text:
Bordeaux Red Blends from Argentina, South America
Winemaker's Notes
Intense, deep red color with fine hints of crimson. The nose offers pleasant aromas of red and dark fruit, with redcurrants, also some mint and cedar. The bouquet fills out with notes of vanilla, spices and mocha, characteristic of French oak. This is a dense, complex wine, with good tannic structure. The lingering finesse of the tannins gives the wine good length and a pleasant, soft mouthfeel. Deep, aromatic and complex with very appealing intense fruit. Has yet to reach its peak.
Critical Acclaim
The Wine Advocate - "The 2009 Caro Blend is made up of 60% Malbec and 40% Cabernet Sauvignon aged for 18 months in 80% new French oak. A glass-coating opaque purple color, it is a serious wine with a Bordeaux-like personality. Captivating aromas of sandalwood, exotic spices, violets, leather, and assorted black fruits titillate the nose while pointing to a full-bodied, plush, layered wine that manages to stay light on its feet despite its size. It is the best Caro that I have tasted to date and mandates another 3-4 years of cellaring, reaching its peak from 2015 to 2029. "
Wine Spectator - "Powerful, with smoke, spice and toasty oak notes accenting the dark plum skin, kirsch and cassis fruit that gives way to full tannins and a long, smoky finish."
Bodegas Caro Winery
CARO was born of an alliance between two wine cultures (French and Argentine), two noble grape varieties (Cabernet Sauvignon and Malbec), and two renowned wine families (Domaines Barons de Rothschild (Lafite) and Nicolas Catena.)
Immediately after CARO's 2002 release, the first vintage of CARO, 2000, was acclaimed by professionals. The achievement of CARO has naturally led the partners to elaborate another wine based on the traditional Argentinean Malbec, conserving the fine balance between the characteristics of Argentina and the style of Bordeaux wines. As a commemoration to the Andean roots, the Indian name of a pretty little flower, which grows on the high altitude of the Andes has been chosen: Amancaya.
Vignerons since the 19th century, these two powerful organizations have combined their deep knowledge of Mendoza's high altitude terroir and the art of winemaking to create truly unique wine. View all Bodegas Caro Wines
About ArgentinaView a map of Argentina wineries (ahr-jen-TEE-nah)
Notable FactsUnlike its Chilean neighbor, Argentina's vineyards are spread out around the country. The best known region is Mendoza, almost parallel to Santiago to the west. Mendoza contains the sub-regions of Maipu (pronounced MY-pu) and San Rafael. Grape-wise, the most important white is Chardonnay, making wine similar to California's style on the variety. Another fun white grape to try is Torrontes. Almost only grown in Argentina, Torrontes makes wines that are crisp, aromatic and easy-drinking. Some of the best versions of this wine come from the northern region of Salta, with very high altitude vineyards. As for the reds, Cabernet Sauvignon is the main grape for many wines leaving the country, but Malbec, the grape Argentinians like to call their own, makes very distinctive wines that are structured, dense and velvety. Many more varieties happily grow in the country, but for export, and consistent quality, these are the primary grapes.
About South AmericaRelated Links:
Young, organically farmed Carmenère at Chile's De Martino estate vineyard
Customer ReviewsSign In to Add Your Review5 }div>5 out of 5 stars
- 5 Stars: 1
- 4 Stars: 0
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- 2 Stars: 0
- 1 Stars: 0
Alcohol By Volume GuideMost wine ranges from 10-16% alcohol by volume. Some varietals tend to have higher (for example Zinfandel and Cabernet Sauvignon) or lower alcohol levels (Pinot Noir and many white varietals), but there is always some variation from producer to producer. Some wine falls outside of this range, for instance Port weighs in closer to 20%, while Muscat and Riesling are usually a bit below 10%.
Wine Style Guide
Light & Fruity
- Red wines that are more fruit-forward and lighter in tannin and body.
Smooth & Supple
- Medium bodied reds that go down easy, with smooth tannins and supple fruit.
Earthy & Spicy
- Wines where earthy and/or spicy dominate the flavors – typically medium to full body.
Big & Bold
- Full bodied wines that have concentrated fruit and are higher in alcohol and/or tannins. Some need age.
- 5 Stars:


text:
'12 current account surplus hits $7.1B
Increasing remittances, rise in export receipts cited
popular .
The country's current account surplus increased slightly in 2012 in view of the continued rise in foreign exchange remittances and the recovery of the export sector.
The Bangko Sentral ng Pilipinas on FRiday reported that the current account posted a surplus of $7.1 billion in 2012, up from $7 billion in the previous year.
Current account is the sum of the balance of trade (export receipts minus payment for imports), earnings on foreign investments less payments made to foreign investors, and cash transfers or remittances. Surplus indicates that the foreign exchange inflows resulting from these transactions exceed foreign exchange outflows.
It is one of the three basic components of the country's balance of payments (BOP), a record of a country's commercial transactions with the rest of the world.
Remittances hit a new high last year as global demand for Filipino workers remained strong despite economies woes in industrialized countries. Officials said demand from alternative labor markets, such as the Middle East, led the increase in the deployment of Filipino workers.
Money sent by migrants reached $21.39 billion last year, up by 6.3 percent from $20.12 billion in 2011.
The Philippines is the world's fourth biggest recipient of remittances, next to China, India, and Mexico. There are presently more than 10 million Filipinos working offshore.
In the meantime, an improvement in the country's export performance in 2012 helped boost the current account surplus. The Philippines posted $46.3 billion in export receipts in 2012, a 20.9-percent year-on-year growth, reversing the contraction in 2011.
Philippine exports declined in 2011 as global demand for non-essentials, led by electronics, fell amid economic problems in industrialized countries. Electronics products account for at least half of the country's total export earnings.
The BSP also reported that the country's financial and capital accounts, the other components of the BOP, posted a surplus of $136 million and $6.1 billion, respectively. The financial account surplus was up 4.6-percent year-on-year, while the capital account was up by 9.3 percent year-on-year.
Inflows recorded in the capital account were led by grants and donations to the Philippine government. Inflows recorded in the financial account were mainly foreign portfolio and direct investments.
According to the central bank, the robust inflow of foreign portfolio investments and foreign investments in the country's business process outsourcing (BPO) sector fueled the growth in the financial account surplus.
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subset: commoncrawl


text:
New Polar RC3 GPS Watch At Lowest Holiday Prices At Heart Rate Watch Company
Save 20% to 25% off the new Polar RC3 GPS watch, the first ever fully integrated GPS watch from Polar, at the Heart Rate Watch Company now through December 21st.
Bozeman, MT (PRWEB) December 08, 2012
The Polar RC3 is the first-ever fully integrated GPS watch from the folks at Polar, the same people that invented the heart rate monitor back in the 1970′s.
"The Polar RC3 comes in three versions one without a chest strap for those already owning a Polar WIND Wearlink strap, one with a chest strap and a bike version with a speed sensor", says Rusty Squire, President of the Heart Rate Watch Company. He adds, "We are offering 20% to 25% off on these new Polar GPS watch units until December 20th".
"My first impression when I put one on was how light it was and how thin it was compared to other GPS watches", says Squire. "I put it on a postage scale and it was 40% lighter than my Suunto Ambit".
Polar RC3 offers 12 hours of battery life, probably closer to 10 in normal use according to Squire, while many of it's competitors offer eight hours, which is more like 6 according to Squire under normal use. "That is a big increase in battery life for a watch that is this light and thin, plus Polar is using softer more pliable material in their wrist straps, making them more comfortable", says Squire.
To go with the purchase of any new Polar RC3 GPS watch the Heart Rate Watch Company is offering two free fitness books valued at $50. The book "How To Successfully Use A Heart Rate Monitor" and "How To Elevate Fitness Through Strength and Interval Training" are e-books that can be downloaded in PDF format.
For the original version on PRWeb visit: http://www.prweb.com/releases/prweb2012/12/prweb10218876.htm


text:
The Little Girl Named Kelise
The Tiko Black Collection Vol. 1
by Photographer Tiko Black
The Little Girl Named Kelise is a photojournalistic account of the life and character of a five year old child prodigy. The Little Girl Named Kelise is Photographer Tiko Black's first published book.
Call A Photographer.com is a company comprised of many seasoned Photographers whose skills sets range from Portraiture, Photo Journalism, and Upscale Event Photography.
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text:
Last post Jun 19, 2010 01:10 AM by JonathanWood
Apr 11, 2008 06:03 PM|TopographicOceans|LINK
Could someone please help me with this?
I want a User to be able to come back to a Page without having to Log In again.
Example: a User Logs In with Login.aspx . . they are taken to the MainPage.aspx . .
they return to MainPage.aspx the next day and don't have to Log In
(this will only happen if the User checks the "remember me" box)
I'm not using the WebSite Administration Tool.
I just want to secure a few pages, using WebConfig:
<location path="MainPage.aspx">
<deny users="?" />
This is what I have in the Login.aspx - Log_In_Click button:
... after checking password:
FormsAuthenticationTicket tkt;
string cookiestr;
HttpCookie ck;
tkt = new FormsAuthenticationTicket(1, "DBMJ", DateTime.Now,
DateTime.Now.AddYears(1), chkPersistCookie.Checked, "your custom data");
cookiestr = FormsAuthentication.Encrypt(tkt);
ck = new HttpCookie(FormsAuthentication.FormsCookieName, cookiestr);
if (chkPersistCookie.Checked)
ck.Expires = tkt.Expiration;
ck.Path = FormsAuthentication.FormsCookiePath;
Response.Redirect("MainPage.aspx", true);
How do I implement it so the user doesn't have to log back in if (chkPersistCookie.Checked) is checked? Thanks...........
Apr 11, 2008 06:23 PM|mfouwaaz|LINK
Are you using the login control? If so you can change the property 'RememberMeSet' to True -- that will make the cookie persist. If you do not want the 'remember me' box to be displayed you can also change the property 'DisplayRememberMe' to False.
I hope this was your question!
Apr 11, 2008 06:59 PM|TopographicOceans|LINK
I'm not using the WebSite Administration Tool. I'm coding it all myself.
Apr 12, 2008 03:28 PM|TopographicOceans|LINK
I guess I should check the cookie in the Log In page first.
30664 Points
Apr 15, 2008 08:04 AM|XiaoYong Dai – MSFT|LINK
AuthenticationTicket will help you keep a User logged in after signing in. The ticket is passed as the value of the forms authentication cookie with each request and is used by forms authentication, on the server, to identify an authenticated user.
For example:
If the ticket is marked as persistent, where the cookie is stored on the client box, browsers can use the same authentication cookie to log on to the Web site any time. However, we can use the FormsAuthentication.SignOut method to delete persistent or non-persistent cookies explicitly.
Please view this link for detailed information
699 Points
Jun 19, 2010 01:10 AM|JonathanWood|LINK
I don't know what you guys are talking about.
When I set the 'Keep me logged in' option to true, it keeps me logged in for around 15-20 minutes. Has anyone actually tried this the next day?


text:
See all spa hotels in Kaprun
Hotels in the most popular areas of Austria
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See different types of accommodation in Kaprun
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Best Places to Shop for the Holidays
Why not treat yourself to a wonderful holiday shopping experience away from home? Come on! You deserve a special gift too, so let's travel to the best places to shop for the holidays! ...
New Zealand: Beyond the Hobbit
It breaks my heart when I hear of travelers only heading to this beautiful land to take a Hobbit tour. There is so much more of this country to see besides where a movie was filmed. So let's go beyond The Hobbit...
Top 5 Spas Hotels for Ski Buffs
If you adore skiing in some of the world's most exciting resorts, you're certain to make relaxing at the end of s great day on the piste high on your list of priorities. Spas for skiing fans are more popular than ever,...


text:
Home Future StudentsCurrent StudentsFaculty & StaffPatientsAlumni
A-Z | UCD Access | Canvas | E*Value | Web Mail
Do you have what it takes to be a pharmacist? The Pharmacist Hunter searches for "pharmies" in a variety of natural habitats.
Episode 1
The Pharmacist Hunter is back and he's on a quest to discover what students (aka pharmies) do during pharmacy school. From classwork to service learning experiences to rotations in their final year, the videos highlight the evolution of pharmies through four years of graduate school.
Episode 2
Episode 3
© The Regents of the University of Colorado, a body corporate. All rights reserved.
All trademarks are registered property of the University. Used by permission only.


text:
Terms recent incident "distressing," in letter to Manmohan
Attacks on Tamil fishermen by Sri Lankan Navy should be viewed as a national issue and not an isolated problem of Tamil Nadu, Chief Minister Jayalalithaa stated in a letter to Prime Minister Manmohan Singh on Tuesday.
It was sent in the wake of reports of the Sri Lankan Navy chasing away Tamil fishermen by firing in the air, off Mandapam coast in Ramanathapuram district on October 8.
The incident happened the same day Foreign Secretary Ranjan Mathai called on Ms. Jayalalithaa on his way to Colombo.
She described as "distressing," that the attack took place even before the Foreign Secretary reached Colombo.
She had brought to Mr. Mathai's notice various incidents and attacks on Tamil fishermen and requested him to take up these issues with the Sri Lankan government. Sri Lanka was on the one hand participating in various Indo-Sri Lanka meetings to resolve fishermen's problems, and on the other "resorting to violence against our fishermen."
She said that the harassment of fishermen should be viewed as an act of provocation and aggression against India by Sri Lanka. These attacks on fishermen who eked out a living peacefully in their traditional areas of fishing in the Palk Bay area were similar to the acts of firing across the border by Pakistan and China. Pointing out that there had been as many as 16 incidents of attacks, harassment and apprehension of Tamil fishermen by the Sri Lankan authorities since the AIADMK government assumed office, Ms. Jayalalithaa said there was a uniform pattern of either the Sri Lankan Navy or miscreants from Sri Lanka committing such acts.
"The Indian fishermen, especially belonging to Nagapattinam and Ramanathapuram districts, venture out into sea for fishing with the constant fear of being attacked by the Sri Lankan Navy or miscreants."
Keywords: Tamil Nadu Chief Minister, Jayalalithaa, Manmohan Singh, attacks on fishermen, Sri Lankan Navy


text:
Robinson Cano hit his 200th career homer
Aug 20, 2013, 2:30 PM EDT
The Yankees found themselves down 4-0 in the second inning but they came back with three more runs in the third thanks to Robinson Cano's three-run homer. It was his 200th in his career. Here it is:
Andrew Mearns of Pinstriped Bible had a nice post recently about Cano's milestone homers in the past. I'm guessing many wouldn't have guessed that his first one came off of Doug Creek. I'm guessing most people outside of the Creek family are even aware of Doug Creek.
As we mentioned on HBT Daily this morning, Cano is poised for a big, big contract. The question, given his age, the history of second basemen aging poorly and given how many large, albatross contracts given to guys on the wrong side of 30 we've seen lately, is what kind of Cano can expect. And whether his best baseball is behind him along with those 200 homers.
- number42is1 - Aug 20, 2013 at 2:34 PM
what he SHOULD get from the Yanks: 6 years 120-135 Mil with a 7th year mutual option or buyout
what the Yanks WILL offer him: 8 years 175-200 Mil with a 9th year player option.. sigh….
- proudlycanadian - Aug 20, 2013 at 2:39 PM
Nice home run, that made up for the botched play he made in the top of the inning. He butchered a ball hit by Lind and Lind was credited with a hit. It should have been an error.Blue Jay play by play announcer Buck Martinez, dryly said "Cano only has 4 errors on the season and now we know why."
- dirtyharry1971 - Aug 20, 2013 at 10:15 PM
What else does Buck Martinez have to talk about doing bluejay games? "well folks the jays lost another one!!" I mean come on really? I wonder what he said in game 2? "well the jays lost another series" I can only imagine the crickets you hear when listening to a jays game on radio or tv!!!
- El Bravo - Aug 20, 2013 at 2:50 PM
Can O Whoop Ass
- yankees218 - Aug 20, 2013 at 5:52 PM
@proudlycanadian "and now we know why"?? Are you serious? Cano is one of the best defensive, not to mention offensive 2B in the majors.
- proudlycanadian - Aug 20, 2013 at 9:04 PM
Even All Stars make mistakes. Cano screwed up on that play and should have been credited with an error. He got a home town call by the official scorer. The home town scorer was protecting Cano, and Buck Martinez was simply wondering how many other times the home town scorer had protected Cano. I suspect that if Lind had scored, that the official scorer would have changed it to an error so that the Yankee pitcher would not have been charged with an error.
- badintent - Aug 21, 2013 at 2:01 AM
Are you proud of that scum bucket Canadian Dumphead Dempster Eh, eh ?? He couldn't play hockey , and now he can't play baseball, so he ends up on Scum Sox.Ban all Canadians from MLB.Your stupidass RCMP tried to charge Dave Winfield with a felony assault for hitting a sea gull.What should we charge Ryan with hitting a human being ? First degree murder ! Do it in Texas, so we can have his ass fried.Ryan is a Chumpass.
- yankees218 - Aug 27, 2013 at 12:18 PM
How the hell is that Cano's fault? You don;t think this type of this happens every single week (if not day) in the majors? Please, stop crying and get over it.
- proudlycanadian - Aug 20, 2013 at 9:08 PM
Cano had a great game at the plate with his 4 hits.
The Yankee organization played fast and lose with the attendance numbers. The announced attendance was 40,248 even though there were a huge number of empty seats. They may have sold 40,248 tickets, but the actual attendance was probably much closer to half that number.
- dirtyharry1971 - Aug 20, 2013 at 10:19 PM
Don't cry because the jays cant get anywhere near the top 10 in attendance numbers, its not the Yankees fault, its not even your fault. Its just nobody cares about them outside of Toronto cause they are a regional team. Think anyone cares about them in the US? Think again if you do. Oh and after the jays got swept today they are now 11 games below .500!!! Yanks beat them with their A lineup and their B lineup, tomorrow they go for the series sweeeeeeep!!!
- dirtyharry1971 - Aug 20, 2013 at 10:30 PM
Esmil "please god put me back in the bullpen"Rogers proves once again he has no business being a starter today I see. And how about Kevin Pillar? He got his first MLB hit!!! Give that man contact extension as he is now 1 for 20 with only 7 K's!!! Yep bluejay fans Kevin Pillar is your future!!!
- badintent - Aug 21, 2013 at 2:06 AM
nah. the RCMP that pumped 9 bullets into a teenage on a bus , then tasered him as he lay dying as the real heavy hitters. Way to go Canada !! Be proud, proudcanadian. proud of your Nazi state.
- dirtyharry1971 - Aug 21, 2013 at 9:53 AM
Well Said badintent!!! its about time someone tells it how it is around here besides me!
- badintent - Aug 22, 2013 at 12:15 AM
My pleasure. My bill is in the mail. We accept Pay Pal. LOL
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text:
Kerala is aiming at initiation of tourism projects worth a staggering total of Rs.450 crore across the State this fiscal year itself, Home and Tourism Minister Kodiyeri Balakrishnan has said.
Inaugurating a Beach Tourism project under the Tsunami Rehabilitation Programme (TRP) at Andhakaranazhi near Cherthala here on Saturday, Mr. Balakrishnan said these projects would include both State and Centrally-sponsored schemes, all of which would aim at enhancing the tourism potential and related infrastructure of the State without causing any harm to the environment.
A Rs.50 crore mega tourism project for Alappuzha district, the 'Alappuzha Tourism Circuit'project, was awaiting funds from the Centre, he said, adding that the entire sum of Rs.100 crore sanctioned from tsunami rehabilitation funds for the Tourism department was being spent to uplift the coastal area and the fisheries sector.
Revenue Minister K.P. Rajendran, launching the distribution of financial assistance for construction of houses under the TRP, said the State was aiming at completion of all tsunami rehabilitation programmes by December this year, though the deadline stipulated by the Centre was March 31, 2010. The Government had no doubts over whether it would be able to complete the projects and had already invited Prime Minister Manmohan Singh to announce completion of the projects later, he said.
Pointing out that the Centre had commended the State's progress in tsunami rehabilitation in its nine coastal districts, Mr. Rajendran said the Central Planning Commission had even recommended to other States the Kerala model in certain tsunami rehabilitation projects.
Announcing the setting up of five life science parks in coastal schools in Alappuzha, Mr. Rajendran added that the Centre had approved a Rs.400 crore-project to set up permanent calamity relief centres in the State, at least eight of which would be in Alappuzha.
Fisheries Minister S. Sarma laid the foundation stone for two bridges in Andhakaranazhi, a tiny but picturesque fishing village that lost three of its occupants to the December 2004 tsunami. K.C. Venugopal,
MP, delivered the keynote address. District Collector Mini Antony, District Panchayat president R. Nazar, CPI (M) district secretary and District Cooperative Bank president C.B. Chandrababu, and A.M. Arif,
MLA, also spoke.
Keywords: Kerala Tourism, Kodiyeri Balakrishnan, Tourism projects


text:
Differential Equations&Series
Course Description
Prerequisite: MATH 201. Techniques for solving differential equations of first and higher order; focus on linear differential equations. Methods include separation of variables, undetermined coefficients, variation of parameters, D-operators, Laplace transforms and infinite series. Applications include formulation, solution and interpretation of initial and boundary value problems in physics, electricity and engineering. Four class hours weekly.


text:
TDP MP unhappy with brother Balakrishna's comments
The controversy surrounding the use of photos of NTR and NTR Jr. by YSR Congress leaders appears to have sparked off differences in the thespian's family with Harikrishna finding fault with a comment made by his brother Balakrishna.
In a brief interaction with media-persons after having a 'darshan' of Sri Hemachala Narasimhaswamy temple in Warangal district on Monday, Mr. Harikrishna said it was wrong to say that use of NTR's photo by other parties amounted to "political prostitution".
"Anybody can use NTR's photo. Decades ago, his photo in a mythological role as Sri Krishna adorned the walls of every home. If the use of photo is described as bankruptcy now what do you have to say about its removal some years ago," he said.
Apparently he was indirectly referring to the comment made by Balakrishna and the way NTR's photo was removed from the government offices during former Chief Minister N. Chandrababu Naidu's tenure.
Mr. Harikrishna made these significant observations in response to questions from media-persons even while claiming that he would avoid speaking on controversies and about politics on the temple premises.
To another question, he said that his son NTR Jr. should not be held responsible for somebody else's action. (His photos were put up by YSRC leaders to welcome Sharmila during her 'padayatra').
He said that his son had nothing to do with such displays and had made it clear several times that he would continue in Telugu Desam.
NTR Jr. vows loyalty to TDP
Referring to the row on Monday evening, NTR Jr. asserted that as the grandson of NTR, his loyalties and support would always be with the Telugu Desam, a party founded by the latter.
Participating in a function here to celebrate the success of his latest movie 'Baadshah', he appealed to the people to not spoil the mood by dragging him into controversies.
Ever since his photos appeared a few days ago, Telugu Desam leaders had been warning YSRC leaders to stop the display. On their part, YSRC explained that they were helpless as party's local leaders and admirers of NTR Jr. had done it.
Keywords: Balakrishna, TDP, Andhra Pradesh politics, YSR Congress


text:
Register now for free, or sign in with any of these services:
Status: Closed
Know more about this business than we do? Cool! Please submit any corrections or missing details you may have.Help us make it right
Madison Medical and Sports Rehabilitation was founded in 2003 by Dr. Carmen Romano. The goal of the practice has always been to provide complete convenient care for every patient. Keeping a patient under one roof to meet all their needs, Madison Medical offers care with full internal medicine, gastroenterology, podiatry, chiropractic, physical therapy, nutrition and therapeutic massage.
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— 5 star
Spotty service and bad care. Would not recommend. Months of treatments and I still feel pain. Not worth it! Felt like a clinic or a medical mill. I think they see like 400 patients a day and its not personal. I'd go elsewhere if you are looking for professionalism. Noticed that employees and Doctors talk about patients in front of other patients using their names. It is a bit shady.
We are a multi-dicipline facility that provides a full range of care in every visit.
Madison Medical and Sports and Rehabilitation Cent is located at 210 Main St, Madison, NJ. This business specializes in Home Health Care and Rehabilitation Services.


text:
Marian Michael is the North Shore's premier classic apparel shop. For over 75 years we have been the first choice for countless families on Chicago's North Shore. Our customers return for the combination of prestigious lines such as Florence Eiseman, Sarah Louise, Mon Cheri and Johnnie-O plus the warm, friendly greeting and knowledge only a family run business will provide. We sell Graduation Dresses, 1st Communion, and prom dresses. We rent tuxedo's for all ages starting as young as one and have a special graduation tux rental for only $139 or if you rent both your prom and graduation tux at the same time they are $104 each. We offer after hours private shopping by appointment and free gift wrapping with every purchase.
We have a wide selection of dresses for young adults. If you want your son or daughter to be the best dressed child in town check out our elegant girls dresses for social dance, a daddy and daughter dance, a country club event, a bat mitzvah or dinner with grandparents we have a dress you will both love.
We carry much more than what is on our web site. Don't hesitate! Visit us today.
All prices are in USD
Copyright 2015 Marian Michael.
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text:
Latest Coal tar Stories
DUBLIN, Oct.
ESSEX, Conn., Oct. 9, 2014 /PRNewswire/ -- Psoriatrax was developed so it washes away clean.
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The Medicated Bars include: Benzoyl Peroxide, Salicylic Acid, Zinc, Sulfur and Coal Tar. Annapolis, Maryland (PRWEB) August 06, 2014 With the success
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Dermatologists cite high efficacy-to-safety ratio of topical agents for patients with mild to moderate psoriasis SCHAUMBURG, Ill., March 2 /PRNewswire-USNewswire/ -- The American Academy of Dermatology (Academy) has released new guidelines of care for the management and treatment of psoriasis with topical therapies based on an extensive review of scientific literature on the subject and recommendations of recognized psoriasis experts.
PRINCETON, N.J., July 31 /PRNewswire/ -- NeoStrata today announced findings from an ongoing 12-week study that demonstrates benefits of a novel topically applied LCD (coal tar) solution (Psorent(TM)) versus calcipotriol cream (Dovonex(R)) in treatment of moderate plaque psoriasis.
By Judy Harrison, Bangor Daily News, Maine Jul. 11--BANGOR, Maine -- The 1st U.S. Circuit Court of Appeals has upheld the consent decree that will allow the cleanup of coal tar in the Penobscot River to go forward.
- To befool; deceive; balk; jilt.
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Great little place to spend an hour or two with the kids. Kids Under 12 - this an ideal indoor activity place! Our kids 6 and 4 enjoyed it.
I took my 7 year old nephew on a Saturday morning. Pretty quiet when we arrived at 1030 but was packed by noon. Much of the science was beyond his grasp but he enjoyed playing. Neat exhibits and lots of potential
We took our kids here to spend a couple of hours. As per some of the reviews, people are spending about 2 hours there. After 45 minutes, both of my kids had gone through every single center. They did it all. However were not bored at all. They kept going back to each center and trying different things. They very...
Discovery Space is a great small science center conveniently located in downtown State College. We have visited on several occasions, and they change the exhibits frequently. Every time we visit, my girls (now 4 and 7) have fun and learn a few new things too. We have seen the exhibits getting better and better since our first visit to Discovery...
This is an ok place to take your young children. If you have the membership which I do you can't complain about it being free. It is small but for my 2 yr old we can spend an hr or 2 in the afternoon with him running around and he loves it. It's no where near the size as other...
We belong to a club of science facilities and this is our local facility. It's ok. I wouldn't pay the price if I didn't get in with my yearly membership. Some decent displays about our local ecology, but mostly bland with no "wow" factor.
I have 3 kids of various ages, all under 10, and this place is great for bringing them all. It's the only place in town that I can bring them all, and let them loose. I feel safe because it's basically one large room. It seems like there are activities and crafts for the kids going on regularly so it's...
We want to thank you for taking the time to give us a positive review. We're glad your children enjoy their visits!
I have taken two youngsters (ages 6 and 4) here on different occasions. I wondered why I even bothered the second time. The displays were uninteresting, many in need of repair and the interactive activities weren't very. The docents seemed rather disinterested/bored and interacted in a perfunctory manner. Both children went through everything in the place quickly and were ready...
We are sorry to hear you had a poor experience at Discovery Space. We are always open to suggestions for improvement so feel free to share your suggestions/advice with the front desk.
Thank you.
Interesting interactive displays and exhibits for the younger set, but a bit shopworn. Could use some sprucing up; some of the activity stations were not functional when we visited.
Thank you for your evaluation of Discovery Space. Each semester, the PSU Mechanical & Electrical engineering students provide us with new exhibits, created as a semester project, on limited budgets. We have an exhibit from OMSI, opening September 25, called Eat Well, Play Well. It is an exhibit that will help children discover nutrition and fitness by making healthy choices....
There were many children visiting when I was there and every one was fully engaged in one activity or another. There was a puppet show and many hands on learning centers. The Penn State Lunar Lions were there to answer questions and quite a few volunteers to help guide young and old. An offered donation was crumpled and sent through...
We're pleased that you had a wonderful experience at Discovery Space. We loved your comment 'Even giving is made fun there.' We hope you will come back the next time you're in our area.
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"He knows Quebec very well."
The Bank of Canada is keeping its trendsetting interest rate locked at...
As Sepp Blatter sought election to his first term as president of FIFA,...
Canadian Olympian Jessica Smith looking to cement place on team for Pan Am...
Bono has paid tribute to U2's late tour manager, Dennis Sheehan, who died...
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GUELPH – Jason Da Silva didn't even have time to get nervous.
The rookie Guelph Storm goaltender made his OHL debut Sunday and played a key role in Guelph's 7-6 overtime victory over the Peterborough Petes at the Sleeman Centre.
Da Silva, 17, had watched Guelph's first eight games from the bench, but got the call early in the second period after Garret Sparks allowed his fifth goal.
"I was pretty excited. I was nervous going in but as the game went on I was really pumped. It was such an exciting game I was just happy to be playing in it," Da Silva said.
Matt Finn won it for the Storm 23 seconds into overtime, one-timing a blast from the point that found the top corner behind Petes' netminder Michael Giugovaz.
Da Silva stopped 22 of the 23 shots he faced and played a key role in killing off a two-man advantage for the Petes late in the game.
He said in a way it was better to enter a game in relief.
"If I knew I was starting a game, I would probably be a lot more nervous," he said. "You really have no time to be nervous when they tell you to go in like that."
The game, to be polite, not exactly a pretty one. Six of the goals came on the power play and play had little flow.
But the solid Sunday crowd of 3,800 certainly enjoyed the display of offence and the game wasn't without its moments of beauty, most notably a brilliant shorthanded goal by the Storm's Zack Mitchell that tied the game with 2:23 remaining in regulation.
The seven goals was a season-high for the Storm.
"You've got to find a way to win them all," Storm coach Scott Walker said. "I wasn't happy with the way we played, but I wasn't disappointed with my players. It was one of those non-thinking games.
"We all made errors: we made a lot, they made a lot and the refs made a lot. But it was just one of those games where I don't think anyone was focused."
Six different Storm players had multi-point games, led by Zac Leslie who had four assists. Zack Mitchell, Matt Finn and Scott Kosmachuk all had three-point afternoons.
Sunday also marked the return of former Storm winger Francis Menard to the Sleeman Centre.
Traded to Peterborough in the off-season after three years in Guelph, the overager rose to the occasion by scoring two of Peterborough's goals. Menard leads the Petes with 12 points in 10 games.
"It was my last time playing here so obviously it was good to get two goals against my old team," Menard said. "I have a lot of good memories here."
It was a rough weekend for the Petes, who lost twice in overtime and once in a shootout.
"We worked really hard all game and Guelph's a really good team: either team could have won," Menard said. "They just buried on the opportunities they had and we didn't quite bury on ours."
Guelph played without Tanner Richard, who is suspended for two games after instigating a fight late in Friday's game. Cody McNaughton was also out, still recovering from his upper body injury.
The Storm hosts the Sarnia Sting on Friday.
Storm 7 Petes 6 (OT)
First Period
1. Peterborough, Menard 6 (Trojanovic, Lorentz) 5:01 (PP)
2. Guelph, Finn 2 (Leslie, Dickinson) 9:36 (PP)
3. Peterborough, Menard 7 (Trojanovic, Koekkoek) 10:45 (PP)
4. Peterborough, Lorentz 3 (Trojanovic, Findlay), 15:05 (PP)
5. Guelph, Auger 5 (Leslie, Milne), 16:07
6. Guelph, Kosmachuk 7 (Fabbri, Mitchell) 18:58 (PP)
Penalties: Lorentz Pbo (hooking), 0:44; McGinn Gue (interference), 4:32; Findlay Pbo (cross checking), 8:14; Mitchell Gue (roughing), 10:23; Finn Gue (high sticking), 14:10; Tanus Pbo (elbowing), 16:58; Ceresnak Pbo (check from behind), 18:38.
Second Period
7. Guelph, Watling 3 (Auger, Horvat) 1:35
8. Peterborough, Cornel 2 (Maguire, Hietkamp) 2:11
9. Peterborough, Betzold 1 (Varga) 3:14
10. Guelph, Mitchell 4 (Finn, Kosmachuk) 4:36 (PP)
11. Peterborough, Nosad 2 (Ceresnak, Tanus) 15:50
Penalties: Pierog Pbo (misc-usc), 1:30; Bertuzzi Gue (misc-usc), 1:30; Trojanovic Pbo (holding), 4:11; Cornel Pbo (interference), 5:35; served by Garlent Gue (too many men), 6:53; Murphy Pbo (instigator, fighting, misc-instigating), 9:09; Garlent Gue (fight-inst. upon), 9:09; Mathers Pbo (cross checking), 11:08; Bertuzzi Gue (interference), 19:42.
Third Period
12. Guelph, Mitchell 5 (Leslie, Kosmachuk) 17:37 (SH)
Penalties: Horvat Gue (delay of game), 0:58; Trojanovic Pbo (holding), 10:51; McGinn Gue (high sticking), 12:50; Bertuzzi Gue (charging), 16:48; Leslie Gue (cross checking), 17:53.
13. Guelph, Finn 3 (Leslie, Dickinson) 0:23
Penalties: None.
Shots on Goal
Peterborough 13 – 12 – 14 – 0 – 39
Guelph 22 – 18 – 4 – 1 – 45
Power Play (goals/chances): Peterborough 3/9; Guelph 3/9.
Goalies (record, saves-shots): Giugovaz (L, 2-2-2-0, 38-45) Peterborough; Sparks (5-2-0-1, 11-16), DaSilva (W, 1-0-0-0, 22-23, 3:14 second) Guelph.
Referees: Gauthier, Foster; Linesmen: Browne, Pfohl.
Attendance: 3,777.
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Blitz the neighborhoods with these great International Spy Academy invitation doorhangers! Run them through your printer to print your info on the back. Ten perforated 11 x 8.5-inch sheets, 2 per sheet.
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|LeBron apologizes to neighbors, sends cupcakes
|Written by Admin
|Wednesday, 23 July 2014 03:16
Cleveland Cavaliers fans and journalists arrived en masse to the NBA star's Akron area home to await his July 11 decision on whether he would come back to northeast Ohio or stay with the Miami Heat. A commotion ensued, and police were called to direct traffic.
To make amends, the LeBron James Family Foundation sent a note of apology accompanied by a dozen cupcakes to neighbors on Tuesday, according to multiple media outlets.
Several neighbors tweeted photos of the cupcakes and the note saying that ''we are sorry for the chaos,'' adding that the James family is ''so blessed to have understanding neighbors like you.''


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Sab the Artist takes us record shopping at Fifth Element
Categories: Rap/Hip Hop
Sab the Artist visited the Twin Cities for an in-store performance and signing this Friday evening at Rhymesayers' own Fifth Element. "Love Is In The Air" is Sab's most recent project, which you can download for free after the jump.
"Like" Gimme Noise on Facebook and follow us on Twitter at @gimme_noise.
Gimme Noise caught up with him as he was thumbing through the vinyl and CDs and he shared with us his top 5 albums that changed his life:
Beyond Comparison by Beyond (2001)
Life After Death by The Notorious B.I.G. (1997)
Walking With a Panther by LL Cool J (1989)
One For All by Brand Nubian (1990)
Strictly Business by EPMD (1988)
Album download link: Fifth Element Presents Sab the Artist, Love is in the Air
"Like" Gimme Noise on Facebook and follow us on Twitter at @gimme_noise.
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text: No recent wiki edits to this page. Massive Assault Network 2 (MAN2) is a Sci-Fi turn based strategy game. Due to the visuals, the game looks like a RTS. The gameplay is easy to understand, but difficult to conquer. Game Features A.I. opponents for training Fascinating 3D engine "Fancy Camera" captures the most dramatic moments Play multiple games simultaneously Find live opponents of any desired skill level 25 beautiful planets, 42 units of all types


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19 CFR 208.7 - Determinations and reports.
(a) Determinations. When relevant information is not available on the record or any party withholds information that has been requested by the Commission, the Commission will make its determination on the basis of the facts available. When the Commission relies on information submitted as facts available, it will, to the extent practicable, corroborate the information from independent sources that are reasonably available to the Commission.
(b) Time for determinations and reports. The Commission will make its determinations under section 112(c)(2)(A) and (B)(i) of AGOA and transmit its reports to the President by September 25, 2007, with respect to petitions received on or before March 28 and accepted on or before April 11, 2007, and will make its determinations by August 1 of subsequent years with respect to petitions received on or before January 15 and accepted on or before February 1 of those years.
(c) Contents of report. The Commission will include in its report to the President the following:
(1) The determination made with respect to whether a fabric or yarn produced in beneficiary sub-Saharan African countries is available in commercial quantities for use in lesser developed beneficiary sub-Saharan African countries, and an explanation of the basis for the determination;
(2) If the determination in paragraph (c)(1) of this section is affirmative, a determination with respect to the quantity of the fabric or yarn that will be so available in lesser developed beneficiary sub-Saharan African countries in the applicable 1-year period beginning after the determination is made;
(3) Any dissenting or separate views by members of the Commission regarding such determinations.
(d) Public version of report. Upon making its report to the President, the Commission will make such report public (with the exception of information which the Commission determines to be confidential), and publish a summary thereof in the Federal Register.
[72 FR 8626, Feb. 27, 2007, as amended at 72 FR 11287, Mar. 13, 2007]
Title 19 published on 2014-04-01.
No entries appear in the Federal Register after this date, for 19 CFR Part 208.
Title 19 published on 2014-04-01
The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 19 CFR Part 208 after this date.


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RIM BlackBerry PlayBook
RIM BlackBerry PlayBook: Angle Attractively designed, the 14.4-ounce, 5.1-by-7.6-by-0.4-inch BlackBerry PlayBook features a black frame and contour and feels comfortable in hand.
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Gregory voters could allow restaurant alcohol sales
GREGORY - Voters in Gregory will decide Saturday whether to legalize beer, wine and mixed drink sales in bars and restaurants.
It's the eighth wet-dry election in the Coastal Bend since 2004, according to records of the Texas Alcoholic Beverage Commission. Voters approved alcohol sales in four of the previous seven elections.
Approval in Gregory would clear the way for Gilbert Hernandez to sell drinks in La Parilla Tex-Mex Grill and Bar, under construction on U.S. Highway 181. Hernandez circulated a petition to get the issue on Saturday's ballot.
There is no organized opposition to the measure, and Hernandez said he met little resistance during his petition drive. Stores in Gregory already can sell beer, wine and liquor.
Hernandez said he and his family want to provide another dining option in a town with two restaurants and one taco stand.
"Why go to Corpus or Portland or anywhere else if you live around the city limits?" he said. "Why not just eat in your hometown?"
Some surrounding towns, including Sinton and Corpus Christi, allow all alcohol sales — beer, wine and liquor in stores, restaurants and bars. Portland also is wet but doesn't allow stand-alone bars that aren't inside restaurants.
Hernandez, a maintenance mechanic at a local plant, said his family, which also operates a chain of fireworks stands, wanted to support the local economy.
Steve Olivarez, an Ingleside resident who is working on a new store building down the road from La Parilla, welcomes the change the election could bring.
"It's something new and exciting to take that concept into a small town that hasn't seen any real growth in years," he said.
Olivarez is renovating a building for a new store owned by Sue Moreno of Rockport. She said Keedos, a play on the way her father used to say "kiddo," will have sandwiches, a miniature meat market, fruit and vegetable stands and basic convenience items.
Moreno said her store and La Parilla, near the intersection of U.S. Highway 181 and State Highway 35, are well positioned to take advantage of increasing traffic, especially with the anticipated opening of the Tianjin Pipe plant in about two years.
Moreno hopes to open Keedos within a month.
Gregory resident Amy Gomez, 20, isn't old enough to buy a drink, but she's old enough to vote. She said she hasn't talked to anyone opposed to alcohol sales.
"It's a small town and everybody knows everybody," she said. "We know who's going to own the restaurant. They're a good family."
Hernandez said La Parilla will seat 160 to 180 people.
Also on the ballot in Gregory is a proposition that would increase sales tax from 7.75 cents to 8.25 cents per each $1 spent in the community. The city will use the half-cent difference to establish a 4B economic advisory board, which will decide how the money collected will be spent.
The city's administrative consultant John Valls estimated about $45,000 a year would be collected. The money could be used to entice businesses or for quality of life improvements, such as park or drainage upgrades.
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Last week, a federal court, for the fourth time, found that property owners' groups do not have standing to challenge a settlement between the administration and conservation groups under which the administration agreed to make listing decisions under the Endangered Species Act on more the 250 candidate species by 2016. Judge Emmet Sullivan, who entered the original settlements, ruled that settlements imposing procedural deadlines on the Fish and Wildlife Service did not cause any redressable injuries to the plaintiffs.
The case has been something of a poster child for those complaining about so-called "sue and settle" agreements between the administration and environmental groups. However, I think that it's time for the trade groups to give up, move on, and defend, as appropriate, individual listing decisions made by the FWS in pursuant to the settlement.
As Judge Sullivan noted in systematically taking apart each of the plaintiffs' claims, several courts have already rejected the claims, and the D.C. Circuit Court of Appeals rejected almost identical claims in the context of a Clean Water case as well. The bottom line is that an agreement by FWS to decide whether to list candidate species does not cause any injury; the plaintiffs still retain their rights to challenge the individual listing decisions.
I also wonder about the big picture. The standing shoe is often on the other foot. Regulated entities often rely on standing to keep environmental groups out of court. Is it really in their interests to expand standing? I think that this is a sauce for the goose situation.
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.
© Foley Hoag LLP - Environmental Law
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text: Help! [Archive] - Glock Talk Glock Talk > The Main Room > Tech Talk > Help! PDA View Full Version : Help! m2hmghb12-16-2005, 20:31Hard drive is not working on my computer. Keep getting an erroer after the password screen stating hard disk drive failure 0 no boot device available and it makes a clanging noise Hailstorm12-17-2005, 08:57Poke it with a fork. Its done. Get a new harddrive and put XP on it. Use the old drive as a slave after you install the OS. Then you can try to extract any info off the old drive.IF it still reads. Just so you know. Clicking is very bad. ;P Thats of course you don't have your info backed up. If you had forthought, toss the old drive ;f vBulletin® v3.8.7, Copyright ©2000-2015, vBulletin Solutions, Inc.


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The Lakers are in for a semi-light week ahead, having only the undefeated San Antonio Spurs to deal with as they continue to weigh their options on who would take over from "relieved" coach Mike Brown.
After a disappointing 1-4 start, the Lakers are now in immediate search of a replacement to get their act together. For the time being, Bernie Bickerstaff has inherited the role of interim head coaching duties until a new official head coach is announced.
Bickerstaff successfully got the Lakers past the Golden State Warriors, 101-77, Friday (Saturday in Manila) as Kobe Bryant unloaded 27 points together with 9 rebounds and 7 assists.
Next up will be the Sacramento King on Sunday before they face the so-far undefeated Spurs at the Staples Center in what would probably be their toughest opponent for the week.
From there, the Lakers get a three-day break before hosting the Phoenix Suns (Nov. 16), Houston Rockets (Nov. 18) and the Brooklyn Nets (Nov. 20) to cap their 5-game home games.
It is during this stretch that the Lakers are hopeful that a new head coach would have already been on board.
As of this writing, the names of Phil Jackson, Brian Shaw, Mike D' Antoni and Jerry Sloan have been mentioned among the list of candidates that the Lakers are eyeing, a daunting task to help the star-studded squad back on track for another crack at the NBA title.
Jackson is said to be among the favorites for the position, considering the Zen master has proven himself to handle star-studded casts in the past. This included the Jordan-led Bulls and the Bryant-led Lakers whom he last coached in 2010-11.
Jackson is said to be open to the idea, making frequent stops during Lakers practice to visit his girlfriend Jeanie Buss.
D' Antoni is another top prospect although it may take the former Suns and Knicks coach between 10 days to 2 weeks to take on the role. (The question here then is on whether the Lakers are willing to wait that long). Should D'Antoni get the nod, he will be reunited with Steve Nash who is still on the injured list.
Then there is Brian Shaw, someone who is no stranger to Lakers basketball. Shaw played some ball for the Lakers during his prime and has served as an assistant coach then under Jackson. He is currently hooked up with the Indiana Pacers as an assistant coach.
Jerry Sloan is another candidate on the watch, a disciplinarian who can bring in a highly disciplined atmosphere into the all-star roster of the Lakers.
Sloan has been known to give the Lakers a tough grind when he was still with the Utah Jazz. He is best known for efficiently utilizing the famous "mutt-and-jeff" tandem of the Jazz, featuring no other than NBA legends Karl Malone and John Stockton.
Of the coaches mentioned, the wisest choice seems to be Jackson. Being an all-time winningest coach in NBA history and the fact that it will take little time for him to adjust to Kobe, Pau Gasol and Metta World Peace makes Jackson the best option for the job.
Shaw could very well be the next best choice although the elevation could be risky at such a critical phase where the Lakers are groping for form.
D' Antoni focuses more on offense while Sloan could be a wise choice as well thanks to balance on both ends of the hardwood.
Whoever the Lakers choose from that list would need immediate attention. The week ahead sees only the Spurs as a concern but based on Laker tradition, it would be best to win them all and get the Lakers to an above .500 record, something that many expected to be the case in the first place.
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Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceKenmore Range
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Time to do repairLess than 15 mins
Age of Appliance5 - 10 years
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The 2010 Global Burden of Disease Study estimates the premature mortality and disability of all major diseases and injuries. In addition it aims to quantify the risk that diseases and other factors play in the aetiology of disease and injuries. Mental disorders and coronary heart disease are both significant public health issues due to their high prevalence and considerable contribution to global disease burden. For the first time the Global Burden of Disease Study will aim to assess mental disorders as risk factors for coronary heart disease. We show here that current evidence satisfies established criteria for considering depression as an independent risk factor in development of coronary heart disease. A dose response relationship appears to exist and plausible biological pathways have been proposed. However, a number of challenges exist when conducting a rigorous assessment of the literature including heterogeneity issues, definition and measurement of depression and coronary heart disease, publication bias and residual confounding. Therefore, despite some limitations in the available data, it is now appropriate to consider major depression as a risk factor for coronary heart disease in the new Global Burden of Disease Study.
Mental disorders and coronary heart disease are both significant public health issues due to their high prevalence and considerable contribution to global disease burden. The 2001 Global Burden of Disease (GBD) Study ranked unipolar depressive disorders as the third leading cause of disease burden, rising to first place for high- and middle-income countries [1]. In spite of this ranking, the burden of depression may still be underestimated because of inadequate appreciation of the links between depression and other health conditions, such as ischemic heart disease [2].
Ischemic heart disease (IHD) is a major cause of disease burden, ranked fourth globally and second in high- and middle-income countries [1]. A number of cohort studies in recent years have contributed to the growing body of evidence for links between mental disorders and cardiovascular disease. The largest body of work in this area has been done on the association between major depressive disorder (MDD) and coronary heart disease (CHD), with results implying the existence of a robust association [3-7].
Establishing whether depression is an independent risk factor for CHD could have a significant impact on resource allocation and treatment for both depressive and some cardiovascular diseases. Previous GBD studies have included illicit drug use and alcohol use as risk factors for outcomes as diverse as IHD, stroke, hypertensive disease, depression, and intentional and unintentional injury [8]. Mental disorders other than substance abuse have not been incorporated in GBD studies as risk factors to-date.
The 2010 GBD Study currently underway http://www.globalburden.org/ webcite views risk factors in the context of several criteria: evidence of a causal effect should be established, but the risk should be not too broadly defined (for example diet or environment as a whole) or be too narrow (for example every single fruit and vegetable or every toxicant in tobacco smoke). There should be a relatively specific definition of risk factor exposure and risk factors should be potentially modifiable. Sufficient data on risk factor exposure and risk factor disease relationships should exist. Finally, protective as well as hazardous factors should be considered.
In their 2007 paper, Prince et al outline implications for health policy and resourcing based on the under-recognized burden of mental disorders as a risk factor for other disease [2]. The relationship between depression and CHD has been well studied and it is reasonable to consider it for inclusion as a risk factor for CHD in a GBD study. There have been studies on the relationship between depression and other disease entities falling under the umbrella of vascular disease, other than CHD. These studies, for example on the relationship between depression and stroke (CVA), fall beyond the scope of this review. The objective of this paper is to review the available evidence on the role of depression as an independent risk factor in CHD and recommend whether this evidence base is sufficiently robust to include depression as an independent risk factor for CHD in the new GBD Study.
Is the Direct Association Between Depression and CHD Plausible?
Biological Mechanisms
Depression has various direct and indirect biological effects which may explain its link with cardiovascular disease. Current evidence suggest that depression may act through an autonomically-mediated increase in myocardial workload (and thus ischemia), or in ventricular irritability; diminished beat-to-beat heart rate variability; or increased atherogenesis, through relatively direct effects on platelet function or hypercortisolemia-mediated effects on other cardiovascular risk factors such as blood pressure or lipid levels [9,10]. Vascular endothelial dysfunction of the coronary arteries has also been observed in a number of cohorts of depressed patients [11].
Depression-related dysregulation of the sympathoadrenal system and HPA axis has been observed to cause an increase in circulating catecholamines and serum cortisol resulting in surges in heart rate and blood pressure, which increases the risk of atherosclerotic plaque rupture and acute coronary thrombosis [11]. High levels of catecholamines also increase the irritability of the heart muscle which can lead to ventricular arrhythmias and modify the function of circulating platelets [9,11]. Increased cortisol levels lead to inflammation, excessive clotting, metabolic syndrome, induction of hypercholesterolemia and hypertryglyceridemia, and injury of vascular endothelial cells [2,9]. Effects on serotonin metabolism have also been shown to lead to additional alteration of cardiac function, increased platelet activity, and vasoconstriction [2]. Changes in inflammatory immune response, such as raised inflammatory markers, may also predict the development of cardiovascular disease [2,11].
Behavioral Mechanisms
A number of behavioral pathways have been identified in the link between mental disorders and cardiovascular disease. Patients who suffer from a mental disorder are less likely to adopt a healthy lifestyle or to reduce cardiovascular risk factors. Physical activity and diet control are less frequently undertaken and smoking and alcohol consumption rates are often higher [2,11-13]. In addition, obesity has been strongly associated with both cardiovascular disease and mental disorders such as depression, bipolar disorder and panic disorder [2]. Adherence to treatment is often less in depressed patients compared to non-depressed patients [11]. Depressed patients are known to access social services less frequently and insufficient social support has been strongly linked to the development of cardiovascular disease [11].
Temporal Relationship
Establishing the temporal relationship of depression antecedent to CHD is a challenge. Both depression and early stages of cardiovascular disease can go undiagnosed for a substantial period of time. In addition, the relationship between depression and CHD appears to be bi-directional. Increased prevalence of depression post-cardiac event and its negative prognostic effect on cardiac patients has been clearly demonstrated [14,15]. Proof of a temporal relationship can be provided by only including prospective studies in which patients with previous CHD are excluded from the study, or at the very least excluded from the analysis. However, Rugulies and colleagues [5] tested this hypothesis by pooling effect sizes for all relevant studies and then for studies which control for sub-threshold CHD by intensive medical examinations at baseline. They report a small reduction in the effect size (from 1.77 to 1.51) but it remains statistically significant.
It can further be argued that if sub-threshold CHD were present at baseline, relative risk (RR) of outcome would be higher within a short period of time and tail off with longer follow-up. The literature does not support this. Data from the John Hopkins Precursors Study showed that risk of myocardial infarction (MI) after 40 years of follow-up did not differ from risk after only 10 years (RR of 2.12 and 2.1, respectively) [16]. Implications of these findings are that possible sub-threshold CHD at baseline does not significantly affect the risk of incident CHD in depressed samples.
Evidence for Association between Depression and CHD
Several reviews of the association between depression and incident CHD have been published. Specifically four meta-analyses have been published, reporting pooled relative risk for depression and incident CHD between 1.57 and 2.69 [3,5-7]. A further four qualitative reviews were identified, all reporting a high degree of evidence for the role of depression in the development of CHD [13-15,17]. A number of authors conclude that the risk of depression on incident CHD may be equal to that of smoking [6,7,17].
Three other qualitative reviews [9,11,12] document increased cardiovascular morbidity and mortality in patients with depressive symptoms or major depression. A strong suggestion of a dose-response relationship between depression and CHD was identified [5,7,11,14]. Depression meeting diagnostic criteria was associated with a higher risk of CHD compared to depressive symptoms [5,7]. Existence of a dose-response relationship between exposure and outcome supports likelihood of causation [15].
Association is stronger with MI than more broadly defined CHD
A comprehensive meta-analysis based on 28 studies reported a pooled relative risk of 1.60 (95%CI 1.34-1.92) for MI compared to 1.48 (95%CI 1.29-1.69) and 1.63 (1.26-2.12) for CHD and CVD, respectively [7]. It was only when the outcome was narrowed to MI alone that heterogeneity between studies was eliminated. This suggests that classification of outcome (MI), as opposed to other factors was an important source of heterogeneity between the studies. An important limitation of this review is that not all included studies controlled for CHD at baseline. Yet the implication of this finding is that the evidence for depression as an independent risk factor is more consistent for incident MI than for CHD.
Heterogeneity Issues
The literature on depression and cardiovascular disease displays large heterogeneity. Lack of consistency in methodology makes the task of comparing studies and pooling data for meta-analysis difficult and needs to be carefully considered in any systematic review. For example, it has been shown that the prognostic impact of initial depression increases over time, with higher odds ratios for mortality post diagnosis of depression in CHD in studies with longer follow-up periods [18].
Defining and Measuring Depression
For the purposes of the GBD, depressive disorders are required to meet the Diagnostic and Statistical Manual of Mental Disorders (DSM) [19] diagnostic criteria for major depressive disorder (F32-F33) or dysthymic disorder (F34.1), or the WHO International Classification of Diseases (ICD)[20] criteria for depressive disorders including dysthymia (F32.0-F32.2, F32.8, F33.0-F33.2, F33.8, F33.9, F34.1).
However, identification and measurement of depression is complex and the refinement of adequate, quantitative measures is ongoing. Measures of depression used in published studies range from self-report of mood to strict adherence to diagnostic criteria, with a myriad of other surveys and questionnaires somewhere between and varying on the spectra of reliability and validity [11,21].
There exists variation in the cut-off values of 'diagnostic' scoring within studies which use the same measurement instrument [22-25]. The ability to compare findings from various studies employing differing measurement methods is therefore compromised. Case identification according to DSM or ICD criteria is the ideal. Where a study falls short of this, for example in large cohort studies, a diagnosis by a clinician or the use of a measurement tool which has been shown to acceptably represent DSM or ICD criteria is considered sufficient for the case ascertainment of depression. Additional complication comes about by variations in the period of assessment (for example, depression experienced during the past-week versus past 12-months).
Defining and Measuring Coronary Heart Disease
CHD is considered to encompass ischemic heart disease, myocardial infarction and angina, included cases of ICD-9 codes 410-414 and 429, or ICD-10 codes 120-125. The WHO criteria for myocardial infarction (MI) are also accepted. While the term Coronary Heart Disease was recommended by Tunstall-Pedoe (2001) [26], many studies dealing with the relationship between depression and disease of the coronary vessels use alternative nomenclature, such as Coronary Artery Disease (CAD) or Ischemic Heart Disease (IHD). All essentially refer to the disease process of atherosclerosis of the coronary arteries leading to myocardial infarction and angina [27].
MI provides a very well defined clinical marker, both in terms of a clearly definable 'hard' endpoint for cardiovascular disease [12], as well as a marker in time, allowing temporal correlation between MI and depressed mood.
Although case-definitions for CHD are clear in theory, signs of CHD can be very difficult to detect and subclinical in nature. Hence ruling out CHD at baseline and proving an unbiased etiological relationship is challenging [28]. This is particularly true for angina and it is for this reason that angina was not accepted as a proxy for CHD.
Has the Evidence Base Been Affected by Publication Bias?
The possibility of accurately measuring depression as a risk factor for CHD appears to be hampered by significant publication bias. The apparent over-representation of positive studies showing an increased risk could in fact be hiding truer lesser risk of CHD in depressed subjects [3].
Is There Residual Uncontrolled Confounding?
Although the obvious confounding variables should be controlled for as a requirement for inclusion in a quantitative review, residual uncontrolled confounding cannot be ruled out due to the complex nature of the depression and CHD relationship. For example, a depressive state may be associated with other CVD risks such as smoking and other chronic medical conditions.
Reviews of the literature reporting associations between psychosocial factors and CHD found strength of evidence for depression as a causative factor to be strong compared to anxiety where the effect was less consistent [2,15]. A role for anxiety in the development of CHD is biologically plausible. Anxiety, as with depression, affects the autonomic regulation of the heart via the hypothalamic-pituitary-adrenocorticol (HPA) axis [10,29]. Chronic over-activation of these systems due to anxiety would help to explain the increased frequency of cardiovascular risk factors in patients with anxiety disorders [10]. Reduced heart rate variability in those with anxiety disorders could also involve impaired vagal control [12]. In the hypertensive state a chronic anxiety disorder may trigger increased levels of epinephrine and norephinephrine which could also increase the heart rate, total peripheral resistance and even increase the circulating fatty acids [10]. There is significant evidence which links anxiety disorders to sudden cardiac death [30,31]. However, anxiety has not been associated with myocardial infarction in these studies [12,31].
While some reviews have found an association between anxiety and CHD [32], they included fewer of the primary studies with negative findings than the review by Kuper et al [15,33]. We have concluded there is neither strong nor consistent evidence for a causal association between anxiety disorders and CHD [33].
However, depression and anxiety are strongly co-morbid [34,35]. Hence we need to consider anxiety as a confounder in the relationship between depression and CHD. Given the conclusion above that anxiety disorders (alone) do not have a proven etiological relationship with CHD we examined the evidence for the relationship between major depressive disorder and CHD controlling for other mental disorders. In one study the odds ratio (OR) for incident MI was only slightly reduced once phobia, panic disorder and alcohol use/dependence were controlled for (4.16 95%CI 1.49-11.62 compared to 4.54 95%CI 1.65-12.44) [36]. We therefore concluded that there is insufficient evidence for co-morbid anxiety substantially mediating the relationship between depression and CHD.
A number of studies have reported an association between use of anti-depressant medication and fatal and nonfatal CHD [37,38]. This raises the issue as to whether anti-depressant medication, rather than depression, is a risk factor in development of CHD. A limitation of many earlier papers considering the role of antidepressants and CHD [37,38] is that few controlled for the presence of depression or other mental disorders. More recent studies examining depression and CHD have controlled for the use of medications. Retrospective analysis of a primary care sample with IHD found that use, dose and duration of tricyclic anti-depressant consumption were not statistically significant in the development of ischemic heart disease when diagnosis and duration of depression were included in the regression model [39]. In a prospective follow-up of the Baltimore Epidemiologic Catchment Area reported use of psychotropic medication had a marginal effect on the RR of incident MI in a depressed sample (RR 4.16 compared to 4.14) [36].
Should major depression be considered an independant etiological risk factor in the development of CHD for global burden of disease estimates?
There is strong evidence that major depression is an independent risk factor for CHD. The evidence for this has emerged recently and this field is still being actively explored. Studies of the relationship between major depression and CHD frequently have significant differences in their methodology and there are potential biases which may have affected study outcomes.
Several potential confounders such as smoking, weight, physical activity, blood pressure and cholesterol [40] have led to controversy over of the effect size measured in some studies. However, when confounders are accounted for MDD remains strongly associated with at least a doubling in risk of cardiac events over 1 to 2 years after an MI [41].
There is sufficient evidence to recommend that Burden of Disease estimates should include MDD as a risk factor for CHD, and this evidence is strongest for CHD resulting in MI. There are now several large-scale studies from different countries and settings which have reported consistent findings. We conclude the association between MDD and CHD is very unlikely to be due to chance or bias [11]. We agree with Goldston and Baillie [11] that the existence of several plausible pathophysiological mechanisms for the relationship, the strength and consistency of the association and the finding that it is dose-related supports the conclusion that depression is an independent etiological risk factor in CHD.
What is needed is further research to clarify the nature of this relationship and specifically to further quantify it. Issues surrounding methodological heterogeneity could be addressed by adopting standard methodologies. Some such standards have already been published [42,43]. It is vital however that further awareness is raised about major depression as a risk factor for CHD. We believe the inclusion of major depression as a risk factor for CHD in the 2010 GBD study will raise awareness about the relationship and encourage the collection of international data for more accurate ascertainment of the risk. Given that major depression has emerged as a risk factor which confers an only slightly less attributable risk than that of lifetime smoking and a comparable attributable risk to that of both hypertension and obesity [4], such action is warranted.
In a broader context, there is also an urgent need for further well-designed and targeted research examining other mental disorders as independent risk factors for cardiovascular disease. Specific areas identified where future research is needed:
• More and better quality studies with attention to improved methodological consistencies,
• Examination of risk by country and region - more research in low- and middle-income countries,
• Clearer understanding of behavioral and biological pathways and interrelationship of different factors,
• Further validation of and consistencies between measurement instruments,
• Differentiating between the effects of depression, anxiety and substance use disorders in the development of CHD,
• The impact that pharmacological and/or non-pharmacological treatment of depression has on CHD outcomes.
CHD: Coronary heart disease; DSM: Diagnostic and Statistical Manual of Mental Disorders; GBD: Global Burden of Disease; HPA: Hypothalamic-pituitary-adrenal; ICD: International Classification of Disease; IHD: Ischaemic heart disease; MDD: Major depressive disorder; MI: Myocardial infarction; OR: Odds ratio; RR: Relative risk; WHO: World Health Organisation
Competing interests
Harvey Whiteford is Chair of the Mental Disorders Expert Group for the 2010 Global Burden of Disease Study. Amanda Baxter is the Project Manager for the Mental Disorders Expert Group for the 2010 Global Burden of Disease Study.
Authors' contributions
FC Made a substantial contribution to conception and design of the paper, and acquisition and interpretation of data; played a principal role in drafting the article and revising it critically for important intellectual content; and performed final critical editing and gave approval of the version to be published. CS made a substantial contribution to conception and design of the paper, and acquisition and interpretation of data; played an important role in drafting the article and revising it critically for important intellectual content; and performed final critical edit and gave approval of the version to be published. AB made a substantial contribution to conception and design of paper and assisted in the acquisition of data; revised it critically for important intellectual content, and performed a final critical edit; and gave approval of the version to be published. HW made a substantial contribution to conception and design of paper and assisted in the acquisition of data; revised it critically for important intellectual content, and performed a final critical edit; and gave approval of the version to be published.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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