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A device and method in accordance with the invention for generating a signal indicative of a property of a subject tissue in contact with the working surface of a surgical instrument. The invention describes a sensing adjunct to surgical staplers. The adjunct can take the form of an optionally coupled accessory to a surgical stapler, or a stand-alone substitutive component acting to serve as a replacement for a component of the surgical stapler such as an anvil, housing or cartridge. Embodiments include a sensing anvil serving to act in place of a non-sensing surgical stapler anvil to monitor tissue properties of an anastomosis for the purpose of avoiding anastomotic failure.
1. A self contained adjunct sensing system configured to be detachably coupled to a surgical stapler, the adjunct sensing system comprising:
an adjunct housing configured to be detachably coupled to the surgical stapler;
wherein the adjunct housing maintains
at least one sensor configured to sense at least one property of tissue and an interaction with tissue;
a processor configured to receive and process signals from said at least one sensor; and
a communications interface configured to transfer information at least one of to and from the processor.
2. The adjunct sensing system of
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20. An adjunct configured to be detachably coupled with a surgical stapler, the adjunct comprising:
an adjunct housing configured to be detachably coupled to the surgical stapler;
a self contained sensing system, the sensing system including
at least one sensor;
a processor configured to receive and process signals from said at least one sensor; and
a communications interface configured to transfer information at least one of to and from the processor; and
wherein the self contained sensing system is maintained by the adjunct housing.
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40. A surgical assembly comprising:
a device for creating an anastomosis; and
an adjunct maintained by an adjunct housing, the adjunct housing configured to be removably coupled with the device, the adjunct comprising a self contained sensing system configured to sense at least one of a physiologic property of tissue and a mechanical property of tissue using a sensor, process signals related to said sensed tissue properties using a processor, and transfer information related to at least one of said sensed tissue properties and said processed signals using a communications interface.
41. The surgical assembly of
42. The surgical assembly of
The present invention relates to surgical staplers, specifically to surgical staplers with sensors used to detect properties of biological tissue, and a system for exploiting the information gathered by the sensors.
A living organism is made up of cells. Cells are the smallest structures capable of maintaining life and reproducing. Cells have differing structures to perform different tasks. A tissue is an organization of a great many similar cells with varying amounts and kinds of nonliving, intercellular substances between them. An organ is an organization of several different kinds of tissues so arranged that together they can perform a special function.
Surgery is defined as a branch of medicine concerned with diseases requiring operative procedures.
Although many surgical procedures are successful, there is always a chance of failure. Depending on the type of procedure these failures can result in pain, need for re-operation, extreme sickness, or death. At present there is no reliable method of predicting when a failure will occur. Most often the failure occurs after the surgical procedure has been completed. Failures of surgical procedures can take many forms. The most difficult failures to predict and avoid are those that involve biological tissue. This difficulty arises for three distinct reasons. Firstly, the properties that favor the continued function of biological tissue are very complex. Secondly, these properties are necessarily disrupted by surgical manipulation. Finally, the properties of biological tissues vary between patients.
During a surgical operation, a variety of surgical instruments are used to manipulate biological tissues. However, traditional surgical instruments do not have the ability to obtain information from biological tissues. Obtaining information from the biological tissues that surgical instruments manipulate can provide a valuable dataset that at present is not collected. For example, this dataset can quantitatively distinguish properties of tissues that will result in success or failure when adapted to specific patient characteristics.
Surgical instruments that incorporate sensors onto the instruments' working surfaces are described, e.g., in U.S. patent application Ser. No. 10/510,940 and in U.S. Pat. No. 5,769,791. The instruments described in the prior art have the ability to sense tissue properties; however, their utility is limited by an inability to account for the multitude of differences that exist between patients. This limitation of the prior art is clearly illustrated by the fact that the instruments generate feedback after sensor signals are compared to a fixed dataset within the device. Thus, the prior art instruments have no means of adapting to patient-specific characteristics that are of utmost importance in avoiding surgical procedure failure. PCT Patent Application No. PCT/US2006/013985 describes a novel system and methodology for using the information gathered by surgical instruments having sensors in an adaptive, patient-specific manner.
Each surgical procedure has the potential for failure. A common procedure in gastrointestinal surgery is a bowel resection—removing the affected portion of the bowel and then mechanically joining the ends of the remaining segments to re-establish bowel continuity. The mechanical connection of the free ends of bowel forms what is termed a surgical anastomosis. A surgical anastomosis is formed by either traditional techniques using suture material, or by contemporary techniques utilizing surgical staplers. A surgical stapler mechanically joins the bowel by firing a pattern of staples from a cartridge or housing through the two free ends of bowel against an anvil that ultimately forms a securing crimp on the opposing side. There are many embodiments of surgical staplers. Some staplers form linear staple patterns, while others form circular patterns. Some staplers incorporate functionality for cutting tissue. Many staplers have the ability to vary the gap between the base of the staple and the formed crimp.
Anastomotic failure is one of the most feared complications of gastrointestinal surgery due to the resultant morbidity and mortality. Failure of an anastomosis, or intestinal junction, can cause a spectrum of morbidities to the patient including local abscess formation—requiring procedural drainage, tumor recurrence, debilitating pain, dysfunctional defecation, and overwhelming bacterial sepsis resulting in death. Despite improvements in surgical technique, there remains limited ability to assess the anastomotic segment and predict outcome, and as a result anastomotic failure occurs at unacceptably high levels given the severe consequences. For example, in the performance of a low anterior resection (LAR) for excision of rectal cancer, anastomotic failure has been reported to occur in up to 30% of cases. One large multicenter, observational study of 2729 patients reported a leak rate of 14.3%. These anastomotic failures cause a significant and avoidable economic burden on the healthcare system, as well as an incalculable amount of pain, suffering, and hardship for the patients in which the failure occurs. As a precaution many surgeons will avoid creating an anastomosis at the time of surgery and tunnel the free ends of the bowel through the abdominal wall to form a diverting stoma. The rationale of this maneuver is to prevent the leakage of fecal matter into the abdominal cavity from a potential anastomotic failure. Many times the surgeons will perform another procedure to reverse the stoma months after the initial procedure. In the same multicenter study 881 patients were given a temporary diverting stoma to mitigate the risk of an anastomotic leak, however, within this group only 128 patients developed a leak. Thus up to 85% of those patients underwent an additional surgical procedure to reverse the stoma that provided questionable benefit. The arbitrary creation of a temporary diverting stoma, and the eventual reversing procedure presents a significant and avoidable economic burden on the healthcare system, as well as exposes numerous patients to arguably unnecessary surgical risk. Presently, there is no reliable method or device available for predicting anastomotic failure, nor objective criteria by which to decide when a diverting stoma is indicated. Nor is there a device that can help to determine the optimal placement of an anastomosis.
There exists a need for a device, system and methodology for reducing anastomotic failures through the analysis of target tissues before, during, and after the creation of an anastomosis. There also exists a need to objectively determine, at the time of surgery, those patients that would benefit from a diverting stoma procedure. There also exists a need to deliver adjunct therapies to the anastomotic site to optimize outcome.
To accomplish its goal, the present invention couples to the desired stapling platform, which includes traditional off-the-shelf disposable surgical staplers, and uses an array of multimodality sensors to access the viability of the tissues at hand. If tissues are determined to be not suitable for an anastomosis, the present invention alerts the operative team to take corrective action, thus reducing the risk anastomotic failure. If after performing the anastomosis, the tissues are determined to be at high risk for failure, the present invention alerts the operative team to take corrective action.
One representative application of the present invention is in the treatment of colorectal cancer. Colorectal cancer (CRC) is the third most common cause of cancer for men and women in developed countries. Estimates predict that worldwide just under 1.2 million new cases of colorectal cancer were diagnosed in 2007. Rectal cancer accounts for approximately 27% of all colorectal cancers and presents the formidable challenge of ensuring a curative resection while maintaining acceptable function. The mainstay of treatment for rectal cancer is surgical resection—removing the affected portion of the bowel and performing an anastomosis on the ends of the remaining segments to re-establish bowel continuity. The end-to-end anastomosis (EEA) is most commonly performed using circular EEA staplers. As with any surgical procedure, resection of a rectal cancer can have complications. Amongst all of the possible complications the three most devastating to the patient in terms of morbidity and mortality are tumor recurrence, anastomotic leak and anastomotic stricture. Tumor recurrence can be reduced by: following oncologic principles of dissection, providing appropriate adjunctive chemotherapeutic, photodynamic, and radiation therapies, and preventing extra-luminal extravasation of residual intra-luminal neoplastic cells through anastomotic breakdown. Anastomotic failure has been anecdotally attributed to inadequate tissue perfusion and excessive tension at the anastomosis.
When determining the location of a rectal cancer the surgeon notes the distance of the tumor from the anal verge. The anal canal extends from 0-4 cm past the anal verge, and the rectum 4-19 cm. Surgically the rectum extends from the anal sphincters to the sacral promontory. The location of the cancer dictates the type of surgical procedure performed.
The primary goal of a curative resection is to remove all potential tissues harboring cancerous cells. To accomplish this goal, the surgical team aims to resect the tumor with a cancer free margin as well as the tumor's blood supply and draining lymphatic tissue. Tumors located in the upper rectum, greater than 12 cm from the anal verge, are regularly amenable to an anterior resection (AR). Those in the mid rectum, between 6-12 cm, are subject to a LAR with or without a total mesorectal excision (TME), and tumors in the lower rectum, 4-6 cm, are usually treated with an ultra-low anterior resection (ULAR), incorporating a TME, and either a colorectal or coloanal anastomosis. A total mesorectal excision is a technique that attempts to resect the rectum and all investing soft tissues en-bloc. This technique has been touted in the literature as having superior results in terms of minimizing local tumor recurrence, however it is speculated that the procedure has an inverse effect on leak rates due to the excision of the supplying vasculature to the anastomotic site. Every attempt is made to retain fecal continence, however those tumors involving the anal sphincters 0-4 cm are resected through a sphincter sacrificing abdominoperineal resection (APR).
As a secondary goal the surgical team strives to restore continuity of the bowel and ensuing fecal stream. To accomplish this goal an anastomosis is formed. Simply, an anastomosis is the surgical connection of two free ends of a tubular structure. When the continuity of the bowel cannot be restored, the fecal stream is diverted through a stoma, or opening, in the anterior abdominal wall through which the patient eliminates into an ostomy bag. There are two main reasons for stoma formation: resection of the anal sphincter complex, and diversion of the fecal stream. In a sphincter sacrificing procedure such as an APR, the patient is dependent on a permanent ostomy. With a sphincter sparing procedure such as a LAR, the fecal stream may diverted through a temporary ostomy in order to mitigate the risk of overwhelming sepsis resulting from fecal contents entering the abdominal cavity should there be a leak at the anastomosis. Most of the time a temporary stoma can be reversed within a few months after the initial operation through a separate procedure.
Anastomotic failure can cause a spectrum of morbidities to the patient including local abscess formation—requiring procedural drainage, tumor recurrence, debilitating pain, dysfunctional defecation, and overwhelming bacterial sepsis resulting in death. The scientific literature suggests that the cause of anastomotic failure is that inadequate tissue perfusion as a result of redefined vasculature, tissue interaction forces, edema, and tension result in a decrease of oxygen delivered to the anastomotic site. Without adequate oxygen delivery efficient aerobic cell respiration cannot occur within the native cells leading to tissue degradation, collagen matrix cannot mature into strong collagen fibrils, and white blood cells cannot effectively fight bacterial invasion.
The present invention aims to reduce anastomotic failures through the analysis of target tissues before, during, and after the creation of an anastomosis. In one embodiment, the invention is an accessory for a circular stapler that allows measurement of tissue oxygenation, tissue perfusion, and tissue interaction force at twelve circumferential points around both sides of the staple joint. In one embodiment, the device incorporates three sensing modalities at each point: 1) tissue oxygenation using oximetry techniques, 2) tissue perfusion by measuring fluorescent response as fluorescein dye is injected, and 3) tissue interaction forces by utilizing MEMS pressure sensors. In addition, the staple gap height is concurrently monitored by an encoder mounted to the gap adjustment knob of the stapler. Monitoring the pressure and gap height during the creation of anastomosis provides consistency among procedures. An independent reference module with the same or similar array of sensing elements can be used concurrently to establish a baseline measurement at a tissue location independent from the surgical site.
If tissues are determined to be unsuitable for an anastomosis, the present invention alerts the operative team to take corrective action to limit the chance of anastomotic failure. Corrective actions may include any combination of the following: optimizing the location of the planned anastomosis, creating a temporary or permanent stoma, changing the operative procedure, or delivering adjunct therapies to enhance outcome.
Accordingly, several objects and advantages of the present invention are:
To provide an adjunct to a surgical stapler, where the adjunct is configured with at least one sensor that can operate independently of said stapler. The adjunct can take the form of an optionally coupled accessory to a surgical stapler, or a stand-alone substitutive component acting to serve as a replacement for a component of the surgical stapler such as an anvil.
To provide the described functionality without disrupting the surgical workflow.
To provide a sensing adjunct to a surgical stapler that is communicatively coupled to a controller or base station by wireless methods.
To reduce patient morbidity, and mortality secondary to complications, or additional procedures related to intestinal, or other tissue anastomosis.
To reduce surgical anastomotic failures, and improve outcome though the evaluation and analysis of tissues at the anastomotic site prior to, during, and after the creation of the anastomosis.
To provide the operative team an assessment of the viability of a surgical anastomosis.
To provide signal to the operative team when the creation of a diverting stoma, or change in surgical procedure is indicated.
To extend the capabilities of standard non-sensing surgical staplers to enable the sensing and analysis of subject tissues.
To enable the consistency of surgical anastomoses.
To deliver adjunct therapies to the anastomotic site.
To quantitatively monitor the staple gap or height.
To automatically adjust, or provide a signal to the operative team to adjust the staple gap or height responsive to a monitored parameter.
To assist in the firing of a surgical stapler.
To extend the capabilities of standard non-sensing surgical staplers to enable the monitoring, and/or adjustment of a staple gap or height.
To extend the capabilities of standard non-sensing surgical staplers to enable the delivery of adjunct therapies to subject tissues.
To extend the capabilities of standard non-sensing surgical staplers to enable the deployment of a tissue monitor to the anastomotic site such as described in PCT Patent Application No. PCT/US2007/071718.
To incorporate a reference module for the baseline comparison of subject tissues.
To enable tissue interrogation to generate a signal indicative of a tissue property, independently, or in conjunction with other components of the present invention.
To provide for the described functionalities in a durable, limited lifetime, or disposable manner.
To interact with a system which generates real time, patient specific procedural guidance for predicting success of a surgical anastomosis, and avoiding or detecting failure of the surgical anastomosis. Another advantage of the present invention is a system which records data across the entire patient encounter including pre-operative, intra-operative and post-operative periods, as well as immediate, acute, short term, and long term outcomes both locally in hospital-based units as well as remotely in a data repository as described in PCT Patent Application No. PCT/US2006/013985.
Additional advantages of the present invention will become readily apparent to those skilled in this art from the following detailed description, wherein only selected embodiments of the present invention are shown and described. As will be realized, the present invention is capable of other and different embodiments, and its several details are capable of modifications in various obvious respects, all without departing from the invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive.
Reference is made to the attached drawings, wherein elements having the same reference numeral designations represent like elements throughout, and wherein:
The present invention relates to an adjunct or accessory to a surgical stapler, where the adjunct is configured with at least one sensor that can operate independently of said stapler. The adjunct can take the form of an optionally coupled accessory to a surgical stapler, or a stand-alone substitutive component acting to serve as a replacement for a component of the surgical stapler such as an anvil. The sensors may sense mechanical or biological properties. The sensing modalities may include mechanical, optical, chemical, electrical, or other means for generating a signal indicative of a property of a subject tissue. The sensors are incorporated into or coupled to the working surface (i.e. tissue contacting surface) of an adjunct to a surgical stapler. The sensors may be incorporated into a separate accessory for the stapler affixed to either or both the anvil and housing sides of the stapler. The sensors act independently, are communicatively coupled to each other and/or a base station wirelessly. The sensors are powered by an onboard battery, capacitor, or other power storage element. Alternatively, the sensors are powered by an external source, including, but not limited to, inductive coupling, radio frequency (RF) energy, or mechanical motion.
In one embodiment of the present invention, banks of sensors are placed around the periphery of the staple line on a circular stapler. The sensors are located on one or both sides of the stapler (anvil and housing). The banks of sensors are incorporated into an accessory (i.e. a replacement part such as the anvil, or a cap/shell that optionally couples to an existing component of the stapler). The bank of sensors contains mechanical and optical sensing modalities. Mechanical sensing includes, but is not limited to, pressure sensors that monitor tissue interaction forces including compression pressure and tissue tension. Optical sensors include but are not limited to light emitters including light emitting diodes (LEDs) and laser diodes, and light receivers including photodiodes, CCD arrays, CMOS sensors, and spectrometers. The optical sensors are configured to measure at least one of tissue oxygenation, oxygen delivery, oxygen utilization, tissue characterization, and tissue general health using oximetry, or spectroscopic techniques, and at least one of tissue perfusion, tissue flow dynamics, tissue oxygen content, tissue chemical composition, tissue immunologic activity, tissue pathogen concentration, or tissue water content using fluorescence based techniques. The fluorescence based techniques include but are not limited to the following: monitoring and analyzing the intensity and time course of a fluorescent response responsive to the injection or activation of a fluorescent medium, determining oxygen quantities by measuring oxygen quenching of fluorescent radiation using a sensitive material such as Ruthenium by both intensity and time resolved methods, and determining the target tissue property by quantitative fluorescent methods including the use of quantum dots, or other fluorescent based biomarkers.
An additional element of the present invention is the incorporation of an independent reference sensor. The reference sensor contains one or more sensor banks of the same or similar type to those sensors on the working surface of the stapler. One or more reference sensors may be placed on one or more portions of the tissue to serve as a baseline measurement. In one instance, the reference sensor is placed on a healthy portion of bowel and remains in place while an anastomosis is performed on a different site. The reference may also be used as an independent sensor for preoperative or postoperative monitoring, or selection of a surgical site.
A further element of the present invention is the incorporation of a sensor that reports the staple gap or relative change thereof. In one embodiment, a sensing module is placed over the gap adjustment knob on a standard surgical stapler. The sensor incorporates an optical encoder module that interacts with a reflective encoder surface mounted to the base of the surgical stapler.
A further element of the present invention is the incorporation of a motor actuated staple gap adjustment module that will vary the staple gap responsive to at least one of user, or sensor input. The sensor input includes, but is not limited, to tissue oxygenation, compression pressure, or staple gap height. In one embodiment the motor actuated gap adjustment module is placed over the gap adjustment knob/end of a standard surgical stapler.
A further element of the present invention is the incorporation of a motor actuated stapler firing module which will fire the stapler responsive to at least one of user input, or sensor based input.
In another embodiment of the present invention, implantable sensors are placed at the surgical site to perform post-operative monitoring. The sensors may be tethered by electrical or fiber optic means, or may be wireless. Wireless sensors may be powered by an onboard source or external source.
In a further embodiment, the anvil and/or housing can act as a delivery mechanism for doses of adjunct therapies not limited to photodynamic, pharmaceutical, bio-adhesive, brachy-, and nano-therapies. The light sources used for optical sensing may also serve as an agent for activating light-sensitive treatment such as in photodynamic therapy (PDT). Alternatively the adjunct therapies can be delivered from the device to the target site through microtubules, needles, micro-fluidic methods, diffusion, and conduction.
In a further embodiment the reference module can act as a stand-alone tissue interrogator to determine tissue viability, or suitability for a particular procedure. The tissue interrogator can take the form of an instrument used in open or minimally invasive surgery. One representative application of the tissue interrogator embodiment is in the performance of a bowel resection secondary to a bowel obstruction. Often a bowel obstruction is caused by an adhesion which causes the bowel to twist upon itself or a hernia which incarcerates or strangulates the bowel. The blood supply to the bowel can be compromised leading to ischemia, or infarction. Intraoperatively, the surgeon qualitatively determines if the bowel is viable after it has been untwisted or freed. If the bowel does not appear viable the bowel is resected. Often qualitative methods are not accurate in determining bowel viability. An advantage of the present invention is the ability to quantitatively assess bowel viability and ensure the anastomotic joint is performed on tissue that has a minimum chance of failing due to inadequate perfusion.
The present invention will now be described in detail with reference to
Depending on the sensing modality, the sensor data is translated into information that relates to tissue properties. In one exemplary optical sensing embodiment, oximetry-type techniques are used to convert the relative absorption of different wavelengths of light into an oxygen saturation percentage of hemoglobin in the blood. In another optical sensing modality, fluorescence response due to a fluorescent medium that has been introduced into the body is measured, and characteristics of the response including the intensity, rise time, and steady state value are indicative of the blood flow in the tissue in question. Further, compression pressure, and tension on tissues 107 and 109 can be measured at discrete or distributed sites on sensing adjuncts 113 and 115.
The stapler's housing 227 lies on the proximal end of the anastomosis. Control board and power source 229 lie on housing 227. Sensor banks 231 are on the face of control board 229. Optical emitters and receivers 231 are coupled optically through light guides or optical fibers 233 to the working surface of the instrument 235 to monitor tissue 209. Additional control board or power source 239 lies on stapler shaft 201 to provide for additional functionality. The described components of housing sensing adjunct are enclosed in shell 241.
The optical sensors described in the embodiments may take one several forms. In one form, light emitting diodes or other light sources illuminate tissue and light receivers receive the signal. The light receivers can be photodiodes, photodiode arrays, avalanche photodiodes, photomultiplier tubes, linear and two dimensional CCDs, CMOS sensors, spectrometers, or other sensor types. This may be used for oximetry or spectroscopy type measurements. Wavelengths centered near 660 nm, 800 nm, and 950 nm are used in one embodiment for oximetry measurements; other combinations of two or more wavelengths may also be used. In another embodiment, wavelengths near 680 nm 720 nm, 760 nm, and 800 nm are used to make measurements based on first or second derivative spectroscopy; other discrete wavelengths or a multispectral light source may also be used to generate the differential or second differential spectroscopy signal. Additionally, light sources may be used to illuminate tissue infused with a fluorescent dye to monitor perfusion. This monitoring may be done by either an intensity based measurement or a time-resolved measurement. In a further embodiment, the tips of sensors may be coated with a material such as Ruthenium to determine oxygen quantities by measuring oxygen quenching of fluorescent radiation. The coating may be illuminated to cause it to fluoresce and measurements may be made on intensity-based or time-resolved measurements.
The sensors described in the embodiments above can be used to perform said oximetry-type and/or fluorescence-type sensing. These techniques can be combined with other sensing modalities including optical sensors, electrical sensors, chemical sensors, mechanical sensors, electromechanical sensors, MEMS sensors, nano sensors, biochemical sensors, acoustic sensors, immunologic sensors, fluidic sensors, micro-dialysis based sensors or other types of sensors. The sensors may sense electrical properties, chemical properties, general health, tissue oxygenation, blood oxygenation, pulse rate, pulse presence, pulse rhythm, tissue perfusion, staple gap, compression force, tissue interaction force, staple tension, grasping forces, fluorescence, tissue electrical impedance, tissue electrical activity, pH, concentration of cellular respiration metabolites (e.g. lactic acid), electromyography, temperature, fluid flow rate, fluid flow volume, tissue pressure, blood pressure, biomarkers, radiotracers, immunologic characteristics, biochemical characteristics, nerve activity, an evoked potential, oxygen delivery, oxygen utilization, tissue characterization, tissue general health, tissue flow dynamics, tissue chemical composition, tissue immunologic activity, tissue pathogen concentration, tissue water content, blood hemoglobin content, tissue chromophore content (e.g. hemoglobin), tissue neoplastic cell content and tissue dysplastic cell content, and/or other parameters. The sensing modalities may be implemented using techniques known to those skilled in the art.
The embodiments described above demonstrate how the sensing adjuncts integrate with a circular stapler. These embodiments are for meant as illustrative purposes. The sensing adjuncts can be adapted to provide the described functionalities for other surgical staplers, and other surgical instruments.
The present invention can be practiced by employing conventional materials, methodology and equipment. Accordingly, the details of such materials, equipment and methodology are not set forth herein in detail. In the previous descriptions, numerous specific details are set forth, such as specific materials, structures, chemicals, processes, etc., in order to provide a thorough understanding of the present invention. However, it should be recognized that the present invention can be practiced without resorting to the details specifically set forth. In other instances, well known processing structures have not been described in detail, in order not to unnecessarily obscure the present invention.
Only an exemplary embodiment of the present invention and but a few examples of its versatility are shown and described in the present disclosure. It is to be understood that the present invention is capable of use in various other combinations and environments and is capable of changes or modifications within the scope of the inventive concept as expressed herein.
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36 year old man | New York, NY, USA | Seeking men 32-47 within 20 miles
Active within 24 hours
Single In the UES Looking For "The One
One would think that finding a decent guy in NYC would be easy, but that's far from reality. I would love to find a normal down to Earth guy who can hold an amazing conversation over a cup of coffee. I ask that you be masculine (I like men not girls), friendly (you should be able to start a conversation with any of my other friends), independent (you can't live off mommy and daddy), smart (politics and world events are great topics of conversation), funny (make me laugh and don't take life overly serious), mature and open to new possibilities. I like a man with a sense of purpose as guys with goals has always been a turn on. You should like to lay low and watch movies on a Saturday night just as much as going out on the town. Since I love pop culture, a man who respects my love of television and pop culture knowledge is essential. This doesn't mean you have to love everything I do, but you should respect it. A romantic man would be a dream, but I don't need flowers delivered. Small gestures go a long way in making a huge impression on me. Sometimes it only takes a little text message with a wink to say hello.
Book club , Coffee and conversation , Cooking , Dining out , Movies/Videos , Museums and art , Music and concerts , Exploring new areas , Performing arts , Political interests , Travel/Sightseeing
Bowling, Running, Swimming, Walking / Hiking
I exercise 3-4 times per week.
I have Dogs
I like Birds, Cats, Exotic Pets, Fish, Horses
I adopted a little Chihuahua/Terrier mix named Finnigan who is beyond precious to me.
Middle of the Road
I love going out with friends, but I'm not into the club scene. I joke that I am Lamo-Homo because I would rather relax at home or with friends at a favorite restaurant. My ideal date would be dinner, movie, coffee and a long walk around the city.
I'm addicted to Starbucks. I can't resist the little green woman on the cup.
I love hanging out with friends and exploring the city. I'm a pop culture addict so I'm always off to see the latest movie or catching up on my DVR.
I read just about every weekly magazine there is. I am also shamefully addicted to Harry Potter and the Twilight series. Typical, I know!
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|5'10" (177cms) to 6'10" (208cms)
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I am a Senior Photo Editor at a weekly celebrity entertainment magazine.
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I am a mix of German, Irish, Italian and Ukranian.
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|Bachelors degree, Graduate degree, PhD / Post Doctoral

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Fox News latched onto a study of the first full year of budget sequestration, claiming that the report undermines warnings that across-the-board cuts would cost the economy hundreds of thousands of jobs. In fact, the federal workforce has been significantly reduced since sequestration went into effect and fiscal austerity continues to drag down job creation and economic growth in the private sector.
The Wall Street Journal published an error-riddled piece claiming that increasing the federal minimum wage would force more Americans to rely on social safety-net programs when in fact the exact opposite is true.
In a May 5 opinion piece, New York lawyer John H. Heyer argued the minimum wage is a "scam." He then claimed increasing wages will force businesses to lay off employees and, in turn, swell the ranks of federal social safety-net programs, which Heyer refers to as the government "dole." From the Journal:
So the minimum wage, like so many government programs, is really a scam that never gets busted. Isn't that how these programs grow? There are always a few vocal supporters of any program and a lot of silent victims who mostly don't even know what effect the programs have on the public at large and the economy as a whole.
Minimum-wage laws raise business costs and increase unemployment. But they also require bureaucrats--who make a lot more than minimum wage--to administer the dole and regulate wages. So what's not for politicians to like?
Opponents of livable wages frequently claim that the minimum wage drives up unemployment, often citing the Congressional Budget Office's (CBO) most recent report on proposals to increase the federal minimum wage. The CBO report does project that total employment could decrease by between "very slight[ly]" and 1 million by the end of 2016, but that conclusion flies in the face of the overwhelming majority of economic evidence.
A February 2013 study by the Center for Economic and Policy Research (CEPR) reviewed nearly a decade of research on the minimum wage and concluded that "the minimum wage has little or no discernible effect on the employment prospects of low-wage workers." The Economic Policy Institute (EPI) similarly reviewed the available literature on the minimum wage and concluded that "raising the federal minimum wage to $10.10 will not lead to job loss." Conservative media jumped on a March 2014 survey by Express Employment Professionals claiming that businesses would cut jobs due to an increased wage, but even that survey found that 62 percent of minimum wage employers and 81 percent of all employers would not lay off workers as a result of increased wages.
Heyer's claim that increasing the minimum wage hurts the job market is arguable, but the claim that higher wages drive up reliance on federal safety-net programs is demonstrably false. The same CBO report that estimated 500,000 lost jobs from a $10.10 minimum wage also concluded that such a wage would lift 900,000 Americans out of poverty while boosting incomes for Americans living in poverty by $5 billion annually.
Increasing the minimum wage would definitively decrease America's reliance on the so-called government "dole." According to a March 2014 study by the Center for American Progress (CAP), a $10.10 minimum wage would decrease food stamp participation by up to $4.6 billion annually. An October 2013 study by the UC Berkeley Labor Center concluded that low wages in the fast food industry alone -- whose media wage is substantially lower than $10.10 -- cost taxpayers nearly $7 billion annually.
Contrary to Heyer' s allegation, increasing the minimum wage would significantly decrease reliance on "the dole," and significantly decrease the cost to taxpayers who subsidize the poverty wages paid by thousands of businesses around the country. A Media Matters analysis of broadcast evening news found that programs on ABC, CBS, NBC, and PBS largely ignored the high cost of low wages. The latest screed in The Wall Street Journal is not just ignoring the high cost of low wages; it is distorting the relationship entirely.
As the United States Senate voted on a bill that would increase the federal minimum wage, Fox News dedicated 15 times more coverage to the latest "developments" in its on-going campaign to create a political scandal from the September 11, 2012 terrorist attacks in Benghazi, Libya.
Fox News often promotes myths about student loan debt in the United States, misinforming about everything from the lack of protections borrowers receive, to the unsubtantiated claim that student loans drive up college costs, to the myth that struggling borrowers are taking a government handout. As the two-year anniversary of student debt surpassing $1 trillion takes place this week, here is a sample of the network's past student loan misinformation.
Over the past year, broadcast evening news programs on ABC, CBS, and NBC failed to mention the role of reduced taxes on the wealthy as a cause of inequality, despite the fact that economists view taxes as a primary driver of income gaps.
Women accounted for a small share of total guests featured during weekday evening economic coverage on the three major cable news networks, despite a renewed focus on economic discussions that significantly affect American women.
A Media Matters analysis conducted over the past year revealed that women comprised just 28.4 percent of total guests featured in weekday evening segments dedicated to economic news and policy debates on Fox News, CNN, and MSNBC.
Women make up slightly more than half of the total United States population and represent a significant majority of the voting public, but their voices remain vastly underrepresented in cable news segments on the economy.
Previous Media Matters studies have shown that weekday evening cable news coverage of the economy in particular fails to feature economists and experts. This failure is more shocking when measured in terms of gender -- women made up less than 10 percent of economist appearances in the past year.
Given that women make up more than 50 percent of the country, all economic issues are women's issues, and the lack of adequate female representation in these segments is a significant failure. But it is particularly glaring given the recent emphasis from policy makers and advocates across the political spectrum to highlight economic issues that disproportionately affect American women.
For example, according to the Economic Policy Institute (EPI), roughly 56 percent of minimum wage workers are women, and recently dozens of women in the economics profession signed a public letter circulated by EPI imploring lawmakers to raise the federal minimum wage to $10.10 per hour. Raising the minimum wage to this level and tying it to inflation now has the support of congressional Democrats and the White House, but weekday cable guest lists have mostly not included female economists whose research and advocacy support the effort.
The lack of adequate female guest representation in economic discussions is not a result of a lack of available and qualified candidates. Heidi Hartmann, the president of the Institute for Women's Policy Research (IWPR), is a prominent advocate for public policies focused on issues of particular importance to women. Economists Heidi Shierholz and Elise Gould of the Economic Policy Institute have written extensively on the impact of low wages on women and the importance of health care reform. Jeanneatte Wicks-Lim of the Political Economy Research Institute (PERI) also specializes on studying policy effects on low-wage workers. Michigan State University economist Lisa Cook has been a recurring guest on MSNBC's Melissa Harris-Perry in the past, but did not appear during MSNBC's evening weekday lineup in the past year. Christina Romer of the University of California, Berkeley is the former chair of the president's Council of Economic Advisers and co-authored President Obama's economic recovery plan in 2009 with economist Jared Bernstein, himself a regular guest on MSNBC.
The economics profession produces more than enough women with the talent necessary to advocate policies or comment on research in the cable news sphere. It is time for guest lists to start reflecting the diversity of opinion and expertise held by women in the field.
Over the past year, weekday evening cable news shows have hosted significantly more male than female guests to discuss the economy, and have hosted only a handful of female economists.
Fox News is celebrating Equal Pay Day by downplaying the problem of a pay gap between men and women in the United States.
April 8 marks the observance of Equal Pay Day, an awareness campaign to educate the public about the pay discrepancy between working men and women in the United States. According to the most recent report from the American Association of University Women (AAUW), women working full-time in 2012 took home approximately 77 cents for every dollar earned by a man working full-time, a ratio that has remained stagnant for nearly a decade.
Despite the discrepancy in take-home pay between American men and women, right-wing media voices, led by Fox News, continue to disregard the issue entirely, claiming either that the gap is not real or that it is too insignificant to merit a proactive response.
Watch Fox deny reality as it attempts to pretend the gender pay gap away:
Narration by Meagan Hatcher-Mays
Weekday broadcast and cable evening news covered a variety of economic topics including deficit reduction, economic growth, and effects of the Affordable Care Act (ACA) throughout the first quarter of 2014. A Media Matters analysis shows that many of these segments lacked proper context or input from economists, with Fox News continuing to advance the erroneous notion that the ACA and the minimum wage are causes of poor job growth.
Fox News dishonestly attacked the solar industry, implying that Yuma, Arizona's unemployment rate is higher than that of Midland, Texas due to the presence of a solar power plant and lack of natural gas or petroleum exploration. However, Yuma and Midland have completely different economic bases, and the Yuma solar plant has been lauded as a success.


text:
Maps, Directions & Parking
Find Your Way to Cañada College and Around Campus
Class Schedule
A Complete List of Classes
Student Body Card
Pick up Your Cañada College Student Body Card!
Make the most of your Cañada College experience by paying your $8.00 Student Body Fee and receive your official Cañada College School ID
Student ID FAQs (Frequently Asked Questions)
How do I get a Student Body Card?
1.) Go to the Center for Student Life and Leadership Development, Building 5, Room 354
2.) Bring proof that you have a zero balance from Websmart (we do accept screen shots from phones)*
3.) We print ID Cards in-house, and you will receive your card within a few minutes.
What are the hours to get a Student Body Card?
We will start making Student Body Cards for the Fall 2015 in August.
How Long do School Body Cards last?
School IDs expire at the end of each semester. After you receive your Student Body Card, a sticker will be added each semester you wish to validate it.
Where can I get a Student Body Card?
The Center for Student Life and Leadership Development, Building 5, Room 354
What Happens if my card is lost of stolen?
If your card is lost or stolen, you can go to the Cashier's Office and let the staff know. They will charge your account $8, and you can come to Building 5, Room 354 for another card.
What if I am in RadTech or I'm in the Medical Assistant Program?
The RadTech Program does not pay for RadTech Identification Card you will have to inform the Student Life staff the program you are enrolled in. The staff will then check if you have a zero balance or on the payment plan with the Student Body fee payed to Cañada College.
The Medical Assistant Program does not pays for Medical Assistant Program Identification Card you will have to inform the Student Life staff the program you are enrolled in. The staff will then check if you have a zero balance or on the payment plan with the Student Body fee payed to Cañada College.
What if I don't want a Student ID?
You can request to waive the right to your Student ID using the Student Body Reimbursement Form
Why should I get my card? You can receive the following discounts with your Student Body Card!
Check out our list of discounts below and in the Center for Student Life Pamphlet!
$12.99 Online CPR Course with promo code SAVEALIFE
|10% on orders over $99.99 with Code SPECIALDAY
|Student buying guide and discount information to restaurants, stores, and entertainment
|15% off any item found on the website with code BB987Z
$24.95 admission
Monday through Thursday tickets cost $9.50
|$11.95 admission
|$25 start off fee. Monthly fee $50.
|15% of any item on the website. Promo-Code: A943CD
|$19 admission
|10% off any purchase
|10% off entire purchase after enrollment.
Rent to Own homes are residential properties for rent; purchase is an available option, but is not required. A major benefit of these lease agreements is that they are very customizable depending on what is most convenient for the intended renter.
We want to offer you exclusive full-access membership completely free of charge. Simply go to JustRentToOwn.com click on the log-in tab, and enter
|$20 off on any binocular or trinocular microscope over $200
|2 for 1 special; 1 large pizza and get the second one free.
| 15% off any product under $200 that does not have a reduced price with discount code mtpE57SP
|Monthly due $53 a month compared to $70
|10% off any purchase
|Discount on a purchase or lease of a new car from Putnam Buick GMC and Putnam Chevrolet Cadillac.
|25% off any body work
|10% off excluding special offers.
|Buy 1 ticket get 1 free (good Sat 8pm to 10pm and Sun 1:30 pm to 4pm
$12.50 admission
|$5 admission
|$3.00 Admission.
$11 admission
|20% off any purchase
|A free fountain soda or regular chips w/a purchase of any sandwich.
|20% off new patient specials
|Trillium Wellness Clinic
|25% off weight loss program
10% Discount
10% discount on any purchase except gift cards


text:
Local man strikes gold with goatee in Alaska
Ties for first in goatee category
EVANSVILLE - Maybe it's because he resembles Gabby Hayes, the sidekick in all those old western movies.
Or maybe it's his personality, so humble inside his tiny 5-foot-2-inch frame.I think Bremen's personality is what got it. He never meets a stranger."
It could be his reddish-blond goatee, turned-up leather hat, blue bandanna, brown Western coat and boots, too.
Some folks said he resembled the Gold Rush prospector depicted on the logo of this year's International Mustache and Beard Contest.
Whatever it was, 59-year-old Bremen Groves of Evansville struck gold when he went north to Alaska last week.
On a lark, he entered and tied for first place in the Natural Goatee category at the world event, which brought 300 contestants from 15 countries to Anchorage.
"I went up there to support David," Groves said, referring to Evansville podiatrist David Powell, a friend since childhood.
Powell has entered the past two world contests, coming in fourth both times in the Partial Beard Freestyle segment.
This year, as a treat, Powell paid for his friend to fly with him, suggesting Groves enter his goatee "for the fun of it."
Powell didn't really think Groves stood a chance at Saturday's judging, not with stiff competition from facial hair veterans.
Still, he told Groves, a truck driver, to bring along some Western attire for a costume.
Groves found a pair of Rural King boots, borrowed a leather coat from his wife, Rosemary, and a leather hat from one of his sons, and, voila, a star was born.
"Bremen's never been on an airplane, never won a (lottery) scratch-off. He goes with some clothing out of his closet," Powell said, bemused.
"I guess it pays to be yourself."
The judges (ranging from hairstylists and dog sledders to a retired hockey player) weren't wild about Powell's mustache styled like a whale's tail.
But from the moment the two landed in Anchorage a week ago, people seemed drawn to Groves, who won a shiny prospector's bowl as a trophy.
"They were coming up to hug him and ask to have their picture taken with him," Powell said.
"I think Bremen's personality is what got it. He never meets a stranger.
"He walks on stage as contestant No. 204 and a group of Australians, who have a rock band called The Beards, start chanting 'Bremen, 204! Bremen, 204!'"
Even the Germans — who always have dominated the biennial competition but were whisked off their perch this year by the Americans, who won 12 of 19 events — seemed to like Groves.
Was it because there's a city of Bremen in Germany?
Is Groves German?
He laughs, pointing out he was born in Kentucky.
"My mother couldn't think of what to name me, and the doctor said, 'Call him Bremen.'"
Subscribe to the Courier & Press or The Gleaner
Need Help? Call us at 1-877-304-7771.
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text: I had been using ATI for a long time now. The last one I had was 9800Pro. I was fairly happy with it. I ran very smooth on most of the game. Now since the hype of Geforce 6800, I thoght I would give it a shot (especially the price and performance, comparing with ATI X800, on many reviews). And I thought any of the 6800 series should beat 9800Pro on all of the games since is a newer architecture and more pipelines. So I went and got a BFG 6800 OC. I first game I tried was the SIMS 2. I was SHOCKED! It was SLOOOOW comparing to 9800Pro. The frame rate was almost unplayable when there are multiple people on the screen. So I thought maybe something is wrong? (I got Pentium 4 3.0G HT and 1GB RAM) I went to the store and exchanged for BFG 6800GT OC 256MB. And I tested, is much better. But comparing to the 9800Pro, is still not as good. But the price is more than double of 9800Pro. Although I have not try other games (DOOM 3 and FAR Cry). But anybody have the same problem? I really hate to feel like ripped off by Nvidia.... Something cost more than double and a technology suppose to be way better than 9800Pro (double of pipeline, 8 vs 16), but yet the performance waaaayyy off on Sims 2?? Any fixes?


text:
Enterprise Backup and Recovery Methodologies for Oracle
Date Added: Nov 2009
Format: PDF
Organizations house some of their most business-critical information in Oracle Databases, making it imperative to have sound backup and recovery processes in place to protect this data. Backing up and recovering Oracle environments can present unique challenges. A variety of Oracle and NetApp technologies are available that can assist companies in overcoming these challenges. This paper provides an introductory overview of some of the enterprise backup options available for Oracle environments. It is aimed at IT professionals - including database administrators, storage administrators, and managers - and anyone who plays a role in architecting and implementing the backup and restore processes of Oracle systems.


text:
Learn more about Amazing Spiderman:
Format: Wii
Manufacturer: Activision Blizzard
Mfg Part#: 84351
Sku: 227375983
See more in Games
Product Description
Go beyond the movie to experience what it's like to BE Spider-Man like never before. Set shortly after the events of Columbia Pictures' new film, The Amazing Spider-Man throws New York City's brand new hero back into free-roaming, web-slinging action, as he protects the Big Apple from a deluge of unimaginable threats. Experience the new Web Rush mechanic as Spidey twists his way through the NYC skyline with unprecedented speed and grace. The game's original story also explores beautiful indoor environments, as you'll encounter everything from skirmishes with everyday street thugs to pulse-pounding confrontations with Spider-Man's most lethal foes.
Customer Reviews of Amazing Spiderman
Wii spiderman1/15/2013
This game is simply AMAZING!!!! It's the best Spuder-Man game and it's the best superhero game ever!!!! I know that some people disagree with this FACT because they think that arkham city is the best but just think about it for a second. This game looks great, graphics are awesome, gameplay is spectacular and voice acting is incredible.


text:
product details-Tab
Perfectly flavored with natural bergamot
Our tea bags are sealed for freshness in airtight, flavor-protecting fresh packs to ensure your full enjoyment.
Indulge in the soothing ritual of tea.Sipped throughout the day, tea quenches, soothes, satisfies... and delivers healthful antioxidants.
From the wonderful aroma that fills the air the moment it starts steeping, you'll know that Bigelow tea is like no other. To create our distinctive Earl Grey, we blend tender, hand-picked tea leaves with natural bergamot, then individually wrap our tea bags in flavor-protecting pouches to seal in its goodness.
Remember, adding a cup of Bigelow tea throughout your busy day can contribute to your overall well being. So sit back, relax and make tea time your time to refresh mind, body and spirit!- David & Eunice Bigelow
Satisfaction fully guaranteed by Bigelow, the makers of "Constant Comment"® Tea.
Blended and Packaged in the U.S.A.
Bigelow, Inc.©
(based on 3 reviews)
Ratings Distribution
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Reviewed by 3 customers
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Well Packaged
By Lily
from Washington, DC
See all my reviews
Comments about Bigelow Earl Grey Tea, Value Pack, 40 bags:
Tasty, fresh Earl Grey. I appreciate the sealed packettes of four each. Keeps the rest fresh and handy to take on weekends away.
Bottom Line Yes, I would recommend this to a friend
Was this review helpful? Yes / No
- You may also flag this review
My favorite Earl Grey
By kylahchayne
from England, UK
Best Uses
This is my favorite Earl Grey Tea. I live in England & I have tried a lot of teas. Great w/ sugar & a little bit of milk.
excelent tea
By Dar
from Douglassville,Pa
describe yourself Health Conscious, Simple Tastes
I wish it would be stated that the bags are wrapped in duplicate.I often send 1 tea bag in my greeting cards
Hot Tea: One Cup: Pour boiling water over tea bag in a cup and steep for 1 to 2 minutes.By the Pot: Place 4-5 tea bags in a teapot. Add one quart boiling water. Steep 5 minutes.You can serve this tea "as is" or with sugar or honey.
Iced Tea - Quick Brew Method:Place 6 tea bags in one-quart container. Pour 1 cup (8 fl. oz.) boiling water over tea bags; steep 10 minutes. Remove tea bags. Add 3 cups (24 fl. oz.) cold water. Serve over ice. Sweeten to taste. Makes one quart.


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Marc Jacobs shares the latest image along with a sentimental message to the supermodel.
Week in Accessories: Beach Trip
Alesha Dixon attends the pre-final party of Britain's Got Talent sponsored by Virgin Media at Banqueting House on May 11, 2012, in London, England.
Actress Alison Brie arrives at the Premiere of AMC's Mad Men Season 5 at ArcLight Cinemas on March 14, 2012, in Hollywood, California.
50 States of Shopping


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The Gators had four players selected on the final day of the 2014 Major League Baseball Draft on Saturday.
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Best Western Plus Portage Hotel & SuitesRead MoreProperty Location Located in Portage, Best Western Plus Portage Hotel & Suites is in the business district and within the region of Indiana Dunes National Lakeshore and Indiana Dunes State Park. This hotel is within the region of Deep River Water Park and Westfield Southlake Mall. Rooms Make yourself at home in one of the 100 air-conditioned rooms featuring refrigerators and LCD televisions. Your pillowtop bed comes with cotton sheets and down comforters, and all rooms are furnished with sofa beds. Wired and wireless Internet access is complimentary, while 32-inch high-definition televisions with cable programming provide entertainment. Private bathrooms with shower/tub combinations feature complimentary toiletries and hair dryers. Rec, Spa, Premium Amenities Dip into one of the 3 indoor swimming pools or enjoy other recreational amenities including a sauna and a fitness facility. Additional amenities include complimentary wireless Internet access, an arcade/game room, and wedding services. Guests who want to try their luck at the slots can hop on the complimentary casino shuttle. Dining A complimentary hot/cold buffet breakfast is included. Business, Other Amenities Featured amenities include complimentary high-speed (wired) Internet access, a 24-hour business center, and limo/town car service. Planning an event in Portage? This hotel has 1700 square feet (158 square meters) of space consisting of conference/meeting rooms, small meeting rooms, and banquet facilities. Free parking is available onsite.6200 Melton RoadGary, IN US
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Zoom CleanRead MoreBefore expanding to five locations, the owners of the first Zoom Clean found that they couldn't get the results they wanted with just any old soaps and waxes. They soon tracked down a chemist, who glued the periodic table to every doorknob and helped them develop their own innovative line of cleaning products. The resulting detergents, shampoos, polishes, and protectants now cleanse chariots of all shapes and sizes—including semi-trucks, motorcycles, limousines, and boats—to a glossy shine in Zoom Clean's touchless automatic washes, DIY bays, and hand-wash stations. Z Clean 2-in-1 Powder, a highly concentrated multipurpose mixture, protects paint jobs by reducing friction during washing. When they aren't buffing and waxing autos in their detail center, resident technicians perform diagnostic checks, install 3M Window Film, and restore cloudy headlights. They can also steam-clean interiors, scour engines, and refill parched oil tanks.5840 BroadwayMerrillville, IN US
Car-X Auto Service - St. LouisRead MoreWith more than 175 locations nationwide and more than 35 years in the business, Car-X Tire & Auto has earned a prime spot in the parking garage of quality car care and customer service. Started in 1971 by a team of seasoned muffler-shop owners, the service centers have blossomed from their beginnings as specialty exhaust shops to providers of nearly any repair or maintenance service imaginable, from installing performance-enhancing accessories to treating cars to therapeutic trust falls. In addition to promoting safety and long, healthy engine life with brake services and speedy oil changes, Car-X reaches out to the surrounding community with regular philanthropic activities, such as recycling drives and participation in the American Heart Association's Heart Walk.3700 Grant St.Gary, IN US
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Flamingo Pizza of MillerRead MoreIf you're searching for a quick and casual spot to grab some pizza, look no further than local favorite Flamingo Pizza of Miller. G-free and low-fat are just a couple of examples, come here for a quick bite that will leave you feeling healthy. Beer, wine, and more are also available from Flamingo Pizza of Miller's extensive drink list. Grab the kids when you head to Flamingo Pizza of Miller — its family-oriented menu and ambience all perfect for the whole clan. Up for grabs (and free of charge) is Flamingo Pizza of Miller's wifi. The patio tables outside of Flamingo Pizza of Miller are the perfect spot for a summer meal. Planning a special night? Call ahead to reserve a table. Casual dining at its best, Flamingo Pizza of Miller customers are free to enjoy themselves in jeans and a T-shirt. You can also grab your grub to go. Feed the gang at your next get-together with catering from Flamingo Pizza of Miller as well. Valet parking, street parking and garage parking! Oh, my! All of these options are available near Flamingo Pizza of Miller. Commute by bike to Flamingo Pizza of Miller and find easy bike parking. Dining at Flamingo Pizza of Miller will set you back about $30 per person on average. Visa, MasterCard, Discover, and American Express are all accepted. Flamingo Pizza of Miller dishes up breakfast, lunch, and dinner, so stop by for your favorite meal.8341 Locust AveGary, IN US


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Couples Counseling
Sexual Abuse
Contact Us
Life Coaching
Boynton Beach, Florida
Welcome to
Palm Beach Counseling &
Life Coaching
A place for healing,
a place of hope
Serving Palm Beach County and
South Florida since 2006
Take control
of your thinking. Get SASSY!
As a Christian therapist, Im
always thinking of ways we can renew our mindsin truth and
with hope through Gods Word. One process that seems to be
helping people is learning to get SASSY! Our daughter Kristen helped
me enhance the SASSY technique with the accompanying acrosticthanks,
Kristen! (Click
here to see the acrostic and read the full article.)
Almost everyone has trouble falling asleep
sometimes; almost everyone feels occasional concerns about
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12 Who Made a Difference: Sophie Levy
Thanks to Germantown teen, shelter felines get room with a view
On a cold but sunny day, a black-and-white cat sprang into action and landed on a window ledge looking out over the woods and a lone dog in the dog run at the Germantown Animal Shelter.
Instead of their formerly claustrophobic playroom, felines now have two windows at their disposal. Moments later, the cat, named Will Farrell, watched intently from the second window as workers left the Public Services building next door.
The idea to install the windows is largely due to the work of a 13-year-old animal shelter volunteer and future veterinarian Sophie Levy.
In August, she held a garage sale as her bat mitzvah project. She gave the $2,600 she raised to the city to build a window for the cats. Previously, only a few cats housed in cages in the reception area had access to a window where they could stretch out and lounge in the sun's warmth.
In addition to the money Sophie and her family raised, the city chipped in another $1,200 to pay for a second window, for a total cost of $3,800.
"I love it," Sophie said. "I can't believe it's finally here. It's better than I expected. Not only can the cats look out the window but they also can lie in the sun."
Added Sophie's mother, Shelley Levy, "We were really only expecting one window. The second window -- that was a surprise to us." With two windows and the playroom door left open, Mrs. Levy said, "It lets the sunlight in when no one is here."
When shelter supervisor Bethany German allowed two brother cats into the playroom for the first time after the windows were installed, they needed no prompting. "One leaped from one window sill to the next. Being in that room allows them to release some of that energy," she said. "It's so much nicer. It has a more natural feeling."
German thinks the sunlight also has a calming effect on the cats. "They are definitely more active now," she added. Regarding Sophie, German said, "She's definitely well beyond her years. She's very, very mature."
Now that the windows are finished, Sophie is already thinking about an encore garage sale next year. As an equal-opportunity lover of cats and dogs, Sophie may try to spread the love around and help fill a need for the shelter dogs.
"I'd love to give it a second shot," Sophie said. She's uncertain what the project may be but it could involve better cages for the dogs or possibly sodding the dog runs with grass.
Mayor Sharon Goldsworthy appreciates Sophie's efforts to make life better for the shelter animals. "Never underestimate the power of a young person to bring about good things," she said. "Sophie's compassion and her commitment inspired and engaged others to improve conditions at the shelter, and we are grateful for her efforts."
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Originally written on MyTeamRivals.com | Last updated 9/9/12
http://pixel.nymag.com/imgs/daily/sports/2012/09/06/06-knicks-new-uniforms.o.jpg/a_560x375.jpg Today the New York Knicks officially unveiled their for the upcoming 2012-2013 NBA season. The give a nod to the Knicks glorious championship years, and personally, I really like the new look and am glad the changes were made. The most notable change that fans will notice was the removing of the side piping on both the jerseys and shorts. The jersey and shorts are both solid one color now. There was also a solid color waistband added, blue for home and orange for away jerseys, and the Knicks logo is now on the left leg. There were more subtle changes made as well, including a more rounded neckline. On the inside of the collar, there is also a message written that says, "Once a Knick, always a Knick". http://img.gawkerassets.com/img/17yamg2ge53k0jpg/xlarge.jpg The quote is something that center Tyson Chandler really appreciates. "This city embraces...
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Originally written on Fox Soccer | Last updated 11/23/12
Manchester United boss Sir Alex Ferguson has already taken a swipe at Rafael Benitez after he took charge of Chelsea. Benitez has been swiftly installed in the Stamford Bridge hotseat after Roberto Di Matteo was axed as Blues boss on Wednesday and Ferguson is baffled by events in west London. The Scot is full of sympathy for Di Matteo, who was sacked despite landing the UEFA Champions League title and the FA Cup, and he could not resist a dig at old sparring partner Benitez, who was involved in some heated confrontations with Ferguson during his spell at Liverpool. Ferguson feels the Spaniard is 'very lucky' to be handed the Chelsea job, just weeks before they attempt to land the FIFA Club World Cup. "Everyone feels for Roberto Di Matteo, and quite rightly," said Ferguson. "It is quite amazing when you think that he has won the FA Cup and the Champions League. "The biggest disappointment for me is that in two weeks' time they are going to the world championship (FIFA Club Worl...
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Results 1 to 8 of 8
May 10th, 2012 #1
Upgrading from a bamboo pen and touch medium to an intuos3 A5
I bought the bamboo medium tablet as a beginners tablet (previous model). I think it's great and I'm still learning to use it. However I have the opportunity to buy a used intuos3 A5 for ~$100, but am unsure if it's worth the upgrade. According to specs it has a higher surface resolution and it detects pen angle (bamboo doesn't) and the active surface is about the same. The main reason I'm considering it is because I like sketching digitally and the beter resolution might make that easier. Is it worth the upgrade?
Last edited by DanijelC; May 10th, 2012 at 09:53 PM.
Hide this ad by registering as a memberMay 11th, 2012 #2
Id say buy it if you have the cash to spend. Its not a bad price for an intuos. Plus the intuos 3 doesn't have the nib wear issues that the later versions apparently have. I am still using an intuos 3 and don't see any real reason to upgrade.
That being said it doesn't make all that much difference which wacom model you use. A good artist will make just as good pictures with a bamboo as with an intuos, so its up to you.
May 11th, 2012 #3
Thanks for the reply. I don't really have the money, but If I sold my bamboo it would cover the cost of the intuos3. I just thought the 90-100 usd was a great price for a used intuos3 (seller claims it's as good as new).
Of course a professional can make good use of any tool and at my stage the tablet will have least impact on the quality of the result. It's just that I haven't seen many intuos3 selling for such a low price, it seems like a good investment (given that so many artist rave about it ).
May 11th, 2012 #4
However, if the surface area is smaller it can be a step back. I wouldn't get an intuos3 small for example.
May 11th, 2012 #5
Good point. I actually thought that the A5 intuos3 had a smaller active area based on the pictures. But according to specs a bamboo fun is 8.5"x5.4" (~46 square inches) where the intuos3 A5 is 6"x8" (48 square inches). So it actualy has a slightly bigger working area .
May 11th, 2012 #6
But keep in mind your actual working area is in proportion to your monitor. Or rather it will change if you force it to map to your monitor's proportions.
Make sure it comes with a stylus. Your pens are not compatible with the intuos3
May 11th, 2012 #7
I always map a portion of the screen to the tablet, so I get the max out of the tablet area and the movements I make are the same on the screen. The stylus is indeed very important, a new one alone costs $100 . Anyhow, thanks for the feedback. I'm going to try and buy the tablet, hopefully everything works out.
May 19th, 2012 #8
I just got my intuos3 tablet, I just need to buy some extra nibs. Are the new nib types compatible with the intuos3? I'm thinking of buying the WACOM ACK40001 Intuos4 Pen Accessory Kit:
Nib Thick-Bodied Rubber Grip for Use Without Side-Switch
Standard Rubber Grip for Use Without Side-Switch
Replacement Side-Switc
Standard Black Nib
5 x Stroke Nibs
5 x Hard Felt Nibs
5 x Flex Nibs
Nib Extractor
I assume the standard black nib is the equivalent of the standard white nib?
Edit: question answered in this thread (all nibs are compatible).
Last edited by DanijelC; May 19th, 2012 at 08:48 PM.


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Adding up the BenefitsUntil now, socioeconomic benefits and environmental externalities, those consequences of industrial or commercial activities not reflected in their costs, have often been left out... Show More +
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And my skin ain't white.
I think damn near any HW can be KTFO with the right shot. Hell Mark Hunt got KO'd. Cain got KO'd and he'd been rocked a few times. These are HW fighters, if he was getting KO'd by jabs that would be a different story, but he's getting clocked clean and hard by hard hitters. He needs to stop doing that and start doing the hitting. Problem solved.


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1959 Mercedes-Benz 190SL RoadsterTo be OFFERED AT AUCTION at Auctions America's California event, July 17-18, 2015. Click here to view this listing on the... More
1959 Mercedes-Benz 190SL RoadsterTo be OFFERED AT AUCTION at Auctions America's California event, July 17-18, 2015. Click here to view this listing on the... More
- Red exterior- Tan interior- Original 1.9 Liter SOHC I-4 engine- Sunroof finished in black to match the hub caps- Coat hooks- Rare 55-style... More
- California Black Plate car- Garage kept in San Francisco for 30 years- Documented ownership history to 1967- Older repaint in Silver, re-plated chrome-... More
During the 1950s, when Mercedes-Benz was the dominant force in top-level motor sport, the undisputed flagship of the firm's production car range was the... More
1957 Mercedes-Benz 190SL '57 Mercedes-Benz 190SL in original 040G black with burgundy interior. Excellent color combination and highly sought after. This car comes with... More
1959 190 SL , VIN # 9501498 . This black plated Ca 190 SL was parked in a dry LA garage in 1968 after... More
This is a 1959 Mercedes 190SL in excellent highly restored condition. This car has undergone a complete nut and bolt restoration by a noted... More
This 1955 Mercedes-Benz 190SL has metric gauges, KM speedometer, and was originally sold in Germany. The 190 SL's were not imported to the USA... More
In 1954, Mercedes-Benz introduced the 300SL "Gullwing" (W198) to the world at the New York International Motor Sports Auto Show. Sharing the platform was... More
1956 MERCEDES BENZ 190SL W121 - 4 Speed Manual Overall a great candidate for partial restoration. Runs and drives, needs new brakes and full service and tune... More
Mercedes Benz 190 SL in a very good overall condition. Has been restored and mechanically rebuild some years ago. Body very solid and with... More
Mercedes Benz 190 SL LHD in a stunning throughout condition. This is an original European version. Very extensive/ high quality restoration, Bare metal! All... More
We're pleased to offer this attractive "turn-key" 190SL: Chassis #121042-10-6502147 Engine #12192-7500097 (does not match data card) Body #65-01622 Paint code: 040 >Long time current ownership >Previously a black CA... More
1959 Mercedes-Benz 190SL Convertible, After sitting unused for 3 decades in San Francisco, California Colonel Robinson Minick's 190SL was ready for some serious refurbishing.... More


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Omnibus Spending Bill Will Not Come out until December
- November 10, 2014
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An omnibus spending bill needed to keep the government running through next Oct. 1 likely won't be released until early December, according to House Appropriations Committee spokeswoman Jennifer Hing. The fiscal 2015 spending measure likely would be released the week of Dec. 8, reported the Hill. The timing would give lawmakers very little time to debate and vote on the legislation, as the existing continuing resolution runs out Dec. 11. Of course, lawmakers could pass another short-term stopgap measure to give themselves more time to clear an end-of-the-year omnibus …