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A system senses various physiological parameters of a patient such as heart rate or temperature to evaluate the patient and predict when an episode of a chronic symptom may occur. The system further includes a modeling component which generates an individualized predictive model for a given patient wherein the patient's previous episodes of the symptom are utilized to shape the model. The system tests the model to assure accuracy and can revise the model as necessary. Once the model is established, the system monitors patient parameters and can alert the patient to the expected onset of the symptom and/or automatically administer an appropriate drug or other therapy to control the expected symptom. The system is applicable to allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine fits, numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, vision impairment or other chronic symptoms.
1. A method for predicting onset of a symptom in a patient comprising:
monitoring patient state data over a period of time and storing the monitored data;
providing at least a portion of the patient state data to a modeling agent and developing a predictive model for receiving patient state data collected in real time and evaluating such data to provide an output predicting the onset of the symptom; and
providing a controller agent for receiving and responding to the output predicting the onset of the symptom.
2. The method of
3. The method of
4. The method of
5. The method of
6. The method of
7. The method of
8. A system for predicting onset of a symptom in a patient comprising:
a data agent comprising at least one sensor for monitoring and storing historical patient state data;
a modeling agent for establishing and testing a predictive model based on such historical patient state data, by which patient state data collected in real time are evaluated to predict the onset of the symptom; and
a controller agent communicating with the modeling agent for responding to a predicted onset of the symptom.
9. The system of
10. The system of
11. The system of
12. A system for predicting onset of a symptom in a patient comprising:
a data agent that receives and stores for a period of time patient state inputs from two or more sensors, including physiological parameters of the patient, to create historical patient state data;
a modeling agent for establishing a predictive model based on historical patient state data, said predictive model producing in response to real time patient state data at least one predictive output signaling the onset of the symptom; and
a controller agent responsive to the at least one predictive output to initiate an intervention.
13. The system of
14. The system of
15. The system of
16. The system of
17. A system as claimed in
18. A system as claimed in
19. A system as claimed in
20. A system as claimed in claim12 wherein the modeling agent for establishing a predictive model comprises a feed forward neural network with back-propagation learning features.
21. A system as claimed in
[0001] This patent application claims priority from provisional patent application No. 60/351,575, filed Jan. 25, 2002.
[0002] This invention relates generally to medical devices, and more specifically to a method and apparatus for sensing and reacting to patient physiological data.
[0003] Many people suffer from chronic or recurring symptoms or various other unpleasant or disturbing indications caused by a wide variety of medical ailments. Some possibilities include: allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine �fit�, numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, and vision impairment. In fact, approximately 1 in 5 people suffer from some sort of chronic acute symptoms during their lifetime. Understandably, these people desire and seek relief from the medical community. A typical patient suffering from such chronic symptoms might spend anywhere from $500 to $35,000 annually to treat or minimize their symptoms. Treatments for symptoms involve various drug and/or physical therapies, chiropractic care, acupuncture, meditation and yoga.
[0004] People who utilize drug therapies to alleviate their symptoms currently have two choices. They can wait until the onset of symptoms before receiving the appropriate drugs. Alternatively, chronic sufferers can subject their bodies to medication or subject themselves to other therapies on a continual or scheduled basis. Likewise, those who utilize various physical therapies can wait until the onset of actual symptoms, or can engage in those therapies that might prevent the onset of subsequent symptoms on some scheduled basis.
[0005] Neither alternative is particularly appealing to chronic symptom sufferers for whom drug therapy is necessary. That is, patents who wait until the onset of symptoms necessarily endure a period of discomfort or difficulty while they wait for the drug therapy to take effect. Those who subject themselves continuously to medication may suffer the often serious side effects of continuous or too frequent drug therapy. The particular side effects will, of course, depend upon the specific drug therapies being utilized.
[0006] Various devices or sensors exist to collect physiological data regarding a given patient. That is, a patient's current physical condition can, to some extent, be objectively measured. For example, a person's temperature can be taken or their heart rate measured. Some devices already exist that can be worn or carried by the patient to collect data over a period of time. For example, the �Mini Logger� manufactured by Mini Mitter of Bend, Oreg. can measure up to five parameters including temperatures from different locations, movement/activity levels, or heart rate. These devices simply collect the data but do not utilize or interpret the data, nor do they respond to conditions indicated by the data.
[0007] The present invention is, in one embodiment, a body-worn sensor unit capable of predicting the onset of a chronic symptom in a person and alerting the person to the possible onset of the chronic symptom and/or automatically administering an appropriate drug or other therapy. The sensor unit monitors various physiological characteristics of the patient and provides data to stored predictive models. When certain parameter values or patterns are observed, the sensor unit indicates the onset of symptoms and may initiate the appropriate action. The sensor unit learns what physiological data indicate the chronic symptom or the onset of the chronic symptom through patient input and data analysis or modeling.
[0008] In another embodiment, a data agent is provided in the form of a sensor that is worn about the wrist to monitor various physiological parameters such as temperature, heart rate, blood pressure, blood oxygen level, patient movement, cardiac pacing, cardiac rhythm (ECG), or various other parameters.
[0009] In another embodiment, the data agent communicates with a modeling agent that obtains test data from a patient utilizing the data agent to establish a baseline for predictive modeling of symptom onset. The data agent records various physiological parameters and also records indications by the patient of the patient-perceived onset of the symptom. After an appropriate amount of data is recorded, a predictive model may be established. In one embodiment, the modeling agent utilizes a neural network architecture to generate and test a predictive model.
[0010] In another embodiment, a network testing protocol is established to test the system after a predictive model has been established. The data agent obtains various physiological parameters from the patient and this data is fed to the system. The system monitors the data and, when appropriate, makes a predictive symptom analysis. In addition, the patient continues to manually enter data indicating the patient-perceived onset of the symptom. The system then evaluates the predictive success of the system. If successful, the system is allowed to proceed to the next level of use. If unsuccessful, the system incorporates the newly obtained data and reconstructs the model for the patient. In this manner, the system individualizes or learns patient specific parameters that indicate the onset of the symptom.
[0011] In another embodiment, a controller agent is provided to respond to an analysis predicting the onset of a symptom. The controller agent can respond in a number of ways. The controller agent can indicate the predictive analysis directly to the patient (or to a medical care giver observing the patient) through an audible or visual indicator, such as, for example, a flashing light, or generated tone or beep. The controller could also be coupled with a drug therapy delivery device, such as a transdermal patch or other delivery method that can be automatically actuated by the controller agent to automatically deliver a drug therapy. Thus, the patient can receive the appropriate drug therapy automatically, before the onset of the symptom without suffering the consequences of being continually (and unnecessarily) subjected to medication.
[0012] In another embodiment, the data agent can transmit collected data to a third party monitoring the patient for purposes of symptoms management. For example, the collected and analyzed data regarding a patient can be sent to a system coordinated with that patient's doctor or caregiver. The doctor can then utilize the acquired data set (which may be continuous and real-time) to evaluate the patient. In some cases, the patient may be under the doctor's direct care, i.e., staying in a hospital, and the data obtained can be used for symptom management purposes.
[0013] While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
[0014]FIG. 1 is a block diagram of a patient monitoring and predictive analysis system, consistent with the principles of the present invention.
[0015]FIG. 2 is flowchart indicating an overview of the operation of the system of FIG. 1.
[0016]FIG. 3 is a flowchart indicating the process of data collection.
[0017]FIG. 4 is a flowchart indicating the process of network architecture training.
[0018]FIG. 5 is a flowchart indicating the process of network testing.
[0019]FIG. 6 is a flowchart indicating the process of application modeling.
[0020]FIG. 7 is a system diagram of the system of FIG. 1
[0021]FIG. 8 illustrates the weighting values given to various sensory input parameter.
[0022]FIG. 9 is a system diagram indicating the process of network testing.
[0023]FIG. 10 is a system diagram indicating the process of actions taken by a controller agent.
[0024] A. Overview of Components
[0025] The following embodiments are described in reference to a device that monitors certain physiological parameters to predict when a symptom will ensue and to initiate an appropriate action. The present invention can be utilized to monitor any physiological parameter relevant to predict the onset or occurrence of various symptoms or indications and to initiate appropriate action based on those symptoms or indications. Such actions may include the delivery of a drug or other therapy (e.g., electrostimulation) or may include alerting the patient. Symptoms or indications may include, but are not limited to: allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine �fit�, numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, and vision impairment.
[0026]FIG. 1 is a block diagram of a patient monitoring and analysis system 10. The system 10 includes components that perform various functions and these components can be integrated into a single device or split among any number of separate or different devices that can communicate with one another as required. System 10 includes a data agent 12, a modeling agent 14 and a controller agent 16.
[0027] Data agent 12 is a component that receives data from a patient indicating various physiological parameters. For example, data agent 12 may be worn on the body by the patient and include one or more sensors 13 for measuring physiological parameters. In one embodiment, data agent 12 is worn about the wrist and includes sensors 13 (and/or interfaces for external sensors) for measuring temperature, physical activity (i.e., patient movement, including myoelectric signals), heart rate, cardiac rhythm (ECG), blood pressure, blood oxygen levels, breath sounds, skin moisture levels, brain wave activity (EEG) or various other parameters. Of course, while data agent 12 may be worn about the wrist (or located elsewhere) various individual sensors 13 can be placed remotely from data agent 12 while communicating data back to data agent 12. In addition to patient specific parameters (patient state data), data agent 12 can also sense various external parameters that might affect a patient, such as weather conditions including barometric pressure, temperature, humidity, light levels, or other factors (external state data).
[0028] Various types and configurations of sensors 13 can be employed by data agent 12 to measure physiological components. For example, a thermistor can be utilized to measure temperature. Various types of sensors can be utilized to measure the patient's pulse rate. In one embodiment, a piezoresistive film can be applied with a slight amount of pressure against an artery. In another embodiment, a second piezoresistive film is positioned near but not against the artery and the outputs of the first and second piezoresistive films are subtracted from one another to reduce or eliminate noise. Significant noise may be generated through normal patient movement. In another embodiment, a pressure transducer can be utilized. In another embodiment, a piezoresistive film is positioned near but not against the artery and the outputs of the pressure transducer and piezoresistive film are subtracted from one another to reduce or eliminate noise. In another embodiment, a condenser microphone can be utilized to register audible signals representative of the heart rate. In another embodiment, a laser or laser-like emitter (using infrared or other frequency range that safely reaches blood vessels) can be utilized to measure refractive characteristics of blood flows. To monitor patient movement or activity, one or more accelerometers (three-axis will allow for complete three dimensional measurements) may be provided. The sensors collect data on two or more parameters of patient state data that are understood to have predictive value for the onset of a symptom that is intermittent and often chronic.
[0029] Data agent 12 may also register direct patient perception input provided by the patient when the patient experiences the onset of a symptom. This allows system 10 to develop a baseline of sensed data that is correlated to the actual onset of symptoms as subjectively reported by the patient. The patient input can be limited to a single instance type. That is, the patient simply presses a button or otherwise actuates the device when a particular symptom occurs. Alternatively, multiple inputs for symptom progression data could be provided. For example, one indication could be made when the patient believes symptoms will ensue, another when symptoms begin, another, when the symptoms intensify, another when symptoms reach a perceived maximum, and another when the symptoms subside. Likewise, the patient could indicate the onset of symptoms and at various times, indicate the level of intensity by, for example, entering a value on a scale of 1-10. (Where an observer of the patient can report onset of the symptoms, that data may be used with or in place of patient-reported data.) Thus, various patient inputs relating to the patient's experience of the onset and intensity of the symptoms can be recorded.
[0030] Broadly, modeling agent 14 develops a protocol by which system 10 interprets the data received by data agent 12 and makes a predictive determination as to the onset of symptoms. In one embodiment, modeling agent 14 trains a neural network model that becomes able to predict the onset of symptoms associated with the patient's affliction. A neural network is a set of interconnected nodes designed to imitate the functioning of the human brain. Modeling agent 14 may include a multi-layer, fully connected, feed forward neural network. In a fully connected neural network, the nodes at one layer are connected to all of the nodes at the next layer. Each network node connection has an associated weight. While training the neural network, data passes through the network and the weights change so as to better predict the patient's condition (i.e., symptom discomfort/no discomfort) associated with each data reading. Any data errors given as discrepancies in the patient's condition between actual and network computed values are propagated back through the network by changing connection weight values. Training will terminate after a certain number of iterations or when the network converges to a predetermined minimum error rate. One concern, is the possibility of local rather than global network convergence. To avoid this, several iterations of neural network training with alternative initial parameters settings may be necessary to achieve the best result. Because network training is an external process, multiple training iterations do not adversely affect or involve the patient. (For further discussion of neural network training techniques to produce a trained neural network, see R. Roiger and M. Geatz, Data Mining�A Tutorial Based Primer (Addison Wesley 2003) and references cited therein.)
[0031] Modeling agent 14 could utilize other modeling protocols instead of a neural network. For example, modeling agent 14 could be based on an evolutionary (also called genetic) algorithm utilizing a natural selection process to achieve effective predictive results.
[0032] In dealing with patient indications or symptoms, complex patterns in multidimensional data are analyzed to determine an outcome. The complexity of these patterns requires complex computing tools that have only recently been developed and that are sophisticated enough to discern patterns from such data. One such tool is based on the iData Analyzer software product for data analysis available from Information Acumen Corporation of Minneapolis, Minn.
[0033] As indicated above, there are a wide variety of physiological and/or external parameters that can be monitored by system 10. In some instances, it may be possible to reliably predict the onset of one or more symptoms in all individuals based on patterns determined from certain sensed data. That is, should data agent 12 measure certain levels or relationships between specific parameters, system 10 determines that there will be an onset of one or more symptoms, regardless of the individual being monitored. To the extent such cross-individual generalizations can be made, system 10 can utilize them and act upon them. However, in most cases the physiological parameters indicating the onset of one or more symptoms of interest will be unique to the individual patient, particularly if the system inputs include the patient's subjective experience of one or more symptoms. Thus, modeling agent 14 can be used to generate specific parameters relative to the particular patient utilizing system 10.
[0034] In summary, modeling agent 14 receives the biophysical output (patient state) data from data agent 12 along with the one or more symptom progression inputs made by (or for) the patient for a period of time. (As noted above, external state data may also be provided by data agent 12.) By analyzing and weighting the longitudinal/historical data, modeling agent 14 is able to establish criteria for predicting the onset of one or more symptoms of interest. In addition, modeling agent 14 can test system 10 over a period of time to determine the effectiveness and accuracy of the network parameters, and, when appropriate, make adjustments to improve the model. The result is a model (trained network) able to predict symptom onset when it is provided patient state data in real time. The iData Analyzer software product mentioned above includes software models that can be trained on properly normalized historical data and that, once trained, can receive real time inputs embodying patient state data and provide real time prediction outputs.
[0035] Controller agent 16 is a component responsible for acting upon a prediction by modeling agent 14 of the onset of symptoms. In one embodiment that may be useful when important biophysical data is received by the system that includes parameters outside the patient's consciousness, controller agent 16 simply alerts the patient. For example, a tone or beep may sound, a light may flash, a vibrating element may vibrate, or any other appropriate signal may be generated by indicator 15. Thus, the patient can be alerted ahead of time that symptoms will ensue and the patient can engage in or seek the proper preventative measures, such as a specific drug therapy or physical therapy or the like. In another embodiment, controller agent 16 alerts a doctor or other medical care giver that a patient is about to suffer from the onset of symptoms and the appropriate treatment can be administered. In another embodiment, controller agent 16 can be coupled with one or more drug delivery devices or resources 17 to automatically administer a dosage of medication (or coupled with any other appropriate drug, electrical stimulation or other interventional therapy) that addresses the one or more predicted symptoms. For example, controller agent 16 may include a transdermal drug delivery patch that may be electronically initiated. For example, a controlled release technique such as iontophoresis, piezoelectric control, or a micro-valve may be controlled by controller agent 16 to deliver an appropriate drug therapy at the appropriate time. With multiple drug delivering devices 17, drug therapies can be delivered to multiple locations and can be administered repeatedly over time, with or without varying the dosages. In addition, different drug therapies can be controlled and delivered with different protocols in combination by controller agent 16. Thus, any number of drug therapies can be delivered to one or more locations on the patient in patterns of varying complexity, as developed by network modeling.
[0036] In addition to predicting the onset of one or more symptoms, the neural network may also be trained to predict symptom alleviation resulting from medication or other therapy. Thus, with suitable training on data tracking biophysical parameters monitored after medication or other therapy commences, the present system may be used to shape the therapy protocol based on prediction of the extent of symptom alleviation. While adaptive drug delivery systems are known, e.g., U.S. Pat. No. 5,643,212, the present system is based on a predictive analysis.
[0037] B. Overview of Operation
[0038]FIG. 2 is a flowchart indicating an overview of the operation of system 10. Broadly, system 10 may engage in data collection 18, network architecture training 20, network testing 22 and application 24 to establish and then utilize the proper network protocols.
[0039]FIG. 3 is a flowchart illustrating one process useful for data collection 18. For a period of time, the patient will wear 26 (if appropriate) or otherwise engage data agent 12 so that the sensors incorporated therein can monitor the desired physiological (biophysical) characteristics of the patient, i.e., the patient state data, and the patient's surroundings, i.e., external state data, for the desired period. Data agent 12 monitors 28 the output of the various sensors during this period of time and may optionally record 30 this longitudinal data if desired. That is, having a full data set for a given period of time may be useful to the patient or medical personal for any number of potential reasons. For example, a person suffering from hypertension may have blood pressure readings taken over a longer period of time and at more frequent intervals, giving a more accurate indication of the condition than is possible from a measurement taken randomly in a doctor's office.
[0040] In one embodiment, at the onset of one or more symptoms 32, the patient manually provides input 34 to data agent 12 to indicate the presence and/or intensity of symptoms to system 10. The physiological data relevant to that episode of one or more symptoms is recorded 36 in memory. In other words, data is being collected about the patient that represents the physiological parameters that occur before and during the onset of symptoms so that this data can be modeled into a predictive network protocol. Thus, system 10 in one embodiment receives input from the patient that indicates when symptoms are actually occurring. In other embodiments there may be one or more biophysical parameters that sufficiently indicate the presence of a symptom, such that no subjective input from the patient is desired.
[0041]FIG. 4 is a flowchart indicating the process of network architecture training. The data recorded 36 is sent 38 (either as it is acquired or after a predetermined period of time) to modeling agent 14. Data transmission can be performed by a hardwired connection, such as connecting data agent 12 to a telephone line, device cradle, or computer interface or can occur via wireless communication means. Transmission may be to a local patient computer or to one remote from the patient. Once modeling agent 14 begins the process of establishing a network protocol, initial weighting must be assigned 40 to the various data inputs. These initial weighting values can be predetermined based on other uses of system 10 (i.e., previous patient data) or predictively estimated. In any event, the initial weights are set in the network connection layer. That is, data from various sensors is being (or will be) received by system 10. To be useful, a given data input should have some specific effect on the overall modeling process. For example, assume that prior to the onset of one or more symptoms of interest the patient pulse rate always increases beyond a specific level. This data is obviously relevant, however not necessarily determinative. That is, the pulse rate may be raised by exercise or any number of other factors. Thus, the data must be considered with respect to the various other sensory inputs, and this is referred to as the weighting of connections receiving data inputs. A value of importance is assigned to each data input, either individually or with respect to other data inputs.
[0042] The recorded data provided by the patient is then processed 42 by modeling agent 14 as a training instance and modeling agent 14 determines 44 if the onset of one or more symptoms of interest would have been predicted based upon the recorded physiological parameters. Of course, system 10 �knows� these parameters correlate to the onset of symptoms because the patient has so indicated this to system 10 or because the symptom of interest is unambiguously associated with certain physiological data. If there is an error and modeling agent 44 does not recognize the onset of one or more symptoms of interest, modeling agent 14 loops back and revises the weighting and other criteria 40 and reanalyzes the training instance. If modeling agent 14 correctly evaluated the training instance, modeling agent 14 then updates 46 the network parameters being established. The modeling agent 14 determines if a termination condition (i.e., all data analyzed, end of time period, etc.) has been reached 48. If it has, the network architecture training 20 is deemed complete 50. If the termination condition has not been met, another training instance is evaluated 42 and the process continues.
[0043] Once network architecture training 20 has been completed, network testing 22 may be conducted. That is, the patient is again involved in the process and manually indicates the onset of one or more symptoms, or the system monitors the data unambiguously associated with the symptom(s) of interest. Modeling agent 14 evaluates its own performance by comparing its predictive output with the patient provided (or system-sensed) symptom data to determine efficacy. If acceptable, system 10 is ready for use. If not acceptable, modeling agent 10 can repeat network architecture training 20 and may also repeat the initial data collection 18 to acquire new and/or additional data.
[0044] Ideally, the predictive power of the model is sufficient to afford the patient relief from all or most of the impact of the one or more undesired symptoms. That is, the prediction is made enough in advance of the undesired symptoms effects that a drug or other therapy can be introduced. If any delay in effectiveness of the drug or other therapy is present, then the predictive model is preferably trained to accommodate that time dimension in its prediction.
[0045] More specifically and with reference to FIG. 5, network testing 22 proceeds while the patient wears 52 or otherwise engages data collection agent 12 and the incorporated sensors collect 54 various physiological data that are fed 56 into modeling agent 14, which has a trained predictive network established. The data are then analyzed according to the established parameters 58 and predictions are made 60. For example, the model may predict that the patient is about to experience the onset of one or more symptoms of interest, such as a muscle spasm or a more subjective symptom, such as dizziness or pain. These predictions are compared 64 to the patient-provided data. That is, if the onset of one or more symptoms of interest are predicted, the patient should then manually enter 62 (or the system sensors detect) that symptoms have occurred and modeling agent 14 recognizes the correct prediction made by the network protocol. If not (assuming compliance by the patient) modeling agent 14 determines that the prediction was in error. To assure patient compliance during testing where symptoms are subjective, the patient can be queried when the onset of symptoms are predicted by modeling agent 14 so that patient error and forgetfulness is minimized.
[0046] These predictive outcomes are compared with patient perceived or sensor-measured symptom inputs and evaluated 68. If the error rate is unacceptable, network training may be repeated 70. If the network parameters are sufficiently accurate, system 10 can then be moved into the next stage of use 72, knowing that the predictive modeling for this patient is sufficiently accurate.
[0047] Once the network is accurately trained, in an embodiment where the modeling agent 14 is operably linked to a controller agent 16, the patient may begin to actually use the device for symptoms management of one or more symptoms, as represented in FIG. 6. Once again, the patient wears 74 or otherwise utilizes data agent 12 so that the various sensors can detect the required physiological parameters. Data agent 12 collects 76 the relevant data and that data is analyzed 78 by system 10 to determine if the onset of one or more symptoms are predicted based upon the recorded data and the predictive network parameters. Assuming symptoms are not predicted 80, system 10 simply continues to collect 76 and evaluate 78 the incoming patient data.
[0048] If symptoms are predicted 80, system 10 activates 82 controller agent 16 to initiate the proper response to symptoms. As explained above, this may simply be an indication to the patient to take medication or engage in other interventions to manage symptoms. Alternatively, it may actuate one or more drug delivery devices. In either case, the patient or the patient's care giver is able to anticipate the onset of symptoms and the patient can receive the appropriate therapy prior to the patient having to suffer the full impact of the symptoms.
[0049] C. System Diagrams
[0050]FIG. 7 is a system diagram illustrating one embodiment of system 10. Data agent 12 can take various forms and may be worn or carried near the patient 92 so that sensors 86 are appropriately positioned with respect to and if necessary, in contact with, the patient 92. In one embodiment, data agent 12 may be worn about the patient's wrist and one or more sensors 86 are in contact with the patient's skin. Data agent 12 may also include a processor 84 to operate and control the various components of data agent 12 and to receive and process the data generated by sensors 86. A memory 88 may be provided to record some or all of the data from sensors 86. Data agent 12 may be in communication with other components of system 10 and as such, an appropriate communication module 90 is provided. Communication module 90 can either communicate with other components via wireless communication protocols or may be linked to a hard wired data communication system such as a cradle, telephone line, network interface, personal computer communication port or similar components. Finally, communication module 90 may include a indicator to alert patient 92 to the predicted onset of one or more symptoms. The indicator can take various forms such as a display screen, light, speaker or similar component.
[0051] A network processing system or modeling agent 14 is illustrated as a separate component that could be in the form of a dedicated electronic device or may be a personal computer executing a specific software platform. In any event, network processing system 14 analyzes the data and establishes the appropriate predictive model. While illustrated as a separate component, network processing system 14 could be integrated into a single housing with data agent 12. A database 96 is provided that is accessible by network processing system 14.
[0052] A personalization programmer 94 may also be provided. Personalization programmer 94 may have functions that overlap or replace that of network processing system 14. That is, personalization programmer 94 may incorporate all of the data analysis and modeling functions in a smaller and more convenient hand held device.
[0053] In either case, the personalization programmer 94 or the network processing system 14 may optionally communicate with a medical professional 98 monitoring the patient's health for purposes of providing general information or for providing information specific to symptoms management.
[0054] The application controller 16 may be provided to deliver specific therapies, including various drug therapies to the patient 92, when the onset of symptoms are predicted. If no such function is to be provided, the indicator of communication module 90 may be sufficient without having a separate application controller 16.
[0055]FIG. 8 illustrates the weighting values given to various sensory input parameters in a neural network model, wherein interconnected nodes imitate the functioning of the human brain. FIG. 8 represents a multi-layer fully connected feed-forward neural network that processes the data in order to predictively model the onset of symptoms. That is, the inputs S1, S2 . . . SN from various sensors are introduced at the input layer 100 and pass through connections 101 to a hidden or internal analysis layer 102, wherein each sensor value is given a weighting value A1, A2 . . . Am. Thus, the weighting of each sensor value can be varied and controlled, to produce at the output layer 104 the output value 106 derived from network analysis.
[0056]FIG. 9 is a system diagram indicating the process of network testing. Once again, data agent 12 receives data from sensors S1, S2 . . . SN represented by input layer 100. The data is passed to modeling agent 14 which makes a predictive output 116, based on the stored data 96. An evaluation of the predictive outputs is made 110 and if passed 114, the system is implemented. If the prediction failed 112, the network protocols are revised.
[0057]FIG. 10 is a system diagram illustrating data agent 12 receiving sensory data from input layer 100 in the sensors S1, S2 . . . SN during use of system 10 by the patient, after the modeling process has established and tested the model parameters. That data is fed though the network model 14 and analyzed. Should the onset of symptoms be predicted, an indication is passed to controller agent 16 and the appropriate action 120 is taken.
[0058] D. Applications
[0059] To further illustrate how the invention may be used, an application relating to migraine headaches and an application relating to back pain are described.
[0060] Referring to FIG. 1, for an application addressing migraine headaches, the following sensors 13 may be used to collect data: blood pressure, heart rate, body temperature at extremities (such as skin temperature at a fingertip), and muscle tension on forehead, neck or other location viewed by the subject as affected by migraines. These data are sensed at intervals and stored in a time sequence.
[0061] Muscle tension can be measured at one or more points by a sensor that is linked to a transmitter to provide telemetry data to the Data Agent 12. Muscle tension can be measured by an electromyographic (EMG) signal reflecting motor activity. Research indicates that, under static conditions, there is a monotonous relation between muscle contraction level and the amount of EMG produced by the muscle. Research also indicates that the root mean square (RMS) value of the signal reflects the momentary degree of involvement of the muscle, whereas the spectral composition reflects localized muscle fatigue. Under prolonged static contraction, there is a general increase in EMG amplitude and a shift in the frequency spectrum from high to low frequencies, due to a decrease in the propagation velocity of the depolarization wave along the muscle fiber as fatigue sets in. (For a further discussion of muscle state measurement, see http://www.macses.ucsf.edu/Research/Allostatic/notebook/muscle.html).
[0062] For some patients, external state data such as barometric pressure or ambient temperature, humidity or light levels may also be sensed by sensors 13, particularly where a patient intuits that such factors may play a role in provoking migraine episodes.
[0063] In addition, for training of the modeling agent 14, it is useful to have symptom progression input to the data agent 12. The inputs can be separate for each subjective factor for which data is recorded or a single input device with means for distinguishing different types of input, e.g., a button with detection of duration of actuation. Patient subjective factors reported may include: irritability, tingling in extremities, vision affected by aura, nausea or vomiting, runny nose and watering eyes, skin sensitivity and appearance of the headache itself at lower, moderate and higher levels of pain. These data too are received over a period and stored in a time sequence, so as to be associated in time with the data from sensors 13.
[0064] Training of a neural network embodied in the modeling agent 14 results in a model for predicting occurrence of migraine headaches, based on the historical data sequences collected. In addition, it may result in evaluation of which data types are truly of predictive value (alone or in some combination with another item of sensor data). For a discussion of how a data set collected to describe some system behavior can be mined by the use of neural network training techniques to produce a trained neural network, see R. Roiger and M. Geatz, Data Mining�A Tutorial Based Primer (Addison Wesley 2003) and references cited therein.
[0065] The predictive model, once developed in modeling agent 14, preferably undergoes testing. By determining from testing whether the predictive model produces lower or higher levels of false positives or misses symptom situations that should have been predicted, the need for further training or model adjustment can be identified. Also it may be possible to develop confidence level or heuristic certainty factor measurements to be associated with prediction outputs of the neural network embodying the model. These may be used to tune the outputs of the model.
[0066] As shown in FIG. 1, the outputs of the modeling agent 14 are communicated to the controller agent 16. The controller agent may communicate a predictive output via an indicator 15. A simple indicator such as a light or buzzer may signal the predicted onset of a migraine headache. With a more complex indicator, such as a small display, the predictive outputs may include text or visual messages to patients or care givers, whereby a predictive warning is provided, qualified by a confidence level. The exact use of these confidence levels may depend on the consequences of false positives and missed episodes. False positives for a migraine might, for example, lead to over-medication or to unnecessary expense for medication that was not really needed. These consequences need to be balanced against the more subjective value of patient discomfort. The model and the controller agent can be adapted to provide the desired balance.
[0067] Once the predictive model for migraines is fully trained and tested with data from a particular patient, it can be deployed for a particular patient. (Typically the predictive model will be developed with data from and be used only for one patient; however, over time, more generalized models, applicable to certain patient populations may be found in the data.) With sufficient early warning of an impending migraine, the patient may be prompted or instructed to engage in a particular abortive therapy, to abort the migraine episode or the severest portions of it. The controller agent 16 may not only prompt but display instructions on the recommended medication, such as Imetrix, Emerge, Migrainal or Maxalt (all trademarks), and dosage. Alternatively, if the patient has biofeedback training, the patient may be prompted or instructed to engage in the biofeedback exercises to alleviate the migraine symptoms. The information displayed for the patient and caregiver may also be adapted to fit the particular patient. The display can indicate an intervention that is selected based on past experience and symptom alleviation reports of the patient to respond to the particular patients needs. The controller agent can have a menu of different display outputs, one or more of which may be selected based on the prediction model's analysis of the symptoms. For example, different medications might be indicated for different episodes, where historical data provide a basis for predicting different levels of intensity of symptoms. Alternatively, different levels of medications might be indicated depending on how soon the medication can be taken, e.g., take one tablet within ten minutes, take two tablets if medication is not available within one-half hour.
[0068] Referring again to FIG. 1, for an application addressing back pain, the following sensors 13 may be used to collect data: repetitive motion patterns (via accelerometers transmitting data from key body locations); blood pressure; heart rate; skin temperature at certain body points; and muscle tension in the neck, the upper back, lower back, hamstrings or other location viewed by the patient as affected directly or indirectly by the pain or known anatomically to be muscularly linked to the back. The latter can be measured at one or more points by EMG techniques discussed above, again with sensors linked to a transmitter to provide telemetry data to the Data Agent 12. As in the migraine case, these data are sensed at intervals over a period and stored in a time sequence.
[0069] In addition, for training of the modeling agent 14, it is useful to have subjective patient input to the data agent 12. For back pain, the subjective factors to be reported may include: muscle tightness, muscle spasm, numbness, tingling, shooting pains and appearance of the basic back pain symptom itself at lower, moderate and higher levels of pain. These data are received via patient input and stored in a time sequence, so as to be associated in time with the data from sensors 13.
[0070] Training of a neural network embodied in the modeling agent 14 results in a model for predicting occurrence of back pain, based on the data sequences collected by data agent 12. Known data mining techniques may be performed by neural networks resulting in predictive models This proceeds as described above for the migraine case with appropriate testing and determination of confidence or certainty levels. Again as shown in FIG. 1, the outputs of the modeling agent 14, now trained on back pain data, are communicated to the controller agent 16. The controller agent 16 may communicate a predictive output via an indicator 15. An indicator such as a light or buzzer could simply signal to the patient or an observer the predicted onset of a back pain. With a more complex indicator, such as a small display, the predictive outputs may include text or visual messages to a patient or an observer, whereby a predictive warning is provided, qualified by a confidence level. Alternatively, the display may have instructions for the patient to take some preventive action.
[0071] For some back pain, where the therapy is to alter physical activity, i.e., to change a position or to cease a particular activity of repeated motion, there is little serious danger from false positives and the system might be adjusted to provide early warnings with an increased risk of false positives. For chronic and more severe pain, the therapy might be prompting a patient to take an anti-inflammatory or pain relief drug. Here false positives may involve more critical effects of drugs and dosages and should be a greater factor in training, testing and adapting the prediction model in modeling agent 14.
[0072] In both migraine and back pain situations, it is anticipated that appropriate predictive models can lessen a patient's need for drugs or other interventions and/or cause the patient to use drugs at lower dosage levels. This should lead to less addiction, less development of drug tolerance and reduced drug side effects. In addition, early interventions often can limit the duration and/or severity of any episode experienced. Differences between patients can be accommodated both respect to training the prediction models where training is based on individual data
[0073] Although the present invention has been described with reference to various embodiments, persons skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention and that various equivalents are possible within the spirit of the present invention.
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Home » News » Health
Release of powerful painkiller Zohydro has officials worried
Prescription opiates continue to pose big problems in New Hampshire, Foster told the New Hampshire Sunday News, including a spike in heroin addiction and overdoses.
"We have a heroin epidemic, and the heroin epidemic is linked to these lawful drugs," Foster said. "At a time when we're trying to fight these fights, the approval of this drug seems to be running counter to some of those efforts."
"I can see no medical advantage for allowing this drug on the market. And I can see enormous opportunities for injury to my patients and my neighbors.
Fanciullo said he had followed the FDA advisory panel's 11-2 vote against approving the drug last year., so he was stunned when the agency later approved it.
"This is a drug that's one of the most abused drugs in the country, and all of a sudden, it's going to be available in a non-tamper-resistant form at high doses," he said. "Who's in charge?"
Sgt. Brian LeVeille, head of the Special Investigations Unit at the Manchester Police Department, said he's already received notice from the Drug Enforcement Administration that Zohydro ER is coming. One concern, LeVeille said, is that the new drug will come in higher doses than other prescription opiates on the market. And the lack of an abuse-deterrent formulation means it can be crushed and snorted, he said. "We've got a big enough problem with the oxycodone ... and now we're going to introduce something new out there that they can get their hands on?'' he said.
In their Dec. 10 letter, the attorneys general asked the FDA to either reconsider its approval of Zohydro ER or set a "rigorous" timeline for the drug to be reformulated to be abuse-deterrent. They also asked the FDA to work with other federal agencies to impose restrictions on how the drug can be marketed and prescribed.
Last week, U.S. Sens. Joe Manchin, D-W.Va., and David Vitter, R-La., sent a letter to the University of Rochester's medical school dean, raising concerns about what they called "pay-to-play" meetings hosted there between drug manufacturers and the FDA officials who regulate them.
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Randy Johnson, Pedro, Smoltz lead HOF ballot
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Simpsons. Scene it. DVD game.
Simpsons scene it DVD game. Never been used. Great for Christmas. From smoke free home. Please feel free to text as I don't answer numbers I don't know. Thank you. Collection only.
Simpsons scene it DVD game. Never been used. Great for Christmas. From smoke free home. Please feel free to text as I don't answer numbers I don't know. Thank you. Collection only.
Here I have a xbox 360 for sale, fully working great for a present it comes with 2 pads, a few games including gta4, wireless router, 60g hard drive, 100 pound ono WILL SWAP FOR A PLAYSTATION 3, text 07931162367 thank you.
Small kids air hockey table used but in good condition see pics
Two new D.S for quick sale Black Dark blue Boxed
Board game based on the original Nintendo DS game Ideal for family fun or maybe a stocking filler The contents are in immaculate condition and there are no missing pieces. The box is in very good condition however there are slight wear and t
Collectors edition star trek monopoly game, still in wrapping. Going for £60 on ebay but open to offers.
brand new game not opened, unwanted gift! would like 20, can not deliver unfortunately! texts are best if interested just leave a no for contact!
In original undamaged box. Hardly been used. Would make an ideal stocking filler or addition to another train set.
Ideal first train set. Would make an ideal Xmas present. In original undamaged box complete and in good condition.
In excellent condition. Only used once or twice. In original undamaged box. Ideal Xmas present.
No box. From a smoke n pet free home
No box but all pieces there. From a smoke n pet free home..
99p each, indiviual or mulitples i.e. 6, 10, 12 25 etc wholesale available (ideal retail) , various designs anna elsa etc, ideal as little stocking fillers. Will post free of charge if more than one purchased, or if only purchasing one 50p postage ch
Good condition
New Assassins Creed. Excellent condition. Only been played a couple of times.
Perfect condition game ps3 call of duty advanced warfare with special unlock code.
Friends Scene It Game. Excellent condition, only been played a couple of times.
Journey through the enchanted forest and claim the tiara. Boxed. 2 - 4 players. Age 4 upwards. Collection only.
Will you be the first Cinderella to go to the ball? Press on the slipper and the tinkling tells you if you can turn over a card. Boxed. Age 4 upwards. Collection only.
Race around the creepy house but watch out the phantom is after you!! Boxed. 2 - 5 players. Age 4 upwards. Collection only.
50 building pieces, 10 marbles, flashing lights and wacky sounds. Boxed. Age 3 - 7 years. Collection only.
Make oodles of reusable fuzzoodle combinations. Age 5 upwards. Collection only
Incomplete set. 129 pieces (should be 190) but still plenty of pieces to create lots of amazing things. Age 6 - 99 Collection only.
Ride the Merry Go Round and collect your treats. 2-4 players Aged 3 years upwards. Boxed game in nearly new condition. Complete with game instructions. Collection only.
Unwanted birthday present- unopened and in mint condition. Official One Direction: The Game boardgame. RRP £15.99 on ebay.
Brand new, unopened (so still in cellophane wrapping) board game from the tv quiz show Pointless- would make a fab Christmas present for a fan of the show. This is a really good family game- only selling as I love the programme so much I got bought 2


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November 22, 2014
August 26, 2007
Michael Vick filed a plea agreement in Richmond Federal Court Friday admitting to a dog fighting conspiracy and helping kill pit bulls. Monday, he will face a judge for his scheduled plea hearing.
In that plea agreement signed by Vick Friday, he admits that he is guilty of setting up a dog fighting business, buying the property, and the dogs, but he does not admit to gambling on any of the fights.
Vick does not directly say that he killed a dog, but in the statement, he "agrees and stipulates that these dogs all died as a result of the collective efforts of" Vick and his friends.
"I don't know that there's a whole lot of difference between being the guy who drowned, hung or electrocuted a dog. Or knowing that it was being done on your property to your dogs, by your friends," said Dan Dierdorf, CBS NFL Analyst.
Some experts say his plea was his way of trying to avoid being kicked out of the NFL, but it didn't work.
With the NFL's announcement Vick is indefinitely suspended, the NFL commissioner said Vick's conduct is illegal, cruel and reprehensible and added his mere association with illegal gambling violated his NFL contract. Now some say the possibility of him ever wearing a NFL jersey again doesn't look promising.
"I think it's going to be very difficult for another NFL owner basically to put his arms around Michael Vick and say here is the new leader of our team," said Jeff Schult, Atlanta Journal-Constitution.
Vick still has to walk into the courtroom Monday and see whether a judge will accept his plea. He faces anywhere between one and five years in prison.
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The successor to the throne of Paolo Di Canio's reign has finally been found. Gus Poyet, the former Brighton boss, has replaced the Italian. After a faltering start to the Premier League campaign, Di Canio was sacked only after five … Continue reading


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DEFINITION of 'Vomma'
The rate at which the vega of an option will react to volatility in the underlying market. It is the second order derivative of the option value with respect to volatility. It demonstrates the convexity of vega. A positive value for vomma indicates that a percentage point increase in volatility will result in an increased option value, known as positive vega convexity.
Vomma is part of the group of measures known as the "Greeks" (other measures include delta, gamma and vega) which are used in options pricing.
INVESTOPEDIA EXPLAINS 'Vomma'
Vomma is considered one of the more important option pricing Greeks, especially for options that are sensitive to changes in the underlying market. Investors with long options should look for a high, positive value for vomma, while investors with short options should look for a negative one. It is also useful in a delta hedging strategy under traditional methods, but is less useful in dynamic delta hedging.
Vomma calculations form an integral part of the Black-Scholes model.
Black Scholes ModelA model of price variation over time of financial instruments ...
GreeksDimensions of risk involved in taking a position in an option ...
Volatility1. A statistical measure of the dispersion of returns for a given ...
Out Of The Money - OTMA call option with a strike price that is higher than the market ...
Quantitative AnalysisA business or financial analysis technique that seeks to understand ...
Multibank Holding CompanyA company that owns or controls two or more banks. Mutlibank ...
Options & Futures
The Basics Of Option Price
Options & Futures
Getting To Know The "Greeks"
Options & Futures
Capturing Profits With Position-Delta ...
Options & Futures
Out-Of-The-Money Put Time Spreads


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1900, July 17[1]
H.S.H. Prince Louis of Battenberg
Parents: H.S.H. Prince and H.G.D.H. Princess Louis of Battenberg
Place: Frogmore House, Windsor
Names: Albert Victor Nicholas Francis Louis
H.M. The Queen of Great Britain and Ireland
H.I.M. The Emperor of Russia (represented by Prince Louis of Battenberg)
H.S.H. Prince Francis Joseph of Battenberg (represented by Colonel Lord Edward Pelham Clinton, Master of the Household)


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Date: 1880 ca.
Description: The Eau Claire Lumber Company, later the Cutter shoe factory. It was still standing in 1931.
Date: 1896
Description: Interior view of the Eau Claire Public Library. Tables and bookshelves in the public library reading room.
Date: 1891
Description: Bird's-eye view of Eau Claire.
Date: 1875 ca.
Description: Stereograph of the courthouse before remodeling during the spring or summer.
Date: 1870 ca.
Description: Third Ward, East Side, or "Bartlett School." This is probably the earliest picture in existence and is copied form the margin of "an old map." This first...
Date: 1885 ca.
Description: Exterior of the Ingram residence in winter, home of the wealthy lumberman O.H. Ingram.
Date: 1885
Description: Deer hunters' camp in Northern Wisconsin. Image includes six hunters and their dogs posed in front of their cabin with hanging deer carcasses.
Description: Original part built in 1856, where the present Eau Claire House stands. It was later moved to another site and eventually torn down to make room for the Y....
Date: 1888 ca.
Description: View of Tenement Block and Megget Home (built before 1870), River Street. The buildings where the A&P Market stands.
Description: Front view of the inn. Several men and women either stand or sit on the second floor porch, and several stand under the second floor porch at ground level...
Description: The Third Ward, East Side, or Barlett School, after additions had been put on in the rear. The Bartlett after whom the school building was named was Willi...
Description: Front entry way to the "Washington" school, on the northwest corner of Fifth Avenue and Broadway.
Date: 1865 ca.
Description: Presbyterian Church, built in 1857, the first church building in Eau Claire. From a lithograph in the margin of an early map.
Description: Methodist church on Barstow Street, built during the 1860's.
Date: 1865 after
Description: The first Eau Claire House built in 1856. It burned down in 1875.
Description: Corner view of the Ingram block, which contained the public library.
Description: Three or four-story brick building, with a "Drug Book Store" sign at the front, and a winding stair at the side. A man stands on the front sidewalk, and t...
Description: View of the courthouse, with bell tower. The building was built about 1870. The roof and lower part have since been changed.
Date: 1870
Description: Elevated view of the town, looking northwest. The Chippewa River is in the foreground, with a lot of buildings, an intersection, and distant hills. One bui...
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Top 5 Decals for your Library Learning Spaces - There are some beautiful motivational decals out there that would look great on the walls of your Library, Learning Commons or Resource Centre. The Holstee...
4 days ago
Great use of the Wizard of Oz fabric, hope you sell heaps!
Oh my Ivy would absolutely adore one of the Oz purses! It's such a pity I can't make it Saturday. Preparing for my better half's big 40th bash...
Wow, they look fabulous! Great use of such beautiful fabric.
WOW I can see I'm going to go home broke tomorrow ;)
from $20.00 US
Tote Bags
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Mobile Phone Cases
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Regular Mass schedule
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Pray a decade of the rosary with us after daily Mass.
Reconciliation is offered Saturdays 3:30-4:14pm and by private appointment.
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Advent Mission - "Open the Door"
Monday, Tuesday, Wednesday ~ December 15-17 ~ 7:00 pm
Come experience an Advent Mission which will "open the door" for miracles to become more evident in our lives.
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Holy Day Masses are normally scheduled at 12 Noon and 7pm
For a complete list of Holy Days of Obligation please visit the Richmond Diocese website.
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Blues Fest with Popa Chubby, Curtis Salgado Big Band and Christine Santelli
Rockin' the River's Blues Fest Cruise
Full Price
Our Price
Rockin' the River presents a three-hour Blues Fest cruise with an amazing lineup of performers. NYC-based guitarist Popa Chubby tours extensively, and his latest album, The Fight Is On, was released last year. Curtis Salgado holds the Blues Music Award's 2010 title of Soul Blues Male Artist of the Year. Hoboken, NJ native Christine Santelli blends blues, soul, country and folk to create a totally unique sound. They'll all play against the backdrop of New York's iconic landmarks.
* Additional fees apply.
All offers for Blues Fest with Popa Chubby, Curtis Salgado Big Band and Christine Santelli have expired.
The last date listed for Blues Fest with Popa Chubby, Curtis Salgado Big Band and Christine Santelli was Thursday August 18, 2011 / 7:00pm.
Currently at Pier 83
Bear Mountain Cruise: Hiking Trails, Oktoberfest & More
- Full Price:
- $60.00
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- $30.00
Take in the crisp autumn air and awesome views of the fall foliage as Circle Line sails up the sc...Learn More
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Just drive yourselfBear Mountain Cruise info • Oct 27 2014 star this tip starred
Goldstar Member
Bring snacks for the trip up, the prices on board are insane.Bear Mountain Cruise info • Oct 14 2014 star this tip starred
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Each NYC Rockin' the River Cruise is a two hour intimate concert and cruise that sails past the Statue of Liberty, Ellis Island, Brooklyn Bridge and NYC skyline. Full bars and food on board.


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U.S. swimmer Michael Phelps sets record with 20th Olympic medal
August 3, 2012 - 11:14 AMT
PanARMENIAN.Net - Michael Phelps wins his 20th Olympic medal with a dominant swim to beat compatriot Ryan Lochte in the men's 200m individual medley, BBC Sport said.
The American led from the front and looked as if he might break the world record but touched for a historic 16th gold medal in 1:54.27.
Phelps also becomes the first man to defend an Olympic swimming title twice, having won in Athens and Beijing.
Hungary's Laszlo Cseh was third, while Britain's James Goddard was seventh.
Top stories
"Although they have not made an official bid, they have expressed an interest in hosting a world championships," Adamfi said.
Despite finding wrongdoing among the 11 bidding nations, Eckert said the integrity of the votes was not affected.
Nadal has struggled with appendicitis this month and had earlier announced he would not be playing at the Paris Masters.
The grandmaster announced his desicion during an official dinner hosted by Armenian leader, chess federation president Serzh Sargsyan.
Partner news
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Rearranged Van Gogh Museum in Amsterdam to open Nov 28 The Van Gogh Museum currently has some 200 paintings and 500 drawings by Van Gogh and receives about 1.5 million visitors per year.
Berlin Film Fest's Wim Wenders Homage lineup revealed The fest also revealed that the Museum of Modern Art in New York is set to honor Wenders in March with a comprehensive retrospective.
Year's best horror "Babadook" Jennifer Kent's masterful debut: review "It's an enormously compassionate and sadly relevant film about misplaced blame and the often impossible demands of motherhood," the review said.
European Parliament approves resolution for Google break-up The vote was on a broader resolution on the digital economy that passed with 384 votes in favor, 174 against and 56 abstentions.


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LA SHOW: 2014 Chevrolet Spark EV shown
The 2014 Chevrolet Spark EV has been shown today, ahead of the Los Angeles International Auto Show.
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- INTERVIEW: Fiat brand head, Olivier Francois
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Added Oct 27, 2011
by definatalie
Brisbane, Australia
I bought this amazing fabric from Spoonflower months and months ago and was too afraid to sew it up into anything lest I regret it. I became more and more convinced that it couldn't be made into anything other than a skirt so I attached some thick elastic for the waistband and a little lace at the hem and an hour later – a skirt was born!
Fabric – http://www.spoonflower.com/fabric/468200
Oct 30, 2011, 05.08 PMby zickzack
This is awesome! And it looks great with those tights. I think I might have to paint some fabric if you don't mind (and if I have time, erm..)
Oct 28, 2011, 01.16 AMby Vanessa Velasquez
you were right, it was the perfect fabric for a skirt, i looks very nice!!
Oct 28, 2011, 01.13 AMby thecuriouskiwi
The perfect pattern for this fabric, great choice xx it's so funky and different, I bet you get heaps of compliments!
Add to Favorites 5 people added it
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Phenomenal story! Brandford astutely presents facts and figures in a dramatic story, bringing history alive. Simon Vance' delivery is impeccable. This is a paradigm to be studied and emulated, but will never be eclipsed.
"Great read about the political days of my life"
As a young boomer, this work by an elder statesman lays out not only a clear description of recent US political history but a path to correcting many of the wrongs I see in our great republic. Viguerie's insight is invaluable and seminal to those who desire a resurgence of the prosperity and peace that come from living according to Godly and Constitutional principles.
"Great stuff! Tough listen."
Perlmutter's insight is truly invaluable, personally meaningful, and based on sound (and often recent) scientific study; and should be weighed in any dietary considerations. Though he is a bit more humanist and a believer in a millions-of-years-old earth, his reasoning regarding brain chemistry and nutrition are easy enough to digest and winnow from the chaff. What makes this a tough listen is Peter Ganim's sardonic tone. His delivery style is reminiscent of a dramatized Ayn Rand novel, but Perlmutter doesn't set about to lampoon elitists and collectivists, so Ganim's inflection only serves to detract from a book worth studying. To his credit, Ganim does a good job of pronouncing and maintaining meter through some difficult scientific language. I do recommend this book, but warn against Ganim's tone.
"Waste of information"
A great bit of insider research went into getting and compiling notes from within political camps during the 2008 election for this work. Sadly and typically, the authors' bias skews the dialogue. Of course claiming to be non-biased, the authors come off showing themselves to be leftist hacks. Boutsikaris does an admirable job of presentation. (If you are a journalist trained and employed in main-stream media or otherwise Marxist in nature, you'll probably find this work perfectly balanced.)
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Go for a ride to a country pub for a counter meal a drink an a talk an enjoy the cenery
Long rides fast and slow. See the sites and listen to music go from there.
I dont really care for date's in the normal sence rather a more casual date having a good time getting to know someone in a relaxed/ adventurest setting.
Mabe a movie, the park, site see/window shop...dinner...or mabe go out for a coctail! :-)
A dinner , lunch or movie could be the best date idea..I love seafood, a cup of wine could do too. And we could just go hiking or biking on a date and see how it goes for us. I just want to explore more.
Wind therapy is always my first choice
We would grab some dinner and then maybe a movie, just depends on how dinner goed
Totally casual, doesn't have to involve motorcycles.
Going somewhere fun to eat and have a few drinks or taking a ride to wherever
a ride on the guys Harley to a Restaurant and eat a good dinner drink some beer or wine and ride some more
My idea place should be some where we can both seat down and talk better on a table for two
Prefer to meet up a local Biker Bar and chat over a drink.
Just a simple ride in the country and stop for lunch.
Meet for a coffee first and a chat and then see if we like each other.
I think that we could find a bike rally to go to. Do the lunch thing and cruise. I know some really good riding places.
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Book your room at Sukhothai Guest House
Superior RoomMax Occupancy: 3 guests (up to 2 children, 1 infant)
Deluxe RoomMax Occupancy: 3 guests (up to 2 children, 1 infant)
Sukhothai guesthouse with a restaurant
Situated in the city center, this guesthouse is in the same region as Wat Chedi Sung, Sukhothai Historical Park, and Ramkhamhaeng National Museum. Regional attractions also include Wat Chetuphon and King Ramkhamhaeng Monument.
Property Features
In addition to a restaurant, Sukhothai Guest House features a bar/lounge. Other amenities include complimentary wireless Internet access and complimentary high-speed (wired) Internet access.
Room Amenities
Guestrooms have complimentary wireless Internet access, complimentary high-speed (wired) Internet access, and sofa beds; rooms also include separate living rooms and separate sitting areas.Information missing or incorrect? Tell us!
Sukhothai Guest House
Hotel Amenities
Dining options at the guesthouse include a restaurant and a snack bar/deli. A bar/lounge is on site where guests can unwind with a drink. A computer station is located on site and high-speed wired and wireless Internet access is complimentary. For a surcharge, the property provides an area shuttle within 20 km and a roundtrip airport shuttle during limited hours. This Sukhothai guesthouse also offers a library, tour/ticket assistance, and a garden. Limo/town car service and wedding services can be provided. Onsite self parking and valet parking are complimentary. The property may provide extended parking privileges to guests after check-out (surcharge). A total renovation of this property was completed in January 2011.
Sukhothai Guest House has designated areas for smoking.
- Airport transportation (surcharge)
- Total number of rooms - 11
- Number of floors - 1
- Free self parking
- Bar/lounge
- Breakfast available (surcharge)
- Coffee/tea in lobby
- Dry cleaning/laundry service
- Express check-in
- Express check-out
- Front desk (limited hours)
- Shopping center shuttle (surcharge)
- Designated smoking areas
- Tours/ticket assistance
- Free Wi-Fi
- Free wired high-speed Internet
- Computer station
- Laundry facilities
- Library
- Limo or Town Car service available
- Free valet parking
- Garden
- Restaurant
- Safe-deposit box at front desk
- Year Built 2003
- Area shuttle (surcharge)
- Snack bar/deli
- Shopping on site
- Number of buildings/towers - 3
- Television in lobby
- Use of nearby fitness center (discount)
- Wedding services
Family Friendly Amenities
- Separate living room
- Free Wi-Fi
- Snack bar/deli
- Laundry facilities
- Sofa bed
Available in all rooms: Free Wi-Fi , Free wired high-speed Internet
Available in some public areas: Free Wi-Fi , Free wired high-speed Internet
Room Amenities
- Furnished balcony
- Balcony
- Separate sitting area
- Ceiling fan
- Daily housekeeping
- Private bathroom
- Bathrobes
- Hair dryer (on request)
- In-room massage available
- Shower only
- Iron/ironing board (on request)
- Desk
- Sofa bed
- Free Wi-Fi
- Free wired high-speed Internet
- Separate living room
- Room service (limited hours)
- Down comforter
- Individually decorated
- Sofa bed size
Where to Eat
Full breakfasts are available for a surcharge and are served each morning.
Sukhothai restaurant - This restaurant serves breakfast, lunch, dinner, and brunch. Guests can enjoy drinks at the bar. A children's menu is available.
Room service (during limited hours) is available.
Nearby Things to Do
The recreational activities listed below are available either on site or nearby; fees may apply.
- Bicycle rentals nearby
- Ecotours on site
To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
- Accessibility equipment for the deaf
- Accessible bathroom
- Accessible path of travel
- Accessible parking
- In-room accessibility
Hotel Policies
Check-in time starts at 1 PM
Check-in time ends at 7 AM
Check-out time is noon
Payment types
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- The name on the credit card used at check-in to pay for incidentals must be the primary name on the guestroom reservation.
We should mention
This property offers transfers from the airport (surcharges may apply). Guests must contact the property with arrival details before travel, using the contact information on the booking confirmation. Reservations are required for massage services. Reservations can be made by contacting the guesthouse prior to arrival, using the contact information on the booking confirmation. Only registered guests are allowed in the guestrooms. Some facilities may have restricted access. Guests can contact the property for details using the contact information on the booking confirmation.


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For as long as Lori Hahnel can remember, there was a mysterious steel guitar tucked away in the basement of her grandmother's Regina house. She was haunted by it, largely because it seemed such an improbable prop in the story of her hard-drinking, hard-luck grandparents. They were not the sort to talk about their past, having suffered through a […]
What's On Tonight for
Heartbeat 3 stars out of 5 Starring: Tanya Davis, Stewart Legere, Stephanie Clattenburg Directed by: ... »
It was kind of brilliant, actually. The first time a Kyle Mooney digital short aired on Saturday Night... »


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newportFILM Presents Valentine's Double Feature Screening of LOVE, MARILYN, 2/14
newportFILM presents a special Valentine's Day double feature of the new documentary LOVE, MARILYN. It's Marilyn like you have never seen before. Grab a friend or a date and join us for one of two Valentine's night screenings, Thursday, February 14 at 6:30pm OR 8:45pm - you pick - at the Jane Pickens Theater, 49 Touro Street. Tickets: $12*.
*DINNER AND A MOVIE. Book your Valentine's dinner at Christie's restaurant and receive a COMPLIMENTARY bottle of wine with purchase of 2 entrees, just mention you are going to the film (401-847-5400).
*Adam Braver, author of the new novel, "Misfit", based on the last days of Marilyn Monroe's life, will be in attendance to introduce each film.
Watch the trailer HERE. To buy tickets and for more information, follow this LINK.
Drawing on never-before-seen personal papers, diaries and letters, Academy-award nominated director Liz Garbus (Bobby Fischer Against The World, The Farm: Angola, USA) works with acclaimed actresses to evoke the multiple aspects of the real Marilyn - passion, ambition, soul-searching, power and fear - in an absorbing and astonishing portrait. These documents, brought to life in this film by some of our contemporary icons and stars, give us a new and revelatory understanding of Monroe, revealing her carefully guarded inner life.
For more information on upcoming films and events, visit www.newportFILM.com.
|Related Links
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May 29, 2014
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Developers paid $4.4 million Wednesday for the north half of the former Stewart Metal Fabricators plant in east Bricktown as they move forward with a plan to build a $75 million mix of apartments, retail and a hotel.
Developers in Oklahoma City pay $4.4 million for Bricktown site planned for $75 million housing and retail complex
The development is considered by observers at city hall to be one of the more complicated private/public development efforts since the renovation and reopening of the century-old Skirvin hotel in 2006.
Gary Brooks and Andy Burnett, principles in Bricktown Apartments LLC., first announced plans for the project earlier this year when they successfully obtained $4.5 million in federal stimulus funding.
The grant will help pay for the relocation of a large storm sewer line and remove contamination on the site. Other funding sources include $1.5 million in federal brownfield (contamination removal) loans approved Tuesday by the Oklahoma City Council.
As part of the stimulus funding agreement, Brooks and Burnett agreed to include 50 units that are affordable under federal Neighborhood Stabilization Program standards, as well as 200 market rate units to meet the demands of tenants moving downtown — especially students, athletes and employees of the nearby Oklahoma Health Center.
Yet another component of the deal required a land swap between the former owner, Bob Meinders, and the Oklahoma City Urban Renewal Authority, which controlled parcels of land on the north half of the former Stewart property.
"The real stars of this deal are the people at city hall and the Oklahoma City Urban Renewal Authority," Burnett said. "The local departments of planning, the brownfields officials, the Department of Housing and Urban Development and the Urban Renewal Authority really paved the way here."
Brooks, who is also developing the $36 million, 250-unit Edge apartments in MidTown, said he expects demolition of the Stewart Metal Fabricators buildings will begin in January. Site cleanup, relocation of the sewer lines and utilities are then expected to continue for 12 to 15 months. Brooks said if all goes as planned, construction could begin in early 2014.
Continue reading this story on the...
This was a big milestone. But we have a lot more milestones in east Bricktown than on most other projects."
Gary Brooks,
Bricktown Apartments LLC
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An unsavoury move involving butter as a lubricant. Often performed under the table in seedy, or occasionally high class restaurants.
1. "My ho gave me a butter job last night!!"
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