text:
A cardiovascular parameter such as cardiac output is estimated from a current pressure waveform data set without needing to directly measure blood flow or arterial compliance. The general shape of an input flow waveform over one beat-to-beat cycle is assumed (or computed), and then the parameters of a flow-to-pressure model, if not pre-determined, are determined using system identification techniques. In one embodiment, the parameters thus determined are used to estimate a current peripheral resistance, which is used not only to compute an estimate of the cardiovascular parameter, but also to adjust the shape of the input flow waveform assumed during at least one subsequent beat-to-beat cycle. Another embodiment does not require computation of the peripheral resistance and still another embodiment computes a flow estimate from an optimized identification of the parameters defining the assumed input flow waveform.
1. A method for determining a cardiovascular parameter equal to or derivable from cardiac output (CO) comprising:
inputting a current pressure waveform data set corresponding to arterial blood pressure over a current pressure cycle;
determining defining parameters of an assumed input flow waveform as a function of a peripheral resistance value determined for at least one previous pressure cycle;
determining model parameters of a model of a relationship between the assumed input flow waveform and the current pressure waveform data set;
computing a current peripheral resistance value as a function of the model parameters; and
computing an estimate of the cardiovascular parameter as a function of the current peripheral resistance value and the current pressure waveform data set.
2. A method as in
3. A method as in
4. A method as in
the defining parameters include duration and amplitude; and
the duration of the component waveform for the current pressure cycle is set at least approximately equal to a time interval between systole onset and systole in the current pressure waveform data set.
5. A method as in
estimating a diastolic time constant as a product of a sampling rate at which the pressure waveform data set is derived and a function of a model feedback parameter;
estimating an arterial compliance value as a ratio of the diastolic time constant and the peripheral resistance value;
estimating a systolic time constant from chosen points in the current pressure waveform data set;
computing an aortic characteristic resistance value as a ratio of the systolic time constant and the arterial compliance value;
setting the amplitude of the component waveform for the current pressure cycle to be inversely proportional to the square of a function of at least one aortic characteristic resistance value.
6. A method as in
computing the mean of a plurality of aortic characteristic resistance values, which will include at least one aortic characteristic resistance value estimated for a previous cycle;
setting the amplitude of the component waveform for the current pressure cycle to be inversely proportional to the square of the product of the mean and a calibration constant.
7. A method as in
8. A method as in
9. A method as in
setting the amplitude of the component waveform for the current pressure cycle to be proportional to a peak-to-peak value of the current pressure waveform data set and inversely proportional to a function of the current peripheral resistance value.
10. A method as in
determining a mean value of a plurality of previously estimated peripheral resistance values; and
setting the amplitude of the component waveform for the current pressure cycle to be proportional to the peak-to-peak value and inversely proportional to the mean value.
11. A method as in
determining a calibration constant; and
setting the amplitude of the component waveform for the current pressure cycle to be proportional to the peak-to-peak value and inversely proportional to the mean value scaled by the calibration constant.
12. A method as in
the model is a discrete, auto-regressive representation of a multi-element Windkessel model of the aorta; and
the model parameters are coefficients of the discrete, auto-regressive representation.
13. A system for determining a cardiovascular value equal to or derivable from cardiac output (CO) comprising:
an arrangement generating a current pressure waveform data set corresponding to arterial blood pressure over a current pressure cycle;
a processing system including:
an input flow waveform generation module comprising computer-executable code for determining defining parameters of an assumed input flow waveform as a function of a peripheral resistance value determined for at least one previous pressure cycle;
a system parameter identification module comprising computer-executable code for determining model parameters of a model of a relationship between the assumed input flow waveform and the current pressure waveform data set;
a model parameter computation module comprising computer-executable code for computing a current peripheral resistance value as a function of the model parameters; and
a cardiovascular value computation module comprising computer-executable code for computing an estimate of the cardiovascular parameter as a function of the current peripheral resistance value and the current pressure waveform data set.
14. A system as in
15. A system as in
16. A system as in
the defining parameters include duration and amplitude; and
the duration of the component waveform for the current pressure cycle is set at least approximately equal to a time interval between systole onset and systole in the current pressure waveform data set.
17. A system as in
18. A system as in
an averaging module comprising computer-executable code for determining a mean value of a plurality of previously estimated peripheral resistance values;
in which input flow waveform generation module is further provided for setting the amplitude of the component waveform for the current pressure cycle to be proportional to the peak-to-peak value and inversely proportional to the mean value.
19. A system as in
a calibration module determining a calibration constant;
in which the input flow waveform generation module is further provided for setting the amplitude of the component waveform for the current pressure cycle to be proportional to the peak-to-peak value and inversely proportional to the mean value scaled by the calibration constant.
20. A system as in
21. A system as in
the model is a discrete, auto-regressive representation of a multi-element Windkessel model of the aorta; and
the model parameters are coefficients of the discrete, auto-regressive representation.
This application claims priority of U.S. Provisional Patent Application No. 60/670,767, filed 13 Apr. 2005.
1. Field of the Invention
This invention relates to a method for estimating a cardiovascular or hemodynamic parameter such as cardiac output (CO), as well as to a system that implements the method.
2. Background Art
Cardiac output (CO) is an important indicator not only for diagnosis of disease, but also for continuous monitoring of the condition of both human and animal subjects, including patients. Few hospitals are therefore without some form of conventional equipment to monitor cardiac output.
One basis for most common CO-measurement systems is the well-known formula CO=HR�SV, where SV is the stroke volume and HR is the heart rate. SV is usually measured in liters and HR is usually measured in beats per minute, although any other units of volume and time may be used. This formula simply expresses that the amount of blood the heart pumps out over a unit of time (such as a minute) is equal to the amount it pumps out on every beat (stroke) times the number of beats per time unit.
Since HR is easy to measure using any of a wide variety of instruments, the calculation of CO usually depends on some technique for estimating SV. Conversely, any method that directly yields a value for CO can be used to determine SV by division by HR. Of course, estimates of CO or SV can then be used to estimate, or contribute to estimating, any parameter that can be derived from either of these values.
One invasive way to determine cardiac output (or, equivalently, SV) is to mount some flow-measuring device on a catheter, and then to thread the catheter into the subject and to maneuver it so that the device is in or near the subject's heart. Some such devices inject either a bolus of material or energy (usually heat) at an upstream position, such as in the right atrium, and determine flow based on the characteristics of the injected material or energy at a downstream position, such as in the pulmonary artery. Patents that disclose implementations of such invasive techniques (in particular, thermodilution) include:
Still other invasive devices are based on the known Fick technique, according to which CO is calculated as a function of oxygenation of arterial and mixed venous blood. In most cases, oxygenation is sensed using right-heart catheterization. There have, however, also been proposals for systems that measure arterial and venous oxygenation non-invasively, in particular, using multiple wavelengths of light, but to date they have not been accurate enough to allow for satisfactory CO measurement on actual patients.
Invasive techniques have obvious disadvantages, the main one of which is of course that catheterization of the heart is potentially dangerous, especially considering that the subjects (especially intensive care patients) on which it is performed are often already in the hospital because of some actually or potentially serious condition. Invasive methods also have less obvious disadvantages: Some techniques such as thermodilution rely on assumptions, such as uniform dispersion of the injected heat, that affect the accuracy of the measurements depending on how well they are fulfilled. Moreover, the very introduction of an instrument into the blood flow may affect the value (for example, flow rate) that the instrument measures.
There has therefore been a long-standing need for some way of determining CO that is both non-invasive—or at least as minimally invasive as possible—and accurate. One blood characteristic that has proven particularly promising for accurately determining CO non-invasively is blood pressure.
Most known blood-pressure-based systems rely on the so-called pulse contour method (PCM), which calculates an estimate of CO from characteristics of the beat-to-beat pressure waveform. In the PCM, "Windkessel" (German for "air chamber") parameters (characteristic impedance of the aorta, compliance, and total peripheral resistance) are used to construct a linear or non-linear, hemodynamic model of the aorta. In essence, blood flow is analogized to a flow of electrical current in a circuit in which an impedance is in series with a parallel-connected resistance and capacitance (compliance).
The three required parameters of the model are usually determined either empirically, through a complex calibration process, or from compiled "anthropometric" data, that is, data about the age, sex, height, weight, etc., of other patients or test subjects. U.S. Pat. No. 5,400,793 (Wesseling, 28 Mar. 1995) and U.S. Pat. No. 5,535,753 (Petrucelli, et al., 16 Jul. 1996) are representative of systems that rely on a Windkessel circuit model to determine CO.
Many extensions to the simple two-element Windkessel model have been proposed in hopes of better accuracy. One such extension was developed by the Swiss physiologists Broemser and Ranke in their 1930 article "Ueber die Messung des Schlagvolumens des Herzens auf unblutigem Weg," Zeitung f�r Biologie 90 (1930) 467-507.
PCM-based systems can monitor CO more or less continuously, with no need for a catheter to be left in the patient. Indeed, some PCM systems operate using blood pressure measurements taken using a finger cuff. One drawback of PCM, however, is that it is no more accurate than the rather simple, three-parameter model from which it is derived; in general, a model of a much higher order would be needed to faithfully account for other phenomena, such as the complex pattern of pressure wave reflections due to multiple impedance mis-matches caused by, for example, arterial branching. Other improvements have therefore been proposed, with varying degrees of complexity.
The "Method and Apparatus for Measuring Cardiac Output" disclosed by Salvatore Romano in U.S. Pat. No. 6,758,822, for example, represents a different attempt to improve upon PCM techniques by estimating SV, either invasively or non-invasively, as a function of the ratio between the area under the entire pressure curve and a linear combination of various components of impedance. In attempting to account for pressure reflections, the Romano system relies not only on accurate estimates of inherently noisy derivatives of the pressure function, but also on a series of empirically determined, numerical adjustments to a mean pressure value.
U.S. Published Patent Application No. 2004 0158163 (Richard J. Cohen, et al., 12 Aug. 2004, "Methods and apparatus for determining cardiac output") describes yet another technique for determining CO from the pulse pressure profile P(t). According to Cohen's method, the arterial blood pressure waveform (time profile) P(t) is measured over more than one cardiac cycle. For example, assume a pressure measurement taken over three cardiac cycles. The area under the pressure curve is then computed for each cardiac cycle. The pressure profile P(t) is also sampled ("digitized") to form a sequence of discrete values y(j) that represent P(t).
As is well known, the impulse response of any system is the function that describes how it acts (in reality or in a theoretical model) when it is subjected to an impulse of energy, force, etc. One step of Cohen's method involves creating a sequence of impulses x(k)—one at the beginning of each cardiac cycle—that has the same area as the "arterial pulse pressure." A second embodiment of Cohen's method involves creating a sequence of impulses x(k), each of which is located at the beginning of each cardiac cycle, with impulses that have equal areas but that are independent of the areas of the corresponding arterial pulse pressure waveforms. The values of x(k) and y(j) are then used in a convolution computation that models the cardiac system thus:
Given ai and bi, Cohen then derives a single impulse response function h(t) that covers the entire multi-cycle measurement interval. It has long been known that the impulse response function of the heart usually takes the form, approximately, of a first-order exponential decay function. After an initial "settling" time of about 1.5-2.0 seconds, after which the effects of pressure reflections have mostly died out, Cohen then approximates h(t) from the expression:
Cohen then computes CO, for example, from some variant of the formula:
One weaknesses of the approach disclosed by Cohen is that it requires determination of the scaling, that is, calibration factor AC, or, equivalently, determination of C. Accuracy of the CO measurement is therefore closely dependent on the accuracy of the calibration or compliance calculation. Another weakness of Cohen's method is that the recursive expression (Equation 3) used assumes a constant input amplitude and therefore fails to determine the proper d.c. offset. This in turn causes an even greater reliance on accurate determination of AC (or C).
Still another disadvantage of Cohen's approach is that it ignores much of the information contained in the pressure waveform—indeed, one embodiment of Cohen's method uses only a single characteristic of each waveform, namely, the area, when constructing the impulses x(k). In a second embodiment of Cohen's method, the information contained in the pulse pressure waveform is totally ignored. Cohen compensates for this in part by evaluating many pressure waveforms at a time—for example, Cohen's preferred embodiment monitors CO by analyzing "long time scale variations (greater than a cardiac cycle) in a single ABP signal" and determines τD "through the analysis of long time intervals" 60-90 seconds long. Another consequence of Cohen's greatly simplified input signal x(t) is the need for a complicated transfer function model (see Equation 3), which involves many zeroes, many poles, and, consequently, design and computational complexity.
What is needed is a system and method of operation for estimating CO, or any parameter that can be derived from or using CO, that is robust and accurate and that is less sensitive to calibration errors. This invention meets this need, and, indeed, provides an advantageous method and system for estimating even other cardiovascular parameters.
The invention provides a processing system, and a related method of operating it, for determining a cardiovascular parameter, for example, cardiac output (CO), blood flow, stroke volume, or a value that can be derived from any of these. A current pressure waveform data set corresponding to arterial blood pressure is input to the processing system over at least one current pressure cycle; both invasive and non-invasive blood pressure-measuring devices may be used. The defining parameters of an assumed, non-impulsive input flow waveform are then determined as a function of a peripheral resistance value determined for at least one previous pressure cycle, at least one shape-characterizing value in the current pressure waveform data, or both. For example, the defining parameters may be computed so as to form a function that, when transformed according to the cardiovascular model, most closely yields the current pressure waveform data set in a predetermined sense
One of several examples of a shape-characterizing value is the time from the onset of systole to a time at or near systole, which, in some embodiments of the invention, is used together with the difference in pressure at these two times. The model parameters of a flow-to-pressure cardiovascular model are also determined, if they are not given. Examples of such a model include a discrete, auto-regressive representation of a multi-element Windkessel model of the aorta, in which case the model parameters are coefficients of the discrete, auto-regressive representation. An estimate of the cardiovascular parameter is then computed as a function of the determined model parameters.
The assumed input flow waveform is advantageously a series of assumed input waveform components. Examples of such waveform components include square waves, saw tooth waves, polynomials, piecewise linear functions, one or more Bezier curves, one or more sinusoidal component curves, etc.
In one embodiment of the invention, in which the input flow waveform components are determined as a function of a peripheral resistance value, a diastolic time constant is estimated as a product of a sampling rate at which the pressure waveform data set is derived and a function of a model feedback parameter; an arterial compliance value is estimated as a ratio of the diastolic time constant and the peripheral resistance value; a systolic time constant is estimated from chosen points in the current pressure waveform data set; an aortic characteristic resistance value is computed as a ratio of the systolic time constant and the arterial compliance value; and the amplitude of the component waveform for the current pressure cycle is set to be inversely proportional to the square of a function of at least one aortic characteristic resistance value.
In a particular version of this embodiment, the mean of a plurality of aortic characteristic resistance values is computed, which will include at least one aortic characteristic resistance value estimated for a previous cycle, and the amplitude of the component waveform for the current pressure cycle is set to be inversely proportional to the square of the product of the mean and a calibration constant and, optionally, the arterial compliance value. Where the input waveform components are primarily characterized by an amplitude and a duration, the amplitude of the component waveform for the current pressure cycle may similarly be set to be proportional to a peak-to-peak value of the current pressure waveform data set and inversely proportional to a function of the current peripheral resistance value, such as a mean value of a plurality of previously estimated peripheral resistance values. The amplitude may optionally be scaled by a calibration constant.
In one embodiment, cardiac flow is estimated as a function of the assumed input flow waveform. Cardiac stroke volume may then be estimated by integrating the assumed input flow waveform over at least one pressure cycle. The model parameters may be determined either independently, or be predetermined or computed independent of the current pressure waveform data set, or computed at the same time as the defining parameters of the assumed input flow waveform in a single optimization.
In broadest terms, the invention involves a new pulse contour method and system implementation for continuous assessment of cardiac output (or of any value that can be derived from a cardiac output estimate) from peripheral blood pressure. In general, the invention posits an assumed, non-impulsive input flow waveform, at least one of whose defining parameters is a function of at least one value of an input pressure waveform data set, and which is then used in a system-identification routine to determine the parameters of a model of the relationship between input flow and output pressure. Parameters characterizing the relationship are then used to compute an estimate of the cardiovascular parameter of interest.
The primary exemplifying embodiment of the invention described below uses an autoregressive algorithm to compute values of the arterial compliance and the peripheral resistance. The invention then applies these values to the model as well. The following discussion focuses primarily on the preferred embodiment of the invention, since doing so also makes clear the important generally applicable aspects of the invention, but various alternatives are also described.
The invention may be used to advantage with any type of subject, whether human or animal. Because it is anticipated that the most common use of the invention will be on humans in a diagnostic setting, the invention is described below primarily in use with a "patient." This is by way of example only, however—it is intended that the term "patient" should encompass all subjects, both human and animal, regardless of setting.
Because of its clinical significance, it is anticipated that most implementations of the invention will generate cardiac output (CO) estimates—either as an end result or as an intermediate result used for calculating for CO-related value—based on measurements of systemic arterial blood pressure. It would also be possible to use measurements of blood pressure taken elsewhere, however, such as in the pulmonary artery on the right side, although such sites may require invasive intracardiac measurement. Moreover, another embodiment of the invention is described below in which the (or another) cardiovascular value of interest is flow or stroke volume, in which case there may be no need to calculate a CO estimate at all, or to do so as a separate calculation.
The system according to one embodiment of invention implements three main steps: 1) it generates an assumed input waveform, which comprises a train of assumed input waveform components, and which closely approximates the beat-by-beat blood flow signal, which is preferably based on an acquired arterial blood pressure signal and past estimated values of the arterial compliance and the peripheral resistance; 2) it uses the generated assumed input waveform and the acquired peripheral arterial pulse pressure signal to estimate the arterial compliance and the peripheral resistance with a system identification approach relative to a model of the flow/pressure system; and 3) it uses the estimated arterial compliance and peripheral resistance values to generate the assumed input waveform component for the next time interval and calculate a CO estimate.
Arterial compliance and peripheral resistance may thus be estimated continuously based on a recursive system identification approach, in which the current computed values are used to estimate the blood flow of the next time interval. For the first time interval at the start, reasonable initial values may be assumed. Over the next time intervals, this embodiment of the invention converges to the proper mean values of the arterial compliance and the peripheral resistance. The invention enables continuous CO monitoring from the peripheral blood pressure waveform.
Pressure Waveforms
According to the invention, P(t), or any signal that is proportional to P(t), may be measured at any point in the arterial tree, either invasively or non-invasively. If invasive instruments are used, in particular, catheter-mounted pressure transducers, then any artery may be used as a measurement point. Placement of non-invasive transducers will typically be dictated by the instruments themselves—the placement of finger cuffs, upper arm pressure cuffs, and earlobe clamps should be obvious. Regardless of the instrument, it will ultimately produce, or cause to be produced, an electric signal corresponding (for example, equal or just proportional) to P(t).
Rather than measure arterial blood pressure directly, any other input signal may be used that is proportional to blood pressure. Any needed scaling or conversion may then be done at any or all of several points in the calculations described below. For example, if some signal other than arterial blood pressure itself is used as input, then it may be calibrated to blood pressure before its values are used in the computations described below. In short, the fact that the invention may in some cases use a different input signal than a direct measurement of arterial blood pressure does not limit its ability to generate an accurate CO estimate. The only requirement of this invention is that a signal or data set equal or at least having a known relationship to (such as being proportional to) the patient's blood pressure over the interval of interest (including continuously) must be made available to the processing system (see below) that carries out the signal conditioning and various calculations described below.
As is well known, and as is illustrated in
Two-Element Windkessel Embodiment
As mentioned above, the invention takes a system identification approach relative to a model of the flow/pressure system. Prototypes of the invention that use various Windkessel models have been successfully tested, so the description of the invention found here concentrates primarily on embodiments of the invention that use system identification techniques based on different versions of Windkessel modeling. The general method according to the invention may be applied to implement many different systems for estimating CO using other models as well, however (including higher order models). The main requirement is that the model can be reduced to a discrete transfer function with parameters that can be determined through recursive comparison with the input signal model described below.
A first embodiment of the invention is based on the simple two-element resistance-capacitance electrical analog model of the arterial system, that is, the simple Windkessel model shown in
To carry out computations numerically and to estimate blood flow Q(t) (and subsequently CO) from the peripheral arterial pulse pressure P(t), values for the model parameters C and R must be known. The invention estimates the model parameters and the input flow Q(t) simultaneously based on a parametric autoregressive recursive approach.
The model shown in
Since the computations in a digital processing system are performed on the digitized blood pressure signals (that is, P(k) rather than directly on P(t)), the model must be converted to the digital domain (z-domain). To convert the model from continuous-time to discrete-time, the following approximation is used:
Substituting Equation 8 into Equation 7 yields the following discrete-time transfer function:
The transfer function of Equation 9 can be approximated by a first-order autoregressive model (AR model) having the following form:
Note the simplicity of this transfer function model, which has only a single pole, no zeroes, and corresponds to the "real life" Windkessel model. Although the method of this invention is not restricted to such a single-pole, no-zero transfer function model, this illustrates that such simplicity is possible using the invention, with accuracy that should be no less than that achieved by Cohen, and possibly even better. The inventors hypothesize that this is because the input model used in this invention incorporates more information about each cycle of pressure waveform that just its area.
The model coefficients a and b in Equation 10 can be estimated using known parametric system identification methods. In order to apply a system identification approach however, both the input signal and the output signal of the system must be known. Given the system's transfer function, such as Equation 10, and an n'th estimate of the function's parameters (such as coefficients a and b), system identification routines typically generate an output signal (including waveforms) from the input signal and then compare this output signal with the actual, observed output signal, and either directly compute (if the function is simple enough) or, more often, iteratively adjust the coefficients until the difference between the generated and observed output signals is a minimum in some quantitative sense. In other words, these routines compute the values of the function's parameters that give a "best" match between the generated and observed outputs in any known sense. The coefficient values that give this best match are taken as the (n+1)′th estimate. Accordingly, in
It is preferable to avoid the need for both a pressure and a flow transducer, however. Without actual knowledge of flow, only the output (the blood pressure signal) is assumed to be available to the system, with the system's input (blood flow) being unknown.
For this reason, instead of using an actual measured blood flow signal as the input for the system, the invention generates a train of assumed input waveform components Q(i) that is assumed to closely approximate it, with the time limits of each assumed input waveform component being related to known points of the sensed blood pressure waveform. The two key parameters in the construction of an assumed input waveform component as illustrated in the figures are its duration (the width) and its amplitude (the height). Note that the assumed input waveform components are not necessarily impulsive; in other words, each assumed input waveform component is defined by at least two parameters, such as amplitude and temporal width. Other parameters may include shape characteristics (such as for a square wave, triangular waves such as saw tooth waves, etc.); amplitude and frequency for each of a set of Fourier components; the m+1 coefficients of a polynomial of order m; the 8�n parameters of a set of n Bezier curves; the endpoints (or just the x- or y-coordinates of the endpoints) of segments of a piecewise linear approximating function, etc.
According to Equation 7, the amplitude of the flow Q(t) is related to the arterial pulse pressure by a gain factor of R; therefore, the amplitude of the assumed input waveform, Qmax(t), is best estimated by multiplying the peak-to-peak value of the arterial pulse pressure signal Pmax(t) by 1/R:
To estimate the peripheral resistance R, the invention uses a parametric system identification approach, in which the coefficients a and b of Equation 10 are estimated using any known technique, such as least mean square regression. As is known, the way in which these routines work is to measure the difference between the observed output (pressure) waveform and the output (pressure) waveform that is produced by applying the transfer function with given parameters (a and b coefficients) to the assumed input waveform (Q(i)). The routine then iteratively (usually) adjusts the coefficients until a "best" fit is found according to some metric, such as least squares.
The input and the output of the system being identified are, respectively, the train of assumed input waveform components Q(i), which is taken to be an approximation of the flow signal Q(t), and the measured arterial pulse pressure P(t) (or, rather, its representation P(k)). Once the coefficients a and b are estimated, the invention can then calculate vascular resistance as follows:
The value of the peripheral resistance changes slowly from beat to beat; consequently, it will normally suffice to use a single value of R for an entire measurement interval of, for example, 15 or 30 s. The invention estimates R continuously, using a recursive approach: The current computed value of R is used to estimate the amplitude of each assumed input waveform component Q(i,k) in the train of assumed input waveform components Q(i) over the next time interval, and so on. The train of assumed input waveform components Q(i) is then used as the input for the system identification routine, which estimates the new coefficients a and b of the transfer function and therefore the new value of R. For the first time interval, that is, initially, any reasonable initial value of R may be assumed, and can be selected based on known properties of R, determined using well known laboratory methods, or in any other known manner. Over subsequent time intervals, the method converges to the proper value of R. For practical considerations, to reduce the effect of any variation in R and to ensure stability, instead of the previous value of R, the mean value of the N last time intervals may be used instead. Thus, for the n-th assumed input waveform, the amplitude of each waveform component Q(n,k) is estimated as follows:
So, at each iteration, the invention computes Qmax(i,k) for each assumed input waveform component using the mean value of the N past values of R. Then, the train of assumed input waveform components Q(i) is generated with components having respective amplitudes Qmax(i,k). The train of assumed input waveform components is then used to estimate the current value of R, for example, by using the approach of least-mean-square system identification applied to the model described by Equation 10. A CO value can then be computed using the well known formula:
Notice that the invention estimates CO without needing to directly measure the model input signal, that is, the flow, and without needing to determine a compliance value C. Rather, an assumed input signal is used, and C is implicit in the time constant τ, which itself is implicit in the recursively estimated model coefficients a and b.
As illustrated in
A square-wave input signal is not necessary to the invention, however. Rather, other assumed input waveform component shapes could be used that more closely approximate the known profile of flow, such as is illustrated roughly in box 50 of
It would also be possible to perform the computations described here using the data from the input pressure waveform data set extending over more than one pressure cycle and, for example, to determine more than one assumed input waveform component at a time. Moreover, each assumed input waveform component could also be determined such that it is "wider" than what is illustrated in
Three-Element Windkessel Embodiment
The second version of the method is based on the three-element analog model of the arterial system shown in
As in the two-element embodiment of the invention described above, to compute the input flow from the arterial pulse pressure, it is first necessary to estimate the values of the model parameters R0, C and R, either directly or implicitly. As did Wesseling this embodiment of the invention builds on the following assumptions: during systole (switch SW in position 1, the aortic systolic inflow (Qs) is principally determined by the time constant τs=R0 C: the peripheral resistance R is not a major determinant of systolic inflow. During diastole (switch SW in position 2), this inflow is dissipated in the periphery. The diastolic outflow Qd and the pressure decay are essentially determined by the time constant τd=R C. The compliance C is a common parameter in both time constants. This assumption is reasonable because it reflects the actual vascular physiological parameters: during systole the ventricle ejects blood into the compliant aorta. This blood is stored in systole, and, on elastic recoil in diastole, the peripheral vessels are perfused. In order to estimate the model's parameters R0, C and R the following approach is used:
In this aspect of the invention, the peripheral resistance R and the system's time constant τ are first estimated using the model of
In this case, the peripheral resistance would be:
The train of assumed input waveform components needed for system identification is generated using a similar approach as before: Each assumed input waveform component Q(i,k) is located at the start of a systole of the blood pressure waveform and its width is set equal to the time interval between the systole onset and the location of the peak value of the pressure waveform in the current beat (between points di and pi in
In order to estimate R0, the invention uses the following approach: First the compliance C is estimated, using Equations 16 and 17:
R0 is then calculated:
The systolic time constant τs is estimated by selecting two points on the rising edge of the arterial pulse pressure waveform (for example, at 30% and 70% of the diastole level, respectively) as illustrated in
As in the previous case, the amplitudes Qmax(i,k) of the individual assumed input waveform components are estimated using the mean value of R0 over the N last time intervals:
Cardiac output CO may then be calculated as before, that is, as in Equation 15.
Both embodiments of the invention described above ultimately assume a determination of the kr constant in Equations 14 and 22. This is a calibration constant, which reflects the inaccuracies and the deviations due to the presumed first-order AR models of the arterial system.
The calibration constant kr could be estimated using, for example, a CO value measured by a bolus injection or any other "gold standard" method. In this case, the calibration could be done once for the current subject/patient at the start of the recording, and could remain effective for a long time afterward. Such embodiments of the invention can be termed "with-caf" embodiments in that they are provided with a value of kr that is obtained through external calibration. Experimental results and clinical studies using the invention show that the "with-cal" version of the algorithm offers both high accuracy and a very good trending of the estimated cardiac output.
As Equations 14 and 22 show, the calibration constant kr is within the recursion and therefore is affected by the feedback. The fact that calibration is done in the feedback loop, within the recursion and within the averaging, makes the algorithm less sensitive to the errors in the estimation of the calibration constant. In fact, the inventors have demonstrated experimentally that the error in the estimated CO value is proportional to the square root of the error in kr. For instance, if the estimated kr deviates by 30% from the actual kr, then this will cause a deviation of only 5.5% in the estimated cardiac output. This makes the invention more appropriate to use in either a "with-cal" or a "no-cal" mode than are purely linear methods.
Here, the "no-cal" mode is, as its name implies, simply a mode of operation of the invention in which no empirically determined, patient-specific value of kr is supplied at all. This would eliminate the need for external calibration. In such cases, kr could be set either simply to unity, or it could be set to an value pre-determined experimentally on, for example, a representative population of subjects, or of a population of subjects representative in some way (such as with respect to age, weight, sex, pathology, etc.) of the current subject/patient.
Another advantage of the invention is that a benefit of the square-root error dependence is that it is possible to use an averaged calibration constant for a whole population under study. For example, in tests, the inventors were able to use a kr value of 1.4, and yet were able to keep the DC-shift (offset) error under 30% for 85% of the patients. Also, the inventors also propose that noninvasive methods such as ECG and bioimpedance may be used to estimate kr; even in such cases, the recursive nature of the invention makes it more appropriate than prior art systems, since it is less sensitive to any error in the calibration constant estimation.
The invention displays several advantages over the prior art. Some advantages are mentioned above; others include:
System Components
The signals from the sensors 100, 200 are passed via any known connectors as inputs to a processing system 300, which includes one or more processors 350 and other supporting hardware, such as a memory 301, and system software (not shown) usually included to process signals and execute code. The invention may be implemented using a modified, standard, personal computer, or it may be incorporated into a larger, specialized monitoring system. In this invention, the processing system 300 also may include, or is connected to, conditioning circuitry 302 which performs such normal signal processing tasks as amplification, filtering, ranging, etc., as needed.
The conditioned, sensed input pressure signal P(t) is then converted to digital form by a conventional analog-to-digital converter ADC 304, which has or takes its time reference from a clock circuit 305. As is well understood, the sampling frequency of the ADC 304 should be chosen with regard to the Nyquist criterion so as to avoid aliasing of the pressure signal; this procedure is very well known in the art of digital signal processing. The output from the ADC 304 will be a discrete representation of the pressure signal P(t), whose sampled values may be stored in conventional memory circuitry (not shown).
A signal pre-processing module 306 is preferably included, with routines to provide such known pre-processing as digital filtering for general (as opposed to interval-to-interval) noise removal, for motion artifact rejection, pulse beat detection (if needed), for rejection of bad beats, etc. This module may also be implemented wholly or partially in hardware. Known circuitry may be included to indicate, for example, that signal strength is too low, and that the delivered measurement values are unreliable. As such, the module 306 may also be located functionally, wholly or partially, before the ADC 304. The output from the module 306 is shown as P(k), since, if the pre-processing module 306 is included at all its values will form the data set corresponding to pressure that is used in the computations described above.
The values P(k) are passed (usually, accessed from memory by) to a software module 310 comprising computer-executable code for determining the pressure and time parameters used in the computations for the chosen model. For the two-element model described above, these will be the maximum pressure value Pmax, pi and di; for the three-element model, P1, P2, t1 and t2 are determined.
Yet another module 311 computes the mean arterial pressure MAP over the chosen computation interval such as a cardiac cycle, which may be triggered by any known hardware device and/or software routine 340 that detects heart rate or at least signals the beginning of a cardiac cycle. Note that the embodiments of the invention described above do not strictly require any information about the beginning and end of pressure waveforms during a computation interval other that what can be derived from the pressure waveforms themselves. The heart rate monitoring routine or device is therefore optional, although it may be helpful as a way to check that the pressure waveforms are correctly delimited.
Once the values of Pmax, pi and di are available from the current pressure waveform, that is, for the current cardiac cycle, the corresponding current assumed input waveform component Q(i,k) can be generated as described above and added to the train of assumed input waveform components. A module 312 is illustrated in
A system parameter identification module 313 takes the discrete pressure waveform P(k) and the train of assumed input waveform components Q(i) as inputs. As described above, this module computes the coefficients a and b that over each cardiac cycle, yield a transfer function that best generates the observed pressure signal P(t) in any chosen sense, such as least squares.
Once the coefficients a and b are computed, they are passed as input parameters to another module 315, which calculates a value of R and, depending on the implemented embodiment, also τs. The value of R (and of τs if needed) is passed both to the assumed input waveform component generation (or, more generally, the input flow waveform) module 312, and to another module 330 that performs the calculations indicated above for computing the cardiovascular value of interest, such as a CO value, a value that is derived from CO, etc. Yet another module 316—which will in most cases simply be a memory position—provides to the module 312 the calibration constant kr, which may be determined as described above.
Software modules 310, 311, 312, 313, 315, 316 and 330 can be programmed using known techniques. Of course, any or all of these modules may be combined, even into a single body of code; they are shown separately for the sake of clarity. Indeed, any or all of the illustrated modules may be implemented simply as routines within a single estimation software component 370, which may of course be combined with other software components of the processing system 300 as desired. Moreover, any or all of the software components of the invention may also be stored as computer-executable instructions on any form of computer-readable medium (CD ROM, memory or disk space made available for downloading, etc.) for loading into and execution by different processing systems.
Once a CO estimate has been computed, it is passed to any desired output device 500, such as a user-viewable monitor, and displayed, stored or transmitted in any chosen format. An input device 400 is preferably also included to allow the user to input, for example, the calibration constant kr, administrative and patient-specific information, to adjust the display, to choose the computation interval, etc.
Dynamically Constructed Assumed Flow Input Waveforms
It has been mentioned above that the assumed input flow waveform Q(i) need not be a square wave, but rather could be some other shape whose amplitude and duration are adjusted according to the current pressure waveform. It would also be possible to posit, for each pressure cycle, an input flow waveform whose shape is more generally adjustable, with shape parameters that are determined as part of the optimization inherent in the system identification procedure. In other words, parameters defining the shape of each assumed input waveform component could be included, along with the parameters defining the model of the relationship (such as the transform function) between the assumed input flow waveform and the current pressure waveform data set, as optimization parameters of a single identification routine. The parameters of both may then be determined simultaneously to yield both an optimal assumed input flow waveform and an optimal model as defined according to any chosen metric, such as least squares.
The approximate shape of a typical beat-to-beat flow profile is known. See, for example, box 50 in
The result of the numerical optimization will then be parameters defining not only optimal a and b values, but also the parameters defining an optimal parabolic approximation of the input flow waveform. In other words, by relaxing the assumption of a fixed flow waveform shape (such as square-wave with a duration and amplitude defined before system identification) even further, the invention would thus determine not only which transfer function but also which input waveform (not necessarily parabolic) most likely (in the sense of any chosen metric, such as least squares) has led to the observed pressure waveform. Integrating over the approximated input flow waveform may then provide an estimate of total flow over the pressure cycle.
Other approximating functions for input flow could of course also be determined in this manner. For example, a higher order polynomial could be used. As yet another example, the initial input flow waveform could be assumed to be a set of Bezier curves, such that the positions of each curve's two endpoints and two control points (for a total of eight optimization parameters per curve) could be made parameters that are computed in the optimization step of the system identification routine. Yet another example would be the amplitudes of component sine waves pre-determined initially through Fourier analysis of representative, actually measured input flow waveforms. Still other approximating functions will of course occur to those skilled in the art of system identification and reconstruction techniques.
It would even be possible to use the method according to the invention primarily to determine an optimal functional approximation of flow: Assume that one has in some other way (or even using the invention over earlier cycles) determined the parameters defining the transfer function model of the pressure response P(t) to input flow Q(t). For example, one may have determined the parameters of an n-element aortic Windkessel model that one assumes to be accurate enough. The parameters defining the general shape (such as polynomial, sinusoidal, piecewise linear, etc.) of an assumed input flow could then be optimized using the system-identification procedure described above. For each cycle or group of cycles, the specific shape of an optimum input flow model (that is, function) would then be determined even without simultaneous optimization or adjustment of any transfer function model coefficients at all. Cardiac flow may then be estimated from the assumed input flow waveform, either directly or possibly after scaling; any needed scaling may be determined using known methods.
Knowledge of a flow model may be useful in its own right, but may also be combined with other information to provide other diagnostic indicators. For example, integrating the assumed input flow waveform over a cardiac cycle will yield an estimate of cardiac stroke volume (SV). Note that this estimate of SV does not require knowledge of arterial diameter or cross-sectional area as many other SV-estimating systems do.
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text:
Arshavin questions Arsenal big-match mentality
Arsenal ace Andrey Arshavin has slated his teammates' big-match mentality.
Arshavin feels the current squad at the Emirates does not measure up to the one at Chelsea boss Carlo Ancelotti's disposal across the capital.
He told The Sun: "What I feel bitter about is that we lose in all the big matches.
"That is disappointing and lets doubts creep into my mind.
"Chelsea are now 11 points ahead of us, although we played one game less. At the moment, they look the strongest team.
"They have attacking players who can make use of opponents' slightest defensive mistakes.
"Didier Drogba, for example. If we only take pure strikers, he is the strongest in the world. He and Zlatan Ibrahimovic."

subset: commoncrawl


text:
Illumination of the Check Engine Light can be caused by a loose or worn gas cap.
2007 Pontiac Vibe Problem Reports
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Front brake rotors can wear causing a pulsation felt in the brake pedal. Our technicians often recommend replacement of the front rotors and brake pads as the best option to correct this condition.
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Part that opens and closes the outside fresh air vent was stuck in the recirculate position. Dealer replaced the part under warranty which was just about to expire. Only other problem is the front brakes are starting to squeak a bit. Pads are original ones. Probably time for a change. No other problems to report
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FAYETTEVILLE, Ark. (Univ. of Ark.) - On the heels of an NCAA indoor team title, the University of Arkansas men's track and field team racked up 25 All-America accolades as announced Monday by the U.S. Track and Field and Cross Country Coaches Association (USTFCCCA).
With their collection of awards spread among 19 athletes, the Razorbacks earned a nation-leading 17 first-team honors. Across all three aspects of the program, Arkansas now has 203 overall All-Americans in its history.
The Razorbacks' list of All-Americans is highlighted by NCAA champions Andrew Irwin in the pole vault, Kevin Lazas in the heptathlon and 4x400-meter relay foursome Neil Braddy, Caleb Cross, Akheem Gauntlett and Marek Niit. Arkansas successfully defended its national titles in the pole vault and 4x400-meter relay, and added its first-ever NCAA event title in the heptathlon with Lazas' performance.
All three event titles were won in record-setting fashion. The 4x400-meter relay team broke the collegiate record with its time of 3:03.50, replacing the previous record of 3:03.51 set in 2005 by a Florida team that featured world-record holder Kerron Clement. Irwin (5.70m/18-8.25) and Lazas (6,175 points) both improved upon their own school records over the weekend.
In addition to its NCAA champions, Arkansas' list of first teamers also features Tarik Batchelor (triple jump), Kemoy Campbell (3,000 meters), Raymond Higgs (long jump), Stanley Kebenei (5,000 meters), Anton Kokorin (400 meters), Jarrion Lawson (long jump), Anthony May II (high jump), Patrick Rono (800 meters) and Tomas Squella (800 meters). Gauntlett and Niit also earned first-team accolades for their performances at 200 meters.
Second-team certificates also went to Campbell (distance-medley relay), Cross (60m hurdles), May (triple jump), Cameron Efurd (distance-medley relay), Anthony Lieghio (800m, distance-medley relay), Leoman Momoh (800 meters) and Travis Southard (distance-medley relay).
With Monday's release, Niit leads all current Razorbacks with 11 career All-America honors, six of which have come for his indoor achievements. Braddy has also collected double-digit All-America accolades and now has 10 during his career. The list of Arkansas' first-time All-Americans includes Efurd, Kebenei, Kokorin, Lawson, May and Squella. Campbell was an All-American during the cross country season.
Arkansas won its 20th NCAA indoor team title last weekend at the Randal Tyson Track Center in Fayetteville. The win also represented the program's 41st overall NCAA team crown, first since 2006 and first under head coach Chris Bucknam. The Razorbacks scored 74 points on their way to the title, gathering points in 11 of the 13 events in which they were entered.
First-team honors were given to those who placed in the championships' top eight in an event or were a member of an eight-person final. Second-team honors were earned by those who finished ninth between ninth and 16th place.
The Razorbacks will take a weekend away from competition before opening their outdoor season March 23 with the Texas State Quad in San Marcos, Texas.
2013 USTFCCCA All-Americans
First Team
Tarik Batchelor - triple jump
Neil Braddy - 4x400m relay
Kemoy Campbell - 3,000 meters
Caleb Cross - 4x400m relay
Akheem Gauntlett - 200 meters, 4x400m relay
Raymond Higgs - long jump
Andrew Irwin - pole vault
Stanley Kebenei - 5,000 meters
Anton Kokorin - 400 meters
Jarrion Lawson - long jump
Kevin Lazas - heptathlon
Anthony May II - high jump
Marek Niit - 200 meters, 4x400m relay
Patrick Rono - 800 meters
Tomas Squella - 800 meters
Second Team
Kemoy Campbell - DMR
Caleb Cross - 60m hurdles
Cameron Efurd - DMR
Anthony Lieghio - 800 meters, DMR
Anthony May II - triple jump
Leoman Momoh - 800 meters
Travis Southard - DMR


text:
X-Slim X340 at a pre-CeBIT press event today, and we're seriously impressed -- just like the Atom-based X320, the X340 weighs just 2.8 pounds with a four-cell battery and 1366 x 768 13.4-inch screen, but it's got more horsepower with a ULV Penryn chip and GMA4500 graphics with HDMI out. Not bad, especially if this thing comes in under $1000 like we've heard -- we'll keep an eye out while you check out the rest of the pics in the gallery.
Gallery | 8 Photos
MSI X-Slim X340 hands-on


text:
14 Oct 2012 4:05 PM #1
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Forum for Desktop Packager and Sencha Cmd
Any chance of Desktop Packer and Sencha Cmd getting a home of their own (aka perhaps a command line area) on the forums.
Sencha Cmd was part of touch, but now does ExtJS, so both deserve a home of their own and relevant posts be moved there (if feasable)
Pretty Please!Lead Trainer / Sencha Specialist
Teahouse Training Company
Comprehensive Javascript, Sencha and 3rd Party Stack Training available worldwide online, and onsite in APAC, written by certified official Sencha trainers.
Unofficial Sites:
SenchaWorld.com - Videos, and stuff
Sencha.Community - Tools, Extensions and Resources
TeahouseHQ.com - Sencha Ecosystem Training Portal
Code Validation : JSLint | JSONLint | JSONPLint


text:
In addition to being guests on my radio show yesterday, that is?
Each is thinking long and hard about the spreading disruption brought about by the new media revolution.
In a May 3rd column, Brooks reviewed the "Campus Tsunami" that is uprooting and rearranging the world of higher education with breathtaking speed and force.
Christensen, long known as the guru of "disruptive innovation," applies the theories associated with fundamental change to personal life in "How Will You Measure Your Life?", a new book he has co-authored with James Allworth and Karen Dillon.
And Hyatt has studied all the storms that have broken upon publishing and condensed all the lessons he has learned about marketing and product sales into Platform: Get Noticed In A Noisy World.
Put all three on the same radio show and you have a blockbuster of information and transformative thinking. You could access all of that content in podcast form if you subscribed to the Hughniverse, and some of it in transcribed interview form --Brooks and Christensen-- if you visit my website.
But the best way to hear it is in real time, mixed with callers to provoke as well as time to reflect during commercials, news and weather --critical evaluative time as well as a link to interesting and valuable products and services. A three hour oasis in the middle of a media desert.
As Brooks and I discuss specifically and Christensen obliquely, talk radio is the only place you will get such an option. The rest of broadcast media is quickly dying off because the options competing for attention span are so many and varied. Cable --poor CNN, now the graveyard of ratings success-- is sinking fast, swarmed by an army of competitors that move much more quickly and with much more depth.
But if you are in your car, you must listen to audio of some sort or be breaking the law in most places. And the best kind of audio --the addictive kind-- is both interactive and enriching, substantive and funny, startling and useful.
Due to the overwhelming enthusiasm of our readers it has become necessary to transfer our commenting system to a more scalable system in order handle the content.
Indicted: All Six Baltimore Police Officers Involved In The Death Of Freddie Gray Charged | Matt Vespa
Illegal Alien Charged With Child Molestation and Pornography Able To Work With Kids Thanks to Obama Amnesty | Katie Pavlich
Gatekeepers: When Hillary Was Top Diplomat, State Dep't Staff Sometimes Blocked FOIA Requests | Matt Vespa
Gallup: At least 20% of Americans are gay, as estimated by … more than half of Americans | Allahpundit
Amnesia: Contra 2003 polls, heavy majority of Democrats "remember" opposing the Iraq war at the time | Allahpundit
"Get excited": Leaden, furtive presidential candidate to hold first campaign rally on June 13, ending "ramp phase" | Allahpundit


text:
Ivy House Play Reading Circle at London Jewish Cultural Centre, Ivy House
Bring any poem by an established poet which has significance to you. Read aloud and discuss, or simply listen and absorb.
Venue Details & Map
London Jewish Cultural Centre
- Address
Ivy House
94 - 96 North End RoadLondonNW11 7SX
Book a taxi on +44 (0)844 556 0706 or with London's biggest car service app


text:
Printable DIY Wedding Invitation & RSVP Custom - English Rose
Product Info
This contemporary designer DIY wedding invitation has a contemporary look featuring a an elegant rose design, customised with your wedding details and includes a coordinating RSVP card.
A printable file is an affordable way for you to have a custom designed wedding invitation without the high-end price tag.
A high resolution PDF file for you to print at home or at a print processing centre at your convenience. We can also supply a high-resolution JPG file for your records.
Your wedding details including bride & groom's names, wedding date & time, place of venue for ceremony & reception, dress code, RSVP date and any additional wording you would like (we will try our best to work this into the design subject to size of invitation)
Sizes available:
- 5"x7"
- Custom sizes available on request. Please contact us for a custom quote
Would you like us to personalise your invitation with guest names?
- Please purchase this listing https://www.etsy.com/listing/187031489/add-on-personalise-any-invitation-with in addition to this wedding suite and email you excel spreadsheet (preferable) with your guest names to sales [!at] cocoelladesigns.com.au
- Would you like us to take care of the printing for you?
Please contact us for a custom quote. We will take care of the printing, trimming and envelopes for you. We use high quality cardstock and professional quality printers. If our quote is accepted, we will create a custom listing for you to purchase is addition to this invitation listing.
A proof will be sent to you within 48 hours of receiving payment, once you have sent back an approval, we will email you the high resolution file. Please ensure your etsy account has your correct email address as this is where the file will be emailed.
If you require us to look after the printing for you we will send your invitations to you within 3-4 weeks to allow us to prepare your invitations to a finished professional product.
Please note this is for a digital file, you will not receive anything by mail.
All work is copyright of Coco & Ella Designs and is for personal use only. Please do not redistribute or share the files.
Any queries please contact us at enquiries [!at] cocoelladesigns.com.au
You can also find us here:
- www.facebook.com/cocoelladesigns
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Thanks for stopping by!


text:
It's day one of the biggest motor show in the calendar - some 12 halls of highly polished new metal and thousands of feverish journalists tearing around with notepads and cameras. Sounds exciting, doesn't it?
Nope. Which is why you're probably better off sat safely behind your monitor watching the whole thing unfold here on TopGear.com.
And you can do that in two ways - we'll be Tweeting the coolest new cars live from the show floor all day, plus updating the pages of this site with news and photo galleries once the covers start coming off.
Until then, here's our not-in-any-way-robbed-from-the-telly-show Cool Wall-style run down of the Frankfurt highlights, starting with the coolest:
Ferrari 458 Italia: Latest techno-fest from Maranello, developed by Das Stig. Best-looking Ferrari since, well, ever?
Mercedes SLS Gullwing: Spiritual successor to the 300 SL.
Maserati GranCabrio: Spiritual successor to... Oh, erm, we mean 'gorgeous Italian droptop that makes us twitch with inappropriate delight'.
Abarth 695 Tributo: Special-edition Abarth 500 built in partnership with Ferrari. With flappy paddles.
Plethore LC-750: That Canadian supercar thingy we showed you last week.
Audi R8 Spyder: The R8 loses its roof and sideblade. We still want one.
Citroen 2CV: OK, it's actually called Rivolte (sounds disgusting) and it's another futuristic small Citroen.
Citroen C3: New French supermini looks cute and funky.
Citroen DS3: Posh version of the above. Note 'shark fin' B-pillar, which we really dig.
Hyundai ix Metro: Tiny hybrid concept named after British Leyland classic.
Lexus LF-Ch: A rival to the BMW 1-Series at the posh end of the hatchback market. Looks like something from a sci-fi film and has hybrid tech.
BMW Vision Concept: M3 performance, low emissions and nutjob styling? Excellent.
Bentley Mulsanne: Enormous new luxobarge with stonking V8.
Audi RS3: The proliferation of the RS badge continues. We like.
Rolls-Royce Ghost: It's a cheaper, smaller Rolls that isn't small or cheap. But it is cool.
Jaguar XJ: The all-new XJ will be on show in Frankfurt, along with its ample arse.
Peugeot RCZ: A rival for the TT, and a Peugeot we're actually excited about.
New Ford C-Max: Ford's masterclass in funky family transport continues.
Bugatti Royale: New big Bug, named after a Burger King snack but probably faster. Expect to be blown away.
Mini Coupe Concept: Its roof is modelled on a backwards baseball cap, a trend that died in the early 80s, only to be perpetuated by weird mobile disco DJs in Gravesend.
New Toyota Land Cruiser: A car enjoyed mostly by people who track rhino dung in Namibia.
Mazda MX-5 Superlight: A blatant rip-off of the Mercedes SLR Moss. Only smaller, slower and more embarrassing.
New Vauxhall Astra: Probably the most important car here, if you're into sales figures and socio-economic buying trends and the complex interplay between international political economies. Hello? Are you there? You've skipped to the next car already, haven't you?
New Saab 9-5: As driven by your granddad.
Toyota Auris Hybrid: The world's most boring car just got slightly more interesting. Works like a Prius. Built in Britain. Blah. Blah. Blah.
Hyundai ix35: A segment-busting crossover to rival the, erm, segment-busting Nissan Qashqai in the segment-busting SUV/hatch segment.
Kia Sorento: A segment-busting crossover to rival the, erm, segment-busting Hyundai ix35 and Nissan Qashqai in the segment-busting SUV/hatch segment.
Nissan Leaf: An electric car named after some vegetation will never be cool.
So there you have it. Which cars are you most excited about? Use the space below to let us know...


text:
While newspaper publishers are optimistic about the future and digital platforms, more than 40 percent see declining staffs as a serious threat, finds a survey from the University of Missouri School of Journalism, notes Grumpy Editor.
University of Missouri professors Mitchell S. McKinney and J. Brian Houston want U.S. citizens' voices to be heard in the upcoming presidential debates.
In the largest survey of its kind, Michael Jenner, the Houston Harte Endowed Chair at the University of Missouri School of Journalism and Reynolds Journalism Institute at MU, found that nearly two-thirds of responding publishers expressed optimism for the future, while only 4 percent of respondents were not optimistic about the industry.
In the largest survey of its kind, nearly two-thirds of responding publishers expressed optimism about the future of the newspaper industry.
According to the study, media consumers can be divided into two camps: those that seek rewards (like Pavlov's dog) and those that avoid threats.
You care about your community. And you care about your state and — especially — about your country.
News and commentary of interest to journalism innovators and entrepreneurs
With polls showing presidential candidates Democrat Barack Obama and Republican Mitt Romney locked in a tight race, many are predicting that the first presidential debate on Oct. 3 could be a turning point in the election.
A study by the Reynolds Journalism Institute and HCD Research compared people's media use patterns to their fundamental psychological motivations (seeking rewards vs. avoiding threats).
A collection of recaps of Block by Block 2012 posted by attendees.
The results of a national media study revealed that adults who are motivated to seek out rewards rather than avoid threats are more likely to use mobile media platforms to access local and national news compared to adults who are more concerned with avoiding threats than seeking out rewards.
Sixty percent do not foresee a digital-only future
The Donald W. Reynolds Journalism Institute (RJI) at the Missouri School of Journalism is devoted to exploring new ideas, experiments and research that will improve and sustain journalism. In a just completed survey of publishers of U.S. dailies, nearly two-thirds remain optimistic about the future of newspapers
In the largest survey of its kind, nearly two-thirds of responding publishers expressed optimism about the future of the newspaper industry. Forty percent said they were "somewhat optimistic," while 25 percent identified themselves as "very optimistic. Thirty-one percent were neutral. Only four percent identified themselves as "not optimistic;" no respondent chose "not optimistic at all."
Despite industry-wide challenges, publishers of U.S. dailies remain confident about the future of newspapers. And print, publishers say, will continue to play a significant role in their operations.
A survey by Missouri School of Journalism's Reynolds Journalism Institute finds that most publishers of U.S. dailies remain optimistic about the future of newspapers: 40% are "somewhat optimistic," 25% are "very optimistic," 4% are "not optimistic," and 31% are neutral.
With people increasingly getting their news on the go, the Donald W. Reynolds Journalism Institute surveyed mobile media users on their attitudes towards news sites. The good news for journalists is, mobile users, like consumers overall, place a high value on news that's produced by the professionals (63 percent).
Check back later for future events.
Ideas. Experiments. Research. Solutions.
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text:
Cancelled Teen Read Week Trivia
Teens will read The "Giver" by Lois Lowry and "One for the Murphys" by Linda Hunt, and then participate in a trivia contest for some great prizes. Each teen who participates will get a prize and there will be a grand prize and one for the runner up. If you would like to participate please come to the Teen Department to pick up one or both books. Food will be served after the contest.
Seats Available: 24
You will need a valid library card for each person you are registering.


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Results 386 to 387 of 387
Thread: Mixedberries
June 26th, 2014 04:08 PM #386
Can we consider summer camp as babysitting, that way I can still join the club? Though I have children from 6 to 12 (not so children anymore) and I deal with 70/80 of them every morning, around 40 in the afternoons. It counts, right?
I still have exams looming over me, so I'm pretty jealous of your holidays, gals...I can't wait for August, in all honesty, though I'm pretty sure I won't go anywhere fancy this year.Irene; Name lover in her twenties; single; Languages student by day, writer by night.
Current favorites, not in order:
Emily - Evelyn - Hadley - Alice - Emma - Olivia - Zoey - Greta - Eden - Jezebel - Zelda - Anna - Charlotte - Clara - Katherine - Amber
Ethan - Adam - William - Peter - Harvey - Galen - Kenneth - Kieran - Theo - Zander - Daniel - Ezra - Gabriel - Blake - Alexander
The National's Names List
Peculiar Italian Names for Girls
June 26th, 2014 04:11 PM #388Senior Member
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- Oct 2013
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I was wondering what happened to this thread I have just finished working so that I can go travelling for the summer which I'm really excited about. It'll be my last chance to have a bit of fun and relax before I start medical school in September!
I'm jealous of all your babysitting jobs - you can act like a kid and get paid for it!Just a 19 year old weirdly obsessed with names, no babies in the near future
Aila Anwen Arianwen Aveline Calla Caoimhe Cosima Fionnuala Hazel Hestia Josephine Rowan
Alaric Asa Evander Ezra Jasper Leander Lucas Orion Perseus Ruairi
♥ Hazel Arianwen ♥ Asa Benjamin ♥
♥ Rowan Oriana ♥ Lucas Orion ♥


text:
Pre-Mixed Drinks - 2014
Pre-Mixed Drinks Challenge
Nose: Notes of nutty Amontillado sherry and black olives. Beautiful notes of unctuous barley malt, prune pepper and caramel.
Palate: Rich, malty palate with plenty of oak grip. Juicy, fruity and slightly tannic. After a time, the vermouth becomes more prominent, and begins to offer up aromatic wood notes, as well as hint of potpourri and citrus.
Finish: Long, fruity finish with notes of barley wine on the tail.
Overall: This does well to allow the whisky to lead with added nuance from the intensity of the bitters and the herbal richness of the vermouth.
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The Blog
Convicted Car Bomber and Likely Murderer Transferred from Gitmo to Saudi Arabia
9:00 PM, Jun 12, 2009 • By THOMAS JOSCELYN
That may explain why Zuhair, who has had multiple disciplinary problems at Gitmo, has been on a hunger strike for years. He is the type of committed jihadist who will do anything to defy the infidel U.S.
The Department of Justice says that Zuhair's transfer took place "under appropriate security measures." The DOJ reports:
But the Saudi rehabilitation program recently returned at least eleven former Gitmo detainees back into al Qaeda's ranks. The program is not nearly as effective as was once claimed. And if the plan is for Zuhair to enter the program, then there are good reasons for concern.
Zuhair long ago set down his violent path. There is no reason to think that the Saudis can change his mind. And during his terror spree in Bosnia he and his co-conspirators were definitely tied to the Saudi High Commission, a charity with deep ties inside both the Kingdom and al Qaeda.
The DOJ's press release notes that Zuhair was approved for transfer by the Bush administration. But, of course, he wasn't transferred under the Bush administration, which made its own mistakes in transferring detainees. And, of course, a mistake by the Bush administration does not justify a mistake by the Obama administration.


text: IWB holster [Archive] - Glock Talk Glock Talk > Firearms Forums > Gun-Related Clubs > The Bull Dawgs Club > IWB holster PDA View Full Version : IWB holster Jr.08-04-2010, 13:54Whats everyone using for a IWB holster for the 38?? gary newport08-04-2010, 15:25Kramer #3 in horsehide. Russell Lang08-06-2010, 16:30I am using the Sparks VM-II originally made for my G-36, and it works fine. G21H3008-06-2010, 21:56RM lowrider IWB or a Milt Spraks VM-II both made fhe G-38 DLL9mm08-07-2010, 03:54I would suggest a Raven Phantom holster. Can be used IWB or OWB. http://www.themalabarfront.com/product_info.php?cPath=82_85_92&products_id=1561 DannyR08-07-2010, 05:44I have a Raven Phntom and a Blade-Tech Nano. Can't post photos now because I am out of town for the day. fasteddie56508-13-2010, 13:21Crossbreed supertuck is a bit tight for the G 38 and a trifle loose for the G 36. Damn the Cowgirls, get the Horsehide model. SHG2108-13-2010, 16:55I was really disappointed with my crossbreed. I have since moved on to milt sparks. David_Ely08-19-2010, 08:11+1 for the Blade-Tech Nano. It's my EDC holster for my G38. lethal tupperwa08-19-2010, 08:32the fist #7 is much thinner than the leather ones. it is also adjustable. fasteddie56508-21-2010, 07:31I was really disappointed with my crossbreed. I have since moved on to milt sparks. I have no real emotional bond to it, I was thinking of getting a Comp_Tac IWB as I have their paddle holsters and you can swap the kydex out on the leather / clips. My business partner loves his milt sparks, please do tell about them. Should I take the plunge? vBulletin® v3.8.7, Copyright ©2000-2015, vBulletin Solutions, Inc.


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Undefeated Japanese star Naho Sugiyama makes her first trip to America to try and lay claim to Invicta FC's first title belt. read news >>
As expected, a 105-pound women's title fight headlines Invicta Fighting Championships' third event.
The promotion today announced that Jessica Penne and Naho Sugiyama will vie for the promotion's read news >>
Invicta FC crowned their first ever champion on Saturday night as Jessica Penne submitted Naho Sugiyama to cap off a night of women's fights in Kansas City. read news >>
Invicta Fighting Championships' third event will be headlined by an atomweight title confrontation. read news >>
The landscape of women's MMA has flipped upside down in the last year
since Marloes Coenen lost her bantamweight title to Miesha Tate at a
Strikeforce show in Illinois.
After a dispute between h read news >>
Terrion Ware intends to claim the bantamweight champion in the only all-RFA bout at Friday's Legacy FC vs. RFA event on AXS TV. read news >>
Get caught up to date on the latest news in women's MMA, from Alexis Davis finally beating Sarah Kaufman to a new champ in Invicta FC. Filed under: News, UFC read news >>
Another Brazilian underdog. Another submission upset. Another new champion. Four months after Herica Tiburcio stunned Michelle Waterson to win the Invicta FC women's atomweight title, Livia Renata So read news >>
Having captured the Invicta FC strawweight championship on Friday, Livia Renata Souza made sure that America knows her name. read news >>
Livia Renata Souza became the new strawweight champion in the main event of Invicta FC 12, submitting Katja Kankaanpaa with a triangle choke in the fourth round. Check out the full results for the ev read news >>
The Invicta Strawweight title is on the line tonight on UFC Fight Pass as Livia Renata Souza challenges champ Katja Kankaanpaa. Join the discussion at Bloody Elbow. Strawweight champion Katja Kankaap read news >>
Livia Renata Souza will make her Invicta FC debut on Friday night, and it's going to be the biggest night of her life. The Brazilian prospect, who signed a contract with the promotion after going 6-0 read news >>
Invicta FC 12 weigh-ins took place today, and strawweight title holder Katja Kankaanpaa and challenger Livia Renata Souza each came in under the championship limit.Filed under: News, UFC read news >>
Vanessa Porto wants another chance to fight for the Invicta FC title, but she has to get past Roxanne Modafferi first. Porto and Modafferi were originally set to battle at Invicta FC 10 in December, read news >>
Heading into the first defense of her Invicta FC title, Katja Kankaanpaa says 2015 is going to be the Year of the Killer Bunny. read news >>


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Search Result
Search Tags: Craig Jennings
OMB Watch unveils new aspect of FedSpending.org
There's a new feature at FedSpending.org.
Tags: Technology , Recovery.gov , OMB Watch , FedSpending.org ,
Thursday - 12/03/2009, 04:55pm ESTListen
Concerns about recovery.gov contract
Tags: Technology , contracting , Recovery.gov , USASpending.gov , OMB Watch ,
Friday - 07/10/2009, 05:04pm EDTListen
Revamped Recovery.gov garners mixed reviews from OMB Watch
Organization's Craig Jennings says the site looks better, but whether it works at improving transparency is yet to be seen.
Tags: Technology , management , Recovery.gov , OMB Watch , Dorothy Ramienski , Web 2.0 , government 2.0
Thursday - 10/01/2009, 02:37pm EDTListen


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Be realistic: No comparison between Celtics, Red Sox
|10.16.13 at 6:39 pm ET
Could the Celtics be the NBA version of the 2013 Red Sox? Let's be realistic.
'Baseball is such a different sport,' said Danny Ainge, one of a dozen people ever to walk the planet as both a Major League Baseball and NBA player. 'You have so many more players, and in baseball not one player dominates a game as much. In basketball, I don't think there's any correlation we could draw from that situation.'
For more on the differences between this year's C's and Sox, read this column.
Latest from Bleacher Report
- Why Celtics Will Be Better Than Expected in 2014-15
- Should Celtics Fans Buy or Sell Rondo's Hot Start?
- Lessons Learned from Celtics so Far
- Why Green Will Finally Succeed in Boston
- C's Big Offense Showing a Sign of Things to Come?
- Green's Transition to PF Could Reshape NBA Career Arc
- Could Rondo's Play Increase the Chances He's Dealt?


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Selker is an Associate Professor at the MIT Media and
Arts Technology Laboratory and the Director of the Context
Aware Computing Lab (www.media.mit.edu/context). Prior
to joining MIT faculty, in November 1999, Selker was
an IBM Fellow and ran a large research group called
User Systems Ergonomics Research at IBM Research. He
has served as a consulting professor at Stanford University,
taught at Hampshire University of Massachusetts, Amherst
and Brown Universities. Selker also worked at Xerox
PARC and Atari Research Labs.
research has borne fruit in several product lines and
has contributed to products ranging from notebook computers
to operating systems. He is known for the design of
the "TrackPoint" in-keyboard pointing device found in
many notebook computers. His PhD work "COACH" demonstrated
that an adaptive agent can improves user performance.
work is documented in dozens of industry awards, papers
and invention patents .
scientist's answers are available below.Please see our resources
page for the scientists home page and other related infomation.
Reed asks:
a special education student at ETSU and I am interested
in how this technology could be used as communication
devices for non verbal students. Any chance that this
could become affordable enough (and user friendly enough)
that it could be put to actual use by non-communicative
students instead of stuck on a shelf like most of the
first and second generation communication devices? Particularly
the eye gaze technology for kids that have no outward
signs of pleasure responses? Super work! You give us
thanks, Diana
The eye gaze work in Eye aRe is very cheap, the
circuit board and battery Are the most expensive things
in it! This system could be developed to Recognize stare
(interest) blinking rapidly (nervousness, discomfort),
winking, eyes open and eyes closed. Such a set of things
could be used by people to control their environment.
Someone would have to want to make the product and deploy
it... how about you!
the floor tell male from female? What other kind of
information could the floor be programmed to get?
Some work has been done on gait. It seems that we
can recognized various things by how people move and
walk. Still, the best things for the floor are, noticing
that things have moved, making paths for where they
have moved to (finding keys by showing you the paths
for where you have been) showing where people are associating,
making games on the floor, weighing food ingredients
or other things.


text:
Please use this identifier to cite or link to this item: http://hdl.handle.net/10355/4106
|Simulating the effects of riparian zone delineation and management practices on landscape pattern and timber production
|Bellchamber, Sara B.
|University of Missouri--Columbia
|Best management practices (BMPs) are essential to giving the forest manager guidelines to follow that result in the least amount of negative impact on the forest landscape and corresponding riparian areas. The purpose of this research project is to determine the effect that different riparian zone delineations, based on BMP, will have on landscape pattern and timber production over time. LANDIS will allow for the application of three buffer scenarios (a 20 m buffer, a 100 m buffer, and a variable width buffer based upon soil and topographic characteristics) upon the same landscape and the analysis of the results that each technique will have over a long period of time. These boundaries determined the extent to which even-aged harvesting practices would be applied. Results indicated that the most influential variable in the simulation was the application of harvest. The variable width buffer most efficiently protected the stream by widening the buffer from the stream at areas that are more susceptible to erosion or pollutant discharge. Analyzing the effects of different buffering scenarios upon landscape pattern and timber volume provides forest managers with better tools for deciding the best action to take in balancing timber harvest with the biological integrity of streams.
|Other Identifiers:
Items in MOspace are protected by copyright, with all rights reserved, unless otherwise indicated.


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text:
Cosplay Seller Behind LoganProps Responds To Community's Scam Allegations
Last week, Youtube partner and blogger Marlene of ILikeComicsToo wrote a lengthy exposé of her dealings with Jim Logan of LoganProps, a cosplay seller who failed to deliver an order after already having received hundreds of dollars for it. This weekend, Jim released his own statement on the controversy. It is... well. You really need to read it yourself, I suppose.Read More


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Live updates
- Chris Halpin
Drug trafficking boss jailed for £9.5m heroin haul
Two men have been jailed for a total of more than 30 years for masterminding an international heroin smuggling operation from Pakistan.
Ringleader Tahir Mahmood controlled a gang spread over two continents from his home in Stourbridge. After being watched and followed by police in Spain and the UK, he was arrested in raids last year, along with his right hand man Anwar Bashir from Bradford.
The men were directly connected to around 46 kilograms of heroin seized, with a further 49 kilos found as part of the wider operation. In total the drugs had an estimated street value of around £9.5 million. Chris Halpin reports.
- Chris Halpin
The international scale of £9.5m heroin trafficking plot
Today two key players of an international drug smuggling operation were sentenced to more than 30 years behind bars. Tahir Mahmood from Stourbridge, and Anwar Bashir from Bradford, controlled a group of men to smuggle heroin to the value of £9.5m into the UK from Pakistan.
Using couriers or drug 'mules', the heroin was hidden on flights passing through the United Arab Emirates, Spain, Germany, Austria and finally the UK. Watch the video above to find out exactly how the gang planned to flood Britain's streets with heroin.
Jailed heroin gang could have brought 'violence' to Birmingham
The National Crime Agency have said an international drugs gang led by a man from Stourbridge could have brought 'misery, harm and violence' to Birmingham.
Tahir Mahmood was jailed today for a variety of offences into importation of significant quantities of heroin into Europe and the UK after previously pleading guilty.
We proved Mahmood and Bashir were linked to seizures totalling 46 kilos but I believe the network dismantled could have been responsible for many more importations – bringing misery, harm and violence to communities in Birmingham, Bradford and other cities.
"Tackling the supply of drugs on a global level and protecting our borders are priorities for the NCA and its partners. We targeted the couriers one by one and obtained the evidence that led to the downfall of these two men. They are now behind bars where they belong."
CCTV of international drug boss meeting drug mule
This is footage of Tahir Mahmood from Stourbridge meeting a courier at a UK airport who was wearing specially adapted clothing full of heroin.
Tahir Mahmood was the ringleader of the multi-million pound international heroin smuggling gang, he has been sentenced to 16 years in prison today.
His right-hand man, 43-year-old Anwar Bashir from Bradford, has been sentenced to 15 years in prison after being found guilty by a jury after a trial.
Leader of international drug smuggling gang jailed
A man from Stourbridge who controlled a multi-million pound international heroin smuggling gang has been sentenced to 16 years in prison.
Tahir Mahmood was jailed for a variety of offences into importation of significant quantities of heroin into Europe and UK after previously pleading guilty.
- ITV Report
International drug smuggling boss to be sentenced
A man from Stourbridge who controlled a multi-million pound international heroin smuggling gang is due to be sentenced later.Read the full story ›
£10,000 worth of class A drugs seized in Leicester
Around £10,000 of what are believed to be class A drugs have been seized from a house in Leicester following a police raid.
A 21-year-old man has been arrested and is in police custody.
We remain committed to acting upon information from the public concerning drug use and supply in our community. Today's warrant has stopped a large amount of drugs entering out streets. If people have concerns about drugs misuse in their area I would urge them to please get in touch."
Former Britain's most wanted man faces long jail term
West Midlands Police say they have cracked the drugs ring headed by Black Country's notorious criminal John Anslow.
Anslow was cleared of the murder of a Staffordshire man at Woolwich Crown Court yesterday.
However the case allowed police to uncover details of his role overseeing cocaine and cannabis supply across the country.
Anslow, who was once Britain's most wanted man, was discovered when police followed a local drug dealer to an address where evidence linked back to Anslow.
He was found by police hiding out with 8 grams of cocaine in a Bewdley caravan park.
Investigating officer Mike Greenland from West Midlands Police said:
John Anslow headed up an organisation that distributed drugs in the West Midlands and other parts of the United Kingdom. It was an extensive, organised crime gang that's also seen his associates receive lengthy custodial sentences.
Birmingham man sentenced after drugs bust
22-year-old David Mitchell has been sentenced to two and a half years in prison for drug related offences.
He pleaded guilty to possession with intent to supply crack cocaine and cannabis at Birmingham Crown Court.
It comes after police executed a drugs warrant in Kingstanding Road at the start of the year. Mitchell was found in a caravan on the driveway of the property with a large quantity of crack cocaine.
PC Luke Mincher from Birmingham North Police said:
"The drugs haul was estimated to have a total street value of almost £10,000. We are pleased with the court's sentencing and hope that anyone with information about drug dealing will have the confidence to contact us, so that we can take action."
Police say it's 'only the tip of the iceberg' after drugs bust.
In terms of value, this is one of the biggest investigations West Mercia Police has ever conducted into the illegal drugs trade.
While we have seized approximately £10million worth of Class A and B drugs, we think it is only the tip of an iceberg. We believe the conspiracy has been responsible for hundreds of millions of pounds worth of drugs being smuggled into the UK.
We also have evidence that shows these drugs have been sold from the West Midlands region to organised criminal groups nationally who are dealing drugs across the country.


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A section of Delhi University teachers have stated that those among them who are opposed to the four-year undergraduate course are not representative of the entire teaching community. They were also sharply critical of the Delhi University Teachers' Association's recent agitations which, they said, had only alienated the university administration from its teachers.
"There is also a big section of us who welcome the four-year course; we think it is the best thing to happen to Delhi University. Inter-disciplinary learning is something that is long coming. We are all excited at the prospect of the new course and think it is a very good thing for students to have the freedom to learn across disciplines," said political science teacher and Academic Council member Suman Sharma. She added that her only wish was that something like this had been possible during her student days.
The teachers said that the university had been most liberal and inclusive while making the four-year course and arguments like it "benefits only the rich students" that the "Left" was propagating were not true. "Children go abroad to study the four-year course, it is a good thing that a poor kid in Delhi can have access to the same model," said another teacher Mani Bhushan.
"In the name of opposing academic reforms, the Left is holding the entire teaching community to ransom," said former DUTA president and current Executive Council member Aditya Narayan Misra, who belongs to the Congress-affiliated Academics for Action and Development.
"The current DUTA leadership has unsuccessfully carried out agitations on non-issues and have not done anything for the betterment of teachers. They have only antagonised the administration time and again and this has resulted in the administration refusing to engage with the DUTA on any issue. This attitude has only disadvantaged the teachers," he added.
"DUTA not the same"
"In the last few struggles, there were very few teachers who joined the protests, most are scared of administrative action and are disenchanted with the way the DUTA has failed to address their issues. This was not so a few years ago," said former DUTA vice-president and current Academic Council member Sanjay Kumar.
The teachers also claimed that in the earlier days the condition of the ad hoc teachers was better. "Now the university conducts interviews once in four months. It is difficult for a teacher to function properly if his employment comes under question every four months," added Mr. Misra. "Many of them are in their 30s and have Ph.Ds, it's just not right," added Ms. Sharma.
"The diversionary tactics of the Left and their deflective engagement of the university system in non-issues have resulted in the inordinate delay in the approval of service conditions. The permanent appointment of more than 4,000 ad-hoc teachers, promotions and implementation of professorships in the colleges has been blocked," added Mr. Kumar.
"Despite activities of the opposing teachers, the university has communicated to many colleges regarding the permanent appointment of teachers by the end of June and this act should be appreciated," added Mr. Misra.
Keywords: Delhi University teachers, DU teachers, four-year programme, admission procedures, Academic Council