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The present invention is directed toward methods and systems for providing advanced features to a telecommunication device. The systems and methods determine a hierarchical relationship of participants of a conference call and when one participant is communicating with another participant, the parties are made aware of their hierarchical relationship relative to each other.
1. A method of enhancing a conference call, comprising:
(a) connecting first and second telecommunication devices to create a live conference call, the first and second telecommunication devices being associated, respectively, with first and second participants;
(b) determining characteristics of each of the first and second participants;
(c) creating a hierarchal structure of the first and second participants based upon their respective determined characteristics, wherein the first participant has a first hierarchical ranking and the second participant a second hierarchical ranking, and wherein the hierarchical structure indicates the relative values of the first and second hierarchical rankings; and
(d) during the live conference call, providing the hierarchical structure to at least the second participant.
2. The method of
3. The method of
4. The method of
5. The method of
6. The method of
(e) during the live conference call, simultaneously providing the hierarchical structure to the first participant.
7. The method of
(d1) during the live conference call, displaying a first hierarchical structure to the first participant; and
(d2) during the live conference call, displaying a second hierarchical structure to the second participant, wherein the first and second hierarchical structures are different.
8. A computer readable medium comprising processor executable instructions to perform the steps of
9. A communication device, comprising:
(a) an interface for sending across and receiving voice data from a communications network;
(b) a memory coupled to the interface operable to store information relating to characteristics of participants of a conference call; and
(c) a contact organizer operable to process the information relating to characteristics of the participants of the conference call such that a hierarchical relationship is created between each of the participants of the conference call based upon the characteristics of each of the participants, the hierarchal structure indicating the relative rankings of each of the conference call participants and wherein the relative rankings are indicated using an indicator other than the titles of the conference call participants.
10. The device of
11. The device of
12. The device of
13. The device of
14. The device of
15. The device of
16. The device of
17. A communications network, comprising:
(a) network means for connecting first and second telecommunication devices to create a live conference call, the first and second telecommunication devices being associated, respectively, with first and second participants; and
(b) contact organizer means for:
(b1) determining characteristics of each of the first and second participants;
(b2) creating a hierarchal structure of the first and second participants based upon their determined characteristics, wherein the first participant has a first hierarchical ranking and the second participant a second hierarchical ranking, and wherein the hierarchical structure indicates the relative values of the first and second hierarchical rankings; and
(b3) during the live conference call, providing the hierarchical structure to at least the second participant.
18. The network of
19. The network of
20. The network of
The invention relates generally to providing advanced features for a phone. Specifically, embodiments of the present invention allow a participant of a call to know who is talking to them and what is the speaker's hierarchical relationship relative to the participant's hierarchical position.
Communication networks, such as the Public Switched Telephone Network (PSTN), for transporting electrical representations of audible sounds from one location to another are well known. Additionally, packet switched networks, such as the Internet, are able to perform a similar function by transporting packets containing data that represents audible sounds from one location to another. The audible sounds are encoded into digital data and placed into packets at the origination point and transmitted across the packet switched network. At the destination point, the digital data is extracted from the packets and decoded into audible sounds.
In a communication network, it is desirable to provide conference arrangements whereby many participants can be bridged together on a conference call. A conference bridge is a device or system that allows several connection endpoints to be connected together to establish a communications conference. Modern conference bridges can accommodate both voice and video data, thereby allowing, for example, collaboration on documents by conference participants.
In a conference call, the audible sounds received at a device, usually a telephone, are distributed to all of the other devices participating in the conference call. Thus, each participant in the conference call may share information with all of the other participants.
Unfortunately, during a conference call, it may be difficult for a participant to determine who is speaking unless he/she is familiar with the voices of all other participants. Furthermore, the "rank" of the person speaking may be even more difficult to establish unless a listener knows all positions held by all of the other participants.
There have been attempts to correct the problem of identifying speakers during a conference call. For example, in U.S. Pat. No. 6,853,716 to Shaffer et al., which is herein incorporated by this reference, a system and method are described that identifies a speaking participant during a conference call by analyzing his/her voice characteristics. Once the speaking participant is identified, his/her information is determined and displayed to all other participants of the conference call who are receiving the voice signal. This is particularly useful when more than one participant is using one endpoint (telephone). However, this architecture fails to provide the relative rankings of the various participants on an absolute basis. Although titles of each participant are displayed, the meaning of the title is often unknown to the other participants. For example, different cultures use different titles for the same position or the same titles for different positions.
In very formal societies like Japan and Korea, it is necessary to know the rank of a person before addressing him/her as a different form of formal address is used depending upon the rank and possibly age of the person. Even in English speaking countries the knowledge of another person's rank can be important as very distinct persons are addressed formally. Addressing someone before his/her ranking is known may lead to an unintentional insult of the person being addressed.
Furthermore, the importance of a directive/information is often related to the rank of the person delivering the directive/information. In military applications, where rank is of the utmost importance, an order given by a general needs to be addressed differently than an order given by a corporal. Like most business entities, the military is driven by the chain of command. Other participants of the conference need to know exactly who gave the order and what his/her ranking is relative to them. Particularly because an individual ranking just under the general, say a colonel or major, will need to pass the order received from the general down to lower ranking subordinates. Other generals that are participating on the conference may not need to pass the order on to their subordinates. Likewise, an order given by a sergeant is typically not directed toward individuals ranking higher than the sergeant. Without knowing the hierarchical position of the speaker, listeners may not now how to handle certain instructions.
The present invention is directed generally to an architecture for providing hierarchical information to conference call participants during the course of a conference call. The hierarchical information indicates the relative positions of authority of each of the participants.
In a first embodiment of the present invention, a method is provided that includes the steps of:
(a) connecting first and second telecommunication devices to create a live conference call, the first and second telecommunication devices being associated, respectively, with first and second participants;
(b) determining characteristics of each of the first and second participants;
(c) creating a hierarchal structure of the first and second participants based upon their respective determined characteristics; and
(d) during the live conference call, providing the hierarchical structure to one or both of participants.
The hierarchical structure can include an indicator of the relative positions of authority of each participant. Suitable indicators include a hierarchical ranking, a rank value, a hierarchical chart showing differing levels or relative positions of authority, and the like. For example, if the first participant has a first hierarchical ranking and the second participant a second lower hierarchical ranking, the hierarchical structure indicates the relative values of the first and second hierarchical rankings.
The hierarchical structure can take many forms. If a large display is present, the entire organizational hierarchy of each of the participants can be displayed. The hierarchy includes not only the participant but also the participant's superiors and, in some cases, peers and inferiors. In this configuration, the conference participant is highlighted or otherwise indicated to the other participants. The structure can include the whole hierarchy of only the participants, regardless of their respective organizations. In this structure, non-participants are generally not included. The currently speaking participant is highlighted or otherwise indicated to the other (non-speaking) participants. If only a small display is available, the structure may include only an indication of the rank of each participant or, in very small displays, only the current speaker. In any of the above, display configurations, the display can take many forms, such as a tree-structure, disconnected or interconnected bubbles, list, and the like. A visual indicator can change color depending on the rank of each participant. If no display is available, the rank can be automatically "whispered" (or provided to one or more participants in a side tone or channel). Each participant can receive the hierarchical structure of the other participant but not his or her own.
The characteristics may include a variety of information including participant identity, title, age, sex, ethnicity, country of citizenship, country of residence, electronic address, company of employment, role within a project, employment status, and the like. This information can come from many sources including an HR database from a company facilitating the conference call, a switch/server that is currently handling the speaking participant's communication line, a database from a company who has participants in the conference call, a global database, a database from a personal computer, an email account database, and/or an LDAP directory or similar source of hierarchical information.
In one configuration, the hierarchical structure includes first and second hierarchical ranking values. The indicator is thus different from a corresponding title of each of the participants. The structure may include, however, a variety of information, such as the identity and job title of each of the first and second participants. The reporting hierarchy of the person may also be displayed.
In one configuration, the hierarchical structure includes a recommendation on the proper way to address the first participant.
The hierarchical structure may indicate when the first participant is speaking and when the first participant is not speaking.
The hierarchical structures provided to each of the participants may be different. For example, the structures may be participant-configurable.
The present invention can provide advantages over the prior art. For example, it assists conference participants in addressing other participants properly and in evaluating the importance of directives or other information spoken by each participant. The display of all of the participants can be generated automatically and be limited to only the participants or the whole organization. Such options can be configurable by each participant.
As used herein, "at least one", "one or more", and "and/or" are open-ended expressions that are both conjunctive and disjunctive in operation. For example, each of the expressions "at least one of A, B and C", "at least one of A, B, or C", "one or more of A, B, and C", "one or more of A, B, or C" and "A, B, and/or C" means A alone, B alone, C alone, A and B together, A and C together, B and C together, or A, B and C together.
The invention will be illustrated below in conjunction with an exemplary communication system. Although well suited for use with, e.g., a system having a conference bridge or other similar conferencing hardware, the invention is not limited for use with any particular type of communication system or configuration of system elements. Specifically, embodiments of the present invention may be suitable for use with video calls and/or in a videoconferencing environment. Those skilled in the art will recognize that the disclosed techniques may be used in any communication application in which it is desirable to determine and display the hierarchical relationship of participants of a conference call.
As used herein a "conference call" is a communication between two or more individuals. Although most conference calls take place between three or more participants, unique aspects of the present invention may be utilized in a point-to-point communication as well as communications between many participants.
Referring initially to
The communications network 104 can be any data and/or distributed processing network, such as a PSTN, the Internet, or an enterprise network. The network 104 typically includes proxies (not shown), registrars (not shown), and routers (not shown) for managing packet flows in the case of a packet-switched network.
The switch/server 116 is part of an enterprise network that includes the telecommunication device 118. The term "switch" or "server" as used herein should be understood to include a PBX, an ACD, an enterprise switch, an enterprise server, Interactive Voice Response (IVR) server, or other type of telecommunications system switch or server, as well as other types of processor-based communication control devices such as media servers, computers, adjuncts, etc. The telecommunication device 118 is "internal" in that it is directly supported as a telecommunication endpoint by the switch/server 116. The telecommunication device 118 is an example of a device more generally referred to herein as an "internal endpoint" that is used by a subscriber to the enterprise network of which the switch/server 116 is a part.
The database 120 is a device that is operable to store information about various potential participants of a conference call. If the database 120 is located in an enterprise network, then typically information for each employee of the enterprise may be stored in the database 120 (e.g., name, title, extension, voice characteristics, and the like.) The database 120 may also contain global information for potential participants of a conference call. For example, participants of a future conference call may load their identification information into the database 120 prior to participating in the conference call. Alternatively, such information can be obtained from a presence server affiliated with each participant. This way the required hierarchical information can be determined for each participant during the conference call. The database 120 may also be a nationwide directory that can be accessed when a conference call is initiated. As can be appreciated the database 120 may be integral to the switch/server 116 or may be separated therefrom, as depicted. The database 120 may also be a representation of multiple databases. For example, Company A may allow Company B to read from its database for purposes of displaying hierarchical information during calls. Especially if the conference call is being bridged by Company B and/or participants from Companies A and B are present.
The telecommunication devices 108 and 118 generally comprise a memory 124, a user input 128, an output device 132, a processor 136, and an optional contact organizer 140. A telecommunication device 108 and 116 may also include a communication interface (not shown) that is adapted to send information to and receive information from the communication network 104. A suitable communication interface includes a network interface card, a modem, a transceiver, or any other type of device for sending information to and receiving information from the communications network 104. Unlike the telecommunication device 118, the telecommunication devices 108 are referred to as "external" in that they are not directly supported as telecommunication device endpoints by the switch/server 116 and may be used by subscribers or non-subscribers to the enterprise network. The telecommunication devices 108 are an example of devices more generally referred to herein as "external endpoints." As will be appreciated, any of the components of the telecommunication devices, such as the contact organizer 140, may be included in the switch/server 116 rather than in the internal endpoints to the switch/server 116.
The memory 124 includes logical instructions for the processor 136 to perform as well as memory storage buffers. The memory 124 may be any type of memory including Random Access Memory (RAM), Read Only Memory (ROM), Dynamic RAM (DRAM), Flash Memory, Electronically Programmable ROM (EPROM), and the like. Information relating to the conference call may be forwarded to the telecommunication device 132 and stored in the memory 124. The information stored may simply list the participants of the conference call or may be a more complete list outlining each participant, his/her title, and relative ranking compared to other participants. The processor 136, using routines stored in the memory 124, operates, at least in part, to generate output based on data received from the communications network 104 and/or prepare signals received by the user input 128 for transmission across the communications network 104. The processor 136 may be a Reduced Instruction Set Computer (RISC), a Complex Instruction Set Computer (CISC), an Application Specific Integrated Circuit (ASIC), or other type of processing equipment.
The contact organizer 140 may be in the form of logical instructions stored in the memory 124 or may be a separate processor as depicted. The contact organizer 140 is operable to receive data relating to participants of a conference call and, based on that information, organize a hierarchical structure of all participants. The contact organizer 140 is further operable to determine a hierarchical ranking of a speaker during the conference call and relay that information to the user of the telecommunication device 108 through the output device 132.
The user input 128 is typically a signal-receiving unit like a voice transducer or microphone. The user input 128 may also be a touchtone keypad, touch screen, mouse, or other types of user input devices.
The output device 132 is operable to convert the data representing audible sounds into a format intelligible to a user of the telecommunication device 108. The output device 108 may also comprise a visual display as an output device 132 that shows a user the hierarchical ranking of a person who is currently speaking. The output device 132 may be in the form of a speaker, a Liquid Crystal Display (LCD) screen, a set of Light Emitting Diodes (LEDs), a single LED, an up arrow and/or down arrow, a Cathode Ray Tube (CRT) display, or other type of mechanism able to articulate information to a user of the telecommunication device 108.
The telecommunication devices 108 may be packet-switched in a packet-switched network and can include, for example, IP hardphones such as Avaya Inc.'s 4600 Series IP Phones™, IP softphones such as Avaya Inc.'s IP Softphone™, Personal Digital Assistants or PDAs, Personal Computers or PCs, laptops, packet-based H.320 video phones and conferencing units, packet-based voice messaging and Interactive Voice Response (IVRs), and packet-based traditional computer telephony adjuncts.
The telecommunication devices 108 may also be circuit-switched in a circuit-switched network. Circuit-switched telecommunication devices 108 can include, for example, wired and wireless telephones, PDAs, H.320 videophones and conferencing units, voice messaging and response units, and traditional computer telephony adjuncts.
In operation, the telecommunication device 108 receives data representing audible sound from the communications network 104 and messages containing at least identification information and possibly hierarchical ranking information associated with the received sound data. In particular embodiments, the processor 136 may have to associate packets of received sound data with packets of received identification and/or hierarchical information using, for example, time stamps. Upon receiving the sound data, the processor 136 performs any necessary processing on the data, such as, format conversion and/or decoding, and conveys the data to the output device 132. The output device 132 generates signals, audible, visual, or combinations thereof that are intelligible to a user of the telecommunication device 108 and processes the identification and/or hierarchical information in a similar manner.
The telecommunication devices are further operable to send data representing audible sounds to other participants of the conference call. The user input 128 detects the audible sounds emitted by the participant and converts them into electrical signals that can be processed by the processor 136. The processor 136 then performs any necessary processing on the data, such as, format conversion and/or encoding, and forwards the signal on to the communications network 104 for transmission to all other participants of the conference call.
The communications network 104 is in communication with the external telecommunication devices 108 either directly or via routing devices (not shown). The telecommunication devices 108 and 118 are an example of devices more generally referred to herein as "endpoints."
Users of the external and internal endpoints may wish to communicate with one another across the communication network 104. In the event that a simple point-to-point connection is desired, the two subject endpoints are directly connected by hardware within the communications network 104 and a single communication path is established. However, when several users of the external endpoints wish to conference with each other simultaneously, the conference bridge 112 is typically employed. The conference bridge 112 connects each channel from each endpoint participating in the conference call such that every participant of the conference call can hear what any one of the other participants is saying at a given time. This is accomplished by a number of mechanisms. One such mechanism is the received signals from every endpoint are summed together into a single outgoing signal for each participant. Each participant's received signal is never added to (or subtracted from) the summed signal from the summed signal that a given participant will receive. Specifically, if three parties A, B, and C are joined in a conference call, the signals from parties A and B are summed and sent to party C, the signals from parties A and C are summed and sent to party B, and the signals from parties B and C are summed and sent to party A. This is typically accomplished by having each channel of the conference bridge 112 have its own mixer (summation point).
Another way this is accomplished is that the conference bridge 112 may include software and/or hardware that can determine what parties are speaking and automatically sends that signal to all other participants of the conference call. The determination can be made for instance by voice recognition software, channel activity detection, or the like. This requires a little more processing power in the conference bridge 112 and is typically used less frequently for this reason.
It should be emphasized that the configuration of the switch, server, user telecommunication devices, and other elements as shown in
Referring now to
Once the processor 216 has received the sound data from a channel it used the codec 224 to decode and format the sound data such that it can be processed by other components in the conference bridge 112. The processor 216 then uses functions stored on the memory 208 to determine what person is associated with the sound data. The processor 216 may include a digital signal processor (DSP) if digital signals are being utilized. Voice identification may be used to determine who is talking or the channel used by the endpoint to connect with the conference bridge 112 may identify the person. Participant identification information, possibly including hierarchical ranking information, may be stored and retrieved from the database 120 as noted above, or the information may be stored on the memory 208 upon initialization of the conference call. The processor 216 accesses the identification information and possibly the hierarchical ranking information, wherever it resides, and associates it with the sound data that it has just received. The processor 216 then sends the sound data to the mixer 220 to be summed with all other sound data. The summed signal is then forwarded to the codec 224 to be encoded, if necessary, and formatted for transmission across the communications network 104. The properly formatted summed signal, along with identification and/or hierarchical ranking information, is sent to the communication interface 204 where it is transmitted to each participant on their own channel.
Referring now to
Referring now to
Equal, higher, and lower displays can be presented to participants in numerous ways. For example, once the conference bridge 112 has prepared the hierarchical structure 400, the hierarchical structure 400 may be forwarded to each participant's telecommunication device 108 and stored in memory 124. The hierarchical structure 400 may be continuously displayed on the output device 132. Each participant's respective position on the hierarchical structure can be highlighted during the conference. For example, Participant C's display would have the second level 408 highlighted. Then when another person speaks, the level where the speaking participant is assigned may also be highlighted, thus indicating the hierarchical relationship of the speaker to the signal recipient. In other words, if Participant A, B, or C is speaking, then the first level 404 would be highlighted for all of the participants, whereas if Participant D is speaking, then the third level 412 would be highlighted. An "equal" display under such a configuration might result in a change in the type of highlighting. For instance, Participant A's display may continuously have the first level 404 highlighted in yellow, then if Participant B or C speaks, the first level 404 becomes highlighted in orange. The shading of the highlight may also change. As can be appreciated, arrows or other types of indications may be used to display to the users what ranking a speaker has in relation to them. For example, a first arrow may indicate to a user where he/she is located in the hierarchical structure 400, and a second different type of arrow may indicate to a user where a speaker is located in the hierarchical structure 400.
Displaying the entire hierarchical structure 400 to a participant is only possible for telecommunication devices 108 with output devices 132 that can display such a structure. Specifically, if a telecommunication device 108 includes an LED as its only form of visual display or has no visual display at all, then other hierarchical display methods should be employed. For example, an LED that can light up different colors may be used to indicate a hierarchical relationship. An equal display may correspond to the LED lighting up yellow, a higher display may correspond to the LED lighting up red, and a lower display may correspond to the LED lighting up green. Of course multiple LEDs may be used, where each one illuminated based upon different hierarchical relationships between the speaker and listener.
Alternatively, a single LED can be blinked at a particular rate depending upon the hierarchical position of the speaker related to the listener. For example, if one participant is listening to another participant who has a higher ranking than him/herself, then an LED on the listening participant's telecommunication device 108 may blink quickly. Whereas, if a participant is listening to a participant with a lower rank than him/herself, then the LED on the listening participant's telecommunication device 108 may blink very slowly. If a participant is listening to another participant with a substantially equal rank to him/herself, then the LED may not blink at all.
In the event that no visual displays are available, the hierarchical ranking information may be relayed to a listener by a series of beeps prior to, or while, listening to a person speak. A single beep may indicate that the speaker is a higher-ranking participant, two beeps may indicate that the speaker is an equal ranking participant, and three beeps may indicate that the speaker is a lower ranking participant. Another possible configuration can send a voice signal to the receiving party while another participant is speaking. The voice signal may literally indicate whether the speaker has a higher, lower, or equal ranking in the hierarchical structure 400.
In one configuration, the display is augmented by recommendations regarding how to address each of the other speakers. The recommendations are frequently dependent on cultural etiquette. For example, while no distinction is normally made when addressing a CFO versus an employee who is not a corporate officer, such distinctions are common in most cultures. The recommendations state how and by whom each conference participant is to be addressed for cultural etiquette to be followed. It can be important not only to use the proper expression to address certain participants but also to have the proper person (typically a person of similar or higher rank) in each affiliated set of participants to address another higher or lower ranking participant in another affiliated set of participants.
For example, in Japan, honorific titles are usually used after a person's name. One such honorific title is San. San is the most common honorific title and is used when addressing most social outsiders, for example, non-family or business members. Another honorific title used in Japanese culture is Kun. Kun is an informal and intimated honorific used primarily to address males. It is also used by superiors in addressing inferiors, by males of roughly the same age and status in addressing each other, and in addressing male children. Additionally, young women may be addressed as kun by older male superiors in a business setting. If a person having a first hierarchical position on a conference call with Japanese participants is listening to a person having a second lower hierarchical position, the display on the first person's telecommunication device might include the recommendation to address the speaker as kun, if such an honorific title is suitable.
Another type of honorific title used in Japanese culture is Sensei. Sensei is typically used to refer to or address teachers, practitioners of a profession such as doctors and lawyers, politicians, and other authority figures. If a Japanese doctor is a participant in a conference then when the doctor speaks, all other participant's telecommunication devices may display the speaker's name, title, and suggested ways of addressing him/her.
Still another honorific title used in Japan is Sama, which is the formal version of san. Sama is primarily used to address persons of much higher rank than oneself. In commercial and business settings, Sama is used to address and refer to customers. In this context, one speaker may be a customer of another participant on a conference call. When the customer is speaking, the customer's name, along with the recommended honorific title of Sama, may be displayed to any participants who have this person as a customer.
Of course there are many other cultures that use different titles and phrases to address people of different and the same hierarchical ranking. The recommendations displayed on a particular communication device may be based on the participants of a given teleconference or it may be based on where the conference is taking place. The recommendations may also be based on the current speaker's culture. For example, one type of recommendation may be displayed for a Japanese speaker having a higher hierarchical ranking, while another type of recommendation may be displayed for a Korean speaker having a hierarchical ranking similar to the Japanese speaker.
The recommendations may be displayed to all or only a subset of participants adjacent to each participant's name in the hierarchical chart. By way of example, the recommendations pertaining to one set of participants may be displayed only to a selected set of unaffiliated participants.
In one configuration, non-participants may be included in the hierarchical chart to show the peers or superiors of each participant. For example, if the President of Company A is on the conference call, the identity of the nonparticipating CFO of Company A may also be shown at a higher ranking level. The CFO would be shown in a font type or color indicating that he or she is not currently a participant on the conference call. A participant may find such information useful. The display of such information may be an option configurable by each participant. Thus, the displays of the various participants may include different information.
Participants of a conference are allowed to join and leave the conference call as they wish. As such, the hierarchical structure 400 may be dynamically updated as participants enter and leave the conference call. The updating of the hierarchical structure may occur when the presence of a new participant is detected, or the conference bridge 112 may periodically determine if the hierarchical structure 400 needs to be updated.
As can be appreciated, the hierarchical structure 400 may be maintained at the conference bridge 112. The conference bridge 112 may reference the hierarchical structure 400 every time a new voice signal is detected to determine the hierarchical ranking of the speaker related to all other participants. The conference bridge 112 may forward the hierarchical relationship on to each participant's endpoint, along with the corresponding voice signal, for the telecommunication device 108 to display to the user.
In an alternative configuration, the conference bridge 112 may create the hierarchical structure 400 and forward that information on to each participant during the conference call initialization. In this configuration, the conference bridge 112 may make the determination of who is speaking and forward that information on to the telecommunication device 108. The telecommunication device 108 may use the hierarchical structure 400 that it received at the outset of the conference call to make a determination of the hierarchical relationship between the speaker and the listener.
In still a further configuration, the telecommunication device may make the determination of who is speaking and may also determine the hierarchical relationship of the speaker to the listener. As can be appreciated, a number of other possible configurations exist that are within the scope of the present invention.
Referring now to
In step 504, the process begins then a conference call is initiated in step 508. A conference call is initiated when one endpoint directly dials another endpoint or a number of endpoints each connect to a conference bridge 112. During the conference call initialization, the conference bridge 112 references each participant's relevant information from the database 120. Once each participant's information is determined, the hierarchical structure 400 is determined and the ranking order of each participant is determined in step 512.
In step 516, the conference bridge 112 waits until it detects sound data. If it does not detect any sound, then it continues to wait until one of the participants begins to speak. Once the conference bridge 112 detects sound data, the conference bridge processes the sound data in step 520. The step of processing the sound data may include formatting the data to be sent to other recipients of the conference and may also include a voice signal recognition program, or other type of call identification routine.
In step 524, the sender of the sound data is determined. The sender may be identified by voice recognition or channel association. Once the sender has been identified, the conference bridge 112 determines what participants will receive the sound data in step 528. Typically, every participant of a conference call receives every signal received at the conference bridge 112. However, the conference bridge 112 may send the sound data to a select subset of the participants.
For the first identified recipient, the conference bridge 112 compares the hierarchical position of the sender with the hierarchical position of a first receiver by using the hierarchical structure 400 in step 532. At a minimum the conference bridge 112 determines whether the sender is in a higher, lower, or equal hierarchical position to that of the receiver. The conference bridge 112 may also determine to what degree the hierarchical relationship differs between the sender and the receiver. For example, the difference between the sender's hierarchical level and the receiver's hierarchical level may also be a part of the hierarchical relationship.
In step 536, the hierarchical relationship information is forwarded to the recipient's telecommunication device 108. In step 540, the sound data is also sent to the recipient's telecommunication device 108. The hierarchical relationship information may be sent in the same signal as the sound data or may be sent in a different signal. Further, the sound data may be sent on one channel and the hierarchical information sent via another. In step 544, the hierarchical relationship along with the sound data is displayed to the user of the telecommunication device 108 in an intelligible manner. As described above, there are several ways that the configuration data may be displayed to the user of the telecommunication device.
In step 548, it is determined if additional recipients exist for the received sound data. The sound data and hierarchical data may be sent to all participants in the same set of steps, however, some participants may be using different telecommunication device 108, which are enabled with different features. Thus, the sound and hierarchical data signals would have to be processed differently by the conference bridge 112 prior to sending them to the users. If there are additional recipients, then the conference bridge 112 determines what participants remain and determines what format data must be sent to them in. If there are no additional recipients, then the process returns to step 516 to wait for more sound data.
Referring now to
In step 604, the process begins, and then in step 608 the telecommunication device 108 joins the conference call. The telecommunication device 108 may join the conference call by connecting directly to the conference bridge 112 through an outbound call or may receive a call from a participant already connected to the conference bridge 112.
In step 612, the telecommunication device 108 receives hierarchical data related to all participants of the conference call. The hierarchical data may be sent directly from the conference bridge 112 or may be sent from the switch/server 116. The hierarchical data may be in a form of the hierarchical structure 400 or may simply be a listing of participant names and their relative ranking. The telecommunication device 108 stores the hierarchical data in its memory 124 in step 616. By maintaining the hierarchical data at the telecommunication device 108, the conference bridge 112 will not have to send hierarchical data across the communications network 104 every time a new speaker is identified. Rather, the conference bridge 112 will only need to determine who is talking and send that information across the communications network 104. In another configuration, the conference bridge 112 may just send the sound data without making any determination about the sender's identity.
Of course the switch/server 116 does not necessarily have to send the hierarchical data to the telecommunication device 108 at the onset of the conference. The switch/server 116 may also send the hierarchical information, sometimes in the form of the hierarchical structure 400, to the telecommunication device 108 every time a different person speaks. The hierarchical information as it relates to the speaker may be sent to each telecommunication device 108 when that person is speaking. Then when that person is no longer speaking, the telecommunication device 108 can purge that hierarchical information and wait for new information related to a different speaker.
Once the telecommunication device 108 has the hierarchical information stored in its memory, it waits for incoming sound data in step 620. Once the telecommunication device 108 receives the sound data, it determines who the sender of the sound data was (e.g., who is speaking) in step 624. The telecommunication device 108 may have this information sent to it from the conference bridge 112 or the switch/server 116. However, the telecommunication device 108 may also identify the speaker.
In step 628, the telecommunication device 108 accesses the hierarchical data in memory 124 to determine the hierarchical relationship of the sender compared to the receiver. If the telecommunication device 108 is associated with more than one user, the determination of a hierarchical relationship may be made between the highest ranking user of that endpoint and sender, the lowest ranking user of that endpoint and the sender, or other variations thereof.
In step 632, the telecommunication device 108 displays the hierarchical relationship to the user along with the sound data. As noted above, the display of the hierarchical information depends upon the type of output device 132 the telecommunication device 108 has.
In step 636, the telecommunication device 108 determines if the conference call has ended. If the call has not ended, the process returns to step 620 and the telecommunication device 108 continues to wait for additional sound data. However, if the conference call has ended (e.g., the device has been disconnected from the conference bridge 112), the telecommunication device 108 clears the hierarchical data from its memory 124 in order to conserve memory space for later use. Then the process ends in step 644.
The present invention, in various embodiments, includes components, methods, processes, systems and/or apparatus substantially as depicted and described herein, including various embodiments, sub combinations, and subsets thereof. Those of skill in the art will understand how to make and use the present invention after understanding the present disclosure. The present invention, in various embodiments, includes providing devices and processes in the absence of items not depicted and/or described herein or in various embodiments hereof, including in the absence of such items as may have been used in previous devices or processes, e.g., for improving performance, achieving ease and\or reducing cost of implementation.
The foregoing discussion of the invention has been presented for purposes of illustration and description. The foregoing is not intended to limit the invention to the form or forms disclosed herein. In the foregoing Detailed Description for example, various features of the invention are grouped together in one or more embodiments for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed invention requires more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive aspects lie in less than all features of a single foregoing disclosed embodiment. Thus, the following claims are hereby incorporated into this Detailed Description, with each claim standing on its own as a separate preferred embodiment of the invention.
Moreover though the description of the invention has included description of one or more embodiments and certain variations and modifications, other variations and modifications are within the scope of the invention, e.g., as may be within the skill and knowledge of those in the art, after understanding the present disclosure. It is intended to obtain rights which include alternative embodiments to the extent permitted, including alternate, interchangeable and/or equivalent structures, functions, ranges or steps to those claimed, whether or not such alternate, interchangeable and/or equivalent structures, functions, ranges or steps are disclosed herein, and without intending to publicly dedicate any patentable subject matter.
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Rome, Italy
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Driver was punctual arriving ahead of schedule. A trouble-free journey to the airport. Worth the effort for peace of mind.
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subset: commoncrawl


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Mon-Fri: 7am-1am EST / Sat-Sun: 7am-11pm EST
ApplianceKitchenAid Dishwasher
Level of DifficultyReally easy
Time to do repairLess than 15 mins
Age of ApplianceMore than 10 years
0 out of 1 people found this instruction helpful
Removed the screw holding the arm to the feed line, removed the arm assembly along with the water feed line and line bracket. Replaced all parts - no problems.
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Part Number: PS382824
All brand logos are trademarks of their respective owners.
The PartSelect logo is a Registered Trademark of Atlantic Laundry Centres, Ltd.
Copyright © 1999-2015 , Eldis Group Partnership. All rights reserved.


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Does WiFi scare you?
Parents from across Alberta will decide next month if they feel schools should put new restrictions on wireless networks to protect children's health.
How Toronto-based Nymi wants to replace passwords with heart rate authenticationWhether it's logging into a work computer, bank account or even something as simple as unlocking a smartphone, passwords are a necessary and often highly frustrating complication of everyday life. Toronto-based Nymi, formerly known as Bionym, wants to simplify the password-entering
Sony closing Music Unlimited, forges partnership with SpotifyOn Wednesday Sony revealed plans to launch a new Spotify-powered music streaming service on the PlayStation 3, PlayStation 4, and on Xperia smartphones and tablets. The new streaming music platform – called PlayStation Music – will require a paid Spotify premium membership
Apple Watch will start shipping in April, says Tim CookAdam Satariano Apple Watch is coming in April. Apple Chief Executive Officer Tim Cook said on a conference call that the much-anticipated wearable gadget will be shipped starting that month. The company hadn't previously announced what specific month the watch
New Snapchat Discover feature delivers news, entertainment content with 'gorgeous advertising'Snapchat's new Discover feature is set to allow users to see content posted by brands like ESPN, CNN, Vice and Warner Music, moving the disposable image-sharing platform in a new advertising-focused direction. According to a recent blog post on the
Pirate Bay torrent sharing website may be returning Feb. 1The popular torrent indexing website, The Pirate Bay, could be returning on Feb. 1, after going offline roughly a month ago following a police raid on the website's servers in Sweden. Cryptic messages, such as a skull and crossbones and
Logitech Type+ and Keys-To-Go review: Typing with your iPad just got easierSo you got a new iPad for Christmas – lucky you. But now you think that it'd be a good thing to have a keyboard other than the one on the iPad screen. The screen version works perfectly well, but
Nexus 6 review: Is Google's big, pricey smartphone worth buying?Google's Nexus 6 smartphone is gigantic. It's bigger than the iPhone 6 Plus' 5.5-inch screen and the Galaxy Tab's 5.6-inch display, measuring in at an astounding 5.96 inches. Make no mistake, the Nexus 6 is for people who don't mind looking a
Rogers and Shaw sign deal to stream original Amazon video content to shomiRogers Communications Inc. and Shaw Communications Inc. announced on Thursday that the two companies have signed a deal to stream Amazon.com Inc.'s original TV content via their jointly-owned streaming platform, Shomi. The deal includes shows like "Transparent," which won two
Bell Media says it would love to have a CraveTV app but Apple hasn't allowed itMichael Oliveira TORONTO — Read through the tweets posted by CraveTV and Shomi and you'll see suggestions that users might finally get Apple TV apps to access the Canadian streaming services. If it was up to Bell Media, CraveTV would've
UBC Sailbot Team Ready to Take on the Atlantic Ocean (with video)Gillian Shaw A team of engineering and computer science students at the University of B.C. hope the robotic sailboat they plan to launch off the coast of Newfoundland this summer will be the first to cross the Atlantic Ocean completely
Six major takeaways from Microsoft's Windows 10 announcementOn Wednesday during Microsoft's Windows 10 press conference, the company revealed a barrage of new information about its upcoming products and software. Whether it's the company's new VR headset, HoloLens, or Windows 10's "unified apps" strategy, lead by Microsoft's popular Office
Tech Toys: Giroptic, the world's first 360° cameraVancouver Sun Digital Life writer, Gillian Shaw, takes a look at the world's first 360° camera from Giroptic. It's rugged and waterproof, shoots 30 frames per second, and has three microphones for surround sound. Videos can also be live streamed via
Windows 10 launch: Android apps could be coming to Microsoft's mobile devicesMicrosoft Corp. is speculated to be bringing Android apps to Windows mobile platforms when it launches Windows 10 on Wednesday, according to ZDNet, effectively closing the app gap between Android/iOS and Windows devices. As of September 2014, Microsoft has over
Dr. Dre Studio Wireless headphones review: As good as you'll ever hearOne of the most watched TV commercials over this Christmas season has been the Beats by Dr. Dre Studio Wireless headphones one with the kid grooving along until Scrooge asks him what he's wearing. At the end Scrooge says "I


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January 1, 2010
A More Perfect Union
The experts weigh in on how to help adopters find a suitable bunny companion for their pet rabbit.
January 1, 2010
Humane Law Forum: Discrimination at the Adoption Counter
An attorney who specializes in animal law tackles the issue of discrimination, explaining how to make sure your adoption decisions don't leave your organization vulnerable to legal threats.
November 1, 2009
Creating Pro-Kitty Cities
Using new thoughtful and unique adoption campaigns, two shelters try to draw attention to and increase adoptions of their feline residents.
November 1, 2009
The Catnip Conundrum
While the subject of catnip has provoked the occasional heated discussion on shelter listservs over the years, the experts interviewed for this story agreed that, for the majority of cats, there's nothing to ponder: Life is much more interesting with catnip.
November 1, 2009
At Their Service ... with a Smile
As the massive Shelter Pet Project campaign reaches out to communities nationwide, the potential for increased adoptions is huge. Many people will attempt to adopt a pet for the first time, and their experiences have the potential to impact shelters for years to come.
September 1, 2009
Out of the Mall, Into the Shelter
Autumn is in the air, and with it, some fall-themed adoption ideas.
September 1, 2009
Shelter Medicine: For the Long Haul
All shelters, regardless of the length of time they're able to hold animals, should strive for high-quality care. But it's doubly important in facilities where animals will be held for weeks or even months. Veterinarian Lila Miller outlines steps to keep longtimers healthy and happy.
September 1, 2009
Coffee Break: Most Creative, Funny, or Effective Adoption Promotion
In your space, you told us about the most creative, funny, or effective adoption promotion your organization has ever done.
September 1, 2009
Don't Forget About Us
Shelter staffs use special events, savvy marketing, and social networking to promote small-animal adoption.
July 1, 2009
For the Comfort of Canines
A new DVD shows and tells shelters how to keep their dogs comfortable, healthy, and stimulated'with an eye toward encouraging the positive behaviors the dogs will need to be accepted in their new families.


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Note to self:
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The Pre-Banned Version
Joined: Apr 2007
Location: socorro NM 505-five five zero-2583
Oddometer: 3,419
Fuel tanks caps
do not
have dipsticks on them
Some times hydraulic tanks do
We were trying to get to a pallet out of the back of one of our buildings (had to completely empty a row to get to the back) and there wasn't enough room on the dock for all the pallets so we had them strung out in the parking lot. The forklift was out of fuel so I sent Mr M to go get some fuel, when he go back he started dumping the fuel into the forklift. I happened to walk outside and noticed that he was on the wrong side of the forklift!!! (the fuel tank is on the other side he was dumping fuel into the hydraulic tank) After asking why he didn't read the labels on the tanks he mentioned that he had never seen a dipstick on a fuel tank before and thought it was strange. We called the service center and they told us not to run the forklift with fuel in the hydraulic oil it was going to be the next day before we could get the tank drained so we had to drive another forklift from our other site 15 miles away
you actually expect people to take responsibility for their actions in today's society?!
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Aethlon Medical Announces Data Supported Strategy to Increase Hepatitis-C (HCV) Cure Rates
(Photo: http://www.newscom.com/cgi-bin/prnh/20090325/LA88762-a)
(Logo: http://www.newscom.com/cgi-bin/prnh/20090325/LA88762LOGO-b)
Aethlon disclosed that data resulting from over 20 HCV treatments indicates an average viral load reduction of 41% during each four-hour Hemopurifier(R) treatment. In the studies, average pre-treatment viral load of 22,868,000 HCV virus copies/ml blood (cpm) was reduced on average by 9,300,000 cpm during the course of each treatment. Based on this data, Aethlon predicts that short-term continuous Hemopurifier(R) treatment can reduce viral load to low to undetectable levels, thus improving the likelihood that HCV patients achieve a sustained virological response (SVR) from the current interferon-ribavirin standard of care and other candidate therapies. HCV infection is considered cured when SVR extends beyond six months. At present, less than 50% of HCV patients respond to interferon-ribavirin therapy. Additionally, there is a direct correlation between low viral load at onset of interferon-ribavirin therapy and increased cure rates. Based on data analyzed from each four-hour Hemopurifier(R) treatment, Aethlon projects that a patient with a high viral load of 7 million iu/ml would be reduced to undetectable HCV levels after approximately three days of continuous Hemopurifier(R) treatment. This corresponds to a 4.06 log reduction or an 11,000-fold decrease in viral load. An HCV patient with a moderate viral load of 2 million iu/ml would be projected to reach undetectable levels in approximately 2.5 days of continuous treatment. All of the studies were conducted in highly health compromised HCV infected patients who suffer from end-stage renal disease (ESRD) requiring regular kidney dialysis treatment. In these treatment studies, the Hemopurifier(R) inhibited the progression of HCV infection in ESRD patients when included during dialysis treatment administered thrice weekly for four-hours. The studies were conducted at the Fortis Hospital in
About Hepatitis-C Virus
HCV is a leading cause of chronic liver disease and liver transplants. The World Health Organization (WHO) estimates that nearly 180 million people worldwide, or approximately 3% of the world's population, are infected with HCV. 130 million of these individuals are chronic HCV carriers who are at increased risk of developing liver cirrhosis or liver cancer, approximately 15 million of whom are in
About Aethlon Medical
Aethlon Medical creates diagnostic and therapeutic filtration devices to improve the health of individuals afflicted with infectious disease and cancer. Aethlon's lead product, the Hemopurifier(R), is a first-in-class artificial adjunct to the immune system proven to capture infectious viruses and immunosuppressive particles from the human circulatory system. The device targets to inhibit disease progression of Hepatitis-C Virus (HCV) and Human Immunodeficiency Virus (HIV), and serves as a broad-spectrum treatment countermeasure against bioterror and emerging pandemic threats. The Hemopurifier(R) also holds promise in cancer care, as research studies verify the Hemopurifier(R) effectively captures immunosuppressive exosomes that are secreted by tumors to kill-off immune cells. At present, over sixty-five (65) Hemopurifier(R) treatments (representing approximately 260 hours of treatment time) have been conducted in multi-site studies at the Apollo Hospital, Fortis Hospital, and Sigma New-Life Hospital in
Research studies have also demonstrated the Hemopurifier(R) is effective in capturing a broad-spectrum of viruses untreatable with drug therapy, including several of world's deadliest bioterror and pandemic threats. These include: Dengue hemorrhagic fever (DHF), Ebola hemorrhagic fever (EHF), Lassa hemorrhagic fever (LHF), H5N1 avian influenza (Bird Flu), the reconstructed 1918 influenza virus (r1918), West Nile virus (WNV), and Vaccinia and Monkeypox (MPV), which both serve as models for human smallpox infection. The studies were conducted with the assistance of researchers representing: The U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID); The Centers for Disease Control and Prevention (CDC); The National Institute of Virology (NIV); The Battelle Biomedical Research Center (BBRC); and The Southwest Foundation for Biomedical Research (SFBR).
Beyond therapeutic market opportunities, Aethlon is leveraging principles underlying the Hemopurifier(R) technology platform to establish a pipeline of clinical and research diagnostic products and services. Additional information regarding Aethlon Medical can be accessed online at www.aethlonmedical.com.
Certain of the statements herein may be forward-looking and involve risks and uncertainties. Such forward-looking statements involve assumptions, known and unknown risks, uncertainties and other factors which may cause the actual results, performance or achievements of Aethlon Medical, Inc. to be materially different from any future results, performance, or achievements expressed or implied by the forward-looking statements. Such potential risks and uncertainties include, without limitation, the capability of the Hemopurifier(R) to reduce viral loads and other disease conditions, the Company's ability to raise capital when needed, the Company's ability to complete the development of its planned products, the ability of the Company to obtain FDA and other regulatory approvals permitting the sale of its products, the Company's ability to manufacture its products and provide its services, the impact of government regulations, patent protection on the Company's proprietary technology, product liability exposure, uncertainty of market acceptance, competition, technological change, and other risk factors. In such instances, actual results could differ materially as a result of a variety of factors, including the risks associated with the effect of changing economic conditions and other risk factors detailed in the Company's Securities and Exchange Commission filings.
SOURCE Aethlon Medical, Inc.


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Adolescent idiopathic scoliosis (AIS) is the most common pediatric spinal deformity, affecting 1% to 3% of adolescents. (1) This disease, of unknown etiology, occurs in otherwise healthy children with the onset of and highly correlated with, the adolescent growth spurt. The vertebrae become misaligned such that the spine deviates from the midline laterally and becomes rotated axially. Deviation can occur anteriorly (a lordotic deviation) or posteriorly (a kyphotic deviation). Although AIS affects females and males in a nearly 1:1 ratio, progression to severe deformity occurs more often in females. Because the disease can have rapid onset and produce considerable morbidity, school screenings have been recommended. However, screening remains somewhat controversial, with conflicting guidelines supporting this practice or alternatively suggesting insufficient evidence for this.
Diagnosis is established by radiologic observation in adolescents (age 10 years until the age of skeletal maturity) of a lateral spine curvature of 10 degrees or more as measured using the Cobb angle. (2) The Cobb angle is defined as the angulation measured between the maximally tilted proximal and distal vertebrae of the curve. Curvature is considered mild (less than 25º), moderate (25º to 40º), or severe (more than 40º) in an individual still growing. Once diagnosed, patients must be monitored over several years, usually with serial radiographs for curve progression. If the curve progresses, spinal bracing is the generally accepted first-line treatment. If the curve progresses in spite of bracing, spinal fusion may be recommended.
Curve progression has been linked to a number of factors, including sex, curve magnitude, patient age, and skeletal maturity. Risk tables have been published by Lonstein and Carlson (3) and Peterson and Nachemson (4) to help in triage and treatment decision making about patients with AIS. Tan et al. (5) have recently compared a broad array of factors and concluded that using 30 degrees as an endpoint, initial Cobb angle magnitude produces the best prediction of progression outcome.
The familial nature of this disease was noted as early as 1968. (6) About one quarter of patients report a positive family history of disease, and twin studies have consistently supported shared genetic factors. (1) Genome-wide linkage studies have reported multiple chromosomal regions of interest, often not replicated. Ogilvie has recently suggested AIS is a complex polygenic trait. (7) He and colleagues at Axial Diagnostics have published a study evaluating an algorithm using 53 SNP (single nucleotide polymorphisms) markers identified from unpublished genome-wide association studies (GWAS) to identify patients unlikely to exhibit severe progression in curvature versus those at considerable risk for severe progression. The clinical validity of this assay has recently been reported in a retrospective case control cohort study using this algorithm. (2)
The ScoliScore™ AIS prognostic DNA-based test (Axial Biotech, Salt Lake City, UT) is a saliva-based genetic test designed to predict the risk of progression of scoliosis in patients with AIS. The test uses an algorithm incorporating results of testing for 53 SNPs, along with the patient's presenting spinal curve (Cobb angle) to generate a risk score (ranging from 1 to 200), which can be used qualitatively or quantitatively to predict the likelihood of spinal curve progression. The test is intended for white (Caucasian) patients with a primary diagnosis of AIS between the ages of 9 and 13 years-old with a mild scoliotic curve (defined as <25º).
Regulatory Status
The ScoliScore™ AIS prognostic DNA-based test has not been approved or cleared by the U.S Food and Drug Administration (FDA) but is being offered as a laboratory-developed test. The laboratory performing this test is accredited by the Centers for Medicare and Medicaid (CMS) under the Clinical Laboratory Improvement Amendments of 1988 (CLIA).
The FDA has indicated an interest in changing its policy for use of enforcement discretion in the oversight of laboratory-developed tests, but the status of this proposed change in policy and the impact of any particular laboratory-developed test are currently unknown.
Blue Cross Blue Shield of Montana (BCBSMT) considers DNA-based prognostic testing for adolescent idiopathic scoliosis experimental, investigational and unproven.
Federal Mandate
Federal mandate prohibits denial of any drug, device, or biological product fully approved by the FDA as investigational for the Federal Employee Program (FEP). In these instances coverage of these FDA-approved technologies are reviewed on the basis of medical necessity alone. Call the BCBSMT FEP Customer Service Department at 1-800-634-3569 for benefit information.
Rationale for Benefit Administration
This medical policy was developed through consideration of peer reviewed medical literature, FDA approval status, accepted standards of medical practice in Montana, Technology Evaluation Center evaluations, and the concept of medical necessity. BCBSMT reserves the right to make exceptions to policy that benefit the member when advances in technology or new medical information become available.
The purpose of medical policy is to guide coverage decisions and is not intended to influence treatment decisions. Providers are expected to make treatment decisions based on their medical judgment. BCBSMT recognizes the rapidly changing nature of technological development and welcomes provider feedback on all medical policies.
When using this policy to determine whether a service, supply or device will be covered, please note that member contract language will take precedence over medical policy when there is a conflict.
Validation of genotyping to improve treatment outcomes is a multistep process. In general, important steps in the validation process address the following:
Literature Review
Analytical validity: There are no published reports on analytical performance of this test. It is offered by a CLIA-accredited laboratory and requirements for analytical performance and quality control are components of this process.
Clinical validity: Ward et al. (2) have recently described a company-sponsored clinical validation study of a DNA-based prognostic test to predict spinal curve progression in adolescent idiopathic scoliosis (AIS). This test involves use of a proprietary algorithm to integrate information from 53 single nucleotide polymorphisms (SNPs) identified as exhibiting an association with AIS in a case-controlled genome-wide association studies (GWAS) study of 2,750 patients. The GWAS was used to develop a 1 to 200 scoring system. A cut-point of 40 or less was selected during the GWAS to identify patients at low risk (less than 1%) of developing severe curvatures requiring surgical intervention. Following generation of data, an analysis of patients with scores of 190 or greater was performed to determine risk for developing severe curves.
Clinical validation of this test (2) was performed in a retrospective analysis of cases preselected by curvature severity (mild, moderate, or severe) and assigned into 3 cohorts identified as: 1) a screening cohort of white females; 2) a spinal surgery practice cohort of white females; and 3) a male cohort. Inclusion/exclusion criteria were cited as being used, but not explicitly provided, although a component of cohort development was matching of prevalence of disease by severity according to that expected from review of the literature or survey of clinical practices. There is minimal information provided about the demographics of patients assigned to each cohort.
Assignment of curvature severity was performed using expert opinion of a single orthopedic spine surgeon and was supplemented by external blinded review of the spinal surgery practice patients using an outside panel of 3 independent scoliosis experts.
The screening cohort was composed of patients (n=176) recruited to ensure 85% exhibited mild or improved curves, 12% moderate curve progression, and 3% severe curve progression. Using a risk score cut-off of 41 or less, the predictive value of a negative test (defined as identification of patients without severe curve progression) was 100% (95% confidence intervals [CI]: 98.6 to100%). No analysis was performed to demonstrate whether this was a statistically significant improvement in prediction of negatives, given the low initial prevalence of patients expected to exhibit severe progression.
The spine surgery practice cohort was composed of patients (n=133) recruited to ensure 68% exhibited mild or improved curves, 21% moderate curve progression, and 11% severe curve progression. Using the risk score cut-off of 41 or less, the predictive value of a negative test (defined as identification of patients without severe curve progression) was 99% (95% CI: 95.4 to 99.6%). No analysis was performed to demonstrate whether this was a statistically significant improvement in prediction of negatives.
In the male cohort (n=163), the prevalence of patients with progression to severe curvature is 11% before testing. The negative predictive value after testing was 97% (95% CI: 93.3 to 99%).
Although there is a description of positive predictive value in patients exhibiting high risk score values, recruitment of patients into this category appears to be derived from patients pooled from different and undescribed sources making interpretation difficult.
A subsequent GWAS evaluating 327,000 SNPs in 419 families with AIS (8) failed to duplicate the associations reported in the study by Ward et al (2).
Clinical utility: No studies have been performed examining the impact of testing on health care outcomes.
Current practice includes careful follow-up of patients. Those with progressive disease are frequently treated with bracing, or in severe cases, with surgical intervention. Careful follow-up and treatment of patients with scoliosis would be expected to have an impact on the gold standard endpoint being used to evaluate this test in this study—severe curvature. Test-induced changes in outcome will provide insight into the clinical utility of the test. Because treatment outcome is used as the endpoint of interest in characterizing the test, changes in outcome may also produce changes in the test's clinical validity.
Idiopathic adolescent scoliosis is a disease of unknown etiology that causes mild to severe spinal deformity in approximately 1 to 3% of adolescents. While there is controversy about the value of both screening and treatment, patients once diagnosed are frequently closely followed. In cases with significant progression of curvature, both medical (bracing) and surgical (spinal fusion) interventions are considered. Classification tables for likelihood of progressive disease have been constructed to assist in managing patients, but these have not proven to be highly reliable and the impact of their use on outcomes is unknown.
Investigators affiliated with Axial Biotec have recently reported on use of a test based on an algorithm incorporating results of 53 SNPs along with the Cobb angle to predict progression of scoliosis. Preliminary clinical validity results for the ScoliScore™ AIS prognostic DNA-based test are available, indicating a high negative predictive value and an uncertain positive predictive value. A single study has been published reporting a high negative predictive value in ruling out the possibility of progression to severe curvature, in a population with a low baseline likelihood of progression. It is not clear if the increase in certainty provided by testing is statistically or clinically meaningful. Furthermore, a similar recently published GWAS study has failed to identify overlapping SNPs for identification of disease progression (prognosis).
The clinical utility of the test remains unknown. There is no direct evidence demonstrating that use of this test results in changes in management that improve outcomes. The value of early identification and intervention(s) for individuals at risk for progression of disease is unclear. As a result, DNA-based testing for AIS is considered experimental, investigational and unproven until results of further research on both clinical validity and utility have been reported.
Disclaimer for coding information on Medical Policies
Procedure and diagnosis codes on Medical Policy documents are included only as a general reference tool for each policy. They may not be all-inclusive.
The presence or absence of procedure, service, supply, device or diagnosis codes in a Medical Policy document has no relevance for determination of benefit coverage for members or reimbursement for providers. Only the written coverage position in a medical policy should be used for such determinations.
Benefit coverage determinations based on written Medical Policy coverage positions must include review of the member's benefit contract or Summary Plan Description (SPD) for defined coverage vs. non-coverage, benefit exclusions, and benefit limitations such as dollar or duration caps.
Experimental, investigational and unproven for all codes
Experimental, investigational and unproven for all codes. M41.122-M41.129


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All Sorts of Weird Stuff offers news and information about George R.R. Martin, in particular about his A Song of Ice and Fire series.
"When I was young, I read all sorts of stuff. One week it would be Lovecraft, the next Vance. It was all imaginative literature, or as my dad called it 'Weird Stuff.' It was all 'Weird Stuff.'"
George R.R. Martin
New to the series? Read our spoiler-free review of A Game of Thrones.
Read our Privacy Policy.
Thanks to Bleeding Cool, we've learned that Avatar Press executive Jim Kuhoric spoke at a panel at C2E2 about various Avatar Press projects, and in the course of it he discussed some of what's coming from George R.R. Martin. First and foremost, of course, is the comic book adaptation of GRRM's World Fantasy Award-winning novella The Skin Trade, to go along with their earlier adaptation of Fevre Dream. Thanks to that, Kuhoric revealed that GRRM will be at San Diego's Comic-Con (which GRRM has previously announced), where he'll make an appearance at Avatar's booth and sign books.
The most intersting item, however, was Kuhoric revealing that there's a "George R.R. Martin original" in the works, which "may" be superhero related. Kuhoric suggests this is a departure, as previously the works they've published have simply been adaptations. They'll reveal more later, but what I suspect this is is a brand new Wild Cards original comic book story, which will almost certainly be scripted by someone other than GRRM (possibly Daniel Abraham, responsible for the adaptation of Fevre Dream and the Dynamic Entertainment comic Wild Cards: Hard Call?).
To see Kuhoric's sremarks, watch below beginning at the 2:50 mark:
For those who drop by Georgerrmartin.com—Martin's official site on the web—will have discovered that it has now gotten something of a facelift. It contains all the great features—the essays, the photos, the miniatures, and more—that make it stand out as uniquely Martin's personal site, but it's been given a much more modern design.
You know, we knew about plans for this for… well, a long while, we won't mention how long exactly. ;) But glad to see it's finally come to fruition.
You've asked for it, and now it's here. The A World of Ice and Fire app—a handy, dandy, official and art-filled guide to the novels that Linda and I helped provide the majority of the content of (with oversight from GRRM)—is now available for Android at Google Play (unfortunately, for the time being, it's US only).
There's a deal of new content along with this version of the app, content that will be included in the iOs app when it gets its next iTunes update. These include:
Over at "Not a Blog", George R.R. Martin reveals that the success of the 2013 A Song of Ice and Fire Calendar, and the very promising work in Gary Gianni's 2014 A Song of Ice and Fire Calendar (Pre-order) , has led Bantam to contract the amazing Donato Giancola to illustrate a 2015 A Song of Ice and Fire Calendar. One of the foremost artists working in SF/F, he has won multiple Chesley and Hugo Awards for his artwork.
We've always hoped Donato would illustrate characters and scenes from the novels in a more substantial body of work than he has previously—his Melisandre painting (Melisandre painting for the cover of Dragon Magazine2 #307 has been his lone piece of ASoIaF art for far too long. Finally, that's being rectified. We've been fans of his work since his gorgeous "Joan of Arc" painting was used for the cover of Mary Gentle's Ash: A Secret History (a fantasy series we very much recommend to fans of ASoIaF, by the way).
For those who may have thought a $50 cover price was a bit steep for The World of Ice and Fire—the book we've co-written with George R.R. Martin—it looks like Amazon.com has received some corrected information: it's now priced at $40, which is presently discounted down to under $28 presently (Preorder).
For that matter, the book appears to have picked up a new subtitle: "The Official History of Westeros and The World of A Game of Thrones". This is actually news to us, since those are decisions outside of our purview.
By the by, speaking of Amazon, they're now shipping the Game of Thrones Complete Second Season Bluray and DVD sets (Order: US Bluray, US DVD) , with the Bluray down to $29.99—more than 50% off the retail price! If you've missed it, I've written up a review discussing some of its features. I even came across a fourth dragon's egg since that review, featuring a Littlefinger and Varys scene that fans will doubtless enjoy.
We've noted this previously, but a new article in Texas A&M's The Eagle provides some amazing insight into the forthcoming Deeper than Swords exhibition at the Cushing Library, focused entirely on A Song of Ice and Fire and the many things that have been born from it. George R.R. Martin was invited to have his life's work archived at the library back in 1993, in recognition of his contributions to science fiction and fantasy fiction and television, and has been a "dream donor" ever since.
Among the holdings in their archives:
''More than 900 of the author's books line the wall. The shelves are filled with Martin's collaborative work, books he has edited, articles about him, manuscripts and correspondence.
"Intermingled with the paper products are VHS mastertapes, tickets from the Emmy Awards, boxes of trading cards, HBO tchotchkes given to actors, board games and programs for conventions where fans congregate to play board games. Nestled with the loot are life-sized replicas of Ned Stark's greatsword and Robert Baratheon's warhammer."
Concerning the event itself, here's what The Eagle has to say:
"The library's exhibit, "Deeper than Swords," will run from March 22 through December and is free to the public. An exhibit and author signing will last from 4 p.m. to 6 p.m. March 22 at Cushing Library. Tickets for a priority signing line are sold out, but a limited number of first-come, first-serve fans will be granted an audience. Food vendors offering medieval treats will be located outside the library, along with actors from the The Texas Renaissance Festival, who will host games to win tickets to the fall event.
"At 6:30 p.m. Martin will give a lecture and answer questions at Rudder Auditorium. More than 1,100 of the 2,400 seats are taken, and reservations can be made for the free event at the MSC Box Office."
(Many thanks to Olaf Keith for pointing this article out.)
This is pretty cool: George R.R. Martin has signed an overall deal with HBO, according to Deadline's Neelie Andreeva.
What does that mean? Per the article:
... has signed a two-year overall deal with the pay cable network.
Under the pact, Martin will continue as co-executive producer on Game Of Thrones, whose Season 3 premieres March 31. Additionally, he will develop and produce new series projects for the network.
We've just received word that Random House's A Game of Thrones comic book adaptation, written by Daniel Abraham> and drawn by artist Tommy F. Patterson, is now available through an app at the US iTunes Store. A faithful adaptation of the books, fans of the TV show will find scenes that never made it to the television series, while fans of the novels will get to see the world and characters visualized with George R.R. Martin's input.
The app costs $3.99, but includes the first issue of the series for free. To learn more, check out our interview with writer (and author) Daniel Abraham shortly after the project was announced.
Over at "Not a Blog", George R.R. Martin discusses various calendars, including Marc Simonetti's 2013 A Song of Ice and Fire Calendar, 2012 A Song of Ice and Fire Calendar artist's John Picacio's own calendar, and the Literary Pin-up Calendar featuring literary characters from a number of fantasy novels, including ASoIaF.
And then, the real treat: the first look at the cover of the 2014 A Song of Ice and Fire Calendar (Pre-order: Amazon US) with art by the award-winning Gary Gianni. Depicted on that cover is a scene from a later novel in the series, and we'll just leave it at that for those spoiler averse… but see below for what we think it is. As GRRM notes, it won't be available until July of next year, but we're eagerly anticipating this. Gianni's a fantastic artist, and if something of its style seems just a littlest bit familiar, bear in mind that Gianni drew the Prince Valiant comic strip for eight years. Some of the armor designs and poses very much evoke Hal Foster's great medieval adventure series.
Just in time for the holidays, the folks over at award-winning RPG publisher Green Ronin have announced a "Winter is Coming" sale featuring some great deals involving the Song of Ice and Fire Roleplay rule book and campaign guide (with their amazing covers by Michael Komarck) and various ancillary books, such as the narrator's kit.
Also, if you missed it, The Night's Watch is on a special pre-order deal for its PDF, with $5 off—and that one features another nice cover. We haven't seen much more than the preview ourselves, but it looks like another well put together supplement from Green Ronin.
Nice. Cyanide has released a brand new DLC for the Game of Thrones RPG (X-Box, PC). Not just featuring new items, weapons, and armor, this DLC actually adds two hours of content to the game in the form of a quest that goes "Beyond the Wall".
It's presently available for the X-Box and PCs (I'm guessing this doesn't mean it's available on Steam yet). A few screenshots can be found here.
Although the game may not have been an unabashed critical hit, one thing worth noting is that just about everyone who's ever played it seems very impressed with the story and its ability to capture the tone and themes of Martin's A Song of Ice and Fire series. From the look of these screenshots for the new DLC, it looks like they may be adding a deal more depth to Mors Westford's already-complicated history. Should be worth checking out.
For our third and final preview image from the Lands of Ice and Fire poster map collection (Pre-order: Amazon US, Amazon UK), we've placed over on our official Google+ page a glimpse of a slice of Essos never before seen, nor ever even hinted at in the novels:
I know enough about the new lands that Martin created in the course of making these expanded maps to say that the choice of this area for this image was very deliberate on my part. There's a couple of neat things hinted at herein that expand the world-building for Essos quite a bit. But as to what that is… well, maybe The World of Ice and Fire will reveal more, or perhaps GRRM will in some interview or Q&A down the road. We shall see!
The Lands of Ice and Fire is due out at the end of the month in the US, and soon after in the UK.
UPDATE: Io9 also has a preview with a number of small slices. A bit more of Braavos, a glimpse at Asshai and the Shadow, and a snippet of the journey map that Linda and I helped with are among the items. And Tor.com has a few more.
Following up from last week's first preview of The Lands of Ice and Fire, the collection of a dozen poster maps featuring all-new maps of Westeros and Essos (Pre-order: Amazon US, Amazon UK), here is our second preview: a key slice of the Free City of Braavos!
I call this a "key" section because, if you look at it, it features a number of locations mentioned in the course of A Feast for Crows and A Dance with Dragons, all of them based both on Martin's own map of Braavos checked against the published texts for any changes or inconsistencies that Bantam, the artist Jonathan Roberts (FantasticMaps on Twitter, and yours truly could find. Looks nice, right?
Courtesy of Bantam, we have a very first glimpse of The Lands of Ice and Fire, a collection of poster maps that we know many fans are anticipating.
The posters are due October 30th in the US (Amazon US) and November 8th in the UK (Amazon UK).
With art by freelance cartographer Jonathan Roberts, this map collection doesn't just feature places we have all seen mapped before, though for our first (yes, first) preview we figured a familiar image was the best start. These poster maps also include the first, almost-complete series of maps featuring the eastern continent of Essos, maps of Braavos and King's Landing, a map focused on the Wall, and more.
We've placed that new image as our Twitter cover image, for everyone to see when they wander by, but a higher resolution version can be found in our Gallery.
Keep an eye out next Tuesday when we release another snippet of the map, this one featuring something quite new…
World Fantasy Award, Chesley Award, Locus Award, and now (finally) Hugo Award-winning artist John Picacio has set up an online shop to sell prints of his work. There's a nice range of prints, but of particular interest to fans of George R.R. Martin's are his 2012 A Song of Ice and Fire Calendar artwork. Prints are limited to 100 for each image, and come signed by the artist.
There's a mass of beautiful work to consider, so do give it a look.
The Westeros network consists of several different sites, including a forum and a wiki, for all your A Song of Ice and Fire needs.


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New Jersey will start construction on a rail tunnel that will link New Jersey and Manhattan this spring. Officials say they have secured funding necessary to start the Hudson River rail tunnel, which was first proposed in the mid-1990s. The project is expected to cost $8.7 billion, and the state has secured part of the $3 billion it expects to receive from the federal government.
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Figure 3.
ascl1b and neurod1 are both expressed in pancreatic endocrine precursors. (A-J) Double fluorescent WISH comparing the expression of ascl1b and neurod1 with the expression of the pancreatic factor sox4b(A, B, F, G), pdx1(D, E) or with the insulin hormone (I, J) at early stages (12 to 16 hpf). The arrows point to a cell neurod1+/sox4b- (G) or neurod1+/ascl1b- (H). The arrowheads point to a cell neurod1+/ascl1b+(H). Z-plane confocal images. All views are ventral with anterior part to the left. (K) Diagram illustrating the time windows for the expression of ascl1b, neurod1 and the pancreatic hormones. Scale bars : 50 µm hpf, hours post fertilization; WISH, whole-mount in situ hybridization.
Flasse et al. BMC Biology 2013 11:78 doi:10.1186/1741-7007-11-78