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To promote the opening of the 30th IKEA store in Clermont-Ferrand, France, the Swedish furniture giant teamed up with communications agency ubi bene to install a vertical rock climbing wall covered with IKEA furniture. The nine-meter-tall wall is decorated just like a showroom, except it is fixed in a vertical position, with hand grips and steps installed for rock climbing purposes.
Forget the smartwatch, the new custom typeface might very well be the biggest surprise Apple has unveiled in years.
A new survey from customer engagement company SDL says it takes two years before your customers trust your brand – or, more specifically, two years for a customer to simply view your brand as one it can rely on.
Infinite scrolling embodies one of the ideal attributes of any good design: people can use it without thinking about it.
Ever wish the weekend had just one more day of rest? Rethinking Mondays gets us a little closer to that ideal schedule.
Experts speculate that Apple Pay's combination of Touch ID and NFC payments could potentially overcome consumer resistance to paying with a phone, making it a real possibility that Apple may have finally succeeded in making a phone a wallet.
To produce the spot, which shows Jeter surprising fans outside Yankee Stadium to the tune of Sinatra's "My Way," Gatorade roped off a few blocks before a home game in the Bronx and let the baseball star go. The shock and surprise on fans' faces when their idol walks into Stan's Sports Bar or signs autographs is genuine.
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Top 3 Plants For Your Survival Garden
Survival gardening is the process of creating a garden that could, if it needed to, become your main source of food. In some cases, homesteaders have created gardens that could be their only source of food for at least a season, if not longer. This kind of self-sufficient gardening takes a lot of careful planning and hard work, but it's not impossible. One of the keys to success in survival gardening is choosing the right plants. In a survival garden, you'll need high-yield plants that offer the human body a variety of nutrients and plenty of calories. Here are the […]Read more »


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login with
Doctors Appointment Went Well for the Most Part
Seen my OB today. Good news, based on his NST, you cannot tell that there is anything going on with our baby's heart. Bad news, Mama cannot stop losing weight, and I am getting really bad. My blood pressure is still good, but it is higher than it has been all pregnancy. I am having trouble being out and about at all. I talked to my doctor about it, and she said that I am doing what I should be. She told me to take it easy, and if bed rest is what my body wants, than obviously its what my body needs. This STINKS. I need to clean my house and get everything ready for baby boy. I cannot be stuck to this bed.
Well, glad to hear the good news. The bad news is only temporary and maybe you can do a little bit each day? Or set a goal of 5-15 minutes of doing something to get ready for baby and spread 3-4 of them out over the course of your day so you feel like you are doing something. You can fold clothes from bed and have the children with your oldest daughter helping the younger ones put them away in their rooms. Think of the little things you can do and maybe your hubby will help you get the bigger stuff done when he's home.
That's what I try to do, but I am nesting too. So sitting in this bed, when my house looks like it does, just makes me depressed.
Moms Expertise04/05/14
Remember that little poem? It can be applied in your situation, as you are "incubating" your baby boy the house stuff can wait, he won't know the difference:
"Babies Don't Keep"
The cleaning and scrubbing will wait till tomorrow,
for children grow up, as I've learned to my sorrow.
So quiet down, cobwebs. Dust go to sleep.
I'm rocking my baby and babies don't keep.
"Babies Don't Keep"
The cleaning and scrubbing will wait till tomorrow,
for children grow up, as I've learned to my sorrow.
So quiet down, cobwebs. Dust go to sleep.
I'm rocking my baby and babies don't keep.
I am happy for your good news.. and just know the bad news and how you feel will definitely pass.. praying for you!
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About Amanda Hurley
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Mowbray unhappy with Rennie
By Robin Slater
Last Updated: 01/01/70 1:00am
Tony Mowbray accused referee Uriah Rennie of 'damaging his own performance.'
Tony Mowbray accused referee Uriah Rennie of 'damaging his own performance' after West Brom moved to the top of the Championship with a 1-1 draw at Leicester.
The Baggies claimed top spot after Derby lost out to Sunderland, but it was not enough to stop Mowbray launching a scathing attack on Rennie.
"At the end of the game I was just a bit bemused by the timing of the final whistle," said Mowbray.
"The goalkeeper takes a goal-kick, their centre-half heads it, Zoltan Gera sticks our centre-forward through with the goalie and then he blows his whistle.
"Ninety nine referees out of 100 blow the whistle when you take the goal-kick. It felt as if there were hundreds of fouls and I think Mr Rennie was just trying to let the game flow - but he was damaging his own performance.
"All I ask for is protection for my team. We're trying to entertain and play the right way."
Foxes boss Rob Kelly was pleased with his side's performance and was a little disappointed not to come out with all three points.
"I was a bit disappointed on our second-half display that we maybe didn't take all three points.
"They're a good team who were in the Premiership this time last year. But we're not going to roll over and let them just outplay us. That's credit to our players."
Kelly also refused to criticise the referee and said the incident between Geoff Horsfield and Paul McShane was "no big deal".
"Geoff is as honest as the day is long," said Kelly.
"I know McShane from his time at Manchester United and Brighton and he's competitive. There were no problems and they shook hands at the end."


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Edon Pinchot, a Jewish day school student who wears a kippah, was in the semifinals of "America's Got Talent" on Aug. 28.
Pinchot, 14, of Skokie, Ill., was among 12 acts performing live on the popular NBC reality show before a a television audience of around 10 million. The second set of 12 semifinalists will perform Tuesday, Sept. 4.
Other semifinalists joining Pinchot, a singer and pianist, included singers, a dancer, a dog ventriloquist, an acrobat, a mind reader and a comedian.
Should enough TV viewers cast their votes for Pinchot, he will advance to the finals and a chance to take home the $1 million prize. He performed an audition in the Vegas round and in the quarterfinals to reach the semis. His kippah has made him a focal point for viewers.
Pinchot, who is Sabbath observant and keeps kosher, is the fourth of five children and has been playing piano since he was 9. His grandmother, Ginger Pinchot of Silver Spring, Md., says Edon is "very athletic. He's one of the stars of his soccer team, and he's also a straight-A student. He's just kind of an all-around guy."
The show's three judges — Howie Mandel, Sharon Osbourne and Howard Stern — are Jewish.
Pinchot will be starting high school soon at the Ida Crown Jewish Academy in Chicago. — jta


text: A slide A slide was a toy consisting of a ladder and a ramp down which one could slide for recreational purposes. In 2266, there was a slide in the Onlies' hideout, an abandoned school. (TOS: "Miri") External linkEdit Playground slide at Wikipedia Retrieved from "http://memory-alpha.wikia.com/wiki/Slide_(toy)?oldid=1849030" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Recreation Add category Cancel Save


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President Satoru Iwata - CEO Nintendo of America Human Resources Kaoru Takemura Managing Director Tatsumi Kimishima Admin & Gral Affairs Masaharu Matsumoto Overseas Eiichi Suzuki Development Genyo Takeda Sales Shinji Hatano Info Development Shigeru Miyamoto Operations Yoshihiro Mori Tokyo Office Ohsuke Saito 1889 Nintendo Playing
Card Company Other Bussiness Toy-making The Ultra Hand 1970 Nintendo Company Limited Nintendo's
Famicom 1983 Nintendo Entertainment System 1985 1963 Acquisitions Shareholders He heads the Executive Committee Hire, motivate, manage the workforce Represent the interest of
the shareholders Ensure that staffs and equipment
work efficiently. Financial markets Business plans Customers Technology Processes Salary payments Internal mobility Facilitate new alliances Daily operations Report at CEO Financial condition Recruit, hire, relocate, manage Markets Delivery deadlines Software Applications support Production quotas Internal controls Payments terms New Market Games 250M users each month $2.8 billion in 2012 200 games with more 1M monthly active users Games More than 100 developers generated more than $1M Lower costs and timelines Easier to pick up, test and play Don't need Hardware Product tester Software Development Front End Developer Game Developer Job & Roles Database Engineer
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Okay, well, I don't know about anyone else but I like to look-up parodies/spoofs of my favorite video games. I just went on YouTube not to long ago and just remember a hilarious RE4 spoof that I watched that was created by the Bentley Bros. Don't know if anybody else watched it but I'll put the link below:
Spoiler alert: Both Ashley and Ada a played by males... 0_o It's freaking weird.
There's also a RE1 spoof made by the same people
Jill is played by a guy on here too... and it's even weirder... especially when they make fun of the tape that the corpse of Kenneth J. Sullivan had.
Anywayz, the purpose of this blog is to put on other RE spoof vidoes from YouTube that others find... that is if anyone even looks for any other videos.


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BankRate.com has acquired the bankaholic.com blog for $15 million according to recent reports.
Financial info site BankRate is expanding its financial product listings, as it's acquiring Bankaholic, which provides info on deposits, savings accounts, and money market accounts. The company will pay $12.4 million up front, with another $2.5 million possible earnout over the next 12 months.
Bankaholic's sole employee John Wu will assist in the transition and remain for an unspecified period of time. BankRate, of course, is exposed to some of the nastier aspects of the economy, though it's held up fairly well and continued to grow.
Google Trends reports around 8,000 visitors per day to Bankaholic. What do you think? Is it a bargain at $15 million?
With a team of professional financial journalists working on the blog for 12 months it could be worth twice as much this time next year.
Blogs have huge value, we all just need to wait until the world realises just how valuable they are and then there will be a lot of rich ex-bloggers around.


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Before we look at a news story from The Tennessean, a little background. Last week I read a fascinating piece in First Things about a particular kerfuffle in one denomination's hymnal development. It began: In his 1934 book, The Kingdom of God in America, H. Richard Niebuhr depicted the creed of liberal Protestant theology, which [Read More…]
Agnus Dei: Presbyterian hymnal fight makes news
August 5, 2013 by


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- Designer : Studio Tecnico Magis
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- H: 74; Ø : 120cm
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- Please note - some self-assembly required
InformationThis round Tavolo XZ3 Dining Table from Magis has a round black or white painted MDF top and a steel leg frame which comes in either a polished chrome or a black or white painted finish.
A good all round and robust dining table - perfect where children are around!
See other Dining Tables
See the Magis collection.


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Hudson/Beltran 5-Piece Formal Dining Set
Only a Few Left in Stock
*Extends to 111"
201 cm W* x 100 cm D x 77 cm H
*Extends to 282 cm
Measurements79" W* x 39" D x 30" H
*Extends to 111"
201 cm W* x 100 cm D x 77 cm H
*Extends to 282 cm
- Includes two 16" insert leaves
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Back to the fundamentals. The Hudson/Beltran Dining Table Set relies on its trestle table base to create a strong foundation. The table's heavily distressed design conjures up the simple charm of a rustic life. It includes two 16" insert leaves that allow you to extend the length of this table as the occasion requires. Memorable and elegant, the Beltran Side Chairs evoke the look of repurposed wood that has been just washed up from at storm at the sea. Crafted from Acacia solids, with a stone wash finish that enhances the distressed look of the dining set. Button tufted back chairs featuring spa blue linen upholstery, dark gray nailheads and tapered legs. For a Vintage-meets-rustic combination that would accompany you for years to come.
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Monday 23 March 1953
It was Monday, under the sign of Aries. The US president was Dwight D. Eisenhower (Republican).
Famous people born on this day include Bo Diaz and Louie Anderson in Minneapolis.
In UK She Wears Red Feathers by Guy Mitchell was in the top 5 hits.
The Hitch-Hiker, directed by Ida Lupino, was one of the most viewed movies released in 1953
while The Silver Chalice by Thomas B. Costain was one of the best selling books.
On TV people were watching Eye Witness.
But much more happened that day: find out below..
You can also have a look at the whole 1953 or at March 23 across the years.
Old Newspapers
Have a look at the old newspapers from 23 March 1953 and get them!
Which were the most popular movies released in the last months ?
TV Series
Which were the most popular TV series released in the last months ?
Find out your future
Get a FREE Numerology report based on the digits of 23 March 1953!
Wish him/her..
Historical Events
Which were the important events of 23 March 1953 ?
- Saint Rebecca (d.1914)
- Roman Empire - Tubilustrium was held in honor of Mars.
- Ancient Latvia - Lieldienas held in honor of Mara and other pagan goddesses.
- Pakistan - National Day (Republic Day).
- Saint Turibius of Mongrovejo (died 1606)
- Saint Ethelwald
- Saint Victorian
- Roman Empire - The fifth and final day of Quinquatria, held in honor of Minerva.
Famous Birthdays:
- Bo Diaz: Venezuelan baseball player (d. 1990).
- Louie Anderson in Minneapolis: Minnesota, USA; comedian (Ratboy, Wrong Guys).
- Geoffrey Clifton-Brown: British Member of Parliament.
- Chaka Khan [Yvette Marie Stevens] in Great Lakes: Illinois, USA; rocker (Rufus - "I'm Every Woman").
- Chaka Khan: American successful black singer and songwriter consistently noted in the field of black music.
- Jacques Landrain: Belgian cartoonist. He died on 18 March 2009.
- Bo Díaz: Venezuelan baseball player (d. 1990)
- Kiran Mazumdar-Shaw: Indian zoologist and businesswoman
Famous Deaths:
- Raoul Dufy: French artist, a painter who was one of the major artists of the Fauve group and considered a master draftsman.
Music Charts
Which were the top hits in that special week of March 1953 ?
Top #1 songs in the USA
Search For Your Ancestors
Subscribe to our Newsletter
Don't miss our monthly news, no spam guarantee Click here to Subscribe
...and if 23 March 1953 was your Birth Date then Join our Birthday Club!
Make this date unforgettable
Genealogy: find out your family heritage
Which were the most popular books released in the last weeks ?
Remember when
What videogames would you be playing back in the days ?


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first edition
1910 · New York
by LE GALLIENNE, Richard
New York: Mitchell Kennerley. 1910. First. First edition. Very good slightly rubbed at spine ends, corners and cover. . (Inventory #: 132946)
by TRENT, Lucia, Ralph Cheyney, Benjamin Musser, edited byNew York : Dean & Company , 1928
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text: Mattel: 6″ Erin Gilbert was released as part of the May 1st 2016 launch of the Ghostbusters line by Mattel. Toy DescriptionEdit Erin Gilbert with Proton Pack and collect and connect Rowan (left and right legs) GalleryEdit Erin Gilbert promo imageErin Gilbert front of cardErin Gilbert back of cardAdd a photo to this gallery Retrieved from "http://ghostbusters.wikia.com/wiki/Mattel:_6%E2%80%B3_Erin_Gilbert?oldid=126599" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Mattel GB:2016 Movie Merchandise Add category Cancel Save


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David Malcolm Lewis
LOCATION: Oxford, United Kingdom
Professor of Ancient History, University of Oxford, 1985–94. Author of Sparta and Persia; joint editor of Cambridge Ancient History (2nd ed., vol. 4–5).
Primary Contributions (1)
Athenian statesman largely responsible for the full development, in the later 5th century bce, of both the Athenian democracy and the Athenian empire, making Athens the political and cultural focus of Greece. His achievements included the construction of the Acropolis, begun in 447. Background and education Knowledge of the life of Pericles derives largely from two sources. The historian Thucydides admired him profoundly and refused to criticize him. His account suffers from the fact that, 40 years younger, he had no firsthand knowledge of Pericles' early career; it suffers also from his approach, which concentrates exclusively on Pericles' intellectual capacity and his war leadership, omitting biographical details, which Thucydides thought irrelevant to his theme. The gaps are partly filled by the Greek writer Plutarch, who, 500 years later, began writing the life of Pericles to illustrate a man of unchallengeable virtue and greatness at grips with the fickleness of the mob and...


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Welsh Gift Shop Home >
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The fabrics are all new, 100% natural cotton, but are tea-dyed to give it a unique 'Vintage antique' look.
Includes insert - if ordering from outside the UK, please email me first as this is a large item! email@example.com


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Laparoscopic cholecystectomy is usually performed for gallstones or polyp of the gallbladder. Multiseptate gallbladder is a rare congenital malformation. Although several asymptomatic cases have been described, patient usually present with right upper abdominal pain. We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved.
Multiseptate gallbladder (MSG) is a rare congenital malformation of the gallbladder. Patients with MSG usually admits to the emergency services with differential symptoms such as right upper abdominal pain, nause and vomiting, and abdominal complaints. We present a case of MSG with recurrent abdominal pain in which laparoscopic cholecystectomy resolves the complaints of the patient.
A 29-year-old female patient was admitted to our hospital with a complaint of recurrent right upper quadrant pain. The pain was associated with nause and dyspepsia especially after fatty foods. Physical examination and laboratory tests (CBC, liver function tests, serum amylase, gamma glutamyl transpeptidase, and alkaline phosphatase levels) revealed no abnormality. An abdominal ultrasound was obtained with the suspect of gallstone. There were multiple linear echoes within the gallbladder dividing the lumen into compartments mimicking a honey-comb pattern (Figure 1). The wall thickness of the gallbladder was normal, and there were no gallstones. Magnetic resonance cholangiopancreatography (MRCP) was performed and showed a grapelike cluster of the gallbladder (Figure 2). According to these findings, multiseptate gallbladder was diagnosed. Laparoscopic cholecystectomy was performed and macroscopic examination demonstrated multiple edematous septa dividing the gallbladder lumen into compartments (Figure 3). The patient was discharged on postoperative first day without complication and followed up for a six-month period. Her abdominal pain and gastrointestinal complaints have resolved after the surgery.
Multiseptate gallbladder (MSG) is a rare congenital malformation of the gallbladder. It most likely results from incomplete vacuolization of the developing gallbladder bud or persistent "wrinkling" of the gallbladder wall [1, 2]. There are multiple septa which give a honeycomb appearance in MSG, and these septa usually involve the lumen of the entire gallbladder whereas they are sometimes found in only a portion of the gallbladder [3–6]. The causes of multiseptate appearance of the gallbladder on sonography include gallbladder diseases such as multiseptate gallbladder, hyperplastic cholecystosis, and cholecystitis [7]. Asymptomatic patients are very rare in literature [3], most patients present with long term abdominal symptoms such as right upper quadrant tenderness, recurrent abdominal pain, nause and vomiting, and gastrointestinal complaints. Septa are the reason of impaired motility of the gallbladder, and this causes a stasis in the bile flow, and it seems to be the reason of recurrent abdominal pain. Ultrasound (US) evaluation of the gallbladder is usually sufficient to diagnose MSG although other modalities such as computed tomography, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) have been described to establish the diagnosis. Ultrasound appearances consist of multiple linear echoes that can be seen to cross the gallbladder lumen, producing a honey-comb appearance [8]. The combination of US and MRCP is the most useful and the least invasive methods to diagnose multiseptate gallbladder.
In conclusion, multiseptate gallbladder is a rare congenital anomaly and a rare cause of recurrent abdominal pain. Cholecystectomy is the choice of treatment in symptomatic patients such in our case. Our patients' abdominal pain and gastrointestinal complaints have resolved after surgery. Cholecystectomy should also be considered in elderly, asymptomatic patients in whom MSG is incidentally discovered, due to the possibility of undetected carcinoma of the gallbladder [9].
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Hermes Press is one of a handful of publishers which exclusively produces books and comic strip reprints focusing on the art and artists of the comics, cartoon and comic strips, pulp magazines of the 1920s and 1930s, art books covering science fiction, and popular culture.
In 2010, collected editions of the Gold Key Dark Shadows comics were released by Hermes Press across five volumes. In 2011, they released a recolored edition of Gold Key's Dark Shadows Story Digest Magazine.


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Validation of ICD-9-CM codes for identification of acetaminophen-related emergency department visits in a large pediatric hospital
Quality, performance, safety and outcomes
Acetaminophen overdose is a major concern among the pediatric population. Our objective was to assess the validity of International Classification of Disease (ICD-9-CM) codes for identification of pediatric emergency department (ED) visits resulting from acetaminophen exposure or overdose.
We conducted a retrospective medical record review of ED visits at Texas Children's Hospital in Houston, Texas, between January 1, 2005, and December 31, 2010. Visits coded with 1 or more ICD-9 codes for poisoning (965, 977, and their subcodes and supplemental E-codes E850, E858, E935, E947, and E950 and their subcodes) were identified from an administrative database, and further review of the medical records was conducted to identify true cases of acetaminophen exposure or overdose. We then examined the sensitivity, positive predictive value, and percentage of false positives identified by various codes and code combinations to establish which codes most accurately identified acetaminophen exposure or overdose.
Of 1,215 ED visits documented with 1 or more of the selected codes, 316 (26.0%) were a result of acetaminophen exposure or overdose. Sensitivity was highest (87.0%) for the combination of codes 965.4 (poisoning by aromatic analgesics, not elsewhere classified) and E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics), with a positive predictive value of 86.2%. Code 965.4 alone yielded a sensitivity of 85.1%, with a positive predictive value of 92.8%. Code performance varied among age groups and depending on the type of exposure (intentional or unintentional).
ICD-9 codes are useful for ascertaining which ED visits are a result of acetaminophen exposure or overdose within the pediatric population. However, because ICD-9 coding differs by age group and depending on the type of exposure, hypothesis-driven strategies must be utilized for each pediatric age group to avoid misclassification.
Acetaminophen is the leading pharmaceutical product consumed in the United States
Reported rates of acetaminophen-related ED visits among children are commonly extrapolated from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP), which contains information on all injuries treated in the ED at a sample of hospitals in the United States. The Centers for Disease Control also collaborates on the NEISS Cooperative Adverse Event Surveillance project (NEISS-CADES) to identify all adverse drug events leading to ED visits for children and teens
Pediatric exposure to and overdose from acetaminophen has received attention from the US Food and Drug Administration Center for Drug Evaluation and Research, which has discussed changing dosing information for over-the-counter products containing acetaminophen for children younger than 12 years
The objective of this study was to evaluate the utility of various ICD-9 codes or combinations of codes for identifying ED visits resulting from acetaminophen exposure or overdose among children.
Data collection
We collected records of ED visits related to acetaminophen exposure or overdose between the dates of January 1, 2005, and December 31, 2010, at Texas Children's Hospital in Houston, Texas, which has the largest pediatric ED in south-central Texas, admitting approximately 85,000 patients each year. Administrative records of the ED visits documented diagnostic information using specific ICD-9 codes (Table
Chart review
A detailed review of the selected medical records was conducted by trained research assistants to confirm that the coding accurately reflected cases of pediatric acetaminophen exposure or overdose. Each record of the visit date and consecutive hospital stay, if applicable, was reviewed by a research assistant. A standardized data abstraction worksheet with a detailed codebook was used for each visit. We defined cases as those in which a suspected or known accidental ingestion or an overdose of an acetaminophen-containing product were clearly documented. We included suspected ingestions because often a child was found with an open bottle but the caregiver was not certain whether the child had ingested any of the contents. The type of acetaminophen exposure or overdose was categorized as unintentional, intentional, or illicit unintended use. Unintentional acetaminophen exposure occurred in cases in which the caregiver suspected ingestion, a provider gave the child an incorrect dose, or the child ingested acetaminophen without an adult's supervision or intention to treat. Intentional acetaminophen exposure occurred in cases in which the patient admitted to intentionally ingesting the medication with the purpose of harming him or herself, or if the treating physician or social worker note included the key words 'intentional' or 'suicidal use.' Illicit unintended use of acetaminophen occurred in cases in which the medical record notes documented the patient admitting to intentionally ingesting the medication for the purpose of "getting high." All charts reviewed with information regarding the visit fell into one of the previously defined categories. Uncertainties regarding intention category were reviewed with a second chart review and consensus among two reviewers. Visits identified by the codes that were missing medical records or did not have any notes regarding the visit were excluded.
Statistical analysis
We estimated the sensitivity for each ICD-9 code of interest under the assumption that all possible acetaminophen-related ED visits had been coded by at least 1 of the codes of interest, implying 100% capture with the codes listed in Table
Identification of acetaminophen-related ED visits
During the specified timeframe, there were 478,973 admissions to the ED of Texas Children's Hospital, and 1,215 (0.25%) of these visits were documented with at least 1 of the relevant ICD-9 codes shown in Table
ICD-9 code performance
General codes among those selected for this study that did not achieve the
When we included only the codes with a PPV of at least 50% in our analysis, sensitivity was high. However, 41 (13.0%) of the 316 cases of acetaminophen exposure or overdose were not identified by these codes. These cases were identified by codes 965.09 (poisoning by other opiates and related narcotics; 31.7%), 965.1 (poisoning by salicylates; 12.2%), or 977.8 (poisoning by other specified drugs and medicinal substances; 9.8%); 13 additional codes identified fewer than 3 cases each.
Several differences in code performance were noted after stratification by age group (Table
Stratification by year (2005 to 2010) indicated a decreasing number of ED visits identified by 1 or more of the ICD-9 codes of interest. However, the number of cases of acetaminophen exposure or overdose, according to the medical record review, did not change significantly over the period studied, suggesting that coding procedures became more efficient over time.
Discussion and conclusion
We selected records of ED visits using selected ICD-9 codes, and from these, cases in which acetaminophen exposure or overdose was suspected or known were identified after a thorough review of medical records. Review of the medical records used in our study showed that 316 out of the 1,215 ED visits identified by the ICD-9 codes of interest (26.0%) were related to acetaminophen exposure or overdose, which would result in a 3:1 ratio of false positive cases. However, when we included in our analysis only the codes with a PPV of at least 50% to avoid a large number of false positives, we captured only 87.0% of cases of acetaminophen exposure or overdose. This suggests that different strategies might be appropriate in different situations when using ICD-9 codes to identify rates of acetaminophen exposure or overdose in pediatric patients. In our analysis, the most cases of acetaminophen exposure or overdose for all ages considered together were identified using the combination of codes 965.4 (poisoning by aromatic analgesic, NEC) or E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics), with a sensitivity of 87.0%, although this combination of codes also yielded a 13.8% false positive rate. For children less than 6 years old, code 965.4 captured 86.4% of cases, with a very low proportion of false positives (5.0%). It is important to recognize that although some strategies are efficient in capturing the most cases, these strategies may also result in a significant number of misclassified cases. It is also important to note all cases coded with 965.4 were also coded E850.4, indicating accidental poisoning. For this reason, using the combination logic of code 965.4 in addition to E850.4 and E950.0 resulted in the same sensitivity as using 965.4 and E950.0 alone.
On the other hand, some studies may require high specificity, such as case–control studies in which certainty about the relevance of the selected cases is important. Under these circumstances, the best code to use, according to our analysis, was 965.4, which resulted in a 7.2% false positive rate for all ages combined (5.0% for 0–5 years, 8.1% for 6–14 years, and 10.2% for 15–24 years); and sensitivity was 85.1% overall (86.4% for 0–5 years, 80.3% for 8–14 years, and 86.8% for 15–24 years).
Our analysis showed that ICD-9 codes could be used to identify circumstantial subgroups of pediatric patients exposed to acetaminophen. For example, for identifying ED visits for young children unintentionally exposed to acetaminophen, using both code 965.4 and accidental codes, such as E850.4 and/or E850.7, maximized sensitivity and PPV. Similarly, for identifying ED visits related to intentional acetaminophen exposure, using codes 950.0 (for suicide or self-inflicted poisoning) and 965.4 in the search led to the most precise identification of cases of interest. To the best of our knowledge, this is the first study to examine the validity of ICD-9 codes used in an ED administrative database to identify potential exposure to or overdose of acetaminophen products in a pediatric population.
ICD-9 codes are useful for ascertaining which ED visits is a result of acetaminophen exposure or overdose within the pediatric population. Previous studies have used ICD-9 codes to evaluate national trends in admissions for acetaminophen exposure in adults
In our study, the codes used for cases of unintentional acetaminophen exposure differed from those used for cases of intentional acetaminophen exposure or overdose among our oldest group of patients (15–24 years). Code E950.0 (suicide and self-inflicted poisoning by analgesics, antipyretics, and antirheumatics) had a 75.0% PPV, although this code alone was not capable of capturing the majority of cases. These findings are consistent with data from others with respect to age and rates of intentional overdose
We found that the number of ED admissions documented with the codes we selected peaked in 2005 and 2007 and sharply decreased between 2008 and 2010. However, the number of confirmed cases per year, was consistent throughout the period studied, indicating that misleading trends may result from the use of incorrect diagnosis codes. From 2007 to 2010, code 965.4 was capable of capturing 100% of cases, leaving no false positives. Changes in coding, policy, or public awareness may have played a part in the decreased number of ED admissions documented with our selected codes during 2007–2010. Previous reports examining data from 2001 to 2008 showed an increase in admissions, ED visits, and calls related to ingestions of pharmaceutical products. Using the National Poison Data System, Bond et al. reported a 57% increase in cases of unintentional acetaminophen exposure or overdose and a 71% increase in cases of therapeutic error nationally between 2001 and 2008
Several limitations should be considered when interpreting our data. First, our findings are representative of results from a single pediatric hospital within a specified time range. Although we examined data from the largest pediatric hospital in Texas, data from other hospitals serving different areas may differ in coding practices, and coding algorithms should be validated in additional hospitals over alternative time periods. In addition, we assumed that all visits related to acetaminophen exposure or overdose were identified by at least 1 of the codes we selected. Due to the large amount of visits, only one trained research assistant reviewed the medical records and concordance statistics are not available, however, a standardized consensus approach was used to classify these cases. Not all true acetaminophen exposures/overdoses might have been captured as some may not have been assigned our selected codes, but if any, we believe this proportion would be very small given our broad code selection, including several general codes with low sensitivity and specificity. In interpreting our findings it is important to note distinctions between exposure and overdose. Since in most occasions ingestion was not observed, overdose could not be confirmed. While the clinical implications of these differences are important, the purpose of our study was to evaluate the value of diagnostic algorithms to identify a majority of potential overdoses. Finally, we examined only the ICD-9-CM coding system, which may not be comparable with the ICD-10-CM coding system for future studies.
Despite efforts to reduce unintentional medication exposures among children, overdose of acetaminophen in this population continues to be a public health concern. Development of prevention strategies and educational activities to reduce pediatric exposure to or overdose of acetaminophen depends on reliable data regarding trends in acetaminophen-related ED visits. Data regarding ED visits related to acetaminophen exposure or overdose is sparse, and detailed abstraction of medical records can be time-consuming and costly. Using reliable ICD-9 codes or combinations of codes can be a useful strategy to estimate the number of acetaminophen exposures and overdoses in the pediatric population. However, researchers and users must be cognizant that approaches maximizing case identification will also result in a significant proportion of false positive cases, whereas strategies to identify only true positive cases will result in an underestimate of the true burden of acetaminophen exposure.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
SA, MES-A, and CF conceived of and designed the study. SA and MES-A acquired the data and SA, SP, and MES-A analyzed and interpreted the data. SA drafted the manuscript and CF, SP, and MES-A provided critical revision of the manuscript for content. SA and SP performed statistical analysis. MES-A obtained funding. SA, CF, and MES-A provided administrative, technical, and material support. MES-A supervised the study. All authors read and approved the final manuscript.
This project was supported by cooperative agreement number No. 1U18 HSO017991-01 from the Agency for Healthcare Research and Quality (AHRQ) using funding from the US Food and Drug Administration (FDA) though Interagency Agreement No. 224-08-3591. The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ, FDA, or the US Department of Health and Human Services.
Nonfatal, unintentional medication exposures among young children--United States, 2001–2003
National surveillance of emergency department visits for outpatient adverse drug events
Medication overdoses leading to emergency department visits among children
The Growing Impact of Pediatric Pharmaceutical Poisoning
Emergency department use after pediatric pharmaceutical ingestion: comparison of two national databases
Emergency department visits for overdoses of acetaminophen-containing products
Estimates of acetaminophen (Paracetamol)-associated overdoses in the United States
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Look at other dictionaries:
candlepin — [kan′dəlpin΄] n. any of the ten nearly cylindrical pins used with a small ball in a game like bowling pl.n. this game … English World dictionary
candlepin — noun Date: 1901 1. a slender bowling pin tapering toward top and bottom 2. plural but singular in construction a bowling game using candlepins and a smaller ball than that used in tenpins … New Collegiate Dictionary
candlepin — /kan dl pin /, n. 1. a bowling pin that is almost cylindrical and can be set up on either end, used in a game resembling tenpins. 2. candlepins, (used with a sing. v.) the game played with such pins. [1900 05; CANDLE + PIN] * * * … Universalium
candlepin — n. bowling pin of slender tapering design (used in the game of bowling) … English contemporary dictionary
candlepin — /ˈkændlpɪn/ (say kandlpin) noun 1. a slender, candle shaped pin used in a game similar to tenpin bowling. 2. (plural) a game using such pins … Australian English dictionary
candlepin — noun a bowling pin that is thin by comparison with a tenpin • Hypernyms: ↑bowling pin, ↑pin * * * ˈ ̷ ̷ ̷ ̷ˌ ̷ ̷ noun 1. : a slender nearly cylindrical bowling pin tapering toward top and bottom 2. candlepins plural but singular in construction … Useful english dictionary
Candlepin bowling — is a variation of bowling that is played primarily in several New England states, and in the Canadian Maritime provinces of New Brunswick, Prince Edward Island, and Nova Scotia.History and DifferencesIt was developed in 1880 in Worcester,… … Wikipedia
candlepin bowling — noun a bowling game using slender bowling pins • Syn: ↑candlepins • Hypernyms: ↑bowling … Useful english dictionary
candlepins — Candlepin Can dle*pin , n. (Tenpins) (a) A form of bowling pin slender and nearly straight like a candle. (b) The game played with such pins; in form {candlepins}, used as a singular. [Webster 1913 Suppl.] … The Collaborative International Dictionary of English
Stasia Czernicki — ( mdash;January 171993) [ [http://www.highbeam.com/doc/1P1 27996136.html Candlepin s Babe Ruth dies at 70 mdash;Stasia Czernicki obituary on NPR s Weekend Edition of] January 231993] was an American professional candlepin bowler widely considered … Wikipedia


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It seems disgraced newscaster Brian Williams will not get his job back once his six-month suspension expires, several news agencies claim.
The NBC Nightly News anchor shocked the world of broadcast journalism by admitting in February that he lied about his helicopter getting hit by an RPG during Iraq War. While he fessed up to that one instance of embellishing his reports, there is good reason to believe that Williams actually has a pattern of stretching the truth.
Per a New York Times report, NBC's investigation team has found at least six more instances when Williams fabricated, misrepresented or embellished the facts to make his reports more interesting.
CNN's anonymous sources inside NBC went even higher and claimed that he lied on air at least 10 times.
The 55-year-old, who has hosted NBC Nightly News for the past decade, is currently halfway through his six-month suspension and was expected to retake his job sometimes in August. But based on these new revelations, it seems highly unlikely that NBC will retain him even though his fans and some of his fellow journalists want him back.
Also Check: From Brian Williams to Bill O'Reilly, What News Can We Trust?


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R. Federer vs G. Simon Match Prediction Wimbeldon 2015. Roger Federer is going to play his quarter-final match against Gilles Simon at Wimbeldon 2015 on dated 8th July 2015. According to Indian standard time it will start at 5:30 PM. In third round match Roger Federer beat Roberto Bautista by 6-2, 6-2, 6-3.
R. Federer vs G. Simon Match Prediction Wimbeldon 2015
While hardly any tennis pundits doubted that Roger Federer would find his way to the quarter-final of his favourite Grand Slam tournament, few expected that the player standing opposite him across the net would be France's Gilles Simon. However, now that the final eight has been set, the two will now meet for an eighth time on the professional tour to determine who will advance to the semi-final stage of the Wimbledon Championships. Federer leads the head-to-head series 5-2. Roger Federer said "It was a good match, I got off to a good start and kept rolling. While Gilles Simon in his third round match beat Tomas Berdych by 6-3, 6-3, 6-2. Gilles Simon said "I had a good feeling from the start I felt he was struggling also to put his game in place, and I was really good at keeping him in the gray area. From Federer point of view perhaps this is his last great chance at Grand Slam title No. 18.
Before this match these two players have played five matches with each other and Federer leads with 3-2. Gilles Simon has played a impressive game in his recent matches but to beat Federer he has to struggle too much.
Before the match we have already predicted these matches of Wimbledon 2015 , visit recent match predictions Click Here
30th june 2015 Roger Federer vs Damir Dzumhur ( Roger Federer win )
2nd July 20215 Roger Federer vs Sam Querrey ( Roger Federer win )
7th July 2015 S. Williams vs V. Azarenka ( Serena Williams win )
Match Prediction:
R. Federer will be the winner
Important Note Must Read:
(This prediction is only for Tennis lover who wanna get the Tennis Info, not for gambling, betting or any other illegal activities.We will not responsible for any consequence. Thanks for supporting us.)


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En France Avec Ma Soeur mai 2010
by Colleen Maki
About the Book
Sue and Colleen's trip to France in May 2010. Visits to Montpellier, Carcasonne, Nimes, Paris and Versailles.
Features & Details
Large Format Landscape, 13×11 in, 33×28 cm
30 Pages
- Publish Date May 30, 2010
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About the Creator
Michigan, USA
I grew up in Marquette, Michigan. Even though I work 500 miles away I return every Summer to live for a month or so. It is the place where I wish I could have had my career. Marquette is a photographer's paradise; as you will see!
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