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America During and After the War
By (author) Robert Ferguson
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America During and After the War by Robert Ferguson
Book DescriptionAn Englishman travels extensively through the United States, taking copious notes on the Civil War, race relations in different regions, and discussing the histories of various political figures.
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The relationship between inotrope exposure, six-hour postoperative physiological variables, hospital mortality and renal dysfunction in patients undergoing cardiac surgery
DOI: 10.1186/cc10302
© Shahin et al.; licensee BioMed Central Ltd. 2011
Received: 20 January 2011
Accepted: 7 July 2011
Published: 7 July 2011
Acute haemodynamic complications are common after cardiac surgery and optimal perioperative use of inotropic agents, typically guided by haemodynamic variables, remains controversial. The aim of this study was to examine the relationship of inotrope use to hospital mortality and renal dysfunction.
Material and methods
A retrospective cohort study of 1,326 cardiac surgery patients was carried out at two university-affiliated ICUs. Multivariable logistic regression analysis and propensity matching were performed to evaluate whether inotrope exposure was independently associated with mortality and renal dysfunction.
Patients exposed to inotropes had a higher mortality rate than those not exposed. After adjusting for differences in Parsonnet score, left ventricular ejection fraction, perioperative intraaortic balloon pump use, bypass time, reoperation and cardiac index, inotrope exposure appeared to be independently associated with increased hospital mortality (adjusted odds ratio (OR) 2.3, 95% confidence interval (95% CI) 1.2 to 4.5) and renal dysfunction (adjusted OR 2.7, 95% CI 1.5 to 4.6). A propensity score-matched analysis similarly demonstrated that death and renal dysfunction were significantly more likely to occur in patients exposed to inotropes (P = 0.01).
Postoperative inotrope exposure was independently associated with worse outcomes in this cohort study. Further research is needed to better elucidate the appropriate use of inotropes in cardiac surgery.
Low cardiac output syndrome is a common complication in patients undergoing cardiac surgery [1]. The aetiology is multifactorial and is believed to be related to a combination of myocardial ischaemia, reperfusion injury, cardioplegia-induced myocardial dysfunction and preexisting cardiac disease [2]. The administration of fluids and inotropes and the use of ventricular assist devices are common therapies in the management of low cardiac output syndrome. Physiological variables such as cardiac index, mixed venous oxygen saturation, oxygen delivery and lactate levels, obtained either from a cardiac output monitoring device or by measuring oxygen consumption and delivery, are often used to guide therapy. Inotropic agents are frequently used and titrated to achieve certain target levels of these physiological variables [3].
However, there is no consensus regarding low cardiac output syndrome in terms of both the physiological parameters that define it and the interventions used to treat it [2]. The use of inotropes has been described to be both centre- and physician-dependent and as being administered to as few as 5% or to as many as 100% of patients undergoing elective coronary bypass surgery [4–6]. Although inotropes have been demonstrated to improve haemodynamics and measured physiological variables [2], they may be a source of increased mortality and morbidity as they can increase cardiac arrhythmias and ischaemia [7]. Very few randomised, controlled trials comparing the different agents used and their effects on clinical outcomes have been performed in patients who undergo cardiac surgery [2]. In a recent observational study, the receipt of dobutamine perioperatively was associated with increased mortality [8]. In addition, investigators in randomised, controlled trials of inotropes in patients with heart failure and left ventricular dysfunction have reported increased side effects and increased mortality [9].
While the use of inotropes as part of a protocol to target physiological parameters within the first six hours after cardiac surgery has been shown to improve outcomes in patients with sepsis [10], it is unclear whether their use in the postoperative cardiac care setting is favourable with respect to morbidity and mortality. This study was undertaken to evaluate the relationship of inotrope use to morbidity and mortality in a cohort of consecutive patients undergoing cardiac surgery.
Materials and methods
Setting and study population
This study was conducted at two adult tertiary care university-affiliated hospitals. Data were collected retrospectively between 1 January 2005 and 31 December 2005 by trained reviewers using standardised data collection sheets. Consecutive patients who had undergone coronary artery bypass graft (CABG) surgery, valve replacement or repair or combined CABG and valvular or aortic procedures were included in the study. Patients who had undergone a heart transplant, pulmonary thromboendarterectomy or placement of a ventricular assistance device were excluded.
All patients had been admitted postoperatively to the ICU. A Swan-Ganz catheter had been used perioperatively at both hospitals to guide patient resuscitation. Serum lactate and mixed venous oxygen saturation levels had been measured in all patients at one site, and selected patients at the other site. To avoid bias, only the data from the patients treated at the hospital with routinely measured serum lactate and mixed venous oxygen saturation were used for the analysis of those variables.
All research was conducted in keeping with the principles outlined in the Declaration of Helsinki. The research ethics committee of the McGill University Health Centre Research Institute approved the study. The hospital's ethics committee waived the need for informed consent as the data were collected retrospectively.
Exposure, covariates and end points
The primary drug exposure studied was postoperative inotrope use. Epinephrine, milrinone and dobutamine were the main inotropes used in the study centres. The definition of 'postoperative inotrope use' varied for each medication. Milrinone exposure was defined as administration of any dose for any length of time in the ICU. Dobutamine exposure was defined as delivery of any dose as long as it was administered for at least three hours in the ICU. Epinephrine exposure was defined as a minimum duration of three hours in the ICU if the dose was < 5 μg/minute or any duration if doses ≥ 5 μg/minute were used. Consistent with the definitions used by other authors [2], norepinephrine and vasopressin were not considered inotropes.
The primary study outcomes were hospital mortality and the occurrence of postoperative renal dysfunction. Renal dysfunction was defined by an increase in creatinine ≥ 200% from baseline in the first five postoperative days or new renal replacement therapy at any point during hospitalisation. These definitions are consistent with stages 2 and 3 of the Acute Kidney Injury Network classification system [11]. Secondary outcomes were ICU length of stay and hospital length of stay.
Data were collected regarding patient age, sex, Parsonnet score, medical history, procedure-related variables and six-hour postoperative physiological variables. Medical histories were abstracted from patient records. Conditions considered were any prior cardiac surgery, hypertension, diabetes, atrial fibrillation, preoperative hospitalisation for heart failure, preoperative renal dysfunction, preoperative dialysis, preoperative left ventricular ejection fraction and left ventricular dysfunction. Preoperative renal dysfunction was defined by a preoperative creatinine level ≥ 150 μmol/L. Left ventricular dysfunction was defined as left ventricular ejection fraction < 30%. Procedure-related variables consisted of cardiac procedures, perioperative intraaortic balloon pump use, reoperation, emergency operation, mean bypass time and severe postoperative bleeding. Cardiac procedures were separated into a CABG-only group and a group who had undergone other procedures, defined as (1) valve repair or replacement or (2) combined CABG and valve repair or replacement. An emergency operation was defined as a cardiac procedure occurring within 24 hours of acute coronary syndrome or immediately after a percutaneous intervention. Reoperation was defined as the need for reoperation 48 hours after the initial cardiac procedure. Severe postoperative bleeding was defined as blood loss > 2.5 L within 24 hours after the initial cardiac procedure. The six-hour postoperative physiological variables consisted of mean arterial pressure, cardiac index, mixed venous oxygen saturation and serum lactate. These tests were performed in the ICU six hours after the operation.
Data analysis
Preoperative variables, intraoperative variables and outcomes in patients exposed or unexposed to inotropes were compared using Student's t-test and the Wilcoxon rank-sum test for continuous variables and a χ2 test for categorical variables. Multivariable logistic regression was performed to test the association between inotrope exposure and outcomes after adjusting for possible confounding variables. A forward stepwise procedure was first used to assess inotrope exposure in the model. Variables were kept in the model if they were believed to be clinically important or if they altered the association between inotrope exposure and outcome by ≥ 10%. Covariates included in the model were Parsonnet score, left ventricular dysfunction, perioperative intraaortic balloon pump use, bypass time, reoperation, postoperative bleeding, preoperative renal dysfunction, treatment hospital, aprotinin use and cardiac index < 2.2 [3]. Variables included in the Parsonnet score were not included in the model, other than a low left ventricular ejection fraction, as we thought this might strongly influence decision making with respect to inotrope use, and its weighting in the Parsonnet score might not reflect this. Colinearity between left ventricular ejection fraction and Parsonnet score was excluded as the variance inflation factor was < 2.5.
A second analytic method, propensity score matching, was performed to evaluate the association between inotrope exposure and outcomes. A one-to-many greedy five-to-one digit technique was performed to match one control in the no agent group (control group) by one case (inotrope-exposed). A 'greedy five-to-one digit match' means that the cases were first matched to controls on five digits of the propensity score. For those that did not match, cases were then matched to controls on four digits of the propensity score. This continued down to a one-digit match on propensity scores for those that remained unmatched. If a one-digit match was not possible, the case remained unmatched and was not included in the matched case control analysis. Matching variables included Parsonnet score, low left ventricular ejection fraction, age, sex, bypass time, procedure type, CABG only or other procedures, and perioperative intraaortic balloon pump use. In this matched sample, baseline characteristics and outcomes were compared between inotrope exposed and unexposed groups by performing paired t-tests for continuous variables and McNemar's test for categorical values.
Because of previous literature correlating patient outcomes with physiological goals [10] and recommendations that certain levels of physiologic variables be targeted [3], we examined the relationship between measured six-hour physiologic variables and outcomes. Specifically, oxygen delivery, cardiac index, serum lactate and mixed venous oxygen saturation were examined. The six-hour postoperative physiological variables were categorised with cutoffs based on recommendations in the literature [3, 10], with the exception of oxygen delivery, which was based on the median value derived from the data. We examined the relationship between inotrope exposure and outcomes after stratifying by the six-hour physiological variables. All data processing and analyses were performed using SAS version 9.2 software (SAS Institute, Cary, NC, USA).
Baseline characteristics for total cohort and patient subgroupsa
Total cohort (N= 1,326)
Inotrope-unexposed (n= 783)
Inotrope-exposed (n= 531)
Mean age (± SD)
66.1 (11.0)
64.6 (10.7)
68.3 (11.0)
Age ≥ 80 years, n (%)
123 (9.3)
51 (6.5)
72 (13.6)
Females, n (%)
404 (30.5)
188 (24.0)
207 (39.0)
Mean Parsonnet score (± SD)
13.4 (10.6)
10.5 (8.3)
17.2 (11.7)
Medical history
Prior cardiac surgery, n (%)
78 (5.9)
26 (3.3)
48 (9.0)
Hypertension, n (%)
904 (68.2)
534 (68.2)
362 (68.2)
Diabetes, n (%)
417 (31.5)
220 (28.1)
193 (36.4)
Atrial fibrillation, n (%)
135 (10.2)
53 (6.8)
80 (15.1)
Preoperative CHF, n (%)
179 (13.5)
79 (10.1)
99 (18.6)
Preoperative renal dysfunction, n (%)
94 (7.1)
31 (4.0)
61 (11.5)
Preoperative dialysis, n (%)
21 (1.6)
9 (0.7)
12 (2.3)
Mean LVEF (± SD)
49.7 (11.8)
53.3 (11.8)
44.4 (15.8)
LVEF < 30%, n (%)
241 (18.2)
74 (9.5)
162 (30.5)
Procedure-related variables
CABG only, n (%)
912 (68.8)
601 (76.8)
303 (57.1)
Other procedure, n (%)
414 (31.2)
182 (23.2)
228 (42.9)
Perioperative IABP, n (%)
132 (10.0)
30 (3.8)
96 (18.1)
Received inotropes intraoperative, n (%)
666 (50.7)
219 (28.0)
447 (84.2)
Emergency operation, n (%)
132 (10.0)
58 (7.4)
74 (13.9)
Reoperation, n (%)
78 (5.9)
20 (2.6)
35 (6.6)
Mean bypass time, minutes (± SD)
101.2 (45.7)
86.8 (32.8)
120 (52)
Severe postoperative bleeding, n (%)
50 (3.8)
15 (1.1)
35 (6.6)
Postoperative variables and outcomesa
Variables and outcomes
Total cohort
Inotrope-unexposed (n= 783)
(n= 531)
Postoperative inotrope and vasopressor use, n (%)
674 (51.3)
279 (35.6)
395 (74.4)
73 (5.6)
5 (0.6)
68 (12.8)
308 (23.29)
308 (58.0)
75 (5.7)
75 (14.1)
332 (25.3)
332 (62.5)
Six-hour postoperative physiological variables
Mean arterial pressure, mmHg (± SD)
75.9 (10.0)
76.7 (10.0)
74.5 (9.7)
Mean oxygen delivery, mL/minute/m2
353 (101)
363 (100)
341 (98)
Mean cardiac index, L/min (± SD)
2.9 (0.7)
2.9 (0.7)
2.8 (0.7)
Mixed venous oxygen saturation, n (%)
70.7 (9.0)
71.3 (8.2)
70.1 (9.3)
Mean serum lactate, μmol/L (± SD)
3.2 (2.7)
2.1 (1.6)
4.1 (3.0)
Died, n (%)
103 (7.8)
15 (1.9)
76 (14.3)
Renal dysfunction, n (%)
105 (8.3)
87 (16.8)
Median ICU length of stay, days (IQR)
1.0 (0.9,1.6)
2.1 (1.0,4.7)
Median hospital length of stay, days (IQR)
8 (6)
7.0 (5.0,9.0)
10.0 (6.0,18.0)
Twelve patients who died within six hours of admission to the ICU were excluded from further analysis, leaving a total of 1,314 patients finally included in the study.
Patients exposed to inotropes differed from those unexposed in that they were older; had higher Parsonnet scores, more comorbid illnesses and lower preoperative left ventricular ejection fractions; were more likely to have undergone valvular or combined procedures; and had longer bypass times. However, at six hours after ICU admission, aside from serum lactate, which was higher in the group of patients exposed to inotropes, postoperative physiological parameters were very similar. The hospital mortality rate was seven times higher in the group of patients exposed to inotropes compared to those not exposed. Similarly, the rate of severe renal failure was significantly higher in the patients exposed to inotropes (Table 2).
As a low preoperative left ventricular ejection fraction may have increased the likelihood that a patient would be treated with inotropes, the effect of inotropes on mortality in the 232 patients with preoperative left ventricular fractions < 30% was examined. In this subgroup, patients who received inotropes had significantly higher mortality than patients who did not, with an odds ratio OR of 14.7 (95% confidence interval (95% CI) 2.0 to 11.1).
Multivariable analysis of association between inotrope exposure and hospital mortalitya
Crude odds ratio
Adjusted odds ratio (95% CI)
Inotrope status
Inotrope unexposed (ref)
Inotrope exposed
2.3 (1.2 to 4.5)
Parsonnet score
0 to 9 (ref)
10 to 14
1.8 (0.7 to 4.6)
15 to 19
1.8 (0.7 to 4.9)
20 to 29
4.6 (2.0 to 10.9)
< 0.001
≥ 30
11.2 (4.6 to 27.5)
< 0.001
Ejection fraction
1.5 (0.9 to 2.7)
Intraaortic balloon pump use
No perioperative IABP use
Perioperative IABP use
3.3 (1.9 to 5.8)
< 0.001
Bypass timeb
1.3 (1.1 to 1.4)
< 0.001
Reoperative status
No reoperation
4.7 (2.3 to 9.3)
< 0.001
Cardiac index at six hours, L/min
Cardiac index ≥ 2.2 (ref)
Cardiac index < 2.2
1.7 (0.93 to 1)
Multivariable analysis of association between inotrope exposure and renal dysfunctiona
Crude odds ratio
Adjusted odds ratio (95% CI)
Inotrope status
Inotrope unexposed (ref)
Inotrope exposed
2.7 (1.5 to 4.6)
< 0.001
Parsonnet score
0 to 9 (ref)
10 to 14
1.2 (0.7 to 2.4)
15 to 19
1.4 (0.7 to 2.9)
20 to 29
2.3 (1.2 to 4.3)
≥ 30
2.8 (1.3 to 6.1)
Ejection fraction
1.0 (0.6 to 1.7)
Intraaortic balloon pump use
No perioperative IABP use
Perioperative IABP use
2.7 (1.6 to 4.7)
< 0.001
Bypass timeb
1.2 (1.1 to 1.4)
< 0.001
Reoperative status
No reoperation
2.3 (1.2 to 4.5)
Renal dysfunction
Normal preoperative renal function
Preoperative renal dysfunction
1.7 (0.8 to 3.6)
Cardiac index at six hours, L/min
Cardiac index ≥ 2.2 (ref)
Cardiac index < 2.2
1.0 (0.6 to 1.9)
Baseline characteristics and outcomes for propensity-matched groupsa
No inotropes (n= 123)
Inotropes (n= 123)
Mean age (± SD)
67.2 (11.5)
67.3 (10.9)
Age ≥ 80 years, n (%)
18 (14.6)
14 (11.4)
Females, n (%)
49 (39.8)
43 (5.0)
Medical history, n (%)
Prior cardiac surgery
5 (4.1)
6 (4.9)
84 (68.3)
78 (63.4)
40 (32.5)
43 (35.0)
Atrial fibrillation
17 (13.8)
15 (12.2)
Preoperative hospitalisation for CHF
20 (16.3)
11 (8.9)
Preoperative renal dysfunction
9 (7.3)
10 (8.1)
Preoperative dialysis
1 (0)
0 (0.8)
25 (20.3)
25 (20.3)
Mean LVEF (± SD)
50.6 (13.9)
45.8 (15.2)
Procedure-related variables
Mean Parsonnet score (± SD)
14.1 (8.7)
14.4 (9.2)
CABG only, n (%)
82 (66.7)
85 (69.1)
Other procedure, n (%)
41 (33.3)
38 (30.9)
Perioperative IABP, n (%)
3 (2.4)
4 (3.2)
Emergency operation, n (%)
14 (11.4)
17 (13.8)
Reoperation, n (%)
4 (3.3)
9 (7.9)
Mean bypass time, minutes (± SD)
99.3 (28.7)
98.6 (32.9)
Severe postoperative bleeding, n(%)
2 (1.6)
6 (4.9)
Died, n (%)
1 (0.8)
10 (8.1)
Renal dysfunction, n (%)
2 (1.6)
12 (9.8)
Median ICU length of stay (IQR)
1.0 (0.9,1.8)
1.8 (0.9,3.2)
< 0.0001
Median hospital length of stay (IQR)
8.0 (6.0,11.0)
9.0 (6.0,18.0)
In this observational study, postoperative inotrope exposure was associated with increased hospital mortality and renal dysfunction in cardiac surgery patients. Hospital mortality and renal dysfunction were consistently lower in patients unexposed to inotropes, even when their six-hour physiological variables were lower than the targets recommended in the literature [3, 10]. The relationship between inotrope exposure and poor outcomes remained significant after adjusting for differences in Parsonnet score, left ventricular ejection fraction, perioperative intraaortic balloon pump use, bypass time, reoperation and cardiac index. In addition, an analysis using propensity score matching produced similar results.
The demonstration of poorer outcomes in patients exposed to inotropes is consistent with the results demonstrated in several previous studies. An observational study of patients who received dobutamine after cardiac surgery demonstrated increased cardiac morbidity after the data were adjusted for confounders [8]. Milrinone has also been described as being associated with an increased risk of postoperative atrial fibrillation in a cardiac surgery population [12]. Further evidence that inotropes may be harmful can be found in the heart failure literature. Randomised, controlled trials of patients with decompensated heart failure treated with phosphodiesterase inhibitors versus placebo revealed that those in the treatment group experienced more episodes of hypotension and cardiac arrhythmia and had higher mortality rates [13–15]. Furthermore, despite promising initial results, levosimendan, a new class of inotrope, was not shown to be superior to dobutamine in a randomised, controlled trial of patients with acute heart failure and left ventricular ejection fractions < 30% [16]. Researchers who conducted a systematic review of controlled trials of β-adrenergic agents compared to either placebo or an active agent in patients with heart failure concluded that there is very little evidence that treatment improves symptoms or patient outcomes and may in fact be harmful [9]. Inotrope use was also associated with increased mortality in a recent observational study of heart failure with an effect size similar in magnitude to that found in our study [17].
Since the 1970s, a number of randomised trials have been undertaken in medical and surgical patients to investigate whether targeting specific resuscitation goals, such as cardiac output and oxygen delivery, would improve patient outcomes [18]. Achieving the prespecified goals often involved the use of inotropic medications to increase cardiac output and oxygen delivery. Such therapy, referred to as 'goal-directed therapy', has been associated with improved outcomes, primarily in patients with sepsis and in certain high-risk surgical patient populations [10, 19]. However, these trials differed with regard to patient mix, physiologic targets, therapies used and management of control arms [20].
Four controlled studies have been published in which a goal-directed therapy protocol was used in the cardiac surgery setting [21–23]. The trials differed with regard to targeted goals, therapeutic protocols and use of inotropic medications. Two of the trials, which employed mainly fluid infusions, demonstrated improved physiological goals with minimal catecholamine use. The largest trial, which targeted mixed venous oxygen saturation, demonstrated shortened hospital stay and less morbidity, but these outcomes were associated with increased catecholamine use. The last trial, which enrolled 30 patients in total, demonstrated no significant difference in outcomes but did require a more intense inotrope regimen to attain the specified goals. Despite demonstrating improved clinical outcomes, all four studies were underpowered to detect any difference in mortality. Furthermore, two of the four protocols required greater catecholamine doses to achieve their goals.
Several mechanisms may explain the increased mortality observed in patients exposed to inotropes. The two most common side effects of inotropic medications are increased myocardial oxygen consumption and cardiac arrhythmia. Both of these side effects may lead to poor cardiac performance [7]. Alternatively, low cardiac output may be due to mechanical obstruction, as in cardiac tamponade, which may require surgical intervention. The use of inotropes in these situations may transiently improve the haemodynamic state but ultimately lead to further harm, as appropriate diagnosis and treatment may be either delayed or missed altogether. Furthermore, catecholamine use has been associated with reduced metabolic efficiency by promoting fatty acid oxidation over that of glucose. This may be a further impediment to optimal cardiac performance. Catecholamine use has also been associated with bacterial growth, increased bacterial virulence, biofilm formation, insulin resistance and hyperglycaemia, all of which may contribute to poor outcomes [25].
Our study has several strengths. First, our results are less likely to be biased by a single centre's practice pattern, as the patients were recruited from two centres. Second, as we routinely collected postoperative physiological data, we were able to adjust for important haemodynamic variables. Finally, because extensive preoperative, intraoperative and postoperative data were collected, we were able to control for many potential confounding factors.
The study's main limitation is that it is an observational study, and thus the associations could be due to residual confounding. Specifically, we may not have fully adjusted the data for confounding by indication and confounding due to severity of illness. To minimise confounding, we performed multiple different analyses, including a propensity-matched analysis.
The results of our study demonstrate that inotrope exposure was associated with increased hospital mortality and renal dysfunction in cardiac surgery patients. The observational nature of the data and the potential for confounding precludes any final conclusions about a causal relationship. Nevertheless, the significant practice variations reported in the literature, and the consistency of our results with those reported in the cardiac surgery and heart failure literature, demonstrate the need for future research [4–6, 26]. As inotropes may be associated with increased morbidity and mortality, adequately powered, randomised, controlled trials are needed to clarify the risks and benefits of inotrope use in cardiac surgery patients.
Key messages
Postoperative inotrope exposure was independently associated with hospital mortality and renal dysfunction.
The increased hospital mortality and renal dysfunction in patients exposed to inotropes are observed even when recommended six-hour physiological variables are achieved.
Patients unexposed to inotropes with six-hour physiological variables below recommended targets had lower mortality than patients exposed to inotropes who achieved these targets.
coronary artery bypass and graft
confidence interval
standard deviation.
We thank Dr Richard Menzies for his help in the analysis of the data and the drafting of the manuscript. We also thank Barbara Verhoef for all her work in data acquisition.
Authors' Affiliations
- Ahmed I, House CM, Nelson WB: Predictors of inotrope use in patients undergoing concomitant coronary artery bypass graft (CABG) and aortic valve replacement (AVR) surgeries at separation from cardiopulmonary bypass (CPB). J Cardiothorac Surg. 2009, 4: 24-10.1186/1749-8090-4-24.PubMedPubMed CentralView ArticleGoogle Scholar
- Gillies M, Bellomo R, Doolan L, Buxton B: Bench-to-bedside review: Inotropic drug therapy after adult cardiac surgery: a systematic literature review. Crit Care. 2005, 9: 266-279. 10.1186/cc3024.PubMedPubMed CentralView ArticleGoogle Scholar
- St André AC, DelRossi A: Hemodynamic management of patients in the first 24 hours after cardiac surgery. Crit Care Med. 2005, 33: 2082-2093. 10.1097/01.CCM.0000178355.96817.81.PubMedView ArticleGoogle Scholar
- Kastrup M, Markewitz A, Spies C, Carl M, Erb J, Grosse J, Schirmer U: Current practice of hemodynamic monitoring and vasopressor and inotropic therapy in post-operative cardiac surgery patients in Germany: results from a postal survey. Acta Anaesthesiol Scand. 2007, 51: 347-358. 10.1111/j.1399-6576.2006.01190.x.PubMedView ArticleGoogle Scholar
- Butterworth JF: Dobutamine: Too dangerous for routine administration?. Anesthesiology. 2008, 108: 973-974. 10.1097/ALN.0b013e318172fb98.PubMedView ArticleGoogle Scholar
- Hernandez AF, Li S, Dokholyan RS, O'Brien SM, Ferguson TB, Peterson ED: Variation in perioperative vasoactive therapy in cardiovascular surgical care: data from the Society of Thoracic Surgeons. Am Heart J. 2009, 158: 47-52. 10.1016/j.ahj.2009.05.014.PubMedView ArticleGoogle Scholar
- Parissis JT, Rafouli-Stergiou P, Stasinos V, Psarogiannakopoulos P, Mebazaa A: Inotropes in cardiac patients: update 2011. Curr Opin Crit Care. 2010, 16: 432-441. 10.1097/MCC.0b013e32833e10fb.PubMedView ArticleGoogle Scholar
- Fellahi JL, Parienti JJ, Hanouz JL, Plaud B, Riou B, Ouattara A: Perioperative use of dobutamine in cardiac surgery and adverse cardiac outcome: propensity-adjusted analyses. Anesthesiology. 2008, 108: 979-987. 10.1097/ALN.0b013e318173026f.PubMedView ArticleGoogle Scholar
- Thackray S, Easthaugh J, Freemantle N, Cleland JG: The effectiveness and relative effectiveness of intravenous inotropic drugs acting through the adrenergic pathway in patients with heart failure: a meta-regression analysis. Eur J Heart Fail. 2002, 4: 515-529. 10.1016/S1388-9842(02)00041-7.PubMedView ArticleGoogle Scholar
- Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M, Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001, 345: 1368-1377. 10.1056/NEJMoa010307.PubMedView ArticleGoogle Scholar
- Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007, 11: R31-10.1186/cc5713.PubMedPubMed CentralView ArticleGoogle Scholar
- Fleming GA, Murray KT, Yu C, Byrne JG, Greelish JP, Petracek MR, Hoff SJ, Ball SK, Brown NJ, Pretorius M: Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery. Circulation. 2008, 118: 1619-1625. 10.1161/CIRCULATIONAHA.108.790162.PubMedPubMed CentralView ArticleGoogle Scholar
- Cohn JN, Goldstein SO, Greenberg BH, Lorell BH, Bourge RC, Jaski BE, Gottlieb SO, McGrew F, DeMets DL, White BG: A dose-dependent increase in mortality with vesnarinone among patients with severe heart failure. Vesnarinone Trial Investigators. N Engl J Med. 1998, 339: 1810-1816. 10.1056/NEJM199812173392503.PubMedView ArticleGoogle Scholar
- Cuffe MS, Califf RM, Adams KF, Benza R, Bourge R, Colucci WS, Massie BM, O'Connor CM, Pina I, Quigg R, Silver MA, Gheorghiade M, Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators: Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002, 287: 1541-1547. 10.1001/jama.287.12.1541.PubMedView ArticleGoogle Scholar
- Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, DiBianco R, Zeldis SM, Hendrix GH, Bommer WJ, Elkayam U, Kukin ML, Mallis GI, Sollano JA, Shannon J, Tandon PK, DeMets DL, the PROMISE Study Research Group: Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE Study Research Group. N Engl J Med. 1991, 325: 1468-1475. 10.1056/NEJM199111213252103.PubMedView ArticleGoogle Scholar
- Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, Thakkar R, Padley RJ, Põder P, Kivikko M, SURVIVE Investigators: Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA. 2007, 297: 1883-1891. 10.1001/jama.297.17.1883.PubMedView ArticleGoogle Scholar
- Mebazaa A, Parissis J, Porcher R, Gayat E, Nikolaou M, Boas FV, Delgado JF, Follath F: Short-term survival by treatment among patients hospitalized with acute heart failure: the global ALARM-HF registry using propensity scoring methods. Intensive Care Med. 2011, 37: 290-301. 10.1007/s00134-010-2073-4.PubMedView ArticleGoogle Scholar
- Giglio MT, Marucci M, Testini M, Brienza N: Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials. Br J Anaesth. 2009, 103: 637-646. 10.1093/bja/aep279.PubMedView ArticleGoogle Scholar
- Boyd O, Grounds RM, Bennett ED: A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high-risk surgical patients. JAMA. 1993, 270: 2699-2707. 10.1001/jama.270.22.2699.PubMedView ArticleGoogle Scholar
- Grocott MPW, Hamilton MA, Bennett ED, Harrison D, Rowan K: Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery. Cochrane Database Syst Rev. 2006, 2: CD004082-Google Scholar
- Kapoor PM, Kakani M, Chowdhury U, Choudhury M, Kiran U: Early goal-directed therapy in moderate to high-risk cardiac surgery patients. Ann Card Anaesth. 2008, 11: 27-34. 10.4103/0971-9784.38446.PubMedView ArticleGoogle Scholar
- McKendry M, McGloin H, Saberi D, Caudwell L, Brady AR, Singer M: Randomised controlled trial assessing the impact of a nurse delivered, flow monitored protocol for optimisation of circulatory status after cardiac surgery. BMJ. 2004, 329: 258-10.1136/bmj.38156.767118.7C.PubMedPubMed CentralView ArticleGoogle Scholar
- Pölönen P, Ruokonen E, Hippeläinen M, Pöyhönen M, Takala J: A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg. 2000, 90: 1052-1059. 10.1097/00000539-200005000-00010.PubMedView ArticleGoogle Scholar
- Goepfert MS, Reuter DA, Akyol D, Lamm P, Kilger E, Goetz AE: Goal-directed fluid management reduces vasopressor and catecholamine use in cardiac surgery patients. Intensive Care Med. 2007, 33: 96-103. 10.1007/s00134-006-0404-2.PubMedView ArticleGoogle Scholar
- Singer M: Catecholamine treatment for shock-equally good or bad?. Lancet. 2007, 370: 636-637. 10.1016/S0140-6736(07)61317-8.PubMedView ArticleGoogle Scholar
- Bastien O, Vallet B, French Study Group AGIR: French multicentre survey on the use of inotropes after cardiac surgery. Crit Care. 2005, 9: 241-242. 10.1186/cc3482.PubMedPubMed CentralView ArticleGoogle Scholar
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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PETA's podcast is your source for exciting new developments in the world of PETA and animal rights as well as some classic moments from the PETA vaults.
July 1st, 2008
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| was $475 |
37% off estimated retail price
Exhibit this trendy accessory by Hermes and get noticed everywhere. Crafted from leather, this Hermes bracelet comes with a bold metal loop with brand detailing and features a slide closure. It features black and orange belt options to match your attire. Original Retail Price: USD $475 Gender: Women Condition: Gently Used (This bracelet is slightly scratched and has discoloration marks) Material: Leather, Metal Dimensions: 20 CM(L) 1.2 CM(W) Size: 15-16 CM Includes: Original Box, Replacement Belt
Estimated retail price US $475
Condition:Used - Gently Used (Noticeable, slight signs of wear)
Gender: Women
Condition:Used - Gently Used (Noticeable, slight signs of wear)
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Over 90% of the orders are shipped within 2 business days.Most handbags/shoes/accessories are shipped within 2 business days, while some watches/jewelry take up to 7 business days to ship. If you would like an exact date of delivery, please contact us.
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Hotel Stars Rouen
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TripAdvisor Reviews Hotel Stars Rouen St-Etienne-du-Rouvray
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Day 18 Friday 6th November
We awoke t be in Avignon and low and behold once again we had a vessel attach to outside our window. River cruising has become so popular that mown the river boats have to moor to each other at times and then the guests walk through the vessel closest to the dock to get to land, the first time this happened it was ,a bit off putting but we have adjusted to it. Avignon also dates back ...
Day 17 Thursday 5th November
... for us, this was lovely to watch. This town is known for hiding the Jews and Pierre's mother hid a doctor in the ceiling of her kitchen for 2 years and he was never found by the Germans,afterwards he became the family Doctor. Interestingly this town of 4000 people has several doctors 4 of which are physiatrists . Another of the groups visited a guides home that has been in her family since the war,she was able to show the people ...
A real live chateau and more flowers
... Connor inside to buy the tickets (you guessed it - only one ticket seller working, hence the very long lines) but once tickets were purchased we turned aboutface and followed the rest of the people from the line to (where we hoped) was the entrance to the gardens. Always a worry to be following a group of people in hopes that they know where they are going.
Turns out we were ok and we had entered at the right space. There were so so many ...
Day 8- Paris, France
... happy we got back on our bikes and continued riding to Giverny. The ride was beautiful. Predominately flat with a little incline every now and then. We rode through lush green hillsides passing cattle and horses along the way. Finally we arrived at Monets Gardens. Our guide gave us a rundown of the garden layout with his suggestion as to how we should navigate our way through. The gardens were breathtakingly spectacular!!! We walked along the edge of the ...
Monet's Home and Gardens
... the pond would be enlarged
to its present day size. The water garden is full of asymmetries and curves. It is inspired by the Japanese gardens that Monet knew from the prints he collected avidly. In this water garden you will find the famous Japanese bridge covered with wisterias, other smaller bridges, weeping willows, a bamboo wood and above all the famous nympheas which bloom all summer long. The pond and the surrounding vegetation form an enclosure separated ...


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- matt1168
- Reviews: 105
Ramada Inn- by Hotels Unlimited: Easy and cheap
Recently renovated, the Ramada Inn and Conference Center, at exit 8 of the NJ Turnpike, 20 minutes west of downtown, is a very popular place for business people and those wanting an overnight stay. It contains one of the largest conference and banquet centers in the state, and for a roadside chain hotel is fairly upscale. There is a bistro/coffee shop located off the lobby downstairs. Room service is offered.
There is a courtyard outside with a pool and garden which is great for weddings and during the summer. The views from the rooms are just of the parking lot or Monmouth St. outside.
- matt1168
- Reviews: 105
Colts Neck Inn Hotel: Another full service hotel
The Colts Neck Inn Hotel is a full service hotel which dates from the 1700's, located about 15 minutes east of downtown on Rt. 537. There isn't much information about this hotel available online, and all I really know about it is that it's supposedly very upscale and "haunted", as well as expensive. There is a shopping center across the street, and a weekday-only busstop on the corner.
- matt1168
- Reviews: 105
Hepburn House Hotel: Beautiful Downtown Hotel
The Hepburn house is located in a beautiful Victorian mansion across the street from the courthouse downtown, and only a 5 minute walk from most downtown restaurants, shops, and transportation facilities. Located on a quiet street, this hotel caters to the business and leisure traveller alike, offering (excellent) and free breakfast every morning, with free wine, sherry, and coffee in the lobby all hours of the day. Although it is small, this hotel is tastefully appointed with furnishings and paintings from the 1800's, and each room is decorated in different style. A night in the Barrister's Presidental Suite (one of the most beautiful hotel rooms anywhere, in my opinion) will cost you only $5 more than a regular hotel room at Freehold Gardens during the fall and winter.
The corridors of this hotel are very narrow, and this hotel is not recommended for those who use wheelchairs or have troubles getting up stairs, because all rooms are on the 2nd, 3rd, and 4th floors, and there is no elevator. The chef makes unique and spectacular breakfasts, which are served in the dining area every morning, and during the summer outside on the porch as well. Most rooms afford a view of the street and courthouse.
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7 Health Benefits of Drinking Alcohol
Written on June 16, 2016 By admin in Health
Fresh Juice At Home Can Bring Great Nutritional Value To Your Life
Many people refuse to eat vegetables altogether because they hate the taste. You can get all the great nutrients from vegetables by juicing them. Read the rest of this article to find out other handy tips to make juicing fun for your whole family!
Try using a masticating juicer. These machines extract the juice in a slower way that retains nutrients. Juice from masticating juicers also be stored.
Add cucumber to dark leafy greens for improved flavor. Many of the leafy greens don't taste very good.Cucumber can mask the unpleasant taste and also add a refreshing flavor of its own.
If you're creating juice for any health reasons, start with dark green veggies as the base for your juice. You should choose spinach, broccoli, spinach or any type of similar vegetable in order to achieve ultimate health benefits. Fill the remaining void with your favorite fruits to give it a great taste.
Drink your fresh juice slowly to fully enjoy its flavor.
7 Health Benefits of Drinking Alcohol
Use the color of your fruits and vegetables to help you figure out which nutrients they provide. Fruits range in color, greens and yellows translate to a variety of healthy vitamins and minerals.Using different colored produce will give you more nutrition and many exciting tastes.
Juicing vegetables is another way to get healthy foods into a child who won't eat them whole. Many children are not like vegetables.You can combine fruits and vegetables into one beverage that has a great taste, and the kids won't know they're eating vegetables.
Resource : pixabay.com
If dismantling, make your juice and then clean up, you will be less like to use it on a regular basis. Clean the juicer right after using it since moist pulp is easier to get rid of.
Use cranberries as part of your juicing routine if you are suffering from a bladder problems. Start adding them the moment you start to feel symptoms of a problem.
Consuming ginger is one way to make gastrointestinal problems go away. Ginger has anti-inflammatory properties and can also help to heal any damage done to the digestive system by acid reflux.
They can lend a bitter flavor to juice, so use them in conjunction with sweeter fruits or veggies, like carrots, berries, and citrus. My favorite is a berry blend of strawberries, blueberries, and cherries. Be creative and blend your own great-tasting juices.
A good juicer to have in order to have great fruit juice are masticating juicers. Masticating juicers come with extra features you won't find on most other juices, such as the ability to mill, grind, and puree your juice. These added features can make juicing more fun.
You want to do this variety so you're filling your body up with the ultimate nutritional advantages. You can cover up flavors that you may not really like with lemons and apples.
Cucumber juice has been shown to be beneficial for maintaining healthy hair and skin. There is a lot of the mineral silica in cucumbers. Silica also strengthens connective tissue and is good for muscles, ligaments, ligaments and tendons.
Include a large amount of negative calorie fruits and vegetables in your juices as much as possible so that there is little need to be burned off. Some of these items are broccoli, including the childhood menaces of broccoli, cabbage and kale.
Citrus fruits, like oranges, tangerines and mandarins, and oranges require a special juice extraction machine. Also, be careful when you use melon, as it usually tastes pretty awful when combined with other fruits.
Make it your goal to learn as much as you can about the wide variety of vegetables and fruits available at your local grocery store.Many people do not know all their options for buying fruits there are and have never considered the existence of more than a few types of vegetables. If you commit to explore new flavors and produce, you will find your juice varied and not predictable.
With the tips you just learned, you should now have a better idea of how good juicing is for your body. Turning to juicing to supplement your diet is a good way to get the vitamins and nutrients you need. Juicing is a great way to get the nutrients you need without having to worry about tastes you may associate with particular foods eaten alone.


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North Carolina sophomore forward Justin Jackson will withdraw from the NBA draft and return for his junior campaign, the school announced Monday.
Justin Jackson RumorsAll NBA Players
Justin Jackson
Position: None
Born: 10/13/90
Height: 6-8 / 2.03
Weight:230 lbs. / 104.3 kg.
Born: 10/13/90
Height: 6-8 / 2.03
Weight:230 lbs. / 104.3 kg.
Jeff Goodman: Most NBA executives told ESPN that Justin Jackson would have been selected somewhere in the 40-60 range. NBA guys said that Justin Jackson needs to be more consistent with perimeter shot, extend range, add strength, improve defense.
Rick Bonnell: North Carolina's Justin Jackson, who interviewed with the @Charlotte Hornets at the NBA Combine, said he's 50-50 on whether to stay in the draft.
Jake Fischer: Atlanta Hawks just worked out prospects Taurean Prince, Justin Jackson, Nigel Hayes, Pascal Siakam, Alex Hamilton & Wes Washpun, per source.
University of North Carolina men's basketball players Justin Jackson and Kennedy Meeks will submit their names to the NBA for the 2016 Draft, but will not hire agents at this time and may return to UNC for the 2016-17 season. Underclassmen have until April 24 to enter the Draft. They have until May 25 to withdraw from the Draft to be eligible to play college basketball next season.
Jeff Goodman: North Carolina forward Justin Jackson is expected to declare for the NBA Draft, but will not hire an agent, source told ESPN.


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"Today I'd like to tell you a little bit about the color green . . ."
Green energy is popular. That popularity makes not just likely, but inevitable that promoters will use the cachet of green energy to attract and sometimes defraud investors. This month the North American Securities Administrators Association (NASAA) issued an alert warning investors:
With energy demands and a desire for energy independence increasing globally, investments in traditional and alternative energy resources are being promoted more often and are becoming attractive to more investors. Some examples include: wind turbines, solar panels, biodiesel, ethanol, coal, oil, gas, hydrogen, wave, geothermal, oil sands, and liquefied natural gas. Many of these investments are highly risky and are usually not appropriate for all investors. It is not unusual for unscrupulous promoters to follow the headlines and take advantage of unsuspecting investors by engaging in fraudulent practices.
With energy demands and a desire for energy independence increasing globally, investments in traditional and alternative energy resources are being promoted more often and are becoming attractive to more investors. Some examples include: wind turbines, solar panels, biodiesel, ethanol, coal, oil, gas, hydrogen, wave, geothermal, oil sands, and liquefied natural gas. Many of these investments are highly risky and are usually not appropriate for all investors. It is not unusual for unscrupulous promoters to follow the headlines and take advantage of unsuspecting investors by engaging in fraudulent practices.
"It's not that easy bein' green"
For those who need real-world proof, the Nevada Secretary of State issued a press release announcing that a Reno man had been sentenced to 10 years in prison for swindling investors in an energy scheme. Here in California, the Commissioner issued a desist and refrain order against a group of companies that claimed to be "committed to acquire or build 100 new green energy power plants, focusing on co-generation and solar technologies". 808 Investments, LLC et al. (Jan. 19, 2010).
"When green is all there is to be"
Thus, it is particularly alarming to see that the California legislature is considering a bill, SB 43 (Wolk), that would add "bill credits" to the list of exempt securities in Corporations Code Section 25100. In general SB 43 allows consumers to purchase an interest in a "community renewable energy facility" and receive a bill credit for the generation component of the customer's electrical service. These investments should not be given a pass from the qualification requirements of the Corporate Securities Law simply because they are "green".
See more »
DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
© Allen Matkins Leck Gamble Mallory & Natsis LLP
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About JohnnyParker
I am Johnny Parker and I am 22. I have studied the weather since I was 5. I have cerebral palsy and my goal is to become a meteorologist.
By: JohnnyParker , 11:24 AM GMT on July 29, 2013
Good Morning! At Smithville, MS, the current temperature is 64 and it feels like 64. Highs will continue to range between 86 and 93 with lows between 66 and 72. There is a 30% chance of isolated thunderstorms on Tuesday, a 40% chance of scattered thunderstorms on Wednesday, and a 40% chance of scattered thunderstorms on Thursday. At the Regional Rehab Center in Tupelo, MS, the current temperature is 67 and it feels like 67. Todays high is 91 with a low of 68. Tuesdays high is 93 with a 30% chance of isolated thunderstorms.
Now, for your severe weather update for the Southeast Region. Could see severe weather potential around August 5th-13th.
Now, for your tropical update. In the Atlantic, a trough of low pressure, associated with the remnants of Dorian, is producing an area of disorganized thunderstorms a couple hundred miles North of the Leeward Islands. Recent satellite-derived surface wind date indicate that this disturbance does not have a closed surface circulation and surface pressures remain high across the area. Environmental conditions are expected to be only marginally conducive for regeneration to occur today before becoming less favorable on Tuesday. The National Hurricane Center is giving this system a 50% chance of becoming a tropical cyclone during the next 48 hours as it moves Westward at 15 to 20mph. This disturbance is expected to pass well the North of Puerto Rico today and move over the Turks/Caicos Islands and the Southeastern Bahamas on Tuesday. An Air Force Reserve Unit Reconnaissance Aircraft is scheduled to investigate this disturbance this afternoon if necessary. In the Eastern Pacific, all is quiet.
Hope yall are having a great Monday and I'll have another post tomorrow morning.
The views of the author are his/her own and do not necessarily represent the position of The Weather Company or its parent, IBM.
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text: Seller: kaspy (724) 100%, Location: Nipomo, California, Ships to: US & many other countries, Item: 122225633211 You will get one AmerTac Solid Metal duel Light Switch Plate Cover 60TT Rose Brass Colored Ornate. It is in great shape and have the original screws included. •You will receive what is shown in the pictures. Please look at the pictures for further description and condition of the item. Please email with any questions. •Shipping is for the United States. International shipping is extra through the eBay global shipping program. •Items are usually shipped within 1 BUSINESS day after payment. •If the item arrives and you are not happy with it, please contact me and we can make it right. Thanks. Color: Brass colored, Maker: AmerTac, Material: Metal


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Sunlit office space on 2nd floor. Ideal for accountant, lawyer, etc. All utilities included plus 1 parking space. Front & side entrance. Steps to Crestwood railroad.
© 2015 Renwick Sotheby's Real Estate LLC
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text:
Evolutionary Phonology
The Emergence of Sound Patterns
By (author) Juliette Blevins
Format: Hardback
Normal Price: $185.00
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Availability: Available to Backorder, No Due Date for Supply
Evolutionary Phonology by Juliette Blevins
Book DescriptionEvolutionary Phonology is a theory of sound patterns which synthesizes results in historical linguistics, phonetics and phonological theory. In this book, Juliette Blevins explores the nature of sounds patterns and sound change in human language over the past 7000-8000 years, the time depth for which the comparative method is reasonably reliable. This book presents an approach to the problem of how genetically unrelated languages, from families as far apart as Native American, Australian Aboriginal, Austronesian and Indo-European, can often show similar sound patterns, and also tackles the converse problem of why there are notable exceptions to most of the patterns that are often regarded as universal tendencies or constraints. It argues that in both cases, a formal model of sound change that integrates phonetic variation and patterns of misperception can account for attested sound systems without reference to markedness or naturalness within the synchronic grammar.
Buy Evolutionary Phonology book by Juliette Blevins from Australia's Online Bookstore, Boomerang Books.
Book DetailsISBN: 9780521804288
(228mm x 152mm x 25mm)
Pages: 388
Imprint: Cambridge University Press
Publisher: Cambridge University Press
Publish Date: 22-Jul-2004
Country of Publication: United Kingdom
Other Editions...
Books By Author Juliette Blevins
Analogy in Grammar, Hardback (July 2009)
In this book, leading researchers in morphology, syntax, language acquisition, psycholinguistics, and computational linguistics address central questions about the form and acquisition of analogy in grammar.
Contemporary Views on Architecture and Representations in Phonology, Paperback (May 2009)
Leading phonologists discuss contemporary work on the topics of metrical theory, feature theory, syllable theory, and the relation among grammatical modules.
Evolutionary Phonology, Paperback (November 2007)» View all books by Juliette Blevins
Explores the nature of sound change in human language over the past 7000-8000 years.
» Have you read this book? We'd like to know what you think about it - write a review about Evolutionary Phonology book by Juliette Blevins and you'll earn 50c in Boomerang Bucks loyalty dollars (you must be a member - it's free to sign up!)
Author Biography - Juliette Blevins
Juliette Blevins was formerly Visiting Professor at the Department of Linguistics, University of California, Berkeley, and joined the Department of Linguistics at the Max Planck Institute for Evolutionary Anthropology, Leipzig, in Fall 2004.
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- Personalize Your Bern Trip
- What style do you prefer?
- Plan Your Bern Trip
- Get the best Bern has to offer
BERN - the best insider tips for vacation, holiday & travel
The city of Bern is situated at the river Aare and Switzerland's sleepy capital, is gate to the French speaking part of Switzerland and located about 20 km north of the Bernese Alps (Jungfraujoch); Bern was founded by the Duke Berchtold V of Zähringen and named after a bear he had killed.
Start your journey at the mainstation, walk towards The Federal Palace (Bundeshaus) make a stop over at the most beautiful hotel of Bern - "The Bellevue" and have a drink on the sun-terrrace; Visit also the landmark "Zytglogge" (Time Bell) - a medieval clock tower with moving puppets- and the newly renovated "Bärengraben" (bear pit) where real bears are living and waiting for your "goodies".
Bern's city center is known for its medieval part, its "covered arcades" and that the locals are speaking slower then the rest of Switzerland; last but not least a cultural highlight is the "Zentrum Paul Klee" - a great museum including a wonderful restaurant called "Schöngrün" dedicated to the Swiss painter Paul Klee.
Bern - our favourite boutique hotels, best restaurants, hottest nightclubs and golf courses. Just hotspots!
WorldTop7 presents the hottest choices for the Bern's best luxury boutique and design hotels, Bern's best night clubs and bars, the best restaurants in Bern, Switzerland.
Bern Tips - Bern, the best insider tips for vacation, holiday & travel
WorldTop7 iphone city guides include information about the best restaurants, nightlife, clubs, bars and events. Have dinner in one of the best restaurants and party in the trendiest... read more


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Results 1 to 5 of 5
- 04-27-2013, 05:55 AM Thread Author #1
Keyboard defaulting is driving me up the wall
I've done some searching, but can't seem to find a solution to my particular problem.
I'm using a Nexus 7 with the default screen displayed keyboard.
I do a lot of spreadsheet work on the N7 using Kingsoft Office, but the real bummer is the keyboard.
Doing a lot of entries on the spreadsheet, I don't want the (Bad word) keyboard to automatically go from 123 back to Alpha everytime I do something.
It there a way/setting I can action to keep the keyboard in 123 mode all the time I'm working on sheets.
- 05-01-2013, 02:05 PM Thread Author #2
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- 05-07-2013, 02:05 AM Thread Author #4
Re: Keyboard defaulting is driving me up the wall
I was looking for some configuration, but but never found one... No-one here replied so I though about it some more. Xperimented and Eureka!
This is a Nexus 7 keyboard BTW, so dunno about yours.
Sheet on screen, keyboard displayed, and directly above it is the writable box, it has a "T" on the left hand end and "Tab" and Re-do arrow on the Righthand end.
Tap the LH end "T" and a numeric keyset will display (I thought is was a calculator).
Tap in the numbers, then tap the cell into which they are meant for... The numeric display will stay in place until all the numeric data has been entered.
To get back to the usual keyboard, tap the "123" that now displays on the left end in place of the "T"
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text:
Hey I have a question, title says it al.
Should I buy 20 cr NB or 40?
I know you get 7 with 40 and 3 with 20 but maybe you could get better cards with the 20 cr NB ?
Thanks !!
If you deem yourself very very Lucky, 2x 20 credit packs might be better. A pack has no doubles, meaning you could receive 2 Ravens by purchasing 2x 20 cred NB packs. But you can get only 1 Raven from opening the 40 cred NB pack.
But like Battery and Bliss have pointed out 40 cred pack is a safer/better choice.
If you can wait, buy the 40 cred NB on next Friday after the new cards (possibly new clan also) are released.
If you can't wait, buy the Elite 40 cred pack.


text:
Why try when it doesn't even matter.
Nothing will ever phase you,
in your eyes she always be a failer.
Why try when it all ends in a fight, you're to short tempered for her to even say hi.
It's so hard to breathe when the weight of your words crash down on her,
they cut a lot deeper than you think.
Why try, you'll never change,
things will always be the same.
While you yell and curse she can tell it's going to e one of "those" nights.
One of those sleepless nights where she cries to the point tears won't fall anymore.
Why try, this is her life,
but why is this something she has to get used to?
What's wrong with society these days?
Who says chubby can't be beautiful?
Who says acne is not acceptable?
Who sets these so called standards we strive to live by?
Take a stand!
Stop bullying, stop pretending you don't notice.
That girl who everyone picks on needs you.
© Copyright 2017 Reylene Abbott. All rights reserved.
Status: Finished
Genre: Poetry
Book / Romance
Short Story / Other
Short Story / Literary Fiction
Paste the link to picture in the entry below:
Paste the link to Youtube video in the following entry:
Cannot annotate a non-flat selection. Make sure your selection starts and ends within the same node.
An annotation cannot contain another annotation.
There was an error uploading your file.


text:
Bellator chief Scott Coker praised Brennan Ward's "big heart" after the welterweight rescued a baby from a busy intersection.Filed under: Bellator, News read news >>
MMA fighter and former UFC light heavyweight champion Jon Jones has hired his nutritionist, Lou Giordano, to also serve as his full-time driver after a recent incident that resulted in his being issu read news >>
After his latest traffic infraction, former UFC champion Jon Jones will need the permission of his probation officer to use a motor vehicle.Filed under: Featured, News, UFC read news >>
Former UFC champion Jon Jones spoke to Ariel Helwani of MMAFighting.com on The MMA Hour on Monday and revealed he was pulled over by police several days ago, cited for drag racing and issued five sep read news >>
Although he is currently on probation, Jon Jones avoided any further complications from traffic citations on Wednesday, eventually agreeing to a $100 donation. read news >>
Audio of Jon Jones' recent traffic stop indicates he got a break, and could have been charged with reckless driving instead of the lesser citations he received. read news >>
Former UFC light heavyweight champion Jon Jones' court case involving three recent traffic citations has been delayed until late March. read news >>
Former UFC light heavyweight champion Jon Jones' day in court on a trio of traffic charges is delayed until March. Filed under: News, UFC read news >>
Former UFC champ Jon Jones responded to critics of his recent traffic violation by posting a video on Instagram. read news >>
Jon Jones will be back before the court in Albuquerque, N.M., this week for a traffic violation, but it doesn't appear it will affect his current probation. read news >>
Bellator featherweight Daniel Straus was arrested Friday on traffic and drug charges in Fort Lauderdale, Fla. read news >>
According to a report from Brazil's UOL Esporte, UFC featherweight
champion Jose Aldo was involved in a weekend traffic accident but walked
away relatively unscathed.
The UFC 153 headliner was r read news >>
A choke-out, traffic congestion, a missed flight, torrential downpours, tornadoes, a late-notice booking and now energy-depleting altitude have all met Tommy Hayden early in his UFC career.
Howe read news >>


text:
Parks Canada
Home > National Parks of Canada > Fundy National Park > Activities > Volunteering
Parks Canada welcomes over 6,000 volunteers to our National Parks and National Historic Sites each year. By getting involved with Fundy National Park's volunteer program, you too can become a part of this legacy, while helping us protect and preserve this special place and share its wonders with others. You'll discover meaningful and hands-on ways to deepen your connection to incredible natural spaces, not to mention meet new people, build career skills, and have fun!
Our volunteer program is growing! Check back regularly for new opportunities to get involved.
Join interpreters for programs that bring you up close and personal with research and monitoring efforts in Fundy National Park. Check the activity schedule for times and dates of these exciting opportunities.
Check in at the Fundy National Park Visitor Centre to report your wildlife sightings, or share your sightings via Facebook or Twitter. We are especially interested in sightings of the following species: Canada lynx, bobcat, coyote, red fox, black bear, American marten, fisher, moose, deer, Atlantic salmon, American eel, bats, butterflies and dragonflies.
For more information on how you can get involved, contact Fundy's Volunteer Coordinator.


text:
Hello, myphone44!
Have you seen any more strange codes? Unfortunately it's difficult to say what the code is. Is it showing incoming or outgoing? Is it showing as a phone number? Or is it in the contents of a text message?
Some third parties do use text message codes for promotions, contests, and updates. It's possible this is what you're seeing.
If you would like to send us a private message by clicking here, we can try to find out what the code means, but if it's not from AT&T, we can't guarantee we'll find an answer.
Should you choose to send us a message, please include your name, phone number, email address, and the best time to reach you. You can expect a reply within two business days, so keep an eye on the little blue envelope icon in the top right corner of your screen.
In the meantime, please let me know if you have any additional questions or concerns!
Welcome to the AT&T Community Forums!!! Stop by the Community How-To section for tips on how to get started.
This link will open a new window
© 2017 AT&T Intellectual Property.This link will open a new window All rights reserved. AT&T, Globe logo, Mobilizing Your World and DIRECTV are registered trademarks of AT&T Intellectual Property and/or AT&T affiliated companies. All other marks are the property of their respective owners.
Congratulations! You earned the Liz badge!


text:
The Washington Capitals honor a lot of charities, something many teams do. Playing in the city that houses the countries government, though, creates a special bond with the military. The team skates with families of the fallen, recognizes injured soldiers during games, and raises money for military charities.
On Thursday, the Caps did even more, holding their 10th annual Military Appreciation Night. The Caps wore desert camouflage jerseys during warmups (auctioned off during the game), and hosted the Navy Mites on Ice team and the USA Warriors hockey team during the intermissions. A number of tickets were also given away to soldiers and veterans.
Below, take a look at some photos of the special jerseys:
Holt stand
Ovie looks good with the facial hair!
no pictures on Backstrom? he was using the new Bauer APX2 stick tonight.. anyone got a good picture of it?
I respect the reason for them, but I couldn't stand these jerseys. Until I saw it on Holtby.
Great photos , Chris!
I love useless gestures in "support" of the troops. If people really wanted to honor the troops they would march on Washington and demand that our boys be brought home from pointless wars.
I am not in the DC area but as a Veteran and a Capitals fan I would love to owe one of these. Any one know how to aquire em if I am not at the game ?
Russian Machine Never Breaks is not associated with the Washington Capitals; Monumental Sports, the NHL, or its properties. Not even a little bit.
All original content on russianmachineneverbreaks.com is licensed under Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)– unless otherwise stated or superseded by another license. You are free to share, copy, and remix this content so long as it is attributed, done for noncommercial purposes, and done so under a license similar to this one.


text:
British Columbia Minorities
Canada British Columbia British Columbia Minorities
Ethno-Cultural Groups in Canada
For guides to relevant Canadian records for some groups, see Ethno-Cultural Groups topics at Library and Archives Canada, Includes Acadians, Blacks, Chinese, Doukhobors, Dutch, East Indians, Finns, Germans, Greeks, Irish, Italians, Japanese, Jews, Métis, Poles, Russians, Scots and Ukrainians.
See Multicultural Canada, Simon Fraser University for digitized newspapers and other digital collections.
Black Genealogy and History in British Columbia
British Columbia Black History Awareness Society
Black History in British Columbia, video on 1950s emigration to BC, Provincial Capital Commission.
Black History in British Columbia, Historica. Links to articles and websites, includes family histories.
Chinese-Canadian Genealogy and History in British Columbia
Chinese-Canadian Genealogy website, Vancouver Public Library. Information on researching records unique to Chinese Canadians, for example, head tax records and on researching names.
Siyi Genealogy, for research into families from Guangdong, China. Research articles, albums, forum.
The Chinese Canadian Experience in British Columbia, 1850-1950, on-line exhibit and digital collections, University of British Columbia Library, Vancouver, BC.
Chinese Canadian Historical Society of British Columbia, Vancouver, BC.
Chinese Canadian Military Museum Society, Vancouver, BC.
Doukhobor Genealogy and History in British Columbia
Doukhobor Genealogy Website, settlement history, membership lists, cemeteries and more.
Japanese-Canadian Genealogy and History in British Columbia
Nikkei National Museum, Burnaby, BC, digital collections, oral history, library and archives.
Kaslo, WW II, BC Japanese Canadian Museum, on-line exhibit.


text:
After a couple of weeks of intense debate over budget plans proposed in the House and Senate, you may feel that this week's Congressional recess is a welcome break from talk of taxes and spending, deficits and debt. But Congress is back in session April 8 – and the budget battles will return, too.
Wondering if you need to pay attention during the next round? The short answer is yes – because when some of our leaders in Washington talk about cutting spending in the federal budget, they're actually talking about cutting services that women and their families depend on. To learn more about why budget issues are really important women's issues, take a look at this new video from NWLC and the National Priorities Project. It's a few minutes well spent.
p.s. This video is the first in a two-part series – check out Part 2 right here.


text:
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Hi All some advise please...rumour has it that obtaining a Sudan visa at the Embassy in South Africa has a very low success rate and that it takes almost 2 weeks...also that one can fly to Nairboi and get a visa on the same day at the Sudan Embassy in Nairobi. Does anyone know if this will work or has heard of someone who has done this? Thanks.
Generally speaking it's fine, expensive but fine. Then are flare-ups of protests from time to time, but the same could... more
yes it depend on the person life ,,some people like to have ِAristocratic life and some like the simple life , but I... more
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Original publication date: Jan. 7 2013
A 53-year-old Chandler woman was arrested late Sunday on suspicion of threatening to kill her husband after she told police that they "stopped having sex," according to a court document.
At about 11:12 p.m., Gloria Pratt reportedly called police on her husband of two years at their home in Chandler because she said she was upset, according to police.
Upon arriving, officers observed that Pratt was intoxicated, was told about the no-sex and determined that no crime had been committed by either Pratt or her husband, police said.
Police said they wished them luck and left the home, according to a court document.
The document states that about one minute later, officers saw Pratt through a living room window of their home yelling at her husband to "do something" while he was laying on a couch, according to police.
She then reportedly yelled, "I'm going to kill you," before walking toward the kitchen, according to a court document.
The officers knocked on the front door and detained Pratt at about 11:32 p.m., police said.
She was arrested and booked into the Fourth Avenue Jail on suspicion of disorderly conduct-domestic violence and threats-domestic violence, according to a court document.
After being arrested, Pratt reportedly told police that her husband "would get what was coming to him now," according to police.


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text:
Customer Service with German or French language
Aby odświeżyć kliknij tutaj
Pełna treść ogłoszenia Customer Service with German or French language
Exciting, demanding, rewarding
three words that sum up the working day at Serco
Step into the adventure and join Our easyJet Team as:
Customer Services with German or French language
Ref. no.: ST/KM/042014
Place of work: Kraków
Main responsibilities:
Provide support to clients in travel industry sector (via telephone, e-mail, chat)
Handle all enquiries from easyJet Customers via Facebook and Twitter
Respond to queries sent directly by Client
Notify customers of any changes in their journey
Cooperation with customers with special needs during travel
Work with colleagues to ensure Clients expectations are meet
Candidate profile:
Excellent written and oral skills in German or French
Good command of the English language
Excellent customer care and proactive attitude
Confident, flexible and results oriented approach,
Be positive, enthusiastic and proactive outlook,
Willingness to work on shifts
Competitive salary (plus extra bonuses)
Attractive benefits package
Full-paid appropriate training
Private medical care for you and for your family (including dental care after upgrading package)
Employee Referral Award Program
Great development opportunities in an international, fast paced company
A multicultural, great working environment
Fast recruitment process taking 2-3 weeks, with a remote application systems