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Snow Day at Big White: Over 40cm in 24 hours
The storm came in at 10pm on Sunday night. Fluffy flakes of Okanagan Champagne Powder began falling from the sky and haven't stopped since.
Kettle Valley Steak House: What to eat (and drink)
Kettle Valley Steakhouse is not the average kind of restaurant you'll find at a ski resort. That's something you realise as soon as you walk in.
Big White: New Year's Eve 2014
We saw the New Year in with style this season. Two sets of fireworks meant that the entire resort was lit up at 8pm and midnight, with families enjoying free hot chocolate, free glowsticks and Family Challenge Night at Happy Valley Day Lodge.
Big White breaks all-time resort records
Big White Ski Resort near Kelowna, British Columbia Canada is reporting record tourism numbers for the Christmas season, according to resort Senior Vice President Michael J Ballingall.
Big White Christmas Day: Ski with Santa
After a hard night of delivering presents to boys and girls around the world, Santa came to Big White to let off some steam!
Big White: Christmas Eve 2014
The Christmas Eve Parade is one of Big White's favorite traditions, and the festivities this year were nothing short of spectacular.
Dress Like Santa and Ski For Free day
This season, Big White Ski Resort once again challenged all skiers and snowboarders to get into the spirit of the festive season by dressing like Santa or Mrs. Claus for their day on the slopes.
New snow, lift openings & TELUS Park
With plenty of fresh snow in the last few days and a 120cm alpine base, Big White Ski Resort is launching right into the 2014/2015 ski season.
10 Best Things to do in Big White Over the Holiday Season
Twinkling fairy lights, snowy footpaths, endless Christmas trees and Christmas carols blasting over the speaker. Big White Ski Resort is one of the best places in the world to celebrate Christmas – the only difficult part is deciding which activity to take part in!
New TELUS Charging Station
There's nothing more annoying than running out of phone battery while you're skiing or snowboarding - especially because there's no easy place to charge a phone while you're up on the mountain.


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I love the idea of her grappling him at one of the BJJ tourneys.. would prove the same point cuz he couldn't knock her out
I love the idea of her grappling him at one of the BJJ tourneys.. would prove the same point cuz he couldn't knock her out
Rousey by 1st round armbar. Crazy submissions make up for a lot of strength. Penn choked out Hughes and almost did it again in the second fight even though he was much weaker. The Gracies, Sakuraba, Maia, Big Nog all made a career of submitting much more physically imposing fighter. There's no reason to think Rousey couldn't tap out a middle of the pack fighter who weighs the same.
Even Eddie Bravo said he can't stop her when she gets in the spider web position.
I like her less with every interview. She and JDS seem to be having a contest to determine who can lose all their good will the fastest.
Btw anybody watch that video of ronda boxing with the dude thats a world champ at 135 pounds in boxing... But yeah she would fuck dudes up.
I think this thread is missing the fact that Caraway is a very mediocre fighter.
I'd definitely pick Rousey to win in pure grappling. In pure MMA I think she still has a very good chance, my biggest concern would be her eating a powerful punch when crossing the distance. But it's not like Caraway is a powerhouse at 135.
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subset: commoncrawl


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We are a family owned business located in Cape Coral, Florida and have been making the finest beef jerky, marinades, spice rubs, seasonings and BBQ sauces for over 35 years.
Our products are made with the freshest, all natural ingredients and are the perfect balance between sweet and heat. "Guaranteed" The Best you will ever taste.
A USDA-certified copacker is sourced for our jerky and marinade products.
We take pride in all our recipes from start to finish that is why you will never taste a better jerky product any where. We use nothing but the best of ingredients and the out come is top of the line beef jerky so addicting that it should be a crime lol. If you haven't tried Ed's RoadHousE Jerky marinades your missing out ! When you first experience our jerky products you are in for a treat to remember. "Nobody Beats Our Meat"
Monday - Friday: 9am-5pm
Saturday: 9am-12pm
Sunday: Closed
Holidays: Closed


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Around the Area: 03.02.06
Spend Saturday afternoon eating chili and helping battered women and families of fallen police officers.
The Corpus Christi Police Officers Association is sponsoring a chili cook-off from 11 a.m. to 4 p.m. Saturday at Knuckleheads, 819 N. Upper Broadway.
Proceeds from the $5 cover benefit Women's Shelter of South Texas and a fund for families of fallen police officers.
Information: 882-2762
Beth Wilson
Group to hold annual scholarship dance
The Del Mar College Chapter of the Texas Association of Chicanos in Higher Education is having its annual Scholarship Baile (dance) beginning at 7 p.m. Friday at Moravian Hall, 5601 Kostoryz Road.
The celebration will include a silent auction and carne guisada dinner.
Tickets are $15 in advance or at the door. Proceeds will benefit the Del Mar College TACHE scholarship fund. Since 1995, TACHE has awarded more than $23,000 in scholarships.
Information: 698-1247
Adriana Garza
A&M-K to sponsor rodeo this weekend
Texas A&M University-Kingsville is sponsoring the National Intercollegiate Rodeo Association rodeo on Friday and Saturday at the J.K. Northway Exposition Center in Kingsville.
Preliminary performances are at 7:30 p.m. Friday with finals at 7:30 p.m. Saturday.
Each performance will feature nine events including bareback riding, barrel racing, and bull roping.
Tickets are $5 at the door. Children 12 and under are free. Tickets are $3 for A&M-Kingsville students with a valid student I.D.
Adriana Garza
Subscribe to the Caller-Times
Need Help? Call us at 1-800-566-8098.
Monday-Friday: 6am-3pm / Saturday: 7am-11am / Sunday: 7am-11am


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Note: This recipe is especially for pregnant and breastfeeding women, but can be a nutritious part of almost anyone's diet.
Prep time: 25 minutes, including cook time
Makes: 4 pockets
Serving size: 1 pocket
Nutritional analysis (per serving):
472 calories
35 g protein
16 g fat
7 g sat. fat
47 g carbohydrate
8 g fiber
75 mg cholesterol
1400 mg sodium
417 mg calcium
1 mg iron
25 mcg folic acid
Note: Nutritional analysis may vary depending on ingredient brands used.
This recipe is an excellent source of protein, fiber, and vitamins A and C, all of which are essential during pregnancy and breastfeeding.
Reviewed by: Mary L. Gavin, MD
|Allrecipes.com This site offers more than 40,000 free recipes, plus lots of cooking tips and information.
|National Center for Nutrition and Dietetics Offering nutrition information, resources, and access to registered dietitians.
|Food Network TV's Food Network goes online with searchable menus and recipes, an encyclopedia of cooking terms, and ideas from celebrity chefs.
|Women, Infants, and Children (WIC) The Special Supplemental Nutrition Program for Women, Infants, and Children - better known as the WIC Program - serves to safeguard the health of low-income women, infants, & children up to age 5 who are at nutritional risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care.
|MyPlate for Moms MyPlate for Moms tailors the USDA's food guide to suit the individual needs of pregnant and nursing women.
|Eating During Pregnancy To eat well during pregnancy, your extra calories should come from nutritious foods that contribute to your baby's growth and development.
|Breastfeeding FAQs: Your Eating and Drinking Habits Here are answers to some common questions about what breastfeeding mothers should and shouldn't eat and drink.
|Should I Avoid Certain Foods During Pregnancy? Find out what the experts have to say.
|Pregnancy Precautions: FAQs Questions regarding what you can and can't do during pregnancy abound. Knowing what could truly be harmful to your baby versus what's no real cause for concern is key to keeping your sanity throughout the 40 weeks.
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.


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With three friends I'm working on a VLE, called Freevle. This is the coming soon page I designed, you can see it at freevle.org.
This is my first shot, thanks to @sjorssnoeren, who drafted me!
More Floris Jansen
keyboard shortcuts: ← previous shot → next shot L or F like Z toggle zoom


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Date: Sunday, 8-Jul-2012 09:44:23
This is an Awareness Blog to consider the future of your world. Actions are being done now to restore our world. Watch and become AWARE! This blog is an online legacy of John Machaffie a super patriot who gave everything to help his fellow man. Send comments/news to firstname.lastname@example.com 3.5 MILLION VIEWS PER MONTH 65,832,224 VIEWS total
Hi John,
We hope you are well! I did not know where to post this info., so here it is. My wife and I went to Captain Ds seafood yesterday for lunch, I was going to order fish and shrimp dinner, any time we eat seafood I always ask first where they get their seafood from, well the person waiting on us did not know, so she asked the person cooking and he looked on a bag of shrimp and then said it comes from the gulf of mexico, we left there and went elsewhere to eat. Anyway I thought you may want to inform unsuspecting Captain Ds patrons, "they are eating poison seafood".........
Take Care John.
We love you.
Markus and Family....
This is the link to apply for the OPC Needs list:
Needy Person Online Application
This is the link for OPC donors when they are ready to assist with funding to help these applicants:
This is the link to apply to work for OPC; to join John's "angels":
Operation Compassion Angel Application
DISTRESS YOUR HELP NEEDED (John would still want this message posted for his good friend Lynda,
and she needs $215.00 by the 4th so please help with some amount if you are able to. God Bless)
Lynda is a good friend and soul mate helping us getting the word out.
She is one of my intelligence gathering ladies.
She is a 65 yr light worker who has always helping others.
She has been evicted out of her home in GA.
Lynda has been Homeless and she is disabled stuck in a motel since Oct 9, 2014 .
Unable to pay all her bills as she is on disability. She needs help desperately.
People have been stepping up helping her but they can't help no more due to the economy.
She will need money for food and motel bill.
If you can help please do a PayPal email@example.com
Lynda's phone number is 404 977 3322. Give her a call.
Any amount will do small or large until the RV is here when funds start flowing.
I have a large donation for her after the RV and global reset.
Until then the Bad Hombres are blocking our blessings.
Let's continue to show the world what big hearts you have.
Referred by John Machaffie – a good friend


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Ryan Villopoto led wire-to-wire Saturday night at Daytona International Speedway to earn his fourth career 450SX Monster Energy Supercross class victory at the famed track.
The three-time defending series champion passed fellow Kawasaki rider Dean Wilson on the opening lap and went on to lead all 20 laps, winning by a margin of 12.632 seconds over Ken Roczen.
"It's pretty big," Villopoto said of winning at Daytona. "This is a unique track like I said earlier, and to get a win here with the way the track is – it's kinda outdoors, it's supercross, it's very technical – so to get a win here it's awesome. And this is kinda like a turning point in the season, we're closing down onto the homestretch here and to get a win here is huge."
Villopoto made a brief mistake on Lap 12 and washed out in a rutted-turn section. However, he recovered quickly and maintained the lead.
"Whenever you have a fall like that, all that's running through your mind is, `don't stall the bike and get up as quick as you can and take off,'" Villopoto said. "Luckily, I had a nice lead and I was able to get up and regroup."
Ryan Dungey, known as "Mr. Consistency," finished on the podium for the fourth straight race. Broc Tickle was fourth followed by Andrew Short, Wil Hahn and Wilson.
The win gives Villopoto a 28-point lead over Dungey as the series heads to Ford Field in Detroit, Mich. next week. Roczen is third in the championship battle, one point behind his Red Bull KTM teammate.
James Stewart, who sits fourth in the standings, was forced into the mechanics area on the opening lap after colliding with Mike Alessi's bike. Stewart lost one lap to the leaders while getting repairs and would finish 18th. He now trails Villopoto by 52 points.Andrew Short, Broc Tickle, Daytona, Dean Wilson, Ken Roczen, Ryan Dungey, Ryan Villopoto, Supercross, Video


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Fact Checking False Claim Obama Budget Plan 'Reduces Deficit by $5.3 Trillion in a Decade'
New York Times reporter Jackie Calmes recently made the outlandish claim that the President's budget will reduce the deficit by $5.3 trillion over a ten-year period. But a closer look at this claim proves that it just isn't true.
Firstly, Obama and his surrogates don't even claim a savings of $5.3 trillion, so it is a mystery where Calmes got this number. At the late Democrat convention, for instance, Bill Clinton claimed that Obama's plan would save $4 trillion, not $5.3. But even Clinton's mythical savings was deemed untrue by the Washington Post's fact checker.
Worse, all those supposed savings in the Obama proposal is from tax hikes, not any actual cuts in spending. On top of that, most of the supposed savings are mere accounting gimmicks, not true savings.
The other false characterization of Obama's spending proposal is that he means to "pay down out debt." To pay down something, of course, that means to pay off or reduce that something. Obama's plan also does not do this.
The truth is, Obama's latest budget proposal, which calls for $1.8 trillion in new taxes, calls for $1.5 trillion in new spending! That means that Obama's massive tax hike proposal doesn't go to pay down the deficit but to fund new government spending.
Far from spending the deficit down, the president's last budget plan from July makes it clear that in ten years our national debt will increase by $10.6 trillion.
But despite all the evidence proving the lie to Obama's budget — a budget that garnered not one vote from either party in the House or Senate — his campaign has repeatedly made the false claim that he'd save $4 trillion over ten years and now The New York Times has inexplicably upped that fantasy savings to $5.3 trillion.
Senator Jeff Sessions (R, AL) has already called on the Obama campaign to pull these misleading ads. The Romney campaign should too.
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Facebook62.5kTwitter76Email1 Considering how often we see horrific stories of animals being abused and murdered by sadistic monsters, it's a nice break to see the often unnoticed acts of kindness towards...Read More
Warner Todd Huston
Warner Todd Huston is a Chicago-based freelance writer, has been writing opinion editorials and social criticism since early 2001 and is featured on many websites such as Andrew Breitbart's BigGovernment.com, BigJournalsim.com and all Breitbart News' other sites, RightWingNews.com, CanadaFreePress.com, and many, many others. Additionally, he has been a frequent guest on talk-radio programs across the country to discuss his opinion editorials and current events as well as appearing on TV networks such as CNN, Fox News, Fox Business Network, and various Chicago-based news programs. He has also written for several history magazines and appears in the book "Americans on Politics, Policy and Pop Culture" which can be purchased on amazon.com. He is also the owner and operator of PubliusForum.com. Feel free to contact him with any comments or questions : EMAIL Warner Todd Huston and follow him on Twitter, on Google Plus , and Facebook.
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FacebookTwitterEmail Now businesses will have to go hat in hand to Obama to explain themselves about why they are firing


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16 Angel Crafts to Make: Homemade Christmas Ornaments & Decorations
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Christmas Roses Swag
By: Diane Flowers for STYROFOAM Brand Foam
We are adding the craft to your Craft Projects.
The project was added to your Craft Projects.
Click here to view your Craft Projects.
Create a lovely Christmas swag for mantles, railing and doorways with rich silk roses, greenery and berries. Using inexpensive materials for the base helps you stretch your crafting budget.
- STYROFOAM Brand Foam:
- Balls: 6", one; 5", two; 4", four; 3", six
- Artificial roses, four each: red with leaves; cream
- Artificial red berry sprays, two each: glitter berry holly branch; crystal with leaves
- Green reindeer moss, three bags
- Bright green glass ball ornaments, 2", three
- Wire: floral; craft, 16-gauge, 12' length
- Floral pins
- Yardstick or ruler
- Wooden skewer
- Wire cutters or floral shears
- Low-temp glue gun and glue sticks
- Thick, white craft glue
- Optional: Battery-operated mini light string
- Glue reindeer moss to foam balls, covering surfaces. Carefully push skewer through center of each ball, twisting skewer to create a hole large enough to accept two thicknesses of craft wire.
- Fold 16-gauge wire length in half and twist together along entire 72" length.
- Place foam balls on work surface with 6" ball at center, 5" balls on each side, two 4" balls next to those, and three 3" balls on each end. Insert twisted wire through foam balls, leaving enough slack in wire to form curving swag shape as shown. Position balls close enough to touch, but be sure they will hang straight when swag is hung.
- When pleased with shape, tightly twist wire ends to secure. Glue and insert wire ends into sides of 3" balls. Cover exposed wire with small pieces of moss.
- Glue and insert holly stems into center top of 6" ball. Bend stems to follow top edge of swag; secure with floral pins.
- Use wire cutters to trim rose and leaf stems to 2" lengths. Glue and insert two red roses into center top of 6" ball; glue three rose leaf stems behind blooms. Glue and insert remaining roses into swag as shown; glue one rose leaf stem behind each red rose.
- Trim stem ends from crystal berry sprays and insert one into each end of swag above cream roses; secure with floral pins. Bend stems to follow curved ends of swag.
- Use floral pins to secure ornaments to swag. Place one ornament below red center roses and remaining two on opposite sides of center drape.
- Cut two 18" lengths from floral wire. Fold each length in half and twist ends together to secure. Twist wire again, forming two loops in each length. Wrap center of each double-loop around wire between balls at top of swag for hangers. Cover exposed pins or stems with small pieces of moss.
- If desired, secure mini light set to swag with floral pins; glue moss to exposed pins. Attach lights to centers of balls and along edges of swag. Position switch and battery holder at center top of swag and secure with floral pins.
®™ Trademark of The Dow Chemical Company ("Dow") or an affiliated company of Dow. For more project ideas, please see styrofoamstyle.com.
If you like this project, we also suggest:
Bouquet of Roses Votive Holder
Elegant Easter Garden Topiary
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Melissa Ryan
Jul 08, 2014
Hi bobbylonardo--we're actually working on a way for readers to be able to see a larger photo. We hope to roll this feature out soon. In the meantime, I'll add this to my list of projects to update and I'll work on contacting Styrofoam for a better photo of this project. Thanks again and have a great day! FC Editors
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bobbylonardo 50143 99
Jul 07, 2014
Kind of hard to imagine this when the photo is an inch wide. There has got to be a way to show larger photos.
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Caution should be the watch word when it comes to the use of the kratom drug. This advice should not be neglected because doing so would result to dire consequences. Kratom drug is an extract from the leaves of the Kratom tree which originates from countries in Southeast Asia like Thailand, Malaysia, Myanmar and Indonesia.
The extract from Kratom can be taken in tea form, capsule or powdered form. This extract is known to give users with exhilarating and stimulating feelings. Also, Kratom drug is helpful in ensuring that the body gets relaxed. In other words, it gives a sedative feeling which is necessary for relieving pain in the body.
The feelings that users experience after taking Kratom drug could be alluring, however it is important we don't err on the path of Caution! This is because Kratom can produce an effect that could lead to psychological, social, emotional and physical problems.
So, if you want to play it safe with Kratom then the following tip should be taken as invaluable advice to guide your decision.
Kratom has side effects associated with the amount dosages taken. Low dosage can cause lead the body to become edgy.
High dosage can lead to hypersensitivity, nausea, severe vomiting, and sleepiness. You must understand these beforehand so you can prepare for solution when the effects rear their heads.
That said, one of the best places to buy Kratom online is http://www.buykratom.us/ With this site, you are sure of getting the right kratom for your needs. And you are sure that the site is authentic, as many others use it all the time.


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View H-2A agricultural clearance orders. There are current agricultural jobs in:
This list includes:
The Displaced Homemaker Program serves people who have been displaced from their careers as unpaid homemakers.
Services include:
The Federal Bonding Program provides fidelity bond insurance coverage for businesses who hire high-risk jobseekers. This includes:
Federal Bonding Program Fact Sheet
To find out more, contact your Local New York State Career Center.
We operate this federally funded disability employment service in our New York State Career Centers. We provide seamless Workforce Investment Act (WIA) services and accessibility for everyone served in our Career Centers, including individuals with disabilities.
ACCES-VR provides the following services to persons with disabilities:
ACCES-VR is a partner of the New York State Department of Labor. Contact your Local New York State Career Center for more information.
The Trade Adjustment Assistance (TAA) Program is a federal entitlement program that assists U.S. workers who have lost or may lose their jobs as a result of foreign trade. This program provides adversely affected workers with opportunities to obtain the skills, credentials, resources, and support necessary to become reemployed.
If you are eligible, the TAA program offers a variety of benefits and services to support you in your search for reemployment. This includes:
Getting Back to Work After a Trade-Related Layoff TAA Reversion 2014 Fact Sheet
Getting Back to Work After a Trade-Related Layoff TAA Extension Act of 2011 Fact Sheet
Trade Adjustment Assistance for Older Workers
The WARN Act requires businesses to give early warning of closing and layoffs.
For assistance conducting an effective job search, contact your local New York State Career Center.
A Guide to Preparing the Job-Seeking Ex-Offender
Re-entry Toolkit:
This toolkit contains practical worksheets and examples to prepare ex-offender job seekers for employment.
The Division of Immigrant Policies and Affairs works inside and outside the Department of Labor to serve the needs of immigrants. We make sure our protections, services, and programs are available to everyone, including people with limited English proficiency.
NY State of Health is a new way for people to shop for, compare and enroll in health coverage. It is also the only place to get a new kind of financial assistance provided by the federal government to lower the cost of your health coverage. The Marketplace gives you an easy way to compare health insurance plans so you can choose the one that's right for your health needs and your budget.
In the Marketplace, you can apply for help to lower the cost of your health coverage. You may qualify for new tax credits to help pay for your monthly health insurance premiums. You may also be eligible for assistance to help pay for copays, deductibles, and other out-of-pocket costs. The Marketplace will also see if you qualify for free or low-cost coverage from Medicaid or Child Health Plus.
You can learn more and find a trained person who can help you enroll in your area at nystateofhealth.ny.gov or by calling 1-855-355-5777.
You may qualify for temporary assistance. Visit myBenefits.ny.gov from any computer with Internet access. You can do it from your home, the local library or a New York State Career Center. On the site, you can do a five-minute, confidential self-assessment of your income and family situation. The site then lists programs that may help you and tells you where and how to apply in your area. You may qualify for programs such as:
Every hour, someone in New York State needs essential services, but people often don't know where to turn. The United Way advises you to pick up the phone and dial 2-1-1 (or 3-1-1 in the New York City area) to get answers and help. Or, visit http://www.211ny.org/ or www.nyc.gov/311. Some of the many services include transportation, housing, social services, health and medicine.
ACCESS NYC is a free service that identifies and screens for over 30 City, State, and Federal human service benefit programs. You may use this service anonymously or you can create an account. Some ACCESS NYC programs require users to create an account.
Get free help from the Consumer Protection Board on:
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text:
Saudi Arabia
Showdown in YemenComment
Shaffer interview April 21, 2015
U.S. Navy aircraft carrier steams toward Yemen as fighting continues
Saudi Arabia, allies open air campaign against Yemen rebels
That was the week that wasComment
Burkman, Levine January 30, 2015
Cozying up with IndiaComment
Shaffer interview January 27, 2014
First Lady Michelle Obama forgoes headscarf during visit to Saudi Arabia
SpongeBob SquarePants turns up in child's x-ray
Obama to cut short India trip to pay call on Saudi Arabia
Saudi King Abdullah dies at age 90
US, allies conduct more airstrikes in Syria, target Islamic State oil facilities
Saudi citizen caught in attempt to flee U.S., faces sex assault charge
Saudi citizen Hamad Alsuwat came to America to study on a student visa, but according to police, he tried to flee this country as a wanted man before being nabbed by federal authorities at Dulles International Airport.
MERS outbreak now deadlier than SARS, doctors sayComment
More than 60 cases of what is now called MERS, including 38 deaths, have been recorded by the World Health Organization in the past year, mostly in Saudi Arabia.
Secretary Kerry in Saudi Arabia for talks on Iran, other issuesComment
U.S. Secretary of State John Kerry, in Saudi Arabia for talks with Saudi and Gulf Arab officials, said Monday the window of opportunity for a diplomatic solution to the Iranian nuclear problem "cannot by definition remain open indefinitely."
CIA drone strikes against al-Qaida militants stemmed from remote Saudi baseComment
The CIA conducts lethal drone strikes against al-Qaida militants inside Yemen from a remote base in Saudi Arabia, including the strike that killed the U.S.-born al-Qaida operative Anwar al-Awlaki.
Saudi Arabia may not be sending women to the OlympicsComment
Plans for Saudi Arabia to send women to the Olympics for the first time appear to be in jeopardy.
Saudi Arabia females to participate in the Olympics?Comment
Saudi Arabia could send female athletes and officials to the Olympics for the first time after talks with the IOC on a list of potential competitors for the London Games.
Saudi women get right to vote, but can't drive yetComment
Saudi Arabia's king is giving women the right to vote and run in local elections for the first time, but they're still not allowed to drive.
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You can now invite anyone to meet at your favorite Starbucks.
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48 year old woman | Conneaut Lake, PA, USA | Seeking women 40-52 within 100 miles
I think I was born with running shoes on my feet. It isn't as easy as it used to be but I still run and love it!
I believe my closest friends would describe me as caring, happy, active :0) What makes me smile - someone smiling at me and happy dogs...LOL. I am proud that I have been running for 33 years; have completed 6 marathons and have at least 2 more to complete! One to qualify for Boston and Boston itself. After that we'll see. I am grateful for an awesome family. I would like to meet a women who gets life and doesn't overstress; gives people the benefit of the doubt. Relationship - hmm; let's start out as friends and get to know each other. I am in no hurry but I do believe somewhere out there is my life partner.
Coffee and conversation , Cooking , Movies/Videos , Museums and art , Music and concerts , Exploring new areas , Playing cards , Playing sports , Religion/Spiritual , Travel/Sightseeing , Volunteering , Watching sports
Cycling, Football, Running, Walking / Hiking, Weights / Machines
I exercise 5 or more times per week.
I have Dogs
I like Cats, Horses
I have a labradoodle that I love. He is small, only 19 pounds but he is super. He loves people and has a personality all his own.
Middle of the Road
Hmmm....love the lake here. It's beautiful in the summer. Really I just love the sun and warm weather!
Country music, 70's & 80's music, don't really watch much TV but on occassion I will watch CSI and/or Big Bang Theory - very funny!. BUT when the NFL is on, go Steelers!!
Pretty open as long as everyone is having a good time. I am not a bar fly but I do like to 2-Step.
hmm...I find the Bible fascinating. I enjoy nutrition literature too.
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|What she is looking for
|5'0" (152cms)
|5'2" (157cms) to 5'8" (172cms)
|Body type:
|Athletic and toned
|Slender, About average, Curvy, Athletic and toned
|No preference
|No preference
|No Way
|No Way
|Social Drinker, Moderately
|Other profession
|No preference
Certified Personal Trainer/Nutritionist...I am the Site Supervisor at the Cochranton YMCA, part of the Meadville Family YMCA. I love what I do and love making an impact in people's lives.
|I'll tell you later
|No preference
|Never Married
|Never Married
|Have kids:
|Wants kids:
|White / Caucasian
|White / Caucasian
I am optimistic, love life. I am a gluten free girl (not by choice) I love to help people take the best care of themselves as they possibly can. If you are lucky enough to be born with great health, you need to take care of that!
|Christian / Other
|Christian / Other
It is important. I have 2 big eyes on me at all times. It makes me treat people the way I want to be treated and to be kind; truly the only way to be!
|Bachelors degree
|No preference


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Playing Dice and Children's Numeracy
Posted on December 5, 2007 Comments (8)
My father, Willaim Hunter, a professor of statistics and of Chemical Engineering at the University of Wisconsin, was a guest speaker for my second grade class (I think it was 2nd) to teach us about numbers – using dice. He gave every kid a die. I remember he asked all the kids what number do you think will show up when you roll the die. 6 was the answer from about 80% of them (which I knew was wrong – so I was feeling very smart).
Then he had the kids roll the die and he stood up at the front to create a frequency distribution of what was actually rolled. He was all ready for them to see how wrong they were and learn it was just as likely for any of the numbers on the die to be rolled. But as he asked each kid about what they rolled something like 5 out of the first 6 said they rolled a 6. He then modified the exercise a bit and had the kid come up to the front and roll the die on the teachers desk. Then my Dad read the number off the die and wrote on the chart
This nice blog post, reminded me of that story: Kids' misconceptions about numbers — and how they fix them
But there's a pattern to the second-graders' responses. Nearly all the kids (93 were tested) understood that 750 was a larger number than 366; they just squeezed too many large numbers on the far-right side of the number line. In fact, their results show more of a logarithmic pattern than the proper linear pattern.
Categories: K-12, Math, quote, Students
Tags: curiouscat, data, engineers, kids, Madison, Math, scientific literacy, statistics, William Hunter
8 Responses to "Playing Dice and Children's Numeracy"
8-10 Year Olds Research Published in Royal Socity Journal » Curious Cat Science Blog
December 24th, 2010 @ 1:29 pm
Absolutely great stuff. This is how to engage kids in science. Engage their inquisitive minds. Let them get involved. Let them experiment..
Naturally Curious Children » Curious Cat Science and Engineering Blog
January 1st, 2011 @ 2:43 pm
I write this blog because when I was a kid I was curious and had parents who gave me enough interesting answers and interesting resources to build on that curiosity…
Numeracy: The Educational Gift That Keeps on Giving » Curious Cat Science and Engineering Blog
February 19th, 2012 @ 8:24 am
[…] I think. I see, how helpful it is to have a good understanding of numbers. And the costs of not developing a facility with numbers leads to many bad decisions, it seems to […]
September 14th, 2012 @ 1:00 am
Neat to have this with the kids in mind. Engage the mind and produce the great next generation.
Business 901 Podcast with Me: Deming's Management Ideas Today » Curious Cat Management Improvement Blog
November 13th, 2012 @ 5:05 am
[…] William Hunter, my father. Link to paper with Easaw Chacko on Building a Quality Movement within a developing nation, 1972. Developing Children's Numeracy Using Dice […]
Math Education Results Show China, Singapore, Korea and Japan Leading » Curious Cat Science and Math Blog
March 4th, 2014 @ 9:01 pm
2012 PISA results for the math portion: 1 Singapore, 2 Korea, 3 Japan, 5 Switzerland, 7 Estonia, 8 Finland
Analysis Must be Implemented by People to Provide Value » Curious Cat Management Improvement Blog
March 25th, 2014 @ 5:57 am
The greatest statistical analysis is nothing if it can't be implemented by people…
Who Inspires Your Management Thinking and Action? » Curious Cat Management Improvement Blog
January 22nd, 2015 @ 7:04 am
[…] an early age I learned to experiment, appreciate and understand data, respect people and continually improve. These lessons were a natural part of growing up in our […]
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Sesame Street - Toddler Bed and Multi-Bin Organizer - Value Bundle
Bundle includes
Sesame Street Elmo Toddler Bed
- +
Sesame Street Multi-Bin Toy Organizer
Bundle includes
Sesame Street Elmo Toddler Bed+
Sesame Street Multi-Bin Toy Organizer+
About this bundle
The Sesame Street - Toddler Bed and Multi-Bin Organizer - Value Bundle brings the fun and bold colors of Sesame Street's Elmo to your little one's bed. See individual items for a complete description. The items included in this bedroom set give a coordinated look to your child's room. The Elmo Toddler Bed offers a comforting way to transition your child from crib to grown-up bed. It also has durable side rails to keep children from falling out of bed. For spacious organization, the Elmo multi-bin toy organizer has five fabric storage bins in small and medium sizes for storing small accessories, as well as a larger box that acts as a toy box. This bundle offers a fun and cheerful way to bring Sesame Street to your little one's bedroom.
Sesame Street Elmo Toddler Bed:
- 2 safe sleep bed rails for safety and peace of mind
- Features bright colors and a cheerful design
- Coordinates with other items in the collection
- Meets all JPMA safety standards for toddler beds
- Non-toxic finish
- Recommended for children 18 months to 5 years and no more than 50 lbs
- Assembled Product Dimensions: 54"L x 31"W x 29"H
- Mattress sold separately. See our assortment of crib mattresses.
- Sesame Street Bedroom gives a coordinated look for child's bedroom
Sesame Street Multi-Bin Toy Organizer:
- 4 regular-size bins
- 3 double-size bins
- 2 extra-large bins
- Bins are removable
- Easy to assemble
- Assembled dimensions: 25"L x 16.5"W x 30.5"H


text:
Branco Cartoon – Blackout
Note: You may reprint this cartoon provided you link back to this source. To see more Legal Insurrection Branco cartoons, click here.
Note: You may reprint this cartoon provided you link back to this source. To see more Legal Insurrection Branco cartoons, click here.
During MSNBC's August 29 GOP Convention coverage, Ed Schultz and Al Sharpton made patently false remarks during their post-speech commentary of Rep. Paul Ryan. Congressman Ryan was slammed concerning statements he made about the closure of the Janesville General Motors plant. Rep. Ryan reiterated that President Barack Obama promised to keep the plant open, but then shut it down. The left-wingers went rabid and supported the false narrative that the plant was closed by George W. Bush.
Sharpton said if you want "an eloquent person [Ryan] that does not tell the truth, this was a great performance."
General Motors will end medium-duty truck production in Janesville on April 23 [2009], four months to the day after the plant stopped building full-size sport utility vehicles.
About 100 employees associated with the line learned of the layoffs Wednesday.
April will mark the end of vehicle production at the Janesville plant that traces its roots to 1919 and the Samson Model M tractor. Chevrolet production started in Janesville in 1923.
The Isuzu line and its employees build about 25 trucks four days a week. The cab-forward truck is commonly used as a delivery vehicle.
GM and Isuzu strengthened their partnership in 1994 with the launch of the NPR gas-powered trucks in Janesville. Two years later, GM and Isuzu started a separate project that put Isuzu-designed cabs on GM's medium-duty chassis. That line eventually moved from Janesville to Flint, Mich.
So, it appears that Mr. Schultz and Mr. Sharpton are, unsurprisingly, wrong. It was closed under the Obama administration.
Originally posted on Newsbusters.
Congressman Paul Ryan of Wisconsin, the newly nominated GOP candidate for Vice President of the United States, is the right man in the right place, at the right time.
He understands that his duty as Vice President will be the calling of his generation to preserve for his children and their children the America that was given to his generation.
He acknowledges that the current administration came into office during an economic crisis. He also realizes that today 23 million men and women are unemployed or underemployed. He sees one in six Americans living in poverty. He understands that millions of young college graduates cannot find work and have been forced to move back in with their parents.
He sees that without a change in leadership in the White House the next four years will be just more of the same.
As a Congressman, he has been a front row witness to the wasteful Stimulus spending, the catastrophic government takeover of health care, and the robbing of seven hundred and sixteen billion dollars from Medicare to fill the financial void left in the healthcare law despite all the law's hidden taxes.
Ryan vowed that "Medicare is a promise, and we will honor it. A Romney-Ryan administration will protect and strengthen Medicare, for my Mom's generation, for my generation, and for my kids and yours."
As Ryan stated midway through his nomination acceptance speech: "So our opponents can consider themselves on notice. In this election, on this issue, the usual posturing on the Left isn't going to work. Mitt Romney and I know the difference between protecting a program, and raiding it. Ladies and gentlemen, our nation needs this debate. We want this debate. We will win this debate."
Ryan pledged that he and Presidential nominee Mitt Romney "will get America creating wealth again. With tax fairness and regulatory reform, we'll put government back on the side of the men and women who create jobs, and the men and women who need jobs."
He confirmed that if elected, the GOP ticket has a goal to "generate 12 million new jobs over the next four years," and "keep federal spending at 20 percent of GDP, or less."
On foreign policy, Ryan stated that "a Romney-Ryan administration will speak with confidence and clarity. Wherever men and women rise up for their own freedom, they will know that the American president is on their side."
In a rousing, crowd pleasing close, Ryan gave the following assurance:
"We will not duck the tough issues, we will lead. We will not spend four years blaming others, we will take responsibility. We will not try to replace our founding principles, we will reapply our founding principles.
The work ahead will be hard. These times demand the best of us – all of us, but we can do this. Together, we can do this. We can get this country working again. We can get this economy growing again. We can make the safety net safe again. We can do this. Whatever your political party, let's come together for the sake of our country. Join Mitt Romney and me. Let's give this effort everything we have. Let's see this through all the way. Let's get this done."
Ryan's speech was vintage Paul Ryan, calm, fact filled, plain spoken and direct.
Congressman Paul Ryan, the Republican nominee for Vice President offers proof that his generation is ready to be handed the torch of leadership.
When is it ever hilarious that the thought of dozens if not hundreds of black people desperately clinging for life as torrential waters batter their children, mothers or neighbors ever funny? David Chalian, a former political director with ABC News thought it was fair game to use a hate-mongering attack against Mitt Romney and Republicans gathered at the RNC Convention in Tampa, Florida on Wednesday. In his vicious racist attack he said, Romney is, "Happy to throw a party with black people dying."
Chalian, who was recently the Washington Bureau Chief for Yahoo News was fired for his online remarks, which brought no sense of alarm or even admonition from any of his on air colleagues. This has become frighteningly familiar and comfortably abusive behavior by many liberal media persons who repeatedly target Republicans leaders and Tea Party members.
Only last night after Utah mayor and congressional candidate Mia Love gave a stunning speech at the Republican National Convention, her Wikipedia page was hacked. So in an atmosphere of glowing GOP support for a rising star of the GOP who happens to be an African American woman, liberal attackers practiced their deceitful craft. They used morally offensive language on her page and called her a "dirty, worthless wh*re who sold her soul in the name of big business, "and a house ni**er."
This is the repugnant culture that mainstream media reporters and anchors have permitted to fester and grow, that seeds this type of morally bankrupt conduct. This is not new.
You do not have to go back very far to find media targeted bias. Last month, in the wake of the Colorado movie theater shootings, where 12 people were murdered, ABC News went on the air with a libelous claim against a Colorado Tea Party member. During a morning news segment of Good Morning America, Anchor George Stephanopoulos, and Brian Ross, ABC News Chief Investigative Correspondent erroneously and callously linked an innocent Colorado man with the same name to this tragedy without making any attempt at verification of his identity. His only "alleged crime" was having being a member of the Tea Party. Brian Ross was never fired or reprimanded.
We all know the uproar that Obama caused with his now infamous, "you didn't build that" speech. This video breaks down Obama's speech line by line, exposing an even darker side to his speech.
After becoming completely disgusted with MSNBC's coverage of the RNC Convention, beginning with Chris Mathews assumption that all food stamp recipients are black, to their failure to cover Mia Love, or any GOP minority speaker, I took to Twitter to establish a new hashtag #RacistDemocrat, only to discover someone had beaten me to it.
With the thousands of examples of horrible epithets hurled at black conservatives from the left on social media, and the hundreds of examples of somewhat softer racism from the media and political leaders, it seemed important to have a place to post examples.
After Mia Love's speech last night, open-minded tolerant democrats took to twitter to call her horrible names and even went so far as to edit her Wikipedia page, calling her a "house nigger."
From Twitchy.com
Tuesday night after rising GOP star Mia Love brought down the house with her inspiring convention speech, the stomach-turning Left labeled the black conservative a "token" and an "Aunt Tom."
Meanwhile, revoltingly racist, woman-hating Wikipedia vandals were hard at work updating her entry with disgusting slurs like "House Nigger" and "dirty, worthless whore." The page called her a "total sell-out to the Right Wing Hate machine and the greedy bigots who control the GOP."
Glenn Reynolds reported the defacement of Love's Wikipedia page last night.
Here is a screen shot of the page before it was corrected:
While they claim to want a colorblind society, and discourse in a civil manner, it is becoming increasingly difficult to take anyone on the left seriously when they display this kind of bigotry and hatred.
With Hurricane Isaac's slamming the American gulf coast putting a temporary halt to oil production and refinery output, consumers can expect to see higher prices at the pump.
Just in time for the Labor Day holiday.
Before Hurricane Isaac came along, gasoline costs were at an almost four month high. The nationwide average rose to $3.75 a gallon on Aug. 26. "We expect the national average price of gasoline for Labor Day this year to be the highest ever for the holiday," said Michael Green, a spokesman for AAA. Drivers could be paying $4 a gallon by the end of September.
Oct. 3 is the date of the first presidential debate.
The timing could not be better for GOP presidential nominee Mitt Romney or worse for the White House and its hopes for re-election.
By any measure, the administration should be on the defensive over escalating gasoline costs and the hardship higher pump prices will cause average American families. The White House has been consistently hostile towards traditional fuel industries, and has persistently sought to curtail exploration, development and production capacity since 2009.
The current administration has actively sought to discourage drilling on federal land. Since the 2010 BP gulf oil spill it has gone out of its way to stifle offshore exploration. The EPA has made it a regular course of business to impose costly regulations on the development of oil, natural gas and coal.
The White House has wasted hundreds and hundreds of billions of taxpayer dollars subsidizing non-competitive technologies. Solyndra, a solar-panel manufacturer, received a $535 million U.S. loan guarantee, then filed bankruptcy and fired 1,100 workers. There are many other such examples.
The predictable White House solution will be to release supplies from the Strategic Petroleum Reserve. This will be a typical response from the current administration: Divest precious national resources in hopes of achieving the desired political result without solving the real problem or offering a viable solution.
Instead of effectively stimulating the American economy by assisting exploration, development and production of cheap, efficient energy, the White House is obsessed with squandering national treasure on inefficient, uncompetitive energy options that are incapable of surviving without a government backstop.
Odds are that the White House will blame it all on Hurricane Isaac…or on George W. Bush.
Over the past few years, I have found myself getting more frustrated with what is going on in this country. Every time I pick-up the newspaper I find myself saying "what the hell is going on in this country." It seems to me that non-citizens, illegal aliens are getting more from this country than the citizens of this country do. What kind of country do we live in, where people who do not belong here, are better taken care of than the people who are here legally?
Just look around the country, how many states offer illegal aliens discounted college tuition, or sometimes free tuition, while citizens of this country pay thousands more?
If an illegal alien is caught driving without a license, they are let free, while citizens are taken to jail and fined.
An illegal alien applying for welfare and food stamps does not have to supply documentation, just go in and say they are here illegally and they are automatically eligible. While if a citizen goes in for the same benefits they have to supply their life's history.
Just take a look at how much illegal aliens are costing the taxpayers of this country. It's easy to dismiss individual programs that Benefit non-citizens until they're put together and this picture emerges. Often these programs are buried within other Programs making them difficult to find.
1.$11 Billion to $22 billion is spent on welfare to illegal aliens each year by state governments.
2. $22 Billion dollars a year is spent on food Assistance programs such as food stamps, WIC, and free school lunches for illegal aliens.
3. $2.5 Billion dollars a year is spent on Medicaid for illegal aliens.
4. $12 Billion dollars a year is spent on primary and secondary school education for children here illegally and they cannot speak a word of English!
5.$17 Billion dollars a year is spent for education for the American-born children of illegal aliens, known as anchor babies.
6 .$3 Million Dollars a DAY is spent to incarcerate illegal aliens.
7. 30% percent of all Federal Prison inmates are illegal aliens.
8. $90 Billion Dollars a year is spent on illegal aliens for Welfare & social services by the American taxpayer.
9. The illegal aliens cause $200 Billion dollars a year in suppressed American wages.
10. Illegal aliens send home $45 BILLION in remittances to their countries of origin.
Total $338,300,000,000.00 WHICH WOULD BE ENOUGH TO STIMULATE THE ECONOMY FOR THE CITIZENS OF THIS COUNTRY.
Something is wrong, this country has fallen off the tracks somewhere along the line, and it seems our whole society has turned upside down. Washington does not have the stomach for the job, even though it is a simple problem to solve. All they have to do is stop all the freebies, if you are here illegally you get nothing and I mean nothing. Not only will people stop sneaking in to this country once the freebies are gone, but also the ones that are already here, will be running out in record numbers.
What I find ironic, is that Mexico's immigration laws are stricter then our own, yet the Mexican government complains that our laws are unfair; Here are a few examples of Mexican law.
Immigrants are:
§ in the country legally;
§ have the means to sustain themselves economically;
§ not destined to be burdens on society;
§ of economic and social benefit to society;
§ of good character and have no criminal records;
§ contributors to the general well-being of the nation;
§ immigration authorities have a record of each foreign visitor;
§ foreign visitors do not violate their visa status;
§ foreign visitors are banned from interfering in the countries internal politics;
§ foreign visitors who enter under false pretenses are imprisoned or deported;
§ foreign visitors violating the terms of their entry are imprisoned or deported;
§ those who aid in illegal immigration will be sent to prison.
And that's not all, the Mexican authorities are allowed to ask for documentation to prove someone is in the country legally.
Now you see why I say that something is wrong with this country.
This is one man's opinion.
After a very successful first day of the RNC convention, here is the day two schedule:
From Politico:
Fox News contributor Juan Williams took some ribbing from his colleagues Tuesday night after saying Ann Romney looked "like a corporate wife" who hasn't struggled in her life.
"Mitt Romney's wife, Ann Romney, on the other hand looked to me like a corporate wife," Williams said, speaking on a panel after the Republican National Convention's speeches wrapped for the night. "And you know the stories she told about struggle, eh, it's hard for me to believe. She's a very rich woman and I know that and America knows that."
By limiting coverage of the Conventions on television most of America sees only a few prime time speakers. It's too bad, because there are many good convention speeches that aren't covered.
One great example was seen Tuesday when former Democratic Congressman Artur Davis was welcomed to the Republican National Convention. While his crossover affiliation to the GOP has been a news story it has not been widely covered by the media.
The following is Davis' speech to the RNC crowd which was really directed to those Independent and Moderate Democrats who are now feeling that the Hope and Change for which they voted in 2008 was not what they expected. The speech was enthusiastically applauded by conventioneers but may appeal to others who haven't spent this week glued to C-Span live coverage.
This particular video comes via Fox News. You can also share the C-Span clip for those who might better appreciate a more non-biased source: Artur Davis at RNC. It's less than ten minutes and may convince some to come out and vote Republican in 2012.
Update/Correction: MSNBC aired South Carolina Gov. Nikki Haley's speech. Haley is Indian-American. A funny thing happened on race-obsessed MSNBC tonight. The liberal network failed to give viewers coverage of the speakers who happen to be member of racial minorities. As Francesca Chambers, Editor of Red Alert Politics, reported on August 28th:
When popular Tea Party candidate Ted Cruz, the GOP nominee for Senate, took the stage, MSNBC cut away from the Republican National Convention and the Hispanic Republican from Texas' speech.
MSNBC stayed on commercial through former Democratic Rep. Artur Davis' speech, as well. Davis, who recently became a Republican, is black. Then, when Puerto Rican Governor Luis Fortuno's wife Luce' Vela Fortuño took the stage minutes later, MSNBC hosts Rachel Maddow and Chris Matthews opted to talk over the First Lady's speech. And Nevada Gov. Brian Sandoval? Noticeably missing from MSNBC, too. Mia Love, a black candidate for Congress in Utah, was also ignored by MSNBC.
Why is MSNBC trying to exclude conservative Republicans of color in their coverage? Could it be that they are aghast that they're not on the side of the infallible Barack Obama? Could it be because it cuts against their persistent whine that the GOP is the party of "dog whistle" politics aimed at working-class white voters?
It's ironic since Daily Beast contributor Michael Tomasky friviously labeled this year's RNC convention as racist.
Shall we take bets on when Condi Rice's speech will be interrupted by a Michelin tire commercial?
The Democrat-Media Complex is hard at work.
Twin Cities News Talk radio hosts Bob Davis and Tom Emmer visited the RNC in Tampa Florida Tuesday and spoke with The BlazeEditor-In-Chief Scott Baker. The primary topic of discussion was the battle of grassroots activists vs. the establishment party over the rights of the states to choose their own delegates in the rules committee.
Former Minnesota Gubernatorial candidate Tom Emmer explained to Baker what was going on inside the rules committee where it seemed the establishment Republican Party attempted to strip the states of the right to choose their own delegates to be seated, solidifying the power of the party bosses and freezing out the grassroots members like the Tea Party and Ron Paul independents.
It was all "inside baseball" and probably wouldn't make a difference either way in the nomination of the candidate this year, although it did show a nasty rift within the party where the Tea Party and Ron Paul supporters don't trust the establishment party and where the establishment appeared to want to strip the states of their power.
Emmer also talked about the decision of the Minnesota Supreme Court determining that the constitutional amendment to require photo ID at the polls will be on the ballot in November for a vote. View an article on Twin Cities News Talk website on the Voter ID decision here.
Secretary of State Mark Ritchie and Attorney General Lori Swanson opposed the ballot initiative and Ritchie changed the name of the ballot initiative contrary of the will of the legislature. Governor Mark Dayton vetoed a previous bill passed by the legislature. A constitutional amendment passed through ballot would have the power to bypass any veto. The Supreme Court of Minnesota's decision basically established that the decision to require Voter ID ultimately will be decided by the voters, not the Secretary of State, Attorney General or any special interest group.
Watch the video of the interview here below.
(Cross-posted from the Americanmillenniumonline.com)
Many different opinions on how this will effect the delegate system within the Republican National Committee. Those who oppose this system see it as a centralization of power within the RNC itself, taking away the power from the grassroots people. These grassroots or citizens that choose the delegates process would be eliminated and put the power at the top, and possible give the President almost veto power of certain delegates, and limit opposition. This possible power grab by those in power who run the RNC, view it as a way to make the process easier.
However, the purpose of the convention process, IS so that the people get to choose their delegates, and ultimately, from that process they would get to choose their president. There was also, a sort of stability in the current process of rules between conventions, with this new rule that was passed today at the convention, it will allow for rules to be changed in between conventions. Below is a letter from Julianne Thompson a Georgia Delegate.
From the Tea Party Patriots Facebook Page:
By: Julianne Thompson – National Delegate, Georgia
Chairman Reince Preibus, members of the Rules Committee, and the entire voting delegation of the 2012 Republican National Convention:
As a National Delegate to the 2012 RNC, I am extremely disappointed that a rule would be passed through committee that essentially strips the grassroots of all of it's representative power by ridding State Parties of their ability to choose whom they will send as delegates and alternates to represent their State to the Republican National Convention. The rules change would allow the Presidential nominee sweeping new power to override that process and choose their own National Delegates. The rule also allows the RNC (with only a 3/4 vote) the power to amend the party's rules without a vote by the full Republican National Convention.
The GOP is the political Party of the grassroots. Our national delegates are the boots-on-the-ground that get Republicans elected. We are there for County meetings, State Conventions, National Conventions, and most importantly we spend our time and money canvassing our neighborhoods, going door to door, making phone calls, writing personal endorsement letters, and getting-out-the-vote for Republicans. We are the worker bees, and we are the heart and soul of the Republican Party.
We have always believed that our Party is the one who best represents what it means to be an American…freedom! With your current attempt at this rules change, you are essentially striking the first blow that chips away at that freedom, and you disenfranchise the very people that turned the tide for the GOP in 2010 by returning power in the U.S. House of Representatives to Republicans.
I would like to hope that our nominee is unaware of the skullduggery that occurred with regard to this attempt at shutting out the people that have unified to help him win in November. The audacity of creating a firestorm when there is an opportunity for unity and peace that is needed to win back the Senate and take back the White House is irresponsible and I seriously question the motives of those behind this attempt.
Why the change in rules? That is the million-dollar question, and it is fairly easy to answer. There are still those in place in the GOP and on campaigns that would like to use the delegate and alternate seats as rewards for donating large checks to campaigns and the RNC.
If your desire is to win elections, then I strongly suggest that you engage the grassroots and show respect to those who help put you in power.
During a time that should ring of unity, you have put the GOP at a crossroads. Do you want to win this election and future elections? Now is your opportunity to prove it. Either take it to the floor and let us vote it down, and better yet, pull this insulting attempt to disenfranchise the heart and soul of our Republican Party!
Julianne Thompson, National Delegate for Mitt Romney – Georgia
*** ATTENTION NATIONAL DELEGATES: A minority report was put together, so this change could be brought to the floor and voted-on by the entire delegation. Despite attempts to pressure rules committee members into not signing-on to the report, signatures are still being actively sought, so this report can be brought forward.


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Re: Cheapest areas to live in West Palm Beach,FL ?
Hi Fergal, I live in North Palm Beach. Which part of West Palm Beach do you plan to stay in? The time of year can make a difference in the cost and availability. We have a "high" season until April. Most rentals require deposits and an annual lease. Cheap does not always equal convenient. If you can give better idea of what you are looking for, I will try to help. I manage a state park here on Singer Island. www. MacArthurbeach.org (John D. MacArthur Beach State Park.) Let me know if I can help. Good luck! Terry
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An endotracheal tube for insertion into a patient's trachea includes a drug delivery feature and is formed of an elongated body having a proximal end for connection to a ventilator device and an opposing distal end with a bore formed therein and terminating in at least one ventilation opening. The tube also has at least one drug delivery conduit formed in the elongated body and terminating at one end with a proximal opening and at an opposite end with a distal opening. The proximal opening is adapted to be fluidly connected to a drug delivery device adapter, wherein the at least one drug delivery conduit is separated from the bore along its entire length thereof from the proximal opening to the distal opening. The distal opening is formed at the distal end of the elongated body and is located closer to the distal end than the ventilation opening.
1. An endotracheal tube for insertion into a patient's trachea and including a drug delivery feature comprising:
an elongated body having a proximal end for connection to a ventilator device and an opposing distal end with a bore formed therein and terminating in at least one ventilation opening; and
a plurality of drug delivery conduits formed in the elongated body and radially about the bore within the elongated body and each terminating at one end with a proximal opening and at an opposite end with a distal opening, the proximal opening being adapted to be fluidly connected to a drug delivery device adapter, each drug delivery conduit being fluidly separated from the bore, wherein each of the drug delivery conduits comprises a pair of coaxial lumens, namely an inner coaxial lumen and an outer coaxial lumen and as a result, the distal opening is defined by a pair of co-axial orifices;
wherein each drug delivery conduit is separated from the bore along its entire length thereof from the proximal opening to the distal opening, the distal opening being formed at the distal end of the elongated body and is located closer to the distal end than the ventilation opening, wherein each of the plurality of drug delivery conduits is fluidly connected to a different flexible external conduit member that is external to the elongated body and is fluidly connected to the proximal opening of the drug delivery conduit at a first end and terminates at a second end as one drug delivery adapter, the flexible external conduit members being bundled together in a manner that maintains their separation from one another and wherein each of the drug delivery adapters mates with a single main connector that is in selective communication with an MDI adapter that is adapted for attachment to an MDI device, the main connector and the MDI adapter being remote from the elongated tube and only attached thereto by means of the flexible external conduit members, the main connector and MDI adapter being located at free ends of the flexible external conduit members remote from the elongated tube, the MDI adapter having a main port with a first end for attachment to the MDI device for receiving already aerosolized medication and an opposite second end that forms an airtight connection with the inner coaxial lumen, the MDI adapter having a side port that fluidly communicates with the outer coaxial lumen to permit a supplemental pressurized gas to flow through the outer coaxial lumen to the distal opening, the main connector having a component that is rotatable so as to place the MDI adapter in fluid communication with one of the external conduit members associated with one drug delivery conduit to permit delivery of medication along one drug delivery path defined by the selected external conduit member, while maintaining flow of the aerosolized medication into the inner coaxial lumen and the supplemental pressurized gas into the outer coaxial lumen.
2. The endotracheal tube of
an expandable member formed about the elongated tube near the distal end thereof;
a primary conduit formed in the elongated body and terminating in a first orifice that is in fluid communication with the expandable member for inflating the expandable member, the primary conduit terminating at an opposite end in a second orifice which is suitable for connection to an inflation adapter for causing inflation of the expandable member.
3. The endotracheal tube of
a first flexible external conduit member that is external to the elongated body and is fluidly connected to the second orifice at a first end thereof end and is in fluid communication at a second end with the inflation adapter.
4. The endotracheal tube of
5. The endotracheal tube of
6. The endotracheal tube of
7. The endotracheal tube of
8. The endotracheal tube of
9. The endotracheal tube of
10. The endotracheal tube of
11. The endotracheal tube of
12. The endotracheal tube of
13. The endotracheal tube of
14. The endotracheal tube of
15. The endotracheal tube of
16. The endotracheal tube of
17. The endotracheal tube of
18. The endotracheal tube of
19. The endotracheal tube of
20. A drug delivery system comprising:
an MDI device for delivering aerosolized medication;
an endotracheal tube for insertion into a patient's trachea comprising:
an elongated body having a proximal end for connection to a ventilator device and an opposing distal end with a bore formed therein and terminating in at least one ventilation opening; and
a plurality of rigid drug delivery conduits formed in the elongated body and terminating at one end with a proximal opening and at an opposite end with a distal opening, the proximal opening;
wherein each drug delivery conduit is separated from the bore along its entire length thereof from the proximal opening to the distal opening, the distal opening being formed at the distal end of the elongated body and is located closer to the distal end than the ventilation opening;
a plurality of flexible external drug delivery conduits each of which is external to the elongated body and is fluidly connected to the proximal opening of the drug delivery conduit at a first end and terminates at a second end as one drug delivery adapter; and
a positionable MDI adapter assembly for selectively fluidly linking one of the drug delivery conduits with the MDI device so that actuation of the MDI device results in the aerosolized medication being delivered through the one drug delivery conduit to the distal opening, the MDI adapter assembly being movable between a plurality of positions wherein in each position, the MDI is fluidly linked to one of the external conduit members that is associated with one drug delivery conduit, the MDI adapter assembly including a nozzle that is received in the selected drug delivery adapter, the adapter assembly including a main connector that includes a first plate, a second plate, and a central connector disposed between the first and second plates, with the central connector serving to connect the first plate to the second plate, each of the drug delivery adapters being formed as part of the first plate;
wherein each of the flexible external drug delivery conduit and the rigid drug delivery conduit is defined by an inner conduit member and an outer conduit member that is co-axial to and surrounds the inner conduit member, the inner conduit member being integrally coupled to the first plate such that it is fluidly connected to the MDI device and receives medication that is already in an aerosolized state, the outer conduit member being formed below the first plate and includes an integral side port that extends outwardly from the elongated body that permits gas flow within the outer conduit member, the side port being connected to a pressurized gas source that flows within the outer conduit member to the distal opening;
wherein at least two or more of the drug delivery conduits produce aerosol plumes of the medication that have different plume characteristics compared to one another based on a trajectory of each drug delivery conduit in the elongated body and an orientation of each distal opening, the coaxial flow of aerosolized medication and the pressurized gas serving to direct the plume away from a tracheal wall and carina of the patient, thereby preventing impaction losses.
21. The system of
The present application is a continuation of U.S. patent application Ser. No. 10/162,740, filed Jun. 6, 2002 now abandoned, which is hereby incorporated by reference in its entirety.
The present invention relates to medical-surgical devices for intubation, i.e., endotracheal tube (ETT), intended for tracheal insertion in patients requiring mechanical ventilation. This tube is specifically designed for improved intrapulmonary deposition of aerosol particles, both quantitatively, as well as qualitatively in patients on mechanical ventilation via endotracheal tube. Multiple medications readily lend themselves for pulmonary administration. Many diagnostic and therapeutic agents that can be utilized through this route are the bronchodilators, anti-inflammatory agents like steroids, antibiotics, anticholinergics, heparin, surfactant, antiproteases, gene transfer products, insulin, radioactive dyes, etc.
The advantages of intrapulmonary drug delivery as opposed systemic administration are well known. The desired effect at the site of local delivery as opposed to systemic administration minimizes side effects and is the preferred methodology for delivery of several medications. Conventional methods for aerosol delivery have resulted in failure of effective drug delivery to the lungs. They are limited not only in total dose delivery but have also failed to achieve uniform intrapulmonary drug distribution. The two methods currently available for intrapulmonary drug delivery are highly inefficient. They are: (I) Liquid bolus: The medication is instilled in the form of liquid bolus via a bronchoscope or through an ETT. The distribution by this method is non-uniform. Also there is a significant risk of inducing respiratory distress and hypoxemia. (II) Aerosol Inhalation: Conventional methods of aerosol drug delivery have employed Metered Dose Inhalers (MDI's) with low boiling point propellants (CFC, HFA) or aerosol particles generated by heat, traditional compressed air nebulizers, or ultrasonic nebulizers. Even though these methods produce aerosol particles in respirable range (<5 microns) compared with the liquid bolus medication, they are limited in total dose delivery and lack uniform distribution of medication to the lungs. Only a small fraction of the medication reaches the lungs as the majority of the aerosol particles either adhere to the nasal passages and oropharynx or are exhaled out. Efficiency of aerosol delivery drops even further in patients who are intubated and require mechanical ventilation. Inhalation of nebulized material through an endotracheal tube can generally result in deposition of only 1.87% of the delivered particles to the lungs. Methods have been employed that have a combined ventilator dispenser and adapter or other spacer devices with MDI's have revealed equally poor results as most of the aerosol particles adhere to the ETT, the connectors and the inspiratory limb of the corrugated plastic tube.
Investigators over the years have designed numerous endotracheal tubes in an attempt to overcome the hurdles associated with conventional methods of drug delivery to the respiratory system in patients on mechanical ventilation. Most designs of endotracheal tubes so far have only addressed the issue of drug delivery in the form of liquid bolus by incorporating drug irrigation devices in the traditional ETT in the form of secondary canalization with multiple micrometric openings.
Factors that influence uniform delivery of aerosol particles in the tracheobronchial tree are the mid-mean diameter of aerosol particles (which should be in the respirable range, i.e. <5 microns), velocity of the aerosol plume, geometry of the aerosol plume (narrow vs. wide), site of the plume generation (proximal, distal or in the lumen of the ETT), orientation of the plume (central vs. eccentric), time of actuation of MDI in the respiratory cycle, temperature and humidity in the respiratory circuit, etc. These features have not been addressed by any of the currently available endotracheal tubes incorporating drug irrigation devices.
U.S. Pat. No. 4,584,998 describes an ETT with up to three secondary lumens in addition to the primary lumen in which one lumen can serve the purpose of delivering atomized gases to the patient.
U.S. Pat. No. 4,669,463 shows ETT with a secondary lumen in the wall of the main lumen to deliver liquid medication to the respiratory system.
U.S. Pat. No. 4,821,714 describes an ETT with a secondary lumen to deliver medication to the respiratory system. The second lumen splits into two branches that terminate as two orifices, one at the distal tip and other along the exterior wall of the ETT.
Other commercial products include an ETT with a secondary lumen in the wall of the ETT that terminates at a perforation (Murphy eye). The single stream of medication splits when it impacts on the distal edge of the opening resulting in delivery of medication both internally and externally of the ETT.
U.S. Pat. No. 5,642,730 and U.S. Pat. No. 6,079,413 each describes a catheter system for delivery of aerosolized medicine for use with pressurized propellant canister. The system includes an extension catheter that has a length such that the proximal end is connected to the canister and the distal end is positioned in the primary lumen or secondary lumen of the ETT beyond its distal end in the respiratory system. The system describes an extremely complex methodology for centering the device, attenuating the whipping effect and for preventing impaction losses, especially carinal impaction. Over and above this system is too expensive for clinical utility and is only being used as an experimental tool in research laboratories.
U.S. Pat. No. 5,964,223 describes a nebulizing catheter system similar to U.S. Pat. No. 5,642,730. This system describes the flow of liquid medication through the lumen of a catheter which is nebulized at its tip by a flow of pressurized gas through a coaxial lumen.
In summary, none of the prior art ETT's provide means for effective local delivery of medication to the tracheobrochial tree of both lungs.
The present invention relates to endotracheal tubes with an improved system of delivering aerosolized medication to patient's respiratory system. The main object of the present invention is to provide a modified ETT that serves the following purposes: (1) aerosol drug delivery to tracheobronchial tree; (2) generation and delivery of aerosol particles at the distal end of the ETT with mid mean diameter that will allow uniform distribution throughout the tracheobronchial tree; (3) generation and delivery of aerosol particles at the distal end of the ETT such that a significant fraction of the aerosol particles reach the tracheobronchial tree without adherence to the ETT; and (4) simple and inexpensive method of intrapulmonary drug delivery
To achieve all the objects without interfering with the primary functions of the ETT. In other words, the present system does not impede intubation or in anyway make it more complicated for the operator, or more traumatic to the patient. The defined objects are obtained through the present invention, i.e., the ETT that incorporates several features. The present system uses a pressurized canister or a metered dose inhaler (MDI) to deliver aerosolized medication to the respiratory system. MDI is a system that uses a pressurized canister that contains either a suspension of pulverized particles of medication in a liquid propellant or a solution of the medication in a liquid propellant. When the canister is actuated, the mixture of medication and propellant is generated from the distal orifice or the nozzle of the canister.
In addition to the primary cannula for inflation of the distal balloon, the ETT can have six additional secondary cannulations (conduits). The secondary cannulations originate in the proximal half of the ETT and continue distally within the wall of ETT in six different tracts to terminate as six pinhole orifices at the distal tip of the ETT. The six orifices are arranged like the six edges of a hexagon, preferably at 1, 3, 5, 7, 9 and 11 o'clock positions (other arrangements are possible as well). The secondary cannulations exit the ETT in its proximal half and continue as six narrow tubular extensions outside the main frame of the ETT. The tubular extensions are preferably semi-flexible and terminate as six MDI adapters on the peripheral rim of the circular plate (again arranged like the six edges of a hexagon) or as cylindrical fittings for mating with MDI adapters. The terminal orifice of MDI or nozzle locks into the proximal port of MDI adapter. Actuation of MDI with this assembly would deliver medication at the distal tip of ETT.
The six flexible tubules are preferably further packaged in a single bigger hollow tube. The hollow tube along with six tubules terminate proximally on the under surface of a circular plate. The distal end of the hollow tube terminates on the outer wall of the ETT, the junction where six flexible tubules mate with six secondary cannulations. The circular plate has a connector in the center through which it attached to a second circular plate. The lower circular plate is fixed to the connector whereas the upper circular plate can freely rotate around the central connector. In the peripheral rim of the proximal circular plate is attached an MDI adapter. The MDI adapter tapers distally to terminate as an orifice that locks into the proximal orifice of the flexible tubule. The connector has a circular groove in the center and six grooves perpendicular to the circular groove equidistant from each other. These perpendicular grooves are in alignment (parallel) with the cylindrical fittings for MDI adapters. The upper circular plate can rotate around the circumference of the circular groove as well as move superiorly and inferiorly along the six perpendicular grooves. This arrangement permits the MDI adapter to move superiorly along the perpendicular groove of the central connector, which unlocks the MDI adapter from the flexible tubule and positions it in the circular groove. Rotation along the circular groove positions it in the next perpendicular groove. On caudal movement of the circular plate the MDI adapter can now lock into the second flexible tubule. Hence, similar repetitive movements permit the MDI adapter to lock into six flexible tubules one at a time in six different positions. Actuation of the MDI generates aerosol particles that would be propelled through the MDI adapter into flexible tubules, secondary cannulations and finally to be delivered at the terminal orifices at the tip of the ETT. The aerosolized particles generated at any given orifice will be preferentially delivered to one lung. However, six different aerosol plumes generated from six orifices in different positions would ensure a uniform distribution of aerosol particles to both lungs.
Further features of the present invention will become apparent in the accompanying drawings as well as the detailed description of the preferred embodiments.
The present invention will now be described in detail by reference to the drawing figures, where as like parts as indicated by like reference numerals.
A first conduit or tube 120, i.e. primary cannula, of approximately 1 mm diameter runs within the wall on the convex side of the tube(s) 102 and is connected to the expandable cuff 107 for inflation and deflation by being terminated on the outer surface of the ET tube 102 as an opening 122, such as 1 mm opening. This tube 120 alternatively can be attached on the outer surface of the tube 102 on the convex side.
The primary conduit 120 has a proximal flexible part 130 which continues outside the main tubular structure of the ETT 100 and is in fluid communication with the primary conduit 120. The flexible part 130 starts at approximately 18 cm from the distal tip of the ETT 100 and continues proximally for a few centimeters to terminate into a cuff inflation indicator 140 and adapter 142 for a syringe. The connection between the flexible and rigid part of the primary cannula or conduit 120 is through an opening 129 on the outer surface of the ETT 100 which can be about 1 mm in ID (inner diameter). On the lateral surface of the ETT 100 starting at the same level as the cannulation for the inflation of the balloon 107 or at a higher level (as shown in
This secondary conduit 150 continues distally beyond the balloon 107 to terminate as a pinhole opening 152 at the distal tip of the ETT 100. The course of the secondary conduit 150 within the wall of ETT 100 is preferably variable. The secondary conduit 150 is in fluid communication with an exterior, semi-flexible proximal cannula or conduit 160 which is on the outside of the main tubular structure of the ETT 100 without adhering to it just like the flexible part 130 of the primary conduit 120. The semi-flexible conduit 160 makes a connection with the secondary conduit 150 through an opening 154 on the outer surface of the ETT 100. The proximal end of the flexible cannula terminates into a metered dose inhaler (MDI) adapter 170.
The flexible conduit 160 can be an extension of MDI adapter 170 or the two can be fused together if made of different materials. A proximal port 172 of the MDI adapter 170 is designed to fit the nozzle of MDI canister (not shown). The distal end of the adapter 170 tapers into a cylindrical tube matable to the flexible conduit 160, the two made of different polymers. This assembly enables aerosolized medication from MDI canister to be delivered at the distal tip of the ETT 100 on actuation of the canister. The device may include a special syringe, the terminal injection port of which may have a configuration identical to the nozzle of the MDI. This would enable the MDI port 172 to be used for delivering any liquid medication to the respiratory system via a manually operated syringe or any pressurized source. The port 172 can include a cap for closure when not in use.
There are numerous varieties of plastic materials that may be used to manufacture the endotracheal tubes (ETT's) of the present invention; some examples of the same may be—thermoplastics (polyvinyl chloride, polyethylene, polypropylene) silicone, Teflon, etc.; though the one that is most commonly use is polyvinyl chloride (PVC). Since the differences in the compliance and coefficient of friction of various materials could influence the delivery of aerosol medication, the secondary cannulation could be coextruded using a compound or a polymer different from the one used to manufacture the primary ETT. The coextrusion may optimize the physical properties of the secondary lumen and maximize aerosol delivery. Examples of some coextrusions may be—PVC and Teflon, PVC and polypropylene, PVC and silicone, PVC and polyethylene, etc. ETT may be disposable or reusable after sterilization.
Particle Size, Plume Characteristics and Drug Delivery
Effective drug delivery is closely related to particle size. Larger particles may provide a greater total drug deliver; however, a uniform distribution of medication in the distal tracheobronchial tree requires particle size distribution in the respirable range (<5 microns). Besides particle size, the drug delivery rate and distribution is also a function of the site if aerosol particle generation and the characteristics of the aerosol plume. Even though the size of aerosol particles generated in case of a suspension of pulverized powder medication in a liquid propellant is predetermined and is a function of the size of the crushed solid particles of powder medication, the drug delivery rate and distribution will be tremendously affected by the features of secondary conduits and the terminal orifice at its tip. The critical features of secondary conduits are its length, ID, shape and orientation/trajectory. The features of the distal orifice are its location, orientation, shape, and ID. All the aforementioned features will also influence the plume geometry, velocity and orientation and hence the distribution of the particles in the distal tracheolbronchial tree.
According to the present invention, the ID of the secondary conduit may be uniform throughout or tapered along the entire length. Alternatively, it may be uniform in the proximal part and tapered near the distal part. The ID of the secondary conduit may vary from 0.01 mm to 1.25 mm. The combined length of the secondary conduit within the wall of the ETT and its proximal flexible part may also play a critical role in the total drug delivery. A narrow ID of the secondary conduit is very important for the aerosol medication to reach the distal tip of the secondary conduit over approximately 25-30 cm of length; however, if the ID is too narrow, it may pose resistance to the flow and impede aerosol delivery. Another very important factor is the course (trajectory) of the secondary conduit in the wall of the ETT. The trajectory may be directed from the outer wall to the inner wall; alternatively the secondary lumen may stay closer to the outer wall throughout; it may stay closer to the inner wall throughout; or it may stay closer to the outer wall for the most part and may be redirected to the inner wall near the distal part of the ETT. A change in the plane of the secondary conduit in the distal part of the ETT (range 1 mm-10 mm) will change the orientation of the secondary lumen by approximately 5 to 45 degrees. The preferable change in the angle, however, may be 10-15 degrees only in order to prevent tracheal or carinal impaction losses. In another modification of the present invention, the secondary conduit can run inside the primary conduit on the inner wall of the ETT or it can run on the surface on the outer wall of the ETT.
The features of the distal orifice in the present invention can also have numerous variations. The distal orifice of the secondary conduit is located at the tip of the ETT, preferably not in communication with the primary conduit at the ETT and not protruding beyond the distal tip of the ETT. The shape of the distal orifice is preferably circular, however, the shape may be semi circular, lunar, etc. The ID of the distal orifice, which may vary from 0.01 mm to 1.25 mm, may be the same or different from the ID of the secondary conduit. The ID of the distal orifice may be made extremely small to generate a narrow plume or the terminal orifice may be made larger than the secondary conduit with splaying in order to generate a wider plume. The location of the orifice may be closer to the inner wall or outer wall or it may be in the center of the ETT's wall.
An aerosol plume which is central, and wide will result in a greater fraction of the drug loss due to impaction on the ETT (if generated proximal to the ETT or in the lumen of the ETT) or the wall of the trachea (if generated distal to the ETT) prior to reaching the distal tracheobronchial tree. An aerosol plume that is central, narrow and fast is likely to lose a greater portion of the medication by carinal impaction. An eccentrically located narrow and fast plume will avoid carinal as well as tracheal impaction losses and will ensure aerosol particle delivery to the proximal tracheobronchial tree. The distal tracheobronchial tree delivery may require an eccentric, narrow and slower plume or an eccentric wide and fast plume.
In the present invention, the distal orifice of the secondary conduit is located at the tip of the ETT and generates aerosol at a location in the tracheobronchial tree beyond the ETT, thus avoiding impaction losses. The velocity and width of the plume could be altered by adjusting the shape and ID of the secondary conduit and the distal orifice. Over and above the orientation of the plume can be influenced by the trajectory of the secondary conduit. In our invention, since the trajectory is from the outer wall towards the inner wall, preferably in the distal part of the secondary conduit, the plume will be oriented away from the tracheal wall. The eccentric location of the orifice in the wall of the ETT in our invention is preferable as it prevents carinal and tracheal impaction losses. The diameter of the ETT is far smaller than that of the airway passages i.e., the trachea. On placement of the ETT in the trachea and inflating the distal balloon, the wall of the distal circular edge of the ETT is a few millimeters away from the tracheal wall and hence the orifice located in the wall of the distal tip of ETT. Depending on the size of the ETT the two lateral terminal orifices of secondary conduits may be located approximately in the center between the carina and the left or right mainstem bronchi.
One may argue that the lateral location of the orifice would direct the plume preferentially to one lung. This actually may be of tremendous benefit if one wants preferential delivery of medication to one lung which has the pathology. However, if the pathological condition affects both the lungs uniformly the problem can be completely obviated by having two distal orifices diametrically opposite to each other on the lateral surface of the ETT as described in the second embodiment of the present invention in
According to a second alternative embodiment, a modified MDI adapter 440 with an additional side port 442. The upper circular plate 444, with a handle 446, along with a central connector 448 are demonstrated. The MDI adapter has two ports. The main port 440 that has a proximal port to fit the nozzle of the pressurized canister and a distal orifice that makes an airtight connection with the inner coaxial lumen of the rigid cylindrical tubule. It also has a side port 442 that communicates with the outer coaxial lumen of the rigid cylindrical tubule. Note that the rigid cylindrical tubule is the proximal end of the flexible tubule for mating with MDI adapter. The inner lumen of the main port of MDI adapter serves to generate aerosol particles by MDI canister or deliver liquid medication via a syringe at the distal tip of the ETT. The side port or the outer lumen of MDI adapter may be used for vapor or gas flow for either anesthesia or to disperse the aerosolized particles generated near the distal tip of ETT away from the trachea as well as to break the particle into smaller size. This device, just like the one described in
A variety of drug delivery rates and particle size distribution can be achieved by altering the coaxial orifice, diameters, pressure and flow characteristics of the liquid and gas in the respective orifices and by adjusting the distance between the liquid and gas flow by altering the thickness of the membrane separating the two lumens. The liquid lumen, the gas lumen and the thickness of the wall separating the two lumens may vary from 0.025 mm to 1 mm.
In another alternative embodiment of our invention, as described in
In another alternative embodiment of our invention as described in
There is appearance of six secondary conduits 320 which enter the ETT 320 approximately at the same level but follow different tracts in the wall of the ETT 300.
It is noted that the illustration (drawings) and description of the preferred embodiments have been provided merely for the purpose of explanation and although the invention has been described herein with reference to particular means, materials and embodiments, the invention is not intended to be limited to the particulars disclosed herein; rather the invention intends to all functionally equivalent structures, methods and uses such as are within the scope of the appended claims.
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