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A protection device for use in an implantable medical device such as an ICD that communicates with an external programmer. The protection device includes one or more control blocks that inhibit gate triggers for the switching elements (IGBTs) of an H-bridge whenever the drive voltage for these switching elements falls below a pre-determined level. Each control block provides a controlled path to charge the IGBT gate when triggering is required and, importantly, when the gate drive voltage is above a predetermined threshold. The control block further prevents inadvertent or spurious triggering and protects the gate circuitry of the switching elements by providing a low impedance path between the gates and sources of the IGBTs when the latter switching elements are intended to be turned OFF. Additionally, the control blocks protect the IGBTs from over-voltage effects by clamping the output of the gate trigger with a shunt regulator circuit.
1. A telemetry device for use in an implantable cardiac stimulation device including a protection device that protects the stimulation device from a potentially damaging external magnetic field, the protection device comprising:
a carrier control circuit that generates a high frequency carrier signal and that charges an energy storage device with a drive voltage;
switching elements connected to the energy storage device;
a control circuit coupled to the switching elements, that selectively inhibits the application of the drive voltage to the switching elements whenever the drive voltage falls below a predetermined threshold level, and that applies the drive voltage to the switching elements whenever a drive voltage exceeds the threshold level.
2. A device for protecting an implantable stimulation device from a potentially damaging external magnetic field, comprising:
means for generating a high frequency carrier signal and for charging an energy storage means with a drive voltage;
switching means; and
control means for selectively inhibiting the application of the drive voltage to the switching elements whenever the drive voltage falls below a predetermined threshold level, and for applying the drive voltage to the switching elements whenever a drive voltage exceeds the threshold level.
3. An implantable cardiac stimulation device including a protection device that protects the stimulation device from a potentially damaging external magnetic field, the protection device comprising:
a carrier control circuit that generates a high frequency carrier signal and that charges an energy storage device with a drive voltage;
switching elements connected to the energy storage device;
a control circuit coupled to the switching elements, that selectively inhibits the application of the drive voltage to the switching elements whenever the drive voltage falls below a predetermined threshold level, and that applies the drive voltage to the switching elements whenever a drive voltage exceeds the threshold level.
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8. A device for protecting an implantable stimulation device from a potentially damaging external magnetic field, comprising:
a carrier control circuit that generates a high frequency carrier signal and that charges an energy storage device with a drive voltage;
switching elements connected to the energy storage device;
a control block coupled to the switching elements, that selectively inhibits the application of the drive voltage to the switching elements whenever the drive voltage falls below a predetermined threshold level, and that applies the drive voltage to the switching elements whenever a drive voltage exceeds the threshold level.
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wherein when the carrier signal is interrupted, the quick discharge circuit causes the conductive switching element to be discharged expeditiously.
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The present invention generally relates to implantable cardiac stimulation systems and other types of implantable medical devices. Particularly, this invention relates to a method of protecting implanted devices from the effects of external magnetic fields associated with external diagnostic/programmer systems that could result in damage to the implanted devices. More specifically, the present invention relates to an integrated circuit coupled to a high frequency carrier transformer in which the functionality of the integrated circuit prevents damage to the switches in the implanted devices by blocking driving levels with insufficient amplitude. Furthermore, with the inclusion of additional logic circuitry within the integrated circuit, the invention can control more than one protected output using only one transformer, thus contributing to a reduction in the device size.
Implantable devices are implanted in a human or animal for the purpose of performing a desired function. This function may be purely observational or experimental in nature, such as monitoring certain body functions; or it may be therapeutic or regulatory in nature, such as providing critical electrical stimulation pulses to certain body tissue, nerves or organs for the purpose of causing a desired response. Implantable medical devices such as pacemakers, perform both observational and regulatory functions, i.e., they monitor the heart to ensure it beats at appropriate intervals; and if not, they cause an electrical stimulation pulse to be delivered to the heart in an attempt to force the heart to beat at an appropriate rate. In some cases, a number of functions are required for the patient's well being. With space at a premium, it is desirable that multiple functions be incorporated into a single device.
An implantable device, such as a pacemaker, must perform its functions at minimum inconvenience and risk to the person or animal within whom it is used. It must be long-lived and reliable. In most cases, the volume must be minimized. Typically, a noninvasive telemetry system must be provided to allow data and commands to be readily transmitted between the implantable device and an external programmer. The external programmer provides a convenient mechanism through which the operation of the implantable device can be controlled and monitored, and through which data sensed or detected by the implantable device can be transferred out of the implantable device to an external (non-implanted) location where it can be read, interpreted, or otherwise used in a constructive manner.
A permanent magnet can be placed over the implantable device to enable the transmission of specific commands to the implantable device. The implanted device senses the external magnetic field using a reed switch or a special magnetic sensor.
However, the strong magnetic field associated with the external magnet might adversely affect key components in the implantable device. In particular, the strong magnetic field of the external magnet might have unintended, deleterious effects on the high frequency carrier transformer and, ultimately, on the HV (high voltage) switching elements within the device.
In an implantable cardioverter/defibrillator (ICD), key elements in the generation and application of the high voltage electrical stimulation pulses are the main electrical switches that discharge electrical energy (ranging from less than 0.5 Joules to as much as 40 Joules) into the appropriate regions of the heart. These switches, typically power MOSFETs (metal oxide semiconductor field effect transistors) or IGBTs (insulated gate bipolar transistors). If an insufficient IGBT drive voltage is applied, the IGBT can be destroyed, thus rendering the implantable device non-functional.
Drive voltages for the gates of the main switches are derived from the rectified output of the secondary of a high frequency carrier transformer. Reference is made to U.S. Pat. No. 4,800,883 to Winstrom. The use of a 2 MHz carrier frequency allows the core of the transformer to be substantially reduced in size, as required by the constraints on the volume of the implantable device.
However, the reduction in the size of the core leaves the implantable device susceptible to the effects of external magnetic fields such as those represented by an external magnet. In particular, if the core is subjected to a magnetic field of sufficient magnitude and/or asymmetry, the volt-second product of the core may be exceeded. As a result, the core saturates and the output of the secondary decreases due to the reduced coupling factor between the primary and secondary windings. This reduced secondary voltage may be insufficient to effectively and safely drive the gates of the MOSFETs/IGBTs, and might result in damage to or destruction of these switching elements.
Ideally, the isolation transformer is not used while the external magnet is present and, as such, implantable devices are typically equipped with a magnetic field sensor such as a reed switch or Hall effect device that inhibits triggers to the main switching elements. However, it is possible that the magnetic sensor in the implantable device may not sense the field because of dead zones or field nulls near the sensor. For example, even a strong magnetic field perpendicular to the reed switch would not actuate the latter.
If the implantable device attempts to turn on the MOSFETs/IGBTs, and if the transformer supplying the drive to the gate of the switches is saturated, the voltage at the secondary of the transformer may be below the required value, and the main switches may be damaged or destroyed. An IGBT typically requires 15V between the emitter and the gate to be fully ON. While fully on, and at a delivery current of 16 A (e.g. 800V at a 50-Ohm body impedance), the IGBT voltage drop (collector to emitter) is approximately 2V. In this case, for the duration of the applied shock of approximately 5 ms, the IGBT needs to sustain 32 W (e.g. 2V*16A). Considering that the IGBT is insufficiently driven such that the voltage drop is 40V. The current in the circuit would then be (800-40)V/50 Ohm=15.2A. The new power dissipation will be 40V*15.2A=608W, which will destroy the IGBT.
There is therefore a still unsatisfied need for a system that protects the implantable device from an external magnetic field that might saturate a transformer core and lead to damage or destruction of MOSFET/IGBT main switches therein.
The protection system of the present invention addresses and satisfies this need. The protection system includes one or more control blocks that inhibit gate triggers for the switching elements (IGBTs) of an H-bridge whenever the drive voltage for these switching elements falls below a pre-determined level. Each control block provides a controlled path to charge the IGBT gate when triggering is required and, importantly, when the gate drive voltage is above a predetermined threshold.
According to a preferred embodiment, gate triggers for the MOSFETs/IGBTs are inhibited whenever the drive voltage for the MOSFETs/IGBTs falls below a pre-determined level. This reduced voltage may be due to insufficient secondary voltage resulting from a saturated transformer core or from insufficient primary voltage or even defective components. With the inclusion of readily added logic circuitry, the functionality of the invention can be extended to control more than one output that needs to be controlled at the same isolated voltage.
The foregoing and other features of the present invention are achieved by implementing a protection system that employs one or more control blocks in conjunction with a high frequency carrier transformer. The control block, in its most basic implementation, contains logic and control circuitry that inhibits low voltage gate drive pulses that could result in damage to or destruction of the MOSFETs/IGBTs in an implantable device. The control block prevents inadvertent or spurious triggering and protects the gate circuitry of the MOSFETs/IGBTs by providing a low impedance path between the gate and source of the MOSFETs/IGBTs when the devices are intended to be turned off. Additionally, it protects the MOSFETs/IGBTs from over-voltage effects by clamping the output of the gate trigger with a shunt regulator circuit.
The control block is readily produced in a typical 2 □m N-well CMOS process. This technology also includes bipolar transistors, isolated vertical npn transistors and substrate vertical pnp transistors.
Briefly, the operation of the circuit may be summarized as follows: A pulse-code modulated 2 MHz square wave is applied to the primary of a high frequency isolation transformer. The transformer is equipped with a magnetic core to enhance the primary-to-secondary coupling. The output of the secondary is half-wave rectified and is used to pulse-charge a capacitor. During the initial application of the square wave to the transformer primary, the logic circuitry, powered by a voltage derived from rectified secondary output, goes through a transient reset operation to ensure that all logic values are in well-defined states.
At this point, the embedded threshold detector determines whether the available voltage is sufficient for MOSFET/IGBT to be turned ON. In the case where the voltage exceeds the threshold level, a level signal is stored when a brief carrier interruption occurs. After the short interruption, the transformer is again energized and the IGBT is turned ON, only if signal level signal exceeds the threshold. After the IGBT is turned ON, it remains ON as long as the 2 MHz carrier is applied. When this carrier is interrupted, the circuit using three transistors that are configured as a triple Darlington (also referred to as a quick discharge circuit), are triggered, quickly discharging the IGBT gate to emitter capacitance. In addition, the circuit provides a low impedance path between the gate and source of the MOSFET/IGBT. This low impedance effectively renders the MOSFETs/IGBTs untriggerable, and protects them from inadvertent triggers and/or high voltage transients.
The protection system also includes an over-voltage protection scheme that clamps the charge voltage by means of a shunt regulator circuit.
Yet another feature of the invention is its ability to readily accommodate additional output capabilities. For example, an output, not reliant on the interrupted carrier sequence described above, could be available anytime the carrier frequency is applied. An identified use for such an output would be a means of discharging the high voltage capacitors (known as a DUMP function) of a defibrillator included in the pacemaker. Thus, a single transformer is capable of controlling both the shock and dump functions of the implantable device. The flexibility of the invention still allows a magnetic field sensor, such as a reed switch or Hall-effect probe, to be incorporated in the implanted device.
The various features of the present invention and the manner of attaining them will be described in greater detail with reference to the following description, claims, and drawings, wherein reference numerals are reused, where appropriate, to indicate a correspondence between the referenced items, in which:
FIG. 1 is a simplified, partly cutaway view illustrating an implantable stimulation device in electrical communication with at least three leads implanted into a patient's heart for delivering multi-chamber stimulation and shock therapy;
FIG. 2 is a functional block diagram of the multi-chamber implantable stimulation device of FIG. 1, illustrating the basic elements that provide cardioversion, defibrillation and/or pacing stimulation in four chambers of the heart, shown in telemetry communication with an external device/programmer;
FIG. 3 is a schematic representation of a protection system of the present invention, for protecting an H-bridge of the stimulation device of FIG. 2 from high power switching activity occurring within the H-bridge and from strong external magnetic fields;
FIG. 4 is a schematic circuit diagram of the protection system of FIG. 3, shown comprised of a high frequency isolation transformer and an integrated circuit;
FIG. 5 is a timing diagram showing representative waveforms and relative timing at key locations within the circuit depicted in FIG. 4;
FIG. 6 is a schematic circuit diagram of another embodiment of the protection system of FIG. 3, illustrating the functionality of providing DUMP capabilities within the simulation device of FIG. 2; and
FIG. 7 is a schematic circuit diagram of still another embodiment of the protection system of FIG. 3, that includes additional logic and a second output.
The following description is of a best mode presently contemplated for practicing the invention. This description is not to be taken in a limiting sense but is made merely for the purpose of describing the general principles of the invention. The scope of the invention should be ascertained with reference to the issued claims. In the description of the invention that follows, like numerals or reference designators will be used to refer to like parts or elements throughout.
FIG. 1 illustrates a stimulation device 10 in electrical communication with a patient's heart 12 by way of three leads 20, 24 and 30 suitable for delivering multi-chamber stimulation and shock therapy. To sense atrial cardiac signals and to provide right atrial chamber stimulation therapy, the stimulation device 10 is coupled to an implantable right atrial lead 20 having at least an atrial tip electrode 22, which typically is implanted in the patient's right atrial appendage.
To sense left atrial and ventricular cardiac signals and to provide left-chamber pacing therapy, the stimulation device 10 is coupled to a �coronary sinus� lead 24 designed for placement in the �coronary sinus region� via the coronary sinus os so as to place a distal electrode adjacent to the left ventricle and additional electrode(s) adjacent to the left atrium. As used herein, the phrase �coronary sinus region� refers to the vasculature of the left ventricle, including any portion of the coronary sinus, great cardiac vein, left marginal vein, left posterior ventricular vein, middle cardiac vein, and/or small cardiac vein or any other cardiac vein accessible by the coronary sinus.
Accordingly, the coronary sinus lead 24 is designed to receive atrial and ventricular cardiac signals and to deliver: left ventricular pacing therapy using at least a left ventricular tip electrode 26, left atrial pacing therapy using at least a left atrial ring electrode 27, and shocking therapy using at least a left atrial coil electrode 28.
The stimulation device 10 is also shown in electrical communication with the patient's heart 12 by way of an implantable right ventricular lead 30 having, in this embodiment, a right ventricular tip electrode 32, a right ventricular ring electrode 34, a right ventricular (RV) coil electrode 36, and an SVC coil electrode 38. Typically, the right ventricular lead 30 is transvenously inserted into the heart 12 so as to place the right ventricular tip electrode 32 in the right ventricular apex so that the RV coil electrode 36 will be positioned in the right ventricle and the SVC coil electrode 38 will be positioned in the superior vena cava. Accordingly, the right ventricular lead 30 is capable of receiving cardiac signals, and delivering stimulation in the form of pacing and shock therapy to the right ventricle.
FIG. 2 illustrates a simplified block diagram of the multi-chamber implantable stimulation device 10, which is capable of treating both fast and slow arrhythmias with stimulation therapy, including cardioversion, defibrillation, and pacing stimulation. While a particular multi-chamber device is shown, this is for illustration purposes only, and one of skill in the art could readily duplicate, eliminate or disable the appropriate circuitry in any desired combination to provide a device capable of treating the appropriate chamber(s) with cardioversion, defibrillation and/or pacing stimulation.
The stimulation device 10 includes a housing 40 which is often referred to as �can�, �case� or �case electrode�, and which may be programmably selected to act as the return electrode for all �unipolar� modes. The housing 40 may further be used as a return electrode alone or in combination with one or more of the coil electrodes 28, 36, or 38, for shocking purposes. The housing 40 further includes a connector (not shown) having a plurality of terminals, 42, 44, 46, 48, 52, 54, 56, and 58 (shown schematically and, for convenience, the names of the electrodes to which they are connected are shown next to the terminals). As such, to achieve right atrial sensing and pacing, the connector includes at least a right atrial tip terminal 42 adapted for connection to the atrial (AR) tip electrode 22.
To achieve left chamber sensing, pacing and/or shocking, the connector includes at least a left ventricular (VL) tip terminal 44, a left atrial (AL) ring terminal 46, and a left atrial (AL) shocking terminal (coil) 48, which are adapted for connection to the left ventricular tip electrode 26, the left atrial tip electrode 27, and the left atrial coil electrode 28, respectively.
To support right chamber sensing, pacing and/or shocking, the connector further includes a right ventricular (VR) tip terminal 52, a right ventricular (VR) ring terminal 54, a right ventricular (RV) shocking terminal (coil) 56, and an SVC shocking terminal (coil) 58, which are adapted for connection to the right ventricular tip electrode 32, right ventricular ring electrode 34, the RV coil electrode 36, and the SVC coil electrode 38, respectively.
At the core of the stimulation device 10 is a programmable microcontroller 60 that controls the various modes of stimulation therapy. As is well known in the art, the microcontroller 60 typically includes a microprocessor, or equivalent control circuitry, designed specifically for controlling the delivery of stimulation therapy, and may further include RAM or ROM memory, logic and timing circuitry, state machine circuitry, and I/O circuitry. Typically, the microcontroller 60 includes the ability to process or monitor input signals (data) as controlled by a program code stored in a designated block of memory. The details of the design and operation of the microcontroller 60 are not critical to the present invention. Rather, any suitable microcontroller 60 may be used that carries out the functions described herein. The use of microprocessor-based control circuits for performing timing and data analysis functions are well known in the art.
As shown in FIG. 2, an atrial pulse generator 70 and a ventricular pulse generator 72 generate pacing stimulation pulses for delivery by the right atrial lead 20, the right ventricular lead 30, and/or the coronary sinus lead 24 via a switch bank 74. It is understood that in order to provide stimulation therapy in each of the four chambers of the heart, the atrial pulse generator 70 and the ventricular pulse generator 72 may include dedicated, independent pulse generators, multiplexed pulse generators, or shared pulse generators. The atrial pulse generator 70 and the ventricular pulse generator 72 are controlled by the microcontroller 60 via appropriate control signals 76 and 78, respectively, to trigger or inhibit the stimulation pulses.
The microcontroller 60 further includes timing control circuitry 79 which is used to control the timing of such stimulation pulses (e.g. pacing rate, atrio-ventricular (AV) delay, atrial interconduction (A-A) delay, or ventricular interconduction (V-V) delay, etc.), as well as to keep track of the timing of refractory periods, PVARP intervals, noise detection windows, evoked response windows, alert intervals, marker channel timing, etc.
The switch bank 74 includes a plurality of switches for connecting the desired electrodes to the appropriate I/O circuits, thereby providing complete electrode programmability. Accordingly, the switch bank 74, in response to a control signal 80 from the microcontroller 60, determines the polarity of the stimulation pulses (e.g. unipolar, bipolar, combipolar, etc.) by selectively closing the appropriate combination of switches (not shown) as is known in the art.
Atrial sensing circuits 82 and ventricular sensing circuits 84 may also be selectively coupled to the right atrial lead 20, coronary sinus lead 24, and the right ventricular lead 30, through the switch bank 74, for detecting the presence of cardiac activity in each of the four chambers of the heart.
Cardiac signals are applied to the inputs of an analog-to-digital (A/D) data acquisition system 90. The data acquisition system 90 is configured to acquire intracardiac electrogram signals, convert the raw analog data into digital signals, and store the digital signals for later processing and/or telemetric transmission to an external device 102. The data acquisition system 90 is coupled to the right atrial lead 20, the coronary sinus lead 24, and the right ventricular lead 30 through the switch bank 74 to sample cardiac signals across any pair of desired electrodes. Advantageously, the data acquisition system 90 may be coupled to the microcontroller 60 or another detection circuitry, for detecting an evoked response from the heart 12 in response to an applied stimulus, thereby aiding in the detection of �capture�.
The microcontroller 60 is further coupled to a memory 94 by a suitable data/address bus 96, wherein the programmable operating parameters used by the microcontroller 60 are stored and modified, as required, in order to customize the operation of the stimulation device 10 to suit the needs of a particular patient. Such operating parameters define, for example, pacing pulse amplitude, pulse duration, electrode polarity, rate, sensitivity, automatic features, arrhythmia detection criteria, and the amplitude, waveshape and vector of each shocking pulse to be delivered to the patient's heart 12 within each respective tier of therapy.
Advantageously, the operating parameters of the stimulation device 10 may be non-invasively programmed into the memory 94 through a telemetry circuit 100 in telemetric communication with the external device 102, such as a programmer, transtelephonic transceiver, or a diagnostic system analyzer. The telemetry circuit 100 is activated by the microcontroller 60 by a control signal 106. The telemetry circuit 100 advantageously allows intracardiac electrograms and status information relating to the operation of the stimulation device 10 (as contained in the microcontroller 60 or memory 94) to be sent to the external device 102 through the established communication link 104.
The stimulation device 10 additionally includes a power source such as a battery 110 that provides operating power to all the circuits shown in FIG. 2. For the stimulation device 10, which employs shocking therapy, the battery 110 must be capable of operating at low current drains for long periods of time, and also be capable of providing high-current pulses (for capacitor charging) when the patient requires a shock pulse. The battery 110 must preferably have a predictable discharge characteristic so that elective replacement time can be detected. Accordingly, the stimulation device 10 can employ lithium/silver vanadium oxide batteries.
The stimulation device 10 further includes a magnet detection circuitry (not shown), coupled to the microcontroller 60. The purpose of the magnet detection circuitry is to detect when a magnet is placed over the stimulation device 10, which magnet may be used by a clinician to perform various test functions of the stimulation device 10 and/or to signal the microcontroller 60 that an external programmer 102 is in place to receive or transmit data to the microcontroller 60 through the telemetry circuit 100.
As further shown in FIG. 2, the stimulation device 10 is shown as having an impedance measuring circuit 112 which is enabled by the microcontroller 60 by a control signal 114. The impedance measuring circuit 112 is advantageously coupled to the switch bank 74 so that any desired electrode may be used.
It is a primary function of the stimulation device 10 to operate as an implantable cardioverter/defibrillator (ICD) device. That is, it must detect the occurrence of an arrhythmia, and automatically apply an appropriate electrical shock therapy to the heart aimed at terminating the detected arrhythmia. To this end, the microcontroller 60 further controls a shocking circuit 116 by way of a control signal 118. The shocking circuit 116 generates shocking pulses of low (up to 0.5 Joules), moderate (0.5-10 Joules), or high (11 to 40 Joules) energy, as controlled by the microcontroller 60. Such shocking pulses are applied to the patient's heart through at least two shocking electrodes, and as shown in this embodiment, selected from the left atrial coil electrode 28, the RV coil electrode 36, and/or the SVC coil electrode 38 (FIG. 1). As noted above, the housing 40 may act as an active electrode in combination with the RV electrode 36, or as part of a split electrical vector using the SVC coil electrode 38 or the left atrial coil electrode 28 (i.e., using the RV electrode as common electrode).
Cardioversion shocks are generally considered to be of low to moderate energy level (so as to minimize pain felt by the patient), and/or synchronized with an R-wave and/or pertaining to the treatment of tachycardia. Defibrillation shocks are generally of moderate to high energy level (i.e., corresponding to thresholds in the range of 5-40 Joules), delivered asychronously (since R-waves may be too disorganized), and pertaining exclusively to the treatment of fibrillation. Accordingly, the microcontroller 60 is capable of controlling the synchronous or asynchronous delivery of the shocking pulses.
FIG. 3 illustrates an H-bridge 120 which is typically incorporated into the implantable device 10. The ICD energy storage element of the stimulation device 10 is represented by a storage capacitor C0. Though as an illustrative example the main switches (or switching elements) of the H-bridge 120 are shown as IGBTs, other switching elements, such as power MOSFETs, SCRs (silicon-controlled rectifiers), or similar elements may be used.
Typically, the main switches are triggered in pairs. For example IGBT1 and IGBT4 receive simultaneous triggers from control blocks 145 and 148, respectively. Energy is transferred to the heart 12, represented by the load, RL, from the positive rail +HV and the negative rail −HV. The next trigger is applied to IGBT2 and IGBT3, transferring energy from the positive and negative rails as before, but with current flow through the load, RL, in the opposite direction.
The switches or switching elements IGBT1, IGBT2, IGBT3 and IGBT4 in the H-bridge 120 are susceptible to damage and/or destruction in the event of the application of a trigger that falls outside predetermined nominal values. This includes triggers whose voltage amplitude are too large and those whose amplitudes are too small. As an example, an IGBT gate to emitter triggers with drive voltage amplitudes that exceed the nominal value may damage or destroy the gate circuit of these switches. In the event of a serious undervoltage drive at the gate of a main switch, the latter may experience damage or destruction of the switch.
A protection system 150 is added to protect the switching elements IGBT1, IGBT2, IGBT3 and IGBT4. In the example illustrated in FIG. 3, the protection system 150 generally includes four control blocks 145, 146, 147 and 148 that are connected to the switching elements IGBT1, IGBT2, IGBT3 and IGBT4, respectively, of the H-bridge 120. A carrier control circuit 155 is coupled, in turn, to the control blocks 145, 146, 147 and 148 to generate 2 MHz trains, the function of which will be explained later.
Referring now to FIG. 4, it illustrates a basic schematic circuit diagram of an exemplary control block, for example, the control block (or integrated circuit) 145 of FIG. 3, which is coupled to the switching element IGBT1. Part of the carrier control circuit 155 is represented in FIG. 4 by a high frequency carrier transformer 160 and a rectifying diode D1.
The carrier transformer 160 is designed to receive a 2 MHz square wave, 5V amplitude, excitation pulse train on its primary winding from a 2 MHz generator controlled by microcontroller 60. A magnetic core of the transformer 160 provides a low reluctance path for the flux between the primary and secondary windings, resulting in enhanced coupling between the transformer primary and secondary windings. The high frequency operation of the transformer 160 reduces the volume of magnetic material and allows the transformer to be readily adapted for use with the implantable stimulation device 10. The transformer secondary winding generates 18V.
The rectifier diode D1 is placed in series with the output of the secondary winding of the transformer 160, to rectify the output of transformer 160, resulting in a DC voltage on an energy storage capacitor C1 that forms part of the control block 145. The combination of the storage capacitor C1, resistors R1 and R2, a plurality of (i.e., 26) series diodes D2 through D27, and a bipolar npn transistor Q1 forms a shunt regulator 170. The shunt regulator 170 defines a voltage Vcc from which key bias levels are attained and/or derived. In steady state, Vcc is equal to approximately 17.5 V, the sum of 26 forward diode drops along with VBE(on) for the regulating transistor Q1. A bypass capacitor C4 is connected across voltage Vcc.
With reference to FIG. 4 and the timing diagram of FIG. 5, when a 2 MHz carrier pulse train 200 is first applied at time T0 to the primary winding of the transformer 160, an excitation appears on the secondary winding of the transformer 160, and the voltage on the capacitor C1 will increase as it is charged through the diode D1. As the voltage of capacitor C1 increases, a transistor Q2 turns on, generating a bias voltage Vdd. The bias voltage Vdd is equal to the voltage of the transistor Q2 emitter, which, in turn, is equal to the forward voltages on the diodes D13 through D27, in addition to the Q1 base to emitter voltage, less Q2 base to emitter voltage, or the forward voltages of 15 diodes, which is approximately 0.67V. Vdd is therefore equal to approximately 10 V in a steady-state condition. The bias voltage Vdd acts as the supply voltage for the CMOS logic circuitry throughout the sequence of events (from T0 to T7). A bypass capacitor C3 is connected between Vdd and Vss.
Referring more specifically to FIG. 4, a power-on-reset (POR) circuit 180 is formed by the combination of a capacitor C2, a resistor R4, transistors Q3 and Q4 connected to form an inverter, and an inverter I1. The power-on-reset circuit 180 generates a reset signal POR* that resets a RS flip-flop FF1 and a D flip-flop FF2, ensuring that the flip-flops FF1 and FF2 are in a known and required state when the logic sequence begins. Initially, the voltage on capacitor C4 is zero, and as such, through the inverter formed by transistors Q3 and Q4 and inverter I1, the output POR* (power-on-reset bar) remains LOW or active.
The logic LOW provided by the power-on-reset circuit 180 is held for approximately 2 □s, time T1, (as defined by the RC time constant of resistor R4 and capacitor C2), after the carrier signal is initially applied to the primary winding of the transformer 160. After that period has elapsed, capacitor C4 charges to more than � Vdd voltage, transistor Q4 turns ON and transistor Q3 turns OFF, dropping the input of inverter I1 to a logic LOW. The power-on-reset circuit 180 then produces a logic HIGH (POR*=HIGH) and the reset is removed from the flip-flops FF1 and FF2. POR* remains HIGH for the rest of the following sequences.
A threshold detector 190 is formed by resistors R5, R6, R7, R8, and R9, transistors Q5, Q6, Q7 and Q8, and diodes D28 and D29. The threshold detector 190 ensures that the bias voltage Vcc has sufficient amplitude to drive IGBT1 without potential damage; otherwise the drive is inhibited. In particular, if the bias voltage Vcc is less than 15 V, the predetermined threshold, the transistor Q5 does not receive enough base drive to switch it from its OFF state. The Q5 base voltage is determined by the divider R5, R6, R7. When this voltage is below 4 diode drops (i.e., Q5 Base to emitter, D29, D28, Q7 base to emitter), the transistor Q5 does not receive sufficient bias, and will not be able to drive transistor Q7 ON.
A pullup transistor Q8 will pull output V1 HIGH (i.e., equal to Vdd). This will not activate the flip-flop FF1 active low S input, and the flip-flop FF1 will remain reset. The voltage V1 also goes to the flip-flop FF2 clock input, which requires a LOW to HIGH transition. So, V1 being HIGH, will not clock FF2. It is only when V1 goes from LOW to HIGH, as explained later, that it will clock the flip-flop FF2 and set Q equal to the D input of the flip-flop FF2. However, the D input of the flip-flop FF2 is LOW, and thus even if the clocked output Q of the flip-flop FF2 remains LOW, this will maintain a MOSFET transistor Q14 OFF. This, in turn, will keep a Darlington pair Q12/Q13 OFF, and Vc1 will not be applied to an OUT terminal, thus preventing the signal Vc1 from propagating to IGBT1.
Conversely, when the bias voltage Vcc exceeds the required threshold of 15V, (at time T2) transistor Q7 is turned on, and the voltage V1 drops to Vss, a voltage very nearly equal to 0V. The input to the Set (S) line of the RS flip-flop FF1 goes LOW, producing a logic HIGH on its Q output and FF2-D input.
After approx. 4 □s (time T3 in FIG. 5), the 2 MHz train is turned OFF for approximately 2 □s until T5. During this period, voltage Vc1 applied to capacitor C1 and Vdd applied to capacitor C3 will decay, but will not discharge to less than 3V, or Vddmin (FIG. 4). As such, the flip-flops FF1 and FF2 will maintain their state. At T4, Vcc drops below the 15V threshold and V1 goes HIGH. This clocks the input D of the flip-flop FF2 with data equal to Q output of the flip-flop FF1. If, as explained above, Vcc is above 15V before T3, the Q output of the flip-flop FF1 is HIGH, so that the output Q of the flip-flop FF2 will be switched HIGH.
Referring to FIG. 5, at T5, the train is reapplied and Vc1 and Vdd will go to previous levels and V1 will remain HIGH or equal to Vdd. The flip-flop FF1 will not change state and the flip-flop FF2 will not be clocked (as V1 did not go LOW and HIGH to trigger the clock input), and therefore, the Q input of the flip-flop FF2 will remain HIGH (if prior Vcc before T3 was above 15V). This will turn transistor Q14 ON, and causes its drain current to turn the Darlington pair (Q12, Q13) ON and Vc1 will be connected to the output �OUT� turning the IGBT (in this example IGBT1) ON. This will drive the IGBT with a sufficient driving voltage only when the transformer secondary winding generates a voltage that is sufficiently high to bring Vcc above 15V.
The second train, starting at T5 (FIG. 5), will last for a duration of a few milliseconds necessary to deliver the high voltage shock. After this second train is turned OFF, the IGBT will be turned OFF very fast, as it will be explained further.
The introduction of transistor Q6 into comparator 190 adds a small amount of hysteresis to the comparison point by adding a small amount of positive feedback to short resistor R7. This prevents any oscillation that might otherwise occur as the voltage Vcc traverses the threshold in either direction.
With reference to FIGS. 3 and 4, additional protection is afforded to IGBT1 by limiting the voltage that may appear at its gate while IGBT1 is OFF. While the control block 145 is OFF, without drive on its input �IN�, the voltage of capacitor C4 is zero as it is discharged to Vss via resistor R10. Transistors Q9, Q10 and Q12, form part of a clamp circuit 195, and act as a �capacitor multiplier�.
As soon as the OUT terminal voltage is equal to 3 forward diode drops (base to emitter drops of Q9, Q10 and Q11) of approximately 2V, these 3 transistors Q9, Q10 and Q11 turn ON, and act as a capacitor multiplier for C4. An equivalent capacitance between the output �OUT� and Vss is formed with a value of the capacitance of capacitor C4 multiplied by the Darlington current amplification by Q9, Q10 and Q11, of approximately 1000.
If the capacitance of capacitor C4 is equal to 50 pF, an equivalent capacitor of 50 nF is connected between �OUT� and Vss. This is important to protect IGBT1 from turning ON due to transients often generated in defibrillation circuits in which they are installed. In addition, as the OUT voltage tries to exceed 2V, the conductance of 3-transistor (Q9, Q10, Q11) Darlington circuit to Vss goes increasingly lower, until the voltage on the OUT terminal saturates at approximately 2.2V.
Yet another feature of the control block 145 is the very fast turning OFF of IGBT1 by means of a clamp circuit 195 that includes a resistor R10 and a capacitor C4. The functionality may be understood in the following context: When IGBT is turned ON, its large gate to emitter capacitance causes the �OUT� terminal voltage to charge slower than the C4 voltage. This causes the Darlington circuit (Q9, Q10, Q11) to remain OFF.
When the carrier signal is removed to turn OFF IGBT1, the voltage on the capacitors C3 and C4 will decay faster than the voltage on the output OUT. This will bring the transistors Q9, Q10 and Q11 into conduction, thus discharging the large emifter-gate capacitance of IGBT1 across the output OUT, and ensuring that IGBT1 turns OFF very fast. The R4 conductance is multiplied by approximately 1000. If the resistor R4 is equal to 100 kOhm, an equivalent resistance of 100 Ohm or less is between OUT and Vss. Turning the IGBT1 very fast is required to minimize its power dissipation during switching between the ON and OFF states.
Referring now to FIG. 6, it illustrates another control block 145A which is generally similar in function and design to the control block 145 of FIG. 4, but further includes a second output labeled OUT2, which may be added to the control block 145 by the inclusion of transistors Q15, Q16 and Q17, and resistors R12 and R13 with the circuit connections as shown.
The second output OUT2 of the control block 145A provides a drive for a switching element, such as IGBT2 or a MOSFET, that may, for example, be part of an implanted cardio-defibrillator (ICD) that needs to discharge one or more high voltage capacitors CO (FIG. 3), which is referred to as DUMP function. The second output OUT2 provides such a drive irrespective of the carrier sequence, rather producing the drive voltage whenever the carrier is activated by the first train without requiring a train interruption. As shown in FIG. 6, transistor Q15 acts as a diode. When the voltage Vc1 increases, it charges the OUT2 capacitance, which is defined by the gate to emitter capacitance of IGBT1, through resistor R13. When the train stops, C4 will discharge faster than the OUT2 capacitance, and the Darlington pair (Q16, Q17) will enter conductance, discharging OUT2 to Vss.
Normally, the output OUT2 will drive a small power MOSFET or IGBT and will require a much less driving power than the power required to drive IGBT1 through IGBT4. If only dump is required, the first train is maintained as long as required to discharge the high voltage of capacitor C0. After which, the second train is not applied, so the OUT terminal is never driven.
However, during the shock command when the sequence of the first train, pause, and the second train is applied, the output OUT2 will also be active, but this is practically acceptable. The reason is that during the shock period (i.e., a few milliseconds) while activating the output OUT, a dump circuit comprised of the IGBT in series with a resistor connected across C0 and intended to slowly discharge C0 to zero, will discharge C0 by an insignificant amount. In other terms, during the shock period, the main output OUT is activated, and the additional current through the dump circuit will be insignificant compared to the current through RL 12. As an example, if RL 12 which represents the body impedance in FIG. 3 is 50 Ohms, the dump resistance is usually 20 kOhm, or 400 times larger than RL 12, so practically only 1/400 or 0.25% of energy will be lost.
Yet another embodiment of the control block 145 (FIG. 4) is illustrated in FIG. 7 and denoted by the reference numeral 145B. The control block 145B is generally similar in function and design to the control block 145 of FIG. 4, but includes additional logic in the form of a second D flip-flop FF3, an AND gate A1, a transistor Q19, a bias resistor R14, and a pair of transistors Q17, Q18. The operation of the control block 145B is similar to that of the control blocks 145 (FIG. 4) and 145A (FIG. 6) with the exception that the second output OUT3 now requires two carrier interruptions to produce an output OUT3.
The output OUT is practically unaffected by this circuit augmentation, which allows the control block 145B to control multiple outputs using carrier pulse coding, further enhancing its functionality, yet still relying on a single carrier transformer. Flip-flop FF3 will be clocked OFF (i.e., the Q output of FF3 is set to 0) at T4 (FIG. 5), as the Q output of the flip-flop FF2 is LOW, while V1 is equal to the clock signal and goes HIGH.
After the first interruption, if enough drive was applied, the AND gate A1 will receive an input HIGH from the Q output of the flip-flop FF2, and a second input which is active LOW (a bubble at this input) from the Q output of the flip-flop FF2. A HIGH output of the AND gate A1 will drive the output OUT active.
For example, if a second interruption is applied shortly after the first interruption, transistor Q13 will be turned ON during second train for a very short period, which is insufficient to charge IGBT1 on the output OUT. During this second interruption, the second D flip-flop FF3 will be switched ON (i.e., the Q output of FF3 is set to 1) by the potential V1 applied to its clock input. As shown in FIG. 5, similarly to the first interruption at time T6, V1 goes LOW−V1 will go HIGH, next LOW, and clock flip-flop FF3. As the D input of the flip-flop FF2 remains HIGH, because the output Q of the flip-flop FF1 is HIGH, the output Q of the flip-flop FF3 will go HIGH and the right active LOW AND input will go HIGH. This will make AND output LOW, thus disabling transistors Q14, Q12 and Q13, and keeping output OUT LOW. However, the Q output of the flip-flop FF3 will turn transistors Q19, Q17 and Q18 ON, applying Vc1 to the output OUT3.
While a detailed description of specific embodiments of the present invention have been provided, it would be apparent to those reasonably skilled in the field that numerous variations are possible in which the concepts and methods of the present invention may readily be applied.
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Bert takes Austin, TX, couple Shannon and Nate on the perfect Miami vacation, including drag racing, a tour of the city by a local music heavyweight and a surprise Carnival cruise.Go to Episode
South Beach
Miami's South Beach draws in the rich, famous and trendy. It's considered a beach lover's dream, with water sports, sunbathing, volleyball and beautiful people in every direction.
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This Turkey Day vacay: host a friendsgiving feast!
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Mes Demoiselles' Alix sweater is the fall essential with loose knitting that composes a relaxed fitted sweater with oversized sleeves that gather at the wrist | Wide neck with three button closure detail on left shoulder | Rib knit trim finishes sleeves and hem | Oversize fit. Mohair / Acrylic Dry Clean
Mes Demoiselles Alix Sweater 218,04 €
The Louise dress embodies Mes Demoiselles's feminine take on bohemia. Made from cream cheesecloth and embroidered with blue polka dots, it features short puff sleeves, an empire-line bust and full flowing skirt. Keep the look modern with slick, clean-lined sandals.
Mes Demoiselles takes inspiration from the designer's travels around the world, owing to the line's bohemian, eclectic aesthetic. This Zephir tunic is made from luxurious raw-silk and finished with bronze and silver embroidery. Balance the tunic shape with straight-leg jeans and an oversized tote.
Mes Demoiselles creates beautiful, bohemian pieces for home and away. This light and breezy Lina blouse is made from a polka-dot embroidered ivory cheesecloth that works perfectly in high temperatures. Balance the floaty silhouette with slim-cut denim and flat sandals.
Inspired by a love of travel, Mes Demoiselles creates bohemian, warm-weather styles like this ivory and blue striped Dorian poncho. It's made from lightweight cheesecloth cotton and cut to an effortless, loose silhouette that fares just as well with jeans in the city as it does over a printed bikini on the beach.
Elevate everyday staples with this bohemian Keanu jacket from Mes Demoiselles. It's made from a lightweight black cotton and heavily embroidered with a king and queen motif at the back. Layer it under a winter coat, or wear it as a colourful, statement cover-up come spring.
Lamé-Stoff, Leichter Strick, einfarbig, V-Ausschnitt, lange Ärmel, ohne Taschen, ohne Applikationen, Pullover
Mes Demoiselles Langarmpullover 120 € 32 €
Ruching adds easy movement to a strapless gauze Mes Demoiselles maxi dress. Soft padding shapes the embroidered cups, and a wide panel of smocked elastic secures the top hem. Lined. Fabric: Gauze. Shell: 100% cotton. Dry clean. Imported, India. Measurements Length: 49.25in / 125cm, from center back Measurements from size 38
Mes Demoiselles Marie Strapless Dress 304,61 € 91,38 €
Elaborate embroidery lends bohemian charm to a delicate gauze Mes Demoiselles blouse. Tasseled ties secure the split V neckline, and slim button cuffs gather the full sleeves. Fabric: Gauze. 100% cotton. Dry clean. Imported, India. Measurements Length: 26in / 66cm, from shoulder Measurements from size 38
Mes Demoiselles Kacy Tie Neck Top 347,90 €
Carefully crafted in India, this black raw silk Zephir tunic from Mes Demoiselles is a hero vacation piece. It's detailed with traditional metallic bronze and silver embroidery and looks as beautiful under the sun as it does layered over leggings and knee-length boots in the city.
Mes Demoiselles Hose 100 €
Warm-weather dressing calls for a romantic maxi dress like this cream Louise style from Mes Demoiselles. Its made from lightweight, polka-dot embroidered cheesecloth and has short puff sleeves and an elasticated waist. Layer it over the matching slip and finish with tan leather accessories.
Reference Studio54 glamor in Mes Demoiselles' Diane Yellow Sheer Blouse | Golden yellow flocked silk in a scattered dot print | Button front with fold over collar | Long sleeves with single button cuffs | Single front breast patch pocket | Long sleeves with single button cuffs | Hi lo hemline | Sheer. 58% Viscose, 42% Silk dry clean FINAL SALE
Mes Demoiselles Diane Yellow Sheer Blouse 181,16 € 54,51 €
Metallic threads shimmer through the colorful stripes of this mohair-infused Mes Demoiselles sweater. The boxy silhouette creates a cool, slouchy fit. Raw boat neckline. Ribbed cuffs and hem. Long sleeves. Fabric: Loose chunky knit. 54% mohair/30% acrylic/10% polyamide/6% metallic. Dry clean. Imported, China. Measurements Length: 21.5in / 54.5cm, from shoulder Measurements from size 1
Mes Demoiselles Shy Sweater 294,19 €
Metallic yarn adds alluring glimmer to this Mes Demoiselles double-breasted sweater. Pouch pockets frame the placket. Long sleeves. Fabric: Open knit. 47% mohair/26% acrylic/14% polyamide/13% metallic. Dry clean. Imported, China. Measurements Length: 25.25in / 64cm, from shoulder Measurements from size 2
Mes Demoiselles Jimmy Long Cardigan 498,60 €
This Imany lace-trim dress from Mes Demoiselles stays true to the brand's romantic, bohemian aesthetic. It's made from ivory cheesecloth-cotton with a languid silhouette that hangs from the shoulders, skims the body and ends flatteringly mid-calf. Wear it under the sun with strappy sandals, adding a cropped jacket after-dark.
Mes Demoiselles Top 53 €
Work Mes Demoiselles's Parisian sensibility into your new-season wardrobe with this black quilted Andrea jacket. The understated, collarless design is elevated with metallic-gold diamond-shaped embroidery. Slip it over a T-shirt and white jeans for pulled-together daywear style.
Mes Demoiselles 'Esther' leggings 608,99 €
A loose, crinkled-gauze Mes Demoiselles dress gains subtle texture from tonal embroidered accents. Ruching adds movement to the ruffled hem, and plush, braided straps complete the piece. Lined. Fabric: Gauze. Shell: 100% cotton. Dry clean. Imported, India. Measurements Length: 50.75in / 129cm, from shoulder Measurements from size 40
Mes Demoiselles Camee Dress 184,37 € 55,31 €
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It's official: the temperature has officially reached "cold as hell" status. This term may be oxymoronic in nature, so let's just roll with it. Quit hibernating, peel yourself off the sofa, don't join the massives with the annual winter hobby of watching TV. Try "warming up" to one of the outdoor adventures happening this weekend around Louisville.
Bernheim Forest and Arboretum is featuring a "Winter Star Stories" workshop this Friday, December 10th from 6:00-9:00 PM. According to Bernheim's website, "Don Spain and his core of volunteers from the Louisville Astronomic Society . . . will set the stage for the evening experience by [instructing participants] how to look through a variety of telescopes, hear a few star stories, or ensure that you are sufficiently 'moonstruck' for a lunar lighted moon walk." Bundle up because most of the tour is outdoors. The price is $8 for members and $12 for non-members; advanced registration is required.
Kentucky has an amazing underground cave system--Mammoth Cave has the largest in the world. Try warming up underground where the temperature stays moderate year round. Mammoth Cave's winter hours run from 8:45-5:10 and the easy drive could make for the perfect getaway this weekend. Throw in a quick stop at Dinosaur World just off the highway, and the whole family will be happy.
Across the river, Marengo Caves in Marengo, IN (about a 40 minute drive from downtown) offers an expansive cave system tour. I recently toured the cave with a group of my sixth grade students and thoroughly enjoyed the experienced (believe it or not). Our guide was enthusiastic and well-informed; we were often amazed at the structures buried below. Way better than the mall this time of year.
Photo courtesy of Marengo Caves.
|Trifecta of family outdoor adventures [Family and parenting]
|Cool Cave Day Trips from Louisville
|Experience Bernheim Forest after-hours and peer into the universe at their monthly Star Stories and Sky Watch Nights [Family & Parenting]
|The 16th annual Colorfest next weekend at Bernheim [Family and parenting]
|Weekend events that make the end of summer freedom tolerable [Family and parenting]
|Night owls [Family and parenting]
|Bernheim events for the family [Family and parenting]


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Top 5 Tech Talent Needs
More than 800 business executives identify what technology-talent needs will be most pressing in the next 12 months.
Management consultancy McKinsey & Co. surveyed business executives from across functions to find out their attitudes about IT. One question asked where organizations technology-talent needs will be most pressing in the next 12 months. More than 800 executives responded. The results were published in late March. McKinseys takeaway: To address talent challenges, companies should focus on culture and compensation. These are the top five areas of technology talent needs.
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Association for Molecular Pathology creates informatics subdivision http:/
Figuring it out one step at a time.
Data scientist, digital biologist and media publisher.
Association for Molecular Pathology creates informatics subdivision http:/
Obama just did the right thing for the internet — and made life hell for the FCC http:/
The 50 Most Innovative Companies Of 2014: Strong Innovators Are 3x More Likely To Rely On Big Data Analytics http:/
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So I bet you guys were thinking I would completely forget about Thanksgiving. Well, I would would have, but my sister reminded me.
"Hey, you should make those cheesy bacony mashed potatoes to post," she said, "I think people would really like those for Thanksgiving."
So while I was photographing them, she was hovering around me with a fork in her hand, "So, um... is there any part of that that doesn't need to be in the pictures?" she asked, drooling onto my shoulder.
"Ha! Now I see the real reason you wanted me to post these! I thought you were trying to be so helpful thinking of something for me to post, but you only wanted them for yourself!"


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431 5th Avenue
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(201)261-3468(Roman Catholic)0.3 mi | 212 students | Gr. PK-8
River EdgeJewish Education For Special Children
Po Box 361
River Edge, NJ, 07661
(201)262-1090Special Education School (Jewish)0.6 mi | n/a students | Gr. UG
ParamusYavneh Academy
155 Farview Avenue
Paramus, NJ, 07652
(201)262-8494(Jewish)0.7 mi | 740 students | Gr. PK-8
Paramus Visitation Academy
222 Farview Ave
Paramus, NJ, 07652
(201)262-6067(Roman Catholic)0.8 mi | n/a students | Gr. K-8
ParamusBen Porat Yosef
E. 243 Frisch Court
Paramus, NJ, 07652
(201)845-5007(Jewish)0.8 mi | 383 students | Gr. NS-8
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What do you do when you are dissatisfied with your local public schools? Homeschool your children? Send them to private school? Let's look at your options.
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DEO Petroleum plc, the oil and gas development and production company focused on the UK Continental Shelf ("UKCS") region of the North Sea, is pleased to announce that the amalgamation agreement to combine the Licence P218 Block 15/21a Gamma Sub Area ("Gamma") and Block 15/21g ("Spaniards") areas has been finalised. The parties to the agreement will now effect the relevant transfer documentation. A firm commitment well is expected to be drilled by Encore (Operator) in the third quarter of 2012.DEO has a carried interest of 12.62% and will make no cash contribution to the dry-hole cost of the first well. The remaining Gamma/Spaniards equity is held by Encore (28%), Nautical Petroleum (21%), Serica Energy (21%), Faroe Petroleum (8.4%), Maersk Oil (5.74%), and Atlantic Petroleum (3.24%).David Marshall, DEO Chief Executive Officer Comments:"We are delighted to announce the signature of the amalgamation agreement which will allow detailed well planning activities to be finalised. We look forward to the results of the commitment well later in 2012."
This article is for information and discussion purposes only and does not form a recommendation
to invest or otherwise. The value of an investment may fall. The investments referred to in this
article may not be suitable for all investors, and if in doubt, an investor should seek advice from
a qualified investment adviser. More
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"Audio books should not be performed but read!"
Listening to this book resembled listening to a TV or radio program which I found totally distracting. I did not enjoy it. I much prefer to be read to.
"Sexual references get in the way of the plot"
I missed much of this book because I found the sexual references unpleasant and skipped past them. The author writes well and the reader has an excellent voice.
"David Rosenfelt is Clever"
Bury the Lead is a clever well written book. I would listen again.
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Snake Slider for the iPhone/iPod Touch is a highly addictive new puzzle game. The goal is to slide the green snake to the exit. This sounds easy but only the most clever players can solve the 150 increasingly difficult puzzles. The first puzzle set introduces the green and yellow snakes. Move the snakes around so that the green snake can exit the basket. The second puzzle set adds apples and mushrooms. Snakes can eat apples but that will make them longer, leaving less room to move. On the other hand, some puzzles contain mushrooms that will shrink a snake, giving you more space. The third puzzle set adds movable blocks. You can't move the blocks directly but you can use the snakes to push the blocks around. The last carpet adds keys and locks, the snakes can eat keys to open the locks. Use all these elements wisely to solve the puzzles using as few moves as possible. Snake Slider features: ✔ 150 puzzles ✔ Retina support, high resolution graphics ✔ Gradually increasing difficulty ✔ Be
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Originally written on Steelers Depot | Last updated 11/19/14
Last Monday Pittsburgh Steelers head coach Mike Tomlin said during his press conference that we shouldn't read much into the running back rotation currently be used during the offseason practices and that putting the pads on in training camp is when it matters the most. At that time, I speculated Jonathan Dwyer was only being given the majority of the first-team reps because he ended the 2012 season as the starter and on Tuesday running backs coach Kirby Wilson confirmed that to indeed be the case. "We just start them where we ended," Wilson said Tuesday after practice, according to a report Read more [...]
Original Story: http://www.steelersdepot.com/2013/06/...
PLAYERS: Jonathan Dwyer, Mike Tomlin
TEAMS: Pittsburgh Steelers
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News - China - BIRD FLU
Poultry farms may be H7N9 source, study finds
Posted May 19th 2013, 12:00am by Staff Reporter
... virus that has killed 21 people. The study, compiled after a week-long field assessment of the influenza by a panel of experts commissioned by the WHO, was publicised by the National Health ... avian-influenza viruses. Among the 104 confirmed cases, 72 per cent have had exposures to poultry and poultry markets. It said poultry farms were likely the source of infections. "Although the virus ...http://www.scmp.com/news/china/article/1240896/poultry-farms-may-be-h7n9-source-study-finds
Poultry industry prepares for next Rest Day on Sunday
Posted Sep 23rd 2005, 12:00am by Staff Reporter
... LAI YING-KIT Updated at 5.47pm: Hong Kong's poultry vendors have to clean and disinfect their premises during the next Rest Day this Sunday, the Food and Environmental Hygiene Department has announced. A department spokesman on Friday urged poultry r ...http://www.scmp.com/article/517448/poultry-industry-prepares-next-rest-day-sunday
Sunday will be next rest day for poultry industry
Posted Apr 08th 2005, 12:00am by Staff Reporter
... YI HU Updated at 4.17pm: Sunday will be the next monthly rest day for Hong Kong's poultry industry, a Food and Environmental Hygiene Department spokesman confirmed on Friday. He urged all poultry retailers in the territory to 'strictly observe ...http://www.scmp.com/article/495829/sunday-will-be-next-rest-day-poultry-industry
Chickens culled after H5N1 find
Posted Dec 22nd 2011, 12:00am
... Emily Tsang and Ada Lee The early birds were lucky, the rest missed out. Hongkongers quickly snapped up the few live chickens remaining on market stalls yesterday after the government halted supplies from wholesalers and ordered a cull following the disco ...http://www.scmp.com/article/988424/chickens-culled-after-h5n1-find
Live chicken imports from China to increase for Winter Solstice
Posted Dec 17th 2004, 12:00am by Staff Reporter
... chickens each day,' he explained. He said overstocking of live chickens in the retail outlets could lead to the risk of an outbreak of avian influenza. ...http://www.scmp.com/article/482503/live-chicken-imports-china-increase-winter-solstice
Families opt for frozen chickens
Posted Dec 22nd 2008, 12:00am by Staff Reporter
... Ng Yuk-hang Families switched to cooking chilled and frozen chickens for dinner on the winter solstice amid the ban on the sale of live chickens that followed a bird flu outbreak at a local farm early this month. Sales of frozen chickens increased by 30 t ...http://www.scmp.com/article/664686/families-opt-frozen-chickens
Twelve HK farms receive 30,000 day-old chicks from China
Posted Jun 25th 2004, 12:00am by Andy Chen
... ANDY CHENG Updated at 6.15pm: A total of 30,000 day-old chicks arrived at 12 Hong Kong farms on Friday- the first mainland imports after the suspension of imports of day-old chicks was introduced on January 30. The suspension was introduced after suspected avian influenza cases were reported in the mainland earlier in the year. A spokesman for the Agriculture and Fisheries ...http://www.scmp.com/article/460708/twelve-hk-farms-receive-30000-day-old-chicks-china
HK poultry industry easier to monitor than mainland farms
Posted Jul 03rd 2008, 12:00am by Staff Reporter
... of viruses and diminished effectiveness of vaccines, new vaccines should be made. This is the same as human seasonal influenza in which new vaccines are being produced every year to counter ...http://www.scmp.com/article/643783/hk-poultry-industry-easier-monitor-mainland-farms
200 officers search for the elusive backyard chickens
Posted Feb 16th 2006, 12:00am by Mary Ann, Mary Ann Benitez
... Mary Ann Benitez The government yesterday defended its deployment of 200 officers to seek and destroy backyard chickens. They have so far been able to catch just 176 birds. The ban took effect on Monday, with Agriculture, Fisheries and Conservation Depart ...http://www.scmp.com/article/536666/200-officers-search-elusive-backyard-chickens
Centralised killing 'not only solution'
Posted Feb 02nd 2004, 12:00am by Staff Reporter
... reaching Hong Kong, the government suspended mainland poultry imports on Friday and will provide free influenza vaccinations for local poultry farmers and dealers from today. Mr Wong suggested ...http://www.scmp.com/article/443050/centralised-killing-not-only-solution
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- Reviews
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Martin Owners Club Event Celebrates 175th Anniversary
July 24, 2008
On Friday August 1st, at their factory and museum in Nazareth, PA, Martin Guitar will host the 3rd Annual Martin Owner''s Club Event.Read More
Framus Headstocks Get Makeover
July 23, 2008
Warwick-Framus reduces flare on new headstocks.Read More
Gadow Adds the American Deluxe
July 23, 2008
Gadow introduces the American Deluxe to their handmade American series.Read More
Riffs: Guitar Love, Purdue Guitar Workshop, Metal Loving Friar
July 22, 2008
A Guitar Love Story from The Independent Take a look at this piece by a British writer about his relationship with the guitar and guitar music. It''s a great love story,Read More
Premier Collector #3: Vintage Fender Amps and Guitars
July 22, 2008
Five Fender amps from the sixties and seventies, and 15 vintage and newer guitars make Lorne Sheaves'' collection.Read More
Reverend Release Roundhouse RT
July 21, 2008
Reverend releases a new kickin'' guitar.Read More
Fred and Dinah Gretsch Inducted Into Georgia Music Hall Of Fame
July 21, 2008
Fred and Dinah Gretsch to be first instrument manufacturers ever inducted into the Georgia Music Hall of Fame.Read More
Schecter Announces Hollywood Classic Guitar
July 21, 2008
The new Hollywood Classic is part of Schecter Guitar Research''s Hollywood Series.Read More
Riffs: Rush On TV, Speedy Guitar Player, Free Recording Software
July 21, 2008
Rush Appears On Colbert Report from Rolling Stone Last week, Rush made their first appearance on television in 33 years. Hosted by comedian Stephen Colbert on The Colbert Report,Read More
Seymour Duncan Interview, Part 1
July 18, 2008
Every legend has an inspiring story about how it all began and Seymour Duncan is no different. An inquisitive young Seymour fixed a string-damaged Tele pickup back in the day and that launched it all.Read More


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According to the private pilot, after landing, a 180 degree turn was required to back taxi on the runway. During the turn, the main landing gear encountered soft snow at the edge of the runway, and began to sink further into the snow. The pilot increased engine power to return the airplane to the center of the runway; however, the tail of the airplane began to rise and the strong quartering tailwind continued to nose the airplane over which resulted in substantial damage to the right wing strut and vertical stabilizer. The pilot reported the wind, at the time of the accident, was approximately 220 degrees at 15 knots with gusts up to 20 knots. He further reported that there were no mechanical malfunctions or abnormalities that would have precluded normal operation.
The National Transportation Safety Board determines the probable cause(s) of this accident to be:
Index for Apr2014 | Index of months


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Initial NIH BRAIN Initiative investments total $46 million
The National Institutes of Health will put forward $46 million to support the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative in its first wave of investments for the project.
Researchers examine fingerprint scanning to boost vaccination accuracy
Electronically recording and tracking the fingerprints of infants and toddlers holds the potential to improve the volume and accuracy of immunization coverage, according to a Michigan State University study.
Fierce Innovation Awards call for entries: Prove your Fierceness
House bill would boost telehealth for ACOs
A new bill introduced in the U.S. House would boost Accountable Care Organizations' flexibility to use telehealth and remote patient monitoring and would provide reimbursement for those services "in a manner that is financially equivalent to the furnishing of a home health visit."
Facilities receive grants to grow resources for telehealth
More than 100 communities in 42 states will receive grants from the Health Resources and Services Administration (HRSA) to support care in rural areas, including funding to grow resources for telehealth solutions and help communities build networks of care.
New VA scheduling system won't be fully deployed until 2020
Though the Department of Veterans Affairs plans to award a contract for a new scheduling system within months, that system won't be fully functional at VA facilities nationwide until 2020, reports Nextgov.
Most read: Organizations slow to become HIPAA complaint; Researchers design bracelet to secure HIT systems
Texas Health Resources' Ronald Mehring: Teamwork crucial to tackling HIPAA audits
With HIPAA audits looming from the U.S. Department of Health and Human Services Office for Civil Rights, provider organizations are working tirelessly to ensure that when the federal government comes knocking, they won't be caught off guard. For Ronald Mehring, chief information security officer at Dallas-based Texas Health Resources, one of the most important aspects to preparation is teamwork.
Surescripts adds 100 health systems to network
In the past year, Surescripts, the nation's largest health information network, has added close to 100 health systems to its network.
Key lessons on building out infrastructure from Beacon Communities
The 17 organizations taking part in the $250 million Beacon Community project each built out their data-sharing capabilities in different ways, but faced similar challenges, according to an assessment published at eGEMs.
GAO: Federal agencies increase cloud use; still spend more on non-cloud tech
Government agencies, including the Health and Human Services Department, are still devoting more of their IT budget to non-cloud computing services, according to a report from the Government Accountability Office.
HITRUST issues alert on operating system vulnerability
An alert has been issued by HITRUST C3 that a vulnerability--Shellshock--has been discovered in UNIX-based operating systems that could put them at risk to being attacked; and the organization is asking that healthcare organizations take steps to safeguard their systems from the threat.
ICD-10 struggles continue to plague providers
Provider progress in transitioning to ICD-10 has been hampered by the most recent delay--enforced via the passage of the Protecting Access to Medicare Act last spring--according to survey results released this week by the Workgroup for Electronic Data Interchange.
OCR officials mum on HIPAA audit program launch
The healthcare industry should expect to see ramped up enforcement of HIPAA as security breaches of electronic and even paper patient protected health information continue to plague covered entities and business associates, according to Iliana Peters, senior adviser at the U.S. Department of Health and Human Services' Office for Civil Rights for compliance and enforcement.
Poor interoperability a significant barrier for ACOs
Though designed to improve care by sharing data from various sources, poor interoperability remains a huge barrier to accountable care organizations (ACOs), according to a survey from Premier and the eHealth Initiative.
Public health surveillance core element for DC HIE
An evaluation of the District of Columbia Health Information Exchange (HIE) program found a core value in its use for public health reporting, according to a report published at eGEMs (Generating Evidence & Methods to improve patient outcomes).
Electronic med packaging that records dosing boosts patient adherence more than similar tools
The use of electronic medication packaging devices that are integrated into the care delivery system and designed to record dosing events are more frequently linked to improved medication adherence than other such devices, according to new research published this week in the Journal of the American Medical Association.
Cedars-Sinai CIO: Patient expectations will drive data protection efforts
Healthcare organizations facing new and greater threats to patients' electronic health information need to take more steps to keep that data secure, according to Darren Dworkin, senior vice president of enterprise information systems and CIO of Cedars-Sinai Health System in Los Angeles.
New UCSF hospital to focus on patient engagement
At the University of California, San Francisco's soon-to-open Mission Bay Hospital, patient engagement will be one of the main focuses, according to Seth Bokser, medical director of IT at UCSF's Center for Digital Health.
WEDI survey finds little backing for health plan identifier
Health plans and other stakeholders see little value in using a unique health plan identifier (HPID) within electronic transactions, according to a recent survey from The Workgroup for Electronic Data Interchange (WEDI).


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Chrystal & Hill are one of Scotland's leading suppliers of new and used office furniture, office stationery and new and used photocopiers. Providing service to businesses throughout Glasgow, Edinburgh, Ayrshire and Stirling.
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Used Herman Miller Aeron Chairs now in stock
Used Herman Miller Aeron Chairs excellent condition would cost new £9…Read more >


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Time files when you're killing the charts on Billboard. Just five years ago, J.Cole was a newbie on the rap scene, hoping to grab ...Read More
J. Cole's 25 Coldest Lines
Now that J. Cole's debut album Cole World: The Sideline Story is in stores, XXL takes a look back at the North Carolina rapper's 25 ...Read More
J. Cole, Cole World: The Sideline Story
"Cole World, World Tour with no album," J. Cole tweeted earlier this month. Such mobility should be a blessing. Not always, though. Yes, in all of the ...Read More
J. Cole: From "Simba" to "Simba"
When J. Cole was a relatively unknown up-and-comer back in 2007, he dropped The Come Up Mixtape Vol. 1 (we're still waiting on Vol. 2), ...Read More
J. Cole Brings Out Drake at Sold Out NYC Show [VIDEO]
J. Cole had somewhat of a homecoming for the final stop on his BET Music Matters Tour. The North Carolina native, whose self-proclaimed second home is ...Read More
Rick Ross Surprises at Heineken Event [With Videos]
It was a busy weekend for the Heineken Inspire tour in New York City. After an all day event on Friday (July 30) featuring live ...Read More
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I'm Looking for anyone that might know something about her. She was born in Texas. In about 1922 I think she died Feb. 2001 in or near Tuscon, Arizona. Thank you Mary Barrett
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