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E1. BURT 'July 7, 1970 PIEZOELECTR'IC QLEANING DEVICE WITH REMOVABLE WORKPIECE Filed Jan. 50, 1963 I!fflflllillflllllflff? E LE CTRIC OSCILLATOR W A TE R S 0 U R C E T R U s R Y m .V m N L R E 0 ww w A A M E United States Patent 3,518,766 PIEZOELECTRIC CLEANING DEVICE WITH REMOVABLE WORKPIECE Emanuel Burt, 2714 SW. 36th Ave., Miami, Fla. 33135 Filed Jan. 30, 1969, Ser. No 795,239 Int. Cl. A61c 3/06 US. Cl. 3258 6 Claims ABSTRACT OF THE DISCLOSURE A piezoelectric dental cleaning device comprising a tubular piezoelectric crystal centrally supported within a handle-like hollow casing with a seal near the lower end of the crystal, a removable and replaceable working tip having a working end mechanically coupled at the upper end of said crystal to form a compound resonator therewith, means for effecting longitudinal ultrasonic vibration of said crystal and means for delivering coolant through said crystal and directing it outwardly along the tip to a region adjacent the working end of the tip to flush debris loosened by ultrasonic vibration of said working end of said tip.
RELATED APPLICATION A related application Ser. No. 558,028 of Seymour Robinson is co-pending.
This invention relates to a cleaning device utilizing ultrasonic vibrations for dislodging debris, for example, from a tooth, including tartar, stain, loose particles, calculi, etc.
In general, apparatus embodying the principles of the invention comprises a removable and replaceable tip mounted in a hand piece, the tip being mechanically coupled to a piezoelectric crystal in such a 'way so as to form with it a compound ultrasonic resonator. The vibratory action of the crystal is transmitted to the tip by novel mechanical coupling which permits ready removal and replacement of said tip as desired. The crystal as so formed as to provide longitudinal ultrasonic vibrations when it is activated by high frequency electrical impulses and the resultant ultrasonic vibrations are transmitted by means of the novel coupling directly without reverberatory vibrations through the tip to the point of use. The crystal utilized is of tubular configuration made preferably of lead zirconate and/or lead-titanate ceramic material which is so formed that it has the quality of expanding and contracting longitudinally at ultrasonic frequencies and is joined removably end to end to the tip by the novel coupling means so that the ultrasonic tip movements are directly related to the longitudinal expansion and contraction of the activated crystal. While the latter may be designed to be operated at frequencies from 20,000 c.p.s. upwards to 45,000 c.p.s., for dental applications, such frequencies usually will not exceed 35,000 c.p.s. Since each crystal must be designed for a required frequency, the crystal and tip coupled thereto constitute 1 a matched pair and form said compound resonator. Provision is made in the hand piece for supporting and retaining the crystal and coupling for the tip. In addition, a water duct in conjunction with the hand piece and tip is provided for coolingthe crystal as 'well as ejecting a stream of water adjacent the tip during use.
Use of magneto-strictive activation of responsive metal alloys to provide ultrasonic vibrational motion of a cleansing tip is known in the art. However, a major difiiculty in prior art devices is the concurrent production of reverberatory vibrations during use that may produce undesirable effects.
In the foregoing related Robinson application, the
3,518,766 Patented July 7, 1970 working tip and crystal are permanently joined together so that different working conditions requiring different tips entailed is need for a plurality of complete tools. This need is eliminated in the present invention by providing for replacement of the tip as required without undesirable reverberatory vibrations.
Principal objects and features of this invention are, therefore, the provision of a simply constructed light weight ultrasonic cleaning device having particular adaptability for dental use utilizing ultrasonic vibrations of a removable and replaceable cleaning tip which are generated in such a way that they are directly transmitted to the said removable and replaceable tip without any undesirable reverberatory vibrations.
Other objects and features of the invention are the ice provision of a mechanically simple and effective ultrasonic cleaning device utilizing a compound resonator including a tip and a piezoelectric crystal as the source of ultrasonic vibrations that may be manufactured relatively inexpensively and which will be trouble free and long-lasting in operation and free of reverberatory vibrations.
Other objects and features of the invention are to provide a novel manner of providing debris flushing water at the work tip.
Still other objects and features of the invention are to provide a simple system of cooling the crystal transducer and of conveying the coolant to the work tip for flushing purposes.
Further objects and features of the invention will become apparent from the following specification and the accompanying drawings, wherein:
FIG. 1 is a longitudinal sectional view of a device embodying the invention;
FIG. 2 is a section taken along line 2-2 of FIG. 1;
FIG. 2a is a similar section of a modified construction;
FIG. 3 is an end view seen from the plane of line 33 of FIG. 1; and
FIG. 4 is a sectional view of an end plug-in cap for conducting coolant to the device of FIG. 1 as well as electric current to the crystal transducer.
Referring now to the drawings, and in particular FIG.
1, the reference character 10 denotes generally a cleaning device including an outer insulated casing 11 in the form of a tubular hand piece for convenient manipulation by an operator. This casing 11 may be of plastic or any other suitable electrical insulating material and includes a head end 12 'which is externally threaded at 13 and provided internally with a passageway 14 of narrower internal diameter. The opposite or base end of the hand piece is internally threaded at 15 for purposes presently to be described.
A tubular piezoelectric crystal transducer 16 is mounted internally of the hand piece 11. In the embodiment shown, this crystal comprises a lead zirconate-lead titanate ceramic crystal of tubular shape formed so as to be capable of ultrasonic vibrational activity in its longitudinal direction when activated by high frequency electrical impulses delivered to it as will be described. This crystal transducer 16 is of smaller diameter than the internal diameter of hand piece 11 and is supported coaxially with said hand piece preferably as follows:
A metallic tubular insert 17 preferably of stainless steel or like non-corrosive metal having a diameter approximating the internal diameter of crystal transducer 16 is provided. This insert 17 has an annular external collar 18 disposed in its length and the forward end of said insert is positioned with the base (in this instance left end) of said crystal transducer 16 until said collar abuts the base end of said crystal transducer. The said forward end of said insert is permanently secured to the crystal transducer 16 as by epoxy cement at 19. A nonconductive water tube 20 as of silicone rubber is mounted permanently on the rearward portion of metallic insert 17 with its forward end abutting the rearward face of annnular collar 18 thereof.
Electrical connection to the crystal transducer 16 is effected by providing coatings 21 and 22 of silver or other conductive metal respectivel internally and externally of the crystal transducer 16 which are fused thereto. These coatings are approximately 0.0 015 inch thick and extend to about 38 inches of the inner end and A inch of the outer wall of said crystal transducer 16. They may be applied by electrodeposition or in any other conventional way. Flexible leads 23 and 24 in respective conductive contacts with said coatings 21 and 22 are permanently connected thereto respectively by suitable conductive epoxy cement and are respectively connected as by soldering to a pair of connector prongs or pins 26, 27
mounted in spaced-apart insulative condition to project outwardly of a rear end hand piece cap 28 preferably of the same material as said hand piece 11 and applied at the rear or base end of said hand piece.
This cap 28 has an externally threaded portion 29 that may be screwed into the threaded portion at the base end of said hand piece. The maximum diameter of the cap 28 behind its threaded portion 29 is substantially the same as the outer diameter of said hand piece 11 so that when it is screwed into the latter the rear end of the assembly of cap and hand piece are flush and present unbroken continuity for purposes to be described.
The cap 28 also has a receiving hole 30 extending in its axial direction into which the rearward end of Water tube is mounted preferably with a leak-proof press fit, and includes an O-ring 30' of silicone rubber for seal purposes.
The assembly of cap 28 with water tube 20, metallic insert 17, crystal transducer 16 and leads 23 and 24 is adapted to be mounted within said hand piece 11 from its rearward end. Prior, however, to such installation into said hand piece 11, a potting coating 31 of a suitable insulative molding compound such as silicone rubber is applied over the rearward external surface of the crystal transducer 16, over the metal insert 17 and over the flexible leads 23, 24 as well as the exposed surface of the water tube 20. This coating 31 when it sets serves to secure the rearward or base end of said crystal transducer 16 securely in position on cap 28 and when the latter is then screwed onto the rearward threaded end of said hand piece provides a resilient end support for the rearward end of said crystal transducer 16, to insure its proper vibratory activity when excited electrically as will be described. Without this support and clamping action by said potting component inefficient vibratory activities will occur at the work piece 31 which is mounted at the other end of said crystal transducer as will now be described.
This workpiece 31 is preferably of metal, e.g. stainless steel or beryllium copper or other suitable material in the form of an elongated rod portion 32 terminating in an appropriately shaped working tip 33 adapted for particular ultrasonic dental tooling operations. Since this tip may vary in specific shape as required, it is essential that the workpiece of which it is part be removable and replaceable on the crystal transducer 16 as required. Specifically novel coupling and mounting means between the forward or outer end of crystal transducer 16 and the workpiece 31 are required to provide efficient transmission of the longitudinal vibrations of the electrically excited crystal transducer 16 without reverberatory vibrations so that said workpiece 31 and crystal transducer become in fact a compound resonator in order to provide efficient dental tooling action by the specific working tip 33 of said workpiece 31.
To this end, the novel coupling means between the crystal transducer 16 and the workpiece 31 comprises a tubular metallic impedance transformer 34 of stainless steel or other suitable metal. The inner tubular portion 35 of this transformer 34 has approximately the internal diameter of the outward or forward end of said tubular crystal transducer 16 and is inserted into the latter to the limit permitted by the annular shoulder 36- and rigidly and permanently secured to the crystal transducer as by an epoxy cement 37. The annular shoulder 36 has substantially the same diameter as the external diameter of said crystal transducer 16 and its peripheral surface projects forwardly for a portion of the length of said transformer and then tapers inwardly to provide a bevelled annular shoulder surface 38 and terminates in a cylindrical straight walled tubular portion 39 of somewhat larger external diameter than the inner tubular portion 35.
The central axial hole 40 of the metallic transformer 34 extends through the length of the latter and communicates with the inner hollow space 41 of said crystal transducer 16.
The inner end 42 of the workpiece 31 is removably and replaceably insertable as by a press fit into the forward end of the axial hole 40* of transformer 34. When so mounted, the workpiece extends outwardly coaxially and forwarding of tubular crystal transducer 16.
A hollow, removable forward screw cap 43 of metal or rigid plastic material with internally threaded end 44 is removably screwable onto the threaded end 13 of hand piece 11. This screw cap 43 has a hollow portion 45 of larger internal diameter than the maximum diameters of the crystal transducer 16 and its attached transformer 35. It also is provided internally with a tapered shoulder 46 adjacent to but spaced from the tapered or bevelled surface 38 of said transformer and a forward hollow tubular portion 47, the diameter of whose hole 48 is of substantially larger diameter than that of the body of workpiece 32 which extends through and outwardly thereof without making contact anywhere therewith.
An O-ring 49 of rubber or other resilient material located internally of cap 43 between its tapered shoulder 46 and bevelled shoulder surface 38, serves when cap 43 is screwed into place to maintain the forward end of crystal transducer 16 as well as the body of workpiece 32 axially centered and aligned and free of all contact with internal surfaces of hand piece 11 or cap 43 and also to provide back pressure against the resilient potting coating 31'.
The cleaning device 10 thus far described is connected to a source of water supply as well as oscillatory electric power supply through a removable plug in end fitting 50 (FIG. 4). This fitting 50 comprises a tubular body 51 that may be mounted over the rearward cap 28 and rearward portion of hand piece 11 with a slide fit. It includes a water plug conduit 52 connected to a source of water supply 53 which fits into the rear end of water tube 20 and electrical sockets 54 (only one of which is shown) into which the plugs 26 and 27 extend when the end fitting is mounted on the hand piece 11. These sockets 54 are connected to a conventional oscillator 55 whose output'and frequency may be varied as desired. The oscillating power delivered from oscillator 55 will provide the desired piezoelectric effect and ultrasonic vibrations of said crystal transducer 16 and workpiece 32. For example, at an operating frequency of about 2 8,900 c.p.s., the applied voltage to the crystal transducer would be in the range of about 53 to 200 volts (RR) 40 watts at desired voltage. Conduit 23 and the inner wall of the crystal transducer 16 are preferably connected to the hot side of the oscillator 55 and conduit 22 and outer wall of transducer 16 to the neutral side for protection against possible shock.
To provide for a water outlet and to direct a pressure jet stream of water to the tip 33 of the workpiece 31 adjacent the region of the dental surface being worked upon for removal of debris thereat by such stream, the
workpiece is provided either with a longitudinally extending narrow slot or groove 56 or is of hollow extruded stainless steel whose lumen 56' is approximately .024" in diameter. The respective inner ends of the slot, groove or lumen communicate via hole 40 with the inner space 41 of crystal transducer 16 and the respective outer ends terminate in proximity to the work tip 33 of said workpiece 31. This narrow slot or groove or lumen provides a restricted outlet for water or other coolant fed from the water source to water tube 20 and the interior space 41 of said crystal transducer 16 and ejection of this water as a pressure stream or jet adjacent the dental surface being treated 'by the tip 33 thus providing circulation of water or other coolant longitudinally through the crystal transducer 16 to cool the latter during operation and provides a flushing pressure jet stream for debris at the worktip 33.
In operation, the appropriate workpiece 31 is press fitted into place, cap 43 tightened and fitting 50 applied to the rear end of the hand piece 11, thus connecting water from source 53 and oscillatory current from oscillator 55 to the crystal transducer 16. This creates ultrasonic vibrations in said transducer 16 which, via the metallic transformer 34, are transmitted directly to the workpiece 31 and its tip 33 so that the latter also has ultrasom'c vibrations created in it so that when it is ap plied to a tooth or other dental surface to be cleaned these vibrations serve to liberate accumulated dirt on such surfaces which are flushed away as debris by the jet water spray delivered via slot or groove 56.
The crystal transducer 16 of tubular form consist of a lead zirconate-lead titanate ceramic having the unique quality of expanding and contracting in longitudinal direction when excited by high frequency electrical oscillations as described. While such crystals may be designed to produce this effect with oscillations at from 20,000 c.-p.s. to 45,000 c.p.s., preferably, for dental application, the response will not exceed 35,000 cps. Each crystal 16 is designed to respond more or less to a specific frequency and the replaceable workpiece 31 coupled thereto removably as described provide matched pairs providing Crystal 1 C1ystal2 (strontium (niobium additive) additive) u lin coeflicients:
C 1%1u? 59 64 66 70 Kn 34 35 Piezoelectric Constants:
D 3 (meters per volt) 284X- 375x10- D3 (meters per volt) -120 l0 -170 10- Gas (volt-meters per Newton) 25 10- 24x10- G31 (volt-meters per Newton) 1l 10- --11.5 10-= Dielectric Constant,Ka 1, 300 1, 700 Frequency Constants:
Radial (cycle-meters per second) 2, 100 2, 000 Thickness (cyelemeters per seeon 1, 950 1, 800 Elastic Constants:
YEn (gIIL/OIII. 8.2)(10- 6.1)(10' YEas (gm./cm. 6.6)(10 53 x10- Density (gm./cm. 7.6 7. 6 Mechanical Q, 600 65 Curie Point 0.). 325 365 Crystal 16 can be electrically energized to have vivratory components in other than longitudinal directions to provide various mechanical effects at the tip as desired. This would be accomplished by changing the excitation frequency. In addition, the location of applying the voltage to the crystal can be utilized to produce different effects. For example, by applying the voltage across opposite ends of the crystal produces a torsional effect. Another factor of crystal operation is the relative extent of crystal surface coverage by the silver coating. By fiattening the tip and making the width and thickness of the tip approximately equal one can achieve lateral movement of the outer tip end and consequently the pattern of tip movement can be altered by adjustment of the tip design if other than pure longitudinal or axial motion of the tip is desired.
While specific embodiments have been disclosed, variations within the scope of the present disclosure may be possible within the skill of the art. There is no intention of limitation to the exact disclosure or abstract herein presented.
What is claimed is:
1. A piezoelectric dental cleaning device comprising a tubular hand piece having head and base ends, a tubular piezoelectric crystal transducer, a removable head cap for the head end of said hand piece, a removable base cap for the base end of said hand piece, a tubular insert secured permanently to a rearward end of said tubular crystal transducer, liquid conduit means secured at one end to said tubular insert and at its other end in said base cap, electric conduits joined electrically to inner and outer surfaces of said tubular crystal transducer, connectors extending outwardly of said base cap and electrically connected to respective of said conduits, resilient potting coating covering the rearward end of said transducer, the tubular insert, said liquid conduit means and said electric conduits to support said rearward end of said transducer resiliently in said hand piece when the base cap is mounted thereon, coupling means comprising a tubular metallic transformer secured permanently at the opposite end of said crystal transducer, a metallic workpiece mounted with a press fit into said transformer, and projecting through said head cap, said head cap and said transformer having corresponding tapered surfaces, resilient ring-like means positioned between said corresponding tapered surfaces of said transformer and said removable head cap to center said opposite end of said crystal transducer in said headpiece and maintain said workpiece free of contact with said head cap, said work-piece having a longitudinally extending conduit communicating at one end with the inner hollow space of said crystal transducer and terminating at its other end in proximity to a working tip of said workpiece, and means mountable over the base end of said handpiece for coupling a source of coolant for transit through the hollow space of said transducer to cool the latter and outwardly thereof as a jet via said other end of said longitudinally extending conduit, and means in said lastnamed means to connect said electric conduits to a source of oscillating electric current.
2. A piezoelectric dental cleaning tool according to claim 1, wherein said tubular metallic transformer has a portion dimensioned to fit into said opposite end of said transducer and to be"'secured permanently thereto, an annular external collar abutting said end, an inwardly tapered portion beyond said collar portion providing one of said tapered surfaces and a cylindrical tubular portion beyond the tapered portion into which latter tubular portion said workpiece is removably mountable with said press fit, and said head cap has an internal tapered shoulder providing the other of said tapered surfaces.
3. A piezoelectric dental cleaning tool according to claim 1, wherein said first mentioned tubular insert includes a portion mounted into said rearward end of said tubular crystal transducer, an annular shoulder portion abutting said rearward end and a second portion lying outwardly of said annular shoulder portion, said liquid conduit means having one of its ends mounted on said latter portion and its other end mounted in an opening in said base cap.
4. A piezoelectric dental cleaning tool according to said prongs to said source of oscillating electric current.
5. A piezoelectric dental cleaning tool according to claim 1, wherein said means mountable over the bas e end of said handpiece includes a water plug conduit couplable with said water conduit and connected to said coolant 9 source.
6. A piezoelectric cleaning device according to claim 1, wherein said piezoelectric crystal transducer is comprised of at least one of the group of materials consisting of lead zirconate and lead titanate ceramic crystals dirnentioned to provide longitudinal ultrasonic vibrations at frequencies ranging from about 20,000 to 45,000 c.p.s.
References Cited UNITED STATES PATENTS 3,213,537 10/1965 Baiamuth et a1. 32-28 3,368,280 2/1968 Friedman et a1. 32-58 3,427,480 2/1969 Robinson 310-8.1
ROBERT PESHOCK, Primary Examiner US. Cl. X. R. BIO-8.1
Patent Citations
Referenced by
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MGID Is Exhibiting at the Affiliate Summit East 2015!
So if you are planning to go, stop by table #211, if not — maybe you should consider! The summit has been the "go to" destination for affiliate marketing for 12 years now and it's a great chance to network and share best practices.
The world's leading affiliate marketing industry conference and exhibition is coming to New York on August 2-4 and MGID is thrilled to represent native advertising there!
We can work closely with you on how affiliate marketers can utilize this new and powerful source of traffic for their offers and give in-depth advise on your particular situation. If that's not enough, we have some gifts and special traffic packages only available to people who visit us.
We'll be announcing more information shortly, stay tuned!
See you there!
Emma Stone and Steve Carell MGID's Most Clickable Oscar® Nominees
Global Native Advertising Platform Finds Carell and Stone Have the Best "Click Factor" for Online Ads
Less than a month from the big day, native advertising pioneer MGID announced the most clickable nominees for the 87th Academy Awards®. Emma Stone, nominated for best actress in a supporting role for her performance in Birdman and Steve Carell, nominated for best actor for his performance in Foxcatcher, both ranked 10 out of 10 on MGID's Click Factor scale.
The scale, ranked from 0 to 10, measures how viral a piece of content is based upon user engagement, click-through statistics, and other traffic metrics pulled from more than 3,000 entertainment online news sites and blogs.
The other nominees did not rank over a Click Factor of 2, demonstrating a large margin between content that was viral and content that wasn't. Female nominees with the best click factor were, in order of clickability, Emma Stone, Keira Knightley, Rosamund Pike, Felicity Jones, Marion Cotillard, Meryl Streep, Reese Witherspoon, Laura Dern, Julianne Moore and Patricia Arquette. Male nominees with the best click factor, respectively, were Steve Carell, Edward Norton, Benedict Cumberbatch, Mark Ruffalo, Bradley Cooper, Eddie Redmayne, Ethan Hawke, J.K. Simmons, Robert Duvall, and Michael Keaton.
MGID also conducted a survey of its more than 86,000 Facebook fans to find who they thought would win the Oscars®. Meryl Streep and Reese Witherspoon were chosen along with Bradley Cooper and Edward Norton.
"We certainly don't think an Oscar nominee's Click Factor will indicate who will win the award, or even whether or not they are good actors, but it is a great way to see what Internet audiences are interested in," said Sergey Denisenko, CEO, MGID. "Also the disparity between what our Facebook fans cited as their favorite nominees and what audiences clicked on demonstrates that just because a celebrity is popular, doesn't necessarily mean they are 'clickable.'"
"ACADAMEY AWARDS®" and "OSCARS®" are registered trademarks and service marks of the Academy of Motion Picture Arts and Sciences. MGID is not affiliated with the Academy Awards or the Academy of Motion Picture Arts and Sciences.
Miley Cyrus and Jaden Smith MGID's Most Clickable Celebrities in Native Advertising for 2014
Data from More than 3,000 Online Entertainment Publishers Places Cyrus and Smith as Celebrities with the Best 'Click Factor'
Pop sensation Miley Cyrus and rapper/Karate Kid Jaden Smith rank as native advertising's most "clickable" celebrities, from MGID's more than 3,000 partner entertainment websites. Other notable clickable names included Hayden Panettiere, Chloe Moretz, Jim Parsons and Jason Statham.
Celebrity "click factor" is derived from an algorithm that aggregates data on user engagement and virality among millions of visitors to entertainment, lifestyle and sports publishers. MGID uses "click factor" to identify the entertainment topics that are most desirable by the end-user and can help inform content creators and advertisers relevant audience trends.
MGID's list of top most clickable names in native ads was divided by male and female, where female celebrities seemed to enjoy significantly higher "click factor" than males did. 2014 findings revealed that, with only a few exceptions, female celebrities are far more popular in native advertising than their male counterparts.
The top 10 most "clickable" female celebrities are:
- Miley Cyrus
- Hayden Panettiere
- Chloe Moretz
- Ariana Grande
- Bella Thorne
- Kaley Cuoco
- Miranda Cosgrove
- Selena Gomez
- Kelly Osbourne
- Willow Smith
The top 10 most "clickable" male celebrities are:
- Jaden Smith
- Jim Parsons
- Jason Statham
- Ben Affleck
- Dwayne the Rock Johnson
- Justin Bieber
- Daniel Radcliffe
- Ryan Gosling
- Lil Wayne
- Prince Harry
MGID measures the "click factor" of celebrities by calculating a range of criteria, including number of articles published, the number of impressions the ads received and the amount of "click-throughs" the article generated.The anonymous behavior of nearly 20 million individual website visitors who clicked on more than 180,000 of native ads on 3,000 websites, worldwide, was analyzed. The data was tracked through MGID's native advertising widgets, housed on entertainment and lifestyle websites to monetize and engage their audience.
"Click factor is a great tool for understanding the pulse of Internet audiences," said Sergey Denisenko, CEO, MGID. "For native advertising to be successful, website visitors must take a captive interest in the content given to them. It is clear that ads featuring these celebrities reflect the most important trends of 2014 with entertainment and lifestyle audiences."
MGID, global native advertising pioneer and member of the Interactive Advertising Bureau, connects millions of people annually with targeted entertainment and lifestyle content on thousands of websites, improving the online experience of the consumer to the benefit of both advertisers and publishers.
MGID Announces the Top Ten Clickable Native Advertising Topics for the First Half of 2014
Mid-Year Trends Analysis Reveals Internet Destinations with the Best "Click Factor" Include Flash Games and "Then and Now" Childhood Crushes
Native advertising pioneer MGID identified the top-ten Internet content trends for the first half of 2014 today, having aggregated engagement and virility from millions of visitors to more than 3,000 entertainment, lifestyle and sports websites. Flash games topped the list as the type of content that had the best "click factor" among the visitors of the MGID network thus far in 2014.
The top 10 most clickable trends for the first half of 2014 are:
Flash Games
Childhood Crushes (Then and Now)
Facebook Picture Fails
Couple Physical Training
Luxurious Lifestyle
Bollywood Stars
Movie Mistakes
Kaley Cuoco
Elsa Transformation (from Frozen)
Hayden Panettiere Bikini Style
MGID measures the "click factor" of Internet content by calculating specific traffic criteria, such as the number of articles published about the topic and the amount "click-throughs" generated as a result of publishing the content.
The analyzed traffic came from nearly 9 million individual website visitors, clicking on content from more than 3,000 websites, worldwide. MGID tracked the data from user clicks on native advertising widgets that thousands of online publishers use to engage and monetize their audience.
"Whenever we see pop culture and entertainment trends in our system, it gives us some further insight into the behaviors of our audience," said Sergey Denisenko, COO, MGID. "It is paramount that we understand audience behavior so that we know how advertisers canbetter engage website visitors with authentic and relevant content that is interesting to them. Our platform makes it possible for websites to create high valuable content and to connect with users looking for that content."
MGID, a comScore-verified traffic vendor in the trending native advertising space, connects thousands of websites with millions of people annually and services publishers and advertisers with a content-driven campaign platform that improves the experience of both the advertiser and the consumer.
MGID Moves U.S. Headquarters to Los Angeles to be Closer to Key Sports, Entertainment, Lifestyle Clients
Native Advertising Pioneer MGID Delivers More than 1 Billion Native Ads Impressions Daily Over a Network of 3,000 Partners.
MGID, a pioneering network in native advertising, is moving its U.S. headquarters to Los Angeles to be closer to sports, entertainment and lifestyle clients. Founded in 2008, MGID now delivers more than one billion targeted native ads impressions daily through its 3,000 publisher partners, serving web-surfers with relevant, entertaining news, pop culture articles and multimedia.
A global leader in the native advertising space, MGID covers more than 50 categories of subject matter and currently generates more than 90 million authentic, unique monthly visitors.
MGID prides itself on delivering quality traffic comparable to that of context ads and organic search traffic, but for a fraction of the cost.
"Lifestyle advertisers are beginning to understand that the old ways of doing things do not resonate with today's audiences," Sergey Denisenko, COO, MGID, explains. "Website visitors respond to content only if it is tailored specifically to their interests. Irrelevant ads are a turn off. Our customers want content their website visitors will be genuinely interested in."
MGID has become a trusted content network that delivers with comScore-verified traffic that is in full compliance with IAB standards. Account specialists are available 24/7 to advise customers on how best to optimize their campaigns or monetize their sites.
MGID's new U.S. Headquarters are at 1514 17th St. #207, Santa Monica, Calif., 90404. For more information, see http://mgid.com.
MGID in Numbers (according to comScore)
MGID team is happy to present the result of company's business activity in numbers for 2013. Data and stats, verified by comScore - a leading internet technology company in analytics, were throughly analyzed and compiled to create short and clear presentations for our users, vistors, clients and natvie advertising business insiders.
MGID Network (US) stats for February-December 2013 (11 months):
Fem MGID Network (US) stats for March-December 2013 (10 months):
MGID Network (World Reach) stats for 2013:
Don't hesitate to contact us to discover the new opportunities for your business today.
MGID Grows Traffic for Sports and Gaming Websites
Digital media giant MGID Inc. announces the launch of their Sports and Gaming sub-networks. These networks were created for advertisers and publishers who want to attract more high quality and relevant traffic to their websites, increasing their audience in an intelligent way.
The new MGID Inc. initiative will cater to the growing Sports and Gaming categories in a way which ease the process of increasing pages viewed through the rise of relevant users. Many reputable websites with premium content from their respective categories, have already joined the new sub-networks and are enjoying its benefits.
"The launch of these two highly anticipated sub-networks, resulted from long discussions with partners and clients, as well as users – who are our core focus." - commented, Nick Marr, Company Director (MGID Europe). "These sub-networks open some very attractive opportunities for websites with Sports and Gaming content. I believe the Sports and Gaming sub-networks will allow relevant websites to see their traffic growth potential explode."
Being a part of the Sports and Gaming sub-networks allow advertisers and publishers to:
- Get a 10%-15% increase in page views
- Increase the number of relevant unique visits
- Raise in ads revenue from banner impressions
- Get the opportunity to promote/advertise content on a huge network of websites
- Save money – MGID does it for free and it's an easy process to start
Example of a gaming widget
Example of a sports widget
MGID launches advanced GEO-targeting features
MGID Inc., the leader in digital marketing announces the launch of its Advanced GEO-Targeting System® features, which allows advertisers to push the limits realizing maximum potential from their ad-campaigns!
The technology behind the new extended targeting opportunities allows advertisers to target not only all countries, but also particular regions within these countries. The update is applicable only for clients who use our services on the bidding basis. It has been thoroughly tested and is now ready for use by MGID's network partners.
Aside from the introduced features MGID Inc. is developing a city-targeting feature that will be available very soon.
"Thanks to the targeting options recently presented by our company, advertisers will be able to choose from a wider range of ad campaign settings." - said Robert Bardunias, Executive Vice President of MGID Inc. "It allows our clients to create incredibly sophisticated campaigns with targeting features that correspond to their precise advertising/demographic needs. We are convinced that our customers will be delighted when they use the MGID Advanced GEO-Targeting System®."
In order to use the new targeting-features, please consult your traffic expert, and he/she will be glad to assist you with the advanced GEO-targeting adjustments.
Twilight star Kristen Stewart is the world's most clickable celebrity this summer
Actress ranks top of MGID's Click Factor - the top 10 celebs consumers felt compelled to click on.
Kristen Stewart – who rose to fame as Bella Swan in the Twilight films – is summer 2012's most clickable celebrity. Web traffic generator MGID's Click Factor ranked the American actress as the celebrity consumers felt most compelled to click on during the period June 1st to August 31st 2012.
With a Click Factor of 9 the Twilight star topped the list. Second place went to singer Beyonce with a Click Factor of 8, while rapper Nicki Minaj came third with a Click Factor of 7.3. Surprisingly the results revealed that singer Justin Bieber – the world's most Googled celebrity – only ranked ninth, with a Click Factor of just 2.7. Since the summer Click Factor scores are calculated from the beginning of June to the end of August, Prince Harry only just squeezed onto the list in last place following his late August exploits in Las Vegas.
MGID measures the Click Factor from the Internet user clicks generated via the MGID widgets that many thousands online publishers display on their websites. MGID's widgets have a reach of 120 million people. The widgets display compelling editorial teasers – an image and a descriptive headline – developed by MGID's expert team. These teasers attract Internet users' attention and encourage them to click on the links for more information, taking them through to a publisher's or advertiser's website.
The MGID Click Factor is calculated using criteria including the number of times people clicked on teasers about celebrities, how many articles online publishers produced about each celebrity and the average amount of click-throughs per teaser.
MGID's widgets appear below articles on websites, rather than the more typical advertising spaces above and beside publisher's content. Online publishers carrying MGID's widgets are rewarded in two ways: by gaining revenue for carrying teasers to advertorials or by receiving more traffic to their website.
MGID Click Factor Summer 2012 results:
Kristen Stewart
Nicki Minaj
Selena Gomez
Kim Kardashian
Emma Watson
Megan Fox
Sunny Leone
Justin Bieber
Prince Harry
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Originally written on Fox Soccer | Last updated 4/1/13
Dimitar Berbatov was never concerned about QPR's comeback or Fulham's Premier League survival following their 3-2 win at Craven Cottage. Fulham exploited generous defending from their West London rivals to establish a 3-0 lead inside 41 minutes through the striker's double and a Clint Hill own goal. Adel Taarabt pulled one back in the first half and Loic Remy added a second, moments after seeing a penalty saved, before Fulham lost Steve Sidwell to a red card for a late foul on Armand Traore. And despite a late onslaught from the visitors, the Bulgarian always felt Martin Jol's side had enough quality to hang on. "We have always been safe, I don't think anyone should worry - we play good football," Berbatov told Sky Sports 1. "I was not nervous, we almost threw the game away, we had a comfortable lead. "Maybe when they scored their second goal they believed. We held our lead we should score more, but three points is good for us."
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text: Thursday's game against the Islanders will be a significant one for the Rangers organization, and not just for the opportunity to string together their fourth straight win. The rivalry match will mark Rangers prospect J.T. Miller's fifth NHL game, after which the club must make an important decision: whether to keep the 19-year-old center up with the big club or send him back to the team's AHL affiliate to save a year of eligibility on his contract.


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Pneumococcal diseases remain a major cause of morbidity and mortality worldwide. Updated data on drug-resistance from different populations may be important to recognize changes in disease patterns. This study assessed current levels of penicilin resistance among Streptococcus Pneumoniae causing pneumonia in Spanish middle age and older adults.
Antimicrobial susceptibility was tested for 104 consecutive isolates of Streptococcus pneumoniae recovered from patients 50 years or older with radiographically confirmed pneumonia in the region of Tarragona (Spain) between 2002 and 2007. According to the minimum inhibitory concentration of tested antimicrobials (penicillin, erythromycin, cefotaxime and levofloxacin) strains were classified as susceptible or resistant. Antimicrobial resistance was determined for early cases (2002–2004) and contemporary cases (2005–2007).
Twenty-seven (25.9%) were penicillin-resistant strains (19 strains with intermediate resistance and 8 strains with high resistance). Penicillin-resistance was higher in 2002–2004 than in 2005–2007 (39.5% vs 18.2%, p = 0.017).
Of 27 penicillin-resistant strains, 10 (37%) were resistant to erythromycin, 8 (29.6%) to cefotaxime, 2 (7.4%) to levofloxacin, and 4 (14.8%) were identified as multidrug resistant. Case-fatality rate was higher among those patients who had an infection caused by any penicillin susceptible strain (16.9%) than in those with infections due to penicillin-resistant strains.
Resistance to penicillin among Streptococcus pneumoniae remains high, but such resistance does not result in increased mortality in patients with pneumococcal pneumonia.
Streptococcus pneumoniae is the most frequent isolate from clinical samples of respiratory tract infection, including acute exacerbations of chronic bronchitis and community-acquired pneumonia [1-3]. The emergence of multiple drug-resistance has complicated the empirical treatment of pneumococcal infections. Several surveillance programs that span numerous countries indicate that the proportion of drug-resistant Streptococcus pneumoniae isolates continues to increase worldwide[4]. However, in Spain, where there was a great increase of penicillin-resistance in 1980s, stabilization in 1990s and a decrease in penicillin-resistant isolates in the last few years has been reported [5-7].
In elderly people, the population group with highest rates of pneumococcal infection, the penicillin intermediate-susceptibility strains has not been associated with increased mortality or unsuccessful treatments, so these strains can be treated with β-lactams. If we consider penicillin-resistant pneumococci, data reported on mortality has not been uniform[4,8,9].
Updated data about drug-resistance in Streptococcus pneumoniae isolates from different populations may be important in recognizing changes in disease patterns. The present study describes current levels of drug resistance among Streptococcus pneumoniae causing community-acquired pneumonia in Spanish middle aged and older patients, and evaluates clinical factors associated with increasing drug resistance or mortality.
Hospital case-series that included 104 consecutively recruited isolates of Streptococcus pneumoniae recovered from patients 50 years or older with a radiographycally confirmed community-acquired pneumonia in the region of Tarragona (a mixed residential industrial urban area in the Northeast Mediterranean coast of Spain) with Antimicrobial susceptibility to penicillin tested between January 2002 and April 2007.
The isolates of S. pneumoniae were identified from blood and sputum samples in the microbiology laboratory of two reference hospitals in the study area (Joan XXIII and Sant Pau i Santa Tecla) by standard methods. Pneumococcal serotyping was carried out by the Quellung reaction using the Statens Serum Institute (Copenhagen, Denmark) typing sera. Penicillin susceptibility was determined by the Kirby-Bauer disk diffusion method with a disk containing 1 μg oxacillin (BD BBL, Sparks, MD USA). Isolates were defined as resistant when the growth inhibition diameter was 19 mm or less. Minimal inhibitory concentration (MIC) for penicillin and cefotaxime was determined by E-test method (AB Biodisk, Solna, Sweden) following the manufacturer's instructions. Penicillin-susceptible was considered when MIC ≤ 0.06 μg/mL, penicillin intermediate-resistant when MIC 0.12 – 1 μg/mL and high resistance when MIC ≥ 2 μg/mL. Cefotaxime susceptibility was considered when MIC ≤ 1 μg/mL, cefotaxime intermediate when MIC 2 μg/mL and cefotaxime resistant when MIC ≥ 4 μg/mL. Erythromycin and levofloxacin susceptibility was determined by the Kirby-Bauer disk diffusion method with a disk containing 15 μg erythromycin and 5 μg levofloxacin respectively (BD BBL, Sparks, MD USA). Erythromycin susceptibility was considered when the growth inhibition diameter was ≥ 21 mm, erythromycin intermediate between 16 and 20 mm, and erythromycin resistant ≤ 15 mm. Levofloxacin susceptibility was considered when the growth inhibition diameter was ≥ 17 mm, levofloxacin intermediate between 14 and 16 mm, and levofloxacin resistant ≤ 13 mm, according to the guidelines established by the National Committee for Clinical and Laboratory Standards (formerly NCCLS)[10]. Multidrug resistance was defined as intermediate resistance or resistance to penicillin plus intermediate resistance or resistance to ≥ 2 antimicrobial agents[11].
Cases were validated by checking clinical records and, according to the presence of underlying medical conditions, all patients were grouped into 3 risk strata on the basis of the degree of immunocompromise and risk for pneumococcal disease. High-risk level included persons with conditions associated with possible immunocompromise: immunodeficiency (including AIDS), asplenia, cancer (solid organ or haematological neoplasia), chronic nephropathy (nephrotic syndrome, renal failure, dialysis or transplantation), and long-term corticosteroid therapy (20 mg/day of prednisone or equivalent). Moderate-risk level included patients without a level 1 condition but who had a history of chronic lung disease (chronic bronchitis, emphysema or asthma), liver disease (cirrhosis or alcoholic hepatitis), heart disease (congestive heart failure or chronic angina) and diabetes mellitus. Low-risk level included patients without the above mentioned risk conditions.
Pneumonia severity index (PSI) was calculated according to criteria described in classical meta-analysis, and case-fatality was considered when the patient died (in-hospital or not) within the first 30 days after the diagnosis of pneumonia[12,13].
Penicillin-resistance was determined for early cases (2002–2004) and contemporary cases (2005–2007). For the statistical analysis, continuous variables were compared by Student's t test, whereas categorical values were compared using chi-squared or Fisher's test as appropriate.
The study was approved by the ethical committee of the Catalan Health Institute and was conducted in accordance with the general principles for observational studies set out by this institution (Exp FIS 050231).
Patient characteristics
Median age of case patients was 71.9 years (SD: 11.6), and 75 (72.1%) were male. Fifty-nine (56.7%) were 50–74 years-old, and 45 (43.3%) were 75 years or older. Five cases were managed as outpatient and 99 were hospitalised (20 of which required admission to the ICU). Overall case-fatality rate was 15.4% (40% among those admitted in the ICU).
The most prevalent underlying conditions were chronic pulmonary disease (33.7%), smoking (28.8%), chronic hearth disease (25%) and diabetes mellitus (21.2%). Thirty-one cases (29.8%) were assigned to high-risk level, 46 (44.2%) to moderate-risk level and 27 (26%) to low-risk level. Twenty-five (24.1%) patients were assigned to PSI classes' I-III and 79 (75.9%) to classes IV and V (table 1).
Table 1. Clinical characteristics of patients with pneumococcal pneumonia according to penicillin susceptibility.
S. Pneumoniae serotypes
Pneumococcal serotype was identified in 60 cases, whereas 14 cases were due to nonserotyped organisms and 30 were not serotyped. Of the 60 serotyped cases, 12 (20%) were due to type 3, seven (11.7%) due to type 1, four (6.7%) due to type 14, four (6.7%) due to type 6A, four (6.7%) due to type 8, three (5%) due to type 6B, three (5%) due to type 12F, two (3.3%) due to type 5, two (3.3%) due to serotype 4, two (3.3%) due to type 19F, two (3.3%) due to type 23A, two (3.3%) due to type 35B, two (3.3%) due to type 7F, two (3.3%) due to type 19A, two (3.3%) due to type 23B and one due to types 9V, 9N, 15B, 16, 23F, 33 and 38.
Antimicrobial susceptibility
Of the total 104 cases, 27 (25.9%) were penicillin-resistant strains: 19 strains with intermediate resistance and 8 strains with high resistance (four cases with MIC = 2 μg/mL; four cases with MIC = 4 μg/mL)
Of the 100 isolates tested for erythromycin, 19 (19%) were resistant. For levofloxacin, 89 isolates were tested and five (5.6%) were resistant. Among the 93 isolates tested for cefotaxime, nine (9.7%) were resistant (table 2).
Table 2. Antimicrobial resistance to cefotaxime, erythromycin and levofloxacin observed among pneumococcal strains isolated over the study period.
Only four (14.8%) isolates were identified as multidrug resistant S. pneumoniae (MRSP). Of these, one case was highly resistant to penicillin, cefotaxime and levofloxacin and three cases were highly resistant to penicillin, erythromycin and cefotaxime. Median age of patients with MRSP was 76.8 years, all of them had an underlying disease (one was current smoker, one had chronic heart disease and two had a chronic pulmonary disease), three were non-bacteremic cases and only one died. In three cases the microorganism was resistant to the initial antimicrobial regimen, and one of them died. Only two MRSP were serotyped (6B both of them).
Globally, 76 specimens were recovered from blood samples and 28 from sputum samples. Of the 42 resistant strains at least to one antibiotic, 26 (62%) were isolated from blood and 16 (38.1%) were from sputum. Although the difference did not reach statistical significance, penicillin resistance was substantially higher among Streptococcus pneumoniae recovered from sputum than from blood (44.4% vs. 24.2%, p = 0.186).
Comparing penicillin-susceptible and non-susceptible strains, statistically significant differences were observed only for age (table 1). Of the 19 serotyped strains with penicillin resistance, four (21.1%) were serotype 14, three (15.8%) were serotype 23B, three (15.8%) were serotype 6B, two (10.5%) were serotype 19F, two (10.5%) were serotype 6A, and one were serotypes 1, 3, 8, 9V and 35B.
Penicillin-resistance was substantially lower in contemporary isolates than in early isolates (18.2% vs 39.5%, p = 0.017). Of the 38 early isolates, 10 strains with intermediate resistance and five strains with high resistance. Of the 66 contemporary strains, 9 strains with intermediate resistance and three strains with high resistance. Among patients 50–74 years old and among patients with moderate risk this decrease was statistically significant (table 3).
Table 3. Comparison of patients with pneumococcal pneumonia caused by penicillin-resistant strains in early and contemporary isolates according to their age and risk stratum.
Impact of resistance on severity outcomes
Mean length of hospital stay was slightly higher among patients infected with penicillin-resistant strains than in penicillin-susceptible strains (16.9 vs. 13.5 days; p = 0.358). PSI score did not differ in both groups (112.5 vs. 111.1; p = 0.838).
Overall mortality was 15.4%. One patient died among the 8 cases with an inadequate initial antimicrobial therapy, based on antibiogram results. Although it was not statistically significant, mortality was considerably higher among those patients who had an infection caused by a penicillin susceptible strain than in those with infections due to penicillin-resistant strains (16.9% vs. 11.1%; p = 0.474).
Antimicrobial therapy
The antimicrobial therapies initially used in the 104 patients were: levofloxacin in 26 cases (25%), an association of macrolide and cephalosporin in 18 cases (17.3%), amoxicillin clavulanic acid in 14 cases (13.5%), a cephalosporin in 14 cases (13.5%), an association of macrolide and amoxicillin clavulanic acid in 14 cases (13.5%) and other treatments or associations in 18 cases (17.3%).
Considering the 8 cases classified as high-resistance to penicillin, antimicrobial therapy initially used after CAP diagnosis was levofloxacin in 3 cases, amoxicillin clavulanic acid in two cases, an association of macrolide and cephalosporin in two cases, and one case was treated with tazobactam. One patient (a man 88 years-old, PSI class V, treated with amoxicillin clavulanic acid, with bacteremic pneumococcal pneumonia due to serotype 6B, resistant to penicillin (MIC = 2) and resistant to cefotaxime, erythromycin and clindamycin) died two days after hospital admission, whereas the remaining 7 patients were non-fatality cases.
Considering the 19 cases classified as intermediate-resistance to penicillin, antimicrobial therapy initially used after CAP diagnosis was cephalosporin in 5 cases, amoxicillin clavulanic acid in 4 cases, an association of macrolide and cephalosporin in 4 cases, levofloxacin in 2 cases, and other treatments or associations in 4 cases. Two of these patients, both treated with a third generation cephalosporin, died within 10 days after hospital admission (one case was a man 67 years old with bacteremic pneumonia, PSI class V, due to serotype 14; and an other case was a man 76 years-old with bacteremic pneumonia, PSI class IV, due to serotype 6A), whereas the remaining 17 penicillin intermediate resistance cases were non-fatality cases.
In the present study, the overall rate of penicillin-resistance among isolates of Streptococcus pneumoniae was considerable (25.9%). The proportion of penicillin-resistance was higher among early isolates than in contemporary isolates, which concurs with other Spanish studies[5,7,14]. Among Spanish individuals, Fenoll et al[7] found that a high-level penicillin-resistance rate (MIC > 2 mg/l) decreased from 13.3% in 1997 to 12.9% in 2001. In Catalonia, the high-level penicillin-resistance fell from 15% (1989–1993)[3] to 8.9% (1999–2002)[14], which fits with the 9% found in our study. In contrast, the results found in other countries showed an increase in penicillin-resistance rate. In United States, the high-level penicillin-resistance increased from 14.7% (1998–1999) to 18.4% (2001–2002)[15]. Although several factors explain the emergence of drug resistant Streptococcus pneumoniae, the single most important consideration, however, is the selective pressure of use of antimicrobial agents. Reductions in the rate of resistance found in our study could be explain by a reduction in consumption of antibiotics in Catalonia, going from 17.77 defined daily doses per 1000 inhabitants per day (DHD) in 1999 to 12.58 DHD in 2006, and could be partially attributed to the vaccination that covers serotypes typically associated with drug resistance[14].
We found a statistically higher age among patients infected with penicillin-resistant strains than in those infected with penicillin-susceptible strains. However, because of low statistical power, we could not reject that prevalence of underlying conditions was the predisposing cause for this age-related differences in the aetiology of pneumococcal pneumonia.
In accordance with previous studies[5,14] we found a high proportion of underlying diseases among patients with pneumococcal pneumonia. Although not statistically significant, the proportion of penicillin resistance in our study was higher among patients with low or moderate level risk in early isolates. Conversely, in contemporary isolates this proportion was higher among patients in high level of risk. Some studies[6,16] have reported that patients with chronic pulmonary disease, HIV infected, suspected aspiration or who were admitted to the hospital within the previous 3 months were more likely than other patients to have penicillin resistant pneumococcal pneumonia. In our study, only two patients had been hospitalized in prior 3 months, and none of them were HIV infected. Chronic pulmonary disease was highly prevalent in our study but differences were not observed in prevalence by penicillin resistance status.
Almost three quarter (74.1%) of penicillin-resistant pneumococcal pneumonia were PSI classes IV-V. There was a similar percentage of penicillin-resistant pneumonia between PSI classes IV-V and PSI classes I-III. This results agree with those found in other studies[6,16] that only reported a trend for higher PSI classes to be associated with penicillin-resistant pneumococcal pneumonia.
In the present study, the rate of penicillin susceptibility was higher in bacteremic than non-bacteremic cases (65.8% vs. 42.9%). These fits with Aspa's report[6], where penicillin susceptibility was 71% among blood culture isolates and 50% among sputum isolates. In the USA, a higher prevalence of resistance to penicillin among lower respiratory tract than among isolates recovered from blood samples (16.2% vs. 13.7%) has also been reported[15].
In our study, most penicillin resistant S. pneumoniae isolates were resistant to at least one additional antimicrobial agent, and 3.8% (four cases) of all isolates were identified as MRSP. As described in previous studies penicillin resistance, particularly high-level resistance, predicts resistance to other antimicrobials[11,14,17-19]. We found that all MRSP were highly resistant to penicillin and cefotaxime, and three of them were highly resistant to erythromycin too.
We found that an inadequate initial antimicrobial treatment was started in 7.7% of patients. Although in our study there was no excess mortality due to initial inappropriate treatment (12.5%), likely due to a small sample size, it is important to take into account underlying condition or regional pattern of drug resistance for S. pneumoniae in determining adequate antimicrobial therapy[11,17,20].
In accordance with other studies[5,14,21,22], penicillin resistance was not related with higher mortality. It has been suggested that the primary determinant of virulence might be the serotype rather than its sensitivity to penicillin, and it is possible that the mechanisms conferring penicillin resistance are related to those leading to a loss of virulence. Previous studies of pneumococcal bacteremia did not show differences in mortality between those with susceptible and those with non-susceptible pneumococci after adjustment for age, underlying disease, severity of illness on presentation, and appropriate concordant treatment[5,6,16].
We found that three serotypes (14, 6B and 23B) were associated with increasing risk of penicillin resistance, accounting for a 53% of serotyped pneumococci causing penicillin-resistant infections and the serotype 6B was responsible for 50% of cases of MRSP. In accordance with our results, Fenoll et al[7] reported that 56% of penicillin-resistant pneumococcal strains belonged to serotypes 6 (18%), 14 (19%) and 19 (19%). In a long term follow-up between 1983 and 2003 Mufson et al[23] found that all blood isolates of penicillin-resistant were capsular serotypes 6, 9, 14, 19 and 23.
Main limitation in this study includes the relatively low number of cases and the difficulty to generalize results. According to classical breakpoint criteria, it could be concluded that, in the study area, resistance to penicillin among Streptococcus pneumoniae remains high, although such resistance does not result in increased severity or mortality. However, it must be emphasized that, according to the new breakpoint criteria for intravenous penicillin[24], almost all strains in our study would be susceptible.
To date, criteria for penicillin susceptibility of Streptococcus pneumoniae remains unchanged for patients without meningitis who can be treated with oral penicillin (e.g., for outpatient pneumonia). However, since 2008, for patients without meningitis who are treated with intravenous penicillin, the new breakpoints are ≤ 2, 4, and ≥ 8 μg/mL for susceptibility, intermediate-resistance and high-resistance, respectively[24]. Thus, considering the new pneumonia breakpoints, 100 (96.2%) of the 104 cases in our study would be penicillin-susceptible (MIC ≤ 2 μg/mL), 4 (3.8%) would be penicillin intermediate-resistant (MIC = 4 μg/mL) and none would be high resistance (MIC ≥ 8 μg/mL).
According to the change in pneumonia breakpoint for susceptibility[24], percentages of strains resistant to penicillin have dramatically decreased worlwide. In Spain, a large surveillance study that included 2,721 isolates of S. Pneumoniae obtained from November 2001 to October 2002 in diferent Spanish Hospitals[25] reported that (taking into account the old pneumonia breakpoint) 20% of overall strains were penicillin resistant (MIC >2 mg/mL) and 24% were intermediate resistant strains (MIC = 0.12–1 mg/mL). However, if we consider the new pneumonia breakpoint, 94.3% of the total strains in the forementioned study would be currently considered penicillin susceptible, which is also in agreement with data found in the present study (96.2% penicillin susceptible strains in our study considering the new breakpoint).
According to classical pneumonia breakpoints for susceptibility to penicillin, the resistance among Streptococcus pneumoniae was considerable, but with the use of new breakpoints, the percentage of Streptococcus pneumoniae penicillin-resistant decreases dramatically.
In vitro penicillin resistance is not associated with increasing mortality, even considering new breakpoints for susceptibility to intravenous penicillin.
The low mortality rates reported among patients with pneumonia due to penicillin resistant strains could likely be due to the fact that patients were treated with active agents, such as penicillins or third generation cephalosporins.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
AV-C, FB, ES, OO-G and CdD designed the study, assessed outcomes, and wrote and edited the paper. FG-B, XR and XC obtained the data. VA did the statistical analysis. AV-C coordinated the study.
This study was supported by a grant from the "Fondo de Investigación Sanitaria" of the Spanish Health Ministry (expedient FIS-050231).
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Neuman MI, Kelley M, Harper MB, File TM Jr, Camargo CA Jr, EMNet Investigators: Factors associated with antimicrobial resistance and mortality in pneumococcal bacteremia.
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Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement M100-S17.
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Clavo-Sánchez AJ, Girón-González JA, López-Prieto D, Canueto-Quintero J, Sánchez-Porto A, Vergara-Campos A, Marin-Casanova P, Córdoba-Doña JA: Multivariate analysis of risk factors for infection due to penicillin-resistant and multidrug-resistant Streptococcus pneumoniae: a multicenter study.
Clin Infect Dis 1997, 24(6):1052-9. PubMed Abstract | Publisher Full Text
Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, Coley CM, Marrie TJ, Kapoor WN: A prediction rule to identify low-risk patients with community-acquired pneumonia.
N Engl J Med 1997, 336:243-50. PubMed Abstract | Publisher Full Text
Fine MJ, Smith MA, Carson CA, Meffe F, Sankey SS, Weissfeld LA, Detsky AS, Kapoor WN: Efficacy of pneumococcal vaccination in adults. A meta-analysis of randomized controlled trials.
Arch Intern Med 1994, 154:2666-77. PubMed Abstract
Vallès X, Marcos A, Pinart M, Piñer R, Marco F, Mensa JM, Torres A: Hospitalized Community-Acquired Pneumonia due to Streptococcus pneumoniae. Has resistance to antibiotics decreased?
Chest 2006, 130:800-806. PubMed Abstract | Publisher Full Text
Karlowsky JA, Thornsberry C, Jones ME, Evangelista AT, Critchley IA, Sahm DF: Factors associated with relative rates of antimicrobial resistance among Streptococcus pneumoniae in United States: Results from the TRUST Surveillance Program (1998–2002).
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Falcó V, Almirante B, Jordano Q, Calonge L, del Valle O, Pigrau C, Planes AM, Gavaldà J, Pahissa A: Influence of penicillin resistance on outcome in adults patients with invasive pneumococcal pneumonia: is penicillin useful against intermediately resistant strains?
J Antimicrob Chemother 2004, 54:481-8. PubMed Abstract | Publisher Full Text
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Fenoll A, Giménez MJ, Robledo O, Aguilar L, Tarragó D, Granizo JJ, Martín-Herrero JE: Influence of penicillin/amoxicillin non-susceptibility on the activity of third-generation cephalosporins against Streptococcus pneumoniae.
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Riedel S, Beekmann SE, Heilmann KP, Richter SS, Garcia-de-Lomas J, Ferech M, Goosens H, Doern GV: Antimicrobial use in Europe and antimicrobial resistance in Streptococcus pneumoniae.
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Campbell GD Jr, Silberman R: Drug-resistant Streptococcus pneumoniae.
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Yu VL, Baddour LM: Infection by drug-resistant Streptococcus pneumoniae is not linked to increased mortality.
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Song JH, Oh WS, Kang CI, Chung DR, Peck KR, Ko KS, Yeom JS, Kim CK, Kim SW, Chang HH, Kim YS, Jung SI, Tong Z, Wang Q, Huang SG, Liu JW, Lalitha MK, Tan BH, Van PH, Carlos CC, So T, Asian Network for Surveillance of Resistant Pathogens Study Group: Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens.
Int J Antimicrob Agents 2008, 31(2):107-14. PubMed Abstract | Publisher Full Text
Mufson MA, Chan G, Stanek RJ: Penicillin resistance not a factor in outcome from invasive Streptococcus pneumoniae community-acquired pneumonia in adults when appropriate empiric therapy is started.
Am J Med Sci 2007, 333(3):161-7. PubMed Abstract | Publisher Full Text
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Pérez-Trallero E, García de la Fuente C, García-Rey C, Baquero F, Aguilar L, Dal-Re R, García-de-Lomas J, Spanish Surveillance Group for Respiratory Pathogens: Geographical and ecological analysis of resistance, coresistance, and coupled resistance to antimicrobials in respiratory pathogenic bacteria in Spain.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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Dengue Fever Presents: Sleepwalking Through the Mekong by Various Artists on Napster
1 Recommendation
Three's recommendation
The film "Sleepwalking Through The Mekong " not only chronicles the journey taken by Los Angeles based Khmer rock band Dengue Fever (www.myspace.com/denguefevermusic) to lead singer Chhom Nimolâs native Cambodia during the 2005 Water Festival. But also answers a question I've longed to find an answer to, what is this music, where is it from, and how come I have only hear of it recently? The bandâs performances there marked the first time a Western band had performed classic 1960s and â70s Cambodian rock ânâ roll in the country where it was created and nearly erased from existence by the brutal Pol Pot regime. More than a rockumentary, the film serves up a portrait of modern Cambodia as the band tours through Phnom Penh and beyond, crossing a great cultural chasm with the same spirit of Cambodiaâs original rock pioneers. DVD bonus material includes a biography of the band Dengue Fever, live performance segments, comments from director John Pirozzi, segments on the Cambodian Water Festival, the traditional Cambodian Coconut Dance and Cambodiaâs Master Musicians. The accompanying CD soundtrack includes classic tracks from Cambodian artists Ros Serey Sothea, Sinn Sisamouth and Meas Samoun, as well as original material created by Cambodian master musicians Tep Mary and Kong Nai with Dengue Fever, and previously unreleased Dengue Fever instrumental tracks âMarch of The Balloon Animalsâ and âPhnom Chisor Serenadeâ.
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The Greenpeace airship A.E. Bates is inflated near the Vermont Yankee Nuclear Power Station in Vernon, Vermont, Nov. 14, 2010. The thermal airship flew near the risky and dangerous nuclear reactor to send a message to Entergy, the plant's corporate owners and potential buyers with a banner reading "Shut Down Vermont Yankee."
© CJ Gunther/Greenpeace
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Holomorphic Operator Functions of One Variable and ApplicationsSpringer 2009; US$ 179.00
Deals with holomorphic operator functions of a single variable and applications. This book offers a generalization of some results from the basics of analysis of scalar functions of one complex variable. It presents application for holomorphic families of subspaces and Plemelj-Muschelishvili factorization. more...
Interpolation, Schur Functions and Moment ProblemsSpringer 2006; US$ 189.00
Under "Schur analysis", one encounters problems related to Schur functions such as interpolation problems, moment problems, study of the relationships between the Schur coefficients and the properties of the function, and others. This volume presents the analysis of Schur and Caratheodory functions and the solutions of problems for these... more...
The State Space Method: Generalizations and Applications (Operator Theory: Advances and Applications / Linear Operators and Linear Systems)Springer 2006; US$ 189.00
A collection of essays representing some of the advances in the state space method. Methods covered include noncommutative systems theory, the aspects of the theory of discrete systems, discrete analogs of canonical systems, and applications to the theory of Bezoutiants and convolution equations. more...
Recent Advances in Operator Theory, Operator Algebras, and their ApplicationsSpringer 2006; US$ 209.00
This book consists of articles originating from the 19th International Conference on Operator Theory, held in Timisoara in Summer 2002. It contains developments covering a broad range of topics from operator theory, operator algebras and their applications, particularly to differential analysis, complex functions, ergodic theory, and more. more...
Modern Operator Theory and ApplicationsSpringer 2007; US$ 189.00
Presents the results in Fredholm theory for singular integral and convolution operators, estimates for singular integral operators on Carleson curves acting in Lp spaces with variable exponents, the finite sections method for band-dominated and Toeplitz operators, Szego type theorems, and the averaging method for nonlinear equations, among others. more...
Results and Problems in Combinatorial GeometryCambridge University Press 1985; US$ 40.00
In this short book, the authors discuss three types of problems from combinatorial geometry. more...
Basic Classes of Linear OperatorsBirkh�user Basel 2012; US$ 129.00
This book provides an introduction to functional analysis with an emphasis on the theory of linear operators and its application to differential equations, integral equations, infinite systems of linear equations, approximation theory, and numerical analysis. As textbook designed for senior undergraduate and graduate students, it begins with the geometry... more...
Separable Type Representations of Matrices and Fast Algorithms: Volume 1Springer 2013; US$ 129.00
This two-volume work presents a systematic theoretical and computational study of several types of generalizations of separable matrices. The main attention is paid to fast algorithms (many of linear complexity) for matrices in semiseparable, quasiseparable, band and companion form. The work is focused on algorithms of multiplication, inversion and... more...
Separable Type Representations of Matrices and Fast Algorithms: Volume 2 Eigenvalue MethodSpringer 2013; US$ 129.00
This two-volume work presents a systematic theoretical and computational study of several types of generalizations of separable matrices. The main attention is paid to fast algorithms (many of linear complexity) for matrices in semiseparable, quasiseparable, band and companion form. The work is focused on algorithms of multiplication, inversion and... more...
Recent Trends in Toeplitz and Pseudodifferential OperatorsSpringer 2011; US$ 169.00
The aim of the book is to present new results in operator theory and its applications. In particular, the book is devoted to operators with automorphic symbols, applications of the methods of modern operator theory and differential geometry to some problems of theory of elasticity, quantum mechanics, hyperbolic systems of partial differential equations... more...


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It's not just humans who will be affected by the zombie apocalypse, but animals too! Show the crowd proof of this when you wear the Zombie Chimp Boy's Costume. Tattered top comes complete with plush sleeves and a zombified monkey mask.
Want a fun accompaniment to your chimpanzee costume? This year, get some Halloween shoes that will make you go bananas! Able to fit over your own shoes, no monkey costume is complete without these fabulous feet. Half latex, half hair.
Monkey see, monkey do on Halloween when you wear this clever Chimp adult mens costume. The great thing about this comfortable costume is that you can eat and drink and still stay in character, or be a character if you please.
Step into the ring of Rome ready to battle in this Gladiator boys costume. The body armor of this gladiator costume features an attached cape and comes complete with a tunic, arm bands, cuffs, leg guards and a matching headpiece.
Transform when you sport this officially licensed Transformers Bumblebee boys costume. The yellow and gray printed jumpsuit features a matching dimensional character mask.
Clown around after dark on Halloween when you wear this creepily crafty Evil Clown boys costume. The black and red top of this clown costume comes complete with matching pants, a collar, spiked cuffs and a mask with wig.
Be bold and be bad on Halloween when you wear this Convict boys costume. The short sleeve shirt of this convict costume comes complete with matching pants and a striped hat. Break out and find yourself some candy!
Lock up criminals and lay down the law on Halloween in this Policeman boys costume. The classic navy blue uniform of this police costume comes complete with a police hat, shiny badge, billy club and handcuffs with key - everything you need to serve and protect!
No matter what battle you're fighting on Halloween, you'll look the part when you wear this Dreads Commando boys costume. The black muscle top jumpsuit features a black, gray and white digital camouflage bottom and comes complete with a vest, knee pads and a beret with attached dreadlocks.
Whether you love or hate math and science, this Classic Nerd boys costume is scientifically proven to be very funny. Crack up the crowd when you show up in this jumpsuit styled to look like high-rise plaid pants, complete with an attached bow tie and belt.
Need a prescription for a super-scary Halloween? Look no further because this Demented Doctor boys costume fits the bill! The blood-spattered lab coat comes complete with a terrifying red mask with attached black hair.
Create some amazing and legendary deeds of your own on Halloween when you don this officially licensed Skylanders Spyro boys costume. The purple jumpsuit of this dragon costume comes complete with shoe covers, wings and a PVC character mask.
The British are coming, the British are coming! Recreate a historical midnight ride on Halloween in this authentic looking Paul Revere boys costume. The green jacket of this Paul Revere costume features an attached vest and shirt front, complete with a hat and pants with attached boot tops.
Get out of the shadows and into the fight when you wear the Ninja Warrior Boys Costume. This black shirt comes complete with matching pants, a tunic with an attached belt, epaulets, arm guards and a hood with face mask.
Destroy the competition on Halloween when you use your stealth skills wearing the Dragon Ninja Boys Costume. This muscle chest jumpsuit features attached arm and leg gauntlets, a waist belt with ninja star and a black hood.
Tell jokes and take souls when you wear the Sinister Jester Boys Costume. This red and black, harlequin-design outfit consists of a shirt, matching pants, waist sash, hood with attached collar and creepy jester mask.
Steal from the rich and give back to the poor when you decide to dress in the Robin Hood Boys Costume. This green hoodie comes complete with an attached brown vest, a belt with storage pouch, gauntlets and boot covers.
Beware of the morning sun when you stay up all night on Halloween in this Vampire boys costume. The black and dark red, 100% polyester vest of this vampire costume features an attached poet-sleeved shirt and comes complete with a jet-black, red lined cape.
Master the art of stealth and deception on Halloween when you wear this incredibly detailed Ninja Master boys costume. The long-sleeved black top comes complete with long black pants, a charcoal and black mesh armor tunic, matching mesh shoulder armor, shin guards, wrist guards, belt and a black…
Reach for the stars when you wear this official looking Junior Astronaut boys costume. There are no boundaries in the zipper front jumpsuit, equipped with zipper storage pockets and comes complete with matching hat. Blast off for an amazing Halloween adventure in this cool costume.
Rise up and feast on the living when you wear this Zombie Classic boys costume. The top and pants of this zombie costume features sewn-in body parts and comes complete with a mask and attached wig along with a pair of gloves.
Be prepared to knock them dead in this Zombie Hunter boys costume. The blood-spattered tan coat of this zombie hunter costume comes complete with a green T-Shirt and a matching hat so you are properly equipped for the rigors of serious zombie pursuit and capture.
Be prepared when zombie roam the streets and have your disguise ready with this Street Zombie boys costume. The one-piece hoodie and coat features a hooded sweaT-Shirt front and comes complete with fingerless gloves and a creepy zombie mask.
Run, jump, and swim to rescue animals when you dress in this officially licensed Diego boys costume. Dora the Explorer's adventurous cousin has a knack for helping out. Help out on Halloween in this signature blue and yellow shirt and shorts set.


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Light and delicate with a classically refined sensibility, the John Rocha Voya collection by Waterford Crystal has a timeless elegance that will add a touch of sophistication to any home. Combining intricate traditional cuts with a graceful modern shape and slender stem, Waterford John Rocha Voya giftware is a dazzling addition to any decor style. Since 1997 innovative Irish designer John Rocha has brought his signature clean, contemporary aesthetic to the world of Waterford Crystal, producing a wide range of iconic styles known for their simple beauty. The John Rocha Voya collection by Waterford Crystal has everything you need to bring this beautiful look to your next event including large bouquet vases, bouquet vases, crystal bowls, and rose bowls.
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Marsh Pro-Rite Reversible Whiteboard
3' H x 4' W Size
3'6" H x 5' W Size
4' H x 6' W Size
Marsh Pro-Rite Reversible Whiteboard
Additional Documents
Weights & Dimensions
3' H x 4' W Size
3'6" H x 5' W Size
4' H x 6' W Size
|Product Type: Whiteboard
|Style: Free Standing
|Reversible: Yes
|Combination Board: Yes
|Casters: Yes
|Framed: Yes
|Application: Commercial
|Color: White
|Country of Manufacture: United States
|Size (3' H x 4' W Size): Small 2' - 4'
|Size (4' H x 6' W, 3'6" H x 5' W Size): Medium 4' - 6'
|Assembly Required: Yes
About the ManufacturerMarsh Industries is dedicated to providing their customers with the kind of quality products meant to make school and office life easier and more productive. With everything from markerboards and display cases to childhood development tools and accessories, they are sure to have exactly what you're looking for. Many of their products come with warranties or custom sizes, and all include M-Class packaging to ensure flawless condition upon arrival. At Marsh, they continue to set the industry standard by providing beautifully crafted products every time.
Marsh Industries maintains a 12,000sq. ft. warehouse and 96,000sq. ft. production facility that allows them to stay on the cutting edge of product development. To do this, they feel it is most important to understand and act upon the needs of their customers. They are committed to working with you to provide custom solutions ensuring that you get exactly what you want. Having the Marsh advantage means you get all around quality that will not only meet your needs but exceed your expectations.
Marsh Pro-Rite Reversible Whiteboard
Questions & Answers (1)
"Hi, by any chance is this magnetic?" asked by Verlene
Still have questions about this product? We're here to help
Customer Reviews
|5 star
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|1 star
nice basic, affordable model that works
jpoe from Salt Lake City, UT – Verified Buyer
Our business purchased 2 for use in an open office for software developers. We needed something affordable for a small tech company, mobile, and not so large that it would dominate the room. These have worked great and were easy to assemble.
OUR SKU # MR1113Pro-Rite Reversible Whiteboard is also sometimes listed under the following manufacturer numbers: RW34CK2K2, RW45CK2K2, RW46CK2K2


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I´m trying to create a Template where list all files attached in a post, page some custom post types. It´s like a a "Download" page for all files inside those post_types. So I get it in a way but not completly.
First I use a WP_query to bring the post_types I want:
$all_files = array(
'post_type' => array('papers','post','page'),
'posts_per_page' => -1,
$all_files_query = new WP_Query($all_files);?>
<?php if ($all_files_query->have_posts()) : ?>
<?php while ($all_files_query->have_posts()) : $all_files_query->the_post(); ?>
Then inside the loop I add a get_post to bring the attachments and filtered by some post_mime_type:
$attachments = get_posts( array(
'post_type' => 'attachment',
'post_mime_type' => 'application/pdf,application/msword,application/vnd.ms-powerpoint,application/vnd.ms-excel,application/zip,audio,application/vnd.openxmlformats-officedocument.spreadsheetml.sheet, application/vnd.openxmlformats-officedocument.presentationml.presentation,application/vnd.openxmlformats-officedocument.wordprocessingml.document,application/vnd.openxmlformats-officedocument.presentationml.presentation',
'posts_per_page' => -1, 'post_parent' => $post->ID,
'exclude' => get_post_thumbnail_id()
) );?>
<?php if ( $attachments ): ?>
<?php foreach ( $attachments as $attachment ): ?>
$class = "post-attachment mime-" . sanitize_title( $attachment->post_mime_type );
$thumbimg = wp_get_attachment_url( $attachment->ID );
<a class="source-file-link" href="<?php echo $thumbimg; ?>">
This works in some way, list all post who have an attachment file inside it´s editor. But I get this problems:
- It ONLY bring ONE file, if the post/page/CPT have more than one file inside just show the first.
- If a file is attach at the same time in two different post just shows the newest post.
Here I´m stock, can´t find a way to fix it.
Is there another way to do this?
Or is a retriction of how wp_query or get_post works?
Thanx for any advice.


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Thank you for a super stay, albeit a short one. Bed lovely and comfortable. Very friendly atmosphere. Hope to return.
Sonja - Herts
Aug 2014
Thank you for a most enjoyable stay and looking after us so well. A nice friendly atmosphere.
Margaret & Martin - Milton-under-Wychwood
Aug 2014
Lovely week. Great hosts, very friendly and welcoming. Delicious breakfasts. Thank you for going your of your way to make our stay perfect.
Martin & Stella - Ely, Cambs
Aug 2014
Very friendly and accommodating.
John & Carole - Lincoln
Aug 2014
Very friendly and welcoming.
Richard & Gillian - Kendal
Aug 2014
Lovely welcome and a great breakfast - will come again.
Martin & Tina - Southampton
Aug 2014
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