text:
It is impossible for birds to have evolved from theropod dinosaurs, and there is no mechanism to support such an illusory claim.
The theory of evolution claims that birds evolved from a small, carnivorous reptile known as the theropod dinosaur. In fact, however, a comparison of birds and reptiles shows that these classes are very different from one another and that no evolution can have taken place between them. (See The Origin of Birds.)
An examination of the anatomies and fossil records of birds and reptiles also shows no evidence that evolution ever happened. In an article titled "Demise of the 'Birds Are Dinosaurs' Theory," the American biologist Richard L. Deem writes:
The results of the recent studies show that the hands of the theropod dinosaurs are derived from digits I, II, and III, whereas the wings of birds, although they look alike in terms of structure, are derived from digits II, III, and IV . . . The second study shows that the theropod dinosaurs did not possess the correct skeletal structure or lung structure to have evolved into birds. The evolution of theropods into birds would have required the introduction of a serious handicap (a hole in their diaphragm), which would have severely limited their ability to breathe. As Dr. Ruben said, such a debilitating mutation "seems unlikely to have been of any selective advantage."246
There are other problems regarding the "Birds Are Dinosaurs" theory. In comparison with Archaeopteryx, theropods' front legs are very small in relation to their bodies. (See Archaeopteryx.) Bearing in mind the body weight of these animals, the development of any proto-wing appears impossible. The majority of theropod dinosaurs have no semilunatic wrist bone (which is found in birds), and possess other wrist components that are absent in Archaeopteryx. In all theropods, the VI nerves leave the skull from the side, together with various other nerves. In birds, however, the same nerves leave the skull through a hole, which is unique to them, in the front of the skull. Another problem is that a great many theropods emerged after Archaeopteryx. 247
Another major distinguishing feature between theropod dinosaurs and birds is the structure of these dinosaurs' hip bones. Dinosaurs are divided into two kinds, depending on their hip bone structure: Saurischian (with reptile-like hip bones) and Ornithischian (with bird-like hip bones). In members of the Ornithischian group, the hip bones really do closely resemble those of birds, hence their name. However, in other respects they bear no resemblance to birds whatsoever. For that reason, evolutionists are forced to regard Saurischian dinosaurs (those with reptile-like hip bones), which include the theropods, as the ancestors of birds. Yet as can be seen from their description, the hip bone structure in these dinosaurs bears absolutely no resemblance to that in birds. 248
In short, it is impossible for birds to have evolved from theropod dinosaurs, because no mechanism exists that could possibly overcome the enormous differences between the two classes.
246. Richard L. Deem, "Demise of the 'Birds are Dinosaurs' Theory," http://www.direct.ca/trinity/dinobird.html
247. Ibid.
248. Duane T. Gish, Dinosaurs by Design, Master Books, AR, 1996, pp. 64-65.


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VOICES Ideas and Insight From Explorers
Tag archives for Elwha Dam
Rebirth on the River: Washington's Elwha Flourishing After Big Dam Removals
By Jason Jaacks The first signs of life are beginning to return to the Elwha River in Washington State, where the largest dam removal in U.S. history is nearly complete. The Elwha River begins in the heart of Olympic National Park and flows 45 miles (72 kilometers) to the Strait of Juan de Fuca. Historically,…

subset: commoncrawl


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Protecting wildlife...
Saving our disappearing wildlife
Our oceans support an estimated ten million species, only three percent of which have been identified. But our rich ocean wildlife is being depleted, disappearing before we have even had the chance to learn about it. We are losing biodiversity at a rate never witnessed before, at huge cost to ourselves, and leaving a degraded environment that leaves wildlife vulnerable in the face of change.
If our oceans are to cope with what the future will throw at them, we need to act now. We need to halt the loss of biodiversity and take care of the fabric of life in our seas. We are all connected to the sea in ways we may not realise, and the health of our seas is key to a rich and productive future.
MCS wildlife protection in action
We are working to protect our precious seas and wildlife, and there are lots of ways for you to get involved. We are campaigning for marine protected areas in the UK, studying the amazing wildlife in our seas, and working on frontline conservation projects involving local people in the stewardship of their marine resources, both in the UK and abroad, with our coral reef projects.
Sign up to receive the
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text:
Click here to renew your license online
The Division of Corporations, Business and Professional Licensing staffs the hearing aid dealer program. The Department of Commerce, Community, and Economic Development adopts regulations to carry out laws governing hearing aid dealers in Alaska. It makes final licensing decisions and takes disciplinary actions against people who violate licensing laws.
Applicants must complete an application for licensure, pay application and license fees, and post a surety bond. An Alaska Business License may also be required, please check with the Division.
Alaska Statutes are passed by the legislature. Regulations (also called the Alaska Administrative Code) are rules adopted by the department to implement, interpret, and make specific the statutes. Both statutes and regulations have the force of law.
AS 08.55 specifically applies to hearing aid dealers. AS 08.01 - 08.03 and regulations 12 AAC 02 apply to all professions regulated by the division.
Proposed regulations are advertised in Alaska newspapers and we invite public comment on them. If you would like to receive notice of proposed regulations, please write to the regulations specialist and request that your name be added to the Hearing Aid Dealers interested parties list. Please advise us if you move or wish your name removed from the mailing list.
National organizations may provide information on the regulation of hearing aid dealers in other states.
Licensing Examiner: Virginia Geary
Telephone: (907) 465-2695
Fax: (907) 465-2974
P.O. Box 110806
Juneau, AK 99811-0806
Email: firstname.lastname@example.com


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The Weekly MILP (Moms In the Legal Profession) Roundup** is hosted on a rotating basis at the PT-LawMom, Attorney Work Product and Butterflyfish blogs and is usually posted no later than Monday. Next week Butterflyfish will have it.
First, congrats to Butterflyfish who has a new Angelfish!
LL has tidbits.
PT-Lawmom has a new love: he's square but he's hawt.
Googiebaba has dinosaurs (and an open invitation for the party!)
LC is surviving.
The Wild Northwest Litigator has an app for that.
Jenny starts the semester off... with the plague.
The Cowgirl in the City is putting things in order.
Shan gets grades.
-R- is hoarding Christmas, and trying not to panic.
The Erbgarden has time travel.
CM is looking for bath tips.
E.H. is overcome by the spirit.
RG is looking respectable.
Dakota recaps the holidays.
SuzieJD is feeling rejected.
Momttorney found a new bed.
The Southern Female Lawyer is now the Shameless Domestic Hussy, is taking a legal sabbatical and is knocked up.
[And, that reminds me, apparently I'm knocked up too. Cora is unimpressed, and my bewbs hurt. That's about the extent of it.]
Join us next time for the Roundup over at Butterflyfish!
If you would like to have your blog added to the MILP blogroll for weekly review or would like us to consider a specific post, drop the hostess(es) an email or leave a comment at their respective sites.
**Hat tip to the "original" Roundup Evan Schaeffer's Legal Underground and Thanks, But No Thanks
Tuesday, January 18, 2011
MILP Roundup #186
Posted by Proto Attorney at 8:49 PM
10 comments:
- kristine said...
- This comment has been removed by the author.
- January 18, 2011 at 9:50 PM
- devinemissk said...
Hey hey! Congrats!
- January 18, 2011 at 9:52 PM
- CM said...
Congratulations!! Can't wait to hear the details (about the baby, not the knocking up).
- January 18, 2011 at 9:58 PM
- E.H. said...
Congrats!!! Yay! And sorry about the boobs. I hate that part. :)
- January 18, 2011 at 11:23 PM
- Butterflyfish said...
what what WHAT?????
- January 18, 2011 at 11:41 PM
- Mama said...
WOOOOOOOOOOOOOOO! I'm so pleased for you!
- January 19, 2011 at 11:42 AM
- Meredith said...
Nice way of slipping that in there! I almost missed it. Congrats to everyone - especially big sister!
- January 20, 2011 at 12:09 PM
- LL said...
I totally missed this -- CONGRATULATIONS!!
- January 20, 2011 at 1:47 PM
- Burdekin said...
DUUUUUDE!!! That is so awesome! How far along are you? Let's bitch together...
- January 20, 2011 at 6:33 PM
- Burdekin said...
Burdekin is me, Shameless Domestic Hussy/ SFL by the way. Hook me up with that sweet email lovin'!
- January 20, 2011 at 6:34 PM
Subscribe to: Post Comments (Atom)


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The Campaign for Physics: A Science Education Initiative
The Campaign for Physics raised $5 million in support of science education at the K-12 level and beyond. Through the Campaign APS and AAPT (American Association of Physics Teachers) have helped school districts implement systemic science education reform which has provided students with a science curriculum and learning environment that will nurture their interest in and appreciation for science. APS & AAPT also created a support structure for science teachers, particularly in urban settings, who are seeking ways to improve their teaching skills and techniques by developing a resource center for their use in obtaining information on the best in science teaching curricula and materials. In addition, the Campaign has provided mentor and financial support for bright undergraduate minority students interested in pursuing careers in science.
The following programs have been made possible by the generous support of Campaign donors
The following programs have been made possible by the generous support of Campaign donors
- The Teacher-Scientist Alliance Institute
- The Physics Teacher Resource Agent Program
- The Physical Science Resource Center
- The Minority Scholarship Program for Undergraduate Physics Majors
- Thirty-nine Nobel laureates and leaders of corporate America launch initiative to reform science education
- Thirty-nine Nobel laureates and leaders of corporate America celebrate success of initiative to reform science education
- APS and AAPT Launch The Campaign for Physics (December 1995 Volume 4)
- Captains of Industry Join 39 Nobel Laureates To Lead Campaign (April 1996 Volume 5) (pdf)
- Campaign for Physics celebrates reaching $5 Million funding goal (February 1998, Volume 7) (pdf)


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Freedom to Marry goes to Netroots Nation
Postedon Jun 04, 2012 at 03:00 pm
This week, Freedom to Marry's New Media team will be attending Netroots Nation, an annual conference where progressive voices exchange ideas, organizing tactics, and goals for the future.
House Democratic Leader Pelosi endorses freedom to marry plank in 2012 platform
Postedon Feb 15, 2012 at 07:50 am
Just two days after launching our Democrats Say I Do campaign calling on the Democratic Party to adopt a plank in support of the freedom to marry, House Leader Nancy Pelosi endorsed the proposed plank.
Field update: On the ground in Minnesota
Postedon Sep 15, 2011 at 10:30 am
Freedom to Marry's Field Director Regina Clemente just got back from Minnesota, where she's working with the Minnesotans United for All Families coalition to defeat the anti-gay constitutional amendment on the November 2012 ballot.
Creating Change: Minnesota and Beyond
Postedon Feb 03, 2011 at 01:25 pm
How Freedom to Marry is working for marriage at the country's biggest conference on gay issues – and how exclusion from marriage is affecting a Minnesota couple who have been together for nearly four decades.
Freedom to Marry's Sean Eldridge on Marriage – Personal and Political
Postedon Feb 02, 2011 at 02:30 pm
In an interview on Swirl Radio, Freedom to Marry Political Director Sean Eldridge spoke about the state of the marriage movement in America, as well as his own recent engagement to Facebook co-founder Chris Hughes.
Barbara Bush, marriage equality & Obama
Postedon Feb 02, 2011 at 12:30 pm
Jonathan Capehart makes the case for President Obama conducting a "series of under-the-radar meetings to help him in the 'evolution' of his stance and thinking on marriage for same-sex couples."
Two Iowa Senate democrats say loyalty to Gronstal trumps support for marriage amendment
Postedon Feb 02, 2011 at 10:00 am
A handful of Senate Democrats who would be the deciding votes on an amendment to ban marriage equality said Tuesday they won't join minority Republicans to force a vote this year.
Barring a change of heart, that means the effort to allow a public vote on a constitutional amendment to ban the freedom to marry is dead in the Iowa Legislature this session.
Freedom to Marry Commends Governor Quinn on Signing Civil Union Bill, Calls for Next Step
Postedon Jan 31, 2011 at 08:00 pm
A statement from Evan Wolfson, Executive Director of Freedom to Marry, on today's signing of the Illinois Religious Freedom Protections and Civil Unions Act by Governor Quinn.
Video: Iowa Democratic Chair urges lawmakers not to be distracted by marriage ban
Postedon Jan 31, 2011 at 02:30 pm
Retaining the jobs we have and creating new ones, that's what Iowa's Democratic Chair says the state's lawmakers should be focusing on, not banning marriage equality.
Eric Hartley: Still waiting for 'the real thing'
Postedon Jan 31, 2011 at 11:30 am
While many gay or lesbian couples from Maryland got married in Washington, D.C., after that city legalized same-sex marriage last year, Barry Kessler and David Hankey have waited. The Arnold couple was a bit wary of a D.C. marriage. The Maryland attorney general says the state can recognize out-of-state marriages, but what if it didn't for some reason?
But the real reason they're waiting is less legal and more profound: They want "the real thing," as Hankey put it.


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For all media inquires, please contact:
Brandon Puttbrese firstname.lastname@example.com • GS&F • 615.385.1100
Ashland City, Tennessee (Wednesday, 29 November 2006)
A. O. Smith would like to announce the unveiling of the new residential and commercial unit line brochures. The completely revised literature includes never before released information on the "Vertex" and other new innovative product lines. The "Vertex" is A. O. Smith's latest edition to its residential products line. This gas water heater performs at 90% thermal efficiency and delivers continuous hot water.
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Kite Skua Swarovski ATM 80 Spotting Scope Case
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Maximum protection and ease of use are crucial when it comes to selecting a spotting scope case. The Kite Skua case for the Swarovski ATM scope provides exactly that. A waterproof neoprene case fits securely around the body and eyepiece for protection while transporting and offers quick access to scope functions in the field.


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Dark chocolate bars are the purest form of chocolate and have been proven to greatly benefit your health, taken in moderation. Our dark chocolate bars range from 56% up to 100% and include the best of fine blends, flavoured and single origin. To help you decide which dark chocolate bar is for you we have included flavour profiles and tasting notes for each. Please also take a look at the chocolate bar reviews to assist your choice.
From Duffy's
A single origin, dark chocolate made from bean to bar by Duffy's, with organic 'Hispaniola' cocoa beans from the Dominican Republic. Notes of tangy pineapple, sweet strawberries with green tea.Read more...
From Bonnat
A wide and delicate flavour profile is offered with this fine dark chocolate bar from Bonnat. Floral, nut and soft fruit notes with low acidity are created from the fine flavour cocoa exclusively from Cuba.Read more...
Created exclusively from 100% Criollo, the highly coveted and extremely rare cocoa variety. Providing a unique and full fruit tasting flavour profile, as one would expect from this particular varietal and origin.Read more...
Created from fine flavour cocoa grown on the Juliana plantation in the heart of the protected area, Pratigi in Brazil. This fine dark chocolate bar from Bonnat offers delicate fruity flavours.Read more...
From Willies chocolate
A full flavoured dark chocolate with 70% cocoa content. A bittersweet dark chocolate with notes of cherries, plums and in this instance sweet spice, due to the fine flavour Trinitario cocoa beans used. Single estate of Los Llanos, Colombia.Read more...
A cylindrical block of 100% pure cocoa created by Willies chocolate for use with cooking and desserts. Simply grate the required amount. Made exclusively from fine flavour Criollo cocoa from Peru. Distinct notes of raisins and plums.Read more...
Made from rare and expensive, fine flavour Criollo cocoa beans from Guatemala. This 70% dark chocolate bar provides mellow notes of honey with an acidulous edge of blackcurrant balanced with an earthy, pepper finish.Read more...
Made with fine Criollo cocoa beans from Nicaragua. Created from bean to bar in England by Duffy;s. This 72%, single origin dark chocolate bar contains notes of cranberries with rich chocolate notes and hazelnuts.Read more...
An internationally award winning chocolate bar from Bonnat. The Kaori chocolate is made from highly fragrant cocoa beans from Brazil. A mild but sunny flavour profile balanced with notes of nuts and coffee.Read more...
The Apotequil chocolate bar from Bonnat is created with rare Porcelana cocoa beans from Peru. A refined and wide ranging flavour profile with floral, citrus and yellow fruit notes.Read more...
Created from fine flavour cocoa beans grown just outside the famous village of Chuao in Venezuela. An incredibly fruity dark chocolate from Bonnat as to be expected from this world famous cocoa region. Dried fruits with a spicy edge.Read more...
A single origin, 100% cocoa, bitter dark chocolate bar from Willie's Cacao. Made from bean to bar using Trinitario cocoa from Sur Del Lago in Venezuela. This intensely bitter dark chocolate offers nutty notes with an incredibly smooth texture.Read more...
From Marou
Using a blend of fine flavour cocoa from the highland district of Dak Lak province in Vietnam. This single origin dark chocolate offers spicy notes with an earthy base and a long finish. Made from bean to bar in Vietnam.Read more...
From Equal Exchange
A classic chocolate recipe that never fails to please and this particular chocolate bar, using organic pure ingredients and fairly traded cocoa, is one of the best. Single origin, 55% percent dark chocolate infused with natural orange.Read more...
Awake your taste buds with this award winning, dark chocolate bar containing lemon, ginger and black pepper. Generously ginger biased with a warm and spicy nature finished with a peppery edge. A very interesting and unique chocolate bar recipe.Read more...
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Submit News
Ionic Wind Cooling Next Step in CPU/GPU Cooling
Tuan Nguyen
January 4, 2007 3:44 PM
Recipient E-mail
Sender E-mail
Kronos cooling run at 8.5kilo-volts to cool a device 25 degrees Celsius - Image courtesy TheFutureofThings.com
Kronos Advanced Technologies claims that's the way we're headed
Lately, heatsinks and traditional fans have become so large that they are beginning to be obstructive and are sometimes too heavy. This is an issue on the graphics processor front in many ways, as there isn't enough room for large heatsinks,
yet GPU thermal exceeds that of high-speed CPUs
A company called
Kronos Advanced Technologies
is working on a method of
removing heat from devices such as CPUs by using ionic discharge to
create a fluid motion of air. This technology has been around for a few years and is used in products such as ionic air filters, which have no moving parts but still move volumes of air and create quite a strong breeze. The same concept is being applied to micro processor cooling.
Despite the advancement however, the volume of air moved over the CPU core is still small because the core surface area is small. Heatsinks are used to increase surface area of the hot surface, so that when air is moved over the fins, more heat can transfer to the air. The Kronos' device will attempt to remove hot air away from the processor core directly without the need for heatsinks. With this method, the velocity of air being moved needs to be extremely fast in order to compensate for the lack of surface area -- and speed is something that ionic air "movers" lack.
Right now, Kronos is still working on prototypes, which it claims are scalable from very small micro coolers to large scale sizes. Power requirements also appear to be quite steep at this point in time. One of Kronos' demonstration shows a heated area being reduced from roughly 50C to 25C using an ionic cooler, but the power supply required around 8.5kV, or 8500 volts, to stay stable.
"We are going to continue to work with them to make sure they understand the reality of the Internet. A lot of these people don't have Ph.Ds, and they don't have a degree in computer science." -- RIM co-CEO Michael Lazaridis
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Welcome to Shop Elect, Biggest Marketplace for Industrial Electrical & Engineering.
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SIRIUS CT based thermal overload relays
Answers for industry.The permanent advancement and continuous innovationof SIRIUS modular system optimally prepare our customersfor current and future requirements and provide them withefficient solutions for switching, protection and startingof motors up to 250kW. The new SIRIUS CT based thermaloverload relay (CT OLR) is designed to provide a reliable andeconomical solution for motor protection from 55A to 500A.Features: Relay width matching with Sirius contactors Straight through transformer variant in Size S6 Overlapping current range Reliable protection in case of overload, phase unbalanceand phase failure
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Vision Statement
The Library through its quality instructional collections, innovative services, and well trained staff directly supports the College's mission to provide a superb educational and research environment for the community of learners at Saint Mary's.
Critical to this vision is a facility capable of providing the learning infrastructure and physical spaces required for higher education in the 21st Century. The Library facility must encompass existing knowledge and new information in a building designed around the nexus of knowledge-based collections, access technologies, and information services.
College libraries have traditionally been viewed symbolically and physically as the heart of the institution. Recognition of its centrality to the educational endeavor at Saint Mary's requires a design that is informed by both the College's traditions and its promise to the future.
In an effort to identify and articulate the key elements that guide our planning efforts, the campus community was invited to participate in a number of sessions focusing on the Library facility project. Common ideas, concerns and themes emerged which will guide the planning efforts from here forward. These efforts are summarized below into thematic categories for the entire campus community to view and respond to.
Project Core Values
Student/learner centered
Spaces to support individuals, collaboration, community
Technology integrated with design
Express St Mary's unique history
Support the integration of the collections
Flexible to allow for growth
Promotes thinking & learning
Image/Message to Community
Invitational & welcoming
Social and intellectual Hub
The campus "Living Room"
Building clearly identifiable as Library
Meeting place for all
Showcase Saint Mary's College
Information center
Campus context
Design integrates with larger campus
Architecture responds to existing campus style
Physically linked to larger campus
Centrally located for access
Integrate outdoor/indoor spaces
Architectural Features
Clear building organization
Entry/Lobby should be comfortable
Warm and inviting
Exhibit/display spaces
Accessible Computer lab
Architecture should inspire sense of discovery
Quality furnishings
Design with acoustics in mind
Strong wayfinding & signage systems
Building Components
Variety of study spaces
Information Commons
Computer access throughout
Wireless access
Book collections
Clearly visible service counters
Special collections/archives
Teaching classroom
Periodicals space
Quality staff space
Comfortable furnishings
Computer lab
Exhibit/display spaces
Increase access to power & data outlets
Locker space for commuting students
Energy efficient building systems
LEEDS standards (not certification)
Use of Daylighting throughout
Natural materials, durable
Efficient HVAC systems
Strong lighting program
May 2008


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Introductory FREE Shipping!
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Package contains 4 Intermediate Strength Iron Boot STRAPS! Iron Boots, bars, and/or weights NOT INCLUDED. Photos are only for demonstration purposes.
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To examine the impact of mode of anesthesia on perceived quality of sleep and to analyze the perceived quality of sleep in affecting recovery from surgery.
A randomized, controlled, open multicenter trial was conducted in 5 hospitals in Southeast Sweden. One-hundred eighty women scheduled for fast-track abdominal hysterectomy for benign conditions were randomized to spinal anesthesia or general anesthesia; 162 women completed the trial; 82 allocated to spinal anesthesia and 80 to general anesthesia. Symptoms and perceived quality of sleep after surgery were registered daily in the Swedish Postoperative Symptoms Questionnaire.
Women in the general anesthesia group experienced bad quality of sleep the night after surgery significantly more often than the women who had spinal anesthesia (odds ratio [OR] 2.45; p = 0.03). This was almost exclusively attributed to a significantly higher consumption of opioids postoperatively in the general anesthesia group. Risk factors for bad quality of sleep during the first night postoperatively were: opioids (OR 1.07; p = 0.03); rescue antiemetics (OR 2.45; p = 0.05); relative weight gain (OR 1.47; p = 0.04); summary score of postoperative symptoms (OR 1.13; p = 0.02); and stress coping capacity (OR 0.98; p = 0.01). A longer hospital stay was strongly associated with a poorer quality of sleep the first night postoperatively (p = 0.002).
The quality of sleep the first night after abdominal hysterectomy is an important factor for recovery. In fast-track abdominal hysterectomy, it seems important to use anesthesia and multimodal analgesia reducing the need for opioids postoperatively and to use strategies that diminish other factors that may interfere negatively with sleep. Efforts to enhance quality of sleep postoperatively by means of preventive measures and treatment of sleep disturbances should be included in fast-track programs.
The study was registered in ClinicalTrial.gov Protocol Registration System (NCT00527332) with initial release September 7 2007.
Kjølhede P; Langström P; Nilsson P; Wodlin NB; Nilsson L. The impact of quality of sleep on recovery from fast-track abdominal hysterectomy. J Clin Sleep Med 2012;8(4):395-402.
The purpose of fast-track programs in surgery is to enhance postoperative recovery.1 Fast-track programs usually involve modalities to optimize preoperative conditions, including the provision of detailed information about the cause of events peri- and postoperatively. In the operative period, the use of regional anesthesia and minimally invasive surgery are advocated. Multimodal pain control, antiemetic prophylaxis, early mobilization, and enteral nutrition are encouraged. Fast-track programs almost unanimously recommend use of opioid-free or opioid-reduced multimodal analgesia postoperatively.1
Current Knowledge/Study Rationale: Surgery may cause significant sleep disturbances that may influence the postoperative recovery. This study sought to evaluate the impact of mode of anesthesia on perceived quality of sleep postoperatively and to analyze the perceived quality of sleep in affecting recovery after abdominal hysterectomy in a fast track program.
Study Impact: Perceived quality of sleep was significantly better after spinal anesthesia mainly due to the significantly lower need of opioids postoperatively. The quality of sleep is an important factor for postoperative recovery and efforts to enhance quality of sleep postoperatively by means of prevention and treatment of sleep disturbances should consistently be included in fast-track programs.
One of the most prevalent postoperative symptoms following hysterectomy is disturbed sleep.2 Postoperative sleep disturbances may affect mood, resulting in decreased vigor and an increase in the subjective feeling of sleepiness and fatigue. Thus, postoperative sleep disturbance may be an important factor for postoperative recovery and consequently an important issue to be considered in programs to enhance postoperative recovery. However, fast-track programs seldom include concepts to improve sleep postoperatively1; it was only recently that Krenk et al. suggested that prophylactic intervention to improve sleep architecture be included in fast-track methodology.3
The impact of surgery and anesthesia on postoperative sleep after hysterectomy in a fast-track setting has not been carefully studied. Surgery has been shown to cause circadian disturbances on several levels, including a disrupted sleep pattern.4–7 A substantial decrease in REM sleep occurs on the first postoperative night,6,7 followed by a profound rebound phenomenon on the second to fourth postoperative night, when REM sleep increases in both intensity and amount.4,6,7 Opioid use, whether acute (as when used postoperatively) or chronic, has been associated with abnormal sleep architecture.8 Gögenur et al. found that the subjective quality of sleeping was significantly worse during the first 4 days postoperatively after abdominal surgery.5 This might indicate that this period is the most important if sleep disturbance is to have an impact on postoperative recovery. Although Rosenberg-Adamsen et al. concluded that general anesthesia per se is not an important factor for sleep disturbance postoperatively when comparing general and regional anesthesia,6 the studies to which they referred used different anesthetic agents. In addition, their studies were not conducted on fast-track programs.
We have previously presented the results of the primary and secondary objectives of an open randomized multicenter study comparing general anesthesia and spinal anesthesia in fast-track abdominal hysterectomy for benign conditions (the "GASPI study") with focus on postoperative recovery.9–11 The trial showed a significantly better outcome for patients given spinal anesthesia, with fewer perceived symptoms postoperatively, faster recovery of quality of life, and shorter sick leave. In addition, the consumption of opioids was significantly lower in the spinal group, almost 5-fold lower on the first postoperative day. Based on these results and applying the philosophy of the fast-track concepts, we hypothesized that women having abdominal hysterectomy for benign conditions conducted in spinal anesthesia perceive the quality of sleep postoperatively as being better than do women who have had a hysterectomy carried out under general anesthesia.
The aims of this secondary post hoc analysis of the GASPI study were to examine the impact of mode of anesthesia on perceived quality of sleep and to analyze the perceived quality of sleep in affecting recovery from surgery.
This open, controlled, randomized multicenter study compared the results of elective abdominal hysterectomy in a fast-track program for benign conditions conducted under general anesthesia with results of operations conducted under spinal anesthesia. Five hospitals in the Southeast of Sweden participated in the trial, which was conducted between March 2007 and December 2009. The study was approved by the Regional Ethical Board in Linköping (registration no. M159-06).
The study has been presented in detail previously.9–11 Inclusion criteria were ASA 1-2 women age 18-60 years with benign gynecological disorders. Exclusion criteria were former or planned concomitant bilateral oophorectomy, postmenopausal women without hormone therapy, gynecological malignancy, morphine allergy, physically disabled, severe psychiatric or mental disorder, and any condition contraindicating regional anesthesia. The patients signed informed consent forms prior to inclusion in the study. One-hundred eighty women were randomized and 162 completed the study; 80 were allocated to general anesthesia and 82 to spinal anesthesia.
The fast-track program is described in Figure 1.
5-HT3, 5-hydroxytryptamine type 3; IV, intravenous; PONV, postoperative nausea and vomiting; PACU, post anesthesia care unit; VAS, visual analogue scale.
Summary of the fast-track program and anesthesia5-HT3, 5-hydroxytryptamine type 3; IV, intravenous; PONV, postoperative nausea and vomiting; PACU, post anesthesia care unit; VAS, visual analogue scale.
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Both modes of anesthesia were standardized. In summary, general anesthesia was based on propofol 1-2 mg/kg given for induction, followed by a maintenance dose of 6-10 mg/kg/h given continuously as intravenous (IV) infusion. The patients were intubated after fentanyl 0.1-0.2 mg and rocuronium 0.6 mg/kg were administered and ventilated with oxygen in air. Rocuronium and fentanyl were repeated during anesthesia when the attending anesthetist saw they were needed. Twenty minutes before completing surgery 5 mg morphine was given IV
The spinal anesthesia was administered using a 25-gauge needle in the L3/L4 or L2/L3 intervertebral space. The anesthetic consisted of 20 mg hyperbaric bupivacaine (5 mg/mL) and 0.2 mg morphine (0.4 mg/mL). Fifteen minutes after administration of anesthesia, the level of the neural blockade was determined with a cold test and registered. The patients were sedated throughout the operation with a continuous IV infusion of propofol 2-5 mg/kg/h. The patient received general anesthesia according to the protocol described above if the spinal anesthesia was insufficient for the surgery.
Modes of skin incision and hysterectomy were decided on by the gynecologist prior to randomization. The hysterectomy was performed as a standard extrafascial hysterectomy according to the principles described by Thompson.12
After surgery, the patient was transferred to the post anesthesia care unit (PACU) for postoperative monitoring of hemodynamic and respiratory stability, degree of sedation, pain, and nausea. When the vital signs were stable and the patient was awake, she was discharged from PACU to the gynecological ward where the monitoring was continued. Provided that measures were within clinically normal limits, the monitoring was registered once every hour for 12 h, then once every third hour until 24 h after surgery. The monitoring was identical after both modes of anesthesia. Mobilization was initiated in PACU and actively encouraged in the ward. Similarly, eating and drinking were recommended as soon as possible after surgery. The patient was discharged from the hospital when the standardized criteria for discharge were obtained (Figure 1).
Clinical data including data on complications were collected continuously during hospital stay and at the follow-up visit 5 weeks postoperatively. Duration of hospital stay was defined as the time from start of anesthesia to the time the patient left the hospital.
Postoperative symptoms were assessed by the Swedish Postoperative Symptoms Questionnaire (SPSQ).10,13 The patient completed the form on a daily basis, preferably in the evening during the first 7 days postoperatively, starting in the evening after surgery (day 0) and thereafter once weekly until the 5-week postoperative visit. The questions were both open-ended and closed-ended. The closed-ended questions could be answered by choosing an answer from a set given on a Likert-type scale. The open-ended questions required written responses. The patient was initially asked if she at the moment of completing the form experienced a number of symptoms commonly reported after surgery (pain in the area of surgery, nausea, retching, headache, abdominal pain, tiredness, drowsiness, and blurred vision) and how she rated the intensity of each of these symptoms. The answers were rated on a 4-point scale: "none" (0), "yes, a little" (1), "yes, somewhat" (2), and "yes, a lot" (3). To estimate overall discomfort from the symptoms at the moment of completing the form, a sum score was calculated. The minimum sum score was zero and maximum 24. The higher the sum score, the greater the discomfort experienced. In order to obtain information about the quality of sleep postoperatively, we added the question in the SPSQ: How did you sleep during the recent night? The options for the answers were: "Excellent," "Neither well nor badly," and "Badly."
The capacity to cope with stress was measured approximately 1 week preoperatively by the Stress Coping Inventory (SCI).14,15 The respondent rates how often she thinks she is able to cope with each of the 41 stressful situations described in the SCI form.15 The answers are rated on a 6-point Likert-type scale, ranging from "almost never" (1), "rarely" (2), "occasionally" (3), "rather often" (4), "very often" (5) to "almost always" (6). The minimum sum score is 41 and the maximum 246. The higher the SCI sum score, the greater the stress coping capacity. The SCI sum score was first calculated after termination of the study and thus blinded for the participant, staff, and investigators during the study period.
At discharge from the hospital the patient was granted sick leave for 14 days. The research nurse contacted the patient by telephone the day after discharge and then once weekly until the visit 5 weeks postoperatively. At these contacts, the sick leave was prolonged by ≤ 7 days at a time until the patient considered she was able to return to work or felt sufficiently recovered. Duration of sick leave was defined as the time from the day of surgery to the day of return to work to the same extent as preoperatively. Women, who were on sick leave for reasons other than the hysterectomy, were unemployed, or had disability pension were excluded from the analysis of sick leave.
Power calculation and estimation of sample size were based on the primary outcome measure of the trial, duration of hospital stay, and have previously been described.9 No power calculations were done a priori for the secondary outcomes. The analyses were conducted according to the intention-to-treat principles.
Data are presented as mean and one standard deviation (SD) or as number and frequency (%). Univariate analyses were conducted by means of nonparametric tests (Mann-Whitney U-test and Yates corrected χ2 test, as appropriate). Level of significance was set at 5%.
Factors associated with the perceived quality of sleep were analyzed by means of multiple logistic regression models. Adjustments were carried out simultaneously for factors known to be confounding factors of sleep disorders6: age, BMI, mode of hysterectomy (surgical stress, i.e., extent of surgery), stay in PACU after midnight for monitoring, interval of monitoring of vital signs, and SCI sum scores. Subsequently, other factors were added one by one separately as potential confounders in order to analyze whether they were independent risk factors for perceived bad quality of sleep. Results are reported as odds ratio (OR) and 95% confidence interval (CI).
Analysis of covariance (ANCOVA) models were used to investigate associations between outcome measures and perceived quality of sleep the first night after surgery. For the analysis of association between duration of hospital stay and quality of sleep, adjustments were performed simultaneously for the confounders depicted above and for the SPSQ sum score and the occurrence of complications during hospital stay. For the analysis of duration of sick leave, complications occurring perioperatively and during a 5-week period postoperatively were added as independent factors, as was the physical work load. Subsequent post hoc analyses were done with Fisher protected least significant difference (PLSD).
Data were processed in the software StatView for Windows, Version 5.0.1 (SAS Institute Inc., SAS Campus Drive, Cary, NC, USA).
Demographic and descriptive data are presented in Table 1. The preoperative data were well balanced between the 2 groups, showing that the randomization process worked well. The clinical data and the outcome measures shown in Table 2 differed significantly in many aspects, often in favor of the SA group.
Demographic and descriptive data
Clinical data and outcome measures
The self-reported perceived quality of sleep for the first 5 nights postoperatively is presented in Table 3. Significantly more women in the GA group reported that they slept badly the first night after surgery compared with women who had the operation in SA. This difference was almost exclusively attributed to the amount of opioids given postoperatively until the next morning. When adjusted for the amount of opioids, there was no statistical difference in the proportion of women who reported that they slept badly the first night between the GA and SA groups (OR 0.84; 95% CI 0.25-2.89; p = 0.79). The amount of opioids given postoperatively was an independent risk factor for experiencing bad quality of sleep the first night postoperatively (OR 1.07; 95% CI 1.01-1.14; p = 0.03). However, the statistically significant difference in quality of sleep between the 2 groups remained when adjustments were made for the fentanyl given perioperatively. In addition, fentanyl seemed to be an independent if weak protective factor for good quality of sleep (OR 0.02; 95% CI 0.00-0.90; p = 0.04). The use of a rescue antiemetic was also an independent risk factor for bad quality of sleep even when adjusted for the use of opioids (OR 2.45; 95% CI 1.02-5.92; p = 0.05). Similarly, relative body weight gain on day 0 was a risk factor for bad quality of sleep in the night after surgery (OR 1.47; 95% CI 1.02-2.10; p = 0.04).
Self-reported quality of sleep night 1-5 after fast-track abdominal hysterectomy in relation to mode of anesthesia
The SPSQ symptom sum scores measured day-by-day for the first 5 days postoperatively were concurrently statistically significantly associated with bad quality of sleep, even when adjusted for daily use of opioids. (OR Day 0 1.13; 95% CI 1.02-1.24; p = 0.02. OR Day 1 1.18; 95% CI 1.04-1.35; p = 0.01. OR Day 2 1.23; 95% CI 1.10-1.49; p = 0.001. OR Day 3 1.44; 95% CI 1.17-1.77; p = 0.0005. OR Day 4 1.57; 95% CI 1.23-2.00; p = 0.0003.)
None of the following variables were significantly associated with the quality of sleep the first night after surgery (data not shown): propofol, rocuronium, phenylephrine, administration of anesthesia that differed from the anesthesia specified in the protocol due to an initial effect insufficient for surgery, use of anti-pruritus medication, operating and anesthesia time, time in PACU, and intravenously given fluid perioperatively.
Of the confounding factors used in the multivariate models, only the SCI sum score was found to be an independent risk factor for occurrence of sleep of bad quality (OR 0.98; 95% CI 0.96-0.99; p = 0.01).
The ANCOVA models revealed that the quality of sleep the first night was strongly associated with duration of hospital stay (F2,157 = 6.695; p = 0.002) (Figure 2). Excellent quality of sleep was associated with a significantly shorter stay in hospital (42 ± 16 h) compared with 54 ± 10 h for those who perceived bad quality of the sleep. No such association was observed concerning duration of sick leave (F2,143 = 1.667; p = 0.19). The p-values of the Fisher PLSD post hoc tests are shown in Figure 2.
Boxes represent mean and error bars represent SD; p-values represent results of Fisher PLSD post hoc tests.
Associations between the quality of sleep the night after surgery and duration of hospital stay and sick leaveBoxes represent mean and error bars represent SD; p-values represent results of Fisher PLSD post hoc tests.
The study demonstrated that sleep the first night postoperatively is an important quality to be given careful consideration even in fast-track program, as it affects the postoperative recovery substantially. Abdominal hysterectomy under spinal anesthesia offered significantly better quality of sleep than did general anesthesia, which led to a significantly shorter stay in the hospital. However, this effect was almost exclusively attributed to a significantly lower consumption of opioids postoperatively in the spinal anesthesia group. As shown in this study, quality of sleep after surgery is a feature that influences the recovery. Many factors, some of which can be treated or interfered with, seem to be associated with this phenomenon in fast-track abdominal hysterectomy.
There are some methodological concerns in this study. The study was not powered to detect differences in secondary outcome measures, and the study should therefore be seen as exploratory and hypothesis generating. There is a lack of baseline information about quality of sleep, and thus no adjustment has been made for this obvious potential confounder.6 However, the study was randomized and the allocation showed even distribution between the two groups for all other investigated preoperative variables, including psychological and quality of life measurements.11 We therefore find it less likely that baseline quality of sleep would be unevenly distributed between the two groups. The quality of sleep was determined by posing a simple question that could be answered by choosing an answer from a set of three options given on a Likert-type scale. This might be considered as a crude method and may lack the properties needed to detect possible subtle differences. However, other authors have used a simple visual analogue scale for the purpose of measuring the quality of sleep.5,16–18
Several factors contribute to disturbed sleep postoperatively.6 Use of opioids has been shown to change sleep architecture substantially in healthy subjects.19 This coheres with our findings that the amount of opioids given postoperatively was an independent risk factor for bad quality of sleep. Interestingly, we found that fentanyl improved quality of sleep. Fentanyl is a short-acting opioid and was given exclusively during surgery. Mustola et al. have recently shown that fentanyl given during general anesthesia reduces the surgical stress response.20 The injury caused by surgery provokes a complex stress response involving release of stress hormones, humoral mediators of the endocrine and metabolic system, and activation of the immune system.6 All these factors may influence sleep architecture adversely. Thus by reducing the stress response, fentanyl may consequently improve sleep architecture and quality of sleep. The relative body weight gain the first day after surgery was an independent risk factor for bad quality of sleep in the present study. Since we found no association between sleep and the volume of the IV fluid given perioperatively, the relative body weight gain may be an effect of increased release of stress hormones and inflammatory processes and thus may represent an increased stress response.
We found that quality of sleep in the first night postoperatively was associated with the length of hospital stay. This is to our knowledge the first report to show such a clinically important association. The standardized criteria for discharge were emphasized in the fast-track program. In the analysis, we adjusted for several confounders that might influence the hospital stay or quality of sleep. Still, we found a significantly longer stay in hospital for the group who perceived having had a bad quality of sleep the first night after surgery. This indicates that the quality of sleep is an important factor for postoperative recovery.
Our results seem to support the conclusion stated by Rosenberg-Adamsen et al.6 that mode of anesthesia—spinal or general anesthesia—per se does not influence the quality of sleep postoperatively. An anesthetic technique that gives good and prolonged analgetic effect with minimum use of opioids postoperatively should be chosen in fast-track programs. It is a common clinical impression that symptoms such as pain21 and postoperative nausea and vomiting (PONV) causes disturbed night sleep. Use of opioids and rescue antiemetics may be regarded as surrogate measures of pain and PONV. However, the drugs themselves may interfere with sleep, so it may be difficult to ascertain whether it is the symptom or the drug that affects the sleep. We found that postoperative symptoms in terms of the SPSQ symptom sum score, irrespective of treatment of symptoms, was a strong risk factor for bad quality of sleep the five first nights postoperatively. This is an important finding, indicating that fast-track programs should include the use of modalities designed to decrease troublesome postoperative symptoms in order to positively affect and maintain sleep of good quality.
In conclusion, the quality of sleep the first night after elective abdominal hysterectomy is an important factor for the recovery. In fast-track it seems important to use anesthesia and multimodal analgesia that reduce the need of opioids postoperatively and use strategies that diminish other factors that may interfere negatively with sleep. Efforts to enhance quality of sleep postoperatively by means of prevention and treatment of sleep disturbances should be included in fast-track programs. Further studies are needed.
This was not an industry supported study. The authors have indicated no financial conflicts of interest.
analysis of covariance
American Society of Anesthesiologist classification of physical status
body mass index
confidence interval
5-hydroxytryptamine type 3
general anesthesia
odds ratio
post anesthesia care unit
protected least significant difference
postoperative nausea and vomiting
spinal anesthesia with intrathecal morphine
Stress Coping Inventory
standard deviation
Swedish Postoperative Symptom Questionnaire
Visual Analogue Scale
The study was financially supported by grants from the Medical Research Council of South East Sweden; Linköping University and the County Council of Östergötland.
Kehlet H, Wilmore DW, authors. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183:630–41. [PubMed]
Kim KH, Lee KA, authors. Sleep and fatigue symptoms in women before and 6 weeks after hysterectomy. J Obstet Gynecol Neonatal Nurs. 2009;38:344–52. [PubMed]
Krenk L, Rasmussen LS, Kehlet H, authors. New insights into the pathophysiology of postoperative cognitive dysfunction. Acta Anaesthesiol Scand. 2010;54:951–6. [PubMed]
Gögenur I, Wildschiotz G, Rosenberg J, authors. Circadian distribution of sleep phases after major abdominal surgery. Br J Anaesth. 2008;100:45–9. [PubMed]
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Rosenberg-Adamsen S, Kehlet H, Dodds C, Rosenberg J, authors. Postoperative sleep disturbances: mechanisms and clinical implications. Br J Anaesth. 1996;76:552–9. [PubMed]
Rosenberg J, author. Sleep disturbances after non-cardiac surgery. Sleep Med Rev. 2001;5:129–37. [PubMed]
Wang D, Teichtahl H, authors. Opioids, sleep architecture and sleep-disordered breathing. Sleep Med Rev. 2007;11:35–46. [PubMed]
Borendal Wodlin N, Nilsson L, Kjølhede P, authors; for the GASPI study group. The impact of mode of anaesthesia on postoperative recovery from fast-track abdominal hysterectomy: a randomised clinical trial. BJOG. 2011;118:299–308. [PubMed]
Borendal Wodlin N, Nilsson L, Årestedt K, Kjølhede P, authors; for the GASPI study group. Mode of anesthesia and postoperative symptoms following abdominal hysterectomy in a fast-track setting. Acta Obstet Gynecol Scand. 2011;90:369–79. [PubMed]
Borendal Wodlin N, Nilsson L, Kjølhede P, authors. Health-related quality of life and postoperative recovery in fast track hysterectomy. Acta Obstet Gynecol Scand. 2011;90:362–8. [PubMed]
Thompson JD, author; Thompson JD, Rock JA, editors. Hysterectomy. Te Lindeés Operative Gynecology. 1992. 7th edition. Philadelphia: JB Lippincott Company; p. 687–706
Alkaissi A, Gunnarsson H, Johnsson V, Evertsson K, Ofenbartl L, Kalman S, authors. Disturbing post-operative symptoms are not reduced by prophylactic antiemetic treatment in patients at high risk of post-operative nausea and vomiting. Acta Anaesthesiol Scand. 2004;48:761–71. [PubMed]
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Persson P, author. On the mode of hysterectomy-with emphasis on recovery and well-being. Linköping University Medical Dissertations no. 1104. 2009;ISBN 978-91-7393-687-3.
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Gögenur I, Middleton B, Burgdorf S, Rasmussen LS, Skene DJ, Rosenberg J, authors. Impact of sleep and circadian disturbances in urinary 6-sulphatoxymelatonin levels, on cognitive function after major surgery. J Pineal Res. 2007;43:179–84. [PubMed]
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Mustola S, Parkkari T, Uutela K, Huiku M, Kymäläinen M, Toivonen J, authors. Performance of surgical stress index during sevoflurane-fentanyl and isoflurane-fentanyl anesthesia. Anesthesiol Res Pract. 2010;2010.pii:810721
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PuzzlingLogic Grid puzzles come with a handy interactive grid that will help you solve the puzzle based on the given clues.
Five people were solving their favorite type of puzzle on a website. From the clues below, determine the name of the person, their screen name, what puzzle they solved, and how long it took to solve it.
1- Michael's wordsearch took eight minutes longer to complete than person who screen name is whsprec.
2- Keith's screen name is Genius1.
3- It took usernameplease 6 minutes to solve their problem, which was not a logic grid.
4- Jennifer took four minutes longer on her puzzle than Brittany did on hers, which was not sudoku.
5- The person who solved a letter-equation was named PeaceAll, and did not take 18 minutes.
6- It was the cryptography puzzle which took 14 minutes to complete.
AnswerMark, screen name whsprec, did the logic grid in 10 minutes
Brittany , screen name PeaceAll, did the letter-equation in 2 minutes
Jennifer, screen name usernameplease, did sudoku in 6 minutes
Michael, screen name Dragon Master, did the wordsearch in 18 minutes
Keith, screen name Genius1, did the cryptography in 14 minutes.
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Men's Golf Concludes Fall Season at The Ocean Course
Oct. 26, 2013
LEXINGTON, Ky. – With three top-five finishes under its belt already through three tournaments, the University of Kentucky men's golf team will look to make it four-of-four when the Wildcats compete in the Invitational at The Ocean Course on Kiawah Island, S.C., Oct. 27-29.
The Ocean Course at Kiawah Island Golf Resort has played host to the 2007 Senior PGA and 2012 PGA Championships and is only the fourth course to host each of the PGA of America's major championships. Probably no other golf course in the world outside of the United Kingdom and Ireland is affected as much by the wind. Located on the eastern-most end of Kiawah Island, The Ocean Course has more seaside holes than any other course in the Northern Hemisphere.
"The chance to compete on The Ocean Course will be a great test for our guys," said Kentucky head coach Brian Craig. "This is the type of championship course that will help a young player improve and I am looking forward to see how we handle the challenge. Our biggest goal this week is to show that we can play three solid tournament rounds. We have shown that our good rounds are quite good but need to improve on our consistency overall. The key will be to focus on what we can control: strategy, emotional control, attitude, etc., which in turn will bring about more consistency."
The Wildcats have notched three top-five finishes in their first three tournaments of the season. Kentucky placed fifth in the season-opening tournament at the Northern Intercollegiate, third at the Wolf Run Invitational and fifth at the AutoTrader.com Collegiate Classic. UK has placed at least one individual in the top 10 in each of the first three tournaments.
The last time out for UK was at the AutoTrader.com Collegiate Classic where the Wildcats shot a final round score of 275, which ranks in a tie for the second-best team round under Craig. Senior Ben Stow led the way finishing tied for second at seven-under par. Stow's final round of seven-under par, 65, ranked in a tie for second as the best individual round in the Craig era.
Kentucky's lineup on Kiawah Island will be led by Stow, David Snyder, Stephen Powers, Cody Martin and Stephen Stallings. Harrison Greenberry will compete as an individual. Stallings, a freshman from Louisville, Ky., is making his first appearance in a collegiate tournament.
The course is a par-72 (36-36) layout with a total distance of 7,051 yards. The 54-hole stroke-play tournament will begin on Sunday at 7:50 a.m. with the first round of 18 holes. The second round continues Monday at 7:50 a.m. and concludes Tuesday with a shotgun start at 8 a.m. All times are Eastern.
Kentucky is one of 14 teams in the field featuring: No. 5 Georgia, No. 29 South Florida, No. 40 Florida, Charleston Southern, College of Charleston, Francis Marion, Georgia Southern, Michigan, Michigan State, Notre Dame, Rice, South Alabama and Western Carolina.
Fans can follow the action with live scoring available at Golfstat.com. For more information on the University of Kentucky men's golf team visit UKathletics.com and follow on Twitter at @UKmensgolf. The Wildcats begin spring competition at the Mobile Bay Intercollegiate in Mobile, Ala., from Feb. 17-18.
The Ocean Course
Kiawah Island, S.C. Oct. 27-29
Par: 72 (36-36)
Yardage: 7,051
UK Lineup:
1. Ben Stow
2. David Snyder
3. Stephen Powers
4. Cody Martin
5. Stephen Stallings
Individual: Harrison Greenberry


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Topic: Nanoknife Video and Information
Hi, everyone,
http://online.wsj.com/article/SB1000142 … 46848.html
Pros and cons about nanoknife.
Also, please click on the video folder at the top of the article to see how it works.
Quoted from the manufacturer from its web site.
"The NanoKnife System has received FDA clearance for the surgical ablation of soft tissue. It has not received clearance for the therapy or treatment of any specific disease or condition." [510(k) Number: K080376]
God bless.


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im Lauderdale Holds Benefit Concert for Flat Rock Playhouse, 12/6
Grammy-winning artist, Jim Lauderdale will appear in a special fundraising concert for Flat Rock Playhouse on Thursday, December 6, 2012 at Bonclarken Conference Center in the Youth Activity Building at 7:00 pm. An Evening with Jim Lauderdale, sponsored by Howard George and Noah George of Keller Williams Realty, is part of the "Save The Playhouse" campaign.
Having opened for such diverse artists as Johnny Cash and George Clinton, An Evening with Jim Lauderdale is sure to appeal to music lovers of many varieties. Jim Lauderdale is predictably unpredictable, surprising and satisfying. Neela Munoz, Flat Rock Playhouse director and actor will serve as host for the evening.
Jim Lauderdale is a multi-talented performer and songwriter, with successes in both country and bluegrass music. His roots stem from the Carolinas, yet his career has taken him all over the United States and abroad, making him an international recording artist with an ever-growing fan base. Jim won both Artist of the Year and Song of the Year at the first "Honors and Awards Show" held by the Americana Music Association in 2002. Subsequently, he has hosted this same show for the last seven years.
Lauderdale is no stranger to Flat Rock or to The Playhouse, having spent summers at his parents' Bonclarken home. During these summers, he worked at Flat Rock Playhouse with Leona Farquhar, wife of founder, Robroy Farquhar. The creative atmosphere of The Playhouse helped to fuel his interest in the performing arts. Lauderdale performed the role of George Jones in in the 2001 World Premiere of Stand By Your Man: The Tammy Wynette, co-produced by Flat Rock Playhouse and the Ryman Auditorium in Nashville, Tennessee.
Lauderdale is among Nashville's "A" list of songwriters, with songs recorded by artists such as: Patty Loveless, George Jones, The Dixie Chicks, Solomon Burke, Mark Chesnutt, Dave Edmunds, John Mayall, Kathy Mattea, Lee Ann Womack, Gary Allan, Blake Shelton, Vince Gill and George Strait. He also contributed several songs to the successful soundtrack of the George Strait film, "Pure Country." Not content to just write hits for the stars, he's toured with the likes of Lucinda Williams, Mary Chapin Carpenter, Rhonda Vincent and Elvis Costello, among others.
Jim Lauderdale has always had that ability of writing music that reflects his originality as well as a sense of total authenticity. His musical influences include the legendary Dr. Ralph Stanley and George Jones. These influences and his unique sense of melody and lyric have helped to forge a sound that is truly his own. Lauderdale is a two-time Grammy winner, having won his first in 2002 with Dr. Ralph Stanley for "Lost in the
Lonesome Pines." His second Grammy was awarded at the 50th Grammy Awards for his second solo bluegrass album, "The Bluegrass Diaries." Lauderdale received Grammy nominations for his first CD with Dr. Stanley, "I Feel Like Singing Today" as well as for his first solo bluegrass CD "Bluegrass." His current release, "Patchwork River" (his second collaboration with Grateful Dead lyricist, Robert Hunter) is currently on the Americana radio charts.
Howard George and Noah George of Keller Williams Realty present An Evening with Jim Lauderdale, onstage Thursday, December 6 at 7:30 pm. The gates open at 6:00 pm the doors open at 7:00 pm. General admission tickets are $25. Tickets can be purchased; by calling The Playhouse box office at 828-693-0731 or toll-free at 866-732-8008. All proceeds from the concert will benefit the "Save The Playhouse" fundraising campaign.


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Quote:Ok thats your problem solve it by thinking this way, one of the reason for Co-ed classes is for women to learn how to deal with men. So in order to help her you have to start making light contact. Start by telgraphy to help her, show the fist or kick you gonna strike with (wiggle it) or (raise it) kick or strike moderately fast as she learns to block it throw it harder and harder. So she work this into single counter then combinations. Do this offensively and defensively trying to hit her but pulling back some. She needs to learn to use her foot work and her blocks to defend, take offensive and counter.When she is attacking you tell her faster and harder push her to train harder to deal with a mans strengths so she can learn how to counter or attack within it. You can't play with her thinking she can't do it, she wouldn't have that rank if she didn't have the bsic skills, maybe not yet but with your help she can get it.Some women that spar men often tear thru their division until they meet another female tiger. Make her a tiger instead of a kitty Cat. So you see its not all about you is It.Women can give some pretty weird fakes and fients that can throw a skilled fighter off, some can hit pretty hard and have really good combinations, thats where we want to take her. Good luck, when she is gets better you will have to get better.
Quote:Stop fighting women you will have plenty of time for that hn you get married
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Crescent II Gas Fireplace with Essence front in bronze
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Denver, CO (SportsNetwork.com) - Colorado Rockies pitcher Franklin Morales will not make his scheduled start Friday against the Cincinnati Reds due to the pending birth of his child.
The Rockies announced that Matt Belisle will pitch in Morales' place. The start will be the veteran right-hander's first since May 25, 2008, when he faced San Diego while then a member of the Reds.
Belisle, who is 3-6 with a 4.93 ERA in 54 relief outings this season, has made all but 43 of his 512 career appearances out of the bullpen. Over six seasons with the Rockies, all 380 of his games pitched have come in relief.
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Klein, Malone to Play in East-West Shrine Game
Klein, Malone to Play in East-West Shrine Game
Jan. 8, 2013
MANHATTAN, Kan. – Kansas State quarterback Collin Klein and defensive back Nigel Malone have been selected to play in the 88th East-West Shrine Game, the organization announced Tuesday.
The selections mark the 48th and 49th in school history for the annual game, which will be held this year on January 19, at Tropicana Field in St. Petersburg, Fla., beginning at 3 p.m. (CT) on NFL Network. Kansas State players have earned 30 East-West Shrine Game selections since 1993, including current NFL players Jeromey Clary (2005), Jeron Mastrud (2009) and Tysyn Hartman (2011).
The 2012 Big 12 Offensive Player of the Year and a Heisman Trophy finalist, Klein finished his K-State career with a 22-6 record as a starting quarterback to tie the school record. He led the Wildcats to their third conference championship in school history and the first since 2003 as Kansas State finished the regular season 11-1 overall and 8-1 in Big 12 play. Klein finished out his senior campaign with 920 rushing yards and 23 touchdowns, a mark that is second in school history to his 27 scores in 2011. He also greatly improved his passing as he went 197-of-304 for 2,641 yards and 16 touchdowns and finished with the second-best completion percentage in school history at 64.8.
Malone is a two-time semifinalist for the Jim Thorpe Award as the nation's top defensive back and two-time First Team All-Big 12 performer. He tied for team-high honors with five interceptions a year after finishing second in school history with seven picks in 2011. The Manteca, Calif., product also broke up nine other passes and was one of eight players with 50 or more tackles this season as he finished with 51.
Klein and Malone are the third and fourth Wildcats to earn invitations to postseason all-star games this year as linebacker Arthur Brown and wide receiver Chris Harper will play in the Senior Bowl (January 26, 3 p.m., NFL Network).
The participating players in the East-West Shrine Game come together for the beneficiary of the event, Shriners Hospitals for Children, an international pediatric specialty health care system.


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"Barbecued" Tofu
For genuine BBQ flavor, couple this spicy tofu with crunchy slaw and serve as a sandwich or wrapped in a large leaf of lettuce with sliced tomato and red onion.
- Prep:
- Total Time:
- Servings: 4
Photography: Sang An
Source: Body+Soul, June 2006
- 1 package (14 ounces) regular tofu, firm or extra-firm, drained
- 1/2 cup barbecue sauce
- 1 tablespoon pure chile powder
- Cooking spray
- 4 rolls, split (optional)
Cut tofu cake horizontally (slicing parallel to work surface) into 4 rectangles and press.
Cover the bottom of a small pan with half of barbecue sauce. One by one, rub both sides of each tofu rectangle with chile powder; place in a single layer on sauce. Top with remaining sauce. Let stand for 30 minutes.
Preheat broiler with rack 6 inches from heat. Line a baking sheet with aluminum foil; place a baking rack on top. Spray rack with cooking spray. Take tofu slabs out of the barbecue sauce and place on rack with space between pieces. Reserve leftover barbecue sauce. Broil until top of tofu is browned and bubbly, about 5 minutes.
Turn tofu over and brush with reserved sauce. Broil until browned and bubbly, about 5 more minutes. Serve hot or at room temperature, on bread with coleslaw if desired.


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Toby Carvery Ainsdale
537 Liverpool Road, Sefton, Southport, Merseyside, PR8 3BJ
537 Liverpool Road, Sefton, Southport, Merseyside, PR8 3BJ
We pride ourselves on bringing families together and there's no better way to do this than gathering around a table and enjoying good food. We've made it easier than ever this May as kids can eat for just £1 each!
Come and try our fantastic new menu and watch as the kids enjoy the best food at the very best value.
As an extra treat we are now extending our offer to include the bank holiday weekend. Extra chances for you and your little ones to enjoy a roast together.
If you haven't already, sign up to our mailing list to claim your voucher for this offer.
Terms and Conditions: Upon presentation of a voucher, guests will be able to purchase children's main meals for £1. This will allow up to 2 children per party to have a main meal for £1 per full paying adult. This does not include drinks and cannot be used at Breakfast. Valid to redeem Monday - Saturday only exc Bank Holidays until 9th September.


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studio near center cose to metro station
N.º máximo de huéspedes2
Cuartos de baño1
Tamaño30 m²
- Cocina
- Aparcamiento disponible
- Internet/WiFi
Resumen del alojamiento
|baccio bandinelli, 50142 Florence, Italia
|Tipo de propiedad
|Código de referencia
|Tasa de aceptación
|Tiempo de respuesta
|En pocas horas
|Calendario actualizado
Being on the ground floor, you will usefully not have to carry your suitcases up numerous flights steps as in many other apartments in the center of Florence! There is a master bedroom, a kitchenette, a TV, and heating. There is paying parking in our or the adjacent streets.
The tariffs are from Monday to Saturday between 08:00-20:00 at a cost of 1€ per hour with a maximum tariff of 12€ per day.
The largest park in Florence, Cascine Park, is some 2 minutes walk away and reached by simply crossing the River Arno. Anyone who loves sports can take long walks, go jogging or rent a bike. Additionally, on Tuesday mornings there is a produce market. Close to the apartment there is a bar, a newspaper stand, a take-away pizza place, a Chinese and other restaurants, a rotisserie and a useful grocery store.
It is close to both bus and tram stop named PAOLO UCCELLO (50 metres or 164 feet away). The trams pass every 4 minutes (from 0500 to 0030). The tram takes 5-6 minutes to reach either the Central Station or Duomo tram-stops. If you choose to walk, it is a 15-20 minute easy stroll along the River Arno River, where there are stunning views of Florence. Thanks to the convenient location it is also possible to take day-trips and easily reach the Florentine countryside and other beautiful places such as Fiesole, Saint Gimignano, Greve, Montecatini and Siena.
As we are on the left-bank of the River Arno, there are far fewer tourists and many more Florentines, so if you want to really discover the true Florence, come and stay in my gorgeous apartment!
Normas del alojamientowe ask you to contact us before making the Reservation, we are glad to exchange a few words and get to know our future guests, and we are available to provide information and advice on florence.
This house is No smoking.
Please respect the peace of the palace in the evening.
After booking you the data will be required to complete the rental agreement, required by law, all guests must be identified as at the hotel on arrival through their documents.
Florence City Council requires the payment of the tourist tax, € 2.50 per person per night (up to max 7 nights) to be paid in cash at check-in, it is not possible at the time the payment through the site.
There are the following exemptions:
a) children up to twelve years old ;
b) people who care for patients admitted to local hospitals, including outpatient care, for a maximum of two assistants per patient;
c) patients who make hospital care in outpatient care;
d) students of the University of Florence
The Flat is equipped with energy performance certificate - Class F IPE 223.901 kWh / m2 year
|Precio semanal para hasta 2 huéspedes
|350 €
|N.º máximo de noches
|4 meses
|Entrada a partir de las
|Entrada antes de las
|Bajo acuerdo
|Salida antes de las
|Política de cancelación
Claudio ist ein sehr aufmerksamer Vermieter und gibt schon vor der Anreise viele Tipps und Anregungen! Während des Aufenthalts ist er hilfsbereit und immer zu erreichen. Die Wohnung liegt gut und ruhig und man kann dort wunderbar nach Kunst und Kultur entspannen, sie ist gut ausgestattet und gemütlich. Wir kommen gerne wieder?
Tutto davvero perfetto. Claudio molto gentile e simpatico e devo dire molto disponibile ad aiutarci con consigli e indicazioni!
L'appartamento è davvero bello, e davvero comodo.
Consigliato sicuramente!
Very nice support from the owner before and during stay. A lot of touristic infos is also offered in the studio. Nice quiet apartment, in a semi-basement, so the view is very limited which surprised us at first. But for a short stay, it was not too bad. In May, it was humid but we used the dehumidifier during all our stay, which helped a lot.
The best thing about the location is the tram at 50 meters. It makes it very easy to connect with the train station and the center is then quite easy to walk.Grocery is little far by foot so it is better to buy the grocery in town or take the tram. Nothing special to do in the area but the centre is near by tram or bus. Or by foot for good walkers.
Muy bonito estudio cerca del centro y fresca en el verano caliente. Perfecto!
Really nice studio close to the center and fresh on hot summer. Perfect !
- Alojamiento de calidad asegurada
- Verificamos telefónicamente a cada anfitrión
- Pago seguro a través de cifrado SSL


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Mashed Potatoes 'n' Brussels Sprouts Recipe
5 3 3
Tired of eating the same old mashed white potatoes? Try this tasty recipe. These potatoes are fluffy and delicious.
Recommended: 20 Ways to Cook with Cauliflower
VERIFIED BY Taste of Home Test Kitchen
- 3 pounds potatoes (about 9 medium), peeled and quartered
- 2 cups fresh or frozen brussels sprouts
- 2 garlic cloves, peeled
- 1/2 cup half-and-half cream
- 2 tablespoons butter
- 2 teaspoons chicken bouillon granules
- 1 teaspoon salt
- 1/4 teaspoon dried basil
- 1/8 teaspoon pepper
- Place potatoes in a large saucepan and cover with water. Bring to a boil. Reduce heat; cover and cook for 15-20 minutes or until tender.
- Meanwhile, place 1/2 in. of water and brussels sprouts in a small saucepan; bring to a boil. Reduce heat; cover and cook for 5 minutes. Add garlic; cook 3-5 minutes longer or until tender.
- Drain potatoes, sprouts and garlic; cool slightly. Place in a food processor; cover and process for 1-2 minutes. Add the remaining ingredients; cover and process just until blended. Transfer to a serving bowl. Yield: 6-8 servings.
Originally published as Mashed Potatoes 'n' Brussels Sprouts in Country Extra January 2008, p49
Reviews forMashed Potatoes 'n' Brussels Sprouts
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Reviewed Nov. 22, 2010
"A-maaaazzzing!!! Never had brussel sprouts before, so I gave this recipe a try. Hands down best mashed potatoes Ive ever had. And I'm not exactly the best cook. Yay me! yay recipe! MMmmmgood! Swear ; )"
Reviewed Oct. 4, 2010
"I LOVE THIS DISH!!!! I have made it twice. I love brussels, but my husband and daughter HATE them. This is a great way to incorporate veggies in to their diet without them really knowing or tasting them. So yummy! love love love this one!"
Reviewed Oct. 31, 2009
"This was my "experimental" holiday dish last Thanksgiving and this year my daughter asked for it again. It was great. The recipe can also be adapted for soup too."


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FIND Channel 4's Chatty Man in talkative mood when he presents an intimate work-in-progress show.
Alan Carr will appear at the Evesham Arts Centre on Sunday, July 13 to try out new material for a forthcoming tour in a show lasting about 90 minutes and including a special guest appearance.
Tickets are not on sale yet and they will be available to buy face-to-face or over the phone from the Evesham Almonry, Abbey Road, on a first-come, first-served basis, and there are no plans to sell them online or at the arts centre.
Full details of when and how tickets will go on sale will be emailed to people on the arts centre's 'What's On' and 'Comedy' mailing lists three days before the tickets are released.
A spokesman for the arts centre said: "We expect this show to sell out very quickly. We ask everyone to remember that the arts centre has modest ticket-booking facilities and only 312 seats.
"Please be patient with our box office volunteers. Please understand that not everyone who wants to see Alan Carr in Evesham will be able to."
The show starts at 8pm and tickets are £17, with a limit of four per person.
For more information and tickets, go to eveshamartscentre.co.uk or call the Evesham Almonry on 01386 446944.