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A cardiac rhythm management device which employs pacing therapy to regularize the ventricular rhythm. Such ventricular rate regularization may be employed within bradycardia pacemakers, ventricular resynchronization devices, or implantable cardioverter/defibrillators.
1. A cardiac rhythm management device, comprising:
a sensing channel configurable for sensing depolarizations from a right ventricle;
ventricular pacing channels for delivering paces to both right and left ventricles;
a controller for controlling the delivery of paces by the ventricular pacing channels in accordance with a ventricular escape interval that is reset by a right ventricular sense;
wherein the controller is programmed to pace the left ventricle at a specified pacing instant defined with respect to expiration of the ventricular escape interval; and, wherein the controller is further programmed to operate in a ventricular rate regularization mode in which the ventricular escape interval is increased after delivery of a ventricular pace and decreased after a ventricular sense.
2. The device of
3. The device of
an atrial sensing channel; and,
wherein the ventricular escape interval is started by an atrial sense.
4. The device of
an atrial pacing channel; and,
wherein the controller is configured to deliver an atrial pace upon expiration of an atrial escape interval and wherein the ventricular escape interval is started by an atrial pace.
5. The device of
6. The device of
wherein the controller is configured to measure an R-R interval associated with each ventricular sense, an R-R interval being the time between a ventricular sense and a preceding ventricular sense or pace; and,
wherein the controller is further configured to operate in the ventricular rate regularization mode by adjusting the ventricular escape interval in accordance with a measured R-R interval.
7. The device of
a filter for increasing the ventricular escape interval upon delivery of a ventricular pace; and,
a filter for decreasing the ventricular escape interval upon occurrence of a ventricular sense in accordance with the measured R-R interval.
8. The device of
9. The device of
10. The device of
11. A method for operating a cardiac rhythm management device, comprising:
sensing depolarizations from a right ventricle;
delivering paces to the left ventricle in accordance with a ventricular escape interval that is reset by a right ventricular sense;
pacing the left ventricle at a specified pacing instant defined with respect to expiration of the ventricular escape interval; and,
operating in a ventricular rate regularization mode in which the ventricular escape interval is increased after delivery of a ventricular pace and decreased after a ventricular sense.
12. The method of
13. The method of
sensing atrial depolarizations; and, wherein the ventricular escape interval is started by an atrial sense.
14. The method of
15. The method of
16. The method of
measuring an R-R interval associated with each ventricular sense, an R-R interval being the time between a ventricular sense and a preceding ventricular sense or pace; and,
operating in the ventricular rate regularization mode by adjusting the ventricular escape interval in accordance with a measured R-R interval.
17. The method of
increasing the ventricular escape interval upon delivery of a ventricular pace; and,
decreasing the ventricular escape interval upon occurrence of a ventricular sense in accordance with the measured R-R interval.
18. The method of
19. The method of
20. The method of
This application is a continuation of U.S. patent application Ser. No. 10/394,497, filed on Mar. 20, 2003, which is a continuation-in-part of the following co-pending, commonly assigned patent applications: U.S. patent application Ser. No. 09/316,515, filed on May 21, 1999, entitled "Method and Apparatus for Treating Irregular Ventricular Contractions Such as During Atrial Arrhythmia," now issued as U.S. Pat. No. 7,062,325, and U.S. patent application Ser. No. 09/792,651, now abandoned, filed on Feb. 23, 2001, entitled "Apparatus and Method for Ventricular Rate Regularization," which disclosures are herein incorporated by reference in their entirety.
By virtue of the preceding statement, the following issued patents are incorporated by reference into the present disclosure: U.S. Pat. Nos. 6,351,669 and 6,285,907.
This invention pertains to cardiac rhythm management devices and methods for operating such devices. In particular, the invention relates to methods for employing pacing therapy to maintain hemodynamic stability.
The human heart normally maintains its own well-ordered intrinsic rhythm through generation of stimuli by pacemaker tissue that results in a wave of depolarization that spreads through specialized conducting tissue and then into and through the myocardium. The well-ordered propagation of electrical depolarizations through the heart causes coordinated contractions of the myocardium that results in the efficient pumping of blood. In a normally functioning heart, stimuli are generated under the influence of various physiological regulatory mechanisms to cause the heart to beat at a rate that maintains cardiac output at a level sufficient to meet the metabolic needs of the body. Abnormalities of excitable cardiac tissue, however, can lead to abnormalities of heart rhythm that are called arrhythmias. All arrhythmias stem from one of two causes: abnormalities of impulse generation or abnormalities of impulse propagation. Arrhythmias can cause the heart to beat too slowly (bradycardia, or a bradyarrhythmia) or too quickly (tachycardia, or a tachyarrhythmia), either of which may cause hemodynamic compromise or death.
Drug therapy is often effective in preventing the development of arrhythmias and in restoring normal heart rhythms once an arrhythmia has occurred. However, drug therapy is not always effective for treating particular arrhythmias, and drug therapy usually causes side-effects that may be intolerable in certain patients. For such patients, an alternative mode of treatment is needed. One such alternative mode of treatment includes the use of an implantable cardiac rhythm management device that delivers therapy to the heart in the form of electrical stimuli. Such devices include cardiac pacemakers that deliver timed sequences of low energy electrical stimuli, called pacing pulses, to the heart via an intravascular lead having one or more electrodes that are disposed in the myocardium of the paced chamber. Heart contractions are initiated in response to such pacing pulses, and by properly timing the delivery of the pacing pulses, the heart can be made to contract in proper rhythm, greatly improving its efficiency as a pump. Such pacemakers are often used to treat patients with bradycardia due either to conduction abnormalities (e.g., AV block) or to sinus node dysfunction.
Cardiac rhythm management devices may also be used in the treatment of tachyarrhythmias such as tachycardia (i.e., a heart rate that is too rapid). Pacemakers, for example, can be configured to deliver paces to the heart in such a manner that the heart rate is slowed, a pacing mode referred to as anti-tachycardia pacing. Another class of cardiac rhythm management devices, implantable cardioverter/defibrillators (ICD's), deliver high energy electrical stimuli to the heart in order to terminate fibrillation, which is the most extreme form of tachyarrhythmia. Fibrillation, which may occur in either the atria or the ventricles, refers to the situation where electrical activity spreads through the myocardium in a disorganized fashion so that effective contraction does not occur. An ICD delivers a high energy electrical stimulus or shock to either the atria or ventricles in order to terminate the fibrillation, allowing the heart to reestablish a normal rhythm for the efficient pumping of blood. In addition to ICD's and pacemakers, cardiac rhythm management systems also include pacemaker/ICD's that combine the functions of pacemakers and ICD's, drug delivery devices, and any other implantable or external systems or devices for diagnosing, monitoring, or treating cardiac arrhythmias.
Irregular ventricular tachycardia, in which the ventricles beat more rapidly and irregularly than normal, can be due to a variety of etiologies. Certain patients, for example, are prone to premature ventricular contractions due to ectopic excitatory foci in the ventricular myocardium. Another cause of ventricular tachycardia is atrial fibrillation. The intrinsic ventricular rhythm that occurs during an episode of atrial fibrillation is a result of the chaotically occurring depolarizations occurring in the atria being passed through the AV node to the ventricles. The intrinsic ventricular rate is then governed by the cycle length of the atrial fibrillation and the refractory period of the AV node. Although the intrinsic ventricular rate is less than the atrial rate, due to the refractory period of the AV node, it is still rapid and irregular. When the ventricles contract at irregular intervals, the contraction can occur prematurely before diastolic filling is complete which decreases the stroke volume for that contraction. This can be especially significant in, for example, congestive heart failure patients who are already hemodynamically compromised. Concomitant atrial fibrillation where the atria no longer act as effective priming pumps can also contribute to the problem. An irregular ventricular rate can thus depress cardiac output and cause such symptoms as dyspnea, fatigue, vertigo, and angina.
An objective of the present invention is to use pacing therapy to maintain hemodynamic stability in the presence of an irregular intrinsic ventricular rhythm. Such pacing therapy may be used in conjunction with any type of cardiac rhythm management device that is capable of delivering ventricular paces.
The present invention is a system and method for regularizing the ventricular rate by adjusting the lower rate limit of a pacemaker configured to deliver ventricular paces in accordance with changes in the measured intrinsic ventricular rate. By making the ventricular escape interval track a mean interval between intrinsic beats, less variability in the overall ventricular rhythm is allowed by the pacemaker. Ventricular rate regularization may be used to improve cardiac output when used with conventional bradycardia pacing and may also be used to improve the efficacy of ventricular resynchronization therapy. Cardiac rhythm management devices configured to specifically treat atrial or ventricular tachyarrhythmias with defibrillation shocks may also advantageously employ ventricular rate regularization.
As will be described below, ventricular rate regularization may be advantageously applied together with a number of different cardiac rhythm management therapies. Ventricular rate regularization therapy may, for example, be implemented in a device configured to deliver conventional bradycardia pacing therapy to the atria and/or ventricles. Ventricular rate regularization may also be implemented in a device configured to deliver atrial or ventricular resynchronization therapy, where it has special advantages. Devices configured to deliver anti-tachyarrhythmia therapy in the form of ventricular defibrillation shocks may also use ventricular rate regularization when an irregular ventricular rate is detected that does not warrant a defibrillation shock. Finally, ventricular rate regularization is useful when implemented by an implantable atrial cardioverter/defibrillator both in maintaining hemodynamic stability when an episode of atrial fibrillation occurs and in facilitating the delivery of an atrial defibrillation shock synchronized with an R-wave.
1. Bradycardia Pacing Modes
Bradycardia pacing modes refer to pacing algorithms used to pace the atria and/or ventricles when the intrinsic ventricular rate is inadequate either due to AV conduction blocks or sinus node dysfunction. Such modes may either be single-chamber pacing, where either an atrium or a ventricle is paced, or dual-chamber pacing in which both an atrium and a ventricle are paced. The modes are generally designated by a letter code of three positions where each letter in the code refers to a specific function of the pacemaker. The first letter refers to which heart chambers are paced and which may be an A (for atrium), a V (for ventricle), D (for both chambers), or O (for none). The second letter refers to which chambers are sensed by the pacemaker's sensing channels and uses the same letter designations as used for pacing. The third letter refers to the pacemaker's response to a sensed P wave from the atrium or an R wave from the ventricle and may be an I (for inhibited), T (for triggered), D (for dual in which both triggering and inhibition are used), and O (for no response). Modem pacemakers are typically programmable so that they can operate in any mode which the physical configuration of the device will allow. Additional sensing of physiological data allows some pacemakers to change the rate at which they pace the heart in accordance with some parameter correlated to metabolic demand. Such pacemakers are called rate-adaptive pacemakers and are designated by a fourth letter added to the three-letter code, R.
Pacemakers can enforce a minimum heart rate either asynchronously or synchronously. In asynchronous pacing, the heart is paced at a fixed rate irrespective of intrinsic cardiac activity. There is thus a risk with asynchronous pacing that a pacing pulse will be delivered coincident with an intrinsic beat and during the heart's vulnerable period which may cause fibrillation. Most pacemakers for treating bradycardia today are therefore programmed to operate synchronously in a so-called demand mode where sensed cardiac events occurring within a defined interval either trigger or inhibit a pacing pulse. Inhibited demand pacing modes utilize escape intervals to control pacing in accordance with sensed intrinsic activity. In an inhibited demand mode, a pacing pulse is delivered to a heart chamber during a cardiac cycle only after expiration of a defined escape interval during which no intrinsic beat by the chamber is detected. If an intrinsic beat occurs during this interval, the heart is thus allowed to "escape" from pacing by the pacemaker. Such an escape interval can be defined for each paced chamber. For example, a ventricular escape interval can be defined between ventricular events so as to be restarted with each ventricular sense or pace. The inverse of this escape interval is the minimum rate at which the pacemaker will allow the ventricles to beat, sometimes referred to as the lower rate limit (LRL).
In atrial tracking pacemakers (i.e., VDD or DDD mode), another ventricular escape interval is defined between atrial and ventricular events, referred to as the atrio-ventricular interval (AVI). The atrio-ventricular interval is triggered by an atrial sense or pace and stopped by a ventricular sense or pace. A ventricular pace is delivered upon expiration of the atrio-ventricular interval if no ventricular sense occurs before. Atrial-tracking ventricular pacing attempts to maintain the atrio-ventricular synchrony occurring with physiological beats whereby atrial contractions augment diastolic filling of the ventricles. If a patient has a physiologically normal atrial rhythm, atrial-tracking pacing also allows the ventricular pacing rate to be responsive to the metabolic needs of the body.
A pacemaker can also be configured to pace the atria on an inhibited demand basis. An atrial escape interval is then defined as the maximum time interval in which an atrial sense must be detected after a ventricular sense or pace before an atrial pace will be delivered. When atrial inhibited demand pacing is combined with atrial-triggered ventricular demand pacing (i.e., DDD mode), the lower rate interval is then the sum of the atrial escape interval and the atrio-ventricular interval.
Finally, rate-adaptive algorithms may be used in conjunction with bradycardia pacing modes. Rate-adaptive pacemakers modulate the ventricular and/or atrial escape intervals based upon measurements corresponding to physical activity. Such pacemakers are applicable to situations in which atrial tracking modes cannot be use. In a rate-adaptive pacemaker operating in a ventricular pacing mode, the LRL is adjusted in accordance with exertion level measurements such as from an accelerometer or minute ventilation sensor in order for the heart rate to more nearly match metabolic demand. The adjusted LRL is then termed the sensor-indicated rate.
2. Ventricular Rate Regularization
Ventricular rate regularization (VRR) is a ventricular pacing mode in which the LRL of the pacemaker is dynamically adjusted in accordance with a detected intrinsic ventricular rate. When a pacemaker is operating in a ventricular demand pacing mode (e.g., VVI), intrinsic ventricular beats occur when the instantaneous intrinsic rate rises above the LRL of the pacemaker. Thus, paces can be interspersed with intrinsic beats, and the overall ventricular rhythm as a result of both paces and intrinsic beats is determined by the LRL and the mean value and variability of the intrinsic ventricular rate. VRR regularizes the overall ventricular rhythm by adjusting the LRL of the pacemaker in accordance with changes in the measured intrinsic rate.
The intrinsic ventricular rate is the rate at which intrinsic ventricular beats occur and can be defined both instantaneously and as being at some mean value with a certain variability about that mean. The instantaneous intrinsic rate can be determined by measuring an R-R interval, where an R-R interval is the time between a present ventricular sense (i.e., an R-wave or intrinsic ventricular depolarization) and the preceding ventricular sense or ventricular pace, with the instantaneous rate being the reciprocal of the measured interval. The mean intrinsic rate can be determined by averaging the instantaneous R-R intervals over a period of time. The LRL of a pacemaker is initially set to a programmed base value and defines the ventricular escape interval, which is the maximum time between ventricular beats allowed by the pacemaker and is the reciprocal of the LRL. At any particular mean intrinsic rate above the LRL, a ventricular pace is delivered only when, due to the variability in the intrinsic rate, an R-R interval would be longer than the ventricular escape interval were it allowed to occur. As the mean intrinsic ventricular rate increases above the LRL, fewer paces are delivered and more variability in the overall ventricular rhythm is allowed. The VRR pacing mode counteracts this by increasing the LRL as the mean intrinsic ventricular rate increases to thereby increase the frequency of paced beats which decreases the incidence of long intrinsic R-R intervals and thus lessens the variability in the overall ventricular rate. The VRR mode then decreases the LRL toward its base value as the number of paces delivered increases due to a decrease in either the mean intrinsic ventricular rate or its variability. The LRL adjusted in this manner is also referred to herein as the VRR-indicated rate.
In one embodiment of VRR, the LRL is adjusted to increase toward a programmed maximum value by measuring an R-R interval when a ventricular sense occurs and then computing an updated ventricular escape interval based upon the measured R-R interval. When a ventricular pace is delivered, on the other hand, the Is LRL is made to decay toward the programmed base value.
When a ventricular sense occurs, the measured R-R interval is input to a recursive digital filter 515 whose output is the updated ventricular escape interval. The filter 515 multiplies the measured R-R interval by a filter coefficient A and then adds the result to the previous value of the output (i.e., the present ventricular escape interval) multiplied by a filter coefficient B. The operation of the filter is thus described by VEIn=A(RRn)+B(VEIn-1), where A and B are selected coefficients, RRn is the most recent R-R interval duration, and VEIn-1 is the previous value of the ventricular escape interval. A useful way to conceptualize the filter 515 is to decompose the coefficients A and B into a scaling factor a and a weighting coefficient w such that A=a�w and B=(1−w), where w is between 0 and 1. Viewed this way, the filter is seen as computing a weighted average of the present R-R interval multiplied by the scaling factor a and the present ventricular escape interval. The filter thus causes the value of the ventricular escape interval to move toward the present R-R interval multiplied by the scaling factor at a rate determined by the weighting coefficient. This corresponds to the filter moving the pacemaker's LRL toward a fraction 1/a of the instantaneous intrinsic ventricular rate, up to a maximum pacing rate MPR, as determined by the measured R-R interval. If a ventricular sense has occurred, the current LRL is necessarily less than the measured instantaneous intrinsic ventricular rate. If it is also less than 1/a of the intrinsic rate, the LRL is increased by the filter up to a value that is 1/a of the intrinsic rate (as limited by the MPR) to result in more pacing and less variability in the overall ventricular rhythm.
When a ventricular pace is delivered due to expiration of the ventricular escape interval without a ventricular sense, filter 516 multiplies the present ventricular escape interval by a filter coefficient C so that VEIn=C(VEIn-1). To provide stable operation, the coefficient C must be set to a value greater than 1. Filter 516 then causes the ventricular escape interval to increase in an exponential manner with each pace as successive values of the escape interval are input to the filter up to a value corresponding to the base LRL.
The updating of the ventricular escape interval may be performed in various ways including on a beat-to-beat basis, at periodic intervals, or with averages of successive R-R intervals. In a presently preferred embodiment, however, the updating is performed on a beat-to-beat basis with each ventricular sense or pace causing adjustment of the LRL by filter 515 or 516, respectively. The two filters operating together thus cause the LRL to move closer to 1/a of the measured intrinsic rate (up to the MPR) after a ventricular sense and to decay toward the base LRL value after a ventricular pace.
The coefficients a and w (or A and B) and C are selected by the user and may be made programmable so that the behavior of the system can be adjusted to produce the clinically best result in an individual patient. For example, as the scaling factor a is made greater than 1, the filter 515 causes the LRL to move toward a smaller fraction 1/a of the detected intrinsic rate which allows more intrinsic beats to occur and greater variability in the overall rhythm. As a is decreased back toward 1, the filter 515 tends to move the LRL of the pacemaker toward a larger fraction of the detected instantaneous intrinsic rate, thus increasing the amount of pacing and decreasing the amount of variability allowed in the overall ventricular rhythm. If a is made smaller than 1, the LRL is moved toward a rate higher than the intrinsic rate, further increasing the amount of pacing to a point where most of the ventricular rhythm is made up of paced beats. The larger the weighting factor w, the faster the LRL is moved to the specified fraction of the intrinsic rate, making the system more responsive to increases in the variability of the intrinsic rhythm. The larger the decay coefficient C, the more rapidly will filter 516 cause the LRL to decrease toward its programmed base value when ventricular paces are delivered due to no ventricular senses being detected within the ventricular escape interval. The controller limits the updated ventricular escape interval as a result of the operations of filters 515 and 516 to minimum and maximum values in accordance with the programmed maximum pacing rate MPR and base lower rate limit LRL, respectively.
As noted, the coefficients of filters 515 and 516 can be made programmable by the user, such as by using a remote programmer. In another embodiment, the user selects a desired performance parameter (e.g., desired degree of rate regularization, desired amount of pacing, desired decay rate, etc.) from a corresponding range of possible values. The appropriate combinations of coefficients for filters 515 and 516 are then automatically selected to provide filter settings that correspond to the selected user-programmed performance parameter. The filter coefficients can also be made functions of other parameters, such as the measured R-R interval and current LRL setting, and dynamically adjusted.
The VRR system in this embodiment uses the programmed base LRL of the pacemaker as the lower limit to which the LRL is permitted to decay when no ventricular senses are detected. The base LRL can be changed periodically by the user with an external programmer, and certain pacemakers also have the capability of dynamically adjusting the LRL in order to adapt to exercise. In such rate-adaptive pacemakers, the LRL is adjusted in accordance with exertion level measurements such as from an accelerometer or minute ventilation sensor in order for the heart rate to more nearly match metabolic demand. The adjusted LRL is then termed the sensor-indicated rate. If a rate-adaptive pacemaker is operated in a VRR mode, the sensor-indicated rate can simply be regarded by the pacemaker as the base LRL. The lower limit for the VRR-indicated rate is then the sensor-indicated rate rather than the programmed base LRL.
3. System Description
The controller 10 of the device is a microprocessor which communicates with a memory 12 via a bidirectional data bus. The memory 12 typically comprises a ROM (read-only memory) for program storage and a RAM (random-access memory) for data storage. The operation of the controller constitutes circuits for sensing and pacing both atria and both ventricles. The pacemaker has atrial sensing and pacing channels comprising electrode 34 a-b, leads 33 a-b, sensing amplifiers 31 a-b, pulse generators 32 a-b, and atrial channel interfaces 30 a-b which communicate bidirectionally with microprocessor 10. The device also has ventricular sensing and pacing channels for both ventricles comprising electrodes 24 a-b, leads 23 a-b, sensing amplifiers 21 a-b, pulse generators 22 a-b, and ventricular channel interfaces 20 a-b. In the figure, "a" designates one ventricular or atrial channel and "b" designates the channel for the contralateral chamber. In this embodiment, a single electrode is used for sensing and pacing in each channel, known as a unipolar lead. Other embodiments may employ bipolar leads which include two electrodes for outputting a pacing pulse and/or sensing intrinsic activity. The channel interfaces 20 a-b and 30 a-b include analog-to-digital converters for digitizing sensing signal inputs from the sensing amplifiers and registers which can be written to by the microprocessor in order to output pacing pulses, change the pacing pulse amplitude, and adjust the gain and threshold values for the sensing amplifiers. An exertion level sensor 330 (e.g., an accelerometer or a minute ventilation sensor) enables the controller to adapt the pacing rate in accordance with changes in the patient's physical activity. A telemetry interface 40 is also provided for communicating with an external programmer 500 which has an associated display 510. As will be discussed more fully below, the device of
4. Bradycardia Pacing With VRR
VRR can be employed to modify conventional bradycardia pacing in order to improve the deleterious hemodynamic effects brought about by an irregular intrinsic ventricular rhythm.
In order to also implement VRR, filters 515 and 516 are enabled by the supervisory controller program. Filters 515 and 515, as described above with respect to
5. Cardiac Resynchronization Therapy with VRR
Heart failure is clinical syndrome in which an abnormality of cardiac function causes cardiac output to fall below a level adequate to meet the metabolic demand of peripheral tissues and is usually referred to as congestive heart failure (CHF) due to the accompanying venous and pulmonary congestion. CHF can be due to a variety of etiologies with ischemic heart disease being the most common. Some CHF patients suffer from some degree of AV block or are chronotropically deficient such that their cardiac output can be improved with conventional bradycardia pacing. Such pacing, however, may result in some degree of uncoordination in atrial and/or ventricular contractions due to the way in which pacing excitation is typically spread throughout the myocardium without the benefit of the heart's specialized conduction system. The resulting diminishment in cardiac output may be significant in a CHF patient whose cardiac output is already compromised. Intraventricular and/or interventricular conduction defects (e.g., bundle branch blocks) are also commonly found in CHF patients. In order to treat these problems, cardiac rhythm management devices have been developed which provide pacing stimulation to one or more heart chambers in an attempt to improve the coordination of atrial and/or ventricular contractions, termed cardiac resynchronization therapy.
Cardiac resynchronization therapy is pacing stimulation applied to one or more heart chambers in a manner that restores or maintains synchronized bilateral contractions of the atria and/or ventricles and thereby improves pumping efficiency. Certain patients with conduction abnormalities may experience improved cardiac synchronization with conventional single-chamber or dual-chamber pacing as described above. For example, a patient with left bundle branch block may have a more coordinated contraction of the ventricles with a pace than as a result of an intrinsic contraction. In that sense, conventional bradycardia pacing of an atrium and/or a ventricle may be considered as resynchronization therapy. Resynchronization pacing, however, may also involve pacing both ventricles and/or both atria in accordance with a synchronized pacing mode as described below. A single chamber may also be resynchronized to compensate for intra-atrial or intra-ventricular conduction delays by delivering paces to multiple sites of the chamber.
It is advantageous to deliver resynchronization therapy in conjunction with one or more synchronous bradycardia pacing modes, such as are described above. One atrial and/or one ventricular pacing sites are designated as rate sites, and paces are delivered to the rate sites based upon pacing and sensed intrinsic activity at the site in accordance with the bradycardia pacing mode. In a single-chamber bradycardia pacing mode, for example, one of the paired atria or one of the ventricles is designated as the rate chamber. In a dual-chamber bradycardia pacing mode, either the right or left atrium is selected as the atrial rate chamber and either the right or left ventricle is selected as the ventricular rate chamber. The heart rate and the escape intervals for the pacing mode are defined by intervals between sensed and paced events in the rate chambers only. Resynchronization therapy may then be implemented by adding synchronized pacing to the bradycardia pacing mode where paces are delivered to one or more synchronized pacing sites in a defined time relation to one or more selected sensing and/or pacing events that either reset escape intervals or trigger paces in the bradycardia pacing mode. Multiple synchronized sites may be paced through multiple synchronized sensing/pacing channels, and the multiple synchronized sites may be in the same or different chambers as the rate site.
In bilateral synchronized pacing, which may be either biatrial or biventricular synchronized pacing, the heart chamber contralateral to the rate chamber is designated as a synchronized chamber. For example, the right ventricle may be designated as the rate ventricle and the left ventricle designated as the synchronized ventricle, and the paired atria may be similarly designated. Each synchronized chamber is then paced in a timed relation to a pace or sense occurring in the contralateral rate chamber.
One synchronized pacing mode may be termed offset synchronized pacing. In this mode, the synchronized chamber is paced with a positive, negative, or zero timing offset as measured from a pace delivered to its paired rate chamber, referred to as the synchronized chamber offset interval. The offset interval may be zero in order to pace both chambers simultaneously, positive in order to pace the synchronized chamber after the rate chamber, or negative to pace the synchronized chamber before the rate chamber. One example of such pacing is biventricular offset synchronized pacing where both ventricles are paced with a specified offset interval. The rate ventricle is paced in accordance with a synchronous bradycardia mode which may include atrial tracking, and the ventricular escape interval is reset with either a pace or a sense in the rate ventricle. (Resetting in this context refers to restarting the interval in the case of an LRL ventricular escape interval and to stopping the interval in the case of an AVI.) Thus, a pair of ventricular paces are delivered after expiration of the AVI escape interval or expiration of the LRL escape interval, with ventricular pacing inhibited by a sense in the rate ventricle that restarts the LRL escape interval and stops the AVI escape interval. In this mode, the pumping efficiency of the heart will be increased in some patients by simultaneous pacing of the ventricles with an offset of zero. However, it may be desirable in certain patients to pace one ventricle before the other in order to compensate for different conduction velocities in the two ventricles, and this may be accomplished by specifying a particular positive or negative ventricular offset interval.
Another synchronized mode is triggered synchronized pacing. In one type of triggered synchronized pacing, the synchronized chamber is paced after a specified trigger interval following a sense in the rate chamber, while in another type the rate chamber is paced after a specified trigger interval following a sense in the synchronized chamber. The two types may also be employed simultaneously. For example, with a trigger interval of zero, pacing of one chamber is triggered to occur in the shortest time possible after a sense in the other chamber in order to produce a coordinated contraction. (The shortest possible time for the triggered pace is limited by a sense-to-pace latency period dictated by the hardware.) This mode of pacing may be desirable when the intra-chamber conduction time is long enough that the pacemaker is able to reliably insert a pace before depolarization from one chamber reaches the other. Triggered synchronized pacing can also be combined with offset synchronized pacing such that both chambers are paced with the specified offset interval if no intrinsic activity is sensed in the rate chamber and a pace to the rate chamber is not otherwise delivered as a result of a triggering event. A specific example of this mode is ventricular triggered synchronized pacing where the rate and synchronized chambers are the right and left ventricles, respectively, and a sense in the right ventricle triggers a pace to the left ventricle and/or a sense in the left ventricle triggers a pace to the right ventricle.
As with other synchronized pacing modes, the rate chamber in a triggered synchronized pacing mode can be paced with one or more synchronous bradycardia pacing modes. If the rate chamber is controlled by a triggered bradycardia mode, a sense in the rate chamber sensing channel, in addition to triggering a pace to the synchronized chamber, also triggers an immediate rate chamber pace and resets any rate chamber escape interval. The advantage of this modal combination is that the sensed event in the rate chamber sensing channel might actually be a far-field sense from the synchronized chamber, in which case the rate chamber pace should not be inhibited. In a specific example, the right and left ventricles are the rate and synchronized chambers, respectively, and a sense in the right ventricle triggers a pace to the left ventricle. If right ventricular triggered pacing is also employed as a bradycardia mode, both ventricles are paced after a right ventricular sense has been received to allow for the possibility that the right ventricular sense was actually a far-field sense of left ventricular depolarization in the right ventricular channel. If the right ventricular sense were actually from the right ventricle, the right ventricular pace would occur during the right ventricle's physiological refractory period and cause no harm.
As mentioned above, certain patients may experience some cardiac resynchronization from the pacing of only one ventricle and/or one atrium with a conventional bradycardia pacing mode. It may be desirable, however, to pace a single atrium or ventricle in accordance with a pacing mode based upon senses from the contralateral chamber. This mode, termed synchronized chamber-only pacing, involves pacing only the synchronized chamber based upon senses from the rate chamber. One way to implement synchronized chamber-only pacing is to pseudo-pace the rate chamber whenever the synchronized chamber is paced before the rate chamber is paced, such that the pseudo-pace inhibits a rate chamber pace and resets any rate chamber escape intervals. Such pseudo-pacing can be combined with the offset synchronized pacing mode using a negative offset to pace the synchronized chamber before the rate chamber and thus pseudo-pace the rate chamber, which inhibits the real scheduled rate chamber pace and resets the rate chamber pacing escape intervals. One advantage of this combination is that sensed events in the rate chamber will inhibit the synchronized chamber-only pacing, which may benefit some patients by preventing pacing that competes with intrinsic activation (i.e., fusion beats). Another advantage of this combination is that rate chamber pacing can provide backup pacing when in a synchronized chamber-only pacing mode, such that when the synchronized chamber pace is prevented, for example to avoid pacing during the chamber vulnerable period following a prior contraction, the rate chamber will not be pseudo-paced and thus will be paced upon expiration of the rate chamber escape interval. Synchronized chamber-only pacing can be combined also with a triggered synchronized pacing mode, in particular with the type in which the synchronized chamber is triggered by a sense in the rate chamber. One advantage of this combination is that sensed events in the rate chamber will trigger the synchronized chamber-only pacing, which may benefit some patients by synchronizing the paced chamber contractions with premature contralateral intrinsic contractions.
An example of synchronized chamber-only pacing is left ventricle-only synchronized pacing where the rate and synchronized chambers are the right and left ventricles, respectively. Left ventricle-only synchronized pacing may be advantageous where the conduction velocities within the ventricles are such that pacing only the left ventricle results in a more coordinated contraction by the ventricles than with conventional right ventricular pacing or biventricular pacing. Left ventricle-only synchronized pacing may be implemented in inhibited demand modes with or without atrial tracking, similar to biventricular pacing. A left ventricular pace is then delivered upon expiration of the AVI escape interval or expiration of the LRL escape interval, with left ventricular pacing inhibited by a right ventricular sense that restarts the LRL escape interval and stops the AVI escape interval.
In the synchronized modes described above, the rate chamber is synchronously paced with a mode based upon detected intrinsic activity in the rate chamber, thus protecting the rate chamber against paces being delivered during the vulnerable period. In order to provide similar protection to a synchronized chamber or synchronized pacing site, a synchronized chamber protection period (SCPP) may be provided. (In the case of multi-site synchronized pacing, a similar synchronized site protection period may be provided for each synchronized site.) The SCPP is a programmed interval which is initiated by sense or pace occurring in the synchronized chamber during which paces to the synchronized chamber are inhibited. For example, if the right ventricle is the rate chamber and the left ventricle is the synchronized chamber, a left ventricular protection period LVPP is triggered by a left ventricular sense which inhibits a left ventricular pace which would otherwise occur before the escape interval expires. The SCPP may be adjusted dynamically as a function of heart rate and may be different depending upon whether it was initiated by a sense or a pace. The SCPP provides a means to inhibit pacing of the synchronized chamber when a pace might be delivered during the vulnerable period or when it might compromise pumping efficiency by pacing the chamber too close to an intrinsic beat. In the case of a triggered mode where a synchronized chamber sense triggers a pace to the synchronized chamber, the pacing mode may be programmed to ignore the SCPP during the triggered pace. Alternatively, the mode may be programmed such that the SCPP starts only after a specified delay from the triggering event, which allows triggered pacing but prevents pacing during the vulnerable period.
In the case of synchronized chamber-only synchronized pacing, a synchronized chamber pace may be inhibited if a synchronized chamber sense occurs within a protection period prior to expiration of the rate chamber escape interval. Since the synchronized chamber pace is inhibited by the protection period, the rate chamber is not pseudo-paced and, if no intrinsic activity is sensed in the rate chamber, it will be paced upon expiration of the rate chamber escape intervals. The rate chamber pace in this situation may thus be termed a safety pace. For example, in left ventricle-only synchronized pacing, a right ventricular safety pace is delivered if the left ventricular pace is inhibited by the left ventricular protection period and no right ventricular sense has occurred.
As noted above, synchronized pacing may be applied to multiple sites in the same or different chambers. The synchronized pacing modes described above may be implemented in a multi-site configuration by designating one sensing/pacing channel as the rate channel for sensing/pacing a rate site, and designating the other sensing/pacing channels in either the same or the contralateral chamber as synchronized channels for sensing/pacing one or more synchronized sites. Pacing and sensing in the rate channel then follows rate chamber timing rules, while pacing and sensing in the synchronized channels follows synchronized chamber timing rules as described above. The same or different synchronized pacing modes may be used in each synchronized channel.
In any of the resynchronization pacing modes discussed above, the effectiveness of the therapy is increased to the extent that the frequency of pacing is increased. Accordingly, VRR may be employed to increase the pacing frequency in a ventricular resynchronization pacing mode by adjusting the filter coefficients in the manner described above to result in more paced beats. The LRL adjusted by the VRR filter in this case then corresponds to the ventricular rate chamber escape interval.
5. Implantable Ventricular Cardioverter/Defibrillator with VRR
Tachyarrhythmias are abnormal heart rhythms characterized by a rapid heart rate. Examples of tachyarrhythmias include atrial tachyarrhythmias such as atrial tachycardia and atrial fibrillation (AF), and ventricular tachyarrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF). Both ventricular tachycardia and ventricular fibrillation are hemodynamically compromising, and both can be life-threatening. Atrial fibrillation is not immediately life threatening, but since atrial contraction is lost, the ventricles are not filled to capacity before systole which reduces cardiac output. If atrial fibrillation remains untreated for long periods of time, it can also cause blood to clot in the left atrium, possibly forming emboli and placing patients at risk for stroke.
Cardioversion (an electrical shock delivered to the heart synchronously with an intrinsic depolarization) and defibrillation (an electrical shock delivered without such synchronization) can be used to terminate most tachyarrhythmias, including AF, VT, and VF. As used herein, the term defibrillation should be taken to mean an electrical shock delivered either synchronously or not in order to terminate a fibrillation. In electrical defibrillation, a current depolarizes a critical mass of myocardial cells so that the remaining myocardial cells are not sufficient to sustain the fibrillation. The electric shock may thus terminate the tachyarrhythmia by depolarizing excitable myocardium, which thereby prolongs refractoriness, interrupts reentrant circuits, and discharges excitatory foci.
The device in
VRR may be employed in ICDs configured to deliver ventricular defibrillation shocks and having a pacing capability. Such devices may be implanted in patients who are prone to ventricular arrhythmias but are not normally in need of either bradycardia or resynchronization pacing. In these cases, the device may detect a ventricular tachyarrhythmia which does not warrant either a defibrillation shock or anti-tachycardia pacing. VRR pacing may then be initiated in order to improve the patient's cardiac output and possibly lessen the chance of a more dangerous tachyarrhythmia occurring. The device may be programmed to deliver the VRR therapy for a specified length of time after each detection of such a tachyarrhythmia.
6. Implantable Atrial Cardioverter/Defibrillator With VRR
VRR may also be employed in devices configured to deliver atrial defibrillation shocks in order to both maintain hemodynamic stability and to more safely deliver the atrial defibrillation shock. In order to avoid the possible induction of ventricular fibrillation, atrial defibrillation shocks should be delivered synchronously with a sensed R wave and after a minimum pre-shock R-R interval. This is done because the ventricle is especially vulnerable to induction of fibrillation by a depolarizing shock delivered at a time too near the end of the preceding ventricular contraction (i.e., close to the T wave on an EKG). Delivering the shock synchronously with a sensed R wave thus moves the shock away from the vulnerable period, but at a very rapid ventricular rhythm, the ventricular beats may be so close together that even synchronously delivered shocks may induce ventricular fibrillation. Shocking should therefore be delayed until the ventricular rhythm is slow enough to safely deliver the defibrillation pulse as determined by measuring the R-R interval. As noted above, however, the intrinsic ventricular rhythm during atrial fibrillation tends to be both rapid and irregular. If the intrinsic rhythm could be slowed and made more predictable, an atrial defibrillation shock could be more safely delivered.
If AV conduction is intact in a patient, atrial fibrillation results in a very rapid and intrinsic ventricular rhythm, and regularizing the ventricular rate improves cardiac output directly through its effect on diastolic filling. Ventricular rate regularization may be applied in this instance with parameter settings such that the ventricles are driven at a rate near the intrinsic rate. The intrinsic ventricular rhythm that occurs during an episode of atrial fibrillation is a result of the chaotically occurring depolarizations occurring in the atria being passed through the AV node to the ventricles. The intrinsic ventricular rate is thus governed by the cycle length of the atrial fibrillation and the refractory period of the AV node. If a ventricular pacing pulse is delivered before the next intrinsic beat occurs, the ventricular depolarization is conducted retrogradely to the AV node causing late depolarization of the AV node during the ventricular beat. The refractory period of the AV node is also delayed, which delays the time before an atrial depolarization can be conducted through the node to result in an intrinsic beat. The effect of the pace is thus to lengthen the time until the next intrinsic beat. Ventricular rate regularization at a pacing rate near the intrinsic ventricular rate during atrial fibrillation thus not only improves hemodynamics, but also increases the probability that a shockable R-R interval will occur.
Although the invention has been described in conjunction with the foregoing specific embodiment, many alternatives, variations, and modifications will be apparent to those of ordinary skill in the art. Such alternatives, variations, and modifications are intended to fall within the scope of the following appended claims.
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"Thanks Janell! I appreciate all the hard work and effort you put into selling my folk's house for me. I am very happy with the results we achieved. The house sold in a reasonable amount of time with no ...."
""Janell was fantastic - everything I needed, when I needed it! She was attentive to my needs when looking for the perfect house, and was persistent when selling my old house. She assisted in coordinatin...."
""Janell was warm and inviting from the moment we were in touch with her about the prospect of purchasing our first home. She walked us effortlessly through our loan pre-approval, and took our wants and ...."
Listing information deemed reliable but not guaranteedEqual Housing Opportunity.


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Watch the Heat take home the championship, score free vodka
Watch the Heat take home the championship, score free vodka
Watch the Heat take on Oklahoma at Haven tonight and enjoy a specialty "Big Three" menu of cocktails and bites including Fever (Grey Goose martini, pear vodka, jalapeño, lychee, and prosecco), wings and Mexican "hot" chocolate (liquid nitrogen ice cream with cayenne pepper, coriander and cinnamon mix-ins). Bonus - if the Heat bring home a championship, Haven & Stoli HOT vodka are hosting a post-game victory party featuring an hour of free "Citrus Inferno" cocktails (Stoli Hot vodka, fresh lime, simple, passion fruit and Mandarin Napoleon). 1237 Lincoln Rd, Miami Beach; 305-987-8885
Quick Bites
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- The List: 10 best bets for Father's Day dining in South Florida


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Euphonix has announced the sale of a new Max Air console to Oregon Public Broadcasting (OPB) station KTVR. Located in Portland, OR, OPB has five full-powered TV transmitters and five DTV transmitters around the state. The new Max Air digital audio mixing system sports 96 channels, 32 faders, plus an eight-fader center section, and will be installed into KTVR's new studio production facility in Portland, replacing the existing analog desk. The station is in the midst of an extensive facility renovation toward becoming a fully digital production facility. Other changes include the addition of high-definition cameras, a high-definition production switcher, new character generators and a new monitor wall, as well as numerous other improvements. According to director of engineering Don McKay, the Euphonix Air Max was chosen only after an extensive examination of the digital console options and several demonstrations. Because OPB uses a lot of volunteer operators, intuitive operation — especially in executing 5.1 surround mixdowns — was in important consideration in console selection. The console's Layouts function allows operators to easily bring up preconfigured channel groups, snapshot recall of all settings, PatchNet routing, and a large 17in touch screen for easy command and control.
OPB saw the need to make this upgrade to meet content production needs for the PBS system as well as the broadcaster's other stations across Oregon. The massive commitment will necessitate a temporary facility closure in August during installation.
For more information, please visit www.euphonix.com/broadcast/products/max_air/max_air.htm
An Inside Look at Four Virtual Reality Start-Ups
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Mark Kudsi Directs 'Art of Patron Virtual Reality Experience'
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Top Twitter TV Shows for 2014-15 Season Unveiled
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Filmmaker Embraces Short Documentary Format with Oscar-Nominated 'Crisis Hotline'
North Metro Television Goes Wireless with Comrex LiveShot
Spectra Logic and HauteSpot Networks Introduce Body-Worn Camera Video Surveillance Solution
Huge Ultra HD Display Lights Up Times Square


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Health Benefits of Millet
Millet might not be the most typical kind of seed crop which you're expecting on your table, however, this particular group of extremely adjustable seeded grasses are grown around the world, for both livestock feed as well as human consumption.... Read more
Health Benefits of Barley
Barley is a kind of whole grain which was first grown about 10,000 years back in Ethiopia as well as in some parts of Southeast Asia. It absolutely was utilized by our historical forefathers not just for food as well as for making alcoholic drin... Read more
Health Benefits of Buckwheat
Buckwheat is an extremely beneficial plant source for the wealth of health advantages, together with a decrease in blood pressure, protection against certain kinds of cancer, control over diabetes, enhanced digestion as well as cholesterol level... Read more
Health Benefits of Wheat
Wheat, originating from south-western Asia, is a term defining the herbs through the Triticum genus. In the world it rates second after corn at the number of farms that grow wheat. In olden days, wheat grains were consumed raw, later these were... Read more
Health benefits of Red Rice
A variety of rices are known as "red rice." Generally, individuals mean an unhulled or partially hulled rice that includes a red husk, as opposed to the a lot more common brown. Just like other unhulled rices, red rice includes a nutty flavor,... Read more
Health benefits of Brown Rice
Rice is actually a food staple and main crop developed around the world. There are many different types of rice – which includes long-grain basmati, black rice, white rice and sticky (or glutinous) rice – however in terms of health a... Read more
Health benefits of Rice
Rice is definitely the seed of the grass varieties Oryza sativa (Asian rice) or even Oryza glaberrima (African rice). As a cereal grain, it's the most generally ingested staple food for the large part of the world's human population,... Read more
Health benefits of Hazelnuts Oil
Beyond being a food staple of the much-vaunted Mediterranean diet hazelnut oil is in reality a greatly beneficial oil, discovering applications in personal care, home improvement, green cleaning, natural treatments along with other areas. It's a... Read more
Health Benefits Of Oyster Mushroom
As the title recommends, Oyster mushrooms look like an oyster in their look. These types of mushrooms usually are whitish or even greyish in color. These types of mushrooms smell and also taste just like oysters too. Unlike other mushrooms, oyst... Read more
Health benefits of Hazelnuts
Hazelnuts, also referred to as filbert nuts or even cobnuts based on their species, are made by hazel trees, that grow in temperate climates in several parts of the world, even though they are indigenous to Europe and Asia. A cob is oval or even... Read more


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Spicyorilled Lamb Chops
4 Nov 2010
|Ground ginger
|1⁄3 Teaspoon
|1⁄4 Teaspoon
|Curry powder
|1 Teaspoon
|1 Teaspoon
|Tomato sauce
|1 Cup (16 tbs)
|Cider vinegar
|3 Tablespoon
|3 Clove (15 gm), smashed and chopped
|Lamb chops
|8 , trimmed of fat (1 inch thick)
Place all ingredients, except lamb chops, in saucepan. Boil 10 minutes.
Place lamb chops in deep glass dish and pour sauce over. Marinate 1 hour.
Preheat barbecue at medium-high.
Oil grill and add lamb chops. Cover and cook 6 to 7 minutes on each side. After meat is seared, season well and baste with marinade during cooking.
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Spicyorilled Lamb Chops Recipe


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Rihanna: Bikini Clad In Barbados
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Ellegant Stuffed Chicken
|Broiler fryer
|3 1⁄2 Pound
|2 Tablespoon
|Green onions
|2 , minced
|Ground pork
|3⁄4 Pound
|White bread slices
|2 , diced
|1⁄3 Cup (5.33 tbs)
|3⁄4 Teaspoon
|Dry sherry
|1 Tablespoon
|Salad oil
|1 Tablespoon
|1 Cup (16 tbs)
|Chicken bouillon cube/Envelope
|All purpose flour
|2 Tablespoon
|Parsley sprigs
|1 (For Garnish)
1. Set chicken liver aside; reserve remaining giblets and neck for use another day. Rinsechicken and refrigerate. Prepare stuffing: Mince liver. In 3-quart saucepan over medium heat, in hot butter or margarine, cook onions and liver until liver is firm; remove saucepan from heat. Stir in ground pork, bread, egg, milk, salt, and 1/4 cup sherry; cover and refrigerate stuffing.
2. Bone chicken: Place chicken, breast side down, on cutting board. Cut along both sides of backbone; discard bone. Spread chicken open, breast side down, to expose rib cage. With sharp knife, cut through white cartilage at "V" of neck, being careful not to tear skin. Hold chicken breast at neck and tail ends; bend back to expose breastbone. Remove breastbone. Cut out wishbone and discard. Then, working with one side of breast at a time, insert knife under rib cage and scrape meat free, lifting ribs away from breast as you work. Using same scraping motion, and with tip of small knife, remove hipbones from thighs and discard.
3. Spread stuffing mixture over inside of boned chicken. Pull meat and skin over stuffing and skewer closed. To reshape bird, turn chicken breast side up. Starting at neck end, with string across top of breast, bring ends of string under wings and legs; tie legs together. Fold wings under back to hold chicken steady.
4. Insert meat thermometer between breast and thigh into center of stuffing; brush bird with salad oil. Place bird, breast side up, on rack in open roasting pan. Roast in 350°F. oven about 1 1/2 hours or until meat thermometer reaches 170°F. During last 15 minutes of roasting time, brush chicken generously with pan drippings for an attractive sheen.
5. When chicken is done, place on warm platter; keep warm. For gravy, remove rack from pan; skim all but 2 tablespoons fat from pan, leaving pan liquid and brown bits. Add water and bouillon to roasting pan; over medium heat, heat mixture to boiling, stirring to loosen brown bits. In cup, mix flour and 1/4 cup sherry. Gradually stir flour mixture into hot liquid in pan; cook over medium heat, stirring until gravy thickens.


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By: Grooveraider
Johnny Arcade test drives Super Spy Hunter for the 8bit NES @ 1990 Winter Consumer Electronic Show (WCES) in Las Vegas. CHECK OUT: www.original-gamer.com Where Gamer's Run The Site Also my retrogaming channel: www.youtube.com/grooveraider Where Gamer's Run The Site
Views: 912 | Posted: 08/11/2010
Behold the franchise that takes a licking, and keeps on sucking....
Views: 31,127 | Posted: 09/22/2006
A look Spy Hunter's past and present with the series creator Goerge Gomez, Nowhere to Run Producer Jeremy Airey, and The Rock.
Views: 9,614 | Posted: 08/24/2006
IES Agent Alex Decker will leave you nowhere to run.
Views: 12,160 | Posted: 08/08/2006
Hot vehicles, advanced weaponry, and good old fashioned smackdowns.
Views: 28,628 | Posted: 07/25/2006
Exhilarating multi-terrained vehicular combat.
Views: 27,170 | Posted: 07/13/2006
Fast paced action and even faster cars.
Views: 10,145 | Posted: 07/12/2006
Catch the bad guys by boat, car, or automobile.
Views: 17,760 | Posted: 05/17/2006
Spy Hunter: Nowhere to Run and Stranglehold
Views: 13,085 | Posted: 05/12/2006
The Rock shows off his new ride.
Views: 11,981 | Posted: 04/26/2006
Week of
Jun. 28
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Jul. 05
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3DS, Vita
Release Date: 06/30/2015
Release Date: 07/08/2015
Team17 brings a classic Worms battle back to PC with Steam integration.
PC, Android, Windows Phone 8, iOS
Release Date: 07/12/2015
Combine the skills of multiple characters to solve puzzles and the mystery.
Release Date: 07/14/2015
Kratos' epic on PS3 is coming to PlayStation 4 in full HD and with new features.


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Select Local Merchants
Jiffy LubeRead MoreThe highly trained technicians at Jiffy Lube tend to about 24 million customers each year with services such as the Signature Service Oil Change package, which promotes the longevity of each vehicle. Staffers acknowledge that oil plays a crucial role in maximizing the lifespan of each car—it cools the motor and prevents moving parts from deteriorating. More than 20,000 technicians who have completed an extensive training program certified by the National Institute Automotive Service Excellence (ASE) nurse vehicles at Jiffy Lube. In addition to performing oil changes, Jiffy Lube's savants perform air-filtration, electricity, and windshield services, among others. The technicians' quality pledge includes a commitment to transparency, which stipulates that they will inform car owners of any necessary services, only complete a service after it has been approved, and refuse to replace windshields with saran wrap.5518 Saint Barnabas RdOxon Hill, MD US
eOilchange.comRead MoreMotorists can treat their hacking and wheezing motorcar to a trio of oil changes at eOilChange.com's participating auto shops. During each 30-minute service, skilled technicians replace used motor oil with up to 6 quarts of standard engine juice and install a new oil filter to ensure vehicles' veins pump clean, contaminant-free oil. Most autos are welcome, save trucks that weigh more than one ton, and all three services must be performed on the same vehicle. Drivers have 365 days to use all three oil changes at a single location, which means cars won't need to suck fresh oil from vulnerable pump jacks for at least a year.6201 Marlboro PikeDistrict Heights, MD US
AUTOMOTO SolutionsRead MoreAUTOMOTO Solutions was once an exclusive restoration company that serviced BMW, Ferrari, and Porsche dealerships. The staff has since begun welcoming all types of automobiles into their shop, but they still treat every last one like a luxury vehicle when performing cosmetic body repair. Patented Rapid Restore technology allows them to remedy small cosmetic blemishes in a guaranteed 24 hours, while color-retrieving technology matches up new repairs with the exact shade of the car's finish. To get each vehicle looking as new as the day it rolled out of one of Henry Ford's test tubes, AUTOMOTO Solutions also offers detailing services and leather repair.5325 Beech Rd., Unit 11Temple Hills, MD US
Auto Care Special nationalRead MoreWith participating locations nationwide, Auto Care Special lets customers reach out to their local garages for a grab bag of free and discounted maintenance services. Cards may be redeemed for multiple vehicles over the course of one year for services such as oil changes, safety inspections, and engine-light diagnoses. Those who move or create alter-egos over the course of the year can scan the locations page for participating garages in their new cities of residence to receive a complimentary maintenance bundle.3501 Pohanka PlaceMarlow Heights, MD US
Leher Limousine Airport TransportRead MoreNo matter where you're going, Leher Limousine's professional drivers will get you there on time and in style. Their fleet includes both executive sedans and executive limos, all of them spotless and spacious, and ready to help you make an impression when traveling to the airport, a business meeting, or ice skating practice8634 Edgeworth DriveCapitol Heights, MD US
Wiygul Automotive ClinicRead MoreThe wrench-wielding virtuosos at Wiygul Automotive Clinic call upon more than 35 years of automotive experience to keep roadsters running smoothly with a variety of services. Steel ponies of all makes and models can roll into the shop's service bays, where mechanics pore over parts to confirm safety and snuff out problems. Safety inspections and state emissions tests pinpoint fume outputs and confirm that seat belts and airbags adhere to safety standards established by Evel Knievel fan fiction. Technicians also repair engines, transmissions, and power steering; adjust heating and cooling systems; and encircle wheels with Dunlop and Goodyear tires. Wiygul Automotive Clinic doubles down on its work with 24-month/24,000-mile warranties on parts and labor, and shuttles drivers home and back during their cars' appointments.6001 Lane DrAlexandria, VA US


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My Favorite Beers At The Montana Brewers Spring Festival
The Montana Brewers Association held their 2nd annual Montana Brewers Spring Festival last night at Metra Park.
The Montana Brewers Association held their 2nd annual Montana Brewers Spring Festival last night at Metra Park.
It's that time of year again. The weather's warming up and that means we'll be spending our Thursday nights partying downtown at "Alive After Five".
The Downtown Billings Association just released the dates, locations and musical acts for the 11th Annual event
The great state of Montana has an official state bird, and a official flower, but what about an official state sandwich? Some businesses have laid claim to the honor. Last year, Zagat declared the Staggering Ox's "Nu
According to a report from Q2 News, Angelica Gray walked away from Billings pre-release center Passages on Tuesday night. The inmate had been at the facility for only two weeks, she was serving time possession of dangerous drugs out of Lewis and Clark County.
Sure, there are places you can buy donuts in Billings like Log Cabin Bakery and Albertsons but there hasn't been a dedicated donut shop in the Magic City since Krispy Kreme on King Ave closed their doors in 2008
She spent 17 agonizing hours in labor having you. Now, it's time to show her you care. NewsTalk 95.5 is looking for the best Montana Mom and we are going to give FREE LASIK from the Eye Clinic Surgicenter, a family feast at Fancy Sushi and flowers from the Garden Avenue Greenhouse. Submit a phot
Finally, a safe place to search for your next career, where you don't have to be there at a certain time, dress a certain way, or worry about who might see you. Take a look at the many businesses
The PBR is back in Billings and we had the chance to chat with a couple of the best bull riders in the world. Check out our interview with 19 yr. old PBR Rookie Gage Gay from Greensboro, NC and Montana native Matt Triplett
There is an extended studies program in the Billings area for gifted students. Part of the curriculum is learning about architecture and building models to show off the skills they've acquired.
At Off The Leaf espresso on Grand Avenue they have this cool chalkboard for patrons to but friends, family members and colleagues to purchase drinks or snacks for each other in advance and as you can see from the picture above it's called "Pay It Forward"... like the movie.
The Flakes want to congratulate their friends over at the Billings Clinic for being named one of the best hospitals in the country.
The Billings Clinic was cited by Becker's Hospital Review as one of the 100 best hospitals in America
I've lived in Billings now for nearly a year and a half and had no clue that there was a family of wild turkeys living near downtown Billings. Sunday night I was driving down 27th street from the airport 6 wild turkeys (Dad was the size of an Ostrich, his mate and 4 Turklets... Turklings... or whatever you'd call them) crossed the street slowing down traffic.


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Toukiden Extreme Shows Its Guns And NaginatasBy Sato . July 18, 2014 . 2:30am
The trailer starts with a look at some of the new monsters, then the new weapons in action at the 0:40 mark with the Naginata, Kanabo, and Gun, followed by the weapons that were in the previous game.


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Editorial: Myra does it again
Myra Janco Daniels
Consider it an encore.
Myra Janco Daniels, the founding CEO of the Naples Philharmonic Center for the Arts, keeps looking ahead after retiring from that labor of love.
She raises the curtain on plans for a new one — an education/activities center for latchkey kids in East Naples.
She is joining forces with the Salvation Army to craft a facility to give children from kindergarten through high school something worthwhile, educational and productive to do after school. That surely beats these students heading to empty homes to wait for parents to finish work for the day.
The center is envisioned to include computer labs, sports, a creative arts school, classrooms and workshops.
Aptly, the architect is Eugene Aubry, who designed the Philharmonic Center for Daniels.
The project will be uplifting for East Naples in general in style as well as substance — especially the site at the northwest corner of Airport-Pulling Road and Estey Avenue. It was one of the original camps for the homeless in the 1980s.
Daniels' vision and fortitude — some would call it relentless optimism — was the guiding light for launching a philharmonic orchestra, then a center for its performances and much more, and then an art museum next door.
And now this.
Although her clientele is vastly different in terms of age and social standing, the net impacts of her efforts remain the same: making the community a better place into the future.
Daniels says she has raised about $800,000 of the $3 million it will take to build the center. She aims to raise another $5 million for an endowment to keep the learning center going.
For more information, contact Daniels at 239-598-4047 or email email@example.com.
When she was building the Phil, Daniels reached out by saying, "Let us entertain you for the rest of your lives."
Now the new pitch might be: "Let us educate you for the rest of your lives."
The Daniels touch assures this project is in good hands and will be done smartly.
When she retired from the Philharmonic we said she had earned some time off. But now we are glad to see her back to work.
Subscribe to the Naples Daily News
Need Help? Call us at 1-888-878-6842.
Monday-Friday: 6am-6pm / Saturday: 7am-3pm / Sunday: 7am-2pm


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By Catholic Online (NEWS CONSORTIUM)
3/12/2014 (1 year ago)
Catholic Online (www.catholic.org)
By next month, Norway is expected to become the first country where one in every 100 cars is purely electric. One percent might not sound like a lot, but in the U.S., an equivalent number would be something close to .07 percent.
By Catholic Online (NEWS CONSORTIUM)
Catholic Online (www.catholic.org)
3/12/2014 (1 year ago)
Published in Green
Keywords: Norway, subsidies, electric cars
LOS ANGELES, CA (Catholic Online) - Popular electric vehicles in Norway include the Think and Buddy, which are both produced by Norwegian car makers, as well as Nissan's Leaf and Tesla models. An electric vehicle currently fails to turn heads, especially in the nation's capital of Oslo.
Norway had a fledgling electric car industry of its own years ago. In order to boost sales and reduce emissions, a very generous package of incentives was offered to Norwegians. The most salient and economical one were no taxes. In a country where taxes can double or even triple a car's purchase price, that's huge.
Transport Minister Ketil Solvik-Olsen said the original picture of an electric vehicle as being "tiny, kind of plastic cars seating two people, where you would freeze to death during the wintertime." Therefore, sales were not expected to be brisk in snowy, mountainous Norway.
Parliament decided the tax break would end when the country's EV total reached 50,000, or in 2017, whichever came first.
Norway's electric car industry had pretty much fizzled in 2013, but California-based Tesla was cranking them out, kick-starting other major automakers into action. Tax incentives became a lot more alluring.
Norway became the first country last year to ever have an all-electric vehicle top the monthly best-seller list: the Tesla Model S. In October, it was a different all-electric model: the Nissan Leaf.
There are other many incentives to switch to electric: no tolls, free use of the bus lanes, free parking, free ferry rides and free charging at municipal stations. Norwegians with gas-powered cars pay about $9 a gallon to keep them moving.
In just one year, Norway's EV population doubled to its current total of almost 25,000. A onetime target of 50,000 could be met by the summer of 2015.
EV proponents are ecstatic. Electric cars, they say, are quieter and good for the environment. That's especially true in Norway where 99 percent of generated electricity comes from clean hydropower.
Could there be a possible fly in the ointment? Bjart Holtsmark, one of the few vocal critics of Norway's EV policy, has crunched the numbers and figures that Norway is currently subsidizing each Nissan Leaf - about half the EV population - to the tune of $8,000 per year.
In the U.S., by comparison, EV owners are eligible for a one-time federal tax credit of up to $7,500.
Using that $8,000 figure, Holtsmark goes on to calculate that, in terms of its EV policies, Norway is paying $13,500 per ton of CO2 reduction. A ton of CO2 on the European permit market costs $5.
"If we should have such high subsidies for electric cars in Norway, it must be the goal that electric cars could be a solution for the rest of the world also. You can't have these subsidies only to introduce electric cars in Norway," Holtsmark says.
St. George
St. Ann
St. Francis of Assisi
St. Florian
St. Brigid of Ireland
St. Anthony
St. Joseph
St. Clare
St. Benedict
St. Isidore the Farmer
St. Barbara
St. Joseph of Cupertino
St. Gerard
St. Matthew
St. John the Baptist
St. Christopher
By Elise Harris, CNA/EWTN News
Cardinal Pietro Parolin, the Vatican's Secretary of State, has expressed his hope that Pope Francis' recent environmental encyclical will have a strong impact on the United Nations' three major gatherings this year, and will inspire global powers not only to ... continue reading
By Talia Ramos (NEWS CONSORTIUM)
Summer months bring an intense heat to farmlands and drought stricken parts of the world. The heat from the sun can damage not only crops that need regular water supply, but will also cause sickness, dehydration and death to farm animals. MUNTINLUPA, PHILIPPINES ... continue reading
By Hannah Marfil (NEWS CONSORTIUM)
The severe drought in California has recently alarmed residents of San Francisco, as its century-old sewer system takes a serious hit. Contrary to the popular belief that the drought might give the sewers a break, as it is expected to facilitate less water, it ... continue reading
By Atarah Haely (NEWS CONSORTIUM)
A mysterious object lit up in the sky on June 29 in the southeast. The source has since been confirmed as a space junk passing by and reentering our atmosphere. Sightings of the "fireball" were taken to social media, where people tried to guess whether it was a ... continue reading
By Linky C. (NEWS CONSORTIUM)
A normal life remains to be far-fetched for residents in the town of Monson, CA, located 200 miles from the northern part of Los Angeles. Residents in the area have already spent four gruesome months without running water in their homes. The four years of drought ... continue reading
By Catholic Online (NEWS CONSORTIUM)
The Kiwa tyleri is a furry breed of crab that is only found in the hydrothermal vents in Antarctica. The species can only thrive in water that is between 945 and 104 degrees in Antarctica - making it rare indeed. Growing to only two inches in length, the Kiwa ... continue reading
By Catholic Online (NEWS CONSORTIUM)
The water shortage in California, now dragging into its fourth year is being categorized as "extreme to exceptional drought." Everyone, including all western U.S. states is now expected to conserve - and not just in California. Below are the facts that everyone in the ... continue reading
By Atarah Haely (NEWS CONSORTIUM)
Scientists have cross-bred corals coming from different latitude with variety of temperatures underwater and found that there are some corals that adapt better in climate change than others. With the rapid decline of coral reefs, experts are hoping that this new ... continue reading
By Hannah Marfil (NEWS CONSORTIUM)
With the pressing idea that humans have to find suitable life outside Earth in mind, many projects and experiments are being conducted to find a livable environment on Mars. The planet is not yet suitable to live on but a new project suggests that they may have the ... continue reading
By Catholic Online (NEWS CONSORTIUM)
A spiny little organism rightfully called the Hallucigenia sparsa - so hallucinogenic was it in appearance, had scientists scratching their heads, literally unable to make heads or tails of it. Living in the Cambrian age of 508 million years ago, the ... continue reading


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People Pets
The Cutest Pets on Twitter This Week!We put the call out on Twitter for your cutest photos and you delivered! See our first-place furballs and some runners-up from our daily #cutepic photo contest
Credit: Twitter/JVSEDI
Updated: Saturday Dec 21, 2013 | 06:00 AM EST
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Girls T-Shirts Size 7-16
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Recent Interviews with FOSS Ladies
ROSE Blog: Rikki's Open Source Exchange
One of the many things I love about working in the field of open source is how cooperative it is. For example, look at these recent interviews by and about women from a variety of backgrounds and experience:
Tina Gasperson interviewed LinuxToday's managing editor Carla Schroder for Linux.com.
.51's Maria Webster recently interviewed Drupal developer Angela Byron and Linux Journal's webmistress Katherine Druckman. She also posted an article series by programmer Gloria W. (Thanks for the correction, Maria!)comments powered by Disqus
Issue 177/2015
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NoScript Flaw
Mozilla's script blocker add-on could be putting malware sites on the whitelist.
RIP SSLv3
The Internet community officially banishes the notoriously unsafe Secure Sockets Layer protocol.
Mate 1.1 Arrives
Popular desktop environment continues the Gnome 2 legacy – with new support for the Gnome 3 toolkit.
US Government Requires HTTPS
The Obama White House has issued a memorandum telling all US government agencies they must use HTTPS for all websites and web communication.
Mozilla Signs Firefox Add-Ons
New program will dial up security for the Firefox browser.
Fedora 22 Arrives
Red Hat's community distro embraces the cloud.
Code.org and College Board Team Reach Out for Talented High School Coders
New partnership will bring more and better CS training to US schools
A Peek Inside TeslaCrypt Ransomware
Criminals offer online help over Tor network
Mumblehard Still Spams
Sophisticated malware is still present on Joomla and WordPress sites around the world.
Launchpad Gets Git
Future versions of Ubuntu's code service will support the popular Git version control system used with Linux and other open source projects.


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The National Telecommunications and Information Administration (NTIA) has approved the first digital-to-analog converter boxes under its Convert Box Coupon Program, the agency said last week.
The two models from Digital STREAM Technology support all 18 ATSC digital television formats. The company estimates the DigitalSTREAM D2A1D10 and DigitalSTREAM D2A1D20 will have a suggested retail price of $69.99.
NTIA, which is part of the U.S. Department of Commerce, released and other information about the DTV transition during an expo in Washington, D.C. The agency also announced retailer RadioShack intends to participate in the coupon program and promote consumer education about the DTV transition.
For more information, visit: www.ntia.doc.gov/ntiahome/press/2007/DTVexpo_092507.html.
An Inside Look at Four Virtual Reality Start-Ups
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comScore Introduces MobiLens Plus
North Korean Propoganda Art Inspires the Credits of 'The Interview'
Imaginary Forces Creates Kaleidoscopic Titles for 'Bosch'
Filmmaker Embraces Short Documentary Format with Oscar-Nominated 'Crisis Hotline'
North Metro Television Goes Wireless with Comrex LiveShot
Spectra Logic and HauteSpot Networks Introduce Body-Worn Camera Video Surveillance Solution
Huge Ultra HD Display Lights Up Times Square


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Goma, D.R. Congo Mission
The Next Generation Alliance exists to serve member evangelists through mentoring and equipping, collaborative outreach events, and training and conferences.
Copyright © 2014 Luis Palau Association
Created by Ekko Designs
"The last 5 letters in the word jealousy are LOUSY" great quote from @FrankSheltonJr
@wendyJ_blondie We can't wait either!! #extendtheimpact


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A little of this, a little of that as the spring season for high school sports draws near ŌĆ"
Spring is a time devoted to rebirth, renewal and revitalization. At Lincoln High School, the ushering in of the season immediately on the heels of winterŌĆÖs wicked and sometimes disruptive nature has been greeted by winds of wholesale change.
Two new varsity head coaches have appeared on the scene with Andy Hallam replacing Ed Hunt on the LionsŌĆÖ baseball front while Richard Ryan takes the reins from previous softball mentor Jon Bruckner. RyanŌĆÖs appointment was made official at the Feb. 13 meeting of the Lincoln School Committee with the minutes revealing that BrucknerŌĆÖs resignation took effect Jan. 9.
Ryan played baseball for four seasons at Providence CollegeŌĆÖs now defunct baseball program. His daughter Kelly is a senior softball player at Bryant University after spending her freshman through junior campaigns at Division III Caldwell (N.J.) College. Kelly is a graduate of Mount St. Charles.
Speaking about the new head of the softball program and what he brings to the table, Lincoln High principal Kevin McNamara said, ŌĆ£Richard has been a volunteer assistant coach at Woonsocket and Mount St. Charles. HeŌĆÖs coached some travel teams.ŌĆØ
As for the background story surrounding the varsity baseball gig, Lincoln officials were forced to scramble to find a replacement for Hunt shortly after the commencement of preseason workouts. McNamara wished to refrain from the particulars surrounding HuntŌĆÖs departure, citing ŌĆ£a matter of personnel.ŌĆØ
Regarding the timing of the hire in reference to next MondayŌĆÖs startup date of the regular season, McNamara mentioned, ŌĆ£this is a critical position that we had to move quickly to fill.ŌĆØ
HuntŌĆÖs eight-year run saw the Lions achieve unprecedented success under his watch, starting with 93 regular-season wins against 51 defeats. With Hunt calling the shots, Lincoln teams went on to capture three Division I-North titles (ŌĆÖ07, ŌĆÖ08, ŌĆÖ11) while placing second on three occasions. His only losing season was an 8-10 mark in 2004, his initial season in the dugout after succeeding John Rekos.
ThereŌĆÖs also the high volume of Division I prospects that came out of Lincoln with Hunt at the helm, an amount typically not seen at a R.I. public high school. At URI alone, the pipeline includes Dan Rhault, Tom Coulombe, Kyle Borden, Chris Pickering and Ryan OŌĆÖDell. Kyle Lister was on HuntŌĆÖs first Lincoln squad before going off to Holy Cross. Luke Abraham played one season at South Florida before transferring to Bridgewater State.
Another Lincoln baseball alum, Zach Trenteseaux, appeared in 13 games for Bryant University in 2011. This past winter saw Lions junior Nick Zammarelli verbally commit to Elon University with Hunt playing an integral role in the playerŌĆÖs recruiting.
Regarding Hallam, McNamara expressed confidence that the right person is in place. A teacher at the high school, Hallam guided the Lincoln girlsŌĆÖ basketball team to the Division I playoffs in his first season at the helm after a two-year postseason absence. HeŌĆÖs also served as Jim DawberŌĆÖs right-hand man on Hurd Post 14.
ŌĆ£I expect Andy will do very well,ŌĆØ was the endorsement McNamara offered. ŌĆ£Under his leadership, IŌĆÖm confident that we wonŌĆÖt miss a beat.ŌĆØ
HallamŌĆÖs appointment will become official at the townŌĆÖs next school committee meeting on April 9. The process of finding an assistant coach is moving along with whispers of Joe Conti, the softball player agent for Lincoln Little League, emerging as the leading candidate.
ŌĆō A meeting to discuss the proposed merger of several area American Legion baseball clubs and the potential ramifications that could result is on the docket for next week. Representatives from Upper Deck Post 86, Hurd Post 14 and Blackstone Valley Spinners/Post 33 will be present with members of the state board.
Among the hot-button issues that figure to get cleared up at this important meeting include a). Setting a course of action that will allow youngsters who donŌĆÖt make the senior or junior teams to have the opportunity to explore the possibility of playing with neighboring Legion teams, b). Agreeing upon the high school that will serve as the teamŌĆÖs home base, be it Cumberland or Lincoln, and c). Squaring away sponsorship issues.
ŌĆ£We expect that any confusion which may have surfaced will be alleviated,ŌĆØ remarked Legion chairman John Parente. ŌĆ£WeŌĆÖll do whatever is right.ŌĆØ
ŌĆō In other Legion news, the use of wooden bats is here to stay after going through a trial-and-error process last summer. In addition, Ray Ventura has been installed as the permanent head coach for Collette Vacations/Post 79 with Matt Bergeron continuing his role as the overseer of the Pawtucket-based outfit. Bergeron is also an assistant baseball coach at Rhode Island College.
Lastly, congratulations to Pawtucket sports icon George Patrick Duffy, who in February was inducted into the R.I. Legion Hall of Fame. Mr. Duffy was a onetime head honcho of the operations for Collette.
ŌĆō The high school football schedule for the 2012 season is nearing completion and with it comes news that Tolman and St. Raphael will not renew acquaintances on the gridiron. The game would have been a non-leaguer, requiring some finagling and compromise after the Tigers were bumped up to Division I while the Saints remain in Division II.
One would think the two schools would take a hard look at the success stemming from the three games staged over the past two seasons ŌĆō attracting crowds that are rarely seen at todayŌĆÖs high school sporting events. Perhaps the powers-that-be could have cut through whatever red tape is in place and settle upon a contest taking place the week between the Injury Fund and the kickoff of league play.
Tolman-St. Raphael represented a bright light for Pawtucket, rekindling the fire that existed when the pair were Thanksgiving rivals while introducing the true meaning of ŌĆ£rivalryŌĆØ to a new generation of followers. Instead of Tolman-SRA, local football fans are left with Tolman-Mt. Hope and Hendricken-St. Raphael as the warmup acts for divisional play. Neither one of those games will come close to replicating the buzz that would be felt had the Tigers and Saints reached some sort of common ground.
ŌĆō Cumberland football head coach Chris Skurka has been empowered as the lead mentor of the Rhode Island faction in the annual GovernorŌĆÖs Cup football clash against Connecticut with St. Raphael head coach Mike Sassi on the staff to oversee the secondary. The all-star game is set for Saturday, June 30 at Rentschler Field, home to UConn football.
ŌĆō As much as the 2012 Baseball Prospectus handbook offers fantastic insight into how players may fare, the eyebrows of this scribe were raised upon viewing the player comparables for recently retired shortstop Craig Counsell. To reference Counsell, a lifetime .255 hitter in 16 MLB seasons, in the same class as Hall of Famers Wade Boggs and Barry Larkin seems a bit of a stretch, donŌĆÖt you think?
ŌĆō The news of Austin Rivers leaving after one season at Duke for the NBA is a head-scratcher in this sense: Whenever an underclassman forgoes any remaining collegiate eligibility to pursue pro basketball glory, usually you hear accompanying stories pertaining to how Player X is looking to provide a better life for his family. ThatŌĆÖs not the case with Rivers, who was not brought up under the strain of financial hardship that many of his peers seemingly encounter and desire to escape.
His father, Celtics head coach Doc Rivers, made it clear Wednesday that he supports his sonŌĆÖs decision, yet the question remains why. Upon getting drafted, Austin Rivers will not assume the role as the familyŌĆÖs chief breadwinner. Facing absolutely no pressure to take care of anyone, the youngster would have been better served to put off his NBA dreams for at least a couple of years and remain a student-athlete.


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2009 Election and General Assembly
2009 Election and General Assembly
Candidates ListsPlease, check the following pages for alphabetical list of registered candidates:
- Corporate Members representatives candidates list
- Individual Members representative candidates list
2009 Election Time Line
Election processBecause there was no qurom at last Board of Directors, the Board could not make a negotiated decision with regard to the election and therefore required that we strictly apply the bylaws: only Members in good standing can participate in the election, i.e. vote or be candidate for a seat on the Board or for the Chairperson seat. This means that Individual Members must return their fully executed (signed) membership agreements and Strategic and Corporate Members must settle their call for dues for 2009. As a consequence we have rescheduled the election process so as to allow members who want to vote or be candidate to clarify their memberships.
ELECTION OF BOARD MEMBERSBased on the current number of Strategic Members, Corporate Members will vote to elect 14 representatioves and Individual Members will vote to elect one representative. Strategic Members do not vote. The new schedule is as follows:
- April 6-20: membership validation period
- April 21-30: candidates campaign
- May 1-10: online vote
- May 12: results
- May 15: Board meeting and Chairperson election.
Subject: Candidature from (personal name) (organization name) to the OW2 board
* Membership Category
(Corporate Members or Individual Members)
* Motivations (<200 words)
* Applicant Name
* Applicant Bio (<200 words)
ELECTION OF CHAIRPERSONThe Chairperson is a member of the Board and is elected by the members of the Board. The schedule for the 2009 election is as follows:
- April 16-21: Registration of Candidates
- April 21-30: Candidates campaign: Q&A with the applicants on the mailing list
- May 01-15: Vote: online or face-to-face during a board meeting
- May 15: Result of Chairperson election
GENERAL ASSEMBLYThe 2009 General Assembly of the OW2 Consortium will be held on April 1, 8:30 10:00 just before the opening session of the OW2 Annual Conference. It will take place in the OW2 Conference Center set up within the Solution Linux trade show, in Paris, Porte de Versailles. The draft Agenda of the General Assembly is as follows:
- Report of the Management Office -Financial, General- (20' incl. Q&A)
- Report of the Board of Directors (20' incl. Q&A)
- Report of the Technology Councils (20' incl. Q&A)
- Q&A with the Candidates to the Board of Directors (30')
Useful Links
Joinindustry leaders, academics and individuals and help shape the future of middleware


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Global Security Newswire
Daily News on Nuclear, Biological & Chemical Weapons, Terrorism and Related Issues
Russia Missile Tests Raise Questions
The U.S. State Department is refuting an assertion in a Washington Free Beacon report on Thursday that Russia may be in violation of the 1987 Intermediate-Range Nuclear Forces Treaty with its recent tests of several new ballistic missiles.
On Oct. 10, Russia test-fired its SS-25 intercontinental ballistic missile to a distance less than 2,000 miles. Moscow declared the goal of the trial was to develop a new "combat payload," the Beacon reported.
The Beacon stated the test flight of the long-range intercontinental ballistic missile "appears to be" a circumvention of the nuclear-missile accord. Still, independent issue experts and U.S. officials interviewed by the publication offered different views over whether Russia was in violation or not.
A State Department official told the Beacon: "The test of a Russian RS-12M Topol ICBM on Oct. 10, which was announced in the Russian press, was conducted consistent with the requirements of the New START treaty and was not subject to any provisions or restrictions under the INF Treaty."
According to the Federation of American Scientists, under the INF Treaty Russia and the United States agreed to give up all of their nuclear-tipped ground-launched cruise and ballistic missiles with ranges between 300 and 3,400 miles.
The SS-25 is known as the RS-12M in Russia.
Russia on three occasions also has tested its fifth-generation RS-26 long-range missile to a distance shorter than ICBM-flight capability. The road-mobile RS-26 is also known as the Yars M.
NOTE: This article was updated at 5 p.m. on Friday, Oct. 25.
Note to our Readers
GSN ceased publication on July 31, 2014. Its articles and daily issues will remain archived and available on NTI's website.
NTI Analysis
North Korean Ballistic Missile Models
May 14, 2015
This page contains interactive 3D missile models for North Korea. Users can drag the model by pressing and holding their mouse's scroll wheel. They can zoom in and out on the model by rolling their scroll wheel up and down, and can orbit the model by clicking and dragging their left mouse button.
Nuclear Disarmament Dynamic Map
Feb. 19, 2015
The Nuclear Disarmament Resource Collection contains information and analysis of nuclear weapons disarmament proposals and progress worldwide, including detailed coverage of disarmament progress in countries who either possess or host other countries' nuclear weapons on their territories.
Country Profile
This article provides an overview of Russia's historical and current policies relating to nuclear, chemical, biological and missile proliferation.


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From Publishers Weekly
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Wonderful collection of essays from the master thinker of global finance.Published 10 months ago by Robert R Derbenti
Hey Amazon,
I ordered, and received the Kindle version of this book, read chapter 1, was going to continue reading today, and had an overlaying message on my screen that this... Read more
Could it be that those who commisioned the book gave the author a considerable pile of pesos more than the relative peanuts he'll receive from its publication? Read morePublished on May 19, 2011 by specwiz
Martin Wolf is no doubt much better than other journalists reporting on economic issues, who never know what they are talking about. But MW is not much better either. Read morePublished on November 24, 2010 by marshall
El libro esta muy detallado pero el autor como que trata de justificar en cada momento su punto de vista y deja fuera mucha evidencia.Published on June 28, 2010 by samuel
It is said that generals are always fighting the last war. The thesis of Martin Wolf's "Fixing Global Finance" is that the saying holds also for economic planners. Read morePublished on May 2, 2010 by Omer Belsky
Questions about current account deficits and international savings rates send many fiscal analysts into jingoistic declamations. Read morePublished on January 5, 2010 by Rolf Dobelli
Most books on the mechanics of financial crisis have taken a focus on either the Minsky type instability that was building up from the securitization business or the micro level... Read morePublished on October 20, 2009 by A. Menon
Martin Wolf's submission on the global train wreck is short, written in a readable, journalistic style, and duly supplemented with graphs and tables. Read morePublished on March 31, 2009 by reader 451