad, Sally: Taiwanese Parliament.
Mrs. Kwan: You tell them, Kwi-Chang. No more big government! Rip his heart out!
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You may correct errors and omissions on this page directly. Clicking the 'Update' button will take you through a step-by-step process.


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Jeff Gibbons-Let the Drip From the Ceiling Become an 8 Foot Hole in the Roof
January 25, 2014 - February 22, 2014
Opening Reception: Saturday January 25, 8pm-10pm centraltrak 800 Exposition Ave., Dallas, TX 75226
Venue: CentralTrak
Ticket: Free
Season: 2013-14
CentralTrak: 800 Exposition Ave Dallas, Texas 75226
Art Ball Prize winner and current CentralTrak artist-in-residence Jeff Gibbons opens a solo exhibition entitled Let the Drip From the Ceiling Become an 8 Foot Hole in the Roof in CentralTrak's gallery. The exhibition's name is derived from Gibbons' experience renovating a derelict home in Detroit, Michigan. The gallery installation includes several repurposed television sets with looping video and unexpectedly humble sculptural works. In this exhibition, Jeff Gibbons' artworks unite to create a surprisingly meditative and melancholy atmosphere.
Jeff Gibbons received his MFA in Intermedia at the University of Texas at Arlington. He has most recently received the Dallas Museum of Art: Art Ball Prize. His work was exhibited at the Dallas Art Fair and included in the silent auction at the DMA's sold-out fundraiser, the Art Ball. He has notably started artist collaborative Apophenia Underground with fellow artist Justin Ginsberg, who have received a great deal of attention for their curatorial projects in vacant retail spaces in Deep Ellum. Gibbons has had solo exhibitions at Oliver Francis Gallery, The McKinney Ave Contemporary, and 500x and has participated in several group exhibitions through various venues, including the Texas Biennial, the Dallas Biennial (online), El Centro College, and Conduit Gallery, Dallas, TX.\
Gallery Hours: Saturday, 12 - 5 p.m. and by appointment, 214-824-9302
For more information contact:
[email protected]
Opening Reception: Saturday January 25, 8pm-10pm
800 Exposition Ave., Dallas, TX 75226
Persons with disabilities may submit a request for accommodations to participate in this event at UT Dallas' ADA website. You may also call (972) 883-2982 for assistance or send an email to [email protected]. All requests should be received no later than 2 business days prior to the event.
The opening of Parking Structures 1 and 3 and the addition of spaces to existing surface lots has made it easier to find parking for your favorite events. Click here to find out more.
Due to on-going campus construction, please visit Pardon Our Progress to keep updated with the latest construction projects


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Juventus are the best supported club in Italy and the seventh most popular in Europe, writes Sport Mediaset.
The Old Lady, fresh from winning their second consecutive Scudetto, have 11.2m followers in Italy – that's a 29 per cent share and an increase of 0.3 per cent over the last year.
Milan follow on 16.3 per cent, Inter recorded 16 per cent, Napoli have an 11.6 per cent stake, while Roma are fifth in the standings with 7.7 per cent.
In Europe, the report alleges that Juve have 38m tifosi behind Barcelona [70m], Real Madrid [62m], Bayern Munich [53m], Manchester United [52m], Arsenal [45m] and Chelsea [43m].
Keep up to date with the latest news and action from Spain's Primera Division with Football Espana - from the team behind Football Italia. [12]


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Tuesday, February 21, 2017
'Fat Rabbit Farm' Pilot Debuts on YouTube
Fat Rabbit Farm LLC has released their official animated short pilot for their eponymous IP Fat Rabbit Farm, in partnership with FremantleMedia Kids & Family. The companies are ... Continue Reading →
Teletoon to Debut 'Butt' Import June 12
Teletoon has set June 12 as the Canadian premiere date for the Australian animated comedy series The Day My Butt Went Psycho. The Day My Butt Went Psycho is based on Scholastic's ... Continue Reading →
MIPTV: Nelvana Invites 'Zack' & 'Mike'
Corus Entertainment's Canadian toon studio/distributor Nelvana Enterprises will be hyping two animated series in production at MIPTV this year–the new oddball comedy Zack ... Continue Reading →


text: Paid twice for same shipment, credit card charge and personal check. Tried to resolve this with Gevalia. First they said they would credit my card. Never did. Second time they said they would send me a check. Never did. I then put a dispute on my credit card after not being able to get through to customer service. Finally got to Gevalia and they told me they issued a credit that very day (what a coincidence!) but it will take 4-5... Read more ›


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Ripple effect android app
This project received 6 bids from talented freelancers with an average bid price of $47 USD.Get free quotes for a project like this
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Is Smile Exchange incorrect or missing key business information? Update your Hotfrog listing today.
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Hotfrog Ireland provides information regarding Smile Exchange in Macroom Cork. Smile Exchange is located at Bowl Road, Macroom Cork and provides business services. Contact them on (01) 436 1864 or by visiting them on their website http://www.smileexchange.ie.
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Which Joe gave his name to 'sloppy joes'? We look at five interesting sandwiches and their lexical origins.
A plant of a genus that includes lady's mantle and its relatives.
- 'The outside comes in, in ad hoc bunches of alchemilla and marguerites, new potatoes, dill, basil, and bunches of mint, we wander out with cups of tea and notebooks.'
- 'Euphorbia, hedera and alchemilla are prime examples.'
- 'Some of her favorite perennials include: Achillea, lobelia, alchemilla and tritoma.'
- 'By far the most common alchemilla in most of Britain today is the robust garden plant Alchemilla Mollis.'
- 'The queen is so close I can practically smell the bouquet of white alchemilla she's holding.'
Modern Latin, from a medieval Latin diminutive of alchimia 'alchemy', from the belief that dew from the leaves of the plant could turn base metals into gold.
Further reading
6 punctuation marks you might be using incorrectlyRead more
We take a look at several popular, though confusing, punctuation marks.
An A-Z of country name originsRead more
From Afghanistan to Zimbabwe, discover surprising and intriguing language facts from around the globe.
How brothers became buddies and brosRead more
The definitions of 'buddy' and 'bro' in the OED have recently been revised. We explore their history and increase in popularity.


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Hotels in Albuquerque
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Barcelona Suites Albuquerque3 star hotel
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- 310 Rio Grande Boulevard Sw, Albuquerque, NM, United States, 87104 , Map
Super 8 Albuquerque/Midtown Hotel2 star hotel
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Fatih Wrought Iron News
We will have pleasure again about the visiting of our customers to our stand at Yapı Turkeybuild Exhibition from 10th May 2016 to 14th May 2016.
We are waiting for you at our stand which is located at hall 6 and number 501.
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2016 Fatih Wrought Iron Catalogue
Our New 2016 Fatih Wrought Iron Products anda Applications Catalogue has been released.
2016 catalogue has new design and new products.
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Formed Sheet Having Special Pattern
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To access our web site faster and easier, you can use Fatih Wrought Iron extention for Google Chrome web browser.
You can download the extention free from Chrome Store.
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This Lent, take a 40-day devotional journey with Dietrich Bonhoeffer. Click here to sign up.
16:7 Andronicus and Junia. Early commentators understood these to be a husband and wife. They were fellow Jews, and had been converted ("in Christ") before Paul himself. They had apparently been in prison at some time with Paul (cf. 2 Cor. 11:23) and had served with distinction as special envoys ("apostles") of the churches. This use of "apostle" is broader than the strict sense of the Twelve plus Paul (see 2 Cor. 1:1 note).
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ELA is composed of business-minded attorneys dedicated to helping our clients achieve their business objectives. Our mission is to be an indispensable and highly-valued team member through insightful thought partnership, effective problem solving, and passionate client service.
The incumbent legal services business model seems to be based on the view that clients exist to provide cash flow to their law firms. Consequently, business owners, responsible managers, and decision makers feel compelled to defer and narrow the scope of interactions with their lawyers as a strategy to manage blistering fees. Recognizing the dysfunction of this perception and turning it on its head, ELA was formed, and our reason to exist is first and foremost to serve and protect the interests of our clients. We are professionals and artisans first and fee generators second. Taking the long view, we know that if our clients do well, then we do well.
To realize on this vision, we couple our passion for excellence, service and seasoned experience with entrepreneurial creativity and flexibility in structuring our fee arrangements with our clients. When and as appropriate, we align our endeavor with those of our clients by sharing risk. Any team spending its own or its investors' money that believes it deserves tight alignment with and fair value from solution-minded business lawyers is speaking our language.


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Areas: New Hotels
Asia Pacific
Aloft Sanya Haitang Bay - Opening January 1, 2018
Lot D-3-6, C6 Area
Sanya, Hainan China
T: To be Announced
After a tasty meal in Nook, our all-day dining restaurant, enjoy beaches, endless sports action, and the world's largest duty-free complex.
Aloft Yangzhou Guangling - Opening January 1, 2019
Guangling District
Yangzhou, Jiangsu China
T: To be Announced
Meet in one of our five venues that total more than 1,100 square meters, then check out historic attractions and modern hotspots.
Aloft Shanghai Nanxiang - Opening January 1, 2018
36/4, 7 Block, Nanxiang Town
Shanghai, Shanghai China
T: To be Announced
Our loft-inspired scene is close to the Jiading District's cultural and scenic attractions, as well as the expressway and subway.
Aloft Shanghai Zhangjiang Haike - Opening June 28, 2017
100 Hai Ke Road, Zhangjiang
Shanghai, Shanghai China
T: To be Announced
Adjacent to Shanghai Tech University, our modern hotel with always-buzzing public spaces is also close to Zhangjiang Hi-Tech Park.
Aloft Chengdu East Railway Station - Opening January 1, 2019
Cnr of Yinghui Road and Jiancai Road
Chengdu, Sichuan China
T: To be Announced
Stay in style in West China's most mesmerizing city! Find endless fun at our downtown location next to the new high-speed railway station.
Aloft Chengdu Pixian - Opening January 1, 2019
Pihua Road, Pitong Town
Chengdu, Sichuan 518062 China
T: To be Announced
Stay in style in Western China's most scenic city! We're a quick trip to Pixian County's High Tech Zone, and a host of ancient attractions.
Aloft Tianjin Beichen - Opening June 1, 2019
South side of Shuangjing Road
Tianjin, Tianjin China
T: To be Announced
Loft-inspired modern style shakes up one of Tianjin's fastest-growing districts. We're close to the Hai River and several business parks.
= New and upcoming hotel


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Office of the Vice President for Enrollment and Student Affairs
MissionThe Division of Enrollment and Student Affairs facilitates student learning by providing high quality programs, services, and developmental opportunities, while fostering an inclusive campus community in support of the educational mission of The University of Montana.
Enrollment & Student Affairs Planning Principles and Values
We provide high quality programs to prepare students to understand and address the needs of society.
Fiscal Responsibility
We budget wisely and prepare for a future where fewer dollars may be available for new programs and services.
We utilize improved technology to continually enhance service delivery.
We collaborate with faculty, staff, and students to offer educational programs and services.
Respect for Diversity
We foster a campus community that welcomes all, celebrates diversity, and is student-centered.
We encourage and reward innovative thinking that improves the substance and delivery of programs.
Student Safety
If you have information, want to report an incident or need help, contact:
Rhondie Voorhees
Dean of Students
(406) 243-6413
For support services or to speak with an advocate call the Student Advocacy Resource Center (SARC) at (406) 243-6559.
For more information on resources, reporting, and University policy related to student safety and sexual assault, please visit the student safety page.
For information about the Student Conduct Code, please visit the Dean of Students page.


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CSS Menu Drop Shadow (IE) and Cross Browser Alignment Issues
This project received 11 bids from talented freelancers with an average bid price of $12 USD / hour.Get free quotes for a project like this
Project BudgetN/A
Total Bids11
Project Description
I am experiencing some issues with a drop down menu which I have taken from [url removed, login to view] and adjusted to incorporate a second drop down menu which can be seen at [url removed, login to view] In addition to this I have added a -webkit-box-shadow and -moz-box-shadow and attempted to implement progid:[url removed, login to view] for IE. I am having problems with 2 areas which are the shadow and the alignment of the drop down menu.
Design Code and Demo
I have uploaded the demo to [url removed, login to view] and the code is all within the source file of this.
1. Drop Shadow
The shadow works exactly as intended in Firefox/Chrome & Safari but I am having problems with the drop shadow in Internet Explorer. The actual drop down menu shadow works fine in IE but the header drop shadow doesn't work which I have added to #menu a.menu-open. (See attachment image)
2. Drop Menu Alignment
I have experienced some problems in certain browsers with the positioning of the drop down menu and was wondering if anyone could also help with this. The menu works perfectly in Firefox and Google Chrome but has minor alignment issues in other browsers which I have outlined in the attached picture which shows various browsers and the alignment problems.
I am looking for someone to check the code and see if it is missing anything that would fix this and not require going down the CSS Hack route?
Many thanks in advance
Skills Required
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text: 000 FXUS64 KOUN 210916 AFDOUN Area Forecast Discussion National Weather Service Norman OK 316 AM CST Tue Feb 21 2017 .DISCUSSION... Main focus is on the potential fire weather conditions over the next several days. A sfc trough will continue to move across the rest of the area this morning shifting winds to the NW. Ahead of this trough, dense fog has developed across portions of central, south central, and southeast OK. As this trough moves into these areas bringing slightly stronger NW winds and drier air, visibilities are expected to improve with dense fog expected to hang on the longest in the far SE. A dense fog advisory was issued earlier but with the scenario described above the advisory could/will likely need to be canceled early for portions of the advisory area when visibilities improve. Winds will shift back towards the south later today. Warm/hot temperatures are expected through Thursday with highs in the 70s and 80s. Models show a trough moving into the central U.S. later this week with a 500mb low developing and moving into the upper Midwest by Saturday. This system will cause a cold front to move across the region Thursday night bringing cooler air to the area which will knock temperatures back down closer to normal for this time of year. In fact, below freezing temperatures will be possible Fri night/Sat morning across a good portion of the fa. Southerly winds will return Sunday with temperatures warming into early next week. Models differ as to whether there will be rain in the fa Sunday night into Monday due to some warm air advection. Currently, have low chances in far SE portions of the fa but right now it looks like most of the area will remain dry. .Fire Weather... Elevated to possibly Critical wildfire conditions are expected through at least Friday, mainly across portions of western Oklahoma and western north Texas. The Critical conditions would be possible on Thursday. Warm/hot temperatures will combine with low humidities today and Wednesday to cause Elevated conditions. However, winds are expected to remain relatively light the next couple of days preventing conditions from approaching Critical levels. Thursday will have the temperatures and low humidities (10-20%) but with stronger SW to W winds leading to possibly Critical conditions. There is some question on how strong the winds will be Thursday afternoon but right now it looks like could be 15-25 mph with gusts to 35 mph. In addition to these conditions, a wind shift to the NW behind a cold front Thursday night could have implications to any ongoing fires. Elevated wildfire conditions will be possible on Friday as well in portions of western north Texas. With winds expected to be fairly light today and ERC-G values likely around the daily average, will not issue a RFD at this time, but if winds end up a little bit stronger today and/or ERC-G values come in a bit higher this morning then a RFD may need to be issued. RFDs at least will likely be needed over the next few days with a Fire Wx Watch/Red Flag Warning possible on Thursday. With uncertainties will hold off on a watch for Thursday for now. && .PRELIMINARY POINT TEMPS/POPS... Oklahoma City OK 73 45 79 50 / 0 0 0 0 Hobart OK 75 42 80 47 / 0 0 0 0 Wichita Falls TX 73 45 82 51 / 0 0 0 0 Gage OK 76 42 82 47 / 0 0 0 0 Ponca City OK 73 42 79 48 / 0 0 0 0 Durant OK 73 48 79 52 / 0 0 0 0 && .OUN WATCHES/WARNINGS/ADVISORIES... OK...Dense Fog Advisory until 9 AM CST this morning for OKZ020-026- 030>032-040>043-046>048-050>052. TX...None. && $$ 30/25


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A reflective custom imprinted armwrap or pantstrap with reflective panels to keep you identifiable to traffic in the dark.
This sports promo backpack provides style, comfort and plenty of storage
Spirited colorblocking—for him and her! An attractive custom polo shirt made from a flat tricot micropique for smooth, snag-resistant wear.
Score a promotional touchdown with this small inflated promotional football.
These Sport-Tek moisture wicking custom jackets add a pop of color and style to your company employee apparel selection.
Keep your electronics and valuables dry with this Waterproof Imprinted Cell Phone Pouch.
Roll into any party fully stocked with ice cold beverages using these custom cooler bags with a 24 can capacity.
Show off your team colors with this Price Buster Embroidered Cap.
Take on your opponents in maximum comfort with this Sport-Tek custom t-shirt.
Avoid all that watsed space when your water bottle is empty. Carry this foldable, promotional bottle instead!
This unique promotional hot/cold pack is filled with non-toxic gel beads that stay hot or cold.
Custom jump ropes made from woven nylon are a health and fitness giveaway that will get results.
Resistive metal hand grip promotional exerciser with soft EVA grips helps strengthen hand muscles.
Sooth sore muscles and aches with these custom hot/cold packs filled with colored gel beads that are non-toxic.
This brightly colored aluminum promo carabiner keyholder will be a key part of your promotional efforts.
Promote outdoor safety and your logo with this promotional first aid kit.
Made of 600D PolyCanvas, this printed duffle bag is a perfect travel piece with multiple accessory pockets.
This mini sized custom basketball set with your logo is a slam dunk of a promotional gift.


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Apart from the Diamond four C's, one of the most frequently cited properties of a diamond is diamond fluorescence. By definition, diamond fluorescence is the degree to which it gives off a colored hue when exposed to ultraviolet radiation. In some circles, diamond fluorescence is considered an undesirable trait. So, some vendors and buyers have lower expectations for the prices of diamonds that exhibit higher levels of fluorescence.
Diamond Fluorescence & Its Impact On Appearance
However, this is not a universally accepted position. There is an ongoing, heated debate regarding what impact a diamond's fluorescence has on its appearance to the naked eye under normal conditions.
There is no debate as to whether diamond fluorescence actually exists or not, as a diamond's fluorescence or lack thereof is clearly visible when the diamond is placed under a black light. Obviously, the people in the "fluorescence is bad" camp are of the opinion that fluorescence has a clear and detrimental effect upon the appearance of a diamond even when viewed in normal light.
Then there are those who take a more nuanced view of diamond fluorescence. Some argue that, although any fluorescence in diamonds with good color ratings is a negative, a small to medium amount of fluorescence can actually improve the appearance of diamonds with lower color grades. Some also believe that fluorescence can improve the overall appearance of naturally colored diamonds.
To some, fluorescence itself is an impurity that afflicts some diamonds. In these cases, as with those who simply believe that fluorescence negatively affects a diamond's appearance, this naturally leads to a reduction in the value of diamonds that exhibit fluorescence, and the more fluorescent a diamond is, the more its value suffers in these circles. One prominent voice on the anti-fluorescence side is the respected Rapaport Report, a diamond industry publication that is often cited as the standard in diamond valuation.
Diamond Fluorescence & Its Impact On Quality
On the other hand, there is another side that posits that fluorescence has absolutely no meaningful impact on the quality or appearance of a diamond, and therefore that fluorescence should not factor into the pricing of a diamond. The basic foundation of this position is the argument that it isn't really possible to distinguish diamonds of differing fluorescence from one another with the naked eye under normal light conditions.
This position appears to be backed up by a greater body of evidence. Most significant are the results from a study carried out in 1997 by the Geological Institute of America, which found that even individuals involved directly in the diamond trade, including professional diamond appraisers, were unable to consistently identify or discern differing levels of diamond fluorescence.
Even more importantly, ordinary individuals involved in the study were unable to discern any effect from diamond fluorescence. This really should settle the debate, as it is the consumer's tastes that drive the diamond industry, and it wouldn't make much sense to charge a consumer more money for a particular diamond based on a variable that has no meaningful effect.
Nevertheless, there are still some vendors who will downgrade the price of diamonds that exhibit higher levels of diamond fluorescence. For consumers, this can represent a good opportunity. If you're looking at two diamonds with the same ratings in every category except for diamond fluorescence, and the vendor is selling the more fluorescent diamond at a lower price, you essentially have the chance to buy the "same" diamond for less.


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Wego.com.sg recently found 3 hotels in Brewer, United States. Find a range of accommodation in Brewer at great prices. Book luxury Brewer hotels or find last minute accommodation. Save more on cheap hotels in Brewer with affordable room rates.
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Seven penalties from Jean-Marc Doussain sank Saracens' hopes of a home game at Allianz Park in the quarter-finals of the Heineken Cup but, unless something disastrous happens in their final game against Connacht this weekend, they will be in the top eight when the knockout draw is made.
It is provocative to describe Saracens as subdued, but that is what they were in the second half of a game which produced only one try but was a true contest of will and power on a spring-like day.
When Sarries took their bow at the end, as Toulouse walked their way through a lap of honour, heads were not down. But there was not even the consolation of a losing bonus point, which was all they had salvaged when losing by one point to Toulouse at home in October. And, when they lost Mako Vunipola to the sin-bin for 10 minutes midway through the second half, exchanges were even at three points each.
Mark McCall, the Saracens coach, acknowledged that Toulouse had the ability to raise their game – though not when losing to Connacht at home – and the top team in the English table had clearly come second.
But McCall, while paying tribute to the work done by a truly impressive Toulouse back row trio, said he still felt he had a squad which could go all the way in the European Cup. There are some gnarly old campaigners in that band of brothers, but also some younger talent coming through well.
It took referee Alain Rolland just 20 seconds to award the first penalty to Toulouse, and Doussain just a few more to give his side the lead, but the remainder of the opening exchanges belonged to the visitors as they battered their way upfield. The first of some rugged passages of defence for both sides was under way.
And the first blood went to Saracens. Their pack had the better of the exchanges throughout the first half and a sniping run by Chris Ashton also gave them what proved to be the game's only try. The sell-out crowd, with the exception of the few travelling members of the Fez tendency, did not like that.
In a rapier-versus-broadsword battle, the Toulousains made some seriously threatening runs to the Saracens line only to be stopped, sometimes to the whistling disdain of the crowd, in less than legal fashion. In one run down the left wing Hosea Gear left Ashton for dead; Yoann Huget was his tantalisingly mercurial self; and Clément Poitrenaud, filling the gap left in the centre by Florian Fritz, out with a broken arm from a motorcycle accident, was another who could complain of illegal blocking when chasing the ball. Clearly Rolland did not agree.
Englandfly-half Owen Farrell gave Saracens back the lead with a 27th-minute penalty but the third and fourth of Doussain's kicks gave the four-time European champions a four-point lead at half time.
The second 40 minutes were worth a huge amount of money to both sides. Each team knew a win would almost certainly guarantee a home quarter-final. With all the funding that should generate, that could add up to a million-pound game with the mouthwatering prospect of more to come.
It might not repay Nigel Wray for all the money he has poured into Saracens over the years. It would allow Toulouse coach Guy Novès, often pacing the line on his own, looking like Captain Ahab urging his men to kill the whale of opposition, easily to contemplate inking in a transfer agreement for Toby Flood.
"It was a very good performance," Novès said. "Very physical. A true match."
Not that he is likely to take his foot off the pedal for the final match, away to Zebre in Italy. A win with a four-try bonus point would be icing on the cake in a three-week run that began with a Toulousain victory over Clermont Auvergne.
When Saracens entertain Connacht, they will be equally determined not to take anything for granted.
Scorers: Toulouse – Penalties: Doussain 7. Saracens – Try: Ashton. Penalties: Farrell 2.
Toulouse: M Médard; Y Huget, Y David (rep. G Fickou 48) , C Poitrenaud, H Gear; J-M Doussain, J Vermaak (rep S Bezy, 79); S Ferreira, C Ralepelle (rep C Tolofua 65), C Johnston (rep G Steenkamp, 60), Y Maestri (rep R Millo-Chluski, 60), P Albacete, Y Nyanga, T Dusautoir Cap (repI Tekori, 77)), L Picamoles.
Saracens: A Goode; C Ashton, C Wyles (rep D Taylor 55), B Barritt, D Strettle; O Farrell (rep C Hodgson, 68), N de Kock (rep R Wigglesworth, 51); M Vunipola, S Brits (rep J Gworge, 71), J Johnston, S Borthwick (Capt), A Hargreaves (rep G Kruis, 51), J Wray (rep E Jooubert, 55), K Brown, B Vunipola.
Referee: A Rolland
Attendance: 18,838
- More about:
- Guinness Premiership
- Mark Tucker
- Saracens (rugby)
- Toulouse


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Is Fahy's Bar and Restaurant incorrect or missing key business information? Update your Hotfrog listing today.
Contact details
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Hotfrog Ireland provides information regarding Fahy's Bar and Restaurant in Cashel. Fahy's Bar and Restaurant is located at Ladyswell Street, Cashel and provides Social services. Contact them on (062) 61737.
Is Fahy's Bar and Restaurant in Ladyswell Street, Cashel your business? Claim your listing and attract more leads by adding more content, photos and other business details.
We have more Social services in Cashel available on Hotfrog Ireland. You can update your search for Cashel Social by location, keyword or service options.
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Engage students around the world in a meteorology lesson using Skype.
Earlier this year, Skype formalized a community through which teachers can collaborate with other teachers on projects that might incorporate Skype, share methodologies, or find partner classes and guest speakers. As one of the first beta-testers for Skype in the classroom, I proposed a "Weather Around the World" lesson for students and teachers to engage in using Skype. This lesson plan summarizes the core elements of this collaborative online learning activity.


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Welcome to your brand-new Films On Demand! Questions? Visit our enhanced
Support Center!
Secular Capitalism is powered by the spiritual passion of protestantism. The Protestant Revolution transformed society.
Medieval Catholicism is described as a religion of retreat. Catholicism emphasized that poverty and godliness went hand in hand.
Protestantism was egalitarian in that it made no distinction between the priest and the ordinary person.
John Calvin was an influential French theologian and pastor during the Protestant Reformation. He was a principal figure in the development of the system of Christian theology later called Calvinism.
Calvin insisted that the only way to salvation was by faith.
In the world of work, Protestants found the answer to their painful spiritual predicament. Success in the world was a sign from God they were blessed. Work became a way to glorify God.
Calvin espoused profit with in a just and godly commonwealth. Protestantism also concentrates efforts on social justice.
Protestants worshipped God through an act called "sacred toil." Diligence, moderation and sobriety were traits they admired.
Max Weber The Protestant Ethic and the Spirit of Capitalism. His premise being the Protestant ethic was a force behind an unplanned and uncoordinated mass action that influenced the development of capitalism. This
The preoccupation with business gave rise to a new Protestant obsession: time. Discipline and time management was the best way to ensure God's favor.
Puritan inspired institutions are still household names today.
John Winthrop obtained a royal charter, along with other wealthy Puritans, from King Charles for the Massachusetts Bay Company and led a group of English Puritans to the New World in 1630. In famous speech he calls America, "City upon a hill."
Early colonists survived harsh conditions of New World with spiritual mettle and a culture of self-sufficiency.
Benjamin Franklin embodies Protestant work ethic. Self-help, personal industry and betterment were his guiding ethos.
Benjamin Franklin's Poor Richard's Almanac centers values around profit making.
Capitalism explodes in the eighteenth century and allows for social mobility.
Wedgewood is described as a non conformist capitalist. He reformed the pottery trade. Wedgewood institutes a disciplined sense of time.
The Industrial Revolution had a profound effect on roads and infrastructure in cities and towns.
Catholic Empires kicked started the slave trade but as Protestants went in search of profit they began to dominate the slave trade.
The church supports slavery using bible for rationale.
Slavery pitted competing value systems against one another: profit vs. life.
Anti-Slavery campaign begins in Britain by non- conformist agitations. This was the first popular human rights movement.
Mechanical factories turn workers into wage slaves.
In mills and mines children work in dangerous conditions. The relentless pursuit of profit comes at the cost of human life. Michael Sadler is gripped by moral indignation.
Archival interview with a mill worker who describes the crippling work in the mill.
By the end of the 19th century, British capitalism is no longer so brutal.
Liberty and the drive for prosperity describe the American dream. Henry Ford treats his workers well and ensures high quality labor. The car symbolized a new era of mass consumerism.
American 20th century centered around an economic creed of personal wealth.
Wall Street experiences philosophical vacuum as there is no restraint when it comes to making a profit.
The impact of capitalism prompts environmental protesters like Greenpeace to protest injustice.
The legacy of the Reformation is still evident in many facets of modern life.
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Made with strategically placed cushioning, the Nike Elite Cushion Crew Running Socks (1 Pair) offer exceptional impact protection, mile after mile. The Dri-FIT fabric and mesh vents help keep your feet dry and comfortable.
Thank you for visiting Nike Elite Running Cushion Quarter Socks - HO14 Running Socks on oakleysbikes.co.uk
We bring the products from many websites to one website for you to search, save and compare.


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Hong Kong TV Schedules Lite
De AWENIX
Abre iTunes para comprar y descargar Apps.
Hong Kong TV Schedules Lite supports the programs from TVB, ATV, You can enjoy an overview TV program on your iPhone or iPod touch, which makes you the best TV watching experience.
** Our full version support now TV, Cable TV, TVB Pay Vision, and bbTV over 390 channels **
The interface of Hong Kong TV Schedules is user-friendly, you can have quick access to everything you want. All functions are clearly labeled and illustrated with eye-catching icons. The design can cater everyone, users can manage the software just by flicking you fingers
You can input the keywords of your favorite shows to the program, through the "keyword filtering" of the whole subscribed Channel, a list of your desired shows will be generated. The list can be saved, it is not necessary to input every time, from now on you would not miss out any of your favorite program.
A quick and smart search function is also provided by Hong Kong TV Schedules, just simply entering the keywords and the system will help you to sort out from the entire subscribed channels list.
Ad-words filtering
If you are annoyed by the ad-words shown in the program names, Hong Kong TV Schedules can help to filter all the ad-words, no more "XXX Presents", "YYY Special" or other sponsors titles would be displayed.
Hong Kong TV Schedules provides both Traditional Chinese and English interface, the program names can be shown in bilingual, this function is based on the availability of the broadcast service providers.
Technical Support
If you have any enquiries, suggestion or bug report, feel free to contact email@example.com, our technical support team is happy to provide assistance to you.
Novedades de la versión 1.4
Fixed minor bugs
- Gratis
- Categoría: Estilo de vida
- Actualizado : 29/07/2011
- Versión: 1.4
- Tamaño: 1.1 MB
- Idioma: Inglés
- Vendedor: AWENIX
Compatibilidad: Requiere iOS 3.0 o posterior. Compatible con iPhone, iPad y iPod touch.


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By Joscelyn Ramos Campbell | 06/16/2016 - 12:24
Father's Day 2016 is this Sunday, June 19th. It's a revered holiday for the men we love most but what if Dad's age is slowing him down a bit or he's in ill-health?
Read more
By Priscilla Rodriguez | 06/18/2015 - 17:39
We're sure the man in your life love to stays fresh to death!
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By Celia Fernandez | 06/17/2015 - 13:59
Mario Lopez is one hot dad!
Read more
By Dan Koday | 06/10/2014 - 14:05
Dad's love may be unconditional, but it doesn't mean he can't be bought every once in a while… Father's Day is the perfect time to spoil your papi and we've found 20+ seriously great gifts that
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By Samantha Leal | 06/10/2014 - 09:36
Get the tissues ready! Dove's new ad highlights fathers and the role they play in their childrens' lives.
Read more
By Samantha Leal | 06/16/2013 - 12:00
Roel DeLaGarza Jr. is a member of the Marine Corps, but a more important title he has would be "dad." Father to three children – Alexis, 11, Alyssa, 8, and Trey, 3 – the Corpus Christi native has applied the wisdom provided by his own dad to his parenting. Although he's rarely able to see his father now that he's in the military and due to his father's medical condition, he got the chance to spend time with his family thanks to Mission: Care sponsored by Dove Men+Care! We caught up with Roel to talk family, military and the program.
Read more
By Rosy Cordero | 06/14/2013 - 13:28
Frankie J has just released his newest album, Faith, Hope Y Amore, his first full-length studio album in nearly four years! But besides his amazing music, one thing we love about him is his obvious love for his family. Whether posting pictures of his kids, cheering on their games or just talking about them in interviews, it's apparent he's a proud daddy.
We caught up with the singer to talk Father's Day plans and what he plans on doing now that his oldest son is nearing the age of first dates!
Watch below:
Read more


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Incidence and prognostic impact of new-onset atrial fibrillation in patients with septic shock: a prospective observational study
DOI: 10.1186/cc9057
© Meierhenrich et al.; licensee BioMed Central Ltd. 2010
Received: 21 January 2010
Accepted: 10 June 2010
Published: 10 June 2010
Since data regarding new-onset atrial fibrillation (AF) in septic shock patients are scarce, the purpose of the present study was to evaluate the incidence and prognostic impact of new-onset AF in this patient group.
We prospectively studied all patients with new-onset AF and all patients suffering from septic shock in a non-cardiac surgical intensive care unit (ICU) during a 13 month period.
During the study period, 687 patients were admitted to the ICU, of which 58 patients were excluded from further analysis due to pre-existing chronic or intermittent AF. In 49 out of the remaining 629 patients (7.8%) new-onset AF occurred and 50 out of the 629 patients suffered from septic shock. 23 out of the 50 patients with septic shock (46%) developed new-onset AF. There was a steady, significant increase in C-reactive protein (CRP) levels before onset of AF in septic shock patients. ICU mortality in septic shock patients with new-onset AF was 10/23 (44%) compared with 6/27 (22%) in septic shock patients with maintained sinus rhythm (SR) (P = 0.14). During a 2-year follow-up there was a trend towards an increased mortality in septic shock patients with new-onset AF, but the difference did not reach statistical significance (P = 0.075). The median length of ICU stay among surviving patients was longer in patients with new-onset AF compared to those with maintained SR (30 versus 17 days, P = 0.017). The success rate to restore SR was 86%. Failure to restore SR was associated with increased ICU mortality (71.4% versus 21.4%, P = 0.015).
AF is a common complication in septic shock patients and is associated with an increased length of ICU stay among surviving patients. The increase in CRP levels before onset of AF may support the hypothesis that systemic inflammation is an important trigger for AF.
Cardiac arrhythmias are well-known complications in postoperative and critically ill patients. In the past, the main concern has been focused on arrhythmias after cardiac and noncardiac thoracic surgery. Following coronary artery bypass grafting, the reported incidence of atrial arrhythmias range from 10 to 65% [1, 2]. Following noncardiac thoracic surgery, the incidence of atrial arrhythmias range from 9 to 29% and was associated with a higher ICU admission rate, longer hospital stay and greater 30-day mortality [3].
In recent years increasing attention has been devoted to atrial arrhythmias after noncardiac, nonthoracic surgery [4–6]. Brathwaite and colleagues pointed out a high incidence (10%) of new-onset atrial arrhythmias in patients undergoing major non-cardiothoracic surgery [6]. Seguin and colleagues focused on new-onset atrial fibrillation and observed an incidence of 5% on a noncardiac surgical ICU [5]. Both working groups demonstrated that new-onset atrial arrhythmias in this patient group are associated with increased morbidity and mortality [5, 6]. In agreement with former studies, Seguin and colleagues identified sepsis and septic shock as a risk factor for the development of new-onset atrial fibrillation (AF) [5, 7].
Interestingly, apart from the results presented by Seguin and colleagues [5], who included a subgroup of 23 patients with septic shock, no further prospectively acquired data about the incidence and prognostic impact of new-onset AF in patients with septic shock are available.
Therefore, the main purpose of the present study was to assess the incidence of new-onset AF in patients with septic shock, admitted on a noncardiac surgical ICU, and to evaluate its prognostic impact with respect to mortality and length of ICU stay.
Further, there is increasing suspicion that inflammation per se is a main trigger for the development and maintenance of AF. Therefore, we analyzed inflammation parameters before and after occurrence of new-onset AF.
Finally, no data regarding the treatment of new-onset AF in critically ill patients are available to date. Thus, we describe the success rate to restore sinus rhythm (SR) using antiarrhythmic drugs and electrical cardioversion in this patient group.
Materials and methods
The study was performed on a general surgical 14-bed ICU, including thoracic but not cardiac surgery, over a 13 month-period (March 2006 to March 2007). This ICU admits trauma patients and all types of postoperative surgical patients, including those with neurologic, lung and vascular surgery, except cardiac surgery, who require mechanical ventilation, renal replacement therapy, hemodynamic support, or special observation. The study was approved by the ethics committee of the University of Ulm (Approval No 23/06) and informed consent was obtained from all patients who were conscious during inclusion as well as those patients who regained consciousness during the follow-up.
Study design
The study was designed as a prospective single-center observational study. During the study period, all patients who developed new AF on the ICU and all patients fulfilling the criteria of septic shock were included in this study. Patients with known intermittent AF or episodes of AF in their history and patients with chronic AF were registered but not included in the study. The majority of patients were examined preoperatively by an anesthesiologist from our clinic. In case of clinical signs for coronary artery disease (e.g. angina pectoris) or heart failure, patients were routinely examined by a cardiologist and in the first step an exercise electrocardiogram and transthoracic echocardiogram were performed. The following variables were recorded for all included patients: sex, age, premorbidity including cardiovascular diseases (hypertension, coronary artery disease, heart failure, cardiomyopathy, valvular disease, previous arrhythmias) and chronic obstructive pulmonary disease. Previous regular medication was also documented including ß-blockers, digitalis glycosides, calcium channel inhibitors and angiotensin-converting enzyme inhibitors.
When AF occurred, current clinical variables including mechanical ventilation, use and dosage of catecholamines, serum electrolytes (Na+, K+, Ca2+), and renal replacement therapy were registered. Furthermore, in all patients with new-onset AF, the number of leucocytes, C-reactive protein (CRP) and maximum daily temperature were recorded - retrospectively if possible during the three days before onset of AF and prospectively for the following five days after onset of AF. The Simplified Acute Physiologic Score II (SAPS II) [8] on admission as well as the daily calculated Sequential Organ Failure Assessment (SOFA) score [9] were determined in all patients. Moreover, length of stay in the ICU and ICU-mortality were documented. All patients were followed-up for two years after admission to the ICU.
Diagnosis of new-onset atrial fibrillation
In all patients admitted to the ICU, a continuous three-lead electrocardiogram was registered. In case of sudden increase in heart rate (> 110 beats/min) or loss of interval between one R wave and the next R wave (RR-interval) regularity, a 12-lead electrocardiogram was derived. The diagnosis of AF was then made if irregular ventricular activity and chaotic atrial activity with no apparent P waves were present [10].
Treatment of new-onset atrial fibrillation
All patients with new-onset AF received treatment to re-establish SR consisting of either electrical cardioversion or medical therapy (amiodarone, ß-blockers, digitalis glycosides), or a combination of these approaches. Treatment of new-onset AF was not performed according to a fixed protocol, but according to the decision of the responsible intensivist. Type of AF therapy and success of the therapy with respect to restoration of SR were recorded in all patients.
Diagnosis of septic shock
The diagnosis of septic shock was based on the definitions of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference [11]. The presence of the following criteria were required for the diagnosis of septic shock: (i) systemic inflammatory response syndrome; (ii) evidence of infection; (iii) organ dysfunction; (iiii) circulatory failure requiring vasopressor therapy with norepinephrine for (> 0.1 μg/kg/min) more than five hours to maintain mean arterial blood pressure above 65 mmHg despite adequate volume substitution.
Statistical analysis
For continuous variables, the median and range are reported, whereas for categorical variables, the number of patients in each category and the corresponding percentage are given. The characteristics of different groups were compared using the exact Mann-Whitney U-test for continuous variables and Fisher's-exact test for categorical variables. Changes of CRP plasma levels, number of leucocytes and maximum daily temperature over time were analyzed by one-way analysis of variance, and, if significant, Dunnett's method was used to compare the variables with the baseline value (value observed three days before onset of AF).
The Kaplan-Meier method was used to create the survival curves for septic shock patients with new-onset AF and for septic shock patients with maintained SR. The survival curves were compared using the log-rank test.
For all analyses, a P-value of less than 0.05 was considered to be significant.
Overall occurrence of new-onset AF
A total of 687 patients were admitted to the ICU during the study period. Of these 687 patients, 58 revealed pre-existing chronic or intermittent atrial AF. Forty-nine (7.8%) of the remaining 629 patients developed new-onset AF during their stay on the ICU. The incidence of new-onset AF was 9.2% (38/413) in men and 5.1% (11/216) in women; the difference was statistically not significant (P = 0.10). In 67% of patients, new-onset AF occurred within the first three days of ICU stay.
Occurrence of septic shock and incidence of AF in septic shock
Sixty-four of all admitted patients (9.1%) suffered from septic shock. Fourteen of the 64 patients with septic shock had pre-existing chronic AF. Remarkably, of the remaining 50 patients with septic shock, 23 (46%) developed new-onset AF.
On the other hand, in only 26 of 579 (4.5%) patients without septic shock did new-onset AF occur. Thus, new-onset AF was much more frequent in patients with septic shock than in those without septic shock (46% versus 4.5%; P < 0.001).
Patient characteristics
New-onset AF, no septic shock
(n = 26)
New-onset AF and septic shock
(n = 23)
Maintained SR and septic shock
(n = 27)
Sex (f/m)
Age (years)
67 (46-84)
66 (41-85)
56 (18-80)
< 0.01
History of hypertension
Coronary artery disease
Heart failure
Valvular disease
Calcium antagonist
ACE inhibitor
Type of surgery
Lung surgery
Abdominal surgery
Traumatologic surgery
Vascular surgery
Aortic surgery
Severity of illness scores, laboratory tests and use of catecholamines during ICU stay
New-onset AF, no septic shock
(n = 26)
New-onset AF and septic shock
(n = 23)
Maintained SR and septic shock
(n = 27)
Severity of illness scores
SOFA max
8.5 (4-14)
12 (7-17)
9 (5-18)
< 0.01
34 (7-60)
31 (15-63)
30 (12-65)
Max. CRP level (mg/dl)
249 (14-339)
288 (72-483)
273 (23-412)
Use of catecholamines
Noradrenaline max.
0.18 (0.00-1.00)
0.50 (0.15-2.00)
0.30 (0.15-1.40
< 0.01
Noradrenaline at AF (μg/kg/min)
0.05 (0.00-0.40)
0.40 (0.03-1.10)
< 0.01
(number of patients)
< 0.01
Serum electrolytes at AF
K+ (mval/l)
4.4 (3.9-5.0)
4.4 (3.8-5.6)
Na+ (mval/l)
137 (130-163)
140 (132-161)
Ca++ (mval/l)
1.2 (1.1-1.6)
1.1 (0.7-1.3)
Septic shock patients with new-onset AF demonstrated a significantly higher maximal SOFA score during the ICU stay compared with septic shock patients with maintained SR (P = 0.01), although the SAPS II score at ICU admission was not significantly different (Table 2). Doses of noradrenaline and frequencies of dobutamine use did not significantly differ between septic shock patients with new-onset AF versus those with maintained SR (Table 2). Serum electrolyte levels did not reveal apparent disturbances when new-onset AF occurred (Table 2).
Inflammation parameters before and after onset of AF
Also, the maximum daily temperature revealed a slight increase up to the first day after new-onset AF, whereas the number of leucocytes demonstrated a slight decrease, but these changes were statistically not significant (data not shown).
Patients outcome
New-onset AF, no septic shock
(n = 26)
New-onset AF and septic shock
(n = 23)
Maintained SR and septic shock
(n = 27)
4 (15%)
10 (44%)
6 (22%)
28-day mortality
4 (15%)
9 (39%)
6 (22%)
60-day mortality
6 (23%)
11 (48%)
7 (26%)
ICU length of stay, days
(surviving patients)
10.5 (2-45)
(n = 22)
30 (9-123)
(n = 13)
17 (4-48)
(n = 21)
< 0.001
Success rate to restore SR and recurrence of AF
Electrical cardioversion was performed in 17 of 49 patients with AF, but was combined in all cases with additional drug therapy. Amiodarone was the drug used most frequently (36/49 patients), followed by digitalis glycosides (31/49) and ß-blockers (25/49), indicating that the majority of patients received a combination of antiarrhythmic drugs.
In 42 out of the 49 patients with new-onset AF, SR was successfully reconstituted, including 23 out of 26 patients without septic shock and 19 out of 23 patients with septic shock. Only one of the seven patients, who could not be converted to SR, did not receive amiodarone.
Failure to restore SR was associated with an increased ICU mortality. ICU mortality was 5 out of 7 patients who could not be cardioverted to SR in contrast to 9 out of 42 successfully cardioverted patients (P = 0.015).
Recurrence rate of AF was high (42.9%), with no significant difference between AF in patients with septic shock and AF patients without septic shock (48% versus 38%, P = 0.57).
In this prospective observational study, we demonstrate a high incidence of new-onset AF in septic shock patients. Remarkably, 46% of all patients with septic shock developed new-onset AF. Among surviving septic shock patients, those who developed new-onset AF had a prolonged ICU stay in comparison to septic shock patients with maintained SR. Further, septic shock patients with new-onset AF may have a poorer prognosis. In the present study, we found a trend towards an increased mortality during a two-year follow-up, but the difference was not statistically significant.
Overall, incidence of new-onset AF in our study was 7.8% (49/629), which is in the range of previous studies (1.8 to 10%) performed in noncardiac ICUs [5–7, 12–14]. However, many of these studies did not clearly focus on AF but rather on a broad variety of atrial arrhythmias. Moreover, in older studies, the patients were not continuously monitored [12, 13]. Seguin and colleagues exclusively looked at AF on a surgical ICU and found an incidence of new-onset AF of 5.3% [5]. Thus, our study confirms that new-onset AF is a common complication in critically ill patients. In agreement with previous studies, we found that in two-thirds of the patients, new-onset AF occurred within the first three days on the ICU [5, 6].
Salman and colleagues retrospectively analysed patients with sepsis and reported an incidence of AF of 31% [15]. With respect to the incidence of new-onset AF in septic shock, Seguin and colleagues included a subgroup of 23 patients and observed new-onset AF in 30%, which is slightly lower when compared with our finding of 46% [5]. One reason for this difference might be our restrictive definition of septic shock, in particular the requirement of vasopressor therapy with norepinephrine for more than five hours with a dosage more than 0.1 μg/kg/min.
In the present study, septic shock patients with new-onset AF were older, more frequently revealed a history of hypertension and developed a higher maximal SOFA score during ICU stay in comparison to septic shock patients with maintained SR. Age and a history of hypertension have been identified in previous studies as risk factors for the development of AF in non-selected ICU patients [5, 7]. The higher SOFA score in septic shock patients with new-onset AF indicates that presumably there is an association between severity of illness and the development of AF.
A variety of further factors including pre-existing heart failure, ischemic heart disease, valvular disease, electrolyte disturbances and use of catecholamines have been addressed as potential co-factors or causes for the development of new-onset AF in critically ill patients [5–7]. In the current study, only a small number of patients developing new-onset AF revealed pre-existing heart failure, ischemic heart disease or valvular disease. Furthermore, we did not find apparent electrolyte disturbances when new-onset AF occurred. Also, regarding the treatment with catecholamines there was no significant difference between septic shock patients with new-onset AF in comparison to those with maintained SR. The present data do not support the hypothesis that one of these factors plays a mayor role in the development of AF in critically ill patients.
The pathophysiological mechanism underlying the development of AF in critically ill patients and in particular in septic shock is not known. However, there is increasing evidence that the systemic inflammatory response per se is a predominant trigger of AF in critically ill patients. The occurrence of AF after cardiac surgery has been shown to be closely related to the complement CRP activation on the postoperative day two or three [16]. Also, in the non-operative setting, a series of studies has now demonstrated an association of elevated CRP levels with the development and maintenance of AF [17–19]. Chung and colleagues found two-fold higher CRP levels in patients with AF than in control subjects. Furthermore, patients with persistent AF had higher CRP levels than those with paroxysmal AF, suggesting that inflammation plays an important role in the maintenance of AF [17]. In addition, elevated CRP levels have been correlated to a decreased success rate of electrical cardioversion and subsequent maintenance of SR [20–22]. The hypothesis, that inflammation may trigger the development of AF in critically ill patients, is supported by our observation of increasing CRP plasma concentrations before the onset of AF in septic shock patients. Also, in AF patients without septic shock, CRP levels were very high when AF occurred. However, maximal CRP levels occurring during ICU stay did not differ between septic shock patients with new-onset AF and septic shock patients who maintained SR, indicating that other factors may contribute to the development of AF in critically ill patients.
Although new-onset of AF, as reemphasized by the present data, is a frequent and major problem in ICU patients, no evidence-based data regarding the treatment of AF for this patient group are available. In the current study, restoration of SR was possible in 85% of the patients. In the majority of patients, amiodarone was used, but was frequently combined with electrical cardioversion or other drugs. On the other hand, in 12 patients, restoration of SR was possible without the use of amiodarone. Although amiodarone seems to be an effective drug for restoration of SR, we do not know whether the outcome is positively affected by this measure. Previous studies on AF in non-critically ill patients have impressively demonstrated that restoration of SR patients does not automatically imply an improvement in clinical outcome [23, 24]. Furthermore, prophylactic intravenous administration of amiodarone for supraventricular tachyarrhythmias after pulmonary surgery has been associated with an increased risk for the development of acute respiratory distress syndrome [25]. Therefore, prospective randomized controlled studies are necessary to evaluate the use of amiodarone in critically ill patients.
The present study contains several limitations. Presumably, the number of patients was too low to demonstrate a significant association between new-onset AF and mortality rate in septic shock patients. Further, due to the limited number of patients, it was not possible to perform a multivariate analysis to identify independent risk factors for the development of AF in septic shock patients. Moreover, therapy of AF was not performed according to a fixed protocol. Therefore, the failure rate to restore SR has to be appraised with caution.
We have found that new-onset AF is a very common complication in septic shock patients that is associated with an increased ICU length of stay among surviving patients. Higher SOFA scores observed in septic shock patients with new-onset AF may indicate an association between severity of illness and the occurrence of AF. The observation of increasing CRP levels before onset of AF may support the hypothesis that systemic inflammation is an important trigger for the development of AF in critically ill patients. Success rate to restore SR by antiarrhythmic drugs and electrical cardioversion was high, and failure to restore SR was associated with increased mortality.
Key messages
Almost half of all patients with septic shock develop new-onset AF.
New-onset AF in septic shock patients is associated with increased ICU length of stay among surviving patients.
Septic shock patients with new-onset AF demonstrate a higher maximum SOFA score during ICU stay compared with those with maintained SR.
Increasing CRP levels before onset of AF support the hypothesis that inflammation is an important trigger for the development of AF.
Failure to restore SR in critically ill patients is associated with an increased mortality.
atrial fibrillation
C-reactive protein
Simplified Acute Physiologic Score
Sequential Organ Failure Assessment
sinus rhythm.
We thank Mr Henning Leesch, medical documentation specialist, for his excellent assistance in data acquisition.
Authors' Affiliations
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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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What is tapioca, quick-cooking? About the cooking ingredient tapioca, quick-cooking. Including 69 recipes, nutrition data, and where to find it.
Quick cooking tapioca, sometimes called minute tapioca a ground tapioca product that is commonly used as a thickener in some recipes.
Tapioca, quick-cooking is usually found in the baking supplies section or aisle of the grocery store or supermarket.
Tapioca, quick-cooking is a member of the Sweets USDA nutritional food group.
|1 package (3.5 oz)
|1 portion, amount to make 1/2 cup
|In Chinese:
|British (UK) term:
|Tapioca, quick-cooking
|en français:
|tapioca, à cuisson rapide
|en español:
|tapioca, de cocción rápida
There are 69 recipes that contain this ingredient.
|Usda nutrition data
|about 2 years ago
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The Dirty Pretty Things
Bang Bang You're Dead
Video Stream
April the 24th sees the release of DirtyPretty Things debut single 'Bang Bang You're Dead'.
After selling out their first tour in twenty minutes, Carl Barât's (ex-Libertines) new band, Dirty Pretty Things have another tour for April and May to coincide with the single. We had Babyshambles last year, 2006 is the year of the pretty thing. Carl spent a long time in his Waterloo flat, writing. He played some songs to Didz Hammond, (formerly Cooper Temple Clause) and the rest is history, the Dirty Pretty Things were formed!
Click here to see the video to the brilliant single from Dirty Pretty Things - 'Bang Bang You're Dead' - out to buy 24th April.
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Wed 26th Preston 53 Degrees
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Wed 10th Nottingham Rock City
Fri 12th Wolverhampton Wulfrun Hall
Sun 14th London Astoria
Wed 17th Leeds Metropolitan University
Thu 18th Middlesborough Town Hall
Fri 19th Edinburgh Liquid Rooms
Sat 20th Glasgow Barrowlands
Tickets £10 except London £12. 24 Hour cc Hotline: 0871 2200 260 or buy on-line: www.gigandtours.com
Site - http://www.dirtyprettythingsband.com
Six (Live)
So Sexy
Blurred Lines (Unrated Version)
Spider Man: Homecoming - Trailer
How Would You Feel (Paean) [Live]
Dat Sexy Body
That's What I Like [Live]
The singer releases her new album later this year.


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