text:
An infusion pump and method are provided which control flow rates with variable fluid pressure and variable series flow resistance.
1. A fluid delivery apparatus for maintaining a desired flow rate of a fluid from a fluid source along a fluid path, comprising:
an inflatable bladder bearing against the fluid source to drive the fluid from the fluid source along the fluid path, the flow rate being responsive to varying pressure in said inflatable bladder;
an adjustable flow resistor for varying flow resistance in the fluid path, the flow rate being responsive to adjustment of said flow resistor;
an inline flow sensor capable of operating over a wide flow rate range for detecting an actual flow rate of the fluid;
a processor coupled to said adjustable flow resistor and said flow sensor for comparing the actual flow rate of the fluid with the desired flow rate of the fluid to determine a difference between the actual flow rate and the desired flow rate;
means for adjusting the flow resistor; and
means for varying the pressure in said inflatable bladder.
2. The apparatus of
said adjustable flow resistor including a valve member in the flow path coupled to an adjustment member, the valve member movable between a first, closed position and a second, fully open position in response to adjustment of said adjustment member.
3. The apparatus of
said adjustable flow resistor including a rotatable housing and a valve member in the flow path coupled to the rotatable housing, the valve member movable between a first, closed position and a second, fully open position in response to rotation of said rotatable housing.
4. The apparatus of
means for rotating said rotatable housing responsive to the difference between the actual flow rate and the desired flow rate to reduce the difference between the actual flow rate and the desired flow rate.
5. The apparatus of
6. The apparatus of
7. The apparatus of
means for selectively increasing and decreasing the pressure in said bladder responsive to the difference between the actual flow rate and the desired flow rate to reduce the difference between the actual flow rate and the desired flow rate.
8. The apparatus of
9. A method for maintaining a desired flow rate of a fluid in a fluid delivery device, the fluid flowing from a fluid source along a fluid path, comprising:
inflating an inflatable bladder that bears against the fluid source to drive the fluid from the fluid source along the fluid path, the flow rate being responsive to varying pressure in said inflatable bladder;
determining an actual flow rate with an inline flow sensor adapted to sense a real time flow rate over a wide flow rate range and comparing the actual flow rate to the desired flow rate;
if the actual flow rate is not equal to the desired flow rate, adjusting one or both of pressure in the inflatable bladder and an adjustable flow resistor to reduce the difference between the actual flow rate and the desired flow rate; and
said adjustable flow resistor for varying flow resistance in the fluid path, the flow rate being responsive to adjustment of said flow resistor.
10. The method of
monitoring a volume of fluid flowing from the fluid source as a function of time; and
monitoring a rate of pressure decay in said bladder.
11. The method of
determining whether the difference between the actual flow rate and the desired flow rate is within a first threshold value;
if the difference between the actual flow rate and the desired flow rate is not within the first threshold value, adjusting the adjustable flow resistor;
determining whether the difference between the actual flow rate and the desired flow rate is within a second threshold value; and
if the difference between the actual flow rate and the desired flow rate is not within the second threshold value, adjusting the driving pressure in the inflatable bladder.
12. The method of
13. The method of
calculating a volume of fluid in the fluid source to be infused;
determining a prespecified time at which at said calculated volume of fluid in the source is to be completed; and
varying the actual flow rate by adjusting one or both of pressure in the inflatable bladder and the adjustable flow resistor to cause the infusion of the calculated volume of fluid to be completed at said prespecified time.
14. The method of
input of the prespecified time via a user interface of a computer-based information handling system; and
calculating a completion time based on said calculated volume of fluid and the desired flow rate.
15. The method of
said adjustable flow resistor including a rotatable housing and a valve member in the flow path coupled to the rotatable housing, the valve member movable between a first, closed position and a second, fully open position in response to rotation of said rotatable housing.
16. The method of
if the actual flow rate is not equal to the desired flow rate, generating a control signal for rotating said rotatable housing proportional to the difference between the actual flow rate and the desired flow rate to reduce the difference between the actual flow rate and the desired flow rate.
17. The method of
said adjustable flow resistor is adjusted by rotating said rotatable housing a stepper motor coupled to said processor.
18. The method of
said inflatable bladder including a pump fluidically coupled to said bladder for increasing the pressure in the inflatable bladder and a vent valve fluidically coupled to said inflatable bladder for reducing the pressure in said inflatable bladder.
19. The method of
if the actual flow rate is not equal to the desired flow rate, selectively increasing and decreasing the pressure in said bladder responsive to the difference between the actual flow rate and the desired flow rate to reduce the difference between the actual flow rate and the desired flow rate.
20. The method of
The present disclosure relates to fluid flow control systems, such as intravenous infusion pumps, and more particularly to feedback control infusion pumps with flow sensing, volume sensing, variable pressure control, and variable flow resistance.
A conventional large volume infusion pump is typically equipped with a motor that, in connection with a mechanical assembly and through the interface of a fluid barrier, pushes a small amount of fluid per motor "step." The mechanism might be a cam, a leadscrew, or other such assembly. The fluid barrier might be a syringe, an extruded tube, a molded cassette, or other such device that separates the pumping mechanism from the fluid in question. In each case, the fluid movement is determined by a certain number of motor steps over time.
At slow flow rates, the motor steps are relatively infrequent with long dwell periods. At high flow rates, the motor and mechanism are run at their maximal capacity until one element has reached its engineering limit. The flow rate is inherently pulsatile, yet this pulsatile nature is less significant at higher flow rates where the natural compliance of the outlet of the pumps serves to dampen the pulses into more or less a continuous stream of fluid.
The motors used conventionally are inherently powerful enough to overcome significant forces and resistances, so they are capable of generating significant pumping forces. This forceful pumping is an artifact and has no desirable clinical effect. The sensing mechanisms commonly used are pressure based and made with indirect contact with the fluid to be pumped. In most cases, the fluid barrier, such as an extruded tube, exerts far more force than the internal fluid pressures. The result is a lack of sensitivity to pressure changes and a lack of feedback as to the actual conditions of fluid flow. It is common for conventional pumps to operate indefinitely without recognizing that the actual fluid flow rate is far below the targeted level.
Conventional motor driven pumps are notoriously inefficient with respect to external power consumption. For devices that have a high requirement for portability, this power inefficiency translates into unreliable operation.
Prior to the use of pumps, most infusions were done by the adjustment of a gravity-based pressure (e.g., by adjusting the height of a liquid container) and the adjustment of inline resistance (e.g., by moving the position of a roller clamp), both in response to an inline flow sensing method (e.g., performed by a user counting drops into an air chamber). Although this prior art method was labor intensive and had limited rate range, it offered some significant advantages over the subsequent "advances" in technology. First, the use of gravity head heights for a delivery pressure was energy efficient. No external power supply was required. Second, the pressure was low, so the dangers of high-pressure infusions were avoided. Third, the gravity infusions could be augmented with a low cost and readily available pressure cuff, supplementing the fluid flow to rates well above those possible by an instrumented "pump" line. Forth, a gravity administration was not capable of infusing large amounts of air into the output line, because the hydrostatic pressure goes to zero as the fluid source empties.
The present disclosure seeks to combine the meritorious aspects of a conventional "gravity" infusion with the benefits of a controlled intravenous infusion pump. In each aspect, this disclosure takes the desired principles of a gravity infusion and reduces the dependence upon skilled labor and extends the range and precision of fluid flow control and provides advanced information management capabilities.
An ideal embodiment of an infusion device would be one with continuous flow, wide flow rate range, high energy efficiency, accuracy of volume delivered over time, minimal operating pressures, maximum sensitivity to external conditions, freedom from false alarms for air-in-line, simplicity, low cost, intuitive operation, automated information exchange, safety, and reliability.
Certain infusions have historically been managed by air pressure delivery systems, most commonly found in the operating room and in emergency situations. Prior art attempts have been made to determine the flow rate via pressure monitoring and control. For example, U.S. Pat. No. 5,207,645 to Ross et al. discloses pressurizing an IV bag and monitoring pressure to infer flow rates. However, the prior art systems lack independent flow sensing, and, therefore, do not offer enough information to provide accurate and safe infusions.
Under the best of circumstances, there is not enough information in the pressure signal alone to provide the accuracy needed for intravenous infusion therapy. Furthermore, there are a number of likely failure modes that would go undetected using the pressure signal alone. An infusion pump must be able to respond to events in a relevant time frame. International standards suggest that a maximum period of 20 seconds can lapse before fluid delivery is considered "non-continuous." As an example, for an infusion of 10 ml/h, the system would want to resolve 20 seconds of flow, which corresponds to 0.056 mL. This volume represents one part in 180,000 of the total air volume. Temperature induced change in pressure brought about by a normal air conditioning cycle is far greater than this signal. The measurement of pressure alone is not adequate for an intravenous infusion device. No general purpose, full range, infusion devices using pressure-controlled delivery are known to be on the market.
An entire class of "passive" infusion pumps exists whereby a constant pressure is created on a fluid filled container by way of a spring, elastomeric structure, gas producing chemical equilibrium, or other means. This constant pressure fluid is fed into a high resistance output line, providing relatively stable fluid flow.
In typical pressure based flow control products, a relatively high pressure pushes fluid into a known, high, and fixed resistance, providing a constant flow rate with good immunity from changes in external conditions. It is the purpose of this disclosure to provide a highly flexible flow control system with a very broad flow rate range, operating under minimal pressures, with a relatively low and variable resistance.
It would therefore be useful to develop a device that could control fluid flow based on a responsive fluid flow sensing means that forms a closed loop control by changing both the fluid driving pressure and the inline resistance. In contrast to the conventional approach to flow control wherein a user observes fluid flowing as it formed drops in an air chamber, then adjusts pressure by varying the head height of the fluid source, and then adjusts the inline resistance via a manual valve, the present disclosure provides an apparatus and method that automatically and accurately measures fluid flow rate, precisely adjusts the hydrostatic pressure of the fluid source, and precisely adjusts inline fluid flow resistance to achieve or maintain a target flow rate.
A fluid control system and method are disclosed which combine the measurement of flow rate, an adjustable fluid pressure, and an adjustable inline resistance.
The invention may take form in various components and arrangements of components, and in various steps and arrangements of steps. The drawings are only for purposes of illustrating preferred embodiments and are not to be construed as limiting the invention.
Referring to the drawings, wherein like numerals reference numerals are used to indicate like or analogous components throughout the several views,
Referring now to
A calibration tank 60 of known volume is connected to the air pump 50 via a tank connection line 604, a tank valve 102, and a tank valve line 602. The tank 60 may be vented to atmosphere via a tank vent valve 104.
The liquid 40 is fluidically coupled to an output 500 via a liquid drain line 610, going through a fluid flow resistor 400 and through an output line 612. The liquid 40 may be, for example, a medication fluid, intravenous solution, or the like, and the output 500 may be, for example, a patient or subject in need thereof. An inline flow sensor 900 is provided in the line 612, as described in greater detail below.
The tank 60 is connected to a tank pressure sensor 204 and a tank temperature sensor 304. The bladder 20 is connected to a bladder pressure sensor 202 and a bladder temperature sensor 302.
Referring now to
With continued reference to
With reference now to
Ultimately, the objective of volume measurement is to know the quantity of liquid 40 remaining in an infusion and how that quantity changes over time.
The pressure frame 10 defines a rigid container of known volume, Vframe. This volume is known by design and is easily verified by displacement methods. Within the pressure frame 10, there is the air bladder 20, which has a nominal capacity greater than the volume Vframe. When expanded, the bladder must conform to the geometry of the rigid container and its contents. The volume of liquid 40 to be infused, Vtbi, is equal to Vframe, less the fixed and known volume of the bladder 20 itself, Vblad, less any incompressible materials of the bag 30, Vbag, and less the volume of gas in bladder 20, Vgas. Once the value Vgas is computed, then Vtbi may be computed as follows:
With the following method, at any given point in time, the volume of air contained in the bladder, Vgas, can be measured and Vtbi can be subsequently computed.
For purposes of economy and flexibility, the pump 50 may be an imprecise air pump, such as that of a rolling diaphragm variety, although other types of pumps are also contemplated. The output of such a pump may vary significantly with changes in back pressure, temperature, age of the device, power supply variation, etc. One advantage of the device and method disclosed herein is that they allow an imprecise pump to be used in a precision application, by calibrating the pump in situ.
The initial pressure in the bladder 20, Pbladder1, is measured using the bladder pressure sensor 202. The tank valve 102 is set to a closed state via the tank control valve line 702 from the processor 700. The bladder valve 106 is set to an open state via the tank control valve line 706 from the processor 700. The pump 50 is activated by the processor 700 via the pump control line 750 for a period of time, Stest, nominally, for example, about 250 milliseconds. A new measurement of the pressure in the bladder 20 is made, Pbladder2. Based on the percent of pressure change from this pumping action, a new pump activation time, Spump, will be computed. This calculation needs no precision; it is only intended to find an amount of pumping that provides a significant change in pressure, Pdeltatarget, in the bladder 20, for example, on the order of about 10%.
In step 804, the pump 50 or the tank vent valve 104 are activated to increase or decrease, respectively, the pressure, Ptank, in the tank 60, so that it approximately equals the pressure, Pbladder, in the bladder 20. The combination of valve and pump settings required for such adjustments are shown in the table below:
Adjustments made in step 804 can be made iteratively until Ptank is roughly equal to Pbladder, for example, within about 5% of the relative pressure measured in Pbladder. This does not need to be a precise process. Following the adjustment, the pressure in tank 60, Ptank2, is recorded.
In step 806, the system is configured to increase the pressure in tank 60, as shown in the above table. The pump 50 is activated for a time period equal to Spump. After a delay of approximately five seconds, the pressure in the tank 60 is measured, Ptank3. This delay is to reduce the effect of an adiabatic response from the increase in pressure in the tank 60.
In step 808, the system is configured to increase the pressure in the bladder 20, as shown in the above table. The pump 50 is activated for a period equal to Spump. After a delay of approximately five seconds, the pressure in the bladder 20 is measured, Pbladder3. This delay is to reduce the effect of an adiabatic response from the increase in pressure in the bladder 20.
Because the initial pressures in the bladder 20 and the tank 60 were approximately equal, the quantity of air mass injected into the tank 60 in step 806 and into the bladder 20 in step 808 will be roughly equal, even though the pump 50 need not be a precise metering device.
We take advantage of several simplifications. First, the ambient temperature for sequential steps 806 and 808 is unchanged. Second, the atmospheric pressure during sequential steps 806 and 808 is unchanged. These conditions simplify the ideal gas law formula and allow the use of gauge pressure measurements, rather than absolute pressure.
In step 810, the volume of gas in the bladder 20, Vgas, can be calculated with a reduced form of PV=nRT:
As examples of this calculation, if the pressure change were the same in the bladder 20 and the tank 60, then Vgas would be equal to Vtank. If the pressure change in the bladder 20 were 20% as large as that in the tank 60, then Vgas would be 5 times greater than Vtank.
Step 812 derives the value for Vtbi from Vgas, using known values for Vframe, Vblad, and Vbag and using the calculated value of Vgas, from step 810.
The valves 102, 106, 104, and 108 can be configured in many ways, including multiple function valves and or manifolds that toggle between distinct states. The depiction herein is made for functional simplicity, not necessarily economy or energy efficiency.
The exploded view of
The interior of the proximal housing 932 is shown in
Referring to the section view of
The graph depicted in
In operation, the light source 921, which may be, for example, an LED array, transmits light through the first optical rib 933 a and into the cavity 955. The light incident upon the ball 942 is transmitted through the ball 942 and through the second optical rib 933 b to form a light intensity pattern on the photosensor array 922. The photosensor array 922 may be, for example, a charge-coupled device (CCD) array, photodiode array, complimentary metal oxide semiconductor (CMOS) digital detector array, or the like.
The optical transmitter may include one or more light source elements having a wavelength, for example, in the infrared (IR), visible, or ultraviolet (UV) region and the housing and ball member may be formed of a material that optically transmits light of the light source wavelength. The light source may be an array of light elements, such as LEDs, or laser, etc. The light source may be segmented along the axis or may be a continuous, e.g., scanned or otherwise optically formed beam. The light source may illuminate the detector array along its length simultaneously or by sequentially scanning along its length. The refractive effect of a transparent ball member may have a focusing effect on the light passing therethrough that may be detected by the photosensor array. Alternatively, a nontransmissive ball may be employed and the ball position may be determined by detecting the position of a shadow cast by the ball on the photosensor array. In still further embodiment, the ball member may have reflective surface and the optical sensor array may be positioned to detect light reflected from the surface of said ball.
The output of the photosensor array 922 may be passed via the data line 710 to the processing system 700, which may include a position-detection module or circuitry wherein the axial position of the ball 942 within the channel 955 is determined. The axial position of the ball 922 may in turn be used to determine a flow rate and/or calibrate or correlate ball 922 positions with known flow rates calculated by other means such as plural volume measurements made using the method outlined in
In certain embodiments, the known flow rates corresponding to axial ball positions may be stored in a memory of the processing system 700, for example, in a table, database, or the like. In such embodiments, when an axial position of the ball 922 is measured, the measured position of the ball may be compared with the table of known flow rates and the flow rate corresponding to the measured axial position is then determined. In other embodiments, calibration measurements of axial ball position and known flow rates may be used to derive an algorithmic formula for mapping a measured axial ball position to a corresponding flow rate. In such other embodiments, when an axial position of the ball 922 is measured, the derived algorithmic formula may then be used to determine the flow rate.
While the present disclosure provides a currently preferred implementation of the system herein, it will be recognized that alternate inline flow sensors are also contemplated.
Once the fluid volume has been computed, then multiple measurements made over time will yield knowledge of fluid flow rate, which is, by definition, fluid volume changing over time. Repeated measurements of volume over time provided more and more resolution of average flow rate. The average flow rate and the volume of liquid 40 remaining to be infused can be used to estimate the time at which the fluid volume will be delivered. If the infusion is to be completed within some specified period of time, any error between the specified time and the estimated time can be calculated and the flow rate can be adjusted accordingly.
There are situations where the short-term flow rate is of interest. Rather than make repeated volume measurements over a short period of time, there is an alternative approach. Once the gas volume in bladder 20 is known, then the observation of pressure decay in the bladder can be converted directly to a flow rate. It is important to know that the measurement of pressure decay, by itself, is not adequate to compute flow rate. For example, if the pressure were decaying at a rate of 10% per hour, this information cannot be converted into flow rate, unless the starting gas volume is known. As an example, if Vgas has been measured to be 500 ml and the absolute pressure is decaying at a rate of 5% per hour, then the flow rate is 5% of 500 ml per hour or 25 ml per hour. The knowledge of the initial volume is critical to compute fluid flow rate.
The measurement of pressure decay is a simple procedure of observing the time the absolute pressure of Pbladder to drop by a small, but significant, amount, preferably for example about 2%. Because the processor 700 is capable of measuring times from microseconds to years, this measurement carries a very wide dynamic range. By observing a 2% drop, the change in pressure is well above the noise floor of the pressure measurement system.
A flow chart outlining an exemplary process 1000 for calculating flow rate by monitoring the rate of pressure decay in the bladder 20 is shown in
The relationship and purpose of having two independent measurement methods for determining flow rate is best described by referring to
One purpose of the two measurement systems is to calibrate flow measurement 865 with repeated values over time from primary volume measurement 861. Flow measurement 865, e.g., as determined as described above by way of reference to the flow sensor 900, is a measurement of flow rate or the first derivative of fluid quantity with respect to time. If one were to integrate the value of flow measurement 865 over time, the result would be a quantity of fluid. Any errors in this signal would accumulate, providing decreasing volume accuracy over time.
In contrast, an integral signal, such as that from primary volume measurement 861, e.g., calculated using the volume measurement method as described herein, has a fixed error that does not accumulate over time. In fact, as a percentage, the error obtained with an integral signal will decrease over time. As an analogy, if one were to attempt to reach a certain distance in a determined period of time, the use of a speedometer alone would lead to an obvious and significant error. Using this analogy, if one were to use integral measurements, such as those provided by an odometer and a clock, the resultant accuracy would be high.
Flow measurement 865, as described above, operates over a very wide flow rate range and cannot, in any practical way, be calibrated in advance to accommodate manufacturing variances and other environmental factors such as fluid viscosity. For any given fluid flow rate, the signal from flow measurement can be measured and correlated with repeated measurements over time from primary volume measurement 861. For example, if the measurement from flow measurement 865 was observed to a value "x" over a period of ten minutes and a measurement made by primary volume measurement 861 at the beginning of this period was 100 mL and a subsequent measurement made by primary volume measurement 861 at the end of this period was 90 mL, a correlation could be made between flow signal "x" and a flow rate of 10 mL per 10 minutes, or, 60 mL per hour. Flow rate calibration data may be maintained in memory, preferably a nonvolatile memory, of the processing system 700.
Another purpose of the dual measurement system is to distinguish between two sources of fluid directed to the same output. For purposes of distinguishing the source of fluid, assume that flow measurement 865 has been calibrated at various flow rates as described above. If a secondary fluid source 862 is connected to the system, as shown in
Yet another purpose of the dual measurement system is to detect a condition where gas is expressed from the primary infusion liquid. If a quantity of air leaves the system by way of an in-line air elimination filter 864, then an increased pressure drop will be observed. By itself, this increased pressure drop would indicate that the fluid flow rate increased proportionally. If air were to escape the system from air elimination filter 864, the signal from flow measurement 865 would remain unchanged, providing an indication that the pressure drop should be interpreted as an escape of air, not an increased in fluid flow. In this circumstance, without flow measurement 865, the pressure signal would be interpreted incorrectly.
Yet another purpose of the dual measurement system is to detect a condition where a leak in the pneumatic system exists. If an air leak occurs in the system, a pressure drop will be observed. By itself, this pressure drop would indicate that fluid is flowing from the system. If air were leaking, the signal from flow measurement 865 would be zero, providing an indication that the pressure drop should be interpreted as a leak of air, not as fluid flow. In this circumstance, without flow measurement 865, the pressure signal would be interpreted incorrectly.
Referring now to
The flow resistor 400 includes an exterior housing 410 and includes an adjustment feature for varying the position of a valve in the flow pathway for selectively increasing and decreasing flow resistance.
In the illustrated embodiment, the flow resistor 400 includes a rotatable housing 410, which may have a plurality of radially extending 412 projections forming a gear that may be selectively rotated, e.g., by a stepper motor or other motor having an intermeshing member, or the like. The rotatable housing 410 is coupled to an axially movable needle resistor 414 wherein rotating the housing 410 in one direction causes the needle resistor 414 to move in one axial direction and rotating the housing 410 in the opposite direction causes the needle resistor 414 to move in the opposite axial direction, for example, via helical threads formed on an interior surface of the rotatable housing member 410. It will be recognized that alternative embodiment may include other valve types and/or other adjustment mechanisms, including linearly adjustable linkages between the adjustment mechanism and the valve member.
In the illustrated preferred embodiment, the needle resistor axially moves between a first, closed position (see
The flow sensor 900 a includes a housing member 932 a defining a cavity 955 receiving a ball member 942. A spring member 941 urges the ball member in a direction opposite to the direction of flow. The spring member 941 may be a resilient compressible material such as a foam member or the like. Alternatively, the spring member 941 may be a coil spring, flat spring, or the like. An optical emitter 921 and an optical sensor 922 sense the position of the ball 942 to determine a flow rate, as detailed above. The inline sensor 400 and flow restrictor 900 a are depicted as an integral assembly in the embodiment of
The present disclosure provides a flow control system that adjusts either or both of the driving pressure in the bladder 20 and the series resistance to flow of the flow resistor 400 such that any flow rate error is minimized. The use of a closed feedback control system is in stark contrast to conventional infusion pumps, which are most often of "open loop" design with additional sensors and switches to alert "out of bounds" conditions.
In operation, a user may enter a target flow rate, e.g., via a user interface of the processing system 700. Alternately, a target flow rate may be calculated based on other input parameters, such as a specified infusion time or time to complete an infusion. Real time flow sensing as described is used to determine the actual flow rate, which is compared to the target flow rate. In the event the actual flow rate differs from the target flow rate, one or both of the bladder driving pressure and the resistance of the flow restrictor 400 may be increased or decreased as necessary until the actual flow rate is equal to the target flow rate or until the difference between the target flow rate and the actual flow rate is less that some preselected threshold.
Referring now to
At step 1812, it is determined whether the difference between the target flow rate and the actual low rate is within a first preselected threshold range. If the actual flow rate is not within this first threshold range, the inline flow resistance is increased or decreased, as necessary depending on the sign of the difference to bring the actual flow rate closed to the target flow rate using the flow resistor 400 at step 1816 and the process returns to step 1808 and repeats. The adjustments may be a series of incremental adjustments to bring the actual flow rate closer to the target flow rate in iterative fashion. In certain embodiments, the control signal for adjusting the inline flow resistor may be proportional to the magnitude of the difference between the actual flow rate and the target flow rate.
If it is determined that the actual flow rate is within the first threshold at step 1812, the process proceeds to step 1820, wherein it is determined whether the difference between the actual flow rate and the target flow rate is within a preselected second threshold range. If the actual flow rate is within the second threshold range at step 1820, the process returns to step 1808 and repeats. If it is determined that the actual flow rate is not within the second threshold at step 1820, the driving pressure in the bladder 20 is adjusted at step 1824 and the process returns to step 1808 and repeats. In this manner, the flow resistor 400 may be used to adjust the actual flow rate until it is relatively close to the target value, and the adjustment of the bladder 20 driving pressure may be used to refine the flow rate to meet the target flow rate precisely. The second threshold value may be selected as a value within which, the actual flow rate is sufficiently close to the target flow rate such that any error in the flow rate is minimal.
In certain embodiments, it may be desirable to maintain a minimum driving pressure in the bladder 20. Thus, the process 1800 may be modified by assigning a minimum pressure threshold value and periodically monitoring the pressure in the bladder. The pressure in the bladder may fall over time, e.g., as a result of fluid leaving the container or as a result of temperature drop. If the pressure falls below the assigned threshold value, the pressure is increased by activation of the pump 50. Preferably, the pump has a stroke volume and compression ratio that puts the new pressure well above the threshold, so no computational hysteresis is required. Each pump cycle may be followed by a new volumetric calculation.
The air pressure threshold value may be selected by a number of factors including the desired flow rate and should be low enough to remain sensitive to patient pressure and resistance, but high enough so as to reduce the level of noise in the in line flow sensor signal. Noise in the flow rate signal may be the result of hydrostatic changes in the system due to patient movement, coughing, transport, or other mechanical disturbances. If the driving pressure in the bladder is too low, the real time flow sensor signal will be noisy, indicating that the flow rate sensor signal is unacceptably affected by patient movement and so forth. However, maintaining a relatively low pressure is desirable in that it reduces energy consumption and remains sensitive to patient pressure and resistance.
In such embodiments employing a minimum pressure threshold, the threshold value may be a fixed value, e.g., representing a compromise pressure that is high enough to reduce noise in the flow rate signal, yet low enough to reduce energy consumption and provide reasonable patient sensitivity. More preferably, however, the assigned pressure threshold value may be dynamically modified over the course of an infusion so as to provide as low a pressure level above the noise threshold as conditions and the selected flow rate permit. In such preferred embodiments, the adjustment of the pressure threshold is made on a continuous or periodic basis using the following criteria. All things being equal, the system will lower the minimum driving pressure threshold periodically, so that the minimal energy is being consumed and the patient is being exposed to the minimal pressure in the line. This is in contrast to the conventional infusion pump designs, where the driving pressures are either highly pulsatile or kept at very high steady levels (e.g., elastomeric pumps). If the real time flow sensor signal is noisy, as can be seen numerically, it indicates that there are hydrostatic changes happening in the system as a result of patient movement, coughing, transport, or other mechanical disturbances. In the presence of this hydrostatic noise, the pressure threshold may be increased to generate a higher operating pressure, which creates immunity from the noise. Then, the pressure threshold is gradually reduced over time, as conditions permit. Furthermore, in such preferred embodiments, if the desired flow rate cannot be met at low pressures, such as with very rapid infusion rates, then the threshold pressure is increased as needed to achieve the desired flow rate.
In certain embodiments, the volume of fluid remaining to be infused may be monitored over an extended period of time for dose rate management. By monitoring the volume of fluid remaining in an infusion over time, the target flow rate can be dynamically adjusted to ensure that an infusion is completed at a prespecified time. That is, periods in which the desired flow rate is not maintained (for example, during a period of occlusion or other slowdown in flow rate, the period when the pressure is being built up in the bladder at the start of an infusion, or after venting the bladder 20 for any reason, etc.) can be offset by a slight increase in the target flow rate so that the infusion is completed on schedule. The time period may be identified via a number of methods. For example, the end time for a given infusion may be input directly via a user interface of the processing system 700. Alternatively, the end time may be calculated based on the calculated volume of infusate and the flow rate input by the operator.
The "titration" of air pressure in the bladder 20 provides an additional, optional form of flow rate control. Even if the flow resistance is kept at a fixed value, the slight adjustment of targeted air pressure refill threshold points may be used to accommodate small adjustments in net flow rates. The signal from the real time in line flow sensor drives this titration process. The titration of air pressure in this manner may be performed separate and distinct from the gross adjustments discussed above. The slight adjustment in pump fill timing is done without any expenditure of energy on the resistor control.
The present disclosure may also measure downstream occlusion. Most infusion devices measure downstream occlusion by an increase in back pressure resulting from a powerful motor, moving fluid in an open loop manner against a resistance. In some cases, the pressure is measured by a limit switch that allows for very significant pressures to be developed distal to the pump. The compliance of the tube can create a hazardous amount of fluid available for bolus into the patient. In contrast, the present device measures fluid flow directly, and thus, an occlusion or slowdown in fluid flow rate can be seen directly. The steady driving pressure and real time flow measurement enhances the visibility of downstream occlusion; whereas, a conventional pump alternates between zero pressure and high pressure so that changes in resistance are not readily visible.
The present disclosure also has the ability to reduce driving pressures. If desired, in face of a potential occlusion, the pressure in the air bladder can be actively reduced to a lower level, for example, via the vent 108. This reduces the chance of an unwanted release bolus.
The present development may also be adapted to detect an upstream occlusion, which creates a particular challenge for many infusion pumps. Some infusion pumps fail to detect the condition all altogether. Since the present system utilizes a pressurized fluid source, the likelihood of an upstream occlusion is reduced. Furthermore, if an upstream occlusion does occur, the multiple flow sensing methods will detect it immediately. Since the present development measures flow rate directly, rather than inferring it, the detection of an upstream occlusion condition can be automatic.
The present development may also be adapted to measure the patient pressure and resistance. In certain embodiments, the present system may use the flow sensor 900 and the ability to reduce the driving pressure in the bladder 20 to periodically determine the exact pressure in the IV line. In such embodiments, the air driving pressure in the bladder 20 can be reduced until such point that the computation of zero crossing for flow rate can be predicted mathematically, thereby eliminating the need to actually reduce the pressure in the bladder to the equilibrium point where flow actually ceases.
In certain embodiments, a direct measurement of the patient resistance can be measured, trended, and used as the basis for an occlusion alarm. Since the driving pressure of the fluid is known from the pressure sensor 202, and the net flow rate is known, then the total resistance to flow is known. The rotational position of the gear housing 410 can also be determined and correlated to a certain fluid flow resistance. If the resistance of the gear 410 is added to the known and fixed resistance of the remainder of fluid pathway and then subtracted from the total resistance, the remainder is the resistance contributed to by the patient.
The invention has been described with reference to the preferred embodiments. Modifications and alterations will occur to others upon a reading and understanding of the preceding detailed description. It is intended that the invention be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.
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Hello All, This past March I was diagnosed at age 69 with age-related macular degeneration. Having just resumed knitting with a passion in the past two years after many years of doing needlepoint, you can imagine how I felt at hearing the bad news from my opthamologist. My LYS owner assures me that she has several knitters who are completely blind. I hope to retain some of my side vision in the future and forstall the worst effects of the ailment which will take away the central portion of my vision. I'm wearing large hats and sunglasses (I have lived in the sun all my life, in beach-side communities) taking lots of anti-oxidants, but should have been doing these eye-sight helpful things much earlier. So I am knitting up a storm, and loving every minute of it- my hands are sore at the end of the day.
Does anyone have any tips to help those of us continue to knit who are losing our sight? Or is it/will it be just a matter of practice/adjustment as my sight fails? I appreciate in advance any help from the Knitting Daily community- knitters helping other knitters. Thank you.
Sorry to hear about your diagnosis, and the adjustment will surely be difficult for you in many ways. However, there is no reason you can't go on knitting. Knitting is actually one of the easiest types of needlework for blind people. I worked at a school for the blind for many years and many of my students knitted, including those with physical disabilities as well as blindness. For many years knitting was taught to blind girls as a lucrative means of making a living (handcrafts don't pay like they did 50 or 100 years ago). Helen Keller and other Deaf-blind girls in her time knitted fine lace pieces with size 80 and 100 cotton or linen thread and needles like thin wires.
I often knit without looking, and I'd bet maybe you do too. Try knitting with your eyes closed or while watching TV and notice how much of the process is done by "seeing" with your fingers. If you can get any rehabllitation or ocupational therapy services, ask for help with your need to keep knitting. Contact your local school or association for blind people to see if you can meet any blind knitters (there are many out there). I think you may find this adjustment easier than learning to eat, iron, and such without sight. If you do lose your vision totally, you should still be able to do any knitting you want to without help, except colorwork; but even there you can use tactile labels and such to help you keep track of your colors after someone helps you to pick them out. Your blind knitting buddies will be able to help you with this.
Good luck and don't lose heart. Keep knitting as it will be a great source of comfort and support for you during this difficult transition.
Helen Stohlman
Thank you so much, Helen! You've helped me a great deal. I've generally been a positive person during my lifetime, but this has really gotten me down. Am trying to focus on the things I will be able to do and to realize that my knitting skills will not be totally gone is a good thing! I did try to knit with my eys shut, but couldn't do it. But maybe because I didn't have to! Will see how it goes...and will post my progress here. I have a feeling that I am not the only one in my situation. I am a WWII baby, not a Boomer, but there are many boomers with Macular Degeneration, according to my eye doctor, and the research is heating up with the large numbers of people getting it. Thanks again!
No problem, I'm glad it was helpful. I'm 51 so I just make it into the boomers. Reading your message made me think about what the future may hold for me... I have always felt I would do much better with a hearing loss than blindness, but we don't get to choose these things, do we? Good luck and I look forward to hearing your news.
I tried to be aware of how I knit without looking the past few days - I keep my fingertips very close to the needle tips, and use the thumb and index fingers of my left hand to push the next stitch into positon, then stick in the needle and wrap the yarn (I hold the yarn in my left hand). Hope this helps, but I still think some blind knitting friends will be able to help you more!
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Recent News
Jacqueline Vietti named interim president
Dr. Jacqueline Vietti will be the interim president of Emporia State University beginning June 1. The Kansas Board of Regents today appointed Vietti, who has worked in public ...Read More
Regents appoint presidential search committee
The Kansas Board of Regents today appointed the search committee for the next president of Emporia State University and named a search firm. The committee represents Emporia State ...Read More
Emporia State Presidential Search Committee
April 2015
Committee chair
- Andy Tylicki, President of St. James Academy
ESU faculty, staff and administration
- Dr. Cynthia Kane, President of the Faculty and Professor of University Libraries and Archives
- Dr. Sarah Sutton, Assistant Professor in the School of Library and Information Management
- Dr. Sharath Sasidharan, Associate Professor in the School of Business
- Dr. Zeni Colorado, Chair of the Department of Instructional Design and Technology in the Teachers' College
- Dr. Brent Thomas, Dean of the College of Arts and Sciences
- Nikki Metz, Vice President of the Unclassified Commission
- Darcy Johnson, Chair of the University Support Staff Commission
ESU student
- Janet Weaver, Associated Student Government President
ESU alumni and Foundation
- Kim Penner, Board Chair of the ESU Foundation
- Steve Williams, Incoming Board Chair of the ESU Foundation
- Dennis Baker, Alumni Association Executive Committee
- Megan Burgess, Alumni Association
Emporia community
- Rob Gilligan, City Commissioner and Former Mayor
- Jose Feliciano, Jr., Flinthills Mall Merchant Association
Board of Regents
- Zoe Newton, Regent
- Dr. Andy Tompkins & Dr. Blake Flanders, Kansas Board of Regents
Search Firm: AGB Search
- Jim McCormick, Consultant
- Janice Fitzgerald, Consultant
Board of Regents Charge to the Search Committee
- The Committee shall assist and advise the Kansas Board of Regents in the selection of the next President of Emporia State University.
- The Committee shall recommend to the Board in the form of a "Statement of Leadership Characteristics" or "Presidential Profile" the criteria for the position of President of Emporia State University to be approved by the Board by the June 2015 Board meeting. The Board asks the Committee to consider inclusion of strong demonstrated skills in innovation, entrepreneurship, fiscal management, relationship building, creative problem solving, and implementation of a strategic plan.
- Appointees to the Committee will serve without predetermined bias for or against any prospective candidates nominated, referred, or discovered in the search process.
- Committee members will agree to review all candidates without regard to race, religion, creed, or national origin.
- Committee members shall commit to preserve the confidentiality of the search process and candidate identities. Such confidentiality is essential to the successful outcome of the search and must be maintained with professionalism and diligence at all times throughout the search process.
- Appointees will serve with the understanding that the Committee will meet frequently over a period of months and that in-person attendance at scheduled meetings is a top priority.
- The Committee shall work with the advice of a Board retained executive search consultant to search and screen for appropriate candidates. The Committee shall evaluate nominations and applications.
- The Committee will present to the Kansas Board of Regents an unranked list of three to five candidates who are the most qualified for Board selection as the next President of Emporia State University. The Committee will work to advance the final three to five candidates to the Board by November 2015.


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Our work covers custom exhibition stands, events and sets, interiors, graphic design and project management. Strong relationships foster creativity, that is why we really get to know our clients and make sure that our designs will attract the customers they want. We are determined that our work is not only creative and imaginative but also effective and totally tailored to the needs of our clients.
There is no limit to
We aim for the highest standards in our design and construction, in our relationships and in our manner of work which is ethical, honest and environmentally aware. We want to work with people who share our vision and values, who understand what good design can add to a business and whose projects excite us. We are creative, experienced and enthusiastic original thinkers. We work best in a collaborative, open, informal and friendly way. We listen, we learn and we are utterly client focused.
So, if you need a custom exhibition stand, a funky foyer or a great event we can help – just so long as you're looking for unique. We don't do dull. We don't do average.
Ignition provides a highly focused and creative exhibition design service. We work in close partnership with our clients, listen hard and make sure we have a thorough understanding of your business. The result – Ignition produces unique and ingenious designs precisely engineered to our clients' needs. We provide theatricality and practicality. Our designs not only look good but they work hard to add depth and value to brands and businesses.Read More
Ignition works regularly in designing events, we have broad experience ranging from funky festival happenings to slick corporate functions. We understand that event design must pack an efficient punch where design and brand are perfectly integrated for maximum impact.Read More
Ignition designs high-end imaginative corporate and commercial interiors. Our designs help you to stimulate your staff and your business. We create environments which work hard for you; the practical pressures of efficient functioning spaces are fused with a design which will express your brand and impress your customers.Read More
Graphic design is an integral part of our work. At Ignition we believe that all aspects of design must work well together and graphic design should not be an afterthought. We find many of our clients ask us to design and supply supporting marketing material such as printed matter, e-flyers or promotional gifts for pre-show and show activity. We devise made-to-measure campaigns which are creative and inventive and work hard to capture the imagination of our clients and their customers.Read More
Great clients. Great results. Take a look at some of our projects
Custom Exhibition Design Ignition get conceptual for
Ignition deliver's an exhibition stand with a powerful
Ignition produces a powerful exhibition stand design in pure
A sleek and clever corporate event design in Manchester
Ignition creates a low budget, high impact bespoke


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Results 1 to 2 of 2
Thread: Zbrush Deco Trouble
March 5th, 2009 #1
Zbrush Deco Trouble
Recently, I did some deco brush sketching using default and custom alphas. Everything seemed jagged and pixelated but I figured this was some preview mode or something and hoped it will work out when exported. Yet, I was wrong - it turned out even worse.
I tried fiddling with anti-aliasing and render settings, resizing the document, using bigger custom alphas and nothing worked.
Is there any way to work this out?
- Similar Threads
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If this is a wrong thread, I'd appreciate a headup.


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Weird much? (And a little bit on Project E.T.)
by, 26th January 2012 at 10:59 PM (420 Views)
Hello everyone!
Today was a bit weird...that I didn't hear the alarm and woke up at around 8:30am...I was supposed to wake up at 6:10am today!
Someone said that I had turned the alarm off and that it did ring...but I have no recollection of me turning the alarm off. Weird much? Maybe I was sleep-snoozing (trying to get more sleep)...
And something about Project E.T. that has been working in the dark...
Right now, I have 128 Elgyem...Ahhh!!! It's an alien invasion!!! How long is this going to take? I hope I get a Shiny Elgyem egg...or at least get me a shiny when I reach 252 Elgyem...
Thanks for taking your time to read this...
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- Shopping Bag ( 0 items )
Publishers Weekly
Trang, seasoned food writer and author of The Asian Grill, presents an extraordinary array of Asian dishes in her newest book. With a sharp, modern design and a friendly tone, the book helps the reader navigate the world of noodles, starting with their origin (Leijoo, China) and most common pairings (ginger, garlic, soy, scallions, etc.), then delving deep into the many varieties of noodles. No stranger to Asian cuisine, Trang keeps her innovative ideas (such as plum-flavored noodles) from becoming too complicated or obscure, and suggests tips and valuable explanations throughout the book. Each chapter proficiently exhibits one noodle (wheat, egg, buckwheat, rice and cellophane)-plus a chapter on buns, dumplings and spring rolls-and includes a handful of vibrant, original ways to prepare each type. While some recipes, like green tea soba and smoked wild salmon rolls, are bite-size, others, like udon with braised sweet and spicy beef short ribs, are hearty entrees, shining a spotlight on the book's subject. Combining a fun, fresh layout with generally quick and easy-to-prepare dishes, Trang's latest work is sure to find a spot in the kitchens of stylish foodies eager to explore the arguably underdocumented land of noodles. (June)Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.


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The Hot Tub was created by Hot Tug. Six to eight people can comfortably sit.The Hot Tug is
filled 2,000 liters of water and it takes almost three hours to reach desired temperature.
Source: hottug.nl
Have a look! You may also like:
Yin Yang Bathtub
Jewelry Armoire Cheval Mirror
Small Balcony Barbecue for You
La Scala t650 Entertainment Jacuzzi
Cool desk Accessories
20 Beautiful and Creative Bedrooms
Making The Best Use of Broken Pots
Make Cookie Cutters From Soda Cans - DIY


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The Famous Shavian "BOO!"
Jeff Smith 2 p.m., May 21
Volunteers needed to help remove trash and debris from the San Diego River east of Qualcomm Stadium. All tools and supplies are provided. Community service hours can be verified. No sandals or flip-flops allowed. Volunteers will meet in the 24hour fitness parking lot under the trolley stairs. firstname.lastname@example.com or 619-297-7380.
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MINNEAPOLIS - UFC President Dana White said he was willing to pay an
"astronomical amount of money" to bail Jeremy Stephens out of jail in time to
compete at Friday's UFC on FX 5 event.
Stephens read news >>
RIO DE JANEIRO – Dana White won't reveal whether or not he intends to bring current Bellator MMA welterweight champ Ben Askren to the octagon, but after his near-miss with Eddie Alvarez, the UFC boss read news >>
BOSTON – Dana White is no stranger to political battles, but the latest efforts from Boston City Council President Steve Murphy – a man White refers to as a "jackass" – have left the UFC president pa read news >>
SAN JOSE, Calif. – UFC President Dana White said he's spoken with Matt Mitrione, and he's no longer upset at the heavyweight following his unfortunate transphobic remarks. However, Mitrione is still read news >>
If UFC President Dana White has his say, UFC fighters won't be giving interviews other than the weeks leading up to their next bout, and, presumably, right after they step out of the cage, after Matt read news >>
UFC lightweight Jeremy Stephens is in for a long legal battle after being arrested on an outstanding warrant for an assault charge in Des Moines, Iowa from 2011. read news >>
Just hours prior to his UFC on FX 5 collision with Yves Edwards, lightweight Jeremy Stephens was arrested in Minneapolis. However, the development will not prevent "Lil' Heathen" from competing at to read news >>
PITTSBURGH - UFC president Dana White is sticking to his guns.
One day after publicly releasing Nate Marquardt from his UFC contract
following his failure to earn medical clearance from the Penns read news >>
Let's roll back the video tape! With UFC 187 coming to a close late last night (Sat., May 23, 2015), featuring a clash between Anthony Johnson vs. Vitor Belfort for Jon Jones' vacant Light Heavyweigh read news >>
Dana White isn't buying Brendan Schaub's claims that "Big Brown" made over $100,000 in sponsorship money in his previous fights, but would he believe that Donald Cerrone will lose out on close to $60 read news >>
Ultimate Fighting Championship (UFC) heavyweight Brendan Schaub, along with a few other mixed martial arts (MMA) fighters, was less-than-thrilled to learn he was going to have to give up his sponsors read news >>
The UFC president went on Canadian television to defend the promotion's controversial Reebok deal for fighter apparel. Zuffa president Dana White was Michael Landsberg's guest on "Off the Record" air read news >>
UFC president Dana White talks about the need for fighters to change their training methods and the rehab facility the company is building. read news >>
Dana White touches on Luke Rockhold's case for a title shot, Paige VanZant blowing away the doubters, Max Holloway's victory, and more. read news >>


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Visitor tickets and reserved seats for the Boxing Day Test will go on sale on Friday October 11, 2013 at 9.00am.
The MCG will host a Boxing Day Test between Australia and England as part of the 2013/14 cricket schedule.
Further Balcony passes have been released for tonight's Melbourne Victory v Liverpool FC match.
To celebrate Melbourne Rare Book Week, the MCC Library is holding opportunities on July 22 and 23 for the public to view treasures from the Library's rare book collection.
Members are advised that entry tickets and visitor tickets to the Melbourne Victory v Liverpool match on July 24 are unlikely to be on sale at Gate 2 on the night of the match. Any member wishing to purchase tickets to this event should do so as soon as possible to avoid disappointment.


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Manchester United legend Roy Keane is fuming over criticism in Sir Alex Ferguson's controversial autobiography.
A source has indicated that Keano is furious with how Fergie has portrayed him – especially as he feels the successful period of his United career has been glossed over.
The source told the Daily Star Sunday: "The thing Roy finds laughable is that he is painted as an intimidating person. It's as if Ferguson discovers this all of a sudden in 2005 when he is 33 and carrying a hip injury – yet he was the same person all the way through his prime at the club.
"He will choose his moment and say his piece, I'm sure."
For breaking stories and all the great banter like us on Facebook: facebook.com/tribalfootball


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Nothing more than a YouTube browser pointing to the videos I have uploaded… Enjoy… :)
hi whats your favorite house????????
I have to say Storm, by far.
I would say, hmmmm …. ICE
I changed my mine, I would have to say life.
Mine is Fire i'm a adept pyromancer
i play w101 a lot my player name is: Camerondeathbreaker
mine is the ice one i am a lvl 39 theurgist
do we need to defeat the death oni to have the lvl 38 spell of balance (i have a sorcer to)
hi what do yo think is the best school and why?
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Originally written on AllWrestlingNews.com | Last updated 11/19/14
- Taryn Terrell was named "Knockout of the Month" on TNA's brand new Knockouts website. Embedded below is an footage of about Terrell talking about being the first "Knockout of the Month." - Velvet Sky is "Today's Girl" on Maxim.com. You can check out her photo spread at this link. - Mickie James announced that her official album release party will take place on May 7th at Sharky's Bar & Billiards in her hometown of Glen Allen, Virginia. Doors open at 7:30PM, and the show will take place from 8PM – 10:30PM ET. Taryn Terrell Soaks It Up in the Shower
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Hoping that pitchers dramatically improve is simply a recipe for disaster.
Harang, Cueto and Arroyo have been circa 5 ERA pitchers this year. Owings has been just under a 6 ERA pitcher this year. Anyone who expects this to suddenly turn around is just hoping.
One of them may do much better. But another may do much worse. You cannot bank next year on hoped-for turnarounds by so many pitchers.
And the notion that a supposedly "decent" fifth starter is sufficient has been disproven by the Reds time after time because borderline to poor starting pitchers, with a couple of bad breaks, often wind up with ERAs in the 6s and 7s.
More good starting depth. Critical for 2009.


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Former Defense Secretary Robert Gates said Tuesday he considers Edward Snowden, the former intelligence contractor who leaked information about the National Security Agency's secret surveillance programs, a "traitor" who did not work within the carefully constructed system to correct perceived wrongdoing. Continue reading
This week, Jim Lehrer will interview Defense Secretary Robert Gates as he prepares to step down from his administration post and as President Obama prepares to announce the level of troop withdrawals from Afghanistan. Continue reading
Defense Secretary Robert Gates, who is scheduled to retire at the end of June, held a final news conference Thursday. We asked several military analysts to rank his performance as secretary. Continue reading
In our foreign affairs coverage this week, we plan to look at the results of Turkey's elections and what they mean for a constitutional overhaul, and retiring Defense Secretary Robert Gates' tenure. Continue reading
As federal deficits rise, Defense Secretary Robert Gates is looking to cut spending by close to $100 billion in the next five years, a sign that even the Pentagon's massive budget is subject to government-wide belt tightening. He discusses the new budgetary measures, his China trip and "don't ask, don't tell" with Jim Lehrer. Continue reading
In other news Tuesday, Defense Secretary Robert Gates suggested the U.S. would be open to delaying the troop withdrawal from Iraq past the 2011 deadline, but only if Iraqis take that initiative. Continue reading
Defense Secretary Robert Gates on Thursday challenged the notion that the Obama administration is losing control in Afghanistan, despite several recent polls that show flagging public support for the war. Continue reading
Defense Secretary Robert Gates sits down with Judy Woodruff to discuss the insurgency in Iraq, the need for assistance in Afghanistan and shifts in long-term spending priorities. Continue reading
Defense Secretary Robert Gates announced Wednesday that the military has formed a committee to oversee improvements to the Walter Reed Army Medical Center. The co-chairman of the independent review group, Togo West, details the responsibilities of the new committee. Continue reading
Australian prisoner David Hicks faced charges of providing material support for terrorism before a revamped military tribunal system at Guantanamo Bay on Monday. Miami Herald reporter Carol Rosenberg, who was in the courtroom, talks about the case, then analysts Neal Katyal and John Yoo discuss the future of the U.S. base. Continue reading


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Originally written on BlackSportsOnline | Last updated 11/20/14
Wilder is one of the few American Heavyweights that people have high hopes for. He has fought nothing but Tomato Cans, so it is hard to say if he will ever be any good. One thing he needs to do though is stay out of trouble with the law and he had a hard time doing that this weekend in Vegas. The 27-year-old was arrested in Las Vegas on Saturday and is alleged to have attempted to strangle his victim. Wilder was released on a $15,000 bond and appeared in court on Monday. He is due to do so again on July 3. This all happened at a hotel at 7:30am, the morning before the Mayweather fight. Police say a male (Wilder) and female got into an altercation. The woman was taken to the hospital with possible broken nose, swollen lip and eyebrows and strangulation marks on her neck. We will keep you updated as more details are revealed.
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Official GeForce GTX 680 Review and Discussion thread
View Single Post
Join Date: Mar 2004
Posts: 15,486
Re: Official GeForce GTX 680 Review and Discussion thread
Originally Posted by
Driver issue no doubt
I think that's only one piece of the puzzle.
Originally Posted by
Makes sense. Much of Kepler's strength comes from GPU boost. In multi-card configurations, load needs to be balanced correctly or you get stuttering waiting for one card to catch up. Odds are GPU boost doesn't work quite the same in SLI since no two cards will clock the same with power usage.
Another problem with this is that on air, the inside card will be hotter than the outside card, lowering its ability to benefit from GPU boost. So essentially what we are seeing is the "no GPU boost" cards in SLI, compared to the single card.
Looks like good SLI setups will require cards that are water cooled and have comparable OC headroom.
I think a lot of people are missing the fact that at stock speeds, odds are the 680 is equal to or slower than the 7970. The GPU boost is what gives it the single card performance crown.
The cards seem to be a clock race atm. GPU boost is really a
part of the 680's dominance.
Also, it seems likely that Nvidia cherry picked review cards. Kyle at [H] saw his card hit 1300MHz! I'm willing to bet no one sees their card do that. Add to that the fact that many people run poorly ventilated cases.
Don't get me wrong, the 680 is a nice card, but the game this round is different than before. The two architectures are similar now, so for a comparable number of shaders, we are going to start getting into a clock race.
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Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceGeneral Cement Range
Level of DifficultyReally easy
Time to do repair15 - 30 mins
Age of Appliance5 - 10 years
Screw drivers
1 out of 2 people found this instruction helpful
Took the trim out of the box, removed the old trim, cleaned up the "guck" left by the old tenant and then screwed in the new piece. VOILA! A NEW LOOKING OVEN. You didn't ask about dealing with your company. THAT'S THE BEST PART. It took less then 10 minutes to speak to someone knowledgeable, figure out the correct model number, locate the part that I needed and place the order. Here comes the most amazing thing: You are in Canada...I am in Pennsylvania. The part arrived 1 day later!! How did you do that? USPS can't even match that service when mailing to my own city. And this was not a Quirk because about a week later, I ordered another part and IT TOO, ARRIVED IN 1 DAY.You are in my A-List of addresses for anything I need. I can go to you first.Thanks.
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Top 10 Olive Garden Interview Questions and Answers
Question 1 of 10
1. How long do you foresee yourself working at Olive Garden?
Best way to prepare for your Olive Garden interview starts here. Practice 10 Interview Questions.
Next Interview Question
1. How long do you foresee yourself working at Olive Garden?
Top Answer
Well i hope to make my way up in the company so i'm thinking a very long time.
Second Best
I would love to make olive Garden a career because i love being around people and being a people pleaser.
I plan on working at Olive garden for a long time.
I plan to work at olive garden for as long as possible, to help get me through school.
I see myself working here as long as possible. I've been looking for a job for a while now, and this just seems like such a perfect opportunity because it is close to home and I have really been looking to getting a job at a restraunt!
I plan to work here as long as possible to help me get through school.
For a long time.
For a long time. Im a sophomore in highschool so the rest of highschool and into college.
I foresee me making the olive garden a life time career! I hope to exceed to more opportunitys in the future!
For a long time.
Was this question useful?
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2. How many hours do you expect a week?
Top Answer
With also being in school, I would like to work around 20 hours per week.
Second Best
I am expecting at least 20 hours a week, but am very interested in working as many hours as I am allowed.
I would except to work 30 hours or more depending on the restaurants needs.
40 hours all more or when ever i'm needed.
Probably around 20-35.
40 hours.
As many as you can give me.
I expect to work at least 20 hours a week.
I would prefer 40 hours a week and whenever needed.
As many as i can which the company will allow.
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See all Answers
3. How many orders can you memorize at once?
Top Answer
Second Best
5 orders at once.
I always write everything down just so their is no forgetting!
I could probably memorize about 4-5 different orders.
I am not sure because this would be my first job but I have a very good memory so I think id memorize a lot.
When it comes to what people order, I am able to remember a lot of orders for some reason.
About 2 it's best to write it down anyway though.
Eight million.
2,its better to write it down so there is no forgetting.
Quite a few depending how detailed they are such as substitutions.
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See all Answers
4. What are your favorite restaurants?
Top Answer
Olive Garden, Red Lobster.
Second Best
My absoulute Favorate restraunt in Long Horn Steak house and olive garden because of there award winning bread sticks and italian hospitality.
Olive garden, red lobster and buffalo wild wings.
Olive Garden, TGIF, Yard House, the Elephant Bar, Red Lobster.
Olive garden, red lobster and dennys resturant.
why do you want to be a server?
Olive garden.
Olive garden.
I personally enjoy Subway because it right down the street from my house, it is quite convenient when children can choose their own toppings!
I love olive garden,applesbees,ryans
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5. How does Italian food rank to you?
Top Answer
I love Italian food really. So I'll rank it in my top 5
Second Best
I absolutely love italian food. Lasagna, Pasta, Pizza, Garli, I love it all!
I come from an Italian family, so I grew up with Italian food. It reminds me of home and is actually my favourite kind of food. I come to Olive Garden every year on my birthday.
Italian food ranks high in my book. Id say the number one spot because Italian food is more than just the actual tastiness of the food, it is about the experience. When I think of Italian food I think of hospitality. A complete dining experience accompanied by the most delicious foods with the freshest ingredients.
Its A tie for 1 along with Hispanic food. I love them equally, but Italian has that something that just makes you feel full when you smell it, its heavenly taste just envelops your senses an makes you want to indulge in a big bowl of pasta.
It ranks among one of the best types of food with all of its complex flavors.
I come from an italian heritage family so hospitality is number one! Italian food is always the best food because it is homemade,it taste great, and everyone loves Italian!!
Italian food is probably my number one favorite food. I love garli. And italian food has plenty of it.
Italian food happens to be one of my favorite dishes. I often cook an italian dish 3 to 4 times a week.
Italian food is very high up in my appitite i eat a lot of italian food.
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6. Tell me about a time that frustrated you at your last restaurant?
Top Answer
Well its easy to be frustrated about situatioins such as food coming out late,not liking the menu item etc. but you have to stay calm and fix the problem in the best manor possible.
Second Best
I have not worked at a restaurant before.
Ive never worked at a restraunt before, at my previous job ive been frustrated but i never show my frustration, i just overcome it witha smile.
I hardly show my frustration at work because i knew what i was in for from the start.
I have actually never worked in a restaurant before, but I have been a stay at home mom for 13 years, and let me tell you I know frustration of your children not eating their food.
Ive never worked ina restaurant before but on my cheer team this year for school we had a captain who got special treatment and didnt act like a captain but instead of letting it get me down i just moved on and realized there was nothing i could change except for my attitude on the situation.
In one experience we had a dinner rush for about 3 hours of hard pounding crowds no letting up! And I was doing my job as a server but we had a very small family owned restaraunt and we ran out of dishes so I had to manage doing a ton of dishes on top of a dish washer machine breaking and also try and keep up with all my tables and ringing up their bills. It got to a point of frustration but I simply pushed through it and was smiling the entire time.
I try not to show my frustrations at work,I think you should keep them separate so you can focus on your duties.
Well i have never worked at one before this is my first one.
Yes, I have an excellent work ethic and believe if you are not early, you are late.
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7. How do you deal with customer complaints?
Top Answer
You listen to what they have to say, the customer is always right so never lose your cool and always fix the problem to the best of your ability.
Second Best
When a customer complains I do my absolute best to listen attentively to whatever issue they are having in order to solve the problem as quickly and efficiently as possible. I want the customer to feel as though I am there for them and to have an overall wonderful experience.
I firmly believe in the importance of letting the customer be right. In order to build loyalty a company needs to be able to adhere to all customer needs, so i would apologize for any inconveniences and ask what i could do to make it a more pleasant experience
Appologies and understand where they are coming from and ask what what can do to make them feel better. a free meal will do it.
To deal with a customer complaint i would ask the customer what i can do to fix and make the problem better.
Take care of them alone if possible, or get a manager if it is out of my hands.
I apologize and try to fix the problem to the best of my ability. If I can solve the problem I would ask the customer if he/she would like to speak with a manager. Then follow their request.
Be sincere and be calm..... adress the issue directly with the customer about their complaint.
I would listen to their complaint, sincerely apologize for the problem, and tell them that i will fix it right away.
Always stay calm and help them to the very best of your ability.
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8. Why do you want a job at Olive Garden?
Top Answer
I believe that this job will open up many new exciting opportunities for me. It will give me the chance to meet new people and work in a different environment where I can work on my communication and hospitality skills.
Second Best
I want a job at Olive Garden because its a place I enjoy eating at. Therefore, i think it would help for me to give others the great experience of eating here also.
i like working around friendly people and want to work in a more professional place
I would like a job hear because i think it would be the most realistic job for me i will get to interact and make others have an amazing day.
Since my major for college is in sociology it will help me enhance my intepersonal skills and i love working with people.
I am looking for a permanent place to call home in the career category, some place to jump start my career. This is where I plan to hang my retirement hat.
Like i said, it is a comfortable enironment that is warm and cozy. the food is fantastic and the staff has always been great!
It has a great atmosphere here and I enjoying working with people.
I would like to work here at Olive Garden because I love meeting new people and I enjoy interacting with other directly. I also love the idea of always having something to do.
I would love to work and a very professional, classy, and friendly environment where I can interact with people as thy walk in and make them feel welcome.
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9. Are you a reliable person? Explain.
Top Answer
I am a very reliable person, if I tell you that I am going to do something or am asked to do something it is in my personality to follow through to my word.
Second Best
Yes I am I like to have a schedule and be early to everything I have to go to and people are able to rely on me.
Yes, I am a reliable person. I value time so I always make sure I arrive early to work. I would never miss a shift unless I am hospitalized. If I need off I would make sure I have coverage and if I can't find any I would go to work.
I am a reliable person, I am always on time for work and never missed a day. If I need to miss a day is when I have a family emergency. I would find someone to cover my shift.
Yes, I would like to say that I am very reliable. I always believe in doing a job right the first time and I am very persistent. I also would always make sure to be at work on time, stay late if they needed me to, fill in for someone else if I needed to, and make my managers aware well ahead of time if I had a job conflict or could not make it to my shift on a particular day.
Yes i am a reliable person always on call and on time.
Yes always on call and on time.
Yes. I value my work so I always sure I arrive early to work.
Yes i am very reliable, if i were to be scheduled for work or something school related that would always come first before friends or time off.
Yes, because i always focuuse on my job to finish the job a.
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10. Tell me about your last serving position.
Top Answer
Well, it was at a pizza place, usually pretty busy and was a nice place to work, I worked many positions at my last job so I am good at multitasking when needed.
Second Best
This happens to be my first time as a server to be honest but where better to serve great quality italian dishes than olive garden.
Ive never had a serving position.
It was awesome and quite an experience to serve people with delight and pleasure.
My last serving position was at a luncheonette were I waited on five tables at a time. We served breakfast and lunch. It wasn't a high traffic place but it was always packed.
It was awesome and quite an experience to serve with delight and pleasure.
It was quite an experience to serve people with delight and pleasure.
I have never had a serving position but i am looking towards serving.
It was awesome and quite an experince. to serve people with a delight and pleasure.
I served at a small town diner and worked at subway as a sandwich artist. It was a good place to work but not exactly the type of long term position I saw my self in.
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Contact Url
Orange County, FL
Learn more about Olive Garden
Positions at Olive Garden
Olive Garden Server
Olive Garden Dishwasher
Olive Garden Host and Hostess
Olive Garden Pros
Pro #1:
The pros of me working at olive garden would be that i would be in a proffessional work enviroment around lots of friendly people.
Mar 1, 2012
Pro #2:
The pros for working at Olive Garden is you realy get to interact and make peoples day
Mar 9, 2012
Pro #3:
You're surrounded by a great atmosphere as well as great food
Mar 15, 2012
Pro #4:
I love the food, so that is a great benefit. Not only that, I love talking with people and meeting new people, and being a server will definitely allow me to do that.
Mar 15, 2012
Pro #5:
It can help me learn more about myself. For example, I'm not sure about what career I want to go into or what major I want so I thought I have to start somewhere so why not start at olive garden!
Sep 7, 2012
Pro #6:
It seems like a really fun environment and i would love to be around the food all day.
Sep 21, 2012
Pro #7:
I would say working for Olive Garden would have so many positive pieces to it. First off the food is very quality based and family oriented. The environment is comfortable to a family of ten or a couple of two, children are also very welcome there. So getting to be able to work with a diverse group of individuals and experiences would keep my job there very interesting.
Oct 30, 2012
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Olive Garden Reviews
Anonymous Review
Nov 20, 2014
Job Duties
To serve tables and to make the guest experience a good one.
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Anonymous Review
Oct 13, 2014
Job Duties
I was a server which means I greeted and served tables, got refills and anything they needed as well as picking up after others when needed. I also bartended and did togo which is similar.
At Olive Garden I talked to many people, it helped me stay positive through everything, and I had a lot of people coming back just for me.
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Anonymous Review
Oct 2, 2014
Why you left
I am looking for a chance to move into a more professional field of customer service.
Job Duties
I was responsible for my guests from the moment they were seated until they left the front door. I was their connection to the restaurant, their guide for the menu, the one who made sure they were never thirsty and never without something they needed. while food may not be as critical as large sums of cash, a hungry person may beg to differ. I provide the fastest most efficient service possible to 3 groups of guests at a time.
I have worked in customer service for more than 5 years now, my time at olive garden has shown me many more aspects to providing a great customer experience. My goal is to delight customers with good service though all interactions.
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Anonymous Review
Aug 21, 2014
Job Duties
I was expected to answer the phone to take orders, put away dishes, greet and seat customers with a smile, and keep the front area clean.
I have great customer service skills from practicing at different jobs and I am always up beat and positive.
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1910 E98 'Set of 30' Baseball Near Set (27/30) - #1 on the PSA Set Registry!...
2012 August 2 Vintage Sports Collectibles Platinum Night Signature Auction- Baltimore #7057
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B & O Warehouse, 6th Floor
Camden Yard Banquet Room
333 West Camden Street
Baltimore, MD 21201
|Printable auction results for all items in the 2012 August 2 Vintage Sports Collectibles Platinum Night Signature Auction- Baltimore.
The Best of the Black Swamp Find!1910 E98 'Set of 30' Baseball Near Set (27/30) - #1 on the PSA Set Registry! Just weeks ago, the most significant trading card find in hobby history emerged from a small Ohio town, neat individual player stacks of untouched cards, each banded by a short length of twine tied by a print shop employee a full century ago. Discovered in an attic in a box long forgotten beneath an ancient dollhouse, these stunningly pristine relics from the Dead Ball Era make their hobby debut in this Platinum Night auction, providing the Heritage clientele with an opportunity outpacing even the most fanciful dreams of the pre-war trading card collector. Named for the damp landscape on the edge of Defiance, Ohio, where the cards served their one hundred years of solitude, the Black Swamp Find turns the PSA population chart on its head like never before.
Of the thirty players from the E98 series, the collection offered twenty-five players in two color variations, and a trio represented by a single background. Only two players are not represented. The roster includes the greatest of the game including Ty Cobb, Honus Wagner, Chief Bender, Christy Mathewson, Connie Mack, Frank Chance, Hughie Jennings, Johnny Evers, Roger Bresnahan, Cy Young plus others. Ironically, the unknowns have proven to be harder to find than the greats. Player after player, card after card, each is a precious relic that takes you back in time. Currently, the finest E98 set known on any registry has an impressive GPA equal to 5.75. Factoring the lone qualified card as a "4," this presentation earns an unheard of GPA of 7.75! It would be so easy to go on but we will allow the next thousand words to be the image presented to your right. Every card has been graded by PSA. All but three equal or stand alone as the finest copies in existence.
Includes: Graded - PSA Gem MT 10: 2 cards, Johnny Kling, (Pop One of One!) and Chief Meyers (Pop One of Two!); PSA Mint 9: 11 cards, Chief Bender (Pop Three, None Higher!), Hal Chase (Pop One-of-One, None Higher!), Fred Clarke, Ty Cobb, Johnny Evers (Pop One-of-One, None Higher!), Russ Ford (Pop One-of-One, None Higher!), Connie Mack (Pop One-of-two, None Higher!), Larry McLean (Pop Three, None Higher!), Fred Tenny (Pop Two, None Higher!), Hippo Vaughn (Pop One-of-One, None Higher!) and Hans Wagner/Green (Pop Five, None Higher!); PSA NM-MT+ 8.5: 2 cards, Eddie Collins (Pop One-of-One, None Higher!) and Harry Davis (Pop One-of-One, None Higher!); PSA NM-MT 8: 7 cards, Roger Bresnahan (Pop two, None Higher!), Miner Brown (Pop One-of-One, None Higher!), Frank Chance (None Higher), Jack Coombs (None Higher), John McGraw (Pop Four, None Higher!), George Mullin (Pop Six, None Higher) and Cy Young Pop Eight, None Higher!); PSA NM 7: 2 cards, Al Bridwell and Red Dooin; PSA EX-MT 6 (MC): 1 card, Christy Mathewson (Highest numerical grade); PSA Good 2: 1 card, Joe Tinker; PSA Fair 1.5: 1 card, Hughie Jennings. Aside from the Gem MT Honus Wagner, which is being offered elsewhere in this auction, this presentation represents the finest examples pulled from the finest collection of any type of vintage baseball cards ever found! If the Gem MT Wagner goes to another, the winner of this near set will surely be satisfied with a "brand new" Mint 9 example to add to his collection.
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He'll get the bastion booger treatment & for good reason. I see him as a total fail. I dont want to see guys with bigger tiits than my girls in the ring & niether should the rest of you. In no way is he fast or agile. Just another big fat ass.
I'd rather have nothing than have a lie.


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The metal quality is excellent and hopefully it will slide right into its spot.