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October 9, 2000
Locked in a Dead Heat, Both Sides Drop Civility
By RICHARD PÉREZ-PEŃA
nswering Republican assaults on Vice President Al Gore, Senator Joseph I. Lieberman yesterday accused his rivals of "nasty personal attacks," described Dick Cheney as an "attack dog" and even questioned Gov. George W. Bush's own veracity.
It was a day when, in the round of Sunday talk shows, both camps became nasty and personal as the campaign reached a new level of incivility heading into the final four weeks, with polls showing Mr. Gore and Mr. Bush running neck and neck.
On CNN's "Late Edition," Mr. Lieberman drew a contrast between the cordial tone of his debate on Thursday with Mr. Cheney, the former defense secretary, and Mr. Cheney's remarks the next day, when he called Mr. Gore's proposals "hogwash" and "double talk."
"I don't know who that Dick Cheney was at the debate on Thursday night," Mr. Lieberman said. "He was a rational, civil man and he goes back out and becomes an attack dog."
Republicans focused their attacks on Mr. Gore's misstatements of fact — most recently, his statement in last Tuesday's debate that he had visited Texas during a period of wildfires with James Lee Witt, the director of the Federal Emergency Management Agency. Mr. Gore has since acknowledged that he went to Texas not with the director of the agency, but with the deputy director.
Two top Bush advisers — Karl Rove, chief strategist, on NBC's "Meet the Press," and Karen P. Hughes, communications director, on "Fox News Sunday" — called Mr. Gore "a serial exaggerator."
"This is a man who has difficulty telling the truth," Mr. Rove said. "He constantly exaggerates and embellishes." In the debate, he said, Mr. Gore had exaggerated "about being at the Parker County fires."
In fact, Mr. Gore had said in the debate, "I accompanied James Lee Witt down to Texas when those fires broke out." He never said he went to Parker County or to the fires.
Mr. Lieberman reminded viewers that Mr. Bush has had misstatements of his own, as when he cited "The Very Hungry Caterpillar" as a favorite childhood book — though it was written when he was in his 20's. And he ripped into Mr. Bush's record as governor of Texas.
Republicans countered that the Democrats were trying to distract voters' attention from Mr. Gore's own shortcomings.
Copyright 2000 The New York Times Company


text: i was thinking about this question as a guy i love sex and girls and would love to have someone to spend time with and date. yet this whole valentines day concept is completly unappealing to me and i don't have anyone to spend it with. i've never really liked this whole day and found it is aimed at people who are allready in serious relationships or married and for single people like myself its more about making us feel bad for still being single and why aren't we seeing someone.

subset: commoncrawl


text: Quintiles also provides other services for drug makers, including offering a team of sales reps and sales educators that can help get the word out to doctors and practitioners after a drug has been approved. Pike said 27% of Quintiles' business currently stems from biotech firms, with the rest coming from larger, more established drug makers. When asked about cancellations, Pike said those are part of the unpredictable drug business, unfortunately. However, Quintiles is not seeing cancellations ahead of what was expected. Cramer said it should be easy to see why he's a fan of Quintiles, even if the company is, as yet, largely unknown on Wall Street.


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Author | exchange4media News Service | Friday, Dec 31,2004 7:16 AM
Philips India Limited, a subsidiary of Netherlands-based Royal Philips Electronics, added Sur-Taal to its exiting bouquet of DVD players. The company is looking at 50 to 60 per cent growth in the category with the launch of Sur-Taal.
Sur-Taal is a DVD amplifier with power sound and FM radio. "It is a complete audio-video solution and is available at an affordable price of Rs 5,490," he said. This DVD player has two speakers that are in-built and has been engineered in a compact fashion.
Sur (DVP 320 + IN 226FM) is a 1500-W powerhouse and it also comes with a built-in FM radio and two speakers. The bass boost adds depth to this technology-rich, compact, sleek system that also plays VCD. Taal (DVP 320 + IN 126FM ) – the other model is a compact 1000-W player with an in-built FM radio, bass boost, two speakers and also plays VCD.
The communication plan for the DVD has been lined up. The consumer electronics major is focusing on print, radio and outdoor for promotions and JWT is handling the account.
On the launch, Gautam Dalal, Brand Manager, DVD Marketing, said, "Sur-Taal is a winner product all the way. It has been engineered to pack-in all the required elements within its compact design. It is a value-for-money product with a sophisticated style element. Technologically too it is very advanced and matches the quality. "
Dalal, said, "With the launch of DVP 320, Philips has further strengthened its stronghold in the DVD player segment. With this foray, Philips has redefined benchmarks in the DVD category."
Programming HeadRadio Mango


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
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How can I clone a form AND its responses?Asked by mulvinc on May 27, 2015 at 07:38 AM
I would like to create a review copy of the proposals we received, but my reviewers don't need all of the information submitted. Is it possible to clone the original form AND its responses, so that I can remove the questions/fields that the reviewers don't need, while still preserving the original responses (which we need for administrative purposes)?
I have already tried using Excel/Word to do this, by exporting my responses and creating a mail merge. While this worked, it took a lot of time reformatting the responses. I'm trying to find a faster way.
We do not provide functionality to directly clone submissions. Cloning a form will only clone the form itself, the submissions remain with the original form only.
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Thanks, Boris! I'll try that out.
I cloned a form, but when I went to the input forms app, the name of my cloned form didn't pop up on the list to select. Is there something I need to do to make that cloned form appear in the list of available forms for input?
Never mind...It's there now. I guess I didn't wait long enough before trying it.
Hello again.
I have just gotten back to your thread. I am very glad to hear that you've managed to sort it out.
Yes, our apps sometimes need a little time to refresh and update their list, but it usually happens very quickly. Reloading the page helps, or sometimes logging out and back into your account makes them pull the latest information.
Glad you've got the hang of it, please don't hesitate to contact us if you run into any issues along the way. As always, we are here to help.


text:
Choose Between Two Options
- $19 for a chiropractic exam, x-ray, and report (a $300 value)
- $29 for a chiropractic exam, x-ray, report, and adjustment (a $350 value)
Balance Chiropractic & Wellness
From headaches to vertigo, chronic pain to ADHD, Doctor of Chiropractic Christopher L. Bosler has three years of training in treating these issues with functional neurology and, thus, without a prescription or surgery. He partners this with his degree in chiropractic, both of which he puts to use at Balance Chiropractic & Wellness. He welcomes patients into his practice who have sought out relief in traditional medicine, only to continue suffering from chronic aches and pains. He uses x-rays and examinations to uncover the root of their problems, and uses treatments such as spinal adjustments to fix them.


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Michael Sanville Photographer
Alicia PulverModel Female Los Angeles, California, US
Mayhem # 1525228
About MeHello, I model & work as a photographer I've worked as a model & commercial talent in the fashion industry for numerous reputable agencies internationally. I'm based out of Los Angeles, CA. I worked and lived for over 5 years in Milan, Italy. While overseas I've worked in other fashion capitals, such as Paris, Munich, London, etc.
Concurrent to modeling, I started as a photographer in Milan since 2007. I've worked with several reputable agencies in Milan, SF, & LA Primarily doing test shoots for their new faces & others needing to rebuild their book.
If you're interested in collaborating please let me know.
Have you worked with Alicia Pulver? Add Credits for Alicia Pulver! >>
Michael Sanville Photographer
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text:
Dr Angela reveals Ireland's Top 10 sex problems; Part 2
Our resident sex expert Dr Angela Brokmann has heard all sorts of personal, kinky and often odd problems. Here are the most popular topics...
Over the last few years, I've answered thousands of sex questions, from basic enquiries about orgasms and penis size to real kinky queries about secret fantasies and fetish play.
And every time I think that I've surely covered it all, there is a new letter or email coming my way with a question I've never been asked before.
Whatever's on your mind, don't be shy to ask. When it comes to sex there is no such thing as a stupid question - and no question is too embarrassing or daring.
If you missed it, here is PART 1 of the top ten questions I was asked this year, covering the most common issues and problems.
And now here is PART 2:
Q: Is it ok to fake an orgasm?
It is OK to fake an orgasm the odd time, but it shouldn't become a habit. If you've been faking for a long time, there is no need to tell your partner – just stop faking and tell or show him how he should kiss and caress you to make you come for real. It's up to you; let your partner know what he should do for you in bed – without your feedback he'll never learn how to satisfy you.
Q: Should I confess to a fling?
No, keep your fling to yourself, especially if it's over. There are many reasons why you might want to tell your partner, from revenge to heartfelt remorse. But while a confession might make you feel better, it would make your partner feel worse. And it wouldn't be fair to unburden your conscience at your partner's expense.
Q: Our sex life has become boring - how can we spice it up?
Let your fantasy play. Flirt, court and seduce each other. Widen your horizons. Experiment with new positions and sex games. Make love in new places - on the couch, in the kitchen, in the shower, wherever. Go lingerie shopping, pick out kinky sex toys, chance a porn movie, read a sex book together. Treat yourselves to a change of scenery, book a fancy hotel for a night or go away for a romantic weekend.
Q: We want to get kinky, but not harcore. How can we do 'light' bondage?
The most vital prerequisites of bondage games - even if you only play bondage light - are consent and trust. Discuss beforehand how far you are willing to go, and agree on a safe word that immediately stops whatever is going on. Tie you partner's wrists to the bedposts with a soft material and loose knots that he or she can get out of anytime. For some extra kicks, use blindfolds, ice cubes, feather ticklers, clamps or fluffy handcuffs.
Q: She never has an orgasm - how can I make her come?
Treat your girl to a long foreplay. Kiss and tease, then massage her clitoris with light circling movements. Start slow and gentle, then gradually increase speed and pressure. If you can't find the right touch, ask her for directions or let her guide your hand. When she is almost ready to climax, start making love. Keep caressing her clitoris while you are inside her.


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You won't be able to dismiss this by usual means (escape or click button), but you can close it programatically based on user choices or actions.
"I have gotten so many compliments on this save the date card that we went out. My mother left me a hilarious message freaking out about how much she liked it. Also, couldn't have asked for better customer service. I had a few questions and I was always talking with someone who was polite and patient (and calming!). I definitely recommend this product."
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Wednesday, January 27, 2016
On Being a Grad Student and Pursuing Publication
Now, plenty of people in academia also write. Plenty of grad students have notebooks full of poetry or short stories or novels. And plenty of professors--at least, the ones who keep their posts in publish-or-perish academic departments--have experienced the highs and lows of publication. Yet there's still kind of an oddity actively pursuing both commercial publication and a degree in studying things that are published commercially.
An illustration. In one class, a professor (for humorous effect) outlined the belief that many people have that books are written by writers and then proceed directly through the magic of "becoming published" with no further interference. I burst out laughing, not the polite titters of my classmates, but solid "Yes, it's so completely the opposite! What you just said is beautifully absurd! I love it! HASHTAG HILARIOUS!" laughter.
He kind of glanced at me as he continued, "Yes, but you all think this in some way or another!"
Thing is, when you're a writer pursuing publication, you don't. You definitely don't.
And here's the thing--it's often treated in the study of literature as a dilution of the author's intent, all those "things" that can happen to a work between end of drafting and publication. That somehow, the input of agents and editors "takes away" from the work the writer did. I sense a clear undercurrent of that in many discussions of literature. "Well, Dickens did it this way because of the serialized nature of the work..." with a sigh that oh, his work would have been purer had he not been constrained. "It seems the editor took some liberties with the chapter breaks" as though goodness! The editor was quite the idiot and the author in question was infallible.
I feel a kinship of understanding, probably completely inappropriate given that I'm little old me and not a Great Author, with Great Authors, simply because I *get* what they went through to write a complete work. And maybe I'm just not at their level of genius, but input *helps.* My work is *better* after my agent makes a recommendation, even if the rec comes more out of a concern over saleability than "pure" art. Because what is so pure about written work, anyway? It's process work. It's never truly "finished"--we just decide at some point to stop tweaking. Not only that, but it is formula work. Part of the beauty is the way in which is fits a formula. We reject a novel that's thirty pages long because it isn't a novel--yet we criticize the "meddling input" of an editor who suggested re-working the breaks on Shelley's Frankenstein for re-publication. We don't want to harsh the author's writerly buzz with silly concerns about saleability...except we do want the author to utilize form. It's a fascinating, weird question of applications.
Further, it's fascinating to recall that, though we study many Great Authors as bastions of literature today, they weren't necessarily publishing believing themselves to be Bearers of Great Literature. They were, many of them, commercial successes. We can't read them as Literature without remembering that they (even, yes, those Great Authors) knew a thing or two about appealing to an audience. They weren't writing in--or for--a vacuum.
So I find myself feeling the need to push back against this mentality that any "intrusion" on the author's "pure" writing is bad. I'm experiencing the intrusions of people, market pressures, audience expectations--they're not necessarily "bad." They may, yes, guide my work--but we agree that work benefits from some guidance. Constraints can actually produce better work, in my view.
How does writing influence how you think about what you study, or where you work? Does it change your expectations or outlook?
4 comments:
I completely agree. The 'public' has a very misinformed view of publishing and editors. I for one am so grateful for my agent's feedback on my work. I've learned across edits over several books that writers are in their own heads too much. As hard as we try, we can't obtain an outsider's perspective of the story. When I'm polishing a first draft I'm full of many internal 'rules' for the story, and I might sense something isn't working but I can't imagine it another way, so I let it slide. My agent holds me to a higher standard, or is able to pinpoint the things I sensed were off but couldn't specifically identify.ReplyDelete
I think that's part of why traditionally published writers sometimes look down at self-published writers, especially those who become commercial successes. We KNOW our own work is full of inconsistencies and messy bits, and we see the tempering that goes on during the editing process. To see readers gobble up writing we know we'd get taken to task for can be frustrating.Replies
So true about outsider's perspective--that it's really hard to be objective. And I don't see including an outsider as "diminishing" the work at all, but making it clearer.Delete
I think you bring up a fascinating point. Many of the great authors were nurtured by their editors sometimes for years in ways that helped the author's writing mature. Instead of taking us further from the author's vision, the editors may have brought us closer.ReplyDeleteReplies
I *LOVE* how you phrase that--that outside input can take us closer to our own vision. Bingo.Delete


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hi there, can sum1 please help me im a self taught cake maker and love to experiment, i only make cakes for my 4 children or family.
my daughter is about to turn 11 in 4 weeks and she has requested a princess castle cake, i have no idea where to begin can sum1 please help me!!
it would be greatly appreciated X
I havent made a castle cake but there are 'kits' availible. Go to Google and search 'Wilton castle cake kit', first link is the kit i think most people use
hi, with my two castle cake ive done, ive just done a two tier round cake, for the turrets, the first time i wrapped cardboard cylinders in fondant and topped with an upsidedown ice cream cone, and covered that in fondant "shingles". the second time i did it i used rice krispie treat for the cylindar part.. found it to be more stable.. and used the up turned ice cream cone again.
There are a million and one ways to make a castle cake, i believe wilton sells a turret kit? I think castle are fun because the option really are endless and you can make almost anything work. =) good luck
thank thats a great help, i have heard people talking about wilton kits, but didnt know what they ment ha , thanks X
thanks for the responses , naohsmummy when u say for the towers u used a 2 tier round cake how did u do that?
When I was (much!) younger Mammy made castle cakes for me and my sisters and used bought (homemade ones were too soft) swiss rolls for two large turrets at the back of the cake and (Cadbury's) minirolls for two small turrets at the front, all with ice cream cones on top.
I guess it depends on cost if you want to buy the kit.
Hi there! I made a castle cake (you can see in my pics). I did a 10" square, with a 6" round stacked on top. I used cardboard for the turrets, but I like the rice crispie idea also. I iced them in buttercream and I bought a brick mold (pattern press), and rolled them on it once the butter cream crusted. I used the mold on the sides of the 10" and 6" as well. I notched out the corners of the 10" square so the turrets would sit against the corners, and used ice cream cones on top. Put 2 shorter turrets on top of the 6". It was fun, but time consuming.
Hi. When I made my daughters castle cake (in my pictures) I used a square bottom with a 6" round stacked on top. I used cake ice cream cones covered in fondant for the turrets and then put the sugar cones covered in fondant on the top of those. I got the idea and help from cakesrock. It was fun and not terribly hard but it took a lot of time to do.
a round cake, with a smaller round cake stacked on top. hth


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Mine is Changeless by Gail Carriger. :)
Most Helpful Girl
To Kill a Mockingbird, Harper Lee. Awesome book.22|00|0
Mine is Changeless by Gail Carriger. :)
To Kill a Mockingbird, Harper Lee. Awesome book.
Have an opinion?
"All my friends are dead"
umm... adorable..
The last book I finished reading was The Robe. Right now, I'm in the midst of Christ: The Life of The Soul and will soon begin Lord Of The Rings.
I don't even know. I am in the middle of Fear and Loathing in Las Vegas, but I haven't read it since June. I just never feel like reading. But I have a lot of downtime so maybe I should read more.
A Murder is Announced by Agatha Christie
Just finished Indian Killer.
books are for losers
book? eh... that's forever ago, not sure. but I read Bleach 66 manga this week
female thor comic...
The Mist by Stephen King.
Meh novella. Disappointed.
how so?
The idea is good, but the characters are so one-dimensional I can't even begin.
I finished up reading Gone Girl by Gillian Flynn last week. It is for the G@G book club run by @CHARismatic110. :) Looking forward to discussing it soon!
Yuppp! Wednesday!
@CHARismatic110 I'll just be repeating what we've already mentioned, haha.
Lol pretty much
I don't read a lot, but the last book I read was Candide by Voltaire
Women of Brewster Place
uuummm.. i read one like a month ago, don't know the title on English, but an author was Karen Rose.
I read a thousand splendid suns last. I mean I've read it before but it's been a long time so I thought why not reread it
Twas Gone Girl for the bookclub. Currently reading Alpha by Jasinda Wilder. I'm a fan of hers.
You cannot undo this action. The opinion owner is going to be notified and earn 7 XPER points.


text:
This PDU has total
of 8 NEMA 5-15/20R
output receptacles with 15 ft. AC power cord and 15 amp circuit breaker in
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distribute power throughout a rack or enclosure.
1U Rack-Mountable Design
Detachable rack mount ears are configurable for wall mount, under-counter and rack mount
installation. Uses only 1U of rack space when installed in any 19-inch rack,
with the potential for zero U mounting in the cable management area of most rack
LED Meter Display For Monitoring Electric Power Consumption
Its built-in digital LED display offers
visual display of current total power consumption data for the entire PDU, which
is a great feature for engineers to safely
load each circuit to its maximum allowable load capacity without the danger of
overloading the power circuit. Also very beneficial for data center use for helping administrator
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avoid the possible power disaster.
Its digital LED meter display allows the system administrator to
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Remote Control Of PDU Power Strips Through
This smart power strip can work by itself for local monitoring of the AC power distribution or co-operate with
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The optional PDU server unit helps administrator
with tasks like:


text:
Magnum Hunter Resources Corporation has closed on the purchase of approximately 1,700 net mineral acres located in Monroe County, Ohio and Wetzel County, West Virginia for approximately $22.7 million from the Ormet Corporation, et al.
This acquisition will increase the Company's net revenue interest on its existing 875 acre oil and gas lease located on the related acreage from approximately 86% to nearly 100% in the Marcellus Shale formation only.
Under the same agreement, the Company has also acquired an approximate 100% net revenue interest in the balance of the mineral rights to this acreage which will also include the Utica Shale formation.
Magnum Hunter Resources Corporation
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text:
Can Coronary Blood Flow Velocity Pattern After Primary Percutaneous Transluminal Coronary Angiography Predict Recovery of Regional Left Ventricular Function in Patients With Acute Myocardial Infarction?
Jump to
Background—In the era of primary percutaneous transluminal coronary angioplasty (PTCA), it is important to judge whether myocardium within acute ischemic injury is viable. This study sought to investigate parameters derived from the coronary blood flow velocity spectrum immediately after primary PTCA in patients with acute myocardial infarction and to elucidate the clinical value of coronary blood flow measurement in predicting myocardial viability.
Methods and Results—Using a Doppler guidewire, we measured coronary blood flow velocity after successful completion of primary PTCA in 23 consecutive patients with acute anterior myocardial infarction. Regional wall motion was analyzed to estimate anterior wall motion score index (A-WMSI) by echocardiography before PTCA and 1 month after the onset of symptoms. Average systolic peak velocity (ASV) and deceleration time of diastolic flow velocity (DDT) significantly correlated to 1-month A-WMSI (r=−0.54, P=0.007 and r=−0.62, P=0.002, respectively), and optimal cutoff values to predict viable myocardium (defined as 1-month A-WMSI ≤2.0) were 6.5 cm/s for ASV and 600 ms for DDT (sensitivity=0.79, specificity=0.89 and sensitivity=0.86, specificity=0.89, respectively). ASV and DDT also correlated weakly to the change in A-WMSI (r=0.46, P=0.03 and r=0.49, P=0.02, respectively).
Conclusions—Low ASV and rapid DDT of coronary blood flow spectrum immediately after primary PTCA reflects a greater degree of microvascular damage in the risk area. Analysis of coronary blood flow spectrum immediately after primary PTCA by use of a Doppler guidewire is useful in predicting recovery of regional left ventricular function.
Percutaneous transluminal coronary angioplasty has been widely performed in cases of acute myocardial infarction (AMI) because of a higher rate of recanalization, better preserved left ventricular function, and a lower rate of complications compared with thrombolysis.1 2 3 4 However, patency of the infarct-related coronary artery does not always guarantee salvage of myocardium at risk of ischemia.5 Therefore, the great interest of many cardiologists is in the viability of reperfused myocardium. Assessment of regional myocardial perfusion by contrast echocardiography has revealed a no-reflow phenomenon, which is defined as a lack of enhancement of myocardium by microbubbles despite recanalization of the infarct-related coronary artery5 6 7 ; this phenomenon is thought to be established as a result of microvascular damage induced by ischemia. Some studies have shown that the no-reflow segment is not viable,5 8 and it has been shown by use of a Doppler guidewire that the coronary blood flow velocity pattern of no-reflow in patients with reperfused AMI is characterized by the appearance of systolic retrograde flow, diminished systolic antegrade flow, and rapid deceleration of diastolic flow.9 However, the relationship between the coronary blood flow velocity pattern immediately after primary PTCA and the recovery of left ventricular function has not been discussed fully. Therefore, we hypothesized that the degree of reduced systolic antegrade flow or the deceleration time of diastolic flow might reflect the degree of microvasculature damage and be predictive of residual myocardial viability. To test this hypothesis, we prospectively compared the coronary blood flow velocity pattern immediately after primary PTCA with use of a Doppler guidewire and the recovery of regional left ventricular wall motion in the risk area assessed by echocardiography in 23 consecutive patients with successfully reperfused anterior AMI.
Study Population
This study comprised 23 consecutive patients (21 men and 2 women; mean age, 61±10 years; age range, 45 to 75 years) with anterior AMI who were successfully recanalized with primary PTCA including rescue stenting within 12 hours after the onset of symptoms. The study inclusion criteria were as follows: (1) first anterior AMI, (2) successful recanalization with primary PTCA (defined as residual stenosis ≤25% visually) within 12 hours after the onset of symptoms, and (3) informed consent to perform primary PTCA and coronary blood flow measurement. The diagnosis of AMI was based on >30 minutes of continuous chest pain, ST elevation >2.0 mm in ≥2 contiguous ECG leads, a >3-fold increase over the normal value in serum creatine kinase, and Thrombolysis In Myocardial Infarction (TIMI) flow grade 0, 1, or 2 at initial coronary angiography. We excluded patients with prior myocardial infarction, those with a cardiac event during follow-up, and those with inadequate recording of coronary flow velocity spectrum or poor echocardiographic image. The study protocol was approved by the ethics committee of Kobe General Hospital. One of the investigators obtained informed consent from all patients before cardiac catheterization.
Study Protocol
Regional wall motion was examined in the emergency room by use of echocardiography to determine the risk area before angioplasty. All patients received an intravenous bolus injection of 4000 U of heparin before angiography, and 0.5 mg · kg−1 · min−1 of nitroglycerin was continuously given intravenously soon after establishment of the diagnosis. Intracoronary isosorbide dinitrate (2 mg) was given before coronary angiography. Diagnostic coronary angiography was performed via the femoral approach by use of the Judkins technique. After an additional intravenous or intra-arterial bolus injection of 6000 U of heparin, coronary angioplasty, including rescue stenting, was performed. Stents were deployed by high-pressure implantation techniques. An angiographic criterion of <25% residual stenosis was used to determine the end point of the angioplasty procedure. After successful angioplasty, the guidewire was exchanged for a 0.014-in Doppler guidewire (FloWire; Cardiometrics, Inc).10 The tip of the Doppler guidewire was placed slightly distal to the culprit lesion, where there was neither a significant stenosis nor a large side branch angiographically, to assess coronary blood flow to the entire area at risk. Phasic coronary blood flow velocity spectrum was recorded on a Super VHS videotape (FloMap; Cardiometrics, Inc) >10 minutes after the last balloon inflation. Serum creatine kinase was measured serially every 3 hours after recanalization until the peak value was obtained. Patients received conventional drug therapy according to individual need, which was determined by the attending physician. The stented patients received anticoagulation with a ticlopidine and aspirin regimen (ticlopidine 100 mg twice a day and aspirin 81 mg twice a day). All patients underwent follow-up echocardiography to examine regional wall motion recovery 1 month after the onset of symptoms.
Echocardiographic Wall Motion Analysis
The left ventricular wall was divided into 16 segments, and the regional wall motion of each segment was examined and scored according to a modification of the recommendation of the American Society of Echocardiography,11 in which 1 is normal, 1.5 is mild hypokinesis, 2 is hypokinesis, 2.5 is severe hypokinesis, 3 is akinesis, and 4 is dyskinesis.12 Nine of the 16 segments were determined to be in the vicinity of the left anterior descending coronary artery (LAD), and the anterior wall motion score index (A-WMSI) was calculated as an average of the wall motion scores in these 9 segments13 (Figure 1⇓). The change in A-WMSI was also estimated.
Analysis of Coronary Blood Flow Velocity Spectrum
The coronary blood flow velocity spectrum recorded on a Super VHS videotape was digitized by offline computerized planimetry. The digitized coronary blood flow velocity spectrum provided the following parameters: time-averaged peak velocity (cm/s; APV), average systolic peak velocity (cm/s; ASV), average diastolic peak velocity (cm/s; ADV), maximal peak velocity (cm/s; MPV), and deceleration time of diastolic flow velocity (ms; DDT). Retrograde flow was calculated as a negative value.
Analysis of Coronary Angiogram
Percent diameter stenosis and minimum lumen diameter of the culprit lesion were quantitatively analyzed offline by auto edge detection with a validated technique (CMS; Medical Imaging Systems, Inc)14 from a cineangiogram taken before and after primary PTCA. Contrast flow through the infarct-related coronary artery was graded by the standard TIMI flow scale of 0 to 3 from the final coronary angiogram.15 Collateral flow was graded according to the Rentrop classification of 0 to 3 from the initial coronary angiogram.16
Results are reported as mean±SD unless otherwise indicated. The difference between A-WMSI before recanalization and A-WMSI at 1 month after symptom onset was evaluated by paired Student's t test. Comparisons of continuous variables between 2 groups were made by unpaired Student's t test. The χ2 test was used to compare categorical variables. Linear regression analysis was applied to estimate the relation between parameters obtained from coronary blood flow velocity spectrum recordings and 1-month A-WMSI or the change in A-WMSI. Statistical differences were considered significant at a value of P<0.05. The ability of the coronary blood flow parameters to predict viable myocardium was analyzed by use of receiver operating characteristic (ROC) curves, ie, plots of sensitivity versus 1−specificity.17 18
Patient Characteristics and Clinical Results
Thirteen patients (57%) had a history of hypertension, 7 (30%) had diabetes mellitus, 12 (52%) had a cholesterol level >220 mg/dL, and 16 (70%) were smokers. Mean time from the onset of symptoms to coronary reperfusion was 250±129 minutes. Peak creatine kinase level was 5116±3849 IU/L. Nineteen patients developed Q-wave infarction, whereas the other 4 manifested non–Q-wave infarction. There was no clinical, ECG, or enzymatic evidence of reinfarction in any patient during the 1-month follow-up. In-hospital medications were as follows: nitrate (n=23; 100%), ACE inhibitor (n=19; 83%), β-adrenergic blocking agent (n=14; 61%), calcium antagonist (n=3; 13%), and diuretics (n=3; 13%). (See Table 1⇓.)
Angiographic Results
Primary PTCA, including rescue stenting, was successfully performed in all patients. The culprit lesion was the proximal LAD (segment 6) in 17 patients and mid LAD (segment 7) in 6. Eighteen patients had single-vessel disease, 4 had double-vessel disease, and 1 had triple-vessel disease. No patient showed good collateral flow (Rentrop grade 3), 4 showed fair collateral flow (Rentrop grade 2), and the remaining 19 showed poor or no collateral flow (Rentrop grade 1 or 0) on the initial coronary angiogram. Rescue stenting was performed in 10 patients, and the reasons for rescue stenting were as follows: suboptimal result after repeat balloon inflation (n=5), large dissection (n=2), and haziness or recurrent thrombus (n=3). Percent diameters of stenosis before and after angioplasty were 89±15% and 26±15%, respectively. Minimum lumen diameter after angioplasty was 2.4±0.7 mm. Three patients showed TIMI 2 reflow, and the remaining 20 patients showed TIMI 3 reflow. Only 2 patients had insignificant stenosis distal to the culprit lesion. (See Table 1⇑.)
Baseline and Follow-Up Echocardiography
Baseline and follow-up echocardiography examinations were performed in all 23 patients. A-WMSI decreased significantly from baseline to follow-up (from 2.49±0.45 to 1.93±0.54; P<0.0001; Figure 2⇓), and the change in A-WMSI was 0.56±0.42.
Relation Between Coronary Blood Flow Velocity Pattern and Late Results
In accordance with a previous report on low-dose dobutamine echocardiography,13 we defined viable myocardium as 1-month A-WMSI ≤2.00. We divided our patients into 2 groups: viable myocardium group (1-month A-WMSI ≤2.00) and nonviable myocardium group (1-month A-WMSI >2.00). The viable group showed a higher rate of TIMI 3 reflow (14 of 14 versus 6 of 9; P=0.02), a lower peak creatine kinase value (3445±3054 versus 7716±3617 IU/L; P=0.006), and a lower 1-month A-WMSI (1.58±0.33 versus 2.48±0.24; P<0.0001). However, there was no significant difference in baseline characteristics, residual stenosis, or A-WMSI before recanalization (Table 2⇓). Doppler velocimetry data showed significantly higher ASV (12±6 versus 2±8 cm/s; P=0.004), lower MPV (28±11 versus 56±24 cm/s; P=0.0009), and longer DDT (954±326 versus 470±181 ms; P=0.0006) in the viable group compared with the nonviable group (Table 3⇓). Figures 3⇓ and 4⇓ show a typical coronary blood flow velocity spectrum in patients from the viable and nonviable groups, respectively. The coronary blood flow velocity pattern with viable myocardium seems almost normal and that with nonviable myocardium shows reduced ASV caused by systolic retrograde flow and rapid deceleration of diastolic flow velocity. ASV and DDT imme1diately after primary PTCA were compared with 1-month A-WMSI. ASV and DDT significantly correlated with 1-month A-WMSI (y=−8.5x+24.4, r=−0.54, P=0.007 and y=−420x+1576, r=−0.62, P=0.002, respectively; Figure 5⇓), with substantial scatter. On the basis of ROC curve analysis,17 18 optimal cutoff values of 6.5 cm/s for ASV and 600 ms for DDT were chosen to predict viable myocardium (sensitivity=0.79, specificity=0.89 and sensitivity=0.86, specificity=0.89, respectively). There was also a weak correlation between ASV and DDT and the change in A-WMSI (y=9.2x+2.8, r=0.46, P=0.03 and y=428x+524, r=0.49, P=0.02, respectively).
Although stented patients showed significantly lower percent diameter stenosis (17±14% versus 34±13%; P=0.005) and larger minimum lumen diameter (2.7±0.6 versus 2.1±0.6 mm; P=0.03), there was no significant difference in 1-month A-WMSI (1.87±0.59 versus 1.97±0.51; P=NS) or in coronary blood flow parameters (APV, 18±8 versus 17±8 cm/s; ASV, 9±10 versus 7±7 cm/s; ADV, 24±10 versus 23±11 cm/s; DDT, 709±293 versus 808±418 ms; all P=NS) between stented and nonstented patients.
We directly measured coronary blood flow velocity after successful primary PTCA and investigated the relationship of the parameters derived from coronary blood flow velocity spectrum at reperfusion and preserved myocardial viability at late stage. Our major finding was that the higher the ASV and the longer the DDT of the coronary blood flow velocity pattern after primary PTCA, the more the myocardium within a region of acute ischemic injury would recover. We conclude that a low ASV and short DDT can represent characteristics of coronary blood flow with severe microvascular damage, given no significant residual stenosis in the epicardial coronary artery and given that ASV and DDT at reperfusion are predictive of the recovery of regional left ventricular function. To the best of our knowledge, this is the first report to directly compare the coronary blood flow velocity pattern immediately after primary PTCA with the recovery of regional left ventricular function.
Coronary Blood Flow Velocity Pattern and Microvascular Damage
In the present study, patients with low ASV showed poorer regional recovery of left ventricular function. Early systolic retrograde flow has previously been reported to be observed frequently in patients with no reflow in case of AMI after successful recanalization.9 In that previous report, early systolic retrograde flow was explained by an occluded coronary microvasculature, which is thought to cause backflow during systole by contraction of the myocardium. We believe the degree of backflow during systole reflects ASV and that the higher percentage of occluded coronary microvasculature in the infarct-related coronary bed reflects a lower ASV.
Experimental study has demonstrated that microvascular ischemic damage after epicardial coronary artery occlusion affects coronary vascular resistance,19 20 and perivascular edema and capillary leukocyte plugging after myocardial ischemia contribute to prevention of full restoration of myocardial perfusion.21 Short DDT may be explained by an increase in coronary vascular resistance caused by such ischemic microvascular damage. The high ratio of perfused myocardium per functioning coronary microvasculature might reflect the coronary blood flow and would be observed as a short DDT.
Although much better correlation would be expected between ASV, DDT, and the change in A-WMSI, only weak correlations were obtained. This might be related to the fact that good wall motion segments before recanalization, which could be out of the substantial area at risk, were included.
Coronary Blood Flow and TIMI Flow Grade
The TIMI study group grading system has been widely used to assess coronary perfusion,15 and some studies have shown worse outcome with TIMI grade 2 reflow than with TIMI grade 3 reflow.22 23 24 25 Because the TIMI criterion is based on visual judgment of radiocontrast media runoff in coronary angiography and is thought to be affected by various factors, such as injection speed, injection volume, and diameter and size of the coronary artery, an accurate assessment of coronary blood flow is quite difficult.26 We demonstrated that more quantitative assessment of coronary blood flow was possible in patients with reperfused AMI by use of a Doppler guidewire, as previously reported.26
Study Limitations
First, we assumed A-WMSI at 1 month to be an indicator of myocardial viability. This parameter is considered to represent myocardial viability but to be semiquantitative. Further examination should be done in comparison with a single-photon emission CT (SPECT) or PET study to assess the degree of myocardial damage more quantitatively.27
Second, the coronary blood flow velocity pattern may alter with the stenosis. In the present study, there was no significant difference in coronary blood flow parameters between stented and nonstented subjects, and therefore the effect of residual stenosis of the epicardial coronary artery should be minimal. The routine use of stents could decrease residual stenosis to almost 0%; thus, the effect of stenosis in the epicardial coronary artery should not be considered.28 29
Third, coronary blood flow measurements were performed 10 minutes after the last balloon inflation in the present study. Some studies have documented that the hyperemic response continues for several hours and that coronary perfusion dynamically alters within a few hours after prolonged coronary occlusion in animals.30 31 These dynamic coronary flow changes after reperfused AMI may be the reason for the substantial scatter in plots of ASV and DDT versus 1-month A-WMSI demonstrated in Figure 5⇑. The continuous observation of coronary blood flow alternation for several hours after recanalization could resolve these issues.
Clinical Implications
In the present study, we revealed the characteristics of coronary blood flow with effective reperfusion and demonstrated that ASV and DDT after reperfused coronary artery were predictive of the recovery of regional left ventricular function. Analysis of coronary blood flow velocity pattern by use of a Doppler guidewire can be used to predict the regional recovery of left ventricular function at the time of recanalization. This should be helpful in treating patients with reperfused acute myocardial infarction.
The authors gratefully acknowledge the excellent assistance of all medical personnel of the coronary care unit and catheterization laboratory.
- Received November 20, 1998.
- Revision received April 21, 1999.
- Accepted April 30, 1999.
- Copyright © 1999 by American Heart Association
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Ambrosio G, Weisman HF, Mannisi JA, Becker LC. Progressive impairment of regional myocardial perfusion after initial restoration of postischemic blood flow. Circulation. 1989;80:1846–1861.We measured coronary blood flow velocity immediately after primary PTCA in 23 consecutive patients with acute anterior myocardial infarction by use of a Doppler guidewire. Averaged systolic peak velocity (ASV) and deceleration time of diastolic flow velocity (DDT) significantly correlated with 1-month anterior wall motion score index (A-WMSI) (r=−0.54, P=0.007; r=−0.62, P=0.002, respectively). Optimal cutoff values to predict viable myocardium, defined as 1-month A-WMSI ≤2.0, were 6.5 cm/s for ASV and 600 ms for DDT (sensitivity=0.79, specificity=0.89 and sensitivity=0.86, specificity=0.89, respectively). ASV and DDT can be powerful predictors of recovery of regional left ventricular function in patients with recanalized acute myocardial infarction.
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- Can Coronary Blood Flow Velocity Pattern After Primary Percutaneous Transluminal Coronary Angiography Predict Recovery of Regional Left Ventricular Function in Patients With Acute Myocardial Infarction?Takahiro Kawamoto, Kiyoshi Yoshida, Takashi Akasaka, Takeshi Hozumi, Tsutomu Takagi, Shuichiro Kaji and Yoshiaki UedaCirculation. 1999;100:339-345, originally published July 27, 1999https://doi.org/10.1161/01.CIR.100.4.339
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- Can Coronary Blood Flow Velocity Pattern After Primary Percutaneous Transluminal Coronary Angiography Predict Recovery of Regional Left Ventricular Function in Patients With Acute Myocardial Infarction?Takahiro Kawamoto, Kiyoshi Yoshida, Takashi Akasaka, Takeshi Hozumi, Tsutomu Takagi, Shuichiro Kaji and Yoshiaki UedaCirculation. 1999;100:339-345, originally published July 27, 1999https://doi.org/10.1161/01.CIR.100.4.339Permalink:


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These trees have sharp, broad-bladed leaves which grow at the ends of strong branches. The leaves themselves are as hard as rock and equivalent to a sharpened stone axe if used as a makeshift weapon. Unfortunately, Mauristatian Wraith Apes have learnt to use these leaves as such, and can add 1 to their SKILL score if so armed.
Blade Trees are relatively common and anyone walking through such a section of forest containing them has a 5 in 12 chance of unknowingly rubbing themselves against the leaves of the Blade Tree. Anyone cut by a Blade Tree must roll one die and consult the following table to determine the extent of damage they suffer.
|Minor cut: lose 1 STAMINA point
|Gash on the arm: lose 2 STAMINA points
|Gash on the leg: lose 2 STAMINA points
|Serious injury: cannot use sword-arm (-2 SKILL and lose 2 STAMINA)
|Blinded: cannot fight (-3 SKILL and lose 4 STAMINA)
|Neck slashed: death
The hardened, stone-like texture of the Blade Tree leaves may be a defence against small but voracious Wood Beetles. In addition, Blade Trees may be related to similar plants such as the Blade Bush of Bone Island, the Sword Trees of Scorpion Swamp, and the Axeplant of Solani Island[Non-canon]


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You will receive one single or a set of two ladybug hair bows. I created these bows with hot pink and black ribbon with a pink ladybug flatback resin center. This bow measures approx. 2 inches and is attached to a lined alligator clip with no slip grip. I heat seal the ribbon ends to prevent them from fraying.
I hand stitch all hair bows and can attach them to French barrettes instead of alligator clips. If you would prefer a French barrette instead of the alligator clip just let me know.
The attached alligator clip can either be partially or fully lined, double or single prong with grip added. If you have a preference please include choices during checkout.
Please contact me if you have any questions or would like to request a custom order.
Thank you!
I accept PayPal, Credit Cards through Etsy's Direct Checkout, Checks and Money Orders. ***Please note: For e-checks, checks and money orders I am unable to ship until payment clears.
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I ship worldwide every afternoon, Monday-Saturday, excluding holidays.
Domestic packages are sent via USPS First Class Mail if under 13 ounces and Priority Mail over 13 ounces. International packages are sent via USPS. All orders are insured.
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I live in the USA, I am not VAT registered, no VAT is included in the price for any of my products. VAT/customs/duty charged by your country are the *BUYER'S RESPONSIBILITY*. You will have to pay VAT and additional charges upon receipt of your purchase.
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We have a 100% smoke free home. We do have a Yorkie roaming about but he does not come into direct contact with my items.
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Stephen A. Smith Asks Adam Silver to Introduce 'Rooney Rule' in NBA | Stephen A. Smith | Sports | BET
Regulation ensures minority coaching and senior front-office candidates get fair shake in NFL.
Regulation ensures minority coaching and senior front-office candidates get fair shake in NFL.
Six openings in the NFL should leave the league with no excuses for lack of hiring of Black coaches.
Sports journalism remains a white man's game, despite efforts of the National Association of Black Journalists.
Three Black former NFL head coaches say the league needs to rethink its Rooney Rule for promoting minority hiring after 15 top vacancies were all filled by white candidates since the regular season ended a month ago.
Building networks is needed to secure Black job opportunities and lower the disproportionately high Black unemployment rate.
Among the African-American coaching ranks, there are just two offensive coordinators and six defensive coordinators who are best positioned for head coaching positions.
The founder of BET says corporations should promise to seriously consider Black candidates for top positions.
Plaxico Burress is back in the Big Apple — with the New York Jets.
The NFL is proposing a new rule that would penalize teams and offending players alike when the player is called for multiple flagrant hits.
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The Enforcement Directorate (ED) has registered a money laundering case against the West Bengal-based Saradha Chit Fund.
The case was registered at the ED's Guwahati office, after allegations of financial irregularities against the company.
Assam Police has also registered an FIR against Saradha Group after investors complained that they were duped of their hard earned money.
The filing of the case comes hours after the Calcutta High Court directed the company not to make any financial transactions till further orders.
Hearing a PIL for seeking a CBI investigation into the scam, the high court also directed the West Bengal Government to file an affidavit by May 2 on the steps it has taken against the Saradha Group.
The Corporate Affairs Ministry has also decided to set up a Special Task Force under its Serious Fraud Investigation Office to probe complaints of irregularities by chit fund companies.
The decision was taken at a meeting held yesterday by the Corporate Affairs Minister Sachin Pilot with senior officials.
The Saradha Chit Fund scam has robbed thousands of investors of their savings in West Bengal and Assam.
A Kolkata sub-divisional magistrate's court had on Thursday remanded Saradha GFroup Chief Sudipta Sen and two others to 14 day police custody.
The Congress and the CPI-M have demanded a CBI enquiry into the scam.
The Assam Government is also in favour of a CBI probe in the matter.
The Government of Bihar has also ordered a compilation of a data bank about non-banking financial companies. (ANI)


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As a Bajan who lives in Scotland now I really do need to keep my Caribbean cooking up to date, keep home not too far at heart. This is one of my favourite dishes from back home. Serve with rice! You can also sprinkle a little parsley over your dish if you wish. Enjoy!!
The photo makes it look a bit pink but it should basically be a very dark brown, almost black in colour. This is my first recipe on here so let me know what you guys think. Enjoy! :)
This is a fantastic recipe, me and my husband really enjoyed it! I think the previous comment being to sweet was because she didn't have any jerk seasoning, I too had no premade jerk seasoning so I made it from scratch and I can honestly say it was not too sweet. So thanks for this great recipe it is going straight into my favourites folder. - 03 Sep 2015
I have made this a few times now, and it's delicious. You need to have jerk seasoning for this dish to work. The only tweaking I did was to add vegetables to it (finely chopped spinach and leek)....just because I need more veg in my diet!! - 28 Apr 2017
This was very delicious, but a little sweet for my liking. I made it using what I had and my partner absolutely loved it served over Brown Rice. I did not have any jerk seasoning, Tabasco® or dried chilli, no garni or marjoram, and neither did I have gravy browning (I used half a can of chopped tomato instead and supplemented the Jerk Seasoning with All Purpose). I also added a dash of nutmeg as well and it did the job. Next time, I will use 1/2 a spoon of brown sugar. Picture to come later. - 27 Oct 2014


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Joseph Watson
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Property DetailsOverlooking incredible river & creek views, this lovely 3 bedroom/2.5 bath home features stone fireplace, master suite on the main, large bedrooms, walk-in closets, laundry room, large covered porches, full basement, garage & 1.48 acres of beautifully landscaped grounds. Sit on your porch & watch the cascading waters of Valley River or sit on the river's edge to enjoy the fire pit, swings & wildlife. Located in the NC mountains that thrive on both the arts & outdoor activities, fishing, boating, whitewater rafting, horseback riding, hiking & more. Come see your mountain dream home.
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Additional Property InformationThis single family listing located at 94 Kinnins Cove, Marble, NC has three bedrooms, two bathrooms and one partial bathroom. The property is presently availible for $439,000.
Includes features like basement.
This property is presented by Joseph Watson of Appalachian Land Company based in North Carolina.


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Gunmen target anti-Morsi protesters at Cairo palace demo
January 25 marks the two-year anniversary of Egypt's revolution.
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Masked gunmen wounded several protesters and members of the security forces on Saturday outside Egypt's Presidential Palace in Cairo in the latest in a series of shootings in Egypt targeting proteters.
Fifteen people were reportedly wounded in the attack at the palace, AP reported, including nine members of the security forces and six protesters.
The attackers also threw molotov cocktails at protesters' tents. The protesters had staged a sit-in for over a month against President mohammed Morsi's government, demanding Egypt's new constitution be shelved.
A vote on the highly controversial new constitution polarized the country passed by 64 percent amid widespread allegations of fraud.
A day after the protest at the palace began on December 4, clashes led to at least 10 deaths when Morsi's supporters attacked protesters. On December 31, a well-known activist was shot and killed in Tahrir Square.
Morsi's government has been accused of setting up "torture chambres" in the palace to interrogate protesters.
Large protests against the new government are expected on January 25, the two-year anniversary of the start of the 2011 uprising that overthrew former President Hosni Mubarak.
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