text:
Head Trauma Workup
- Author: Craig R Ainsworth, MD; Chief Editor: John Geibel, MD, DSc, MSc, MA more...
Laboratory Studies
After the patient has been stabilized and an appropriate neurologic examination has been conducted, the diagnostic evaluation may begin. Patients with TBI do not require any additional blood tests beyond the standard panel of tests obtained in all trauma patients. A urine toxicology screen and an assessment of the blood alcohol level are important for any patient who has an altered level of consciousness because any central nervous system depressant can impair consciousness.
Imaging Studies
Skull radiographs
Once an important part of the head injury evaluation, skull radiographs have been replaced by CT scans and are rarely used in patients with closed head injury.
Skull radiographs are occasionally used in the evaluation of penetrating head trauma, and they can help provide a rapid assessment of the degree of foreign body penetration in nonmissile penetrating head injuries (eg, stab wounds).
Skull radiographs are sometimes used in patients with gunshot wounds to the head to screen for retained intracranial bullet fragments.
CT scan
A CT scan is the diagnostic study of choice in the evaluation of TBI because it has a rapid acquisition time, is universally available, is easy to interpret, and is reliable.
When first introduced more than 25 years ago, CT scans of the brain required almost 30 minutes to complete. This acquisition time has decreased steadily; the current generation of ultrafast CT scanners can perform a head CT scan in less than 1 minute, faster than the time required to enter patient's demographic data into the scanner.
The standard CT scan for the evaluation of acute head injury is a noncontrast scan that spans from the base of the occiput to the top of the vertex in 5-mm increments.
Three data sets are obtained from the primary scan, as follows: (1) bone windows, (2) tissue windows, and (3) subdural windows. These different types of exposure are necessary because of the significant difference in exposure necessary to visualize various intracranial structures. The bone windows allow for a detailed survey of the bony anatomy of the skull, and the tissue windows allow for a detailed survey of the brain and its contents. The subdural windows provide better visualization of intracranial hemorrhage, especially those hemorrhages adjacent to the brain (eg, subdural hematomas).
Each intracranial structure has a characteristic density, which is expressed in Hounsfield units. These units are defined according to a scale that ranges from (-) 1000 units to (+) 1000 units. Air is assigned a density of (-) 1000 units, water is assigned a density of 0 units, and bone has a density of (+) 1000 units. On this scale, CSF has a density of (+) 4 to (+) 10 units, white matter has a density of (+) 22 to (+) 36 units, and gray matter has a density of (+) 32 to (+) 46 units. Extravascular blood has a density of (+) 50 to (+) 90 units, and calcified tissue and bone have a density of (+) 800 to (+) 1000 units.
When reviewing a CT scan, using a systematic approach and following this same protocol each time are important. Consistency is much more important than the specific order used.
First, examine the bone windows for fractures, beginning with the cranial vault and then examining the skull base and the facial bones.
Next, examine the tissue windows for the presence of (1) extra-axial hematomas (eg, epidural hematomas, subdural hematomas), (2) intraparenchymal hematomas, or (3) contusions.
Next, survey the brain for any evidence of pneumocephalus, hydrocephalus, cerebral edema, midline shift, or compression of the subarachnoid cisterns at the base of the brain.
Finally, examine the subdural windows for any hemorrhage that may not be visualized easily on the tissue windows.
Skull fractures may be classified as either linear or comminuted fractures. Linear skull fractures are sometimes difficult to visualize on the individual axial images of a CT scan. The scout film of the CT scan, which is the equivalent of a lateral skull x-ray film, often demonstrates linear fractures. The intracranial sutures are easily mistaken for small linear fractures. However, the sutures have characteristic locations in the skull and have a symmetric suture line on the opposite side. Small diploic veins, which traverse the skull, may also be interpreted as fractures. Comminuted fractures are complex fractures with multiple components. Comminuted fractures may be displaced inwardly; this is defined as a depressed skull fracture.
Extra-axial hematomas include epidural and subdural hematomas. Epidural hematomas are located between the inner table of the skull and the dura. They are typically biconvex in shape because their outer border follows the inner table of the skull and their inner border is limited by locations at which the dura is firmly adherent to the skull. Epidural hematomas are usually caused by injury to an artery, although 10% of epidural hematomas may be venous in origin. The most common cause of an epidural hematoma is a linear skull fracture that passes through an arterial channel in the bone. The classic example of this is the temporal epidural hematoma caused by a fracture through the course of the middle meningeal artery. Epidural hematomas, especially those of arterial origin, tend to enlarge rapidly.
Subdural hematomas are located between the dura and the brain. Their outer edge is convex, while their inner border is usually irregularly concave. Subdural hematomas are not limited by the intracranial suture lines; this is an important feature that aids in their differentiation from epidural hematomas. Subdural hematomas are usually venous in origin, although some subdural hematomas are caused by arterial injuries. The classic cause of a posttraumatic subdural hematoma is an injury to one of the bridging veins that travel from the cerebral cortex to the dura. As the brain atrophies over time, the bridging veins become more exposed and, as a result, are more easily injured. Occasionally, the distinction between a subdural and an epidural hematoma can be difficult. The size of an extra-axial hematoma is a more important factor than whether the blood is epidural or subdural in location. In addition, a mixed hematoma with both a subdural and an epidural component is not uncommon.
Intra-axial hematomas are defined as hemorrhages within the brain parenchyma. These hematomas include intraparenchymal hematomas, intraventricular hemorrhages, and subarachnoid hemorrhages. Subarachnoid hemorrhages that occur because of trauma are typically located over gyri on the convexity of the brain. The subarachnoid hemorrhages that result from a ruptured cerebral aneurysm are usually located in the subarachnoid cisterns at the base of the brain. Cerebral contusions are posttraumatic lesions in the brain that appear as irregular regions, in which high-density changes (ie, blood) and low-density changes (ie, edema) are present. Frequently, 1 of these 2 types of changes predominates within a particular contusion. Contusions are most often caused by the brain gliding over rough surfaces, such as the rough portions of the skull that are present under the frontal and temporal lobes.
CT scans may be used for classification and for diagnostic purposes. Marshall et al published a classification scheme that classifies head injuries according to the changes demonstrated on CT scan images.[3] This system defines 4 categories of injury, from diffuse injury I to diffuse injury IV.
In diffuse injury I, evidence of any significant brain injury is lacking.
In diffuse injury II, either no midline shift or a shift of less than 5 mm is present and the CSF cisterns at the base of the brain are widely patent. In addition, no high-density or mixed-density lesions (contusions) of greater than 25 mL in volume are present.
In diffuse injury III, a midline shift of less than 5 mm is present, with partial compression or absence of the basal cisterns. No high- or mixed-density lesions with a volume greater than 25 mL are present.
Diffuse injury IV is defined as midline shift greater than 5 mm with compression or absence of the basal cisterns and no lesions of high or mixed density greater than 25 mL
MRI has a limited role in the evaluation of acute head injury. Although MRI provides extraordinary anatomic detail, it is not commonly used to evaluate acute head injuries because of its long acquisition times and the difficulty in obtaining MRIs in persons who are critically ill. However, MRI is used in the subacute setting to evaluate patients with unexplained neurologic deficits.
MRI is superior to CT scan for helping identify diffuse axonal injury (DAI) and small intraparenchymal contusions. DAI is defined as neuronal injury in the subcortical gray matter or the brainstem as a result of severe rotation or deceleration. DAI is often the reason for a severely depressed level of consciousness in patients who lack evidence of significant injury on CT scan images and have an ICP that is within the reference range.
Magnetic resonance angiography may be used in some patients with TBI to assess for arterial injury or venous sinus occlusion.
Once a common diagnostic study in persons with acute head injury, angiography is rarely used in the evaluation of acute head injury today. However, conventional angiography has been the screening and diagnostic modality of choice for identifying blunt cerebrovascular injuries (BCVI) in trauma patients.[4]
Before the development of the CT scan, cerebral angiography provided a reliable means for demonstrating the presence of an intracranial mass lesion.
Angiography in used in acute head injury only when a vascular injury may be present. This includes patients with unexplained neurologic deficits, especially in the setting of temporal bone fractures, and patients with clinical evidence of a potential carotid injury (eg, hemiparesis, Horner syndrome).
Goodwin et al found that conventional angiography is more accurate than 16- or 64-slice CT angiography as a screening tool for BCVI in trauma patients.[4] In a prospective study, 158 patients underwent CT angiography (16-slice or 64-slice) at the time of injury assessment, followed 24-48 hours later with conventional angiography of the cerebral vasculature. CT angiography detected only 13 true cerebrovascular injuries (40.6%) in 12 patients, whereas conventional angiography identified 32 injuries in 27 patients.[4] For detection of cerebrovascular injury, CT angiography had a sensitivity of 0.97 (95% confidence interval [CI], 0.92-0.99) and a specificity of 0.41 (95% CI, 0.22-0.61).
A study by Emmett et al confirmed that angiography is the criterion standard for BCVI diagnosis, but that CT angiography should be added as a screening criterion in order to capture BCVI that goes unrecognized in asymptomatic trauma patients.[5]
Other Tests
Initial clinical evaluation
The initial evaluation of patients with TBI involves a thorough systemic trauma evaluation according to the advanced trauma life support (ATLS) guidelines. Once this has been completed and the patient is stable from a cardiopulmonary standpoint, attention may be directed to a focused head injury evaluation.
The evaluation of the spine for potential injury is critically important in patients with TBI because approximately 10% of those with severe head injuries have a concomitant spine injury. Many of these injuries are cervical spine injuries.
Attempt to obtain a thorough history of the mechanism of the trauma and the events immediately preceding the trauma. Specific information, such as the occurrence of syncope or the onset of a seizure prior to a fall or a motor vehicle accident, prompts a more extended evaluation of the etiology of such an event. Because many patients with TBI have altered levels of consciousness, the history is often provided by family members, police officers, paramedics, or witnesses.
Neurologic assessment
After sufficient information has been obtained regarding patient history, appropriate physical and neurologic examinations are performed.
The neurologic assessment begins with ascertaining the GCS score. This is a screening examination and does not substitute for a thorough neurologic examination.
In addition to determining the GCS score, the neurologic assessment of patients with TBI should include the following:
Brainstem examination – Pupillary examination, ocular movement examination, corneal reflex, gag reflex
Motor examination
Sensory examination
Reflex examination
Many patients with TBI have significant alterations of consciousness and/or pharmaceuticals present that limit the scope of the neurologic examination. When such factors limit the neurologic examination, noting their presence is important.
Pupillary examination
A careful pupillary examination is a critical part of the evaluation of patients with TBI, especially in patients with severe injuries. When muscle relaxants have been administered to a patient, the only aspect of the neurologic examination that may be evaluated is the pupillary examination.
Several factors can alter the pupillary examination results. Narcotics cause pupillary constriction (meiosis), and medications or drugs that have sympathomimetic properties cause pupillary dilation (mydriasis). These effects are often strong enough to blunt or practically eliminate pupillary responses. Prior eye surgery, such as cataract surgery, can also alter or eliminate pupillary reactivity.
Proper assessment of the pupillary response requires the use of a strong light source to override any of the potential factors that may affect pupillary reaction. Each pupil must be assessed individually, with at least 10 seconds between assessment of each eye to allow consensual responses to fade prior to stimulating the opposite eye.
A normal pupillary examination result consists of bilaterally reactive pupils that react to both direct and consensual stimuli. Bilateral small pupils can be caused by narcotics, pontine injury (due to disruption of sympathetic centers in the pons), or early central herniation (mass effect on the pons).
Bilateral fixed and dilated pupils are secondary to inadequate cerebral perfusion. This can result from diffuse cerebral hypoxia or severe elevations of ICP preventing adequate blood flow into the brain.
Pupils that are fixed and dilated usually indicate an irreversible injury. If due to systemic hypoxia, the pupils sometimes recover reactivity when adequate oxygenation is restored.
A unilateral fixed (unresponsive) and dilated pupil has many potential causes. A pupil that does not constrict when light is directed at the pupil but constricts when light is directed into the contralateral pupil (intact consensual response) is indicative of a traumatic optic nerve injury.
A unilateral dilated pupil that does not respond to either direct or consensual stimulation usually indicates transtentorial herniation.
Unilateral constriction of a pupil is usually secondary to Horner syndrome, in which the sympathetic input to the eye is disrupted and the pupil constricts due to more parasympathetic than sympathetic stimulation. In patients with TBI, Horner syndrome may be caused by an injury to the sympathetic chain at the apex of the lung or a carotid artery injury. A unilateral constricted pupil can be caused by a unilateral brainstem injury, but this is quite rare.
A core optic pupil is a pupil that appears irregular in shape. This is caused by a lack of coordination of contraction of the muscle fibers of the iris and is associated with midbrain injuries.
Ocular movement examination
When the patient's level of consciousness is altered significantly, a loss of voluntary eye movements often occurs and abnormalities in ocular movements are frequently present. These abnormalities can provide specific clues to the extent and location of injury.
Ocular movements involve the coordination of multiple centers in the brain, including the frontal eye fields, the paramedian pontine reticular formation (PPRF), the medial longitudinal fasciculus (MLF), and the nuclei of the third and sixth cranial nerves. In patients in whom voluntary eye movements cannot be assessed, oculocephalic and oculovestibular testing may be performed.
Oculocephalic testing
Oculocephalic testing (doll's eyes) involves observation of eye movements when the head is turned from side to side. This maneuver helps assess the integrity of the horizontal gaze centers.
Before performing oculocephalic testing, the status of the cervical spine must be established. If a cervical spine injury has not been excluded reliably, oculocephalic testing should not be performed.
When assessing oculocephalic movements, the head is elevated to 30° from horizontal and is rotated briskly from side to side.
A normal response is for the eyes to turn away from the direction of the movement as if they are fixating on a target that is straight ahead. This is similar to the way a doll's eyes move when the head is turned; this is the origin of the term doll's eyes.
If the eyes remain fixed in position and do not rotate with the head, this is indicative of dysfunction in the lateral gaze centers and is referred to as negative doll's eyes. Some patients may have negative doll's eyes and normal oculovestibular reflexes.
Oculovestibular testing
Oculovestibular testing, also known as cold calorics, is another method for assessment of the integrity of the gaze centers. Oculovestibular testing is performed with the head elevated to 30° from horizontal to bring the horizontal semicircular canal into the vertical position.
Oculovestibular testing requires the presence of an intact tympanic membrane; this must be assessed before beginning the test.
In oculovestibular testing, 20 mL of ice-cold water is instilled slowly into the auditory canal. If is no response occurs within 60 seconds, the test is repeated with 40 mL of cold water.
When cold water is irrigated into the external auditory canal, the temperature of the endolymph falls and the fluid begins to settle. This causes an imbalance in the vestibular signals and initiates a compensatory response.
Cold-water irrigation in the ear of an alert patient results in a fast nystagmus away from the irrigated ear and a slow compensatory nystagmus toward the irrigated side. If warm water is used, the opposite will occur; the fast component of nystagmus will be toward the irrigated side, and the slow component will be away from the irrigated side. This is the basis for the acronym COWS, which stands for cold opposite, warm same. This refers to the direction of the fast component of nystagmus.
As the level of consciousness declines, the fast component of nystagmus fades gradually. Thus, in unconscious patients, only the slow phase of nystagmus may be evaluated.
A normal oculocephalic response to cold-water calorics (ie, eye deviation toward the side of irrigation) indicates that the injury spares the PPRF, the MLF, and third and sixth cranial nerve nuclei. This means that the level of injury must be rostral to the reticular activating system in the upper brainstem.
If a unilateral frontal lobe injury is present, the eyes are deviated toward the side of injury prior to caloric testing. Cold-water irrigation of the opposite ear results in a normal response to caloric testing (ie, eye deviation toward the irrigated side) because the injury is in the frontal region and spares the pontine gaze centers.
When a pontine injury is present, the eyes often deviate away from the side of injury. In this situation, cold-water irrigation of the contralateral ear does not cause the gaze to deviate toward the irrigated ear because an injury has occurred at the level of the pons and the pontine gaze centers are compromised.
A dysconjugate response to caloric testing suggests an injury to either the third or sixth cranial nerves or an injury to the MLF, resulting in an internuclear ophthalmoplegia.
If caloric testing causes a skew deviation, in which the eyes are dysconjugate in the vertical direction, this indicates a lesion in the brainstem. The exact location of injury that results in skew deviation is not known.
Motor examination
After completing the brainstem examination, a motor examination should be performed. A thorough motor or sensory examination is difficult to perform in any patient with an altered level of consciousness.
When a patient is not alert enough to cooperate with strength testing, the motor examination is limited to an assessment of asymmetry in the motor examination findings. This may be demonstrated by an asymmetric response to central pain stimulation or a difference in muscle tone between the left and right sides. A finding of significant asymmetry during the motor examination may be indicative of a hemispheric injury and raises the possibility of a mass lesion.
Sensory examination
Performing a useful sensory examination in patients with TBI is often difficult.
Patients with altered levels of consciousness are unable to cooperate with sensory testing, and findings from a sensory examination are not reliable in patients who are intoxicated or comatose.
Peripheral reflex examination
A peripheral reflex examination can be useful to help identify gross asymmetry in the neurologic examination.
This may indicate the presence of a hemispheric mass lesion.
Other factors
Notably, Ley et al have suggested that diabetic patients with moderate-to-severe TBI are increased risk of mortality, with the likely contributing factor being insulin deficiency.[6]
Intracranial hypertension (ICH) and cerebral hypoperfusion (CH) are secondary insults in patients with TBI that are hard to predict. Stein et al conducted a study to determine whether cytokine levels are indicative of impending ICH or CH in patients with severe TBI. They found that interleukin 8 (IL-8) shows the most promise as a potential biomarker of impending ICH and CH. Results showed higher serum IL-8 levels in patients with poor neurologic outcome and a moderate correlation between serum IL-8 levels with ICH and CH and between cerebrospinal fluid (CSF) levels of IL-8 and cerebral perfusion pressure (CPP).[7]
Maloney-Wilensky E, Gracias V, Itkin A, et al. Brain tissue oxygen and outcome after severe traumatic brain injury: a systematic review. Crit Care Med. 2009 Jun. 37(6):2057-63. [Medline].
Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975 Mar 1. 1(7905):480-4. [Medline].
Marshall LF, Marshall SB, Klauber MR. A new classification of head injury based on computerized tomography. J Neurosurg. 1991. 75:S14-20.
Goodwin RB, Beery PR 2nd, Dorbish RJ, et al. Computed tomographic angiography versus conventional angiography for the diagnosis of blunt cerebrovascular injury in trauma patients. J Trauma. 2009 Nov. 67(5):1046-50. [Medline].
Emmett KP, Fabian TC, Dicocco JM, Zarzaur BL, Croce MA. Improving the screening criteria for blunt cerebrovascular injury: the appropriate role for computed tomography angiography. J Trauma. 2011 May. 70(5):1058-65. [Medline].
Ley EJ, Srour MK, Clond MA, et al. Diabetic patients with traumatic brain injury: insulin deficiency is associated with increased mortality. J Trauma. 2011 May. 70(5):1141-4. [Medline].
Stein DM, Lindell A, Murdock KR, et al. Relationship of serum and cerebrospinal fluid biomarkers with intracranial hypertension and cerebral hypoperfusion after severe traumatic brain injury. J Trauma. 2011 May. 70(5):1096-103. [Medline].
Rincon F, Kang J, Vibbert M, Urtecho J, Athar MK, Jallo J. Significance of arterial hyperoxia and relationship with case fatality in traumatic brain injury: a multicentre cohort study. J Neurol Neurosurg Psychiatry. 2014 Jul. 85(7):799-805. [Medline].
Lin CC, Yu JH, Lin CC, Li WC, Weng YM, Chen SY. Postintubation hemodynamic effects of intravenous lidocaine in severe traumatic brain injury. Am J Emerg Med. 2012 May 23. [Medline].
Temkin NR, Dikmen SS, Wilensky AJ, et al. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med. 1990 Aug 23. 323(8):497-502. [Medline].
Alali AS, Fowler RA, Mainprize TG, Scales DC, Kiss A, de Mestral C. Intracranial pressure monitoring in severe traumatic brain injury: results from the American College of Surgeons Trauma Quality Improvement Program. J Neurotrauma. 2013 Oct 15. 30(20):1737-46. [Medline].
Bauer DF, McGwin G Jr, Melton SM, George RL, Markert JM. The Relationship Between INR and Development of Hemorrhage With Placement of Ventriculostomy. J Trauma. 2011 May. 70(5):1112-7. [Medline].
Lundberg N. Continuous Recording and Control of Ventricular Fluid Pressure in Neurosurgical Practice. Acta Psychiatr Neurol Scand. 1960. 36:148-93.
Karamanos E, Teixeira PG, Sivrikoz E, Varga S, Chouliaras K, Okoye O, et al. Intracranial pressure versus cerebral perfusion pressure as a marker of outcomes in severe head injury: a prospective evaluation. Am J Surg. 2014 Sep. 208(3):363-71. [Medline].
Lazaridis C, Neyens R, Bodle J, DeSantis SM. High-osmolarity saline in neurocritical care: systematic review and meta-analysis. Crit Care Med. 2013 May. 41(5):1353-60. [Medline].
Zhang XY, Yang ZJ, Wang QX, Fan HR. Impact of positive end-expiratory pressure on cerebral injury patients with hypoxemia. Am J Emerg Med. 2011 Sep. 29(7):699-703. [Medline].
Lu J, Gary KW, Neimeier JP, Ward J, Lapane KL. Randomized controlled trials in adult traumatic brain injury. Brain Inj. 2012. 26(13-14):1523-48. [Medline].
Saxena M, Andrews PJ, Cheng A, Deol K, Hammond N. Modest cooling therapies (35ºC to 37.5ºC) for traumatic brain injury. Cochrane Database Syst Rev. 2014. 8:CD006811. [Medline].
Nirula R, Millar D, Greene T, McFadden M, Shah L, Scalea TM, et al. Decompressive craniectomy or medical management for refractory intracranial hypertension: an AAST-MIT propensity score analysis. J Trauma Acute Care Surg. 2014 Apr. 76(4):944-52; discussion 952-5. [Medline].
Valle EJ, Van Haren RM, Allen CJ, Jouria JM, Bullock MR, Schulman CI, et al. Does traumatic brain injury increase the risk for venous thromboembolism in polytrauma patients?. J Trauma Acute Care Surg. 2014 Aug. 77(2):243-50. [Medline].
Farooqui A, Hiser B, Barnes SL, Litofsky NS. Safety and efficacy of early thromboembolism chemoprophylaxis after intracranial hemorrhage from traumatic brain injury. J Neurosurg. 2013 Dec. 119(6):1576-82. [Medline].
Shahlaie K, Keachie K, Hutchins IM, Rudisill N, Madden LK, Smith KA, et al. Risk factors for posttraumatic vasospasm. J Neurosurg. 2011 Sep. 115(3):602-11. [Medline].
Timmons SD, Bee T, Webb S, Diaz-Arrastia RR, Hesdorffer D. Using the abbreviated injury severity and Glasgow Coma Scale scores to predict 2-week mortality after traumatic brain injury. J Trauma. 2011 Nov. 71(5):1172-8. [Medline].
Richmond R, Aldaghlas TA, Burke C, Rizzo AG, Griffen M, Pullarkat R. Age: Is It All in the Head? Factors Influencing Mortality in Elderly Patients With Head Injuries. J Trauma. 2011 Feb 17. [Medline].
Cheng PL, Lin HY, Lee YK, Hsu CY, Lee CC, Su YC. Higher mortality rates among the elderly with mild traumatic brain injury: a nationwide cohort study. Scand J Trauma Resusc Emerg Med. 2014 Jan 28. 22:7. [Medline]. [Full Text].
Jiang JY, Gao GY, Li WP, Yu MK, Zhu C. Early indicators of prognosis in 846 cases of severe traumatic brain injury. J Neurotrauma. 2002 Jul. 19(7):869-74. [Medline].
Elterman J, Brasel K, Brown S, Bulger E, Christenson J, Kerby JD. Transfusion of red blood cells in patients with a prehospital Glasgow Coma Scale score of 8 or less and no evidence of shock is associated with worse outcomes. J Trauma Acute Care Surg. 2013 Jul. 75(1):8-14; discussion 14. [Medline].
Robertson CS, Hannay HJ, Yamal JM, Gopinath S, Goodman JC, Tilley BC, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA. 2014 Jul 2. 312(1):36-47. [Medline]. [Full Text].
Yutthakasemsunt S, Kittiwatanagul W, Piyavechvirat P, Thinkamrop B, Phuenpathom N, Lumbiganon P. Tranexamic acid for patients with traumatic brain injury: a randomized, double-blinded, placebo-controlled trial. BMC Emerg Med. 2013. 13:20. [Medline].
Undefined. [Medline].
Benzel EC, Mashburn JP, Conrad S, et al. Apnea testing for the determination of brain death: a modified protocol. Technical note. J Neurosurg. 1992 Jun. 76(6):1029-31. [Medline].
Bernat JL, Culver CM, Gert B. On the definition and criterion of death. Ann Intern Med. 1981 Mar. 94(3):389-94. [Medline].
Brandt MM, Ahrns KS, Corpron CA, et al. Hospital cost is reduced by motorcycle helmet use. J Trauma. 2002 Sep. 53(3):469-71. [Medline].
Choi SC, Narayan RK, Anderson RL, et al. Enhanced specificity of prognosis in severe head injury. J Neurosurg. 1988 Sep. 69(3):381-5. [Medline].
Crippen DW, Whetstine LM. Ethics review: dark angels--the problem of death in intensive care. Crit Care. 2007. 11(1):202. [Medline]. [Full Text].
Darwin MG, Leaf JD, Hixon H. Neuropreservation of Alcor patient A-1068. From Cryonics, February & March, 1986. Available at http://www.alcor.org/Library/html/casereport8504.html#part2.
Guidelines for the determination of death. Report of the medical consultants on the diagnosis of death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. JAMA. 1981 Nov 13. 246(19):2184-6. [Medline].
Guidelines for the management of severe head injury. Brain Trauma Foundation, American Association of Neurological Surgeons, Joint Section on Neurotrauma and Critical Care. J Neurotrauma. 1996 Nov. 13(11):641-734. [Medline].
Horn P, Munch E, Vajkoczy P, et al. Hypertonic saline solution for control of elevated intracranial pressure in patients with exhausted response to mannitol and barbiturates. Neurol Res. 1999 Dec. 21(8):758-64. [Medline].
Kraus JF, Peek C, McArthur DL, et al. The effect of the 1992 California motorcycle helmet use law on motorcycle crash fatalities and injuries. JAMA. 1994 Nov 16. 272(19):1506-11. [Medline].
Meyfroidt G, Güiza F. Outcome prediction after moderate and severe traumatic brain injury: why two models if we could do with one?. Crit Care Med. 2012 May. 40(5):1685-6. [Medline].
Morenski JD, Oro JJ, Tobias JD, et al. Determination of death by neurological criteria. J Intensive Care Med. 2003 Jul-Aug. 18(4):211-21. [Medline].
Rosenberg WS, Harsh GR. Penetrating cerebral trauma. Grossman GR, Loftus CM, eds. Principles of Neurosurgery. 2nd ed. Philadelphia: Lippincott-Raven; 1999. 173-82.
Rosner MJ, Rosner SD, Johnson AH. Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg. 1995 Dec. 83(6):949-62. [Medline].
Sumas ME, Narayan RK. Head injury. Grossman GR, Loftus CM, eds. Principles of Neurosurgery. 2nd ed. Philadelphia: Lippincott-Raven; 1999. 117-71.
Vivien B, Paqueron X, Le Cosquer P, et al. Detection of brain death onset using the bispectral index in severely comatose patients. Intensive Care Med. 2002 Apr. 28(4):419-25. [Medline].
Whetstine L, Streat S, Darwin M, Crippen D. Pro/con ethics debate: when is dead really dead?. Crit Care. 2005. 9(6):538-42. [Medline]. [Full Text].
|Eye Opening
|1 Year or Older
|0-1 Year
|To verbal command
|To shout
|To pain
|To pain
|No response
|No response
|Best Motor Response
|1 Year or Older
|0-1 Year
|Obeys command
|Localizes pain
|Localizes pain
|Flexion withdrawal
|Flexion withdrawal
|Flexion abnormal (decorticate)
|Flexion abnormal (decorticate)
|Extension (decerebrate)
|Extension (decerebrate)
|No response
|No response
|Best Verbal Response
|>5 Years
|2-5 Years
|0-2 Years
|Oriented and converses
|Appropriate words
|Cries appropriately
|Disoriented and converses
|Inappropriate words
|Inappropriate words; cries
|Inappropriate crying/screaming
|Incomprehensible sounds
|No response
|No response
|No response


text:
Higher-end home sellers cut asking prices 12%
[caption id="attachment_101361" align="alignright" width="437" caption="Click to enlarge"][/caption]
Here is a slightly different view of the Orange County housing market from HousingTracker.net.
It tracks trends in asking prices from brokers' MLS system of homes for sale. In addition, HousingTracker breaks down its data into a pair of neat markers -- the 25th and 75th percentiles that let us see how the market's upper crust and more modest abodes are faring. From theFebruaryreport we see …
At the25th percentile -- the median of the lower half of the price spectrum of local homes for sale…
- Selling price was $295,875 -- that isup0.31%vs. the previous month yet down4.2%vs. a year ago.This is the 3rdconsecutive year-over-year cut in asking prices for these more "affordable" homes.
- Over two years, there's been an4.7%increasechange in prices set by sellers of these more affordable local homes.
At the75th percentile -- the median of the upper half of the price spectrum of local homes for sale …
- Selling price was $641,095 -- that isup0.03%vs. the previous month yet down12.4%vs. a year ago.This is the 11thconsecutive year-over-year cut in asking prices for these more "luxurious" homes.
- Over two years, prices asked aredown11.0%on homes in this slice of upper-crust Orange County homes.
Also …
- The gap between these two price points was117%vs.117%the previous month and137%a year earlier.The gap peaked at 167% in June and July 2009.
- The overall Orange County median listing price, by this math, was $418,975 -- that is-1.1%vs. the previous month and-6.6%vs. a year ago.Over two years, there's been an-3.0%change.
- Supply of Orange County homes for sale inFebruaryaveraged 13,444 --24.4%increasevs. a year ago and1.4%dipvs. same month two years back.
|For some real estate context ...
[rssfeedme cat="lansner" feedpath="/tag/trends/feed/" max="6"]
[rssfeedme cat="lansner" feedpath="/tag/industry/feed/" max="6"]
Most Popular
- Santa Clarita fire may not be the biggest blaze to hit Southern California
- Mistrial declared in trial over 1988 Buena Park rape, slaying of teen
- Court calls O.C. D.A.'s 'papering' of judge in jailhouse informant fallout legal but disr
- Boat rental boom: Boatbound takes AirBnb concept to the water
- Six charged in connection with stabbing death of man found in creek bed
User Agreement
Comments are encouraged, but you must follow our Privacy Policy Policy & Terms of Use
Keep it civil and stay on topic. No profanity, vulgarity, racial slurs or personal attacks. People who harass others or joke about tragedies will be blocked. By posting your comment, you agree to allow Orange County Register Communications, Inc. the right to republish your name and comment in additional Register publications without any notification or payment.

subset: commoncrawl


text:
This property allows you to book online with a credit card. After submitting a reservation request, the owner or manager has 24 hours to accept, at which time your card will be charged and you will receive an email confirmation
3 BR 2 BA Sleeps 6View listing for price180 night min stay
3 BR 2.5 BA Sleeps 6$359 avg/night5 night min stay
1 BR 1 BA Sleeps 4View listing for price
1 BR 1 BA Sleeps 4$204 avg/night3 night min stay
Recent West Maui reviews
"The property's location was perfect. Not so crowded and away from all the other resorts. The beach right in front of the resort was perfect for snorkeling. Our villa was clean. The only thing I think needs to be replaced is the mattress. It was sagging and really uncomfortable. But we'll definitely be back"Guest: Anneke L. Date of Stay: December 2015 Review Submitted: December 27, 2015View listing
"We had a wonderful week in West Maui, and this 3BR 3Bath condo was perfect for our family -- 3 couples and our 10-month-old grandbaby. Being on the ground level with our own little private lawn next to our lanai was a plus, as was being so close to the pool. The whole place was nicely appointed, the kitchen lacked nothing (and even included some basic spices, olive oil, vinegar, etc), the beds were super comfortable (now with very nice linens), and everything was spotless when we arrived. The boogie boards and snorkeling equipment were a bonus. If you're traveling with little ones, I recommend renting baby equipment ahead of time: Akamai Mothers got the crib and highchair in place before we arrived, and their bag of age-appropriate toys and books kept our little guy entertained. In the morning we loved taking the Beach Walk to the far end of the Ka'anapali strip (6 miles round trip) and also the more dramatic Kapalua Coast Trail from Kapalua beach to Fleming beach (3 miles round-trip). I highly recommend this condo for anyone, and the resort is especially ideal for families with little kids."Guest: Anonymous Date of Stay: May 2016 Review Submitted: May 17, 2016View listing
"The condo was lovely and everything we needed for our week in Maui. The only thing I would add is two can lights over the mirror in the bathroom. The bed was comfortable, it was very clean, it was quiet and the overall look was lovely. Oh, no corkscrew for wine, at least we could not find it. We really enjoyed the outside balcony as well, the view was spectacular. Thanks for letting us stay in your condo, we hope to return in a few years!"Guest: sylvia b. Date of Stay: July 2016 Review Submitted: July 15, 2016View listing
"Out of the five properties that I stayed at throughout the Hawaiian islands, Pam and Jay's place was by far the best. The location is excellent. The condo is well-kept, very clean, and supplied with all of the necessities for a pleasant stay. The A/C in the bedroom was an added, and very welcome, bonus. The beach that fronts this property is small, relatively private, and very clean. If you snorkel, there is a wide variety of fish to see. Even if you don't snorkel, you can't miss the green sea turtles that snack on the rock outcroppings and rest on the beach in front of Hoyochi Nikko. The resident managers keep the grounds in great condition. But the best part of this unit is the owner, Pam. She is responsive, helpful and kind."Guest: A guest from Reading, PA Date of Stay: June 2016 Review Submitted: July 6, 2016View listing
Featured Destinations: San Diego Vacation Rentals, Kailua-Kona, Destin Condo Rentals, Key West Vacation Rentals


text:
Grand Khaan Irish Pub
Khövsgöl Lodge Company
This experienced outfit is part of the US-based Boojum Expeditions and has been running trips in Mongolia since 1994. It offers...
Active Mongolia
This reliable Scottish-German operation specialises in rugged hiking, rafting and horseback trips, plus mountain biking. Most of the...
Tsolman Travel
Established in 1993, this is one of the oldest private tour operators in Mongolia. It runs a wide variety of trips at competitive rates...
National Academic Drama Theatre
The well-established Shilla is a good spot for a hot bibimbap (T8,000) a filling meal loaded with rice, egg and veggies in a sizzling...
Seoul St · interesting places nearby
Grand Khaan Irish Pub information
In summertime it seems like half of Ulaanbaatar is crowded onto the deck of this old stand-by. Order a pint and join them. The pub-grub menu (meal with beer T18,000–45,000) includes an array of salads.


text:
Report: Terrorists planned to use iPod as detonator
According to CNN, terrorists planned to use iPods to help blow up airliners heading to the U.S. from the U.K. The plotters reportedly were to carry a "British version of Gatorade," mix it with a gel-like substance to make an explosive, and detonate it with an iPod or cell phone. As is being widely reported today, British authorities arrested two dozen suspects overnight to thwart a massive plot to bring down as many as 10 flights bound for New York, Washington and California. In the U.S., liquids and gels of any kind (except baby formula and medicines) have been banned in carry-on baggage for the time being. Meanwhile, the U.K. has temporarily banned all liquids as well as electronics such as laptops, cell phones and iPods.
Update: While the front page of CNN.com continues to refer to the possible detonating devices as an "iPod or cell phone," CNN's latest story on today's threat refers to only "MP3 players."
iLounge Editorial: The iPod Bomb? Don't Panic
Related Stories
- Update in iOS 10 allows for autoplay of silent videos in Safari
- Apple under fire for providing refurbished replacements under AppleCare+
- Apple releases second iOS 10 public beta
- Apple releases third developer betas for iOS 10, tvOS 10 + watchOS 3
- Apple releases iOS 9.3.3, watchOS 2.2.2, tvOS 9.2.2, iTunes 12.4.2
- Apple expected to release iOS 10 public beta today
Recent News
- Tim Cook to host Hillary Clinton fundraiser
- Report: Apple to update Apple Store app with personalized recommendations
- Report: Apple now prioritizing autonomous driving system in car project
- WSJ: Apple's 'hard-charging' approach unsuccessful in negotiations with TV networks
- Video purports to show official Lightning to 3.5mm headphone adapter
- New iPhone pre-orders to start Sept. 9?
- Apple has sold one billion iPhones
- Parkopedia to provide detailed parking information for Apple Maps [Updated]
- Microsoft releases Pix camera app for iPhone
- Adobe launches new Lightroom viewer for Apple TV
Recent Reviews
- Elgato Avea Flare Portable Mood Light
- Moe Bull Stand for iPad Air 2 + 9.7" iPad Pro
- Netatmo Tags for Welcome Smart Home Camera
- iDevices Socket HomeKit-enabled Light Adapter
- Koogeek Wi-Fi SmartPlug for Apple HomeKit
- Marbotic Smart Letters for iPad
- Ecoxgear Sol Jam Bluetooth Speaker
- Gumdrop Cases DropTech Case + Hand Strap for 9.7" iPad Pro
- Braven BRV-1M Bluetooth Speaker
- Braven BRV-Blade Bluetooth Speaker
Recent Articles
- Inside the betas: iOS 10 Photos gets Advanced Computer Vision
- Inside the betas: iOS 10 Music app delivers 'clarity and simplicity'
- Inside the betas: iOS 10 Maps gets a major redesign
- Inside the betas: iOS 10 shakes up the user experience
- Inside the betas: watchOS 3 promises a real speed boost
- Inside the betas: A sneak peek at what's new in tvOS 10
- Filling the Gap: A look at third-party HomeKit apps
- Instant Expert: Secrets & Features of tvOS 9.2
- Instant Expert: Secrets & Features of iOS 9.3
- Opinion: Why Apple needs a dedicated HomeKit app


text:
Sign Up
Log In
Size:  (micro)
Additional Hints
(No hints available.)
No attributes available
Advertising with Us
There are no Trackables in this cache.
View past Trackables
What are Trackable Items?
93 1
View Logbook
**Warning! Spoilers may be included in the descriptions or links.
Current Time: 07/30/2016 18:47:50 Pacific Daylight Time (01:47 GMT)Last Updated: 2016-07-06T03:33:25Z on 07/05/2016 20:33:25 Pacific Daylight Time (03:33 GMT) Rendered From:UnknownCoordinates are in the WGS84 datum


text:
Photo SpecialJessica Alba: Inside Her Life
Peek into the Fantastic Four star's world as she hangs with her guy, plays with her style and ropes in Hollywood. By Serena Kappes with Liza Hamm
Credit: SIPA
Updated: Thursday Jul 07, 2005 | 06:00 AM EDT
More from PEOPLE
Latest News!
- Mila Kunis Has Felt Shamed for Publicly Breastfeeding Daughter Wyatt 'Everywhere': 'If It's Not for You, Don't Look'
- Read the Cover Story: JFK Jr.: The John We Loved
- WATCH: Jersey Jargon! "RHONJ" Stars Teresa Giudice and Melissa Gorga Translate Their Slang For the Rest of Us
- It Only Took a Little Convincing to Get Guardians' Michael Rooker Blue in the Face for Comic-Con
- Princess Charlene Dazzles in a Lilac Gown at Red Cross Gala: 'She Likes to Surprise Me,' Says Prince Albert


text:
Comments about 'Today in the Bloggernacle: Free family history training and incredible temple photo'
- Oldest first
- Newest first
- Most recommended
My question: A free Family History tech training to help members what?...
How do members help in the work of salvation?
Maybe Mitt Romney could define the distinctives here. Or the missionaries at my door, when I ask how Mormonism's 19th-century doctrines differ from purely Biblical ones. Or the Institute leader, the local stake president or the seminary teacher who accept our church's invitation to share their doctrines, and then won't fully disclose them.
Just let the world know Joseph Smith's full doctrinal revelations and don't sugar-coat them:
What did the founding prophet and his successors say re: a member's obligation and reward on doing his family's geneolgy and "temple ordinance submission".
If LDS can show a pattern of openness about all of their church doctrines, maybe I'll let the missionaries past our doorstep... But then this post won't see the light of day.
- 1:21 p.m. Feb. 20, 2013
- Like (1)
- Report abuse
RE: @ Grace 1:21 pm
Wow.... very interesting post, "Grace". Thanks for sharing your thoughts (I think!) And see??!! The Deseret News DID go ahead and post your comments, in spite of your skepticism! 8^O
But I sense that you are a VERY conflicted and/or confused soul (just my opinion).
You seem to have a thousand questions about the LDS Church, but you won't allow the missionaries into your home to anwer them?? You invite LDS reps to your church, but then accuse them of sugar-coating or covering up LDS history??
Q: Why did you even bother reading this article... let alone even bothering to read a Utah newspaper?? Why not just let it go? Why can't you just leave it all alone?
I suggest you just move-on. Get a life. Best wishes!
- 10:23 a.m. Feb. 21, 2013
- Like
- Report abuse
DeseretNews.com encourages a civil dialogue among its readers. We welcome your thoughtful comments.
— About comments
- Germany: Syrian asylum seekers blows himself...
- Pope Francis: The world's at war, but not a...
- Pope visits Auschwitz in silence, meets...
- President and Sister Uchtdorf visit site of...
- Erin Stewart: Should you teach your kids to...
- President Uchtdorf visits refugees; presents...
- President Uchtdorf presents $3 million to...
- Elder LeGrand R. Curtis Jr. addresses 'A...
- Is Bernie Sanders an atheist? 44
- President Uchtdorf visits refugees;... 35
- Democrats and Republicans double-down... 31
- Erin Stewart: Should you teach your... 22
- 'Duck Dynasty' star: Media,... 21
- Defending the Faith: The 18th annual... 19
- Can Hillary Clinton finally close the... 17
- The Clean Cut: New BYU football video... 14


text:
Your browser does not support iframes.
Sydney, All Sydney, Full Time
30 Jul, 2016
Exciting opportunity to join this award winning mechanical contractor. Receive ongoing training and support. Gain outstanding leadership skills.
Job Category: Engineering
Join a tier-1 hydraulic contractor. Deliver multiple commercial projects. Lead a technically strong team and showcase your management skills.
Job Category: Construction & Architecture
Sydney, All Sydney, Full Time
29 Jul, 2016
Take ownership of all aspects of Electrical deign with this consultancy. Manage the design and documentation process on large scale projects.
Sydney, CBD, Inner West & Eastern Suburbs, Full Time
29 Jul, 2016
One of the fastest growing specialist consultancies in NSW. Coordinate upcoming residential developments. Join a collaborative and supportive team.
Sydney, All Sydney, Full Time
28 Jul, 2016
A highly collaborative and innovative engineering consultancy. Design and deliver your own projects. Flexible working hours in a team environment.
Sydney, All Sydney, Full Time
27 Jul, 2016
Drive this technical design team to meet project deadlines and requirements. Take ownership over a reputable portfolio of clients.
Excel within your career by joining this award winning mechanical contractor based in Sydney. Gain outstanding leadership skills. Manage a team.
Sydney, CBD, Inner West & Eastern Suburbs, Full Time
26 Jul, 2016
The building services department within this Global Tier 1 consultancy has an opening for an Electrical Engineer to work on high end Commercial
Sydney, All Sydney, Full Time
26 Jul, 2016
Manage a diverse team of engineers on large scale commercial and health developments. Maintain a high level of quality in your project deliveries.
This role is ready made for a mechanical engineer to step up experience quickly and reap the benefits that come with joining one of the major players.


text:
T-Mobile USA sold 500,000 iPhones in the handset's first month
T-Mobile USA announced its first set of financial earnings since finally making the iPhone available on its network last month. Carrying the iPhone is being considered T-Mobile's saving grace, mixed with its new "UnCarrier" plans that cut the contract out of the mix for smartphones.
So how did the iPhone 5, 4S, and 4 do in its first month at the fourth-largest carrier stateside? T-Mobile says it moved 500,000 iPhones in total since it being available on its network on 12 April - which, when you think about it, isn't too shabby considering the iPhone 5 has been available for quite some time.
Furthermore, T-Mobile says it saw the first increase in customers since the first quarter of 2009, signalling its new UnCarrier plans might just be doing the trick. T-Mobile currently sits at roughly 34 million subscribers, an increase of about 579,000 customers in Q1.
As we explained in March, the UnCarrier plans allow customers not to sign a two-year contract, but instead pay full price for the iPhone 5 at time of purchase or $99 (£65) up front with $20 a month in payments for the next 24 months. That will round out to $579 over two years, or $70 cheaper than Apple's unlocked version. Once the payment period is up, the phone is unlocked and yours to take to any carrier.
Even with the solid performance, T-Mobile saw its revenue drop from $4.9 billion in Q4 2012 to $4.7 billion in Q1 2013. Net income is down year on year to $107 million from $200 million, though up from the previous quarter.
T-Mobile is looking forward to the future, as its merger with MetroPCS, another US carrier, was approved in April. "We ended the quarter with strong operational momentum, which is continuing into the second quarter, driven by the successful launch of our Un-carrier 'Simple Choice' service plan and the introduction of the iPhone into our device line-up," said T-Mobile CEO John Legere.
"Things only get more exciting from here, having brought T-Mobile USA and MetroPCS together to create the wireless industry's value leader and premier challenger."
Best smartphones 2016: The best phones available to buy today
Samsung Galaxy S7 and Galaxy S7 edge: Release date, specs and everything you...
LG G5: Release date, price, specs and everything you need to know
You can buy the OnePlus 3 in gold on 1 August in UK, 26 July in US
- Motorola Moto E3 (2016) vs Moto E (2015): What's the difference?
- Galaxy Note 7 iris scanner instructions leak, this is how the scanner will work
- Next Nexus (2016): Release date, rumours and everything you need to know
- You can buy the OnePlus 3 in gold on 1 August in UK, 26 July in US
- Apple's 2016 iPhone could be called iPhone 6SE, not iPhone 7
- Full Moto E3 specs finally confirmed
- Samsung fixes Galaxy S7 Active's waterproof flaw, will replace phones
- Samsung Galaxy Note 7 vs Apple iPhone 6S Plus: What's the rumoured difference?
- BlackBerry Hamburg/Neon: Release date, specs and everything we know so far
- Apple iPhone 7 Plus vs iPhone 6S Plus vs iPhone 6 Plus: What's the rumoured difference?
- Pokemon Go: How to raise your XP level, power up and evolve your Pokemon
- Pokemon Go Gym tips: How to battle, train and win
- Help! Pokemon Go isn't working: How to fix common Pokemon Go problems
- Pokemon Go: How to play and other tips and tricks
- Pokemon Go top tips: Master the Pokemon mayhem
- What is Prisma and how does it work? Explaining the Android and iOS app
- Motorola Moto E3 (2016) vs Moto E (2015): What's the difference?
- Pokemon Go server problems: Why does the game keep stopping?
- Casio Edifice EQB-500: Watch first, connected device second
- Pokemon Go: How to get the most from PokeStops and items


text:
COULTER: When Do The Mothers Of ISIS Speak?
Obama's Last Big Military Gamble
It has been a delay of two years of using and arming the Sunni tribes and youths in northern Iraq.
China And Mexico Are Bringing In Nightmare Super Drugs
Synthetic opioids have been tied to overdose deaths across the country.
The Ultimate Attack On Western Civilization
Attacking a Norman priest is like burning down the birthplace of our Western principles.
How The Left Politicizes Anti-Semitism
What other acts of antisemitism within the Democrat Party are still hidden from the public?
What I Told President Obama About Education Reform
His administration has taken a few important steps, but there's still a long way to go
Newt Has It Wrong On Radical Islam
The real war is a war within Islam.
The DNC's Shocking Silence On Islamic Terrorism
Hillary Clinton is proposing a 500 percent increase in our refugee program
The Man Who Sold The World
Why we should all sympathize with the Sanders faithful, for the moment
Conservative Reporter Arrested By The Clintons In 1993 Makes The Case For Trump
Hillary Clinton is no safe alternative.
Democratic National Convention Lineup Could Be Final Nail In Coffin For Law Enforcement Support
The DNC should have chosen a better message that shows respect for law enforcement.
Don't Believe Clinton's Crocodile Tears Over Lost American Jobs
The law must be changed to ensure that qualified Americans are not being passed over.
Michelle Obama's America
She fell short of capturing the full reality of the America we live in
What The DNC Leaks Say About Our Need For Self-Governance
Is there a scandal in Washington that isn't somehow tied to the Clintons?
The Other Side Of Elizabeth Warren
When taking on predatory banks is beyond politics
Democratic Platform: Killing The Unborn Is Fine With Us
The Democratic Party is about to approve the most radically pro-abortion platform in its history.
Darkness vs. Light, 'I' vs. 'We'
We are a democracy — and we only know one approach to solving our problems.
A Reason To Celebrate This Year's Conventions
For the first time, taxpayers aren't subsidizing them
Ryan's Executive Overreach Working Group: It's Time for Congress to 'Man Up' And Do Its Duty
This would be a defining moment: putting Congress back in charge per the Constitution.
Hillary's Foreign Policy Legacy
Mrs. Clinton has shown she has neither the instincts or the character for the job.
Trump Is Ushering In A New Political Force
Nationalism looks to live on after The Donald's campaign
Abortion Poll: Trump-Pence Mainstream, Clinton-Kaine Extreme
Clinton's position was rejected by even a pro-abortion majority of the Supreme Court in 1980.
Use Of Force vs. Use Of Farce
The typical law enforcement officer has 1.4 seconds to decide to use force.
Germany's Liberal Hubris
Angela Merkel's multiculturalism is wearing thin after more terror attacks.
Just Who Is The 'Establishment'?
Some of those campaigning against the establishment assume that anyone holding office is a member.
Republicans Should Take Heed Of Peter Thiel's Example
Thiel's speech in particular produced one of the most dramatic moments in convention history.
DNC Leaks: Proof Democrats Manipulate Voters With Religion, Race
In a grossly cavalier manner, Marshall suggests invoking heritage and religion to undermine Sanders.
Ted Cruz's 'Seinfeld' Moment
Just remember, it's not a lie if you believe it!
What Republicans Missed From Ted Cruz's Speech
In the grand scheme of things, what did Sen. Ted Cruz actually say that was offensive to Republicans?
Mike Pence Saved The Republican Party After The Cruz Disaster
He basically snatched victory from the jaws of defeat. He turned destruction into positive hope.
A Star is Born: Ivanka Trump Takes Cleveland And Republicans By Storm
More than other Trump children, Ivanka Trump seems to take after her father in a special way.
Top Ten Possible Uses For A Waste Of Time Machine
We had all we needed for a summer chock-full of fun, if only we used our imaginations.
Ted Cruz's Bogus 'Conscience' Dodge Makes President Hillary More Likely
He left his own party naked and confused before what will certainly be an impassioned Democratic response.
True Conservatives Should Dispense With The Trump/Pence Con
Pence caved to the demands of the elitist faction's licentious behavioral cult.
Bullfighting And Fiestas: Hemingway At The RNC
Trump decimated his opponents and, if past is prologue, he's on the way to decimating Clinton.
Donald Trump Jr. Hits Home Run On Education
America's government-run school systems are failing to provide a quality education for too many of this nation's children.
COULTER: Michelle's Speech Was Trite, Too
MSNBC covered the banal sayings as if Melania had been caught selling secrets to the Soviets.
Iowa's Tom Vilsack May Be Hillary's 'Perfect' Answer To Pence
I'm betting that Clinton views Vilsack as the perfect foil to Pence
Immigration And The Elites In An Age Of Endemic Terrorism
Terrorism is common in Muslim countries, Western countries are importing Muslims, and terrorist attacks are on the rise.
What The Final Benghazi Report Means For Hillary Clinton
Presidential authorities and the DoS have refused to support certain requests from the Benghazi committee
America's Leaders Must Ignore Demands For Government Takeover Of The Internet
Presidential candidates and leaders of America's political parties must fight to protect a free and open internet
Stop Saying Ivanka Trump Converted To Judaism
Highlighting that someone is a Jew by choice is like saying someone is your neighbor's 'adopted daughter.'
Why Azerbaijan Matters, To Us And To NATO
Azerbaijan's President Ilham Aliyev's presence at the Warsaw Summit proves Azerbaijan's importance.
Corporate Welfare And The Mercantile System
Solving the problem of corporate welfare requires a more modest government
A Good Platform For Farm And Trade Policy: Will It Actually Be Implemented This Time?
Maybe this year, the Trump-led party will actually do what the platform says it will do.
Reports Of The Iran Nuclear Deal's Success Are Greatly Exaggerated
The nuclear deal was crafted to check Iran's nuclear ambitions, but it may end up doing the opposite.
Anthropology: Abandon All Truth Ye Who Enter
Anthropologists insist on the relativity of knowledge, except when it comes to their own statements
Melania Trump's Special Role -- And That Of Political Advisors
That Melania Trump disliked the process by which Pence was chosen is understandable.
Add Intellectual Property Protection To The List of Rights The Government Is Eviscerating
Intellectual property is intellectual property. All of it is protected by the Constitution.
America's Choice: Embrace Terrorists Or Strike Back?
It is far from clear that the administration wants to focus its counterterrorism effort where it belongs.
The Hairdresser-In-Chief And His Narrative On Race
President Obama wants to be your hairdresser-in-chief.


text:
The Rum Diary.
I never go to the movies, and I'm going. Wanna come? Meet you there—I wanna bike. I like twizzlers, jujy fruits…but they aren't eco…let's get Boulder Ice Cream, it's local. The popcorn's all gmo. Save me a seat in the middle, middle-middle, not too far back. I'm happy to sit behind the tall guy.
The Rum Diary – Trailer Johnny Depp Amber Heard Aaron Eckhart Giovanni Ribisi Richard Jenkins Bruce Robinson
hot on elephant
The 4 Stages of a Good Divorce. A Letter to my Children: You do not come from a Broken Home. Mom, can I Call her Mom, Too? To the One Who Tried to Break Me. An Open Letter to the Fixers. How your Stored Memories in the Amygdala can lead to PTSD. Jon Stewart makes first appearance since retiring—"it's not your country." These People are Rare Gems—Keep Them, Fight for Them, don't Give Up on Them. Waylon shares 10 transformingly beautiful Quotes about Love. 40 Things I've Learned in 40 Years.


text:
jobs near Webster, TX
Refine your searchClear Filters
Date Added
More Filters
Dedicated CDL Truck Driver - Better Pay, Home Time, and Miles!
C.R. England - Texas
As a truck driver, you have already earned our respect. Truck Drivers not only START here- They FINISH here....
CDL A Truck Driver - Better Pay, Home Time and Miles!
C.R. England - Texas
As a truck driver, you have already earned our respect. Truck Drivers not only START here- They FINISH here....
CDL A Truck Drivers - Flatbed
Celadon - Seabrook, TX
For you and all Celadon flatbed drivers, that means more freight, more miles, and extra pay opportunities. Were hiring smart, safe drivers just like you....
Webster Retail Co-Manager
Hobby Lobby - Webster, TX
A Co-Manager is the first step to becoming a Hobby Lobby Store Manager, or even developing into a Multi-Unit Manager position....
SOUTHEAST REGIONAL - CDL Truck Driver Needed!
C.R. England - Texas
Dedicated, Intermodal, Regional, National, Solo, Team Driving, Driver trainer, Instructors. Experienced CDL-A drivers with a safe and clean record are offered...
Experienced CDL-A Company Driver Job
C. R. England - Seabrook, TX
We offer some of the best driving positions with a well-balanced life on the road, frequent home time, and stability....
CDL-A Dry Van Company Truck Driver Associate
Knight Transportation - Seabrook, TX
As the elite carrier in the nation, Knight Transportation offers truck driving associates a chance to thrive in their career....
TRUCK DRIVERS - No CDL? No Problem! We Train, We Hire, We Pay!
C.R. England - Texas
CR England offers Zero-Tuition CDL training at our local truck driving school - a $5,000 value! We have never laid off a driver due to lack of freight....
Unit Secretary - Full Time (Humble, Texas)
Kindred Healthcare - Houston, TX
· Answers the telephone, take messages and communicates messages to the appropriate person in a timely manner....
Cleaner - Janitorial Services
Harvard Maintenance, Inc. - Houston, TX
Basic cleaning, including cleaning of all common areas, restrooms, entrances, elevators, walkways, windows, furniture, fixtures, stairs, chairs, tables,...


text:
Photoshop Lady
Your Favourite Photoshop Tutorials in One Place
Drawing a Beautiful Cartoon Lady Character
Under Drawing Effect, Photoshop Tutorial
Painting a cartoon lady is like any other painting art. You need to prepare a draft for your character and plan what color you are going to paint. Then, you set up your brushes and carry out your painting works in different layers plus adding shadow for the image.
Design a Traditional Radio Image in Photoshop Tutorial
In this Photoshop Tutorial, it is going to show you how to design traditional radio image using simple shapes, gradients, patterns and textures. Very awesome!
How to draw hair in Photoshop
This tutorial lays out the basic methods to draw mostly straight or slightly wavy hair in Photoshop. The final step is to smudge out any harsh edges, mostly at the tips of the hair where it meets the face and shoulders.
Coloring a Beautiful Cartoon Artwork for a Lady
Working a cartoon artwork is never an easy task. This tutorial will show you to paint a cartoon artwork of beautiful lady laying on a bed. You will see step by step of this artwork formation.
Create a Nice Coffee Cup
In this tutorial, it will demonstrate how to create a realistic coffee cup with a customizable label using smart objects in Photoshop. You can use the same idea to design your own coffee cup easily.
Making Of Boudicca 3060 A.D.
This article will provide you with a walkthrough of my experiences during the creation of this project. After an image has been detailed, draw over it loosely to tie up edges and make sure that everything is blended and finished off properly.
Making a Simple Art Portrait
In this tutorial, you will see how to create this cool, grainy work with this art portrait. It will show you to create some vector portraits, then get texturing in Photoshop with self-made brushes.
Making of a Wonderful Cartoon Scenery
If you were a cartoon lover, you would be interested in this tutorial. Drawing a cartoon picture is not easy. Generally, it commences from draft and then paint. However, different designers would have different tactics on painting.
Drawing a Nice Dragon Artwork
Drawing whatever scene is started with drafting. Then you use different types of brushes to work on your painting works. Here will show you steps to paint the artwork including adding light, tuning colors etc.


text:
Follow-Up | Dow Indicator | Preview
Amazon.com didn't take its moniker from the river of the same name in Brazil for nothing.
It seems that readers in that emerging nation, along with another gargantuan EM country, India, are in the forefront of e-book growth. With Internet access limited in India and mobile device penetration de minimus in both markets, there's still plenty of room for growth in online book sales there.
Die-Hard: Wired readers are favoring e-books in emerging markets, but some say it has enhanced their print purchases. William Waitzman for Barron's
That's according to Kelly Gallagher, a vice president at Bowker, a bibliography and research outfit. Gallagher held forth on the subject at last week's PublishersLaunch conference, an online publishing forum spearheaded by digital publishing cognoscente Mike Shatzkin, who founded Idea Logical, and Michael Cader, who created Websites Publishers Lunch and PublishersMarketplace.com. The conference was held in New York alongside Book Expo America.
According to Bowker research, while more than 50% of respondents in both Brazil and India plan to buy e-books in the next six months, just one-third in the U.S. plan to do so.
Moreover, 80% of e-book buyers in India are ordering professional/business or academic books. The good news for old media: 14% say using e-books has increased their print-book buying.
Last Week: Review
China's Surprise
China cut interest rates unexpectedly for the first time since 2008, signaling concern about a slowdown in growth in one of the world's most powerful economies. The People's Bank of China cut its benchmark one-year lending rate by a quarter of a percentage point, and loosened control on depositor interest rates.
The Pain in Spain
Spain said that the country's banking crisis had effectively closed credit markets to government borrowing, although the Spanish treasury later in the week sold the equivalent of about $2.5 billion in bonds at higher rates. Fitch cut Spain's debt rating. Spain was expected over the weekend to ask the euro zone for help in recapitalizing its banks, Reuters said.
Taking Stock
U.S. equity markets shook off the slowdown concerns, posting their best weekly percentage gains this year. The Standard & Poor's 500 Index ended the week up 3.7%, to 1325.65 points. The Dow Jones Industrials rose 3.6%, to 12,554.20.
Tap Dancing on Europe
Federal Reserve Chairman Ben Bernanke skirted specific steps to address Europe's debt crisis, but he said the Fed stood ready to act, and The Wall Street Journal said the Fed was considering stimulus measures. Elsewhere, Germany signaled that it would be willing to soften its hard line on such things as common euro-zone bonds, the G-7 pledged cooperation and President Obama urged Europe to act quickly. Former President Bill Clinton said the U.S. was already in a recession. Standard & Poor's affirmed its double-A-plus rating on the U.S.
BofA Disclosure Lapse
Bank of America's BAC -0.2086230876216968% Bank of America Corp. U.S.: NYSE USD14.35 -0.03 -0.2086230876216968% /Date(1469472942445-0500)/ Volume (Delayed 15m) : 27486589 P/E Ratio 12.379042690815007 Market Cap 146917301501.249 Dividend Yield 1.393388372174034% Rev. per Employee 427653 More quote details and news » former CEO, Ken Lewis, said in sworn testimony that he was aware that losses at Merrill Lynch were much greater than were disclosed to BofA holders before they voted to approve the $50 billion purchase, The New York Times reported, citing testimony in a shareholder lawsuit against BofA.
Wisconsin Recall Fails
The Republican governor of Wisconsin, Scott Walker, defended his post in a recall election that seemed to be a referendum on his efforts to scale back union bargaining rights. He is the first governor in U.S. history to survive a recall attempt.
Chesapeake Holders Speak
Shareholders of Chesapeake Energy, CHK -4.517625231910946% Chesapeake Energy Corp. U.S.: NYSE USD5.1465 -0.2435 -4.517625231910946% /Date(1469472941363-0500)/ Volume (Delayed 15m) : 42279270 P/E Ratio N/A Market Cap 3841517450.61905 Dividend Yield N/A Rev. per Employee 2206140 More quote details and news » in a rebuke of its CEO and board, rejected two directors up for re-election. The company said it plans to sell its pipeline and related assets for more than $4 billion.
One Size Fits All
The Federal Reserve approved a plan that would require even the smallest lenders to comply with tougher bank standards.
In Brief
• Nasdaq NDAQ 0.2212715739784629% Nasdaq Inc. U.S.: Nasdaq USD67.94 0.15 0.2212715739784629% /Date(1469472911069-0500)/ Volume (Delayed 15m) : 212212 P/E Ratio 21.021671826625386 Market Cap 11152471959.2422 Dividend Yield 1.8851251840942562% Rev. per Employee 901674 More quote details and news » seeks to pay $40 million to brokers whose orders were mishandled in Facebook's FB -0.07099173553719008% Facebook Inc. Cl A U.S.: Nasdaq USD120.9141 -0.0859 -0.07099173553719008% /Date(1469472933136-0500)/ Volume (Delayed 15m) : 11978907 P/E Ratio 74.61728395061728 Market Cap 346105430678.906 Dividend Yield N/A Rev. per Employee 1557480 More quote details and news » IPO.
• Best Buy's BBY 0.6222775357809583% Best Buy Co. Inc. U.S.: NYSE USD32.34 0.2 0.6222775357809583% /Date(1469472937132-0500)/ Volume (Delayed 15m) : 1241334 P/E Ratio 11.064718162839249 Market Cap 10373280924.8334 Dividend Yield 3.464274667491494% Rev. per Employee 315304 More quote details and news » founder quit.
He Said:
"The situation in Europe poses significant risks to the U.S. financial system and economy and must be monitored closely."
Fed Chairman Ben Bernanke in testimony to Congress.
The Numbers
The Federal Reserve reported some good news about households:
$2.83 trillion: rise in household and nonprofit net worth in the first quarter, to $62.9 trillion
12%: first-quarter surge in stock prices, a big contributor
$67.5 trillion: record net worth, set in 2007
E-mail: email@example.com


text:
Overcast White's Scary Diet, a favorite attraction of Merlin Jones
Find yourself on a trip into the scary visions and sounds from Overcast White's exploits. Visit the magnetic bachelors' woodland retreat, the angry-ent-filled woods, and the dungeon of the Transforming Witch's stronghold. But don't worry -- it will all end up sleepily ever after!
Don't click Pirate Mode
© copyright 2011–2016
A Pants Aflame production


text:
By Brendan Sasso - 01/14/12 02:41 PM EST
House Oversight Chairman Darrell Issa (R-Calif.) said early Saturday morning that Majority Leader Eric CantorEric CantorThree strategies to help Clinton build 'Team of Teams' David Brat may run for Senate if Kaine becomes VP The Hill's 12:30 Report MORE (R-Va.) promised him the House will not vote on the controversial Stop Online Piracy Act (SOPA) unless there is consensus on the bill.
"While I remain concerned about Senate action on the Protect IP Act, I am confident that flawed legislation will not be taken up by this House," Issa said in a statement. "Majority Leader Cantor has assured me that we will continue to work to address outstanding concerns and work to build consensus prior to any anti-piracy legislation coming before the House for a vote."
SOPA is designed to go after foreign websites that offer illegal copies of music, movies and TV shows with impunity. Even without the provision allowing sites to be blocked, the bill would empower the Justice Department and copyright holders to demand that search engines delete links to sites "dedicated" to copyright infringement. Ad networks and payment processors would be prohibited from doing business with the sites.
The bill has sparked a backlash from Internet freedom advocates and Web companies, including Google, Yahoo and Facebook, who say it would stifle innovation and suppress free speech.
The provision that would have required Internet providers to block infringing websites was one of the most controversial aspects of the bill. Google Chairman Eric Schmidt compared the provision to how China censors political speech online.
Issa, who is a former chairman of the Consumer Electronics Association, is close with the tech community and has been an outspoken critic of SOPA. He had scheduled a hearing for next Wednesday to examine the potential consequences of the bill's site-blocking provision, but he announced in his statement Saturday that he would cancel the hearing in light of Smith's decision to drop the provision.
Issa said that even without the site-blocking provision, the bill is "fundamentally flawed."
"Right now, the focus of protecting the Internet needs to be on the Senate where Majority Leader Reid has announced his intention to try to move similar legislation in less than two weeks," he said.
The Senate bill's sponsor, Sen. Patrick LeahyPatrick LeahyNBA pulls All-Star Game from NC over bathroom law When America denies citizenship to servicemembers Criminal sentencing bill tests McConnell-Grassley relationship MORE's (D-Vt.), said on Thursday that he is open to changes to the site-blocking provision.


text:
This time we're going to meet up in the loft of Sports Basement on Ygnacio Valley Road in Walnut Creek. The space is above the retail floor. To access it, find the staircase in the rear of the store, towards the right hand side of the store as you walk in the front. We'll have tables and chairs to use in the loft, so feel free to bring laptops and anything you'd like to share or hack on.
We'll discuss the M.A.C.H. design ideas and the possibility of us having a design competition. What would make a good prize?
I'd love to go -- won't be able to make this one (have to wake up brutally early on Tuesday morning for a meeting).
0 · May 11, 2014
Meetup members, Log in
By clicking "Sign up" or "Sign up using Facebook", you confirm that you accept our Terms of Service & Privacy Policy


text:
Real Madrid vs Chelsea live streaming: Watch preseason friendl...N'Golo Kante could be set for his Chelsea debut against Real Madrid. Pictured: France midfielder Kante and Albania midfielder Odise Roshi in action during a Euro 2016 group stage match, June 15, 2016 Reuters A battle of juggernauts in the ... International Business Times India, 4 hours ago
1,569 images for albania
AFP - Golf-USPGA 3rdlead
NAMPA / XINHUA China to work with WHO, UNAIDS to help developing countries NAMPA / XINHUA Albania's export drops by 6.4 pct in June NAMPA / PTI KASHMIR-LD MEHBOOBA - Security forces were unaware of Wani's presence: Mehbooba NAMPA / PTI LD ...Namibia Press Agency, 1 day ago AFP - Syria-conflict-Nusra-Qaeda-politics lead Namibia Press Agency, 1 day ago
AFP - Indonesia-crime-drugs-diplomacy-execution WRAP-update
NAMPA / XINHUA China to work with WHO, UNAIDS to help developing countries NAMPA / XINHUA Albania's export drops by 6.4 pct in June NAMPA / PTI KASHMIR-LD MEHBOOBA - Security forces were unaware of Wani's presence: Mehbooba NAMPA / PTI LD ...Namibia Press Agency, 1 day ago AFP - France-Britain-energy-politics-nuclear-EDF WRAP-update Namibia Press Agency, 1 day ago
West's Recognition of Kosovo 'Thanks to Albania's Washington Lobbyists'
Albanian and Kosovan politicians have successfully pursued their policy objectives thanks toclose links toUS lobbyists, Nenad Vasic, researcher atthe Belgrade-based Institute forInternational Politics and Economics told Sputnik Serbia . On Tuesday ...Sputnik, 1 day ago
Albania's export drops by 6.4 pct in June
Contributed by NAMPA / Xinhua. TIRANA, July 28 (Xinhua) -- Albania's export in June reached a value of 23 billion lek (187 million U.S. dollars), marking a decline of 6.4 percent compared to the same period of 2015 and growing by 10.1 percent ...Namibia Press Agency, 1 day ago
Albania gets a $50-million helping hand for power line
TIRANA, ALBANIA —Germany is lending 50 million euros ($55 million) to Albania to help it build a power line with neighbouring Macedonia. Under the terms of the agreement signed July 26 between Albania's Energy Ministry and the German Embassy in ...Daily Commercial News, 2 days ago Germany Lends Albania $55 Million for Energy Link Project ABC News, 4 days ago
More from: , FOXNews.com...and 2 other sources
NOA becomes first borrower under Albania Agribusiness Support Facility
The FINANCIAL -- The microfinance institution NOA sh.a. is the first borrower under the new Albania Agribusiness Support Facility with a €5 million credit line. The funding will allow NOA to support local agribusinesses with loans tailored to the ...Finchannel.com, 2 days ago ProCredit Bank Albania joins Albania Agribusiness Support Facility Finchannel.com, 2 days ago EBRD, Albania and private banks to fund neglected farming sector Reuters UK, 3 days ago European development bank considers funding gas pipeline FOXNews.com, 4 days ago
More from: , 4 Traders...and 2 other sources
Graphic warning: Albanian arsonist pours petrol on hospital patient, sets him on fire
Three people are dead after a vicious attack in Albania which saw a man douse a hospital patient in petrol and set him on fire. Arsonist Lefter Canaj had reportedly argued with Dashamir Saraci hours before returning to the private hospital in ...ONE News, 2 days ago Man Sets Fire Inside Hospital, Three Dead (Video) NewsFlow24, 2 days ago (Graphic Video) Guy Sets A Patient On Fire Inside Of A Hospital NewsFlow24, 2 days ago (Photos)Dialysis patient kills 3 by setting hospital ward on fire following argument Uncova, 2 days ago
More from: , Pharmacy Choice...and 3 other sources
Albania: a Diamond Being Polished
Photo: Shutterstock This article was written by , fintech writer, speaker, researcher, consultant and trainer. He is the founder and CEO of Banking Reports, and a member of the Panel of Judges of the European FinTech Awards. In April and May ...Forex Magnates, 3 days ago
Mining company reforests vast tract in Colombia
Albania Coal miner Cerrejon has financed the reforestation of a large swath of land in northern Colombia that was left desolate by decades of mining activity. Cerrejon, owned in equal parts by BHP Billiton plc, Anglo American plc, and Glencore ...Fox News Latino, 4 days ago
Realtime News
on your WebpageAdd Widget >Get your members hooked!


text:
Screenshot instructions:
Red Hat Linux
Click URL instructions:
Right-click on ad, choose "Copy Link", then paste here →
(This may not be possible with some types of ads)
You seem to have CSS turned off.
Please don't fill out this field.
Briefly describe the problem (required):
Please provide the ad click URL, if possible:
Hello UML people,
In case anyone is interested, I am currently starting an 8-month Master's
research project dealing with software emulation of real-time operating
I will be using RTAI Linux, an extention to the Linux kernel to achieve
Real-Time capabilities. (www.rtai.org)
In this research, I will be developing an RTAI emulator (Using User Mode
Linux). This emulator will exist for educational and developmental purposes.
The intent is to produce an open source RTOS emulator that can run on any Linux
box without kernel modification. This is due to the stugles that students have
when installing Linux, recompiling the kernel, and trying a RT Linux variant.
I hope to be able to give students a CD with the RTAI emulator, and a file
system for development, and that is all they need to try out a RTOS. In
addition, this will allow for multiple RTAI emulators to exist on a single
server, giving users access remote access to an RTAI environment for
If the work on the Windows port or User-Mode Linux continues to be successful,
the RTAI emulator will be runnable from the Windows environment as well.
In addition, the RTAI emulator will have full debug capabilities, allowing
users to debug kernel modules, or the kernel itself from the host system.
If you are intersted in following the progress, or reading my inital paper that
outlines my approach, go to:
If you have any questions or comments, please do not hesitate to send them my
Brian Genisio
Do you Yahoo!?
The New Yahoo! Search - Faster. Easier. Bingo.
Sign up for the SourceForge newsletter:
I agree to receive quotes, newsletters and other information from sourceforge.net and its partners regarding IT services and products. I understand that I can withdraw my consent at any time. Please refer to our Privacy Policy or Contact Us for more details


text:
- Miss Florida 2017 stripped of crown days after win - US Weekly
- Lindsay Lohan steps out amid relationship drama - TMZ
- Was Taylor Swift snubbed by the VMAs? - Gossip Cop
- Rachel Platten sings "Fight Song" with lots of stars - Just Jared Jr
- Farrah Abraham sizzles in a revealing bikini - Radar
- New pics from the Clooneys' Italian summer - Lainey Gossip
- Fox News snubs major DNC moment - The Hollywood Reporter
19 April 2010 at 12:17 AM
Chad Michael Murray: Gas Station Saturday
About this photo set: Chad Michael Murray keeps warm in a beanie and a pair of Uggs as he pumps gas into his Land Rover in Los Angeles on Saturday (April 17). Other pics include the… Read More Here
Photo #: 2443766
Posted to Chad Michael Murray, Kenzie Dalton
powered by ZergNet


text:
NFC West Q&A: Will Chandler Jones and Robert Nkemdiche help Ca...Close Covered the Cardinals since 2012 Graduate of Indiana University Member of Pro Football Writers of America Today's question: What kind of impact will the additions of Chandler Jones and Robert Nkemdiche have on the Arizona Cardinals ... ESPN.com, 2 weeks ago
158 images for robert indiana
Saint Petersburg's Russia Museum bring Robert Indiana Retrospective To The City
Thursday, June 16th, 2016 11:53 From Russia With Love, installation view, courtesy Galerie Gmurzynksa Robert Indiana was hugely influenced by Russian Avant Garde art, even though in the early stages of his career he didn't realise it said Yevgenia ...NewsFlow24, 1 month ago The State Russian Museum bring Robert Indiana Retrospective To Saint Petersburg Forbes.com, 1 month ago
Roberts Settlement to Get Historical Marker
ATLANTA, Ind. - The Indiana Historical Bureau will hold a public dedication ceremony Saturday in Atlanta to commemorate the new Indiana state historical marker for Roberts Settlement. The IHB says the marker recognizes the free people of color who ...Inside INdiana Business, 3 weeks ago [IHB] Roberts Settlement Historical Marker to be Dedicated (7/2/2016) IN.gov, 1 month ago
Fort Wayne Plastic Surgeon Dr. Robert Severinac Receives Top Reviews and Awards on Vitals.com for Professional Excellence
Dr. Robert Severinac has received several top awards on Vitals.com as a leading Indiana plastic surgeon This press release was orginally distributed by ReleaseWire Fort Wayne, IN -- ( ReleaseWire ) -- 06/29/2016 -- Indiana plastic surgeon Dr.Digital Journal, 4 weeks ago
Truck possibly used by escaped Indiana inmates found in Ohio
Jail staff noticed Chadwick R. Heath and Michael D. Roberts were missing around 1:30 a.m. Saturday when performing a routine head count before locking them into their cells for the night. K-9 units and officers weren't able to find the escaped ...Equilibrio Informativo, 1 month ago Twо inmates escape frоm Indiana jail thrоugh twо-fооt-vast hоle within the wall NewspaperPost, 1 month ago
Choice of seasoned conservative could help unify GOP
CLEVELAND Donald Trump announced Friday that he has selected Indiana Gov. Mike Pence as his running mate, ending days of feverish speculation and recruiting to the GOP ticket a soft-spoken and seasoned conservative who could help unify the divided ...Washington Post, 1 week ago Indiana Gov. Mike Pence Poised to be Donald Trump's Running Mate Equilibrio Informativo, 1 week ago Trump says he's chosen Pence to be his running mate TD Ameritrade, 1 week ago Trump-Pence 2016? | Quintonio LeGrier shooting | tax rebate Crains ChicagoBusiness, 1 week ago
More from: , New York Post...and 2 other sources
Trump could be a factor in Brady's Deflategate case
FOXBORO, UNITED STATES: The New England Patriots' quarterback Tom Brady passes against the Indianapolis Colts in the first quarter of their game at Foxboro Stadium 30 September 2001 in Foxboro, MA. AFP PHOTO/John MOTTERN (Photo credit should read ...AOL.com, 1 week ago Federal appeals court upholds Brady's 4-game ban for Deflategate AOL.com, 2 weeks ago
In Wake of Deadly Attack, Nice Jazz Fest Featuring Robert Plant, Massive Attack Canceled
in Austin, Texas. In the wake of Thursday night's horrific attack in Nice, France, the Nice Jazz Festival has been canceled. Hours after a crazed attacker drove a truck through a packed crowd gathered to watch aBastille Day fireworks display, ...Billboard, 1 week ago
Trump to Make Statement on VP Pick Friday, WaPo Cites Manafort
Donald Trump's campaign chairman Paul Manafort would not say whether Trump had spoken directly with Indiana Gov. Mike Pence and offered him the job, Washington Post reporter Robert Costa says in Twitter post. Hell make a statement (Friday). And ...Bloomberg, 1 week ago
Lake Michigan Mailers, Inc. Co-Founders Fund Scholarships for Southwestern Michigan College
Lake Michigan Mailers co-founders Robert and Karen Rhoa have funded scholarships at Southwestern Michigan College designated for students enrolled in the Associate of Applied Science Criminal Justice Program. Kalamazoo, Michigan (PRWEB) July 14, ...Benzinga.com, 1 week ago
Realtime News
on your WebpageAdd Widget >Get your members hooked!


text:
* 4 Large Retro Halloween Die Cut Cutout Decorations*vtg Beistle*
This item has been shown 0 times.
* 4 Large Retro Halloween Die Cut Cutout Decorations*vtg Beistle*:
These Retro Vintage Halloween Cutouts can create a classic look to any Halloween party. These vintage looking cutouts are very reminiscent of the cutouts of the 60's and 70's. Included in the package is 4 different retro cutout designs. The classic black cat can spark nostalgia in your guests from a time when they had cutouts like these when they were young. The charming Crescent Moon and Cat is a classic that has been around for many years. The iconic Witch with Moon is a favorite of many from years past. The Vintage Pumpkin cutouts with wide eyes and missing teethhas been widely used in classrooms and parties as one of the most popular Halloween cutouts of all time. These can be hung on a wall or put in a window. Each is printed on both sides of cardstock material. Each cutout measures 14 inches to 24 inches tall.
- Four (4) per package
- Halloween Cutouts measure 14-24 inches tall
- Material made of cardstock
- Printed on both sides
- Four different designs include: The black catsilhouette, Black cat and moon, Witch and moon, and Jack-o-Lantern
* 4 Large Retro Halloween Die Cut Cutout Decorations*vtg Beistle*:
Nos Vintage Klingers Halloween Window Decal Decorations-witch/bats/zombie Hand
Nos Vintage Rauch Halloween Stencils-witch/spider/cat/owl/spider/pumpkin/skull
Nos Vintage Eureka Halloween Pop-up Paper Decoration-witch/skeleton/pumpkin
Vintage Beistle Halloween Cutouts Diecuts Paper Decorations
Vintage Nite Glo Skeleton & Haunted Tree Jointed Cutout Halloween Decoration
Vintage Beistle Fall/halloween Pumpkin Cutout Diecut Paper Decoration


text:
Gave two of theses as presents and my son and husband love the watch
I bought the watch for my brother-in law as a birthday gift. He is a die hard Penn State Fan and when I gave it too him he was extremely surprised (that I'd get him a gift) and more importantly that it was something that he would use on a daily basis. He stated that he "would wear it in the heart of Pitt territory" to irritate the locals I presume. Great gift.
- How did the image on site compare with the actual product? Very accurate.
- How accurate was the sizing? Good Fit
- Please tell us about the quality of the product. Qualtiy looks good.


text:
- Up to 70% off fashion: Revamp your look with savings on selected clothes, shoes, handbags and more. Shop now.
- Find your favourite brands for less in the Fashion Outlet Store.
- Check out our Fashion Sales & Deals for the latest offers from your favourite brands.
Mustard Dukes of Hazard Leather Wallet
Currently unavailable.
We don't know when or if this item will be back in stock.
We don't know when or if this item will be back in stock.
- Officially Licensed Merchandise
- Wallet
- Orange
- Mens
- Official merchandise
Currently unavailable. We don't know when or if this item will be back in stock.
This shopping feature will continue to load items. In order to navigate out of this carousel please use your heading shortcut key to navigate to the next or previous heading.
Customers Who Bought This Brand Also Shopped For
Page 1 of 1 Start overPage 1 of 1
Special Offers and Product Promotions
Product details
Product Description
This Mustard wallet makes the perfect gift or just an awesome treat for yourself! Made with premium real leather, this orange coloured wallet showcases a cool The General Lee design from the Dukes Of Hazard franchise. Offering 3 credit card slots, coin pocket and note section this Mustard wallet is a high quality piece presented in an official Mustard gift box. Dimensions closed are 9x10cm.
Customer Reviews
There are no customer reviews yet.
|5 star
|4 star
|3 star
|2 star
|1 star


text: Wouldn't Your Anna Nicole Conspiracy Theories Go Better With A Nice O.J. Double Murder Confession?seth10/08/07 9:01pmFiled to: light readingDefamerAnna Nicole Smithhoward k sternlarry birkheadRita Cosby3EditInvite manuallyPromoteDismissUndismissHideShare to KinjaToggle Conversation toolsGo to permalink Amazon's recommendation engine suggests shoppers looking for Rita Cosby's shocking Anna Nicole tell-all Blonde Ambition also check out bestselling O.J. Simpson pseudo-confessional If I Did It, the rationale presumably being that while reading up on two mysterious Hollywood deaths is nice, four is even nicer.Cosby, meanwhile, faces a $60 million lawsuit from Howard K. Stern, the man she accuses of having engaged in videotaped intimate relations with Larry Birkhead. Now two of the sources she cites—Haitian nannies employed at Smith's Bahamian home at the time—are denying having said anything of the kind. The author has flown down to the Bahamas to see if she can't jog their memories; in Cosby's defense, however, the French term for "oral sex between men" is just one consonant off from another word that means, "to come to fisticuffs over the honor of a shared woman," which could go a long way towards explaining the nannies' confusion over the matter. Smith's nannies didn't speak to author [Yahoo/AP]Blonde AmbitionReply3 repliesLeave a reply


text:
Abstinence fuels huge HIV drop, study shows
A new Harvard study from Zimbabwe has shown that a 50% drop in HIV prevalence was driven primarily by changes in sexual behavior.
February 16, 2011
A new Harvard study from Zimbabwe has shown that a 50% drop in HIV prevalence was driven primarily by changes in sexual behavior, particularly a drop in casual, commercial, and extramarital sex. "In Zimbabwe, as elsewhere, partner reduction appears to have played a crucial role in reversing the HIV epidemic," wrote Daniel Halperin, PhD, of the Harvard School of Public Health, and colleagues, Lifesite News reports. The study, published this month at PLoSMedicine.org, was commissioned by the UNFPA and UNAIDS. The researchers found that the change in behaviour was motivated by fear of the infection, stemming from the country's high rate of AIDS mortality. They say it was amplified by economic decline because men had less money to pay for sex or to maintain multiple sexual relationships. The researchers suggest that Zimbabwe has been more successful than other African countries in fighting AIDS because it has high levels of marriage and secondary education. SOURCE Huge drop in Zimbabwe HIV rate fuelled by rise in abstinence, fidelity: UNAIDS-funded study (Lifesite News)
Church officials condemn gang rape of Dalit girl
Incident is indicative of lethargic law and order, says priest
Duterte, bishops seek to mend fences
Philippine church, state need not be hostile to each other, prelate says
Freed Indian Catholic aid worker returns home from Kabul
After being kidnapped for six weeks in Afghanistan, Judith D'Souza is now resting with family
Timor-Leste bishops eye liturgy improvements
More work needed through proper formation and training, they say
Rights group urges Pakistan to avoid reviving 'draconian' law
Act targeting terrorists has been used against marginalized communities as well, says human rights commission


text:
The Latest Fad To Hit Target Is No Designer Collab
Target normally makes headlines in the fashion industry for its mega-hyped designer collaborations. But, this time, the chain is in the news for something it did all on its own. Target — or rather, Target.com — now offers bridal gowns in sizes 2 to 28 in the thoroughly unbelievable price range of $69.99 to $129.99.
That's practically unheard of for wedding fare, which is progressively getting more and more expensive. This is actually an extension of the pre-existing Tevolio collection, which included bridesmaid and flower girl dresses, at a similar price point. Given the glamour-craving Bridezillas of the world, we're not sure how popular this will be, but with the simple designs and amazing prices, we certainly have no objection. (Racked)
Photos: Courtesy of Target.
More from Shopping
Fall's Best Boots Were Made For Dancing
Flex dancing, a dance form characterized by rhythmic waving, gliding, and contorting of the body, is often thought of as a man's world. But there are a few...
Alyssa Coscarelli
Aug 6, 2015
Meet Your Favorite New Jewelry Brands
Actively seeking out new jewelry brands never seems to make it to the top of our priority lists. Often, we rely on the tried-and-true brands our grandmothers have educated us on, or we resort to buying up trendy pieces filtered down from this season's runway looks. This usually leaves us with pieces too difficult to ...
Ray Lowe
Jul 21, 2016


text:
Separate names with a comma.
Kangaskhan back out.
[Mega Evolve] Low Kick x3
If Counter, then Yawn on the first instance, Whirlpool on the second and Focus Energy the third.
Eh, if I'm not mistaken I think Texas is supposed to use Psywave~Heal Block~Chill rather than struggling.
[IMG] w/Silk Scarf
whoops forgot about this.
Fidgit: Chill~Chill
Kangaskhan: [Mega Evolve] Fake Out~Dizzy Punch
Porygon-Z: Swift x2
Hah, I'm a gym leader I am immune to DQ unlike the lowly peasant challengers! :P
Imprison (Imprison, Psywave, Rest)~Psywave~Psywave
DQ Warning deadfox081
"Whu?! Rhythmi what are ye doing? You're going to hit the scurvy dogs and me too with that!"
"That's the idea." :D
Arghonaut: Mach...
I find myself surprisingly ill-equipped to deal with Regirock in general it seems.
Swagger~U-Turn~Super Power
Marowak: Bonemerang (Raikou)~Bone Club (Raikou)
Colossoil: Drill Run (Raikou)~Dig (Raikou)
Whoops my bad zarator I think I put myself under the impression that I was counterswitching on accident.
Carry on.
Much as I'd like the symbolism, I think we both know how that one would end.
[IMG] w/Life Orb
Ditto: Rock Slide x2
Conkeldurr: Rock Slide x2
[Once] If Mat Block is used when you are to move, then use Focus Energy
Aerodactyl: Rock Slide x2...
[Mega Evolve] Dizzy Punch x3
Well, as much as I'd like to use Lopunny here, it doesn't do very well against most of this team. Out you go Maya!
[IMG] w/Kangaskhanite
b) Allow to grant bonus via item swapping
a) Cleanse the altar
No Counterswitch
Confuse Ray~Iron Head~Iron Head
[Once] If Reflect, then Reflect and push back.
If your move is imprisoned when you are to use it, then use Shadow...
Ditto-Lucario: Rock Slide ~ Dig (Infernape)
Conkeldurr: Drain Punch + Focus Punch (Lucario-Deadfox) ~ Cooldown (Drain Punch Lucario)
Hyper Voice~Hyper Voice~Hyper Voice
[Once] If Endure then Whirlpool and push back.
If Torment, then change actions to Hyper Voice~Stomp~Hyper Voice...


text:
Source: mybluecanoe.tumblr.com via Emily on Pinterest
Whether you're headed for the woods,
or the office
or your own backyard:
Live deliberately.
We get busy and speedy and wonder where the day went, the week went, the month went.
Take Thoreau's advice: don't coast through it; be deliberate.
Like elephant journal on Facebook.
hot on elephant
The 4 Stages of a Good Divorce. A Letter to my Children: You do not come from a Broken Home. Mom, can I Call her Mom, Too? To the One Who Tried to Break Me. An Open Letter to the Fixers. How your Stored Memories in the Amygdala can lead to PTSD. Jon Stewart makes first appearance since retiring—"it's not your country." Waylon shares 10 transformingly beautiful Quotes about Love. These People are Rare Gems—Keep Them, Fight for Them, don't Give Up on Them. 40 Things I've Learned in 40 Years.


text:
The Panama Canal Authority said it is confident in the process it uses to move ships through the new locks at the canal, following an accident last week that damaged the Xin Fei Zhou after it made contact with one of the walls at the Agua Clara Locks.
The TMS provider was acquired by fellow logistics software firm Kewill in April, and the companies are progressing on merging products and organizations, Lean executives said in a briefing.
The U.N. Economic Commission for Europe said China has ratified the TIR Convention, which it says will further streamline cross-border transportation for cargo moving between China and Europe.
Registration takes less than 1 minute.
The aging Poe Lock was rebuilt in 1968 and is currently the only lock at the Soo Locks Complex equipped to handle 1,000-foot vessels.
The parcel carrier has partnered with automobile manufacturer Smart to conduct a market test in Stuttgart, Germany this fall on a service that will deliver packages directly to the trunk of a customer's Smart car.
About 450,000 TEUs of capacity is expected to be scrapped in 2016, which would be double the amount scrapped in 2015, according to the London-based shipping consultant Drewry.