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When is a split not a split? Jennifer Lawrence and Coldplay frontman Chris Martin were spotted spending the Fourth of July weekend together in New York City.
Your favorite couple of the year is no longer a couple — for a second time.
Jennifer Lawrence and the cast of the Hunger Games film franchise attended a photocall for the launch of The Hunger Games: The Exhibition at Discovery Times Square in NYC on Monday, June 29, and they certainly gussied up for the occasion!
Jennifer Lawrence, Cody Simpson and Joe Jonas all made us LOL this week. Want to see the pics? Check out our gallery!
Jennifer Lawrence is the friend we never thought we needed. …
With just months until the release of the final Hunger Games movie, The Hunger Games: Mockingjay – Part 2, Lionsgate exec Tim Palen is sending the series off in a big way.
To say that Jennifer Lawrence is not your average actress is an understatement.
With summer finally upon, it's time we binge-watch our favorite movies and shows on Netflix. (Because being a couch potato totally beats getting sunburned at the beach.)…
Actress Jennifer Lawrence is set to make a big chunk of change for her next film, and even more money than her co-star hottie Chris Pratt.
Jennifer Lawrence has come out of hiding and her summer style game is seriously on-point.
Not only is Jennifer Lawrence's new bodyguard hot, but he's good with puppies. …
Jennifer Lawrence is ready to take a bite out of the Big Apple.
New troubling details about the awful nude celebrity photo leak resulting from an iCloud breach that occurred last year, dubbed "Celebgate," have arisen from the FBI investigation.
According to unsealed federal court documents, almost 600 online storage accounts were breached, thus confirming that Celebgate is perhaps bigger than first imagined.
The trailer for The Hunger Games: Mockingjay – Part 2 was just released. See Jennifer Lawrence as Katniss Everdeen one last time. …
It's safe to say the countdown for the Hunger Games: Mockingjay – Part 2 premiere started, well, right after the opening of Part 1, and now with five months to go until the release, we have a little something to feed our appetite.
Looks like Jennifer Lawrence and ex-boyfriend Nicholas Hoult have totally moved on since their split in August of last year.
It's been real, Dave.
Dior just can't get enough of Jennifer Lawrence, and can you blame them?
Jennifer Lawrence and Chris Martin were just spotted together in Los Angeles on Wednesday, (May 6, 2015). We have all of the pics to prove it!
Charlize Theron has no time for your misogyny.


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You can now invite anyone to meet at your favorite Starbucks.
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28 year old man | Atlanta, GA, USA | Seeking women 22-27 within 50 miles
Active within 24 hours
Its just gotta click
I'm a very goofy person with a big heart. I like open-minded people who aren't quick to judge others. A person who's laid back, compassionate, and has a great sense of humor is right up my alley. I'm the type of person who loves trying new things. Whether it's a new restaurant or bar, I'll try it all. I have a huge family and hope to have one of my own one day and hope to find some one that feels the same. I also have a 6 year old son that is my best friend so you must like kids.When i"m not working or working out, you can find me relaxing or at a braves game with friends. I love going out and socializing. so some one that is not to much of a home body, but I also like to chill on the couch and eat ice cream.
Cooking , Dining out , Fishing/Hunting , Movies/Videos , Museums and art , Music and concerts , Nightclubs/Dancing , Playing sports , Religion/Spiritual , Shopping/Antiques , Travel/Sightseeing , Watching sports , Wine tasting
Football, Golf, Hockey, Martial arts, Running, Swimming, Weights / Machines
I exercise 5 or more times per week.
I like Cats, Dogs
sun in my belly, vortex, any Irish pub, mellow mushroom and twist sushi.
Where to start...... I am a amateur boxer so I spend a lot of my time in the gym training and working out. But when I am not there, you can find me socializing with friends at the local watering hole or just grabbing dinner.
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CPR in Pectus Excavatum
January 13, 2015 by Cliff
Filed under Acute Med, All Updates, EMS, Guidelines, ICU, Kids, Resus
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Some pectus excavatum patients have a metal 'Nuss bar' inserted below the sternum which can make chest compressions more difficult. In those without one, standard compression depths compress the left ventricle more than in non-pectus subjects, and might lead to myocardial injury.
This has led to a recommendation in the journal Resuscitation:
"Until further studies are available, we recommend strong chest compressions, according to the current guidelines, in PE patients with a sternal Nuss bar and, to minimize the risk of myocardial injury, we suggest a reduced chest compression depth (approximately 3–4 cm) at the level of lower half of the sternum in PE patients who have not had corrective surgery."
Cardiopulmonary resuscitation in pectus excavatum patients: Is it time to say more?
Resuscitation. 2014 Dec 10.[Epub ahead of print]
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Esmolol for refractory VF
Already well publicised on social media, the team at Hennepin County published a retrospective comparison between patients with refractory VF who received esmolol with those who did not(1). The results are impressive and I look forward to further studies on this.
I work in an ED in a hospital with no cath lab and no access to extracorporeal life support, limiting our options for patients who remain in shockable rhythms despite ACLS interventions. We now have esmolol available in our resus room. You might want to keep it in your list of options for ACLS-refractory VF, which might also include double sequential external defibrillation(2) and even stellate ganglion block.
The dose of esmolol used was: loading dose 500 mcg/kg, followed by infusions of 0, 50, or 100 mcg/kg/min
An important point to note in the esmolol study is that almost all patients received high-quality mechanical CPR with the combined use of an impedence threshold device to augment venous return and cardiac output. The authors "speculate that this additional hemodynamic support may be essential given the hypotensive effects of esmolol."
1. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation
Resuscitation. 2014 Oct;85(10):1337-41
INTRODUCTION: We compare the outcomes for patients who received esmolol to those who did not receive esmolol during refractory ventricular fibrillation (RVF) in the emergency department (ED).
METHODS: A retrospective investigation in an urban academic ED of patients between January 2011 and January 2014 of patients with out-of-hospital or ED cardiac arrest (CA) with an initial rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT) who received at least three defibrillation attempts, 300mg of amiodarone, and 3mg of adrenaline, and who remained in CA upon ED arrival. Patients who received esmolol during CA were compared to those who did not.
RESULTS: 90 patients had CA with an initial rhythm of VF or VT; 65 patients were excluded, leaving 25 for analysis. Six patients received esmolol during cardiac arrest, and nineteen did not. All patients had ventricular dysrhythmias refractory to many defibrillation attempts, including defibrillation after administration of standard ACLS medications. Most received high doses of adrenaline, amiodarone, and sodium bicarbonate. Comparing the patients that received esmolol to those that did not: 67% and 42% had temporary return of spontaneous circulation (ROSC); 67% and 32% had sustained ROSC; 66% and 32% survived to intensive care unit admission; 50% and 16% survived to hospital discharge; and 50% and 11% survived to discharge with a favorable neurologic outcome, respectively.
CONCLUSION: Beta-blockade should be considered in patients with RVF in the ED prior to cessation of resuscitative efforts.
2. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases.
Prehosp Emerg Care. 2015 January-March;19(1):126-130
Background. Ventricular fibrillation (VF) is considered the out-of-hospital cardiac arrest (OOHCA) rhythm with the highest likelihood of neurologically intact survival. Unfortunately, there are occasions when VF does not respond to standard defibrillatory shocks. Current American Heart Association (AHA) guidelines acknowledge that the data are insufficient in determining the optimal pad placement, waveform, or energy level that produce the best conversion rates from OOHCA with VF.
Objective. To describe a technique of double sequential external defibrillation (DSED) for cases of refractory VF (RVF) during OOHCA resuscitation.
Methods. A retrospective case series was performed in an urban/suburban emergency medical services (EMS) system with advanced life support care and a population of 900,000. Included were all adult OOHCAs having RVF during resuscitation efforts by EMS providers. RVF was defined as persistent VF following at least 5 unsuccessful single shocks, epinephrine administration, and a dose of antiarrhythmic medication. Once the patient was in RVF, EMS personnel applied a second set of pads and utilized a second defibrillator for single defibrillation with the new monitor/pad placement. If VF continued, EMS personnel then utilized the original and second monitor/defibrillator charged to maximum energy, and shocks were delivered from both machines simultaneously. Data were collected from electronic dispatch and patient care reports for descriptive analysis.
Results. From 01/07/2008 to 12/31/2010, a total of 10 patients were treated with DSED. The median age was 76.5 (IQR: 65-82), with median resuscitation time of 51minutes (IQR: 45-62). The median number of single shocks was 6.5 (IQR: 6-11), with a median of 2 (IQR: 1-3) DSED shocks delivered. VF broke after DSED in 7 cases (70%). Only 3 patients (30%) had ROSC in the field, and none survived to discharge.
Conclusion. This case series demonstrates that DSED may be a feasible technique as part of an aggressive treatment plan for RVF in the out-of-hospital setting. In this series, RVF was terminated 70% of the time, but no patient survived to discharge. Further research is needed to better understand the characteristics of and treatment strategies for RVF.
Open cardiac massage in asthmatic arrests?
January 12, 2015 by Cliff
Filed under Acute Med, All Updates, Resus
This idea was provoked by a colleague some years ago who could not achieve a palpable pulse during CPR of an arrested asthmatic child. He wondered whether the severe hyperinflation was rendering external cardiac compressions ineffective and whether he should have done a (prehospital) thoracotomy.
The literature is not strong. The 2010 AHA Guidelines rightly focus on reducing hyperinflation by disconnecting the tracheal tube from the ventilator circuit, and they mention ECMO for refractory cases, but there is no mention of open chest CPR.
I can only find two papers discussing it, both pretty old. A case series in the British Medical Journal from 1968 describes three patients with asthma who had asystolic arrests but did not achieve femoral pulses with external compressions(1). In two, open cardiac massage was performed resulting in restoration of sinus rhythm and cardiac output, and one appeared to make a neurological recovery.
A case report in 1987 describes a 32 year old man in asystolic cardiac arrest due to asthma(2):
"Ventilation required very high inflation pressures and little air movement was heard within the chest despite the administration of Adrenaline 1 mg and Aminophylline 250mg intravenously, and Adrenaline 1mg via the endotracheal tube. This was followed by an intravenous infusion of 100 ml of 8.4% Sodium Bicarbonate solution. External cardiac massage failed to produce a palpable pulse in the carotid area. The chest was, therefore, opened through a left anterolateral thoracotomy. The lungs appeared hyperinflated, bulky and tense and did not collapse when the pleural cavity was opened. The pericardium was opened and asystole confirmed, following eight to ten compressions of the heart some intrinsic activity commenced, ventilation also became much easier."
He achieved ROSC and became haemodynamically stable but failed to wake up and treatment was withdrawn some days later.
Neither reports include mention of disconnection strategies to reduce hyperinflation. The lack of neurological recovery is not surprising given the apparent prolonged state of arrest the patients were resuscitated from. However there does appear to be a survivor who may not have made it had standard resuscitation (at the time) been continued.
Does this mean I would open the chest in an arrested asthma patient?
Not straight away, no. I would treat dynamic hyperinflation with tube disconnection and external compressions. I would correct absolute and relative hypovolaemia with crystalloid. I would treat bronchospasm (and possible anaphylaxis) with intravenous adrenaline/epinephrine. And I would exclude pneumothorax, possibly with ultrasound or more likely with bilateral open thoracostomies. If however these measures resulted in no detectable carotid flow with external cardiac compressions, ECMO was not available, and the arrest was not prolonged, I would definitely consider doing internal cardiac massage via thoracotomy.
What about you?
1. Grant IW, Kennedy WP, Malone DN
Deaths from asthma
Br Med J. 1968 May 18;2(5602):429–30
2. Diament RH, Sloan JP
Failed resuscitation in acute severe asthma: a medical indication for emergency thoracotomy?
Arch Emerg Med. 1987 Dec;4(4):233–5
London Cardiac Arrest Symposium 2014
December 13, 2014 by Louisa Chan
Filed under Acute Med, All Updates, EMS, Guidelines, ICU, Resus, Trauma
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The focus of the entire day is cardiac arrest and this is the second day of the London Cardiac Arrest Symposium.
Professor Niklas Nielsen kicked off with a presentation of his Targeted Temperature Management trial. It seems that even now there is uncertainty in the interpretation of this latest study. I take heart from the knowledge that Prof Nielsen has changed the practice of his institution to reflect the findings of his study – I have certainly changed my practice. But we need to remain aware that there is more work to be done to answer the multiple questions that remain and the need for further RCTs is recognised.
The management of Cardiac arrest after avalanche is not a clinical scenario that I imagine I'll ever find myself in. The management is well documented in the ICAR MEDCOM guidelines 2012. Dr Peter Paal reminded us that you're not dead until you're rewarmed and dead unless: with asystole, CPR may be terminated (or withheld) if a patient is lethally injured or completely frozen, the airway is blocked and duration of burial >35 min, serum potassium >12 mmol L(-1), risk to the rescuers is unacceptably high or a valid do-not-resuscitate order exists.
The age old question about prognostication after cardiac arrest was tackled by Prof Mauro Oddo. He covered the evidence for clinical examination, SSPE, EEG, and neurone specific enolase. Bottom line, all of these modalities are useful but none are specific enough to be used as a stand alone test so multiple modalities are required.
SAMU is leading the way with prehospital ECMO. They have mastered the art of cannulation (in the Louvre no less!) but there haven't enough cases to demonstrate a mortality benefit. The commencement of ECMO prehospital reduces low flow time and theoretically should improve outcomes. This is begging for a RCT.
The experience of the Italians with in hospital ECMO shoes a better survival rate for in-hospital rather than out of hospital cardiac arrests, explained Dr Tomasso Mauri. They treat patients with a no flow time of <6min and low flow rate of <45min and had a 31% ICU survival rate. If you want to learn more about ED ECMO go to http://edecmo.org.
The Douglas Chamberlain lecture this year was Selective aortic arch perfusion presented by Prof James Manning. He spoke about the use of this technique in cardiac arrest and also in trauma (where it is known to you as Zone 1 REBOA).
In cardiac arrest the aim is to improve coronary perfusion, to preserve perfusion to the heart and the brain, offer a route of rapid temperature control and offer a direct route of administration of adrenaline. Coronary perfusion is seen to be supra normal after SAAP. And the suggested place for SAAP is prior to ECMO.
It's more familiar ground talking about SAAP in trauma. This Zone 1 occlusion preserves cerebral and cardiac perfusion while blood loss is limited and rapid fluid resuscitation can occur.
You can hear Prof Manning on SAAP over at EMCrit (of course!).
It's been another great conference. Put the dates for next year's London Trauma & Cardiac Arrest Conferences in your diary: 8th-10th December 2015!
Happy Holidays & Keep Well
Louisa Chan
New AF guidelines from AHA/ACC
December 1, 2014 by Cliff
Filed under Acute Med, All Updates, Guidelines, ICU, Resus
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2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary
J Am Coll Cardiol. 2014;64(21):2246-2280 Free full text
Left Ventricular Assist Device for Cardiac Arrest?
October 7, 2014 by Cliff
Filed under Acute Med, All Updates, ICU, Resus
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An interesting case report by Dr Heidlebaugh and colleagues from the Department of Emergency Medicine at the William Beaumont Hospital describes a 72 year old marathon runner who arrested during cardiac catheterisation. It suggests a possible novel alternative to ECMO for cardiac arrest.
The patient became bradycardic then asystolic during catheterisation of his right coronary artery. High quality CPR was initiated and an Impella LV assist device was placed. This restored cardiac output which was followed by episodes of venticular fibrillation and then ROSC. His initial low ejection fraction of 15% recovered after targeted temperature management on ICU to 50% and he fully recovered neurologically.
This patient already had femoral arterial access for introduction of the Impella, since he was in a cath lab. He also had immediate CPR on arresting, and was an abnormally fit 72 year old. It remains to be seen whether this procedure can be applied to other patients in cardiac arrest. The authors state:
"..until ECLS is readily available, poor survival and neurological outcome after cardiac arrest might be avoided in many patients by the use of pLVAD to offload the LV and enhance perfusion. Furthermore, there may be a subset of patients, in whom the support that pLVAD offers is sufficient to optimize hemodynamic parameters and bridge to ROSC, thus reducing the need for ECLS."
This video by Dr. I-Wen Wang from the Barnes-Jewish Hospital explains how the Impella is inserted and how it works.
Full Neurologic Recovery and Return of Spontaneous Circulation Following Prolonged Cardiac Arrest Facilitated by Percutaneous Left Ventricular Assist Device
Ther Hypothermia Temp Manag. 2014 Sep 3. [Epub ahead of print]
Sudden cardiac arrest is associated with high early mortality, which is largely related to postcardiac arrest syndrome characterized by an acute but often transient decrease in left ventricular (LV) function. The stunned LV provides poor cardiac output, which compounds the initial global insult from hypoperfusion. If employed early, an LV assist device (LVAD) may improve survival and neurologic outcome; however, traditional methods of augmenting LV function have significant drawbacks, limiting their usefulness in the periarrest period. Full cardiac support with cardiopulmonary bypass is not always readily available but is increasingly being studied as a tool to intensify resuscitation. There have been no controlled trials studying the early use of percutaneous LVADs (pLVADs) in pericardiac arrest patients or intra-arrest as a bridge to return of spontaneous circulation. This article presents a case study and discussion of a patient who arrested while undergoing an elective coronary angioplasty and suffered prolonged cardiopulmonary resuscitation. During resuscitation, treatment included placement of a pLVAD and initiation of therapeutic hypothermia. The patient made a rapid and full recovery.
Image is of M. Joshua Morris, a happy LVAD recipient (not the patient in the described study) who kindly alerted me to this article. Used with permission.
ARISE study: EGDT no better than standard care
October 4, 2014 by Cliff
Filed under Acute Med, All Updates, Guidelines, ICU, Resus
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The second of three major trials assessing early goal directed therapy (EGDT) in sepsis – the Australasian ARISE Trial – has been published.
ARISE tested the hypothesis that EGDT, as compared with usual care, would decrease 90-day all-cause mortality among patients presenting to the emergency department with early septic shock in diverse health care settings.
There was no difference in all-cause mortality at 90 days between EGDT and standard care, in keeping with the results from ProCESS.
Why are the results so different from Rivers' original EGDT study? The authors explain:
"although our results differ from those in the original trial, they are consistent with previous studies showing that bias in small, single-center trials may lead to inflated effect sizes"
This cautions us all against making major practice changes based on one single centre study. In critical care we've learned this before with subjects like tight glycaemic control and Activated Protein C. However I do believe that the things we know to be of benefit – early recognition, source control, antibiotics, and fluids – are effective in making 'standard' care "as good as" EGDT because of heightened awareness of the condition and its treatment, and Rivers' initial study and the subsequent Surviving Sepsis Campaign Guidelines have played a major role in raising that awareness.
The ARISE study is appraised by Wessex's The Bottom Line and discussed on the one and only EMCrit podcast.
The ARISE Investigators and the ANZICS Clinical Trials Group.
Goal-Directed Resuscitation for Patients with Early Septic Shock
N Engl J Med. 2014 Oct;:141001063014008.Full Text
Early goal-directed therapy (EGDT) has been endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease mortality among patients presenting to the emergency department with septic shock. However, its effectiveness is uncertain.
Methods In this trial conducted at 51 centers (mostly in Australia or New Zealand), we randomly assigned patients presenting to the emergency department with early septic shock to receive either EGDT or usual care. The primary outcome was all-cause mortality within 90 days after randomization.
Results Of the 1600 enrolled patients, 796 were assigned to the EGDT group and 804 to the usual-care group. Primary outcome data were available for more than 99% of the patients. Patients in the EGDT group received a larger mean (±SD) volume of intravenous fluids in the first 6 hours after randomization than did those in the usual-care group (1964±1415 ml vs. 1713±1401 ml) and were more likely to receive vasopressor infusions (66.6% vs. 57.8%), red-cell transfusions (13.6% vs. 7.0%), and dobutamine (15.4% vs. 2.6%) (P<0.001 for all comparisons). At 90 days after randomization, 147 deaths had occurred in the EGDT group and 150 had occurred in the usual-care group, for rates of death of 18.6% and 18.8%, respectively (absolute risk difference with EGDT vs. usual care, -0.3 percentage points; 95% confidence interval, -4.1 to 3.6; P=0.90). There was no significant difference in survival time, in-hospital mortality, duration of organ support, or length of hospital stay.
Conclusions In critically ill patients presenting to the emergency department with early septic shock, EGDT did not reduce all-cause mortality at 90 days.
Non-ST-Elevation Acute Coronary Syndromes
September 29, 2014 by Cliff
Filed under Acute Med, All Updates, EMS, Guidelines, ICU, Resus
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The latest AHA/ACC guidelines on NSTEACS have been published ahead of print in Circulation.
Full text is available, and the Executive Summary is available here
Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al.
2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
Circulation. 2014 Sep 23. [Epub ahead of print]
Profound hypothermia and no ECMO?
Patients in cardiac arrest due to severe hypothermia benefit from extracorporeal rewarming, and it is often recommended that they are treated at centres capable of providing cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO).
But what if they're brought to a centre that doesn't have those facilities?
If you work in such a centre do you have a plan, and are you familiar with what equipment you could use?
One option if you have an ICU is to provide extracorporeal warming using a haemofiltration machine used for renal replacement therapy(1). A double lumen haemofiltration catheter is inserted into a central vein and an ICU nurse can often do the rest, although some variables have to be set by the intensivist, often aided by a standard renal replacement therapy prescription chart. The machines are mobile and can be wheeled into the resus room (I have practiced this set up in resus). It might be worth discussing and practicing this option with your ICU.
Another extracorporeal option is to rig up a rapid infusion device such as a 'Level 1′ to connect to arterial and venous catheters so that blood from the patient flows through and is warmed by the machine before being returned to the patient(2). Rapid rewarming has been achieved by this method but it requires some modification to the usual set up and so is much less likely to be a realistic option for most teams doing this on very rare occasions.
Less technical options are the traditionally taught warm saline lavage of body cavities such as the thorax and the peritoneal cavity. These can be achieved with readily available catheters and of course should be combined with ventilation with warmed gas and administration of warm intravenous fluid.
Thoracic lavage can be achieved with open thoracotomy or tube thoracostomy. One or two chest tubes can be placed on each side. One technique was described as:
Two 36 French chest tubes were placed in each hemithorax. One tube was placed in the fourth intercostal space in the mid-clavicular line. Another tube was placed into the sixth intercostal space in the mid-axillary line. Sterile saline at 39.0◦C was infused by gravity into each superior chest tube and allowed to drain passively through each inferior tube.(3)
Rapid rewarming at a rate of 6.8◦C per hour was achieved in an arrested hypothermic man using peritoneal lavage. It was done in the operating room with peritoneal lavage (saline 40◦C) with a rapid infusion system (Level 1) through two laparoscopic access sites. It was combined with external forced air rewarming and warm intravenous infusions(4).
Finally some devices manufactured for inducing hypothermia in post-cardiac arrest patients can also be used to rewarm patients, which might be endovascular devices, such as the Cool Line® catheter(5), or external, such as the Arctic Sun® Temperature Management System(6). It's definitely worth finding out what your critical care services have as far as this equipment goes.
In summary, although the 'exam answer' for cardiac arrest due to profound hypothermia is often ECMO/cardiopulmonary bypass, in most centres that's not an option. It's helpful to remind ourselves that (1) other extracorporeal rewarming options exist and (2) non-extracorporeal techniques can provide rapid rewarming.
1. Spooner K, Hassani A. Extracorporeal rewarming in a severely hypothermic patient using venovenous haemofiltration in the accident and emergency department. J Accid Emerg Med. 2000 Nov;17(6):422–4. Full text
2. Gentilello LM, Cobean RA, Offner PJ, Soderberg RW, Jurkovich GJ. Continuous arteriovenous rewarming: rapid reversal of hypothermia in critically ill patients. The Journal of Trauma: Injury, Infection, and Critical Care. 1992 Mar;32(3):316–25 PubMed
3. Plaisier BR. Thoracic lavage in accidental hypothermia with cardiac arrest — report of a case and review of the literature. Resuscitation. 2005 Jul;66(1):99–104. PubMed
4. Gruber E, Beikircher W, Pizzinini R, Marsoner H, Pörnbacher M, Brugger H, et al. Non-extracorporeal rewarming at a rate of 6.8°C per hour in a deeply hypothermic arrested patient. Resuscitation. 2014 Aug;85(8):e119–20. PubMed
5. Kiridume K, Hifumi T, Kawakita K, Okazaki T, Hamaya H, Shinohara N, et al. Clinical experience with an active intravascular rewarming technique for near-severe hypothermia associated with traumatic injury. Journal of Intensive Care. BioMed Central Ltd; 2014;2(1):11. link to abstract
6. Cocchi MN, Giberson B, Donnino MW. Rapid rewarming of hypothermic patient using arctic sun device. Journal of Intensive Care Medicine. 2012 Mar;27(2):128–30. PubMed
When to Stop Resuscitation
July 9, 2014 by Cliff
Filed under Acute Med, All Updates, EMS, Guidelines, ICU, Kids, Resus, Trauma
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My talk at the SmaccGOLD conference in March 2014
Cliff Reid – When Should Resuscitation Stop from Social Media and Critical Care on Vimeo.
Here are the slides:


text:
Chapter 3. Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
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2014 by Helen Thomson Shall I compare thee to... well, no one actually. A 76-year-old woman has developed an incredibly rare disorder – she has the compulsive urge to write poetry. Her brain is now being studied by scientists who want to understand more about the neurological basis for creativity. In 2013, the woman arrived at a UK hospital complaining of memory problems and a tendency to lose her way in familiar locations. For the previous two years, she had experienced occasional seizures. She was diagnosed with temporal lobe epilepsy and treated with the drug lamotrigine, which stopped her seizures. However, as they receded, a strange behaviour took hold. She began to compulsively write poetry – something she hadn't shown any interest in previously. Suddenly, the woman was writing 10 to 15 poems a day, becoming annoyed if she was disrupted. Her work rhymed but the content was banal if a touch wistful – a style her husband described as doggerel (see "Unstoppable creativity"). About six months after her seizures stopped, the desire to write became less strong, although it still persists to some extent. Doctors call the intense desire to write hypergraphia. It typically occurs alongside schizophrenia and an individual's output is usually rambling and disorganised. "It was highly unusual to see such highly structured and creative hypergraphia without any of the other behavioural disturbances," says the woman's neurologist, Jason Warren at University College London. © Copyright Reed Business Information Ltd
Keyword: Epilepsy; Language
Link ID: 20099 - Posted: 09.22.2014
I'm an epileptic. It's not how I define myself, but I am writing about epilepsy, so I think pointing out the fact that I am speaking from experience is acceptable. I may not define myself by my epilepsy but it's a big part of my life. It affects my life on a daily basis. Because of the epilepsy I can't drive, can't pull all-nighters or get up really early just in case I have a seizure. It's frustrating at times, though I will gladly milk the not getting up early thing when I can, eg bin day. But whereas I've grown up with it, having been diagnosed when I was 17, most people I've met don't understand it. You mention the fact that you're epileptic to some people and they look at you like they're a robot you've just asked to explain the concept of love; they adopt a sort of "DOES NOT COMPUTE!" expression. They often don't know what to say, or do, or even what epilepsy is and often spend the rest of the conversation searching their data banks for information on what to do if I have a seizure, like "Do I … put a spoon in his mouth?" For the record: no, you don't. If putting a spoon in an epileptics mouth helped, then we would be prescribed a constant supply of Fruit Corners. So let me put you at ease. No one expects you to know that much about epilepsy (unless you're responsible for treating it). There are many different types, with many different causes. Not everyone has seizures and often those who do, when given the correct meds, can live pretty much fit-free lives. © 2014 Guardian News and Media Limited
Keyword: Epilepsy
Link ID: 20091 - Posted: 09.18.2014
Elie Dolgin When Carol Steinberg was diagnosed with multiple sclerosis (MS) in 1995, there was only one drug approved by the US Food and Drug Administration to treat the disease. Now there are eleven. Yet none of these agents can help Steinberg. She suffers from progressive MS, a form of the disease that is characterized by steadily worsening neurological function. All eleven approved drugs combat the unpredictable symptom outbreaks that are associated with the relapsing–remitting form of MS. Around 85% of newly diagnosed patients have the relapsing–remitting form; after 10 to 20 years, most of them develop the progressive type. The lack of good treatment options for progressive MS weighs heavily on Steinberg. She uses a wheelchair, but continues to work as a trial lawyer in Newton, Massachusetts. "I'm constantly afraid of my disease getting worse," she says. A global initiative called the Progressive MS Alliance now hopes to kick-start the development of therapies specifically for Steinberg and the million or so people worldwide living with progressive MS. On 11 September, at a joint meeting of the European and Americas Committees for Treatment and Research in Multiple Sclerosis, the alliance announced an inaugural round of research awards — part of a six-year, €22-million (US$28.5-million) programme that is the first concerted effort to tackle the disease's less-common form. © 2014 Nature Publishing Group
Keyword: Epilepsy; Neuroimmunology
Link ID: 20089 - Posted: 09.18.2014
By Erik Schechter The folks who brought us the giant, smartphone-controlled cyborg cockroach are back—this time, with a wired-up scorpion. Be afraid. Backyard Brains, a small Michigan-based company dedicated to spreading the word about neuroscience, has been running surgical experiments on these deadly arachnids for the past two months, using electrical current to induce them to strike. Dylan Miller, a summer intern working the project, insists it's the first time that an electrical current has ever been used to remotely induce a scorpion to strike with its pedipalps (claws) and tail. "I was originally looking at how scorpions sense the ground vibrations of their prey," says Miller, a neuroscience major at Michigan State University, "and I just kind of stumbled on this defensive response." In retrospect, it's easy to see how Miller got there. Scorpions use vibrations and their tactile sense to navigate the world, identifying both prey and predator. A touch on the leg, for instance, tells a scorpion that it's under attack, provoking a defensive fight-or-flight reaction—either fleeing from danger or going full-out Bruce Lee. In nature, the scorpion would have to be physically touched for that to happen. But in the lab, an electrode to the leg nerves and a tiny, remote-controlled function generator feeding a signal will do the trick. The scorpion experiments build on the earlier work Backyard Brains has done with cockroaches, namely RoboRoach. A Kickstarter project back in June 2013 and now a real for-sale home kit, RoboRoach enables purchasers to surgically implant a live roach with three sets of electrodes and then control its movement with a smartphone app via a Bluetooth control unit worn on the roach's back. The controversial kit has been criticized as cruel by people like cognitive ethologist Marc Bekoff, but the company argues that RoboRoach's educational "benefits outweigh the cost." Undaunted by the criticism, Backyard Brains co-founder Gregory Gage was already tossing around the idea of robo-scorpions last October. ©2014 Hearst Communication, Inc
Keyword: Miscellaneous
Link ID: 19891 - Posted: 07.29.2014
By Kelly Clancy In one important way, the recipient of a heart transplant ignores its new organ: Its nervous system usually doesn't rewire to communicate with it. The 40,000 neurons controlling a heart operate so perfectly, and are so self-contained, that a heart can be cut out of one body, placed into another, and continue to function perfectly, even in the absence of external control, for a decade or more. This seems necessary: The parts of our nervous system managing our most essential functions behave like a Swiss watch, precisely timed and impervious to perturbations. Chaotic behavior has been throttled out. Or has it? Two simple pendulums that swing with perfect regularity can, when yoked together, move in a chaotic trajectory. Given that the billions of neurons in our brain are each like a pendulum, oscillating back and forth between resting and firing, and connected to 10,000 other neurons, isn't chaos in our nervous system unavoidable? The prospect is terrifying to imagine. Chaos is extremely sensitive to initial conditions—just think of the butterfly effect. What if the wrong perturbation plunged us into irrevocable madness? Among many scientists, too, there is a great deal of resistance to the idea that chaos is at work in biological systems. Many intentionally preclude it from their models. It subverts computationalism, which is the idea that the brain is nothing more than a complicated, but fundamentally rule-based, computer. Chaos seems unqualified as a mechanism of biological information processing, as it allows noise to propagate without bounds, corrupting information transmission and storage. © 2014 Nautilus,
Keyword: Biological Rhythms
Link ID: 19859 - Posted: 07.21.2014
Sam McDougle By now, perhaps you've seen the trailer for the new sci-fi thriller Lucy. It starts with a flurry of stylized special effects and Scarlett Johansson serving up a barrage of bad-guy beatings. Then comes Morgan Freeman, playing a professorial neuroscientist with the obligatory brown blazer, to deliver the film's familiar premise to a full lecture hall: "It is estimated most human beings only use 10 percent of the brain's capacity. Imagine if we could access 100 percent. Interesting things begin to happen." Johansson as Lucy, who has been kidnapped and implanted with mysterious drugs, becomes a test case for those interesting things, which seem to include even more impressive beatings and apparently some kind of Matrix-esque time-warping skills. Of course, the idea that "you only use 10 percent of your brain" is, indeed, 100 hundred percent bogus. Why has this myth persisted for so long, and when is it finally going to die? Unfortunately, not any time soon. A survey last year by The Michael J. Fox Foundation for Parkinson's Research found that 65 percent of Americans believe the myth is true, 5 percent more than those who believe in evolution. Even Mythbusters, which declared the statistic a myth a few years ago, further muddied the waters: The show merely increased the erroneous 10 percent figure and implied, incorrectly, that people use 35 percent of their brains. The idea that swaths of the brain are stagnant pudding while one section does all the work is silly. Like most legends, the origin of this fiction is unclear, though there are some clues. © 2014 by The Atlantic Monthly Group
Keyword: Brain imaging
Link ID: 19848 - Posted: 07.17.2014
By Tanya Lewis and Live Science They say laughter is the best medicine. But what if laughter is the disease? For a 6-year-old girl in Bolivia who suffered from uncontrollable and inappropriate bouts of giggles, laughter was a symptom of a serious brain problem. But doctors initially diagnosed the child with "misbehavior." "She was considered spoiled, crazy — even devil-possessed," José Liders Burgos Zuleta of the Advanced Medical Image Centre in La Paz said in a statement. [ But Burgos Zuleta discovered that the true cause of the girl's laughing seizures, medically called gelastic seizures, was a brain tumor. After the girl underwent a brain scan, the doctors discovered a hamartoma, a small, benign tumor that was pressing against her brain's temporal lobe. Surgeons removed the tumor, the doctors said. She stopped having the uncontrollable attacks of laughter and now laughs only normally, they said. Gelastic seizures are a relatively rare form of epilepsy, said Solomon Moshé, a pediatric neurologist at Albert Einstein College of Medicine in New York. "It's not necessarily 'ha-ha-ha' laughing," Moshé said. "There's no happiness in this. Some of the kids may be very scared," he added. The seizures are most often caused by tumors in the hypothalamus, although they can also come from tumors in other parts of brain, Moshé said. Although laughter is the main symptom, patients may also have outbursts of crying.
Keyword: Emotions; Epilepsy
Link ID: 19765 - Posted: 06.24.2014
In a new study, scientists at the National Institutes of Health took a molecular-level journey into microtubules, the hollow cylinders inside brain cells that act as skeletons and internal highways. They watched how a protein called tubulin acetyltransferase (TAT) labels the inside of microtubules. The results, published in Cell, answer long-standing questions about how TAT tagging works and offer clues as to why it is important for brain health. Microtubules are constantly tagged by proteins in the cell to designate them for specialized functions, in the same way that roads are labeled for fast or slow traffic or for maintenance. TAT coats specific locations inside the microtubules with a chemical called an acetyl group. How the various labels are added to the cellular microtubule network remains a mystery. Recent findings suggested that problems with tagging microtubules may lead to some forms of cancer and nervous system disorders, including Alzheimer's disease, and have been linked to a rare blinding disorder and Joubert Syndrome, an uncommon brain development disorder. "This is the first time anyone has been able to peer inside microtubules and catch TAT in action," said Antonina Roll-Mecak, Ph.D., an investigator at the NIH's National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, Maryland, and the leader of the study. Microtubules are found in all of the body's cells. They are assembled like building blocks, using a protein called tubulin. Microtubules are constructed first by aligning tubulin building blocks into long strings. Then the strings align themselves side by side to form a sheet. Eventually the sheet grows wide enough that it closes up into a cylinder. TAT then bonds an acetyl group to alpha tubulin, a subunit of the tubulin protein.
Keyword: Miscellaneous
Link ID: 19729 - Posted: 06.14.2014
by Clare Wilson There is a new way to hack the brain. A technique that involves genetically engineering brain cells so that they fire in the presence of certain drugs has been used to treat an epilepsy-like condition in rats, and it could soon be trialled in humans. Chemogenetics builds on optogenetics, which involves engineering brain cells so they "fire" when lights are turned on. Selected neurons can then be activated with the flick of a switch. But this requires fibre optic cables to be implanted in the brain, which is impractical for treating human brain disorders. In chemogenetics, however, no cables are needed because neurons are altered to fire in the presence of a certain chemical rather than light. "It's got more potential in that you can give drugs to people more easily than you can get light into their brains," says Dimitri Kullmann of University College London. Stop the neurons Kullmann's team tested the approach by using a harmless virus to deliver a gene into the brains of rats. The gene encoded a protein that stops neurons from firing – but only in the presence of a chemical called clozapine N-oxide (CNO). Several weeks later, they injected the rats with chemicals that trigger brain seizures, to mimic epilepsy. If the rats were then given CNO, the severity of their seizures dropped within 10 minutes. This is the first time the technique has been used to treat a brain disorder, Kullmann says. "The system is neat," says Arnd Pralle of the University of Buffalo in New York state. But he points out that optogenetics allows faster control than this, because light can be turned on and off instantly. © Copyright Reed Business Information Ltd.
Keyword: Epilepsy
Link ID: 19668 - Posted: 05.28.2014
Sara Reardon The researchers' technique shows neurons throughout the body twinkling with activity. Researchers have for the first time imaged all of the neurons firing in a living organism, the nematode worm Caenorhabditis elegans. The achievement, reported today in Nature Methods1 shows how signals travel through the body in real time. Scientists mapped the connections among all 302 of the nematode's neurons in 19862 — a first that has not been repeated with any other organism. But this wiring diagram, or 'connectome', does not allow researchers to determine the neuronal pathways that lead to a particular action. Nor does it allow researchers to predict what the nematode will do at any point in time, says neuroscientist Alipasha Vaziri of the University of Vienna. By providing a means of displaying signaling activity between neurons in three dimensions and in real-time, the new technique should allow scientists to do both. Vaziri and his colleagues engineered C. elegans so that when a neuron fires and calcium ions pass through its cell membranes, the neuron lights up. To capture those signals, they imaged the whole worm using a technique called light-field deconvolution microscopy, which combines images from a set of tiny lenses and analyses them using an algorithm to give a high-resolution three-dimensional image. The researchers took as many as 50 images per second of the entire worm, enabling them to watch the neurons firing in the brain, ventral cord, and tail (see video). Next, the group applied the technique to the transparent larvae of the zebrafish (Danio rerio), imaging the entire brain as the fish responded to the odours of chemicals pumped into their water. They were able to capture the activity of about 5,000 neurons simultaneously (the zebrafish has about 100,000 total neurons). © 2014 Nature Publishing Group
Keyword: Brain imaging
Link ID: 19631 - Posted: 05.18.2014
By Pippa Stephens Health reporter, BBC News A key difference in the brains of male and female MS patients may explain why more women than men get the disease, a study suggests. Scientists at Washington University School of Medicine in the US found higher levels of protein S1PR2 in tests on the brains of female mice and dead women with MS than in male equivalents. Four times more women than men are currently diagnosed with MS. Experts said the finding was "really interesting". MS affects the nerves in the brain and spinal cord, which causes problems with muscle movement, balance and vision. It is a major cause of disability, and affects about 100,000 people in the UK. Abnormal immune cells attack nerve cells in the central nervous system in MS patients. There is currently no cure, although there are treatments that can help in the early stages of the disease. Researchers in Missouri looked at relapsing remitting MS, where people have distinct attacks of symptoms that then fade away either partially or completely. About 85% of people with MS are diagnosed with this type. Scientists studied the blood vessels and brains of healthy mice, mice with MS, and mice without the gene for S1PR2, a blood vessel receptor protein, to see how it affected MS severity. They also looked at the brain tissue samples of 20 people after they had died. They found high levels of S1PR2 in the areas of the brain typically damaged by MS in both mice and people. The activity of the gene coding for S1PR2 was positively correlated with the severity of the disease in mice, the study said. Scientists said S1PR2 could work by helping to make the blood-brain barrier, in charge of stopping potentially harmful substances from entering the brain and spinal fluid, more permeable. BBC © 2014
Keyword: Multiple Sclerosis; Sexual Behavior
Link ID: 19595 - Posted: 05.10.2014
by Andy Coghlan A pregnancy hormone could prove a simple way to treat multiple sclerosis, after showing promise in a trial of 158 women with MS. MS is a neurological condition that results from damage to the brain and nerves inflicted by the body's own immune system. It affects 2.3 million people worldwide. Symptoms include extreme tiredness, blurred vision, muscle weakness and problems with balance and movement. The symptoms of women with MS tend to ease when they are pregnant, but worsen again after giving birth. This could be because of a hormone called oestriol, which is only produced in significant amounts during pregnancy. The hormone is thought to help suppress the mother's immune system to prevent it attacking the fetus. Fewer relapses Rhonda Voskuhl of the University of California, Los Angeles, and her colleagues wondered whether giving oestriol to people with MS who aren't pregnant might also help with symptoms. They gave 8 milligrams of oestriol daily to 86 women with MS, along with their medication, Copaxone (glatiramer acetate). The women had the most common form of MS, called relapsing-remitting MS, which results in periodic flare-ups of symptoms followed by recovery. After one year, they had 47 per cent fewer relapses than a control group that took Copaxone and a placebo. After two years, the relapse rate was 32 per cent lower than the control group in the group given the hormone, suggesting the effects had plateaued. "We think the oestriol group had bottomed out, and there was nothing left to improve," Voskuhl said, as she presented the preliminary results at the annual meeting of the American Academy of Neurology in Philadelphia last week. © Copyright Reed Business Information Ltd.
Keyword: Multiple Sclerosis; Hormones & Behavior
Link ID: 19569 - Posted: 05.04.2014
Combining the estrogen hormone estriol with Copaxone, a drug indicated for the treatment of patients with relapsing forms of multiple sclerosis (MS), may improve symptoms in patients with the disorder, according to preliminary results from a clinical study of 158 patients with relapsing remitting multiple sclerosis (RRMS). The findings were presented today by Rhonda Voskuhl, M.D., from the University of California, Los Angeles, at the American Academy of Neurology Annual Meeting in Philadelphia. The study was funded by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health; and the National Multiple Sclerosis Society. "While these results are encouraging, the results of this Phase II study should be considered preliminary as a larger study would be needed to know whether benefits outweigh the risks for persons affected by MS. At present, we cannot recommend estrogen as part of standard therapy for MS. We encourage patients to talk with their doctors before making any changes to their treatment plans," said Walter Koroshetz, M.D., deputy director of NINDS. MS is an autoimmune disorder in which immune cells break down myelin, a protective covering that wraps around nerve cells. Loss of myelin results in pain, movement and balance problems as well as changes in cognitive ability. RRMS is the most common form of the disorder. Patients with RRMS experience relapses, or flare-ups, of neurological symptoms, followed by recovery periods during which the symptoms improve.
Keyword: Multiple Sclerosis; Hormones & Behavior
Link ID: 19552 - Posted: 04.30.2014
Scientists have bioengineered, in neurons cultured from rats, an enhancement to a cutting edge technology that provides instant control over brain circuit activity with a flash of light. The research funded by the National Institutes of Health adds the same level of control over turning neurons off that, until now, had been limited to turning them on. "What had been working through a weak pump can now work through a highly responsive channel with many orders of magnitude more impact on cell function," explained Karl Deisseroth, M.D., Ph.D., It is like going from a squirt to a gushing hose. Deisseroth and colleagues report on what is being hailed as a marvel of genetic engineering in the April 25, 2014 issue of the journal Science. Deisseroth's team had pioneered the use of light pulses to control brain circuitry in animals genetically engineered to be light-responsive — optogenetics. Genes that allow the sun to control light-sensitive primitive organisms like algae, melded with genes that make fluorescent marker proteins, are fused with a deactivated virus that delivers them to specific types of neurons which they become part of — allowing pulses of light to similarly commandeer brain cells.
Keyword: Brain imaging
Link ID: 19537 - Posted: 04.26.2014
By JAMES GORMAN SAN DIEGO — Dr. Karl Deisseroth is having a very early breakfast before the day gets going at the annual meeting of the Society for Neuroscience. Thirty thousand people who study the brain are here at the Convention Center, a small city's worth of badge-wearing, networking, lecture-attending scientists. For Dr. Deisseroth, though, this crowd is a bit like the gang at Cheers — everybody knows his name. He is a Stanford psychiatrist and a neuroscientist, and one of the people most responsible for the development of optogenetics, a technique that allows researchers to turn brain cells on and off with a combination of genetic manipulation and pulses of light. He is also one of the developers of a new way to turn brains transparent, though he was away when some new twists on the technique were presented by his lab a day or two earlier. "I had to fly home to take care of the kids," he explained. He went home to Palo Alto to be with his four children, while his wife, Michelle Monje, a neurologist at Stanford, flew to the conference for a presentation from her lab. Now she was home and, here he was, back at the conference, looking a bit weary, eating eggs, sunny side up, and talking about the development of new technologies in science. A year ago, President Obama announced an initiative to invest in new research to map brain activity, allocating $100 million for the first year. The money is a drop in the bucket compared with the $4.5 billion the National Institutes of Health spends annually on neuroscience, but it is intended to push the development of new techniques to investigate the brain and map its pathways, starting with the brains of small creatures like flies. Cori Bargmann of Rockefeller University, who is a leader of a committee at the National Institutes of Health setting priorities for its piece of the brain initiative, said optogenetics was a great example of how technology could foster scientific progress. © 2014 The New York Times Company
Keyword: Brain imaging
Link ID: 19520 - Posted: 04.22.2014
by Ashley Yeager A nerve cell's long, slender tentacle isn't evenly coated with an insulating sheath as scientists had thought. Instead, many nerve cells in the brains of mice have stretches of these tentacles, called axons, that are naked, researchers report April 18 in Science. The unsheathed feeler can be as long as 80 micrometers. Nerve cells can also have specific patterns in the gaps of the insulating layer, called myelin. The differences in the thickness of that coating may control how fast signals travel between nerve cells, the scientists suggest. The finding could have implications for understanding nerve-based diseases, such as multiple sclerosis, and improve scientists' understanding of how signals are transmitted in the brain. © Society for Science & the Public 2000 - 2013.
Keyword: Glia; Multiple Sclerosis
Link ID: 19507 - Posted: 04.19.2014
Everything we do — all of our movements, thoughts and feelings – are the result of neurons talking with one another, and recent studies have suggested that some of the conversations might not be all that private. Brain cells known as astrocytes may be listening in on, or even participating in, some of those discussions. But a new mouse study suggests that astrocytes might only be tuning in part of the time — specifically, when the neurons get really excited about something. This research, published in Neuron, was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health. For a long time, researchers thought that the star-shaped astrocytes (the name comes from the Greek word for star) were simply support cells for the neurons. It turns out that these cells have a number of important jobs, including providing nutrients and signaling molecules to neurons, regulating blood flow, and removing brain chemicals called neurotransmitters from the synapse. The synapse is the point of information transfer between two neurons. At this connection point, neurotransmitters are released from one neuron to affect the electrical properties of the other. Long arms of astrocytes are located next to synapses, where they can keep tabs on the conversations going on between neurons. In recent years, it has been shown that astrocytes may also play a role in neuronal communication. When neurons release neurotransmitters, levels of calcium change within astrocytes. Calcium is critical for many processes, including release of molecules from the cell, and activation of a host of proteins within the cell. The role of this astrocytic calcium signaling for brain function remains a mystery.
Keyword: Glia
Link ID: 19505 - Posted: 04.17.2014
By CATHERINE SAINT LOUIS ALEXANDRIA, N.H. — For most of his life, Kevin Ramsey has lived with epileptic seizures that drugs cannot control. At least once a month, he would collapse, unconscious and shaking violently, sometimes injuring himself. Nighttime seizures left him exhausted at dawn, his tongue a bloody mess. After episodes at work, he struggled to stay employed. Driving became too risky. At 28, he sold his truck and moved into his mother's spare bedroom. Cases of intractable epilepsy rarely have happy endings, but today Mr. Ramsey is seizure-free. A novel battery-powered device implanted in his skull, its wires threaded into his brain, tracks its electrical activity and quells impending seizures. At night, he holds a sort of wand to his head and downloads brain data from the device to a laptop for his doctors to review. "I'm still having seizures on the inside, but my stimulator is stopping all of them," said Mr. Ramsey, 36, whose hands shake because of one of the three anti-seizure drugs he still must take. "I can do things on my own I couldn't do before. I can go to the store on my own, and get my groceries. Before, I wouldn't have been able to drive." Just approved by the Food and Drug Administration, the long-awaited device, called the RNS System, aims to reduce seizures and to improve the lives of an estimated 400,000 Americans whose epilepsy cannot be treated with drugs or brain surgery. "This is the first in what I believe is a new generation of therapy for epilepsy," said Dr. Dileep R. Nair, head of adult epilepsy at the Cleveland Clinic and an investigator in the pivotal trial for NeuroPace's RNS. "It's delivering local therapy. It's not taking tissue out; the brain is left intact. And it's unlike a drug, which is a shotgun approach." © 2014 The New York Times Company
Keyword: Epilepsy
Link ID: 19407 - Posted: 03.25.2014
By Maggie Fox Medical marijuana pills or an oral spray made from cannabis may help ease some of the painful spasms caused by multiple sclerosis that make day-to-day life hard for patients, according to new guidelines from the American Academy of Neurology. But the synthetic formulations of marijuana don't change the course of the disease and might cause unpleasant side-effects, the experts at the academy caution. There is not enough evidence to make any recommendation on smoking marijuana for MS patients, stresses Dr. Vijayshree Yadav of Oregon Health & Science University, who led the team writing the guidelines. Synthetic marijuana in pill form, including the Marinol brand, is legal for use in treating nausea and loss of appetite in cancer. An oral spray called Sativex is approved for treating MS symptoms in Britain but not in the U.S. MS patients often seek alternative and complementary therapies because they have so few options for the chronic and incurable condition, caused when the immune system mistakenly attacks the nerves. A review of those therapies found there's no evidence most of them work. The review found that the herb Ginkgo biloba might help fatigue, but not thinking and memory problems. There's also some evidence that magnetic therapy may help fatigue.
Keyword: Multiple Sclerosis
Link ID: 19402 - Posted: 03.25.2014
By Michelle Roberts Health editor, BBC News online Statins may be useful in treating advanced multiple sclerosis (MS), say UK researchers. Early trial results in The Lancet show the cholesterol-lowering pills slow brain shrinkage in people with MS. The University College London (UCL) scientists say large trials can now begin. These will check whether statins benefit MS patients by slowing progression of the disease and easing their symptoms. MS is a major cause of disability, affecting nerves in the brain and spinal cord, which causes problems with muscle movement, balance and vision. Currently there is no cure, although there are treatments that can help in the early stages of the disease. Usually, after around 10 years, around half of people with MS will go on to develop more advanced disease - known as secondary progressive MS. It is this later stage disease that Dr Jeremy Chataway and colleagues at UCL hope to treat with low cost statins. To date, no licensed drugs have shown a convincing impact on this later stage of the disease. For their phase two trial, which is published in the Lancet, Dr Chataway's team randomly assigned 140 people with secondary progressive MS to receive either 80mg of a statin called simvastatin or a placebo for two years. The high, daily dose of simvastatin was well tolerated and slowed brain shrinkage by 43% over two years compared with the placebo. Dr Chataway said: "Caution should be taken regarding over-interpretation of our brain imaging findings, because these might not necessarily translate into clinical benefit. However, our promising results warrant further investigation in larger phase three disability-driven trials." BBC © 2014
Keyword: Multiple Sclerosis
Link ID: 19383 - Posted: 03.19.2014


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Completed 1V1 singles: GK VS TrevelLog
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The sexy siren of yester years Zeenat Aman says, "When Raja Bundela approached me for this role, I just thought that it would certainly be interesting to work with Raj Babbar again". The flowing chemistry between Raj Babbar who played a rapist and Zeenat Aman, the victim, in 'Insaaf Ka Tarazu' was mind-boggling and it will be a feast to relive the sizzling chemistry..
Zeenat plays mother to Hyder Ali(played by Aamir's brother), while Raj Babbar plays father to South actress Sada, who makes her debut in Hindi with this movie.
"Dil to Diwana Hai", which is expected to roll out in May, explores the changing mentality of the new generation, their attitude towards family values, traditions and the requirements of a bridge that can hold them between ethics and modern culture.
Alok Nath, Sushmita Mukherji, Aroona Bakshi, Hemant Pandey, Shabnam Kapoor, Meenu Bharadwaj, Sweta Girea, Mohsin Khan and Gaurav Ghai are in lead cast. The music has been scored by Anand Raj Anand. The cinematography has been done by Rajesh Joshi, while dialogues are written by Vikram Sood and Jayant Deshmukh">Jayant Deshmukh has done the art direction.-(SAMPURN)
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I am glad to hear it.. i havent seen that movie but i do look forward to seeing yesteryear chemistry me being a teenager and all!
High drama in store for the viewers in the coming episodes of Colors' ... 22
We spoke to one of the jodis of Star One�s Love Ne Mila Di Jodi played ... 112
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Megastar Amitabh Bachchan seems to have lost faith in the saying - ...
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February 18, 2012
Staff Photo: John Bohn Bailey Ulp, a sophomore golfer at North Gwinnett High School, is a Super Six athlete. Ulp and his teammates practice at Bear's Best Golf course in Suwanee.
Stories this photo appears in:
North boys ready for team trip to state
When Bailey Ulp claimed the Region 7-AAAAA individual golf championship last year, he had to prepare for more than one new high school experience.. The North Gwinnett freshman had just played his way into the Class AAAAA state tournament in his first chance, but he suddenly had to prepare
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Swiss Frank Roll Ups
1 Sep 2010
|Cocktail frankfurters
|34 Ounce (2 Package)
|Swiss cheese
|8 Ounce, cut in 2 x 1/4 x 1/4 inch strips
|Refrigerated biscuits
|8 Ounce, quartered (1 Tube)
|2 Tablespoon, melted
|Sesame seeds
|2 Tablespoon
Cut lengthwise slit in frankfurters, not quite through; fill with strips of cheese.
Shape biscuit quarters into 4x 3/4-inch rectangles.
Wind dough around frankfurters.
Place on foil-covered baking sheet.
Brush tops of biscuit with melted butter; sprinkle with sesame seeds.
Bake at 400° for 10 minutes or till browned.
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Swiss Frank Roll Ups Recipe


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Maybe. But it wouldn't be pizza.
Lahmejuan= Armenian pizza.
Ground lamb, peppers and onions on lavish. Not Italian pizza, but the concept is identical, and it's been one of my favorite things since I was a little kid. It's really the only way I like lamb aside from shish kebab.
You have a decent sized Armenian community in Chicagoland, there must be one good Armenian grocer someplace.
Either that, or see when the churches are having their picnics, and go check it out.
Charlie Larkin


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School Board blasts Va. Dept. of Education
Henrico County School Board members blasted the Virginia Department of Education during a work session Aug. 16, calling the state's new Standards of Learning tests in math inappropriate and discouraging and suggesting that they could set the state back by forcing teachers to teach to the test.
Board members made their comments after hearing mostly positive news from school system officials about anticipated state accreditation numbers for Henrico schools.
Ninety-seven percent of the county's public schools (64 schools in total) are expected to earn full state accreditation when final results are released next month, according to preliminary data compiled by the school system.
The results would represent a slight improvement from the 95.5 percent of schools that earned full accreditation last year.
Elementary and middle schools earn accreditation by meeting minimum thresholds of student achievement in the state's Standards of Learning tests. In addition to meeting similar SOL standards, high schools also must meet minimum requirements in the new Graduation and Completion Index (GCI) rating system as well.
But while they were pleased with the anticipated results, School Board members voiced their displeasure with the new math SOL tests.
"Shame on the state Department of Education," Board Chair Diana Winston said, taking issue with the fact that many third-graders in Henrico spent as long as two or three hours taking a test that is supposed to last at most 45 minutes. "What are they testing is what I want to know. They have thrown educators in the state of Virginia back to square one again. I don't know what the state is coming to, because this is not good for children."
Board Vice Chair Beverly Cocke of the Brookland District said that at Moody Middle School, students who spent four hours on the math test were not the exception but the rule. One Hermitage student spent nine hours taking a high school SOL math test, she said.
"The pendulum's just gone too far in the other direction," Cocke said. "This is hurting our children."
Varina District board member John Montgomery said that the new standards would require teachers to spend more time teaching to the test and could impact their ability to mold student learners.
"We're going to rise to the occasion [as a school system]," he said, "but really the question is 'At what cost, and to what benefit?' I don't know how we got to this point, but it sure is discouraging."
Superintendent Patrick Russo told the board that the school system had submitted a Freedom of Information Act request to the state to receive specific data about the average length of time it took students to complete the math tests and that it was awaiting that information.
Schools are considered accredited if they meet or exceed each of the required benchmarks during the most recent school year or if their average results during the most recent three years do so. Preliminary data shows that 59 percent of the Henrico schools expected to earn accreditation this year will have done so by meeting those benchmarks during the 2011-12 school year. The other 38 percent of schools (25 in total) will earn accreditation based on their three-year averages.
All Henrico high schools are expected to meet the GCI rating, which awards 100 points for each student who graduates in four years, 75 points for each student who earns a GED, 70 points for each student who is still enrolled in school after four years and 25 points for each student who earns a certificate of completion. Schools must earn an average of 85 points per student or higher to meet the standard.
Two schools – Fairfield and Wilder middle schools – are expected to be accredited with warning because of low math SOL scores. It would be the second straight accreditation with warning for Wilder.
School system officials have identified 12 "at-risk" schools on which they will focus extra efforts in the coming year with the goal of improving results. Those schools are Donahoe, Fair Oaks, Johnson, Montrose and Sandston elementaries; Brookland, Elko, Fairfield, Rolfe and Wilder middle schools; and Highland Springs and Varina high schools.
Academic Achievement Teams (AATs) will meet regularly at each school to review student data, create and implement plans and review them to make changes as needed in order to impact student learning in a positive way, Assistant Superintendent for Secondary Education Eric Jones told the Henrico School Board during a work session Aug. 16.
'Proof of Heaven' coming to Glen Allen
Dr. Even Alexander, a New York Times best-selling author who has been featured on Oprah and Dr. Oz, was in town last week to promote his June 27 talk, "Proof of Heaven," at Glen Allen High School.
Alexander (pictured, at right, while Unity of Bon Air church member Harry Simmons interviews him) has written about what he considers to be his journey through the afterlife.
Tickets to this month's event are $25 and will support the new Bon Secours Hospice House being built later this year. > Read more.
Innsbrook Rotary celebrates 25 years
The Innsbrook Rotary Club, which is celebrating its 25th year in 2015, has completed a number of volunteer projects this year and raised thousands of dollars for various organizations through three events.
The club's annual rose sale, benefit for youth live auction and Virginia Fire Games competition, combined with individual and corporate donations, have raised nearly $70,000 – money that the club contributes back to the community.
FeedMore is the beneficiary of the club's 25th anniversary project, which provides refrigerated trailers to be used for the distribution of food throughout Central Virginia. > Read more.
Weekend Top 10
For our Top 10 calendar events this weekend, click here! > Read more.
No one injured during fiery morning wreck on I-295
Va. Guard soldiers, airmen eligible for Va. Veterans ID card
Land Lovers, Clean Businesses honored
Henrico Schools holding job fair to recruit bus drivers
Fairfield MS band wins 5 awards
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Print Edition
Jul. 2, 2015Click here to read the print edition.
Weekend Top 10
Voltaggio to host three-course dinners at Family Meal July 21-22
Fan favorite shines in new West End home
Weekend Top 10
Weekend Top 10
- More Entertainment
Obituary – Ruby White
Obituary – Thomas Stewart Gammon
Obituaries – Frances Inthavong
- More Obituaries
'Proof of Heaven' coming to Glen Allen
Innsbrook Rotary celebrates 25 years
Holman student named Miss Va. Coed Junior Teen
- More Community
My daughters' other dads
All hail to mothers and the hardest job of all
Cabin fever cures - and blessings
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Athlete of the Week – July 3: Kayla Sell
Athlete of the Week – June 19: Sydney Whitaker
Steward School's Enright drafted by NY Mets
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ClassifiedsPROFLOWERS. Send Flowers for Every Occasion! Anniversary, Birthday, Just Because. Starting at just $19.99. Go to http://www.proflowers.com/Celebrate to receive an extra 20 percent off any order over $29.99 or… Full text
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CalendarInnsbrook After Hours will present Sublime with Rome with special guests Rebelution and Mickey Avalon at 5:30 p.m. Gates open at 5 p.m. Tickets are $15 to $99. All proceeds… Full text


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Photo Galleries
< MyNorthwest
First photos of Britain's baby Prince of Cambridge
Britain's Prince William and Kate, Duchess of Cambridge hold the Prince of Cambridge, Tuesday July 23, 2013, as they pose for photographers outside St. Mary's Hospital.
1 of 21
Britain's Prince William, centre right, and Kate, Duchess of Cambridge hold the Prince of Cambridge, Tuesday July 23, 2013, as they pose for photographers outside St. Mary's Hospital exclusive Lindo Wing in London where the Duchess gave birth on Monday July 22. The Royal couple are expected to head to London's Kensington Palace from the hospital with their newly born son, the third in line to the British throne. (AP Photo/Lefteris Pitarakis)
Photo by Lefteris Pitarakis
Photo by Lefteris Pitarakis
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How the bears and orangutans keep cool at the zoo
Heran and Keema keep cool at the Woodland Park Zoo in Seattle with frozen treats.
U.S. Open at Seattle's South Lake Union
Activities at the Open for All Fan Experience at South Lake Union Park were set up to connect golf fans with the Chambers Bay tournament.
John Kerry visits Seattle
U.S. Secretary of State John Kerry greets employees at the Seattle Passport Agency on May 18. The location is one of 29 domestic passport agencies that the State Department runs. Kerry returned to the United States following a three-day trip to China and South Korea.


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Charity Property Conference 2015
7 Jul 2015
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Compromise agreements are an extremely useful tool in an employer's armoury - but they remain riven with potential pitfalls, says Jane Klauber.
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101 Clips 14.30
Free Multi-Clipboard and Clip Organizer. If you ever wished that you could copy more than a single clip from one document before pasting to another, 101 Clips is for you. With 101 you can copy up to 25 times and unlike other multi clipboards, 101 shows you a preview of each clip before you paste it. It can also be set to remain on top of your working program. 101 handles all forms of clips including multi graphic Word clips.
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JPEG Comment Editor 1.0
JPEG Comment Editor is a simple and easy to understand application that was developed to help you insert comments into your pictures, making it easier to remember when they were snapped.It gets the job done of adding comments in just a few clicks, thus sparing you from having to resort to more complicated programs.Adding comments to pictures is a simple task that does not require any graphical skills on your part.This useful application enables you to adjust the font, for easier reading of comments.There is a built-in search feature so you can search all the comments stored with the picture.Search will automatically display thumbnail images in search results. You have the option to edit and save comments in search results to speed up your editing process.You can also use the utility to open JPEG comments created by Windows, and be able to edit them as well.The program has several options to load JPEG files for processing. You can browse through your system and open it manually, you can drag and drop files, y ...
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Convert OST to PST Free 14.09
OST files are Outlook Data Files which store the mailbox data of MS Outlook during offline mode. But, certain software or hardware related issues like hard disk failure, virus attack, network errors, sudden power failure, improper Outlook exit, etc. may corrupt OST files. The only way to access corrupt OST files is convert them to PST format. Use a professional OST recovery tool like Recoveryfix for OST to PST. It accurately recovers all Outlook mailbox items including emails, attachments, appointments, contacts, calendars, notes, tasks, journals etc. from corrupt, damaged or inaccessible OST files and converts them to Outlook PST format in almost no time. The Convert OST to PST Software is equipped with two data scanning modes ? Standard and Advance, to perform OST recovery in almost every condition. The smartly programmed tool is even capable of recovering data from password protected and highly encrypted OST files. The advanced software also provides option to recover emails in three different formats ...
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OST to PST File Conversion 14.09
Embedded with advance algorithm, RecoveryFix for OST to PST is skilled to perform conversion of severely damaged files into accessible formats. Apart from OST to PST file conversion, it is also designed to save the recovered files into three other formats, which are DBX, EML and MSG format. This OST to PST converter is compatible with all the versions of MS Outlook, like 2010, 2007, 2003 etc. OST to PST File Conversion tool repairs the entire damaged file precisely including list of contacts, calendars, notes, journals and all other MS Outlook items. Regardless of the data format, it successfully saves the data in HTML, RTF and Text format. After scanning and recovering the data, the software enlists the files in a hierarchal order, to provide a complete view of retrieved files. User can select and preview the repaired files, before saving all the files or selected files. Its adaptable feature allows it to support all the versions of MS exchange, from 5.5 to the latest version 2010. The OST to PST Fil ...
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ByteScout Bitmap Visualizer Addon 1.02.103
visual studio debugger addon to preview Bitmap and Image objects while debugging. Works with Visual Studio 2005, 2008, 2010, 2012, 2013 in Debug mode. Views the original image content, saves history, shows detailed properties of the inspected bitmap or image object
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IBID Info Windows Data Recovery 6.0
Want to one stop solution for hard drive recovery? If yes, then IBID Info Windows data recovery comes as a rescuer in time when your data, photos, music videos, films, document and other records get deleted unfortunately. By applying this user friendly application, you can resolve all your data loss worries in few seconds. This reliable IBID Info Windows file recovery application not only recover lost data from your Windows System?s hard disk, Laptop but also recover lost or inaccessible data from flash drive, USB drive, digital media, Memory card and other storage devices easily. This NTFS partition recovery application embedded with advanced features that can solve almost all types of hard drive data loss issues & recovering data from emptied recycle bin. It can recover data from any situation like virus attacks, Trojan infection, software crash and malfunction, formatted partition, damaged hard drive, lost or inaccessible partition or any other unforeseen reasons under Windows 8.1/8/Win7/Win Vista ...
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OST Email Recovery 14.09
In order to run a business smoothly, users should keep a regular check on their basic functions like communication and management. Both these functions are generally handled by using MS Outlook. The problem comes when the key to run the whole process gets damaged, and that is emails. A single email error can stop the whole process. Since, Outlook emails are prone to corruption, it is always better to have a perfect email recovery utility for fast and safe resolution. RecoveryFix for OST to PST is one such tool which can recover inaccessible OST files easily, with all the MS Outlook properties. This OST Email Recovery tool diminishes all the corrupted elements of an email and restore it in original format. It let user to choose the corrupted OST file and examines it thoroughly, then enlists the recovered files in hierarchal order. Its preview feature enables user to select and view all the repaired files before saving them. The OST Email Recovery software also supports all the versions of MS outlook an ...
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dbForge Data Generator for SQL Server 2.0
dbForge Data Generator for SQL Server is a powerful GUI tool for a fast generation of large volumes of SQL Server test table data. The tool supports all column data types and allows to define tables and columns for data generation, set value ranges, customize parameters for each column data type, preview data before generation, edit and save data generation scripts for the future use.
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Zulu Masters Edition 3.52
Zulu Masters Edition is a DJ program for Windows. Automatic beat detection helps mixing your favorite music fun and easy. Start by loading a track onto the deck and the program will automatically scan the song for a beat. After scanning for a beat, the track will be assigned a BPM (beat per minute) and adjust the tempo on the second track for perfectly matched synchronization. Drag and drop tracks anywhere to preview the song before playing.
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Able MPEG2 Editor 3.2.24
Able MPEG2 Editor lets you remove any parts from MPEG2 (DVD) files without decoding. Using the included video player, you can easily remove any unwanted parts (TV Ads and so on) from MPEG2 (DVD) video files in minutes. You can preview the MPEG2 file, set ranges (start and end points) and cut to the good parts.
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VISCOM Video BroadCast ActiveX SDK 3.62
Streaming FLV, F4V, VOB, MPEG2, MOV, H.264, MP4, 3GP, MPEG1, DIVX, AVI, WMV, ASF video files in real time to client computers. It include Video Broadcast Encoder ActiveX and Video Broadcast Player. Built-in mov, FLV, F4V, MPEG2,VOB, 3gp, mp4 decoder, it support broadcasting FLV, F4V, VOB, MPEG2, AVI, divx, mpeg1, mov, 3gp, mp4 video files over lan and internet. Support add on any directshow compatible decoder. Create high quality video and audio for realtime streaming , Allow to adjust Video Bitrate, Audio Bitrate, frame rate, Width, Height, Time out values before broadcasting. Support broadcasting from playback list with different video format. Return current broadcasting position, total duration of video files. It have client connected , disconnected event , include the client IP address information. Video Broadcast Player support aspect ratio control and allow resize the video screen in design time or runtime. Video Broadcast Player support full screen mode, adjust sound volume. Compatible with a ...
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VISCOM Video Capture ActiveX SDK 7.6
Capture Video/VCR/TV Program to AVI or Streaming file format (WMV file). Add Picture in Picture effect , Video Capture mixing image file or mixing two Video Capture devices, adjust alpha channel and position of each video capture device or image. Capture Video From web cam, capture card, TV Tuner to AVI or Streaming file format (WMV file). Capture Video stream From Axis, Panasonic, D-Link, Eltis, FlexWatch, Gadspot, GRANDTEC, Hawking, HikVision, Hun OsBRiDGE, Panasonic, PiXORD, Planet, RF Link, Samsung Techwin, SOHO, Sony, Sparklan, Stardot, Swann, Sweex, Toshiba, TRENDnet, Trust, VCenter, Vivotek, Xannet, Y-Cam IP Camerea. Frame grabber to memory or clipboard. Refresh audio pin when audio device changed. Detecting insert or remove USB device. Support TV, FM Radio, AM Radio, Digital Satellite Service TV Tuner. Adjustment display area, e.g. full screen or user define size. Support Custom WMV Profile. You can configure streams to use Window Media Video 9 Codec, VBR and CBR bitrates, uncompresse ...
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VISCOM Video Capture Mobile ActiveX 6.01
Capture Video from capture card, tv tuner, dv cam, dvd player to FLV, iPod, PSP, AVI, WMV video. Rotate, invert video. Draw overlay bitmap on live video or save to video file. User define transparent color, alpha value. Draw overlay time stamp (18 different date formats) on live video or save to video file. Draw multi-line overlay text on live video or save to video file and provide over 50 different text styles. SnapShot Bitmap , JPEG from TV Tuner Cards, Web Cam , Capture Cards. SnapShot in Memory (HBITMAP, Picture Box) from TV Tuner Cards, Web Cam , Capture Cards. Support user deinfe WMV Profile. You can configure streams to use Window Media Video 9 Codec, VBR and CBR bitrates, uncompressed audio or video stream, Video Size, Buffer Size, Frame rate, etc. Almost support all capture cards. User define font name/size/color on overlay text/time stamp. Dynamic change overlay properties (e.g font size/color). Single frame and image sequence capture. Video Compressor setting including DivX ...
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VISCOM Motion Detection SDK ActiveX 7.7
Capture Video from capture card, tv tuner, dv cam, dvd player to AVI or WMV 9, WMV8 file format. add Rotate, invert, grayscale effect on a video stream. allow add picture in picture effect, video capture device mixing image file or mixing two video capture devices. allow apply moving effect, zoom in, zoom out effect at specific time on specific picture when using picture in picture effect. Motion Detection for specific region and custom define Motion Sensitivity . Support drawing freehand line, circle, rectangle, Bucket Fill, Erase and Zoom the video. Support add over 190 beautiful frame on video. Support apply Distoring Mirror, Twins, Mosaic special effect to entire screen or selected video portions. Preview Video stream and snapshot From IP Camera. Capture Video stream From IP Camera to AVI file (uncompressed or compressed using any available codec) Support access password protected IP Camera. Support almost all IP Camera that support MJPEG stream. Draw overlay bitmap on live video or save to ...
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VISCOM Video Timeline SDK ActiveX 1.07
With Video Timeline ActiveX Control lets your application immediately support video timeline features within your business application. User friendly video timeline control. (including Drag & drop, scrolling, panning, zooming) Support Add Video Clips, Audio Clips, Effect Clips. Audio clips display audio waveform and volume envelope graph. Clips and effects can be dragged along the timeline ? Clips edges can be dragged to set the clip media time. Preview the timeline, support play, pause, stop. Seek time can be set by clicking on the ruler. Support Show or Hide Video Track, Audio Track, Effect Track. When playback, the timeline automatically scrolls so that the current seek position is visible. Support enumerate DirectShow Effect and using on Effect Clips. e.g. Grayscale, Invert, Mirrow, Rotate, XRay,Blur, Emboss, Pixelate. Support change the color of timeline control. Support unlimited undo and redo feature for the clips. Support save each clips information to project file and supp ...
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PDF Previewer for Windows 10 1.02
The free PDF previewer enables Windows 10 users to see the contents of a PDF document without opening it. When you're looking for a PDF file or you just need a bit of information from one, to preview PDF documents in a fast preview window is easier than opening files. Simply browse and click on any PDF document, and its content is shown in the preview pane of Windows Explorer or Microsoft Outlook. PDF preview in icon level is also available.
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DreamPlan Home Design Software Free 1.42
DreamPlan Free Home Design Software can help you plan and visualize your dream home with a realistic 3D model. Before planning a new home or starting on a new home improvement project, use DreamPlan to perfect the floor plan and preview any new home design. Create the floor plan of your house, condo, or apartment. Set custom colors, textures, furniture, and more.
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DataFitting 1.7.10
DataFitting is a powerful statistical analysis program that performs linear and nonlinear regression analysis (i.e. curve fitting). DataFitting determines the values of parameters for an equation, whose form you specify, that cause the equation to best fit a set of data values. DataFitting can handle linear, polynomial, exponential, and general nonlinear functions. DataFitting performs true nonlinear regression analysis, it does not transform the function into a linear form. As a result, it can handle functions that are impossible to linearize such as: y = (a - c) * exp(-b * x) + c Quickly Find the Best Equations that Describe Your Data: DataFitting gives students, teachers, engineers, researchers and other professionals the power to find the ideal model for even the most complex data, by putting a large number of equations at their fingertips. It has built-in library that includes a wide array of linear and nonlinear models from simple linear equations to high order polynomials. Graphically Re ...
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Business Letter Professional 7.22
Includes more than 1600 typical business letter templates. With this software, you can write impressive and effective letters yourself with strengthened skills, less time and no extra money cost. The embedded text editor in this program allows you to edit, copy, paste, search, preview and save your letters. It also enables you to set an external e-mail program to send your finished letters directly.
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25 Clips 1.40.17
If you ever wished that you could copy more than a single clip from one document before pasting to another, 25 Clips is for you. With 25 Clips you can copy up to 25 times and unlike other multi clipboards, 25 Clips shows you a preview of each clip before you paste it. 25 Clips handles all forms of clips including multi graphic Word clips. It even pastes graphics directly into the body of Outlook.
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AnyMP4 Audio Converter 6.1.50
AnyMP4 Audio Converter is the professional program which can not only convert any audio format to your needed audio formats like FLAC, WAV, WMA, AAC, ALAC, AC3, AIFF, AMR, AU, OGG, MKA, MP3, MP2, M4A, but also extract audios from video files. Also, you can enjoy them on your portable devices like iPad Air, iPad Mini, iPhone 6/6 Plus, iPhone 5s/5c, iPhone 4S, iPod, etc. Moreover, this software enables you to customize the output file by powerful editing functions like trimming the audio to your needed length, merging more than one audio clip together and output one single file, adjusting the audio settings and choosing your preferred audio track, etc. Key Features: 1. Convert audio to your needed audio formats AnyMP4 Audio Converter has the ability to convert different kinds of audio files to other audio formats including FLAC, WAV, AAC, ALAC, AC3, OGG, MKA, M4A, MP2, MP3, AU, AMR and AIFF. So you can enjoy them on your portable devices such as iPhone, iPod, iPad, PSP, PS3 and more. 2. Extract audio ...
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A to Z Clipboard Extender 5.12
A to Z Clipboard is a free utility which allows you to copy up to 25 times before pasting. (Unlike the Windows clipboard which only allows you to copy once.) The small clipboard window floats above your work and you can see the first few words of each clip to remind you what they are. When you put the mouse over a clip, you see more of it in an optional pop up preview window.
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Lookeen Free Desktop Search 10.0.1.588
Lookeen Free - The free desktop search for Windows. Search your Windows main drive quickly and easily with the free version of the award-winning desktop search tool Lookeen. Lookeen is the alternative to Windows Search. Lookeen Free searches through all of your data and presents a clearly arranged set of results. Search words are highlighted in different colors, and the full fidelity preview makes it easy to find the required content.
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1st Choice Free Clipboard Manager 5.12
The 1St Choice Clipboard manager floats on top of your current work. Whenever you cut or copy, the clip appears in one of the slots. The slot only shows the first few words of each text clip or the words "Graphic Clip" but when you move the mouse pointer over the slot, a preview window appears showing the first several lines of a text clip or a thumbnail of a graphic clip. This makes choosing the clip you want to paste very easy.
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Eassos Photo Recovery 2.1.5
Eassos Photo Recovery is the best and specially designed software to fix various photo loss problems, for example, recover deleted photos from camera, restore formatted pictures from memory card, retrieve lost images from cell phone, recover lost photo from corrupted or RAW drive, etc. Various local disk and removable devices are supported, such as memory card, USB drive, SD card, digital camera, mobile phone, computer, etc. 1. Recover deleted and formatted photos as well as recover lost photos from damaged or RAW partitions and drives. 2. Support recovery of various formats of photos and images, such as JPG, BMP, PNG, PSD, MAX, RAW, DNG, MEF, ICO, TIFF, CRW, etc. 3. Users can view and preview files during or after file scanning process and know file quality before actual recovery. 4. Scanning progress can be saved automatically or manually so that users can load it instead of scanning from beginning if program is restarted. 5. Eassos Photo Recovery can perform photo recovery from all Windows system base ...
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