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Royals acquire Shields, Davis from Rays for Myers
KANSAS CITY, Mo. (AP)
The Kansas City Royals have slowly and methodically allowed their top prospects to climb through their farm system in recent years, piecing together a team they believe can compete in the wide-open American League Central.
All that's been missing has been the pitching.
They dipped into the farm system to solve that problem, too.
The Royals sent top prospects Wil Myers and Jake Odorizzi along with two other minor leaguers to the Tampa Bay Rays on Sunday night for former All-Star James Shields and fellow right-hander Wade Davis, making an aggressive move to bolster a rotation that was one of the worst in the major leagues last season.
''We have to start winning games at the major league level, and the way you develop a winning culture is by winning major league games,'' Royals general manager Dayton Moore said. ''It's time for us to start winning at the major league level.''
Kansas City, which hasn't had a winning season since 2003, has long had one of the best farm systems in baseball, and slowly the cream has risen to the big league level - first baseman Eric Hosmer, shortstop Alcides Escobar, third baseman Mike Moustakas and catcher Salvador Perez form a fine nucleus. But there's been a dearth of starting pitching for years, and that's what Moore and the rest of the front office have been trying to fix this offseason.
He's already re-signed Jeremy Guthrie to a $25 million, three-year deal, and took on former All-Star Ervin Santana and $12 million of his contract from the Angels. But the trade for Shields and Davis is Moore's most aggressive move yet, giving Kansas City the ace it has been lacking since trading away Zack Greinke, along with another piece that could fit in the rotation or the bullpen.
''When you can acquire a pitcher like James Shields and Wade Davis, we have to do it, because that's what we've committed to our team - we've committed to our organization,'' Moore said. ''It's important that we start winning games.''
Along with giving up Myers, an outfielder widely voted the minor leagues' top player last season, the Royals also traded away Odorizzi, a talented right-hander who should soon compete for a spot in the Rays' rotation. Left-hander Mike Montgomery and third baseman Patrick Leonard also are headed to the Rays, while the Royals will receive a player to be named or cash.
''We're constantly working to balance the present and the future, and always trying to thread the needle,'' Rays executive vice president of baseball operations Andrew Friedman said. ''As an organization we rely more on the contributions of our young players basically than anyone else in baseball, and with this trade we're hoping to replenish our system and add a lot of players we feel can help us sustain this run of success that we've had for the last five years.''
Shields, who turns 31 this month, has been a stalwart in the Tampa Bay rotation the past seven seasons. He was an All-Star two years ago, when he went 16-12 with a 2.82 ERA and finished third in the American League Cy Young Award voting, and was 15-10 with a 3.52 ERA in 33 starts last season, when he pitched 227 2-3 innings - his sixth consecutive year of at least 200 innings pitched.
The only other pitchers to log at least 200 innings in six straight seasons are the Jays' Mark Buehrle, San Francisco's Matt Cain, Yankees left-hander CC Sabathia and the Tigers ace Justin Verlander.
''If you're going to win consistently in the major leagues, you're going to need a rotation that gives you innings, competes, helps you win,'' Moore said. ''That's what our goal is, to put together a very good rotation. We feel we've done that.''
Shields is due to receive $10.5 million this season. He has a club option for $12 million in 2014 with a $1 million buyout.
The Royals suddenly have a glut of starting pitchers with Shields, Santana and Guthrie joined by Bruce Chen and Luis Mendoza, who are expected back from last year. Luke Hochevar is eligible for arbitration, while Danny Duffy and Felipe Paulino will return at some point during the middle of the season after having Tommy John surgery.
Davis also could be thrown into the mix.
The right-hander started 64 games for Tampa Bay from 2009-11, but he was shuttled to the bullpen last season when the Rays had an abundance of starters. He flourished as a reliever, going 3-0 with a 2.43 ERA, creating some flexibility for him in Kansas City.
Davis is due to make $2.8 million this season and $4.8 million in 2014, with the Royals holding options on the next three years.
The jewel of the deal for Tampa Bay is undoubtedly Myers, who turns 22 on Monday.
The power-hitting outfielder batted .314 with 37 homers and 109 RBIs in 134 games at Northwest Arkansas and Triple-A Omaha, and eventually could help provide some protection in the batting order for Rays star Evan Longoria. Myers showed what he could do during the All-Star Futures Game hosted by Kansas City, when he had a pair of hits and drove in three runs at Kauffman Stadium.
He'll finally get a chance to prove it at the major league level at Tropicana Field.
Odorizzi was 15-5 with a 3.03 ERA for Northwest Arkansas and Omaha, and made two late-season starts for Kansas City, going 0-1 with a 4.91 ERA in 7 1-3 innings. Montgomery was once considered one of the Royals' top prospects, but his stock slid last season, when he went 5-13 with a 6.07 ERA last season while getting demoted from Omaha to Northwest Arkansas.
Leonard hit .251 with 14 homers and 46 RBIs in 62 games for short-season Burlington.
''We're excited to add these guys, anxious to get to know them beyond the information we have on them,'' Friedman said. ''I think it's very possible that Wil Myers and Jake Odorizzi will help us win games in 2013, and Mike Montgomery as well.''
AP Sports Writer Fred Goodall in Tampa, Fla., contributed to this report.
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01/12/2009 | 1 Comment
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Equal treatment of self-employed workers (until 2012)
The objective of this Directive is to pursue the implementation of the principle of equal treatment for persons engaged in an activity (including agriculture) in a self-employed capacity, and for spouses participating in this activity. The Directive also aims to protect these workers during pregnancy and motherhood.
Council Directive 86/613/EEC of 11 December 1986 on the application of the principle of equal treatment between men and women engaged in an activity, including agriculture, in a self-employed capacity and on the protection of self-employed women during pregnancy and motherhood [Official Journal L 359 of 19.12.1986].
The Directive applies to self-employed workers * and to their spouses, who are not employees or partners, and who habitually participate in the activities of the self-employed worker. This Directive is applicable until 5 August 2012, when it is to be replaced by the new Directive 2010/41/EU.
The principle of equal treatment implies the absence of all discrimination on the grounds of sex.
All provisions contrary to the principle of equal treatment must be eliminated by the Member States, in particular in respect of the establishment or extension of a business or of any other form of self-employed activity.
The conditions for the formation of a company between spouses shall be the same as between unmarried persons.
Where a contributory social security system for self-employed persons exists, spouses who are not protected under this system must be able to join a contributory social security scheme voluntarily.
The Member States undertake to examine all initiatives concerning the recognition of the work of the spouses.
Similarly, concerning the interruption of activities owing to pregnancy or motherhood, the Member States shall examine under what conditions female self-employed workers and the wives of self-employed workers may have access to services supplying temporary replacements or to social services, or be entitled to cash benefits (under a social security scheme or public social protection system).
All persons who consider themselves wronged by failure to apply the principle of equal treatment between men and women in self-employed activities must be able to pursue their claims by judicial process.
The measures adopted pursuant to this Directive and the relevant provisions already in force are brought to the attention of the bodies representing self-employed workers and vocational training centres.
|Key terms
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OJ L 359 of 19.12.86


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Retailer heeding Governor Schwarzenegger's call to donate merchandise for evacuees, collecting customer contributions in all California Wal-Mart and
Sam's Club locations
BENTONVILLE, Ark., Oct. 23 /PRNewswire-FirstCall/ -- In response to raging wildfires across Southern California, the American Red Cross has received its first substantial donation to provide support for disaster relief. The Wal-Mart Foundation today announced a cash contribution of $250,000 to enable quick response to those affected by the fires.
Since Sunday, the Red Cross has been providing food, shelter, counseling and other assistance to thousands of individuals most critically affected by the fires. More than 500 Red Cross workers have been assisting these evacuees over the last several days, and the organization is expanding its services rapidly as the needs and changes escalate. Currently, thousands of supplies and volunteers are en route to California as the wildfires continue to spread.
"The Red Cross is a way for neighbors to help each other during times of disaster," said Mark W. Everson, president and CEO of the American Red Cross. "We welcome Wal-Mart to the family of Red Cross supporters who are reaching out to the people affected by the severe wildfires. Because of their generosity, the Red Cross is able to provide crucial aid such as cots, food, comfort kits and a shoulder to lean on to those in need."
In addition to the contribution from the company's Foundation, local Wal-Mart stores and Sam's Clubs in the state of California have responded with donations of water, clothing, blankets and other much-needed merchandise. In total, 20-plus trucks with more than $350,000 worth of merchandise have made deliveries to help with relief efforts. Wal-Mart is also setting up collection sites in each of its 208 California-based stores and Sam's Clubs where customers can make cash donations to help support ongoing relief efforts.
|SOURCE Wal-Mart Stores, Inc.
Copyright©2007 PR Newswire.
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3×30 Yoga in Costa Mesa Hiring Certified Yoga Instructors
Excellent Class Time Openings Available for Yoga Teachers with Local Following
Costa Mesa, CA (PRWEB) October 08, 2013
3×30 Yoga (http://www.3x30Yoga.com), a yoga brand with a focus on Mind-Body Fitness and affordability to make yoga accessible to all. 3×30 Yoga in Costa Mesa, California, is seeking experienced certified yoga instructors with a local student following to join our new yoga studio.
Certified Yoga Instructors wishing to earn a greater measure of compensation, as well as to select instructional times that better suit their lifestyle, and who have built a following of local area students will be well received. "As yoga instructors ourselves, we appreciate the significant value great teachers can contribute to our yoga studio. We are impassioned with being the very best yoga studio within our community," stated co-owner Ryan Thimmig.
Our room temperature studio offers teachers and students a rustic transporting feeling that is quite comfortable and relaxing. 3×30 Yoga is perfectly integrated into The CAMP where people share common interests as they interact and enjoy life.This unique yoga studio houses an inviting practice room along with a separate retail boutique that showcases quality yoga products. Our MindBody system is integrated with our website keeping things simple for students and instructors.
"The vibe at The CAMP and within our 3×30 Yoga studio is the ideal place to practice Yoga," states Jordan Thimmig, co-owner of the new yoga studio. "People recognize The CAMP as an oasis within the Orange County urban landscape. Everyone in this enclave is active, health-minded and deeply concerned about community. We are excited to be offering certified yoga instructors an incredible opportunity to teach in this amazing environment while earning greater rewards for their passion, skills and dedication."
Located at The CAMP, 2937 Bristol Street, Suite C101A, Mezzanine Level in The Seed People's Market, Costa Mesa, CA 92626. 3×30 Yoga studio is conveniently situated just off the 405, 73 and 55 Freeways at the intersection of Bristol and Baker Street minutes from South Coast Plaza.
About 3×30 Yoga, LLC
3×30 Yoga strives to increase Mind-Body Fitness by making yoga accessible for everyone through a choice of affordable Ashtanga, Hatha Vinyasa and Restorative Yoga exercise classes. We cater to students at all levels of yoga from beginners to advanced with a variety of class times and offerings designed to develop your workout consistency. We believe that it is not how much you sweat or how long you sweat, rather it's the consistency of your workouts that is most important and which will change your life. Our mantra is "three 30-minute classes per week will change your life," undeniably a revolutionary approach. Our yoga classes teach you how to move, strengthen, and AWAKEN the body using techniques that make you feel confident and empowered, backed up by practical science, anatomy, kinesiology, and certified yoga training. 3×30 Yoga is committed to sustainable practices, utilizing recyclable and reusable products, selecting sustainable building materials for its studio and supporting eco-friendly and waste disposal programs. For more information, visit http://www.3x30yoga.com.
For the original version on PRWeb visit: http://www.prweb.com/releases/2013/10/prweb11204111.htm


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Back to Dining
Na3Na3 is an impressive blend of Middle Eastern hospitality and authentic Arabic home style cooking, using traditional ingredients and seasonings. With live cooking stations, and hot dishes and freshly baked breads streaming from the open kitchen, the ambience is one of warmth and elegant simplicity.
This Arabic speciality restaurant offers all day dining, with bountiful and beautifully displayed buffets for breakfast, lunch and dinner. Na3Na3 also has specialty nights throughout the week, Halla Night, Seafood Night and a Friday Organic Brunch.
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Dress code:Casual
Location:Lobby LevelThe Address Dubai Mall
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Celebrate in a truly majestic Arabian ambience with cosmopolitan flavours at Na3Na3.
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The award-winning French-Indian cuisine has expanded from Brussels, London and most recently in Dubai. Literally meaning "Gateway to India", the restaurant and bar/lounge is set in a contemporary ambiance.
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This fabulous al fresco lounge offers expansive views of the Burj Khalifa, a selection of grilled and baked delicacies, and after sunset, exotic cocktails.


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CARLSBAD (USA): It was the final year of a turbulent decade, when Richard Nixon was in the White House, the Beatles were about to release "Abbey Road," and Neil Armstrong had just taken man's first steps on the moon.
There was another rocket launch in 1969, one that still resonates in the sports world today — Rod Laver wrapped up his second career Grand Slam of tennis.
"That was sort of a different time," Laver mused recently after his usual Tuesday night match with his son, Rick, and a handful of mates at La Costa. "There were some interesting things that went on."
Hard to believe, but it's been four decades since the slightly built, red-haired Australian known as 'Rocket' won the Australian Open, French Open, Wimbledon and the U.S. Open in the same year.
Now 70, Laver is heading down under next week to be honoured at the Australian Open for the 40th anniversary of his second Grand Slam. He also won tennis' four biggest tournaments as an amateur in 1962.
The four men he beat with his powerful left arm in his 1969 Grand Slam, Spaniard Andres Gimeno and fellow Aussies Ken Rosewall, John Newcombe and Tony Roche, are scheduled to join Laver at a legends lunch.
Laver also is set to present the trophy following the men's final at Rod Laver Arena, the centre court at Melbourne Park.
"I'm very honoured. Plus, having the name on the stadium is quite a coup," Laver said. "That's sort of really the crowning achievement of my whole career — having my name on it."
Laver enjoys talking about his Grand Slams, if asked.
"I guess my make-up's not one to be flamboyant," said Rocket, who was given the sarcastic nickname by Australian Davis Cup captain Harry Hopman, who felt the 17-year-old Laver was a bit lackadaisical. "I just enjoyed playing and competing."
The years go by, and no one's joined American Don Budge (1938) and the unassuming Laver as the only men to win the Grand Slam.
Laver won Wimbledon four times, the Australian Open thrice and the U.S. and French championships twice each. He added six Grand Slam titles in men's doubles and three in mixed doubles.
Laver likely would have won many more Majors but was banned from the Grand Slam events in his prime after he turned pro in 1963. He did not return to the Majors until the Open era in 1968, then promptly won Wimbledon for the third time.
Laver ushered in the 1969 season, the first full year of the Open era, by beating Gimeno in straight sets to win the Australian Open. To get there, he outlasted Roche in a 4-1/2-hour, five-set semifinal that included a 22-20 second set.
A twist
Roche, also a lefty, threw a bit of a twist at Rocket.
"I spent five years in the pro ranks and there were no left-handers in there, so he was totally new to me to play," Laver said. "For me it was hard because the ball's coming the reverse way."
Laver won the French Open with another straight-set final against Rosewall.
He was half-way there.
"I guess I'm thinking its possible now. I've won three Wimbledon's prior. It's possible to win Wimbledon. You're starting to feel pretty good about yourself."
Laver beat Newcombe in a four-set final. In the semifinals, Laver had to rally against Arthur Ashe after losing the first set 6-2. "He started out like a house on fire, and I'm thinking, 'what is going on here?"' Laver said. "Then he's up a break in the second set. I said, 'well, he can't keep this up, surely.' He's bombing my big serves with return serves, serving aces, everything's clicking, and finally, he did, he came down to earth. Those matches are ones that you remember."
Wimbledon was his favourite tournament. "Everybody who's anybody wants to play at Wimbledon. So that atmosphere is just unbelievable. The adrenaline flows and your concentration is better."
A month after turning 31, Laver completed the Grand Slam by defeating Roche in four sets in a rain-delayed Monday final at the U.S. Open.
Laver remembers the helicopter that was brought in to try to dry the court and switching to spiked shoes after losing the first set. "It made a mess of the court," he said.
Having spent his off-court time hidden away in his friend Charlton Heston's Manhattan apartment, Rocket said he didn't feel any pressure.
"I felt keyed up, but I didn't feel like nerves had got to me… you've got to be fortunate not to have any injuries, no colds, no flu, nothing to put you down. It's not only your tennis, it's the good fortune of staying healthy."
Laver always thought Boris Becker and Pete Sampras would win the Grand Slam, but neither even made it to the final of the French Open.
"Roger Federer is very capable of winning all of them," said Laver, who's lived with wife, Mary, in northern San Diego County for several years. — AP


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|285 posts found
Originally posted by yaoming36
That giant is a pain in the arss that makes most raid bosses look like hello kitty he has an AOE of DOOM so its beeter to say back and range him down.
The char fire shaman in the starter area is a complete pain or was during BWE1 he would one shot a group of 50 in easy then continue to whip anyone else that tried.
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Originally posted by Asuran24
And thus, if ArenaNet ever considers putting in raiding, they need to realize that it's only one part of the content, not the only part that matters like so many developers before them think.
If they can do that, and do it without causing everything else to become obsolete, then I have no problems with raiding.
Of course, they should frankly first get everything else sorted before they attempt something like this.
Originally posted by Asuran24
What you ignore is that raiding becomes a huge focus because making raids is a massive amount of effort.
Now, WoW theoretically could have done raids and a lot of other content too. Heck, WoW is probably the only game that's ever been on the market that made enough money to potentially have been able to make content faster than players could get through it. But they'd have to have hired on more people and that would have eaten into their massive profit margin.
Point is, one raid is the equivalent of a massive amount of other sorts of content. Given the fact companies have limited resources, going with raiding does mean massive sacrifices in other areas. That's why such games are designed around raiding, since they are pouring so many resources into it, they want to make sure people play it since they can't do a lot of other content.
Apprentice Member
Joined: 5/19/04
I have already really written off WvWvW as a long term draw to the game as it does not really effect the game world besides buffs--you just do not have the conflict (the risk vs reward is just not there) as well as the absense of meaningful guild vs guild, and all combined with the lack of politics makes me believe the game may not have lifeblood. The in world content--the DE's atm is just plain too faceroll as well.
Right now I believe the game needs to be "harder" on the pve end and at the same time perhaps introduce a greater form of risk vs reward on the pvp side.
Originally posted by Asuran24
Nothing against what you said but you replying from a cell or iPad its hard to read a block of words.
As for your post I can see what you mean but DEV's need to step back and say him we only have these in the game for a very small player base what do we do for the others that dont raid. Those players that dont raid get stuck with most of the time one zone to mess around in for 6 months to a several yrs and thats not fun. Even EQ2's new expansion is like I said above but they have this huge world thats being left out which if they added the down lvling to and gear rewards like GW2 would be awsome make it so much better for none raiders.
Originally posted by Drachasor
I agree in the long run i would rather have mre small scale content added to a game then larger scale content, but not to the point of fully omitting any large scale from the game (For me DE content is kinda a mix of both as it is build to be used by all sizes of groups largely as such i would say it is more of variable content then small or large scale.). Yet here is the issue in many games even when they add a raid to the game's content line-up it is never just the raid normally, as it normally has several smaller scale content instances packaged in with it or quite close by, but the other issue is gw2 being b2p might change their ability to keep up such a content upkeep. Even using wow as an example they got many of their raids either came with an adition instance/s or the playerbase was not even yet to where they needed more content to pay thru (such as when many of the bc raids hit in wow the playerbase was still largely trying to clear many fo the herocs and first few raids.).
Originally posted by Sojhin
Yeah, I get that. Difficulty isn't hard enough to keep you interested in PvE.
What I want them to do is, once they spread out and make a lot more zones and content, I want them to occasionally make entire zones filled with DEs and enemies that require 10+ people to even attempt. There is a lot of potential for a huge variety of activies to be developed and stay valid for the life of the game through the removal of the gear treadmill. We'll see what they actually do though.
SWTOR is the greatest mmo ever!
Apprentice Member
Joined: 9/14/09
Originally posted by Grimlock426
Exactly. And there's no gear progression in GW2.
So raiding + GW2 = Best idea ever.
People'll only need to raid for the fun of beating boss. But they dont' need to do it over and over again just to get their gear to drop.
Novice Member
Joined: 7/19/10
Raids is good in some games for sure But in GW2 with such mechanics Raids wil be huge mess. With out healers and tanks it will be just 30 ppl rolling around trying to hit boss and half of them will be dead every 10 seconds while other half will be running in circles trying to revive ppl. :)
Also yes Raids in game showing gamers age GW2 made for fun so ppl with work and lifes can enjoy it fully. Any heavy Raiding gear farming game focuses on School age teenagers so they can stay in game for more than 4 hours.
It is fun to coordinate with team yes but after long day i dont want to sit near entrance waiting for other ppl to come so we can farm same old boss for some useless piece of gear. Also its always Must come to raid and i personally dont want to raid every day, once a week yeah sure why not. But raiding is nothg but farming for gear and fun only for first 2 kills. Subscription based games like WoW MUST have raids so ppl will waste lots of time in it with a feeling like they are doing somethg. in Normall game we dont need to farm pixels to be able to enjoy content.
Novice Member
Joined: 5/11/12
Originally posted by colddog04
I've heard the dungeons get VERY hard in explorable.
Originally posted by laokoko
Look here there is its more of a equal progression then a steep progression.
Originally posted by Sojhin
Well, they have said there will be harder DEs, and that some of the boss DEs will be much harder than others. I'd imagine you'd see more of that at higher levels generally speaking. So we'll have to see what things are like. I'm sure if there's a call for more challenging DE content then we'll get it.
We do have 5-mans in GW2 for challenging solo content as well as a large variety of fun content that gives you stuff.
I think the more fact that regular content scales will help things a good bit. However "faceroll" DE content is, it can't be nearly as faceroll as doing solo quests with 2+ people in a standard MMO. Merely doing things with others adds longevity. So the fact all activity is designed to be group friendly (save for crafting) helps a great deal.
Arena.Net didn't have problems making hard content in GW1, so I expect they'll be more than happy to provide some in GW2. Might take a little bit to get a feel for what that means though.
Originally posted by GamerUntouch
Yeah, me too. I think that will be the challenging part of PvE. Lots of wipes and changing of builds to make it work.
SWTOR is the greatest mmo ever!
Novice Member
Joined: 5/11/12
Originally posted by laokoko
The problem isn't progression for GW2, it's that raids would be a cluster____.
If you look at events with a massive zerg, it's a spamfest.
Raids would be that, with people randomly dieing, it'd be VERY VERY VERY hard to coordinate, most people couldn't do it.
I mean, if Arenanet can get it to work, the power's to them, but I can't see it happening.
Originally posted by GamerUntouch
Yeah, that's another point. It's a lot easier to design raids (and play them) when there are 3 strongly defined roles to work with.
SWTOR is the greatest mmo ever!
Originally posted by Drachasor
Well wow does do alot of content as many of their raids when they need to add additional content (like when the playerbase steam-rolls the exsting content) does not normally just toss out a raid alone, but instead does push out a raid an afew instances (like in lk you had the 5 man toc with the raid of tocm and then you also had ice crown with the raid having three smaller instances packaged with it, yet it was not till we actually completed or it was needed that more instannced came out.). Even looking back in bc which ahad alott of content updates in it complaed to either lk or cata they produced it when the need arose really.To me though as you largely stated with raidig taking more resources (also with gw2 not using a subb they need to further make sure their money is used wisely) raiding/large scale content would need to be more of a cash shop (none gem purchase) style affair, where the players actually that want the content would fuel the demand an pay for it solely, an so that way it would both allow for raiders to enoy it while also give them a way of not wasteing the money of those that would not use it on it.
Originally posted by Asuran24
But really look at WoW. Look at how much time and effort goes into Raids and how the number of raids they add is comparable to the number of dungeons in content updates (expansions are different, but content expansions after that, not so much). The Devs themselves have commented on how raid making eats up immense amounts of time, which is why WotLK was designed to get as many people raiding as possible (and Cata continued that philosophy). Burning Crusade was different because Raids weren't being designed for most people to get through them...so most people didn't.
It isn't like one raid boss takes as much time as one dungeon boss. The raid boss is MUCH harder to design because of the fact you have to deal with a lot more combos of class abilities and stacking of those abilities. One reason why classes have become more and more similar in WoW over time (another bad thing because of raids).
When one considers that instead of making a raid you could get something like 5+ dungeons or an entirely new zone or more...I'd rather go with zones and dungeons. Isolated big bosses that appear in the open world and don't require the same immense amount of balancing are better.
I want to play a raidless game not because I hate the very idea of raiding*, but because I enjoy all the others things more than raiding. Raiding means a LOT less of all the other stuff.
*Which is not to say that I don't have a lot of problems with how traditional raiding is worked into the game.
Originally posted by GamerUntouch
You could say Raids would be like that in any game, because it's hard to get people to coordinate. There's no inherent reason why this would apply to GW2 anymore than any other game. Though of course GW2 would require different design parameters since you don't have heal spam.
But of course you CAN get people to coordinate if you plan things out and spend a lot of time on it. Thing is, most people don't want to spend a ton of time working on that sort of thing which is what raiding requires.
Advanced Member
Joined: 3/02/12
MoP is coming soon I am sure it will appeal to you, how about you stick with every MMORPG made since 2004 and leave us w/o that crap.
the problem with raiders are two folder:
1. Raiders will NEVER be happy with raids in other games and eventually return to WoW. Anet said it best, you can't beat WoW at it's own game.
2. Raiders make a fraction of the population less than 10% of wow and as a result of problem (1), there is no point bothering with raids. Development resources should not be waste on content worthless to > 80% players.
other fun reasons, raids only exist as a way to significantly reduce gear progression thereby getting suckers to pay more subs.
Advanced Member
Joined: 4/29/06
Originally posted by GamerUntouch
WoW had a ton of gimmick fights and GW2 would be open to that style of raid despite not having the trinity healers or tanks. (Stand here to absorb a beam, don't stand here when there's a green cloud, move out if you are the bomb, etc)
I think the biggest argument against raiding in GW2 is that adding more people to encounters would not improve the game experience. I remember the 40 man raids in WoW and I don't think that they were any more fun than the 10 mans or even some of the harder 5 man dungeons. Adding more players just makes it more difficult to organize groups. Adding more players to an encounter doesn't make the content any more difficult.
ANet could add raids. I could definitely see how many of the WoW raid encounters could work without a trinity. I just don't think there's a very good reason to do so.


text:
Novel methods and devices which provide enhanced mixing and application of two liquid components to form a biomaterial with minimized aerosols is achieved using air flow rates below about 1.25 liters/minute in combination with a ratio of air flow to total liquid flow of from about 150:1 up to about 1500:1. Preferably the air flow is below about 1 liter/minute and the ratio of air flow to total liquid flow is from about 200:1 to about 1200:1. The parameters are ideally suited for the spray application of components which form a surgical sealant, e.g., a fibrin sealant. Also a part of the present invention are novel application methods for biomaterial, e.g., surgical sealant, components at liquid flows below 1.9 ml/minute, novel methods involving the mixing of such components on the exit surface of a spray tip or nozzle, novel spray tips and biomaterial applicators and methods for making such applicators.
1. An applicator system for applying two or more liquids to a desired site including a fibrin monomer liquid and a liquid solution for polymerizing the fibrin monomer, which liquids form a biomaterial upon mixing comprising;
a) a source of said liquids comprising a discrete container for each of said liquids;
b) fluid transferring means for transferring fluid, said fluid transferring means having a first end and a second end, said first end being connected to said containers wherein said fluid tranferring means includes discrete channels or lumen for each of said liquids;
c) an applicator having a spray or nozzle tip, said tip having a surface which includes discrete apertures for each of said liquids which apertures are connected to the discrete channels at said second end of said fluid transferring means; and
d) expelling means for expelling said liquids at a flow rate at or below 3.0 ml/minute, said expelling means being remote from said spray tip so as to permit said expelling means to be outside a sterile field while said spray tip is inside the sterile field.
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The invention relates to a method of applying a mixture of at least two liquid components to form a biomaterial at a desired site and is more particularly concerned with the application of at least two components which will form surgical sealant, e.g., a fibrin sealant.
Numerous biomaterials, e.g., biopolymers, are utilized in the medical arena. Many of these are formed from the combination of two or more liquid components and can therefore be formed in situ by the co-application of such components. An example of this is a surgical sealant, e.g., a fibrin sealant, which can be formed by the co-application of a fibrinogen component and a thrombin component.
U.S. Pat. No. 4,359,049 to Redl discloses a double barrel syringe for applying a tissue adhesive such as fibrin glue or fibrin sealant to a human or animal in need thereof. The fibrin sealant described comprises predominantly two major components, a fibrinogen-containing component and a thrombin-containing component, each in liquid form upon use. Essentially, the thrombin and fibrinogen, when mixed, provide that the peptide chains of the fibrinogen are cleaved and conditions are provided so that the resulting fibrin polymerizes into a clot which is useful for sealing fluid and air leaks, in haemostasis and to connect tissue. To avoid premature clot formation double-barreled applicators are employed which, of course, keep the two components separate until application to a patient is required. The '049 patent discloses that pistons within the two cartridges, each containing one component, can be commonly actuated to dispense fluid simultaneously from each.
Other prior art patents describe various mixing methods for mixing two or more components used in these and other surgical sealants. For example, U.S. Pat. No. 5,116,315 assigned to Hemaedics describes a mixing head where the liquid conduits leading from the component cartridge enter a mixing chamber fashioned so as to provide a swirling of the components before they exit via a common exit channel. Adequate mixing of the components is desired so as to form a uniform fibrin sealant. Inefficient mixing results in the co-administration of fibrinogen and thrombin which may only result in a small yield of actual sealant. A difficulty with fibrin sealant applicators can be the premature formation of the clot within the device, especially those devices where the components are mixed within a mixing head and/or those devices wherein the components exit through a common channel. After the first spray of sealant is complete, a clot may block the exit channels rendering the applicator useless and greatly reducing the surgeon's flexibility in carrying out the sealant part of the surgical procedure.
U.S. Pat. No. 4,631,055 to Immuno includes a gas conveying channel for blowing a gas through the needle or mixing head during discharge of the components. However, an even, uniform distribution of the materials over the anatomical area of interest is still not achieved. Indeed, a significant amount of the components are wasted.
U.S. Pat. No. 5,605,541 discloses a device and a method of applying components of a fibrin sealant. The device comprises a source of a gas and a reservoir for each component wherein the gas source and each of said components are discharged through separate apertures. Preferably, the gas is discharged through the center aperture and the fibrin sealant forming components are discharged separately through each of the annular apertures.
European Patent 592,242 to Edwardson et al. discloses the first completely autologous fibrin sealant. It provides for the co-administration of a fibrin monomer solution with a buffer solution which provides for the polymerization of the fibrin monomer and can be prepared in less than 30 minutes from a single source of blood (preferably that of the patient to receive the sealant). This breakthrough technology provides a fixed amount of fibrin monomer solution from a sample of about 140 to 160 ml of blood. Uniform and efficient mixing is even more important in order to benefit from this safe, efficient, autologous sealant product and therefore new devices and methods for applying two or more components to form a surgical sealant are required.
Ideal application of fibrin sealants involves an efficient utilization of the sealant components to maximize coverage and effective use. Efficient utilization is accomplished by, inter alia, sufficient mixing of the components, uniformly controlled application of the components, the ability to apply the components intermittently and minimization of aerosols. It is also desirable for the surgeon to be able to vary the application rates according to the particular procedure and to be able to work in close proximity, i.e., less than 10 cm and even less than 5 cm, away from the tissue to be sprayed.
Among the parameters which can be most devastating to the performance of sealant applicators are mixing and clogging. Insufficient mixing results in the co-application of individual sealant components and only a portion of the amount of sealant desired is actually formed. This results in waste and poor sealant performance. Because the sealant components begin or continue the coagulation cycle upon mixing with each other there are limitations to the Hemaedics device described above and most current sealant applicators are designed to mix the components outside of the device to avoid clogging. Those skilled in the art can appreciate that proper mixing and application are difficult to control given that the important mixing of components occurs as they leave the device rather than inside the device. The characteristics of the applied sealant film are greatly impacted by the mixing/spray parameters and the fluid dynamics of the two liquids as they exit the device tip or nozzle. Clogging is often the result of the premature contact of the sealant components within the device, however, the handling and transfer of blood within plastic and/or glass tubing and appliances, generally, is inherently problematic, especially as inner device/tubing dimensions become smaller.
U.S. Pat. No. 5,582,596 to Fukunaga et al. discloses a spray applicator suitable for fibrin sealants which can be connected to a gas supply. Two liquid nozzles are located concentrically within two larger gas nozzles. The '596 patent states that the liquid nozzles protrude from the gas nozzle by from about 100 microns to 10 mm. The '596 patent also states that the liquid nozzles are from about 1.0 mm to about 20 mm apart. A commercially available applicator for Bolheal� sealant which appears to be an embodiment of the '596 patent actually has two liquid nozzles which protrude about 600 microns from the gas jets and which have inner diameters of about 625 microns wherein the liquid nozzles are on 3.0 mm centers or are about 2.4 mm apart. The product and '596 patent suggest that low pressures, e.g. 0.75 kg/cm2 to 4.0 kg/cm2 can be used but no mention is made of airflow, or sealant flow rates. Spray angles, aerosols and working distances for this device still leave room for improvement.
WO 97/20585 discloses a novel spray applicator for fibrin sealants which utilizes "in-line" apertures in the spray tip for expelling air (or other gas) and sealant components. That system uses relatively low air flow, i.e., 1.25 liters/min with sealant rates of nearly 2.0 ml/min to nearly 5.0 ml/min. The apertures in the spray tip are only about 300 microns in inner diameter and about 200 microns apart, i.e., on 5 micron centers. It is believed that this device is among the smallest in nozzle dimensions for blood, i.e., fibrin sealant application. Aerosols are considerably reduced and spray angles and mixing improved, but a finer controlled spray with even less aerosols and more efficient utilization of sealant components would be a useful addition to the art.
In accordance with the present invention it has been found that enhanced mixing and application of two liquid components to form a biomaterial with minimized aerosols is achieved using air flow rates below about 1.25 liters/minute in combination with a ratio of air flow to total liquid flow of from about 150:1 up to about 1500:1. Preferably the air flow is below about 1 liter/ minute and the ratio of air flow to total liquid flow is from about 200:1 to about 1200:1. The parameters are ideally suited for the spray application of components which form a surgical sealant, e.g., a fibrin sealant. Also a part of the present invention are novel application methods for biomaterial, e.g., surgical sealant, components at liquid flows below 1.9 ml/minute, novel methods involving the mixing of such components on the exit surface of a spray tip or nozzle, novel spray tips and biomaterial applicators and methods for making such applicators.
FIG. 1 is a lateral view of one embodiment of the application system of the present invention wherein the applicator is shown in partial cross-section.
FIG. 2 is a lateral view of the terminal end of a spray tip or nozzle of the present invention.
FIG. 3 is a lateral view of the terminal end of a spray tip or nozzle of the present invention showing the liquid mixing and flow without any spray gas.
FIG. 4 is a view similar to FIG. 3 but incorporating a spray gas.
FIG. 5 is a lateral view of the spray tip of the present invention.
FIGS. 6A and 6B are illustrations of the tip-forming method of the present invention.
FIGS. 7-9 illustrates various tip/aperture/lumen configurations of the present invention.
The present invention provides for the enhanced application of two or more liquids for forming a biopolymer, e.g., a surgical sealant. The present device and methods provide uniform mixing at low air and liquid flow rates providing the capability to apply thin, even coats of sealant with reduced waste and aerosols. Examples of applications suitable for this new device and method are fibrin sealants wherein a gas, such as air, is used to help mix and apply two or more liquid components which could be a fibrinogen solution and a thrombin solution or a fibrin monomer solution and a fibrin-polymerizing solution, e.g., pH 10 buffer, as set forth in EP 592242 to Edwardson et al. As used herein, the term "total liquid/flow" or "liquid flow" or "sealant flow" refers to the combined liquid flow rates of the fibrinogen and thrombin solutions or of the fibrin monomer and fibrin polymerizing solutions. In addition to these liquid components other useful liquids or agents may be added and co-applied either with one or both of the above mentioned liquid components or via discrete pathways. For example, drugs can be co-applied, e.g., anticancer agents, antibiotics and other pharmaceutical agents as mentioned in EP 592242 or otherwise known in the art. Also, various types of cells can be co-applied which may be useful in the particular biomaterial employed. Further, liquids, polymers or other agents which can vary or control the texture or properties of the applied biomaterial can also be co-applied, e.g., hydrocolloids, alginates and other materials used adjunctively.
The application system can be any of those known in the art, e.g., the double-barrel syringes known to be useful for the delivery of surgical sealant in the prior art. The present invention is also suitable for incorporation into an application system similar in some ways to that described in WO 97/20585 and shown in FIG. 1. Accordingly, FIG. 1 shows an application system generally as 10 including an applicator 11 having an optional handle 12 with a spray tip or nozzle 14 and an optional actuator 16 to initiate application. The spray nozzle or tip 14 terminates in a generally flat lip surface 14′ which is substantially normal to the longitudinal direction of the tip 14 and which includes exit apertures (not shown) through which gases and liquids are dispensed during application. The applicator 11 is in fluid communication via tubing means 18 with a source 20 of liquids and gases to be applied.
The present method employs a low air flow rate of below 1.25 liters/minute coupled with air flow rate to liquid flow rate ratios of 150:1 to 1500:1. Preferably, the air flow rate is below 1.0 liters/minute and the air flow:liquid flow ratio is from about 200:1 to about 1200:1. Most preferred ratios are between 400:1 and 1150:1. This provides that the total liquid flow rates are extremely low, i.e., below about 3.0 ml/minute and preferably below 1.9 ml/minute and even below 0.5 ml/minute but most preferably in the range of 0.5-1.5 ml/minute. Preferred gas flows are from about 500 ml/minute to about 800 ml/minute. These low air flow rates and low liquid flow rates provide excellent efficiency and control of the sealant application which is critical when considering that sealant procedures are typically undertaken with a fixed, i.e., limited, volume of sealant to be used in the surgery. Preferably the higher ratios are used with the higher gas flows and vice versa, as is illustrated in TABLE 1 of Example 1. In addition to a more efficient use of the sealant components, it is believed that multiple thin layers of sealant are more efficient than thicker, less efficient, poorly mixed masses of sealant components which may only partially interact to ultimately form the sealant.
It has further been found that proper mixing and application of the liquid components to form a biomaterial, e.g., a sealant is best accomplished in an applicator having a spray nozzle or tip with liquid and gas apertures of considerably smaller dimension and considerably closer in proximity to each other. Accordingly, a spray tip has been developed which has at least three apertures each of which has an inside diameter of less than 300 microns, where two apertures are for the liquid components which form the sealant and the third aperture provides the spray gas. A lateral view of such a spray tip 14 is shown in FIG. 2. Additional apertures may be provided for a second gas, additives or guide wires for endoscopic use. Preferably, the apertures for the liquid components have inside diameters of less than 250 microns and more preferably between 25 and 150 microns and most preferably between about 50 and 120 microns. The gas aperture can have the same inside diameter as the liquid apertures or preferably is about 20% to 50% larger in diameter than the liquid apertures when used in the present methods. Accordingly, in one preferred embodiment shown in FIG. 2 the spray tip surface 14′ on the applicator has two 100 micron liquid apertures 13, 15 and a gas aperture 17 of about 140 to 150 microns in diameter. Preferably, the apertures are in a straight line and the gas aperture is at one end of that straight line as per WO 97/20585. If the liquids to be applied are delivered in other than a 1:1 ratio then it is preferable to have the liquid of the least amount exiting the aperture furthest from the gas aperture. In a preferred embodiment a fibrin monomer solution (pH4) and a buffer solution (pH10) are applied in a 7:1 ratio per the methods of EP 592242. In such a case it has been found to be desirable to have the pH10 exit from a first aperture, i.e., aperture 13 in FIG. 2, at one end of a line of three apertures, and to have the fibrin monomer solution exit from the middle aperture, i.e., aperture 15. This has been found to greatly enhance mixing of the liquid components when using the present devices and methods.
The mixing of the liquid components according to the present invention is related to the aperture size, the low liquid flow rates, the surface tension qualities of the biopolymer-forming liquids employed and the spacing between apertures. Accordingly, it has been found that when using absolutely no gas, at liquid flow rates below about 3.0 ml/minute and preferably at the lower end of the low liquid flow rates described herein, e.g., 0.5 ml/min-0.7 ml/min., that fibrin sealant-forming liquids will generally, due to their surface tension each form a droplet on the surface 14′ of the spray tip 14 before that droplet departs from the spray tip due to the force of the liquid flow. That droplet is larger than the aperture diameter. This is easy to observe under low magnification and this approximate "droplet diameter" on the surface can be observed for various liquids. It has been found that superior mixing is provided when the spacing between the liquid apertures is such that these surface droplets will overlap or contact each other before being forced off of the spray tip towards the desired target. FIG. 3 shows the spray tip 14 with no air, but with the two liquids at low flow. The two liquids form a combined droplet 19 on the surface before the liquids (now mixed) are forced off of the spray tip 14 towards the target. In this regard, for fibrin sealant-forming liquids it has been found that the spacing between liquid apertures is preferably between 70% and 120% of the diameter of one aperture and preferably between 80 and 90% of the diameter of one aperture. That is, for a spray device having 100 micron liquid apertures, the edge-to-edge distance between those apertures should be between 70 and 120 microns and preferably the spacing should be between 80 and 100 microns. Looked at another way, in accordance with the preferred mixing methods of this invention a spray tip having 100 micron diameter liquid apertures ideally has those apertures at a center-to-center distance of between 120 microns and 220 microns and optimally between 130 and 200 microns. The gas aperture spacing from the adjacent liquid aperture is preferably in the same range as those spacings described above but may be identical to, or different than, the exact liquid-to-liquid spacing used.
During spray application, i.e., when the air or gas is utilized at the aforementioned flow rates of this invention in the aforementioned ratios of air flow to liquid flow of this invention, the droplet mixing at the surface of the spray tip serves as a premix of the liquid components before they are sucked into the air stream and broken up into smaller size droplets and further mixed during delivery to the desired site. This is illustrated in FIG. 4 where the combined droplet 19 can be seen being sucked into the air flow. Essentially the spray droplets being applied from the spray tip or nozzle form a cone shape as they approach the desired site. Cone angles for the present device and method are reasonably controllable according to the flow rates and spray distances selected. Spray angles attainable range from about 10� to about 40� and therefore provide reasonably reproducible widths of applied sealant as the applicator is moved laterally in a swath across a target area.
As mentioned above, the ideal spacing for the apertures on a spray tip or nozzle is determined without gas flow. This also gives way to a novel pinpoint sealant application method which is part of the present invention. Which is seen by referring back to FIG. 3. As mentioned above, the two liquid apertures are spaced such that the liquids form overlapping surface tension droplets forming a combined liquid droplet 19 on the surface 14′ of the spray tip 14. At low liquid flow rates, i.e., preferably below 1.0 ml/min, these combined liquid droplets are forced off of the spray tip one or two at a time to provide a very uniformly mixed, controlled pinpoint, essentially dropwise application of surgical sealant. This application is preferred in certain instances where a focused applicator is required and large areas do not need to be covered, e.g., in certain nerve repair procedures.
Since the apertures in the present device are so small, it therefore follows that only a small area of each of the liquids is exposed to each other and to the outside environment. Accordingly, the tendency for the present spray tip to clog is greatly reduced. Further, the spray applicator of the present invention may be adapted so that the liquids are actually withdrawn a short distance back into the apertures upon discontinuing the spray or delivery mode as is explained in WO 97/20585. When the liquids are supplied from piston-driven cylinders via tubing means to the spray tip, this can be accomplished by withdrawing the pistons slightly. However, if the two sealant-forming liquids do remain on the tip surface of a spray applicator according to this invention, it has been found that the so-formed combined droplet (which may or may not begin to polymerize) either overlaps, or is in close enough proximity to the gas aperture that continuation or initiation of a gas flow alone readily removes the potentially clogging material. The gas flow used alone for this tip cleaning purpose can be any convenient flow either within or beyond the air flow rates otherwise utilized in this invention. Preferably, this tip-cleaning flow rate is the same as or up to 1.5 to 2.5 times greater than the gas flow being utilized for liquid spray delivery. In systems where the delivery of liquids and gas to the applicator are controlled, e.g., by a microprocessor as disclosed in WO 97/20585, it has been found useful to program an air flow into the procedure, where the air flow continues for a fixed period of time, e.g., up to about 30 seconds, after the application of liquid components. This "air only" cleaning step can also be programmed at the beginning of the application cycle.
As can be appreciated by those skilled in the art, forming a spray tip or nozzle of the dimensions prescribed by the present invention is a task of high precision. While injection molding such a spray tip may be possible, it is fraught with difficulties considering the dimensions involved. In accordance with the present invention, spray tips can be formed by the controlled heating and stretching of thermoplastic multilumen tubing where the tubing dimensions, prior to such heating/stretching, are actually several times larger than the desired tip dimensions. For example, low density polyethylene tubings are commercially available, e.g., from Putnam Co., as multilumen tubes having several lumens of the same or varied inside diameters. Unexpectedly, very small diameter tubings like these can be even further drawn and reduced without closing the lumens or destroying the basic shape of the tube, except for reducing the overall dimensions. FIG. 5 illustrates a spray tip 14 of the present invention which has been formed from a multilumen tubing 21. The multilumen tubing 21 has the spray tip 14 at the very end of the reduced tubing 23 which is integral with a transition portion 25. In the transition portion 25 the dimensions of the outside tubing and the interior lumens 27, 29, 31 transition from those of the reduced tubing 23 to those of the main tubing 33.
It has been found that multilumen tubing having .35 mm bore lumens can be carefully heated and drawn to reduce the dimensions, e.g., 3.5 times to provide 100 micron bores, 7 times to provide 50 micron bores and even 14 times to provide 25 micron bores. This remarkable finding provides an extremely cost effective way of preparing precision spray tips which would be virtually impossible to produce (at any cost) using conventional injection molding for thermoplastic materials. Further, it has surprisingly been found that blood components are readily deliverable at these dimensions without premature clotting or clogging problems.
While the method referred to above and described in more detail below with reference to FIGS. 6A and 6B is preferred, any methods or technology suitable for fabricating these spray tips can be used. The spray tip can be of a thermoplastic material as described above or can be of a metal or ceramic material. Depending upon the material and dimensions chosen, known techniques such as molding, laser drilling electron discharge machinery (EDM) or spark erosion methods can be utilized to fabricate the present spray tip.
Further embodiments of the tubing and tip configurations which are part of the present invention are illustrated in FIGS. 7-9. FIG. 7 shows a spray tip 14 having a surface 14′ with in-line apertures, i.e., gas aperture 17 and liquid apertures 13 and 15. Also shown are an auxiliary aperture 50 which can be used for additional liquids or gases, for additional reagents or excipients of for a guidewire for endoscopic purposes. Additionally auxiliary aperture 50 can merely be present to provide a desired stability or flexibility to the tubing itself. Crescent aperture 52 is a second gas aperture, i.e., in addition to gas aperture 17, which has been found useful in the tip-cleaning methods described hereinbelow.
FIG. 8A shows a tubing cross-section with an integral, but separable, lumen 30 which can be used as shown in FIG. 1 as the actuator/pressure sensor tube 30. FIG. 8B shows a side view illustrating how the separable lumen 30 can be separated from the main lumen.
FIG. 9 shows a tip 14 with a surface 14′ with three in-line apertures 13, 15 and 17 and a separable gas lumen 30 and auxiliary lumen 54, 56 which can be used for extra gas, extra liquid, reagents or excipients, endoscopic guide wire or simply to modify stability/flexibility of the tubing.
FIGS. 6A and 6B further illustrate the process for forming the novel spray tips of the present invention. A section of tubing 18 is held between a fixed clamp 40 and a slidable clamp 42. The principles described herein can be employed with any thermoplastic tubing and require some basic knowledge regarding the tubing material selected and the thermoplastic properties thereof. By way of example, a low density polyethylene 4-lumen tube from Putnam Company has an outside diameter of about 2.5 mm and four lumens having inside diameters of between 350 and 500 microns. As can be seen from FIG. 6A, sources of heat are applied to the area between the clamps. Applying the heat to a length of from 5 to 10 cm has been found useful but this will vary according to the desired shapes. The heat is applied until the tubing 18 begins to flow and can be drawn. For the exemplary tubing discussed herein about 280� C. is a sufficient heat source. When the tubing becomes liquid or pliable, the slidable clamp 42 is moved a pre-set distance. For example, if the distance X in FIG. 6A is 10 cm the clamp 42 can be drawn out so that the distance is 3.5�or 35 cm, as shown in FIG. 6B. It has been found that this reduces the dimensions by about 3.5 times. Accordingly, in the center of the reduced tubing 23 the lumen inner diameters in FIG. 6A have been reduced from about 350 and 500 microns to about 100 and 150 microns, respectively. As shown in FIG. 6B a cutter 44 can be used to cut the tubing 18 and form the spray tip as desired. Further, referring back to FIG. 5 it can be appreciated that the tip 14 can be formed anywhere in the reduced tubing 23 or in the transition portion 25 according to the desired aperture size for the tip. It also appears from ongoing studies that a relationship between the diameters of the lumens in the main tubing 33 and in the tip 14 provide desirable spray qualities, ratios of 3:1 to 14:1 being found useful when the tip and tubing are of a single piece of material. Accordingly, cutting to form the tip 14 at a desired position along either the reduced tubing 23 or the transition position 25 serves not only to establish the aperture diameters but the ratio of those diameters in relationship to the lumen diameters in the main tubing 33.
Referring to FIGS. 5 and 6A, a measuring means (not shown) could also be employed in the tip-forming method described herein. Such a measuring means has the purpose of determining either the desired size or desired characteristics of the spray tip by measuring the inner diameters of the lumen or outer diameter of the tubing, either optically or mechanically. In this way, the cut to form the tip could be made in precisely the correct location along either the reduced tubing 23 or the transition portion 25. Alternatively, gas or liquid could be run through the tubing 18 during the cutting step so that a measuring means could continue moving the cutter up the reduced tubing 23 and/or transition portion 25 towards the main tubing 33 until the desired flows are sensed.
A preferred spray applicator according to the present invention comprises an integral, one-piece tubing and spray tip. That is, a multilumen tubing is modified at one end, as described above, to make a reduced spray tip and the main body of the multilumen tubing serves as tubing means to provide fluid communication from the sources of liquid components to the spray tip. Referring back to FIG. 1, essentially the multilumen tubing such as that illustrated in FIG. 5 serves as the tubing means 18, a first end of which connects to the sources of liquid 22, 24 and gas 26. At the second end of the tubing rather than connecting to a spray tip or nozzle, the tubing is formed into the spray tip or nozzle 14 as described herein. An optional handle 12, preferably with an actuator 16, can be positioned anywhere along the tubing 18, e.g., near the nozzle 14 end for maximum directional control by the surgeon or further back along the tubing 18 so that a length of tubing 18 and the spray tip 14 extend out from the handle 12 useful, for example, for endoscopic purposes. The actuator 16 illustrated in FIG. 1 is part of the disclosure of WO 97/20585. Essentially, beneath the actuator 16 which can be, e.g., a flexible membrane of an elastomeric material, is a pressure switch 28 which is connected to a sensing air or gas tube 30. The opposite end of the sensing air or gas tube 30 is also shown connected to the control/drive unit of the sources 20 of gas and air. Depressing the actuator 16 provides that a pressure differential is created in the sensing air or gas tube 30 which pressure differential is detected as a signal in the control/drive unit. In response to this signal the contents of the liquid sources 22 and 24 and the gas source 26 are delivered up the respective lumens 32, 34 and 36 through the tubing means 18 and out the apertures 13, 15, 17 (not shown in FIG. 1) of the spray tip 14. The sensing tubing 30 may be distinct from the tubing means 18 or may be integral with, but separable from, the tubing means 18 as shown in FIG. 1. The application system 10 of FIG. 1 may also include a retaining sleeve 32 which can be of a thermoplastic or elastomeric material and which provides a snug fit between the reduced tubing 23 and the nozzle end 34 of the handle 12. Also a grommet 36 may be included at the rear portion of the handle 12. The sleeve 32 and grommet 36 are added to provide stability to the tubing 18 and tip 14 while handling and using of the applicator 11 of the application system 10 of this invention. The handle 12 can be of any semi-rigid or rigid material and plastic materials used in the medical device field are useful in that they are light and easy to manufacture.
WO 97/20585 also discloses, as is illustrated in FIG. 1 herein, that the source, or expelling means as it is referred to in WO 97/20585, is preferably remote from said spray nozzle or tip such that the sources of liquid and gas components are not held in the hands of the surgeon. This provides that the tubing means/spray tip, with or without a handle, serves as the applicator in such an application system. As such, it can be appreciated that a much more sleek, easy-to-handle applicator is provided compared to the prior art. The source or expelling means herein is also microprocessor controllable. All of these features are part of preferred embodiment of the present invention. The various flow rates and ratios which are a part of this invention can be programmed into the control/drive part of the source so that the surgeon can select and even vary the flow rates and ratios according to the particular procedures and surgical needs at the time. It is also contemplated as part of this invention that the gas or air could be pulsed to provide desired spray/application characteristics. Further in accordance with this invention depressing the actuator can provide that
1) the delivery of the liquids and gas is "on" until a second depression of the actuator; or
2) the delivery of the liquids and gas is "on" while the actuator is depressed and "off" when the actuator is released; or
3) a metered amount of liquids and gas are dispensed each time the actuator is depressed.
The present invention will now be further described by the following Examples but should not be limited to the details described therein.
This example is designed to assess the mixing of two liquid components applied to form a fibrin sealant using the methods and devices of the present invention. The mixing efficiency of the fibrin sealant disclosed by Edwardson et al. in EP 592242 is readily assessed since the two liquids are a pH4 fibrin monomer solution and a pH10 buffer designed to render the mixed solutions neutral which in turn provides for the polymerization of fibrin monomer to a fibrin polymer, i.e., a fibrin sealant. Therefore, by spraying these liquids onto pH paper the mixing can be observed.
A spray applicator essentially as shown in FIGS. 1, 4 and 5 having a spray tip with two 100 micron diameter liquid apertures and a 150 micron diameter gas aperture. The apertures were arranged in a straight line with gas at one end, a fibrin monomer solution aperture in the middle and a pH10 buffer solution at the other end of the line of apertures. The apertures were approximately 90 microns apart (edge to edge).
A fibrin monomer solution was prepared as described by Edwardson et al. in EP 592242 and had a pH of 4. This was to be co-applied with a pH10 carbonate/bicarbonate buffer solution as also bed in EP 592242 in a fibrin monomer to buffer ratio of 7:1.
These liquids were applied to a 20 cm2 section of a full range (1 to 14) pH paper available from Whatman according to the parameters in TABLE 1 below. These spray parameters were also used in Example 2 which follows.
The primary aim for these spray mixing experiments was to observe pattering of non-neutral solutions caused by an incorrect mixing ratio or inefficient mixing or by blockage of either of the liquid apertures. A high portion of carbonate/bicarbonate buffer would be signified by blue spots of the pH paper, a high proportion of fibrin I solution would be signified by orange spots on the pH paper.
None of the applicators tested exhibited any incomplete mixing; the clots were always of neutral pH, signified by a green color on the pH paper. This observation suggests that the clots were well mixed. All samples taken were well mixed and the whole of the closest was at pH7.
The same device, liquids and spray parameters as set forth in Example 1 and TABLE 1 above, were employed in this experiment except as described herein. The fibrin monomer solutions used in this experiment were spiked with 20 μl of a 1% aqueous solution of rhodamine to make observation of the fibrin clots easier.
Applicators were held horizontally within a custom built rig at right angles and at a distance of 5 cm or 10 cm from a 20 cm2 glass plate. A straight line point between application tip and glass plate was drawn on the plate. This point was to be the application target.
The spray was primed onto a shield placed in front of the target for a period of 5 seconds; the shield was then removed and the spraying continued, without pause, for a further 10 seconds onto the glass plate. The diameter of the resultant clot and also the distance of the clot from the target were noted. Any leakage, blockages or apparent deterioration of spray performance were noted.
The purpose of this Example 2 was to assess the spray diameters, spray direction and spray cone angles produced by applicators as described in Example 1. Ten applicators were run through the experiment described herein and the results are compiled in TABLE 2.
It can be seen that a fine, reproducible, variable, controllable spray is provided by the device and methods of the present invention.
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In late May 2014, the Department of Energy (DOE) proposed changes to its process for approving applications to export liquefied natural gas (LNG) to foreign countries that do not have free trade agreements with the United States. In announcing the proposed changes, DOE said that it will stop issuing conditional approvals of LNG export applications. DOE's proposed procedural changes would not grant LNG export licenses until the Federal Energy Regulatory Commission (FERC) has completed its obligations under the National Environmental Policy Act. Only after FERC has completed its work would DOE issue a final determination that the project is in the public interest, as is required by the Natural Gas Act.
This proposed change in policy occurs at an important period in the debate over LNG and other energy exports from the United States. Several bills are pending on Capitol Hill in Washington, D.C. that would alter the process for reviewing LNG export applications. One bill, H.R. 6, has passed the House and has become a political issue for a U.S. Senate race that could determine which party controls the chamber in 2015. Additionally, DOE has continued granting licenses to export LNG; on July 31, DOE conditionally authorized LNG Development Company LLC to begin exporting LNG. That is the eighth LNG export application to be approved by DOE, and the second since March. There has also been a strong push for loosening some of the restrictions on exports of crude oil from the United States. Such exports have essentially been banned for nearly four decades, but the boom in American oil production is forcing a change in the debate, and the White House is paying attention.
This is a busy time in energy policy in Washington, D.C., and the issue of exports remains front and center as the United States faces a newfound abundance of domestic fossil fuels. Those resources have taken on new importance as geopolitical conflicts have increased between Russia and the West in recent months. Fossil fuel companies looking for expansion opportunities into new fuel markets should monitor these developments closely and consider personally advocating for their interests in our nation's capital.
DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.
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ridge vent
I have a cold roof that was put on last year over the existing roof. It has a ridge vent and soffit vents. The original roof also had a ridge vent that is now closed off. Should there be an opening into the attic or should the air space all be above the original roof?
Any advice would be appreciated.
You built a new roof on top of the existing roof, with a new air cavity, correct?
If so, then yes, the interior attic compartment should disperse the contained moisture content to the out side environment.
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Genetic Counseling Center - Santa Clara, CA
Santa Clara Geneticist, Ph.D. Doctors for Genetic Counseling
Type of Physician: Geneticist, Ph.D.
What is a Geneticist, Ph.D.?
A certification by the Board of Medical Genetics; practitioners work in association with a medical specialist, are affiliated with a clinical genetics program, or serve as a consultant to medical and dental specialists.
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What are the benefits of early patient contact? - A comparison of three preclinical patient contact settings
1 Office of the CEO, UW Medicine and Executive Vice President for Medical Affairs, University of Washington, Box 356350, Seattle, WA 98195-6350, USA
2 Department of Medicine, University of Washington School of Medicine, Box 356429, Seattle, WA 98195-4328, USA
3 Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
BMC Medical Education 2013, 13:80 doi:10.1186/1472-6920-13-80Published: 3 June 2013
Despite increasing attention to providing preclinical medical students with early patient experiences, little is known about associated outcomes for students. The authors compared three early patient experiences at a large American medical school where all preclinical students complete preceptorships and weekly bedside clinical-skills training and about half complete clinical, community-based summer immersion experiences. The authors asked, what are the relative outcomes and important educational components for students?
Medical students completed surveys at end of second year 2009–2011. In 2009, students compared/contrasted two of three approaches; responses framed later survey questions. In 2010 and 2011, students rated all three experiences in relevant areas (e.g., developing comfort in clinical setting). Investigators performed qualitative and quantitative analyses.
Students rated bedside training more highly for developing comfort with clinical settings, one-on-one clinical-skills training, feedback, active clinical experience, quality of clinical training, and learning to be part of a team. They rated community clinical immersion and preceptorships more highly for understanding the life/practice of a physician and career/specialty decisions.
Preclinical students received different benefits from the different experiences. Medical schools should define objectives of early clinical experiences and offer options accordingly. A combination of experiences may help students achieve clinical and team comfort, clinical skills, an understanding of physicians' lives/practices, and broad exposure for career decisions.