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Jon Fleischman
Jon is the elected Vice Chairman, South of the California Republican Party.
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FlashReport Weblog on California Politics
*Breaking News* GOP AG Candidate Eastman Files As 'Assistant Attorney General'
by Jon Fleischman - Publisher (bio) (email)(print)
But we have learned that Eastman's candidacy will be getting a significant boost from his ballot designation. Up until recently, Eastman has been the Dean of Chapman University's School of Law (ironically, in that role he was the "boss" of U.S. Senate candidate Tom Campbell, who is teaching there right now). But with Eastman having stepped down from that role, what IS he doing for an income?
Eastman is an ASSISTANT ATTORNEY GENERAL (and has filed his ballot designation as such).
But wait, before you ask whether Eastman has been appointed by California Attorney General Jerry Brown, let me assure you that he most definitely has not. It turns out that Eastman's primary source of income is now a legal case in South Dakota, where he is representing the State in a case before the United States Supreme Court. In this capacity, Eastman was appointed as an Assistant Attorney General by South Dakota Attorney General Marty J. Jackley.
Attached is the official appointment form designating Eastman as an Assistant Attorney General. Below is the rationale for use of this title, provided by the Eastman campaign...
We'll get to more analysis later on, but assuming that his ballot designation is upheld by a judge on the invariable court challenge, it will REALLY help Eastman. Especially given that none of the GOP candidates for Attorney General are going to have the big bucks necessary to run statewide television campaigns (certainly not one that will break through the noise of the Gubernatorial and U.S. Senate races)...
Ballot Designation Worksheet
1. Assistant Attorney General
Background and Substantiation
I resigned as Dean of the Chapman University School of Law on January 28, 2010, and am currently on a reduced teaching load, to be followed by a sabbatical, as is common in academia after stepping down from an administrative post. On February 23, 2010, I was appointed Special Assistant Attorney General by South Dakota Attorney General Marty J. Jackley to represent the state before the Supreme Court of the United States in Reisch v. Sisney, No. 09-953. Attached is the appointment certification. Under South Dakota Codified Law 1-11-5, the South Dakota Attorney General is "authorized to appoint assistant attorneys general as he may deem necessary on a part-time basis for special assignments." (Emphasis added).
As Assistant Attorney General, I have been appointed to represent the state in all matters relative to Reisch v. Sisney. My work as Assistant Attorney General has included substantial activity to seek certiorari of Reisch by the Supreme Court of the United States researching, writing, and overseeing the preparation of the petition filed in this case. (My work on the petition began in November 2009, prior to the formal appointment on February 23, 2010.) I will expend substantial time on this case over the balance of this month and next to review the opposition to the petition and prepare the state's reply brief.
My work as Assistant Attorney General constitutes a principal profession and occupation within the meaning of Elections Code Section 13107(a)(3). My work as Assistant Attorney General has been the primary professional activity since my resignation as Dean from Chapman. Pursuant to the terms of my retainer agreement, I will be paid $20,000 for researching and writing the Petition for Certiorari and representing the state in submitting a reply to opposing briefs. My work has constituted one of my primary, main and leading endeavors since I was retained and ultimately appointed Assistant Attorney General. Should the Supreme Court grant certiorari, I will expend significant effort preparing the briefing on the merits and preparing for and conducting oral argument. I anticipate I would bill the state at least an additional $100,000 for such additional work. Assistant Attorney General Jeffrey P. Hallem can verify these matters. His contact information appears on the attached appointment materials.
In sum, my appointment as an Assistant Attorney General is expressly authorized by statute, I was duly appointed to this position, the position represents my primary professional occupation since January 28, 2010 and the ballot designation of Assistant Attorney General is literally accurate and is the most accurate description given Section 13107(a)(3)'s three-word limitation.
Special Assistant AG Appointment Documentation
Wow, that seems misleading and sketchy.Posted by Brian Leubitz at March 17, 2010 2:48pm
Very misleading! Eastman has lost my vote!Posted by Allen J. Wilson at March 17, 2010 8:59pm
"Misleading"? "Sketchy"???
"Technically accurate" IS accurate!
What would you prefer? "Former dean", "Itinerant speech maker", "unemployed attorney"???
It is misleading PERIOD.
Stop defending the phrase "technically accurate" and making excuses for the man!
Mr. Eastman is commonly known as former Dean at Chapman Law!
How can it be "misleading" if it is the truth?
Eastman IS currently employed as an Assistant Attorney General. Truth. No excuses, just a fact.
"Former Dean" and current AAG are both true; I'll bet that if Eastman didn't make it known that he is currently an Asst. Atty. Gen. there are people who would take shots at him for "hiding" that fact.
Seems to me that your overreaction to this hints at some hidden agenda on your part...
By the way, although I do support and endorse Eastman, I acknowledge that Cooley is also a good choice, and I will fully support whomever our nominee is in the General Election.
By using the designation of Assistant Attorney General, Eastman has put himself afoul of the the Hatch Act -- a non-elected enmployee of an agency which takes federal funds (S.Dakota does) cannot be a candidate for partisan office. Eastman needs a good attorney, wait isn't that what he was supposed to be?Posted by Kevin Ready at March 18, 2010 10:10am
Allen, you should read the ballot designation laws and rules before your offering your opinion. They very clearly state a strong preference not to use a former occupation, especially in the case that you have a new occupation.
John Eastman spends a substantial amount of his professional time and receives a substantial amount of his professional income as an Assistant Attorney General. That is the standard by which ballot designations are chosen.
Since you are supporting another candidate, it appears, one might understand why you don't like this ballot designation. But if you are going to try to explain a legal basis for your statements, you should know the law.
Jeff Flint
Campaign consultant for John Eastman
With regard to Kevin Ready's comments about the Hatch Act, John is not an employee of the State of South Dakota nor the federal government, he is a contacted outside lawyer. South Dakota's laws require the designation of such outside counsel as Assistant Attorneys General. That does not make them employees. The Hatch Act does not apply.
With regard to comments about John's legal ability, that laughable and not really worth responding to. But obviously, in this case in point, a potentially landmark case dealing with states' rights and federal mandates, South Dakota hired a really good attorney, who has Clerked for Clarence Thomas, who has appeared dozens of times before Appellate and Supreme Courts on serious constitutional law questions. Questioning John's legal talent undermines any credibility you have.
For the record: I am not supporting any candidate for Attorney General in the GOP Primary.
However, I will let my view known on June 8th and that will be between me and the ballot!
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Clinique Rinse-Off Eye Makeup Solvent
281 reviews
50% would repurchase
Package Quality: 3.7
Price: $$$
Package Quality: 3.7
Price: $$$
INGREDIENTSWater, peg-32, butylene glycol, disodium cocoamphodiacetate, peg-6, trisodium edta, phenoxyethanol
on 10/24/2011 3:34:00 PM
Age: 18 & Under
Skin: Combination, Fair, Cool
Hair: Blond, Relaxed, Medium
Eyes: Blue
This removes eyeshadow, eyeliner and mascara quite well - really. The only downside is the fact that this stings. I have not got sensetive eyes - nor does my mother - and the first time I used it I felt a sort of tingly feeling, but did not really think about it. I asked my mother how she liked it (this was without her knowing I had tried her brand new makeup remover just before, shh) and she said it stung. I remembered how I actually felt the same, and after that I can really notice it is rough when I am taking off my makeup.
Still, this is not a bad product, and it will be emptied. But sensetive eyes should watch out.
on 10/3/2011 7:48:00 PM
Age: 25-29
Skin: Sensitive, Medium, Neutral
Hair: Brunette, Wavy, Medium
Eyes: Brown
At first I tried the sample size of this product fell in love with it, even tried to make it last longer by diluting it with H2O. But ended up getting the regular size. Still LOVE it. it clears my eye makeup so well. Unlike other brands it doesn't sting my eyes! This product wipes off clean without leaving a chemical film on my skin so I can still use it to clean up mistakes on my eye makeup without washing my entire face and start over. it works well with cotton balls, q-tips and everything else. Love it Loveit, i gotta get more!
on 10/3/2011 7:15:00 PM
Age: 18 & Under
Skin: Normal, Fair-Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Hazel
I was really surprised when I read so many bad reviews! I bought a FULL SIZE (this will become a keyword in this review) and fell in love. In one sweep, my primer, eyeshadow, and liner were all gone! I couldn't believe my eyes (no pun intended!)!
The reason I put FULL SIZE in all caps were because many of the bad reviews were about a sample size of this product. While I do believe that a company should make quality samples, I also believe that you should not judge a product based on a sample. For all I know, that sample could have been poorly made.
Also, I wonder if the people who gave this product one star READ THE DIRECTIONS. You are supposed to saturate a cotton ball with the solution, sweep it over the eye, remove any excess with a tissue, and rinse with cold water.
This product, along with any product WILL NOT work if you do not follow directions.
All in all, I like this product a lot. It gets the job done, and it isn't too expensive. I would buy this product again.
on 9/28/2011 5:32:00 PM
Age: 18 & Under
Skin: Combination, Medium, Not Sure
Hair: Black, Other, Other
Eyes: Brown
I've recieved this as a bonus in a sample size.
I really like this eye makeup remover. Removes with ease, couple swipes. Only need a bit of this to rid of all my eye makeup.
on 6/11/2011 11:58:00 PM
Age: 36-43
Skin: Sensitive, Fair, Cool
Hair: Brown, Curly, Coarse
Eyes: Hazel
I like this product better than the Mary Kay eye makeup remover I'd been using for over a decade. I would take off eye makeup with this, and then wash my face, and it washed off nicely w/o any residue. It also seems like the bottle lasts forever!
No stinging of eyes or skin.
on 6/10/2011 2:14:00 AM
Age: 19-24
Skin: Combination, Fair-Medium, Not Sure
Hair: Brunette, Other, Other
Eyes: Brown
I got a sample from the Clinique counter. This stuff is pretty good, I usually only wear eyeliner and fill in my brows with a bit of powder and this solution takes all that off at the end of the night. The eyeliner I use is the Revlon ColorStay Liquid Liner and it takes that off with no problems. I really like this eye make up remover and will continue to use it until I find a better one.
on 4/22/2011 9:57:00 PM
Age: 19-24
Skin: Combination, Fair-Medium, Not Sure
Hair: Black, Other, Other
Eyes: Brown
I received this as a sample from clinique. I have to say that this product doesn't do a great job on removing makeup.(especially when I'm using double eyelid glue since i have asian eyes...) It makes a huge mess around my eye area and would irritate my eyes if im not very careful. Also, the bottle's opening is way too big that i would spill the product almost every time i use it. But eventually i start to use this again b/c i use olive oil to remove my eye makeup and need a cleanser.
To my surprise, this product removes the oil without me even trying and gives me a clean feeling on the skin. I think this product can be both good and bad depends on how you use it. Mayve i'll buy this again.
on 4/2/2011 11:02:00 PM
Age: 25-29
Skin: Combination, Fair-Medium, Cool
Hair: Brunette, Straight, Medium
Eyes: Blue
Maybe I like this because I'm not using it for it's intended purpose! I use it as a mild cleanser. I normally apply this to my face after using olive oil. It does a great job of taking off the oil while not stripping my face of moisture.
It suds up just a tad and isn't oily or harsh like most makeup removers.
I wish the cap had something that would prevent using too much product though.
on 3/26/2011 9:36:00 AM
Age: 44-55
Skin: Combination, Fair, Not Sure
Hair: Brunette, Other, Other
Eyes: Green
I have bene using this for years and keep returning to it. I wash my face with a foaming cleanser first and then saturate a cotton disc with this eye makeup remover and it does a very good job with no irritation. The fact that my eyes are still humid and that I don't wear waterproof mascara, make it very easy to remove all makeup.
on 3/11/2011 9:23:00 PM
Age: 30-35
Skin: Combination, Fair-Medium, Not Sure
Hair: Brown, Other, Other
Eyes: Blue
Luckily I got this as part of a GWP so I'm glad that I didn't pay for it. Terrible at removing eye makeup, stung like crazy when it got into my eyes and definitely not a product I would ever buy. I can't understand why Clinique would sell this especially since they have a lot of nice products.
Popular Eye Makeup Removers
45 Reviews
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Commercial Services and Supplies
Company Overview of California Public Utilities Commission
Company Overview
California Public Utilities Commission (CPUC) regulates privately owned utilities in California. It engages in regulation of telecommunications, electric, natural gas, water, railroad, rail transit, and passenger transportation companies. Additionally, the commission authorizes video franchises. It also offers consumer protection programs. CPUC, formerly known as the Railroad Commission, was established in 1911 and is based in San Francisco, California with an additional office in Los Angeles, California.
505 Van Ness Avenue
San Francisco, CA 94102
United States
Founded in 1911
Key Executives for California Public Utilities Commission
California Public Utilities Commission Key Developments
Pacific Gas and Electric Company announced that it has paid a $300 million fine levied by the California Public Utilities Commission (CPUC) in association with the 2010 natural gas transmission pipeline explosion in San Bruno, Calif. When the CPUC announced its decision on April 9, PG&E chose to move forward without an appeal. The payment to the state's General Fund is due Oct. 6. The company recently completed the sale of additional stock necessary to fund the payment. In addition to the $300 million fine to be paid to the state, the CPUC penalty requires that PG&E shareholders refund $400 million to gas customers and pay $850 million for gas system safety improvements. The $400 million refund, which will be based on usage, will be returned to customers in early 2016 per the CPUC's direction. In addition to the payment to the General Fund, the company has settled claims amounting to more than $500 million with all of the victims and families of the San Bruno accident, established a $50 million trust for the City of San Bruno for costs related to recovery and contributed $70 million to support the city's and community's recovery efforts. As a result of the concrete actions the company has taken to make safety the cornerstone of its culture following the San Bruno explosion, PG&E became one of the first utilities ever to earn two of the highest internationally recognized safety certifications "the International Organization for Standardization (ISO) 55001 and Publicly Available Specification (PAS) 55-1. The company has taken additional actions including the following: Change began at the top with Tony Earley joining the company as CEO in 2011. The company restructured its gas operations business and hired the best natural gas experts in the country to run it. The company put 3,500 leaders at all levels of PG&E through safety training and review the lessons of San Bruno with every new employee. The company has conducted advanced pipeline safety testing, replaced pipe where necessary and installed more than 200 new automated or remotely controlled emergency shut-off valves. The company decommissioned more than 800 miles of remaining cast-iron pipe in system, replacing with stronger, more efficient and seismically sound pipe. The company built a new gas operations control center, employing the most advanced technology, from which the company can monitor the entire system and respond more quickly and effectively to emergencies. The company has closed out 10 of 12 recommendations from the National Transportation Safety Board and work on the remaining two is on track.
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Uber announced that California regulators ordered the company to pay a $7.3 million fine and hand over required information about safety and accessibility - or shut down in the ride service's home state. The California Public Utilities Commission said Uber was the only ride service that did not provide the information. An Uber spokeswoman said the San Francisco company would appeal the fine. The fine was levied against Rasier-CA, a wholly owned Uber subsidiary that operates UberX in California. The company's operating license could be suspended if it does not pay the penalty and supply the required information within 30 days.
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Topic: Nhl
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NHL Network Preps Olympics Highlights Show
NHL Tonight: 2014 Sochi Edition launches Feb. 12
By Anthony Crupi on Feb. 11, 2014 - 4:00 PM EST
While the Winter Olympics has put the NHL's 2013-14 campaign on ice for the next two weeks, the league's in-house cable network hasn't exactly been idle. In fact, beginning Feb.…


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I was looking through the group listing and right above this group I saw these guys, Moddb.com
Made me laugh :)
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I was looking through the group listing and right above this group I saw these guys, Moddb.com
Made me laugh :)
Heres somethin: After 6 weeks of escorting the Little Rock 9 troopers from the 101st Airborne were sent back to Fort Campbell.
Come on.
Anyone in this group upload something? "_" Because the whole web is almost empty.
The death from sky---Airborne!!
Death From Above?
you guys shoud watch band of brothers
I have watched it.Its very cool.The 101st airborne and the German airborne are the best airborne in the world at that time.
Ahahaha don't make me laugh..
Dont forget the all americans
Promote Airborne Assault Fan Group on your homepage or blog by selecting a button and using the embed code provided (more).


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|By Business Wire
Article Rating:
|February 8, 2013 09:07 AM EST
Data storage, management and restoration expert, Attix5 is today launching Attix5 Pro V7, a world beating data back-up and storage solution for Private, Public & Hybrid cloud.
Attix5 has put over 13years experience into creating the robust, secure solution for Enterprise clients processing terabytes of data that challenges anything available in the current market. Attix5 Pro V7 uses streaming back-up for faster processing requiring negligible client system resources, and supports all operating platforms including Microsoft, Linux, Mac OSX and Solaris.
Luv Duggal General Manager of Sales (UK) commented, "With data volumes and compliance responsibilities constantly increasing, managing and protecting a company's data is becoming more critical. With Attix5 Pro V7, we've developed a solution that really benefits both our end users and resellers. Key features of the service include the introduction of flexible billing models which support Cap-ex and Op-ex software-as-a-service (SaaS) purchasing preferences, enterprise reporting, backup archiving, de-duplication (target and source based) and management capabilities."
For Attix5 resellers, the new configuration options make the back-up and restoration experience much simpler for their clients, reducing support calls and giving high customer satisfaction levels. This, combined with a new pricing structure, also gives resellers better margins. Hybrid Cloud enables large organisations to have LAN speed backup and recovery with the additional benefit of offsite copies for disaster recovery purposes.
Andrew Lockwood, Commercial Director for Data Solutions at Daisy Group commented, 'All businesses need to backup and store data, but in too many cases slow and expensive solutions are failing organisations. With its streaming backup and big data capabilities Attix5 Pro V7 is the next generation data solution we've been looking for. It's fast, secure and simple to use. We are really impressed by all of its features and abilities, from de-duplication to recovery.''
Duggal continued, "We've improved the Attix5 Pro product across the board, from simplifying the customer interface to dramatically improving back-up speeds. So much so that we are now able to achieve backup and restore speeds of up to 150 MB/s whilst still minimising back-end storage and network utilisation – all of this without compromising any of the security nor quality."
About Attix5
Attix5 is an international provider of secure data management, storage and restoration, specialising in virtualization and cloud based solutions.
Attix5 services the key global industry sectors, including Financial Services, Education and Retail.
As more intelligent IoT applications shift into gear, they're merging into the ever-increasing traffic flow of the Internet. It won't be long before we experience bottlenecks, as IoT traffic peaks during rush hours. Organizations that are unprepared will find themselves by the side of the road unable to cross back into the fast lane. As billions of new devices begin to communicate and exchange data – will your infrastructure be scalable enough to handle this new interconnected world?
Oct. 13, 2015 12:30 PM EDT
As a company adopts a DevOps approach to software development, what are key things that both the Dev and Ops side of the business must keep in mind to ensure effective continuous delivery? In his session at DevOps Summit, Mark Hydar, Head of DevOps, Ericsson TV Platforms, will share best practices and provide helpful tips for Ops teams to adopt an open line of communication with the development side of the house to ensure success between the two sides.
Oct. 13, 2015 12:00 PM EDT Reads: 692
The IoT is upon us, but today's databases, built on 30-year-old math, require multiple platforms to create a single solution. Data demands of the IoT require Big Data systems that can handle ingest, transactions and analytics concurrently adapting to varied situations as they occur, with speed at scale. In his session at @ThingsExpo, Chad Jones, chief strategy officer at Deep Information Sciences, will look differently at IoT data so enterprises can fully leverage their IoT potential. He'll share tips on how to speed up business initiatives, harness Big Data and remain one step ahead by apply...
Oct. 13, 2015 12:00 PM EDT Reads: 745
There will be 20 billion IoT devices connected to the Internet soon. What if we could control these devices with our voice, mind, or gestures? What if we could teach these devices how to talk to each other? What if these devices could learn how to interact with us (and each other) to make our lives better? What if Jarvis was real? How can I gain these super powers? In his session at 17th Cloud Expo, Chris Matthieu, co-founder and CTO of Octoblu, will show you!
Oct. 13, 2015 12:00 PM EDT Reads: 278
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo in Silicon Valley. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place Nov 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 17th Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal an...
Oct. 13, 2015 12:00 PM EDT Reads: 205
Developing software for the Internet of Things (IoT) comes with its own set of challenges. Security, privacy, and unified standards are a few key issues. In addition, each IoT product is comprised of at least three separate application components: the software embedded in the device, the backend big-data service, and the mobile application for the end user's controls. Each component is developed by a different team, using different technologies and practices, and deployed to a different stack/target - this makes the integration of these separate pipelines and the coordination of software upd...
Oct. 13, 2015 12:00 PM EDT Reads: 411
Today air travel is a minefield of delays, hassles and customer disappointment. Airlines struggle to revitalize the experience. GE and M2Mi will demonstrate practical examples of how IoT solutions are helping airlines bring back personalization, reduce trip time and improve reliability. In their session at @ThingsExpo, Shyam Varan Nath, Principal Architect with GE, and Dr. Sarah Cooper, M2Mi's VP Business Development and Engineering, will explore the IoT cloud-based platform technologies driving this change including privacy controls, data transparency and integration of real time context w...
Oct. 13, 2015 11:00 AM EDT Reads: 302
The Internet of Everything is re-shaping technology trends–moving away from "request/response" architecture to an "always-on" Streaming Web where data is in constant motion and secure, reliable communication is an absolute necessity. As more and more THINGS go online, the challenges that developers will need to address will only increase exponentially. In his session at @ThingsExpo, Todd Greene, Founder & CEO of PubNub, will explore the current state of IoT connectivity and review key trends and technology requirements that will drive the Internet of Things from hype to reality.
Oct. 13, 2015 11:00 AM EDT Reads: 317
SYS-CON Events announced today that Sandy Carter, IBM General Manager Cloud Ecosystem and Developers, and a Social Business Evangelist, will keynote at the 17th International Cloud Expo®, which will take place on November 3–5, 2015, at the Santa Clara Convention Center in Santa Clara, CA.
Oct. 13, 2015 10:00 AM EDT Reads: 248
SYS-CON Events announced today that Super Micro Computer, Inc., a global leader in high-performance, high-efficiency server, storage technology and green computing, will exhibit at the 17th International Cloud Expo®, which will take place on November 3–5, 2015, at the Santa Clara Convention Center in Santa Clara, CA. Supermicro (NASDAQ: SMCI), the leading innovator in high-performance, high-efficiency server technology is a premier provider of advanced server Building Block Solutions® for Data Center, Cloud Computing, Enterprise IT, Hadoop/Big Data, HPC and Embedded Systems worldwide. Supermi...
Oct. 13, 2015 09:30 AM EDT Reads: 203
"Matrix is an ambitious open standard and implementation that's set up to break down the fragmentation problems that exist in IP messaging and VoIP communication," explained John Woolf, Technical Evangelist at Matrix, in this SYS-CON.tv interview at @ThingsExpo, held Nov 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA.
Oct. 13, 2015 07:00 AM EDT Reads: 6,011
Nowadays, a large number of sensors and devices are connected to the network. Leading-edge IoT technologies integrate various types of sensor data to create a new value for several business decision scenarios. The transparent cloud is a model of a new IoT emergence service platform. Many service providers store and access various types of sensor data in order to create and find out new business values by integrating such data.
Oct. 13, 2015 04:00 AM EDT Reads: 682
There are so many tools and techniques for data analytics that even for a data scientist the choices, possible systems, and even the types of data can be daunting. In his session at @ThingsExpo, Chris Harrold, Global CTO for Big Data Solutions for EMC Corporation, will show how to perform a simple, but meaningful analysis of social sentiment data using freely available tools that take only minutes to download and install. Participants will get the download information, scripts, and complete end-to-end walkthrough of the analysis from start to finish. Participants will also be given the pract...
Oct. 13, 2015 03:00 AM EDT Reads: 407
Too often with compelling new technologies market participants become overly enamored with that attractiveness of the technology and neglect underlying business drivers. This tendency, what some call the "newest shiny object syndrome," is understandable given that virtually all of us are heavily engaged in technology. But it is also mistaken. Without concrete business cases driving its deployment, IoT, like many other technologies before it, will fade into obscurity.
Oct. 13, 2015 03:00 AM EDT Reads: 258
WebRTC services have already permeated corporate communications in the form of videoconferencing solutions. However, WebRTC has the potential of going beyond and catalyzing a new class of services providing more than calls with capabilities such as mass-scale real-time media broadcasting, enriched and augmented video, person-to-machine and machine-to-machine communications. In his session at @ThingsExpo, Luis Lopez, CEO of Kurento, will introduce the technologies required for implementing these ideas and some early experiments performed in the Kurento open source software community in areas ...
Oct. 13, 2015 12:45 AM EDT Reads: 852
Electric power utilities face relentless pressure on their financial performance, and reducing distribution grid losses is one of the last untapped opportunities to meet their business goals. Combining IoT-enabled sensors and cloud-based data analytics, utilities now are able to find, quantify and reduce losses faster – and with a smaller IT footprint. Solutions exist using Internet-enabled sensors deployed temporarily at strategic locations within the distribution grid to measure actual line loads.
Oct. 13, 2015 12:00 AM EDT Reads: 273
"In the past year we've seen a lot of stabilization of WebRTC. You can now use it in production with a far greater degree of certainty. A lot of the real developments in the past year have been in things like the data channel, which will enable a whole new type of application," explained Peter Dunkley, Technical Director at Acision, in this SYS-CON.tv interview at @ThingsExpo, held Nov 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA.
Oct. 12, 2015 11:15 PM EDT Reads: 7,128
Today's connected world is moving from devices towards things, what this means is that by using increasingly low cost sensors embedded in devices we can create many new use cases. These span across use cases in cities, vehicles, home, offices, factories, retail environments, worksites, health, logistics, and health. These use cases rely on ubiquitous connectivity and generate massive amounts of data at scale. These technologies enable new business opportunities, ways to optimize and automate, along with new ways to engage with users.
Oct. 12, 2015 06:00 PM EDT Reads: 262
Through WebRTC, audio and video communications are being embedded more easily than ever into applications, helping carriers, enterprises and independent software vendors deliver greater functionality to their end users. With today's business world increasingly focused on outcomes, users' growing calls for ease of use, and businesses craving smarter, tighter integration, what's the next step in delivering a richer, more immersive experience? That richer, more fully integrated experience comes about through a Communications Platform as a Service which allows for messaging, screen sharing, video...
Oct. 12, 2015 05:30 PM EDT Reads: 1,227
WebRTC converts the entire network into a ubiquitous communications cloud thereby connecting anytime, anywhere through any point. In his session at WebRTC Summit,, Mark Castleman, EIR at Bell Labs and Head of Future X Labs, will discuss how the transformational nature of communications is achieved through the democratizing force of WebRTC. WebRTC is doing for voice what HTML did for web content.
Oct. 12, 2015 03:00 PM EDT Reads: 1,489


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Inside the small room with white cinder-block walls came glimpses of Thomas Robinson.
When one of the eight television cameras surrounding the Kansas junior shifted, wisps of beard on his face and large, earnest eyes emerged through the scrum.
There wasn't room to move in the locker room at the CenturyLink Center in Omaha, Neb., last week without touching someone else. All 6-feet-10 and 237 pounds of Robinson folded into a flimsy plastic chair, where he held his left pinky with his right hand and shifted fingers every few seconds.
Two photographers raised their cameras high above the crush of journalists thrusting six microphones and more recorders and breathless questions toward Robinson. The cameras' clicks overwhelmed his voice.
Deep lines crossed Robinson's forehead when he answered each question with just enough words for a sound bite. Robinson, one of four finalists for the Naismith national player of the year award and a projected top-three pick in June's NBA draft, rubbed his chin. This was his 21st birthday. He shrugged off the day. And maybe, for an instant, the sadness Robinson carries surfaced.
Fourteen months ago, Robinson's 43-year-old mother, Lisa, died of a heart attack at their District home. In the previous month, Robinson's grandmother and grandfather died, too.
Suddenly, Robinson and his 8-year old sister, Jayla, were alone.
That month follows Robinson each trip onto the court, like Friday's Sweet 16 matchup between Kansas and N.C. State in St. Louis.
"Basketball has a whole different meaning for him now than it did a year and a half ago," said Jason Smith, Robinson's coach at the Brewster (N.H.) Academy his senior year. "He plays with that passion and energy, but there's something else fueling that fire. He wants to make it a career to provide for his younger sister."
Basketball became Robinson's outlet. His grief has merged with his on-court gifts to create a player who averaged 17.7 points and 11.8 rebounds per game while attracting constant double- and triple-teams.
"Everybody admires him that comes in touch with him around our game," Kansas coach Bill Self said, "because I don't know how many guys could do what he's done."
Robinson's first two years at Kansas didn't resemble those of most top-50 recruits. He was stuck behind Marcus and Markieff Morris, among others, in a deep rotation of big men. Points and rebounds usually trickled down in single digits. To Smith and Lou Wilson, Robinson's coach at Upper Marlboro's Riverdale Baptist as a junior, Robinson seemed to play at 100 mph. He would try not to make mistakes, play quickly and, more often than not, hand over the ball.
That's not much different than the rangy, energetic 10-year-old Wilson first noticed playing for the AAU's Fort Washington Bullets.
The aggression, relentlessness and borderline ferocity each possession hasn't changed. Robinson still sucks the marrow from every trip down the court. But now he isn't in such a hurry. Working with Kansas assistant and former KU star Danny Manning left him better understanding the game. Robinson wanted to be a smarter player. Then his jumper tightened up. So did his ballhandling.
"He's progressed so much," Kansas junior center Jeff Withey said. "People can't do anything to stop him."


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Posts from Renovating Projects
Before & After: Boring Studio to Beautiful Family Home
Ok, so here's a fun one. I know you guys love seeing transformations that involve entire rooms, and especially entire apartments, and this 'before' was particularly bleak. It's not the worst we've ever seen, but it is a perfect example of the kind of soul-deadening blandness that afflicts NYC postwar apartments. In addition, the homeowners, who had just moved from a two-bedroom, were expecting a new addition. So the 650 square foot studio layout just wasn't going to cut it.
Before & After: Former Rental Kitchen Gets Pop of Personality
Kari's cottage used to be a rental. The kitchen had been "updated" with the cheapest options available, so she set out to give it a bit more style and functionality, while sticking to a first-home budget.
Before & After: 70s Bathroom Gets a Moody Makeover
With shag carpet, vintage wallpaper, and a mustard counter, this bathroom was firmly planted in the 70s. Rosalind decided to bring it into this century with a dark and dramatic makeover.
Before & After: From Bland Bedroom to Longed-For Library
Mandy's first-floor master bedroom was strangely laid out and not particularly "master-sized." She and her husband decided to sleep in another room upstairs, and completely change this one to something they always wanted—a library.
5 Stunning Structures That Got a Second Life as a House
Beautiful structures are everywhere, just waiting for out-of-the-box thinkers to come along and give them another chance! Almost anything can get the ol' switcheroo. Check out these five amazing structures that now house some lucky, lucky people.
Before & After: A Boring Bathroom Gets Some Dark Drama
This is Marissa's old bathroom. It's certainly not the worst 'before' we've seen here on Apartment Therapy — but beneath its bland, dingy-80s exterior lurked a nasty surprise. The previous owner of Marissa's co-op spent a lot of time away from home, and didn't realize that leaks were causing extensive water damage. On top of that, the random dropped ceilings were making this tiny space even more claustrophobic. It was time for a change.
Before & After: "Nothing Wrong" Kitchen Brightens Up
For those amongst us who have a strong urge to stick with "perfectly good" spaces that have "nothing wrong" with them, either look away or be inspired. Becky's kitchen was fine, but she didn't love it. So she and her husband ditched what they didn't like and made it a room they truly love:
Before & After: A Tiny Vintage Bathroom Gets a Fresh Look
Washington Heights homeowners Pepper and Marshall were thinking about combining the two bathrooms in their two-bedroom co-op into a single, much larger, bathroom. But they changed their tune when they realized how much the combination would hurt their home's resale value — and how much additional money and time they would spend moving all that plumbing around. So instead, they decided to make the most of their two existing bathrooms, by replacing outdated fixtures and making smart choices that would open up these small spaces. Today we're taking a look at bathroom #1 — look for the second bathroom in a future post.
Master the Look: Mismatched Tile in the Bathroom
The bathroom is a place for experimentation. It's a small room, so even bold design moves seem a little more palatable. Small rooms are also cheap to finish, giving beer-budget types a chance to splurge on real champagne. And since you only spend a tiny fraction of your day in the bathroom, you can try out something daring and crazy, knowing it's easy to live with if you end up hating it.


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"Mr. Jaafari's surprise victory [for PM] illustrated the growing political power of Mr. Sadr, who led two bloody uprisings against the American occupation and the interim government in 2004...In recent visits to Iran and Syria, Mr. Sadr has expressed solidarity with the leaders of those countries and angry opposition to American policy toward them. Mr. Sadr also commands the Mahdi Army, a broad-based militia that has been largely quiet since 2004 but is still armed and is said to be behind some recent deadly attacks on British troops in Basra." - New York Times We will have an Iraqi PM essentially elected by an "armed terrorist". Is the Hamas situation different? As long as they do not engage in terrorism, they should be legitimate for talks. This is the Russian position now. Wouldn't be surprised if the US realizes it soon too. (My tactical preference: Pretend Hamas is no good and TALK WITH ABBAS. Otherwise, Israel is wasting time and will eventually have to talk with Hamas.)
Australian police arrest 5 over shooting 'linked to terrorism' (Reuters)
from the article: Don't boycott the Palestinians


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Play your guitar through your amp and use your iPhone® 5 or iPad® as though it were an FX rack with this Guitar Cable for iPad & smartphones from Monoprice!
This cable gives you the ability to play your guitar and complete an FX loop to play out of your amp in real time using your iPhone 5, iPad, or other device. Note that creating an FX loop requires the use of third party software and an additional guitar amplifier cable, neither of which is included with this cable.
This cable works with:
- iPod touch® 3rd Generation and later versions
- iPhone 3GS and later versions
- iPad (all versions, including iPad mini®)
- Samsung® Galaxy S® version 3 and later
- Samsung Galaxy Note® version 2 and later
- Any Android™ device using the CTIA standard TRRS connector with the microphone on the sleeve, as described below
The 4-conductor TRRS plug on this cable uses the CTIA standard configuration, which puts the microphone signal on the sleeve (versus being on the second ring in the OMTP standard). The CTIA standard has always been used by Apple® and HTC™, while older Samsung®, Nokia®, Sony® Ericsson™, and Wiko devices initially used the OMTP standard. However, the latest versions use the CTIA standard.
Support Files:
- User's Guide (Oct 30, 2013)
Apple, iPod touch, iPhone, iPad, and iPad mini are trademarks of Apple Inc., registered in the U.S. and other countries.
Samsung, Galaxy S, and Galaxy Note are registered trademarks of Samsung Electronics Co., Ltd.
HTC is a trademark of HTC Corporation.
Nokia is a registered trademark of Nokia Corporation.
Sony is a trademark of Sony Corporation.
Ericsson is a trademark of Telefonaktiebolaget LM Ericsson.
All other trademarks and logos are the property of their respective owners.
| rated by 17 user(s)
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Lilly Pulitzer®
'Marlisa' Print Cotton Maxi Dress
|Item # 994993
Details & Care
A free-flowing strapless maxi illustrated in a pastel Baroque motif is gently nipped by an elasticized band adding flattering blouson dimension to the bodice before falling to a straight full-length skirt.
- Elasticized waist.
- 100% cotton.
- Machine wash, tumble dry low.
- By Lilly Pulitzer; imported.
- Dresses.
Watch the video: Dress Fit Fundamentals
Learn More: The Best Dress for Your Body Type


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Apple iPadAt the moment the iPad is the undisputed king of all tablet computers. It sports an 11-inch screen and runs a version of Apple's (AAPL - Get Report) OS for portable devices, now called iOS4. There are two separate models -- one with Wi-fi connectivity and the other with both Wi-fi and AT&T (T) 3G networking. You can also choose 16GB, 32GB or 64GM of internal memory. Prices range from $499 to $829.
E-Reader Shakeout: The Top 7's Specs
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6 Top Benefits Of Appliance Repair
Modern home appliances and marine appliances need repair every now and then. You have to make sure that you get best marine appliance repair services from a qualified service company. Some of the appliances include dishwashers, stoves, ovens, fridges, and air conditioners among others. So, what are the benefits of hiring an appliance repair company?
Saves you cash
Instead of buying a new appliance you can easily repair it. You can get services from appliance service companies that specialize in marine appliances. Through this service you will reduce transportation cost to the service center from your vessel.
It is quicker
You will receive speeder services once you call the service center. They are always ready and willing to serve you. The repair will give you quick services.
It is safer
Through the use of a repairman, you will be sure that your appliance is safe. The service is done while you are present. You are also saved from injuries such as electrocuting yourself. Professionals also are sure of what they are doing and you will be sure of quality service.
Efficient maintenance
Appliances need maintenance for them to serve you effectively. For proper maintenance you need to hire a repair technician who has the knowledge about the appliances. This is because the appliances contain complex electronic parts.
Excellent customer services
Apart from appliance maintenance, there is a need to ensure that you effectively maintain your appliances. Qualified personnel will perform the service quickly, which will get your boat back up and working efficiently and effectively.
Service at your dock
Experts are sent to the marina. You are able to get their services at the day and time of your choice. You will also get the service within 24 hours.
When you get appliance repair services, you are able to save a lot of cash in the long run. Make sure you look for a qualified company to give you the best service.
The Difference Between Commercial Appliance Repair and Residential Appliance Repair?
Before you understand the difference between Commercial Appliance Repair and Residential Appliance Repair, you need to know in details what either of them entails. In other words, it is necessary to understand what exactly Appliance Repair service is, who needs it and why you might need it.
On top of that, you need to understand the difference between commercial appliances and residential appliances. For instance, a household refrigerator is far much different from an industrial refrigerator. They vary in sizes and usage; therefore, repairing them also requires different skills.
Residential Appliances vs. Commercial Appliances
Residential appliances are those ones which are built for household uses and are mostly found in homes. They are designed for the capacity of usage by single families. They are mostly limited in size and capacity, for instance; a residential laundry machine or refrigerator is built to fit the capacity of your house and usage as well.
On the other hand, commercial appliances are mainly created for industrial use. They are constructed in huge sizes and are able to operate for longer periods of time. Their work capacity is also greater than their residential counterparts. Residential appliances are just a fraction of the cost of commercial appliances. They can do a small portion of what commercial appliances do.
Major differences include:
– Task required of them
– Their structure and capacity
– Different Aesthetic needs
Appliances Break Down
Generally, restaurant equipment is of great concern when they break down as compared to residential appliances. The truth is, any breakdown of an appliance is frustrating regardless of whether it is commercial or residential. However, take an example of a laundry machine. If it's for home use, the frustration cannot be as bad, when compared to the inconvenience a commercial laundry machine causes when it breaks down. Check out this Commercial Appliance Repair Miami Video: https://www.youtube.com/watch?v=lKqyOnLV1hM
When a food service appliance breaks down, you might end up losing your customers and eventually your income. For a laundry business, you cannot afford going out of business for even a single hour. That would mean closing down the whole business that you worked so hard to build. So, what happens when your appliances break down?
Appliance Repair
Whether you are a business owner or just a homeowner, you need to seek quick and reliable appliance repair as soon as your property breaks down. Remember, you fully depend on the performance of your appliances on a daily basis. That is why you bought them in the first place. They cannot be of any help if they just lay there with no use.
When hiring a repair professional, they need to be able to understand the difference between the two categories of appliances. This is because the level of expertise and training to repair the two categories might differ.
Why Commercial Appliance Repair is More Important
When food service equipment breaks down, you have to hire professional repair company to work on it as soon as possible. This is because they are more complicated and high-tech as compared to residential appliances. Again, as mentioned before, this category of appliances is of greater value and might be required for your business to keep running.
Another major reason as to why restaurant equipment repair is of more importance is the fact that they are more expensive to acquire and might have cost you a fortune to purchase. It can be more stressing to have your business appliance out of function for even an hour. That explains why repair services for commercial appliance service might be given a first hand. You can read more educational articles at this Commercial Appliance Repair Miami Twitter Page.
To conclude, any appliance breakdown is unfortunate and should be corrected as soon as possible. The only difference in damage is that commercial appliance breakdown can lead to incurring of further losses. That is why it is necessary to have a reliable and experienced appliance repair team that you can give a call in case of such uncertainties. Most of these appliances such as refrigerators, dishwashers and laundry machines are not easy to acquire or replace with a new one. The only way to keep them serving you is by maintaining them and hiring experts to make corrections in case of faultiness. Remember, you can only trust top rated and highly reputable professionals with your appliance repair projects.


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No blood come out during the first time!
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From skin changes to weight loss to unusual bleeding, here are 15 cancer warning signs that women tend to ignore.
A community for people with Women's Health-related concerns. Ask a question, join a conversation, share experiences: medical conditions, general health, and management.


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This Is What Karma is All About (37 pics)
- Category: Pics |
- 10 Jan, 2013 |
- Views: 14042 |
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Don't mess with Karma.
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Neuroscience in Anesthesiology and Perioperative Medicine
Section Editor: Gregory J. Crosby
Cerebral Oxygen Desaturation Events Assessed by
Near-Infrared Spectroscopy During Shoulder Arthroscopy
in the Beach Chair and Lateral Decubitus Positions
Glenn S. Murphy, MD,* Joseph W. Szokol, MD,* Jesse H. Marymont, MD,* Steven B. Greenberg, MD,*
Michael J. Avram, PhD,† Jeffery S. Vender, MD,* Jessica Vaughn, BA,* and Margarita Nisman, BA*
BACKGROUND: Patients undergoing shoulder surgery in the beach chair position (BCP) may be
at risk for adverse neurologic events due to cerebral ischemia. In this investigation, we sought
to determine the incidence of cerebral desaturation events (CDEs) during shoulder arthroscopy
in the BCP or lateral decubitus position (LDP).
METHODS: Data were collected on 124 patients undergoing elective shoulder arthroscopy in the
BCP (61 subjects) or LDP (63 subjects). Anesthetic management was standardized in all
patients. Regional cerebral tissue oxygen saturation (SctO2) was quantified using near-infrared
spectroscopy. Baseline heart rate, mean arterial blood pressure, arterial oxygen saturation, and
SctO2were measured before patient positioning and then every 3 minutes for the duration of the
surgical procedure. SctO2values below a critical threshold (?20% decrease from baseline or
absolute value ?55% for ?15 seconds) were defined as a CDE and treated using a
predetermined protocol. The number of CDEs and types of intervention used to treat low SctO2
values were recorded. The association between intraoperative CDEs and impaired postoperative
recovery was also assessed.
RESULTS: Anesthetic management was similar in the BCP and LDP groups, with the exception
of more interscalene blocks in the LDP group. Intraoperative hemodynamic variables did not
differ between groups. SctO2values were lower in the BCP group throughout the intraoperative
period (P ? 0.0001). The incidence of CDEs was higher in the BCP group (80.3% vs 0% LDP
group), as was the median number of CDEs per subject (4, range 0–38 vs 0, range 0–0 LDP
group, all P ? 0.0001). Among all study patients without interscalene blocks, a higher incidence
of nausea (50.0% vs 6.7%, P ? 0.0001) and vomiting (27.3% vs 3.3%, P ? 0.011) was observed
in subjects with intraoperative CDEs compared with subjects without CDEs.
CONCLUSIONS: Shoulder surgery in the BCP is associated with significant reductions in cerebral
oxygenation compared with values obtained in the LDP. (Anesth Analg 2010;111:496–505)
(45°–90° above the horizontal plane) include lack of bra-
chial plexus strain, a reduced risk of direct neurovascular
trauma compared with the lateral decubitus approach,
excellent intraarticular visualization, and ease of conver-
sion to an open approach if needed.1,2In the United States,
approximately two-thirds of arthroscopic and open shoul-
der procedures are performed with the patient in the sitting
he beach chair position (BCP) has been used for
shoulder arthroscopic procedures since the early
1980s. The advantages of the conventional BCP
position.3Although the safety of orthopedic surgery in this
position has been well established,4rare catastrophic neu-
rologic events have been reported. Pohl and Cullen5re-
ported 4 cases of ischemic brain and spinal cord injury
occurring after surgery in the BCP. In an additional report,
visual loss and ophthalmoplegia were described after
shoulder surgery in a sitting position.6Eight intraoperative
cerebrovascular events were reported in a survey of the
American Shoulder and Elbow Surgeons Society; all events
occurred during surgery in the BCP.3
The etiology of central nervous system injury after shoul-
der surgery in the BCP has not been established definitively.
Several authors have hypothesized that cerebral ischemia
may occur when anesthetized patients are placed in a 45° to
90° sitting position.5,7In awake volunteers, sympathetic ner-
vous system activation occurs when assuming a sitting posi-
tion; systemic vascular resistance and heart rate (HR) are
increased to maintain mean arterial blood pressure (MAP)
and cardiac output.8–10In anesthetized patients, however, the
response of the autonomic nervous system is attenuated by
the vasodilating effects of IV and volatile anesthetics. Signifi-
cant decreases in cardiac output, MAP, and cerebral perfusion
pressure (CPP) have been observed in neurosurgical patients
From the *Department of Anesthesiology, NorthShore University Health-
System, University of Chicago Pritzker School of Medicine, Evanston; and
†Department of Anesthesiology, Northwestern University Feinberg School
of Medicine, Chicago, Illinois.
Accepted for publication March 29, 2010.
Supported by institutional and/or departmental sources (Department of
Anesthesiology, NorthShore University HealthSystem). FORE-SIGHT cere-
bral oximetry probes were provided to the department at cost for the project
by CAS Medical Systems, Inc., Branford, CT.
Address correspondence and reprint requests to Glenn S. Murphy, MD,
Department of Anesthesiology, NorthShore University HealthSystem, Uni-
versity of Chicago Pritzker School of Medicine, 2650 Ridge Ave., Evanston,
IL 60201. Address e-mail to firstname.lastname@example.com.
Copyright © 2010 International Anesthesia Research Society
DOI: 10.1213/ANE.0b013e3181e33bd9
www.anesthesia-analgesia.orgAugust 2010 • Volume 111 • Number 2
Page 2
when position was changed from supine to sitting.11,12Pro-
longed reductions in systemic pressures and CPP that exceed
critical thresholds (severity and time) may result in perma-
nent neurologic injury.
Near-infrared spectroscopy (NIRS) is a noninvasive tech-
nology that provides continuous monitoring of regional cere-
bral tissue oxygen saturation (Scto2). NIRS technology allows
for the immediate recognition and treatment of cerebral
desaturation events (CDEs) that would otherwise be undetec-
ted with conventional intraoperative monitoring. NIRS has
been used to assess the incidence of CDEs in patients under-
going procedures at high risk for adverse neurologic
outcomes (cardiac, vascular, liver transplant, and major ab-
dominal surgery).13Although orthopedic patients in the BCP
are at risk for cerebral hypoperfusion, no previous clinical
trials have assessed changes in Scto2in this patient popula-
tion. The aim of this prospective cohort study was to deter-
mine the incidence of CDEs in the BCP and compare this
cohort to subjects undergoing shoulder surgery in the lateral
decubitus position (LDP). In addition, the relationship be-
tween CDEs and early clinical recovery was examined.
Patients and Anesthesia
This study was approved by the IRB of NorthShore Uni-
versity HealthSystem and written informed consent was
obtained from all subjects. Seventy consecutive patients
scheduled to undergo elective arthroscopic shoulder sur-
gery under general anesthesia in the BCP were enrolled
(BCP group). During this same time period, 70 additional
consecutive patients presenting for the same surgical pro-
cedure in the right or left LDP were enrolled (LDP group).
Exclusion criteria included preexisting cerebrovascular
disease or orthostatic hypotension; age ?18 years; ASA
physical status IV or V; or anticipated procedure under
interscalene blockade with monitored anesthesia care as the
primary anesthetic. Allocation into the BCP and LDP
groups was determined by surgical preference, and use of
interscalene blocks in each group was also primarily influ-
enced by surgeon preference. Anesthesia care was admin-
istered to the BCP and LDP groups by the same group of
providers (15 anesthesiologists).
Cerebral oximetry values may be affected by depth of
anesthesia, type of anesthetic administered, arterial carbon
dioxide concentrations, inspired oxygen content, and sys-
temic blood pressure management.14–16Therefore, anes-
thetic management was carefully standardized in subjects
in both cohorts. Patients received midazolam 2 mg IV
before being transported to the operating room. Intraopera-
tive monitoring consisted of electrocardiography, auto-
matic arterial blood pressure assessment using a cuff
placed on the nonoperative upper extremity, pulse oxim-
etry, capnography, bispectral index monitoring (BIS?
system; Aspect Medical Systems, Newton, MA), and mea-
surement of core temperature via an esophageal probe.
Anesthesia was induced with propofol 2.0 to 2.5 mg/kg,
fentanyl 100 ?g, lidocaine 50 mg, and rocuronium 0.6 to 0.8
mg/kg. Maintenance of anesthesia consisted of sevoflurane
1% to 3% in an oxygen/air mixture (fraction of inspired
oxygen [Fio2] of 50%). Sevoflurane concentrations were
adjusted to maintain MAP within 20% of baseline values and
BIS values between 40 and 60. In addition, patients received 1
to 2 ?g ? kg?1? h?1fentanyl throughout the surgical proce-
dure. If required, rocuronium (10-mg boluses) was adminis-
tered to maintain a train-of-four count of 2 to 3. Ventilation
was controlled to maintain end-tidal carbon dioxide (Etco2)
between30and34mmHg.Lowerbody forced-air warming
devices (Bair Hugger?; Augustine Medical, Minneapolis,
MN) were used to maintain core temperature above
35.0°C. Ondansetron 4 mg was given to all patients
within 30 minutes of tracheal extubation. Neostigmine 50
?g/kg and glycopyrrolate 10 ?g/kg were administered
at a train-of-four count of at least 2 to reverse neuromus-
cular blockade at the conclusion of surgical closure.
Clinicians were instructed to maintain MAP within 20% of
baseline values throughout the intraoperative period, as per
standard practice involving surgery in the sitting position at
our institution. Baseline MAP was determined in the sedated
patient in the supine position. MAPs below this threshold
a fluid bolus, as required clinically. Patients undergoing
surgery in the LDP were treated with the same MAP protocol.
Cerebral Oxygenation Measurements and
Perioperative Data Collection
Cerebral oxygen saturation was measured continuously
using the FORE-SIGHT system (CAS Medical Systems, Inc.,
Branford, CT). The FORE-SIGHT device is a continuous
wave, spatially resolved cerebral oximeter that uses 4
discrete wavelengths of laser light to calculate the absolute
value of Scto2. Four wavelengths of light allow for more
accurate determination of oxyhemoglobin and deoxyhemo-
globin levels by compensating for wavelength-dependent
scattering losses and reducing interference from other
background light absorbers.17,18Sensors were applied bi-
laterally to each frontotemporal area after cleansing the
skin area with alcohol (the medial margin at the midline of
the forehead [avoiding the temporalis muscle] and the
lower margin 1–1.5 cm above the eyebrow). The cerebral
oximetry and BIS probes were secured in the preoperative
holding area and covered with an opaque wrapping to
prevent light interference.
On arrival to the operating room, MAP and HR were
recorded. Simultaneously, arterial oxygen saturation (Spo2)
and Scto2values were measured in patients before induc-
tion of anesthesia while breathing a 50% air/oxygen mix-
ture. These variables (Scto2, MAP, HR, and Spo2) were then
manually recorded by a research assistant every 3 minutes
for the duration of the operative procedure. Intraoperative
Scto2data were also collected continuously on a USB
device. Baseline Scto2was the mean value observed over a
1-minute period after induction of anesthesia during a
stable interval (MAP within 20% baseline values, BIS
40–60, Etco230–34 mm Hg, and Fio250%) approximately
10 minutes after induction of anesthesia. Baseline measures
for MAP, HR, Spo2, and BIS used in the analysis were also
recorded at this time. Five minutes after these initial data
were collected, the patient was positioned for the surgical
procedure. In the BCP group, the head was secured in a
neutral position to ensure that cerebral venous drainage
was not impaired. The back of the operating room table
was then raised to 80° to 90° above the horizontal plane. In
August 2010 • Volume 111 • Number 2www.anesthesia-analgesia.org
Page 3
the LDP group, patients were placed in the LDP with the
head supported with towels to maintained alignment with
the thoracolumbar spine. The NIRS monitor was positioned
so that Scto2data could be viewed by the research assistant
but not by clinicians providing intraoperative care. If any
Scto2values below a previously defined critical threshold
(?20% decrease from baseline or absolute value ?55% for
?15 seconds) were observed by the research assistant,
clinicians were instructed to treat the CDE. For this investiga-
tion, a prioritized intraoperative management protocol was
used to increase Scto2values. Interventions to treat CDEs
included the following: (1) increasing MAP with phenyleph-
rine (80 ?g), ephedrine (5 mg), or a fluid bolus, as clinically
increasing Fio2concentrations. The number and type of
interventions used to treat low Scto2values were recorded by
the research assistant. In addition, interventions used by
clinicians to treat MAP reductions unrelated to Scto2were
noted. All data were collected until tracheal extubation.
After discontinuation of sevoflurane at the end of the
surgical procedure, the time required to achieve the following
end points were recorded: open eyes on verbal command;
squeeze hand on verbal command; tracheal extubation; and
admission to postanesthesia care unit (PACU). The Aldrete
score was recorded on arrival to the PACU and then assessed
every 15 minutes until discharge. Hydromorphone was used
for postoperative analgesia and titrated to achieve pain scores
of ?2 on a scale of 0 to 10 (0 ? no pain, 10 ? worst pain
imaginable). Any episodes of nausea and vomiting during the
PACU admission were noted, and the severity of events
graded on a 3-point scale (1 ? mild, 1 episode; 2 ? moderate,
2–3 episodes; and 3 ? severe, ?3 episodes). The need for
rescue antiemetics was also assessed. The times needed to
meet discharge criteria and achieve actual discharge were
noted. All recovery data were collected by PACU nurses
blinded to intraoperative cerebral oximetry information.
However, PACU nurses and research assistants were not
blinded to patient positioning.
Patient demographic data that were recorded included
age, sex, height, weight, preoperative hemoglobin, ASA
physical status, and preexisting medical conditions. Details
of the intraoperative anesthetic management included du-
ration of anesthesia, administration of crystalloids, doses of
opioids and rocuronium provided intraoperatively, and
core temperatures at the conclusion of the anesthetic.
Statistical Analysis
Sample size was determined based on the primary outcome
variable, the incidence of CDEs. Scto2values below a
predetermined critical threshold (?20% decrease from
baseline or absolute value ?55% for ?15 seconds) were
used to define these events. In a pilot study of patients
undergoing surgery in the BCP, CDEs were observed in
50% of the subjects. We hypothesized that we would
observe 50% fewer CDEs in patients having surgery in the
LDP. Group sample sizes of 66 in each group achieve 80%
power to detect a difference of 0.25 between the null
hypothesis that both group proportions are 0.50 and the
alternative hypothesis that the proportion of the LDP group
is 0.25 with a 2-tailed significance level (?) of 0.05 using ?2
or Fisher exact test with continuity correction.
Discrete data were compared using Fisher exact test
(NCSS, Kaysville, UT). The 95% confidence intervals for the
differences in percentages were calculated using the Far-
rington and Manning score. Ordinal data and continuous
data that were not normally distributed are presented as
median and range. These data were compared between
groups using the Mann-Whitney U test and within groups
using Wilcoxon signed rank test (StatsDirect, Cheshire,
UK). The median differences and their 95% confidence
intervals were calculated.
Normally distributed continuous data are presented as
mean and SD. These data were compared using the un-
paired t test (NCSS), except for the hemodynamic data.
Mean differences and their 95% confidence intervals were
calculated. Hemodynamic, Spo2, BIS, and Scto2data were
compared within and between groups using a 2-factor
analysis of variance with repeated measures on 1 factor,
with the Holm-Sidak method for pairwise multiple com-
parisons in post hoc analysis (SigmaPlot 11.0; Systat Soft-
ware, Inc., San Jose, CA).
Multiple logistic regression analysis (StatsDirect) was
performed to determine predictors of nausea. Variables
included in the initial analysis were those identified in
univariate analyses as having a value of P ? 0.10. In the
final analyses, variables with high P values were removed
from the model 1 at a time and were excluded from the
final model if their removal either did not diminish the fit
of the model or actually improved it, as determined by the
correct prediction of both positive and reference responses.
The sensitivity and specificity of the logistic model were
calculated from the model-predicted reference and model-
predicted positive responses (using the default threshold
probability for positive classification of 0.5) and the actual
reference and actual positive responses. No external vali-
dation was attempted.
The criterion for rejection of the null hypothesis estab-
lished a priori was a 2-tailed P ? 0.05.
One hundred forty patients were enrolled in this clinical trial.
Sixteen subjects were excluded from final analysis because of
the following factors: changes in patient positioning (45°
beach chair) (4 in BCP group); protocol violations (3 in BCP
group and 3 in LDP group); incomplete data collection (2 in
BCP group and 3 in LDP group); and procedure canceled
before entering the operating room (1 in LDP group). As a
result, data analysis was performed on 61 patients in the BCP
group and 63 patients in the LDP group. The BCP and LDP
groups were similar in terms of demographic characteristics.
There were no differences between groups in age, weight,
height, sex, preoperative hemoglobin values, preexisting
medical conditions, or ASA physical status (Table 1). Intraop-
erative management data are presented in Table 2. The
duration of anesthesia was longer in the LDP group. A higher
percentage of patients in the LDP group received interscalene
blocks (71.4%) compared with the BCP group (8.2%, P ?
0.0001) and a lower dose of intraoperative fentanyl was used
in the LDP group (P ? 0.0001).
Hemodynamic data are presented in Figures 1 and 2.
The ANOVA statistics revealed that whereas HR and MAP
decreased in both the LDP and BCP groups after induction
Cerebral Desaturation in the Beach Chair Position
Page 4
of anesthesia, intraoperative HR and MAP values did not
differ between groups. No differences between groups
were noted in Spo2(Fig. 3), end-tidal sevoflurane concen-
tration (Fig. 4), or BIS (Fig. 5) data throughout the intraop-
erative period.
Scto2data are presented in Figure 6 and Table 3. Scto2
values before (75.5 ? 4.0 vs 75.9 ? 3.9) and after (baseline:
80.4 ? 5.0 vs 81.1 ? 5.1) induction of anesthesia were
similar between the LDP and BCP groups. The ANOVA
statistics revealed that Scto2not only decreased over time
Table 1. Patient Characteristics
Beach chair group
38 (62.3%)/23 (37.7%)
49.8 ? 13.9
81.5 ? 20.0
170.1 ? 9.8
14.0 ? 1.5a
2 (3.3%)
1 (1.6%)
26 (42.6%)
0 (0%)
9 (14.8%)
5 (8.2%)
3 (4.9%)
Lateral group
40 (63.5%)/23 (36.5%)
47.8 ? 14.8
85.3 ? 17.9
173.3 ? 11.0
13.9 ? 1.4b
1 (1.6%)
3 (4.8%)
23 (36.5%)
1 (1.6%)
6 (9.5%)
4 (6.4%)
5 (7.9%)
Difference (95% CI)
?1.2% (?18.0% to 15.6%)
1.9 (?3.2 to 7.1)
?3.8 (?10.5 to 3.0)
?3.1 (?6.8 to 0.6)
0 (0–0)
0.1 (?0.5 to 0.6)
1.7% (?5.5% to 9.8%)
?3.1% (?11.7% to 4.5%)
6.1% (?11.0% to 22.9%)
?1.6% (?8.5% to 4.4%)
5.2% (?6.7% to 17.6%)
1.9% (?8.2% to 12.4%)
?3.0% (?13.1% to 6.6%)
P value
No. of patients
Sex (male/female)
Age (y)
Weight (kg)
Height (cm)
ASA physical status
Hemoglobin (g/dL)
Previous MI
Sleep apnea
Thyroid disease
Smoking history
Drinking history
0 (0%)
3 (4.9%)
0 (0%)
0 (0%)
7 (11.5%)
4 (6.6%)
0 (0%)
6 (9.5%)
0 (0%)
0 (0%)
8 (12.7%)
8 (12.7%)
?4.6% (?15.1% to 5.3%)
?1.2% (?13.3% to 10.9%)
?6.1% (?17.5% to 4.8%)
CI ? confidence interval; MI ? myocardial infarction; COPD ? chronic obstructive pulmonary disease; CVA ? cerebrovascular accident; TIA ? transient ischemic
Data are mean ? SD, median (range), or number of patients (%).
an ? 60.
bn ? 52.
Table 2. Perioperative Variables
Beach chair group
5 (8.2%)
Lateral group
45 (71.4%)
Difference (95% CI)
?63.2% (?74.6% to ?48.5%)
P value
No. of patients
Interscalene block
Total time (min)
Dose fentanyl (?g)
Dose rocuronium (mg)
Crystalloid (L)
Final OR temperature (°C)
Times to recovery landmarks (min)
Open eyes
Squeeze hands
Tracheal extubation
Arrive PACU
Aldrete scores
30 min
60 min
90 min
Nausea severity (1–3 scale)
Vomiting severity (1–3 scale)
Pain medication
Pain medication dose (mg hydromorphone)
PACU discharge (min)
Criteria met
Actual discharge
117 ? 31
200 (50–500)
50 (30–140)
1.11 ? 0.39
35.9 ? 0.6
135 ? 46
100 (0–325)
50 (30–155)
1.20 ? 0.38
36.1 ? 0.6
?18.0 (?32 to 4)
50 (25–100)
0 (0–10)
?0.09 (?0.23 to 0.05)
?0.1 (?0.4 to 0.1)
8 (1–25)
8 (1–26)
10 (2–36)
17 (5–35)
8 (2–16)
8 (2–22)
9 (0–24)
13 (5–28)
0 (?1 to 1)
1 (0–3)
0 (?1 to 2)
3 (1–5)
8 (2–10)
9 (7–10)
9 (8–10)b
10 (8–10)d
9 (8–10)f
24 (39.3%)
1.5 (1–3)h
13 (21.3%)
1 (1–2)j
52 (85.3%)
1.5 (0.5–4)l
8 (2–10)a
9 (2–10)a
10 (8–10)c
10 (8–10)e
10 (9–10)g
5 (8.1%)a
1 (1–2)i
1 (1.6%)a
?1 (?1 to 0)
0 (?1 to 0)
0 (0–0)
0 (0–1)
?1 (?1 to 0)
31.3% (17.1%–45.1%)
0 (0–1)
19.7% (9.8%–31.8%)
33 (52.4%)a
1 (0.5–4.0)m
32.9% (17.0%–47.3%)
0 (0–0.5)
80 (35–193)
93 (45–298)
83.5 (39–145)a
94 (55–181)a
?1 (?13 to 10)
2 (?10 to 12)
CI ? confidence interval; OR ? operating room; PACU ? postanesthesia care unit.
Data are mean ? SD, median (range), or number of patients (%).
an ? 62,bn ? 58,cn ? 57,dn ? 18,en ? 27,fn ? 9,gn ? 4,hn ? 24,in ? 5,jn ? 13,kn ? 1,ln ? 52,mn ? 33.
August 2010 • Volume 111 • Number 2www.anesthesia-analgesia.org
Page 5
but also was lower in the BCP group than the LDP group
across time (P ? 0.0001). The percentage of patients devel-
oping a CDE was higher in the BCP group (80.3%) com-
pared with the LDP group (0%, P ? 0.0001). In addition, the
median number of CDEs was greater in the BCP group:
?20% decreases in Scto2from baseline (4 [0–38] BCP; 0
[0–0] LDP; P ? 0.0001) and Scto2?55% (0 [0–4] BCP; 0
[0–0] LDP; P ? 0.003). Furthermore, the median number of
interventions required to treat CDEs was also greater in the
BCP group (2 [0–11] BCP; 0 [0–0] LDP; P ? 0.0001). Scto2
values increased after initial treatment interventions in 61%
of patients, with most responses occurring within 30 to 45
seconds. Eight patients had 12 episodes of Scto2?55% (all
in the BCP group). Nine of the episodes resolved within 1
minute of treatment. The duration of the episodes ranged
from 30 seconds to 9 minutes.
Recovery data are presented in Table 2. Lower doses of
opioids were used in the LDP group in the operating room
and PACU, which was likely attributable to the higher use
of interscalene blocks in this group. The incidence of nausea
and vomiting was also lower in this group. The time from
the end of the procedure to PACU admission was shorter,
and early Aldrete scores were higher, in the LDP group. All
other immediate and early recovery variables were similar
between groups.
Further analysis was performed to determine the impact
of intraoperative CDEs on postoperative recovery (Tables 4
and 5). Data were analyzed only on subjects who did not
receive interscalene blocks because use of this technique
Figure 1. Heart rate (bpm) for the patients in the beach chair position
group and in the lateral decubitus position group. The data are
presented as mean ? SD. The horizontal line indicates the time
during which the heart rates in the patients of the 2 groups differed
from their baseline heart rates (9–90 minutes, overall P ? 0.05).
There were no differences between the groups at any time. The
number of patients in the beach chair position group decreased from
61 at baseline to 60 at 45 minutes and then progressively over time
to 50 at 1 hour and to 20 at 90 minutes, whereas the number of
patients in the lateral decubitus position group decreased from 63 at
baseline to 61 at 48 minutes and then progressively over time to 54
at 1 hour and to 40 at 90 minutes.
Figure 2. Mean arterial pressure (mm Hg) for the patients in the
beach chair position group and in the lateral decubitus position
group. The data are presented as mean ? SD. The horizontal line
indicates the time during which the blood pressures in the patients
of the 2 groups differed from their baseline blood pressures (6–90
minutes, overall P ? 0.05). There were no differences between the
groups at any time. The number of patients in the beach chair
position group decreased from 61 at baseline to 60 at 45 minutes
and then progressively over time to 51 at 1 hour and to 20 at 90
minutes, whereas the number of patients in the lateral decubitus
position group decreased from 63 at baseline to 61 at 48 minutes
and then progressively over time to 54 at 1 hour and to 40 at 90
Figure 3. Arterial oxygen saturation (SpO2, %) for the patients in the
beach chair position group and in the lateral decubitus position
group. The data are presented as mean ? SD. There were no
differences between the groups at any time. The number of patients
in the beach chair position group decreased from 61 at baseline to
60 at 45 minutes and then progressively over time to 51 at 1 hour
and to 20 at 90 minutes, whereas the number of patients in the
lateral decubitus position group decreased from 63 at baseline to 61
at 48 minutes and then progressively over time to 54 at 1 hour and
to 40 at 90 minutes.
Figure 4. End-tidal sevoflurane concentrations for the patients in the
beach chair position group and in the lateral decubitus position
group. The data are presented as mean ? SD. There were no
differences between the groups at any time. The number of patients
in the beach chair position group decreased from 61 at 15 minutes
to 60 at 45 minutes, to 58 at 60 minutes, to 45 at 75 minutes, and
to 25 at 90 minutes, whereas the number of patients in the lateral
decubitus position group decreased from 63 at 15 minutes to 58 at
45 minutes, to 55 at 60 minutes, to 49 at 75 minutes, and to 43 at
90 minutes.
Cerebral Desaturation in the Beach Chair Position