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Among other things, an entry monitor has circuitry to detect when a person enters a monitored space and an indicator perceptible to other people in the space to indicate a cleanliness state of the hands of the person who has entered the space.
1. An apparatus comprising:
a badge storing identification information about a person; and
a wearable holder for the badge, the holder comprising:
an electronic sensor to be used by the person to generate test results indicating a cleanliness state of the person's hands, and
communication elements to send at least some of the identification information and test results to an external device.
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10. An apparatus comprising:
an electronic sensor to be carried by a person or mounted in a stationary position accessible to a person's hands, and to be used by the person to detect a cleanliness state of the person's hands, the electronic sensor having a lifetime that is limited by a number of test cycles; and
circuitry to count a number of times a person has run a cleanliness test using the sensor and compare the number of times cleanliness tests have been run using the sensor to the number of test cycles.
11. The apparatus of
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This application is a continuation of U.S. patent application Ser. No. 11/353,746, entitled Hand Cleanliness, filed Feb. 14, 2006 now U.S. Pat. No. 7,616,122, which is a continuation-in-part of U.S. patent application Ser. No. 11/157,094, entitled Hand Cleanliness, filed Jun. 20, 2005 now U.S. Pat. No. 7,286,057.
This description relates to hand cleanliness.
Health care workers, food handlers, and others ought to clean their hands frequently and thoroughly, but they often don't. Better hand cleaning habits can be promoted by governmental regulations, company rules, social pressure, and technology. Techniques that have been proposed for improving cleaning habits include the use of special cleaning agents as well as mechanisms and electronic devices to regulate, monitor, and report on how frequently and how effectively people clean their hands.
In one general aspect, an electronic sensor is configured to be carried by a person and to be used by the person to detect a cleanliness state of the person's hands, and a holder for the electronic sensor has a structure to temporarily receive an identification badge of the person.
Implementations may include one or more of the following features. The badge and the holder contain respective communication elements to permit information about a cleanliness test performed by the person using the electronic sensor to be communicated to the badge. The badge includes a unique identifier of the person that can be read electronically.
In one general aspect, an electronic sensor is carried by a person or mounted in a stationary position accessible to a person's hands, and is used by the person to detect a cleanliness state of the person's hands. Circuitry detects and provides an alert when the electronic sensor is nearing the end of its useful life.
Implementations may include one or more of the following features. The circuitry includes a counter of a number of times the sensor is used. The sensor comprises an ethanol sensor.
In one general aspect, the sensor includes a chemical sensor that is sensitive to a cleaning material other than ethanol.
In one general aspect, the sensor includes a ceramic sensor for ethanol.
In one general aspect, circuitry counts a number of times a person has run a cleanliness test using the sensor.
Implementations may include one or more of the following features. A circuit communicates the count wirelessly to a reader for reporting to a third party.
In one general aspect, a storage device is coupled to the sensor to store information about the frequency, timing, and/or results of cleanliness measurements performed by the user using the electronic sensor.
In one general aspect, a monitor has detection circuitry to detect a presence of one or more people in a monitored space and reporting circuitry to report a cleanliness state of hands of the people in the monitored space, based on information provided by one or more sensors used to sense a disinfecting agent on the hands of the people.
Implementations may include one or more of the following features. The detection circuitry detects the presence of one or more people by wireless communication with a device held on or by the person. The wireless communication comprises RFID communication. The monitored space comprises a room in a health care facility. The sensors are worn by one or more of the people. The sensors are associated with the monitor. The sensors sense ethanol. The cleanliness state is reported with respect to each of the people separately. The cleanliness state is reported to everyone in the space.
In one general aspect, an entry monitor has circuitry to detect when a person enters a monitored space and an indicator perceptible to other people in the space to indicate a cleanliness state of the hands of the person who has entered the space.
Implementations may embody one or more of the following features. The circuitry to detect when a person enters a monitored space includes a wireless communication element. The indicator comprises a light. The indicator can indicate a disinfected state and a non-disinfected state. The indicator is set to indicate a non-disinfected state of the person's hands when the person enters the space, whether or not the person's hands are then in a disinfected state. The indicator is set to switch to indicate a disinfected state only after the person successfully establishes the disinfected state using a sensor that senses a presence of a disinfectant. The indicator is set to switch to indicate a disinfected state only after all of the people who have entered the room have successfully established the disinfected state using one or more sensors that sense a presence of a disinfectant. The circuitry obtains, from a device worn by the person, information identifying the person uniquely.
In one general aspect, badges worn by people who enter a space contain indicia that uniquely identify the respective people who wear the badges, one or more sensors sense a presence of a disinfectant material on hands of each of the people, and a monitor detects the presence of one or more of the people in a space and indicates a cleanliness state of the people in the space.
In one general aspect, system monitors cleanliness states of hands of people who are moving from space to space in a facility; the system includes circuitry to identify each of the people uniquely in more than one of the spaces of the facility, circuitry to test the cleanliness state of the hands of one or more of the people in one or more of the spaces, and to associate the tests with the identities of the people, and a communication network to exchange information about the tested cleanliness of the people in the spaces of the facility from time to time and to provide related reports to a third party.
In one general aspect, on a device that is worn or carried by a person and contains an identifier uniquely associated with the person, a record is stored of tests performed by the person on a sensor to determine a cleanliness state of the hands of the person at a succession of test times. In general, in one aspect, the invention features an electronic sensor configured to be carried by a person and to be used by the person to detect a cleanliness state of the person's hands.
Implementations may include one or more of the following features. There is also a device configured (a) to identify the person, (b) to be associated with the electronic sensor, and (c) to be carried by the person. There is also a device configured to be associated with the electronic sensor and to provide an indication of the cleanliness state of the person's hands. The indicating device is configured to be carried by the person, and the indicating device and the sensor together are capable of detecting a cleanliness state of the person's hands and providing an indicator of the cleanliness state, without requiring cooperation between the apparatus and any device external to the apparatus. There is also a circuit to control how long after the state of the person's hands has determined to be clean, the state is presumed no longer to be clean.
In general, in another aspect, the invention features a single unit that includes an electronic sensor to be used by a person to detect a cleanliness state of the person's hands, and a device to provide an indication of the cleanliness state of the person's hands.
In general, in another aspect, the invention features a single unit that includes an electronic sensor to be used by a person to detect a cleanliness state of the person's hands, and a device to identify the person.
In general, in another aspect, the invention features a circuit that is configured to control how long after a cleanliness state of a person's hands has been determined to be clean, the state is presumed no longer to be clean.
Implementations may include one or more of the following features. The electronic sensor is configured to sense a presence or absence of a material indicative of the cleanliness state, for example, a vapor or alcohol. The cleanliness state comprises a disinfection state. The identification device comprises a badge. The identification device and the sensor are part of one unit. The electronic sensor, the identification device, and the indication device are part of one unit. The unit is configured to be worn by the person. The indication device comprises a visible indicator. The circuit comprises a countdown timer that is triggered in connection with the cleanliness state being determined to be clean. The circuit is part of the unit.
In general, in another aspect, the invention features a badge that includes indicia identifying a person who carries the badge, a sensor to be used to detect a cleanliness state of the person's hands, and a visible indicator to indicate to other people the cleanliness state of the person's hands.
In general, in another aspect, the invention features a person using an electronic sensor carried by the person to detect a cleanliness state of the person's hands.
In general, in another aspect, the invention features issuing a signal from a circuit to indicate how long after a state of a person's hands has been determined to be clean, the state is presumed no longer to be clean.
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In addition to providing the disinfection determining function, the badge 10 can be of a shape and form and can display information sufficient to serve a conventional function of complying with government and institution regulations that require health care workers to carry visible identification. For example, the badge includes a photograph 17 of the doctor, and other information including the doctor's name 19 and identification number 21. A typical badge could be approximately credit-card size.
Because health care workers are required to carry such badges for other reasons, providing the disinfection determining function within the same badge make it more likely that the worker will use that function than if the function were provided in a separate device that the worker was expected to carry separately. In addition, because the badge worn by a worker must be visible to others in the health care environment, the feature of the badge that indicates whether the user's hands are clean or unclean will naturally be visible to others. Thus, the worker, merely by having to wear the badge, will be subjected to social pressure of peers, patients, and managers with respect to the cleanliness of the worker's hands. This makes the use of the disinfection determining feature of the badge and the improvement of cleanliness habits self-enforcing. The institution by whom the worker is employed need only provide badges that include those features without directly managing or monitoring their use.
A pair of electrodes 24, 26 on either side of the sensor is used to determine when a finger 28 or other part of the hand or other skin has been placed against the sensor. When skin of a finger or other part of the hand touches both electrodes, the resistance between them will decline. By measuring that resistance the control circuit can detect the presence of a finger.
The badge is used by the doctor in conjunction with disinfecting her hands using cleaners of the kind that include ethanol (for example, the liquid known by the name Purell available from GOJO Industries, Akron, Ohio, and which contains 62% ethyl alcohol). Such cleaners are considered to be more effective than soaps and detergents in killing bacteria and viruses and are widely used in health care and other environments. When the ethanol-based cleaner is rubbed on the skin of the hands, the ethanol kills the bacteria and viruses. The effect will last for several hours but eventually wears off. Ethanol is volatile and eventually evaporates from the skin, leaving the possibility (which increases over time) that live bacteria and viruses will again contaminate the skin from the air and from objects that are touched, for example.
The concentration of ethanol on the skin and the decay of that concentration from evaporation tend to determine the onset of subsequent contamination. In turn, the concentration of ethanol on the skin can be inferred by the concentration of ethanol vapor near the skin. By placing the skin near an ethanol detector for a short period of time, it is possible to determine the vapor concentration of ethanol and thus to infer the ethanol concentration on the skin and the disinfected state of the skin. When the current inferred concentration is above a threshold, it is possible to make an assumption about how long the hands will remain disinfected.
The badge can be used in the following way to improve the hand cleaning habits of the user.
In some simple examples, the badge can be configured to determine and display two different states: disinfected and not disinfected.
Except when the badge has recently enough (say within two or three hours) entered the disinfected state due to a measurement cycle in which an adequate concentration of ethanol vapor had been sensed, the badge will assume a default state of the user's skin of not disinfected. Thus, when the badge is first powered on, or reset, or the permitted time since a prior successful measurement has elapsed, the state becomes not disinfected. When the state is not disinfected the red light is lit and the word re-test is displayed on the LCD.
In some implementations, the badge can be made to switch from the not disinfected state to the disinfected state only by a successful ethanol measurement cycle. A successful cycle is one in which a finger or other part of the body is held in position over the sensor (touching both of the electrodes) for a period that is at least as long as a required measurement cycle (e.g., 30 seconds or 45 seconds or 60 seconds depending on the design of the circuit), and the concentration of ethanol vapor that passes from the skin into a measurement chamber of the sensor is high enough to permit an inference that the skin is disinfected.
Thus, when the doctor wipes her hands with the cleaner to disinfect them, she can then press one of her clean fingers against the sensor 16 and the two electrodes 24, 26, for, say, 60 seconds.
Touching of both of the electrodes simultaneously by the finger is detected by the control circuit which then begins the measurement cycle. The control circuit could start the red and green lamps to flash alternately and to continue to do so as an indication to the user that the electrodes are both being touched and that the measurement cycle is proceeding. At the end of the sensing cycle, the control circuit determines a level of concentration of ethanol and uses the level to determine whether the finger, and by inference, the hand of the doctor is disinfected. Each time a measurement cycle has been fully completed, the red and green lights may both be flashed briefly to signal that the cycle has ended and the finger may be removed.
The control circuit continually monitors the electrodes to determine when a finger or other skin is touching both of the electrodes. When that event is detected, a measurement cycle count down timer (which is initialized for the number of seconds needed to complete a measurement) is started. At the beginning of a cycle, a voltage is applied to the heater to begin to heat the sensor element. Initially the heater voltage may be set to a higher than normal value in order to shorten the initial action period described below. Then the heater voltage is reduced. At the end of the measurement cycle, a measurement voltage is applied across the series connection of the measurement cell and the series resistor, and the voltage across the series resistor is detected and compared to a threshold to determine whether the state should be set to disinfected or not disinfected.
When the control circuit determines that the hand is disinfected, the control circuit switches to the disinfected state, lights the green lamp (and turns off the red lamp), and displays the word clean on the LCD. In addition, upon the initiation of the disinfected state, the control circuit starts a re-test count down timer that is initially set to the period during which the skin is expected to remain disinfected (for example two hours).
If the control circuit is in the disinfected state and the user voluntarily performs another successful measurement cycle (for example, if, during the two hours after the prior successful measurement, she disinfects her hands again), the re-test count down timer is reset.
Anyone in the vicinity of the doctor who can see the lights or LCD is made aware of whether, according to the doctor's use of the badge, the doctor's hands are disinfected or not. People who find troubling the indication that a person's hands are not disinfected can complain to the person or to the employer, for example.
During the sensing cycle the doctor must keep her finger against the sensor for at least a certain period of time, say 60 seconds, to give the sensor and the control circuit time to obtain a good reading. If the doctor removes her finger before the end of the period, the control circuit remains in or switches to the not disinfected state and displays the word re-test on the LCD display.
If the doctor holds her finger against the sensor long enough to complete the sensing cycle, the results of the sensing cycle are displayed on the LCD and by lighting either the red light or the green light.
If the sensing cycle ends with a determination that the finger is not disinfected, the doctor can try again to apply enough of the cleaner to her hands to satisfy the circuit and can test the ethanol concentration again. And the cycle can be repeated until the disinfected state is determined.
In addition to causing the green light to be illuminated and the LCD to show clean, successfully completing an ethanol test also causes the control circuit to reset a count down timer (not shown in
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Tin oxide sensors are small, low cost, and relatively low in power requirements. An example of a tin oxide ethanol sensor is the Model TGS 2620-M available from Figaro USA Inc. of Glenview, Ill., although other sensors available from other vendors could be used.
The sensor includes an integral heater and four connections, two for the sensor element, and two for the heater. By wiring a resistor in series with the element and measuring the voltage drop across the resistor, the control circuit can determine the amount of current flowing in the element and hence the resistance of the element which will vary with ethanol concentration.
Tin oxide sensors with heaters are subject to a so-called initial action that occurs when the sensors are not energized for a period and then are energized. The resistance of the sensor drops sharply during an initial period of energization, whether gases are present in the surrounding air or not. The longer the period of unenergized storage (up to about 30 days), the longer the period of the initial action. Therefore using tin oxide sensors in the badges requires a trade off between powering their operation for a period longer than the initial action but not so long that the energy drain caused by measurement cycles reduces the lifetime of the battery to an unacceptably short period. Experiments suggest that if the user keeps her finger in contact with the sensor for at least 20 or 30 seconds, the sensing of ethanol then begins to dominate the initial action and permits detection of the ethanol concentration. Other approaches may provide a shorter initial action (such as applying a larger voltage for the first few sections of operation and then the normal voltage after that).
The badge provides a simple, effective, portable, inexpensive way to confirm that the ethanol treatment has occurred no longer than, say, two hours ago, which likely means that the hands remain disinfected. No other external equipment is needed. The disinfection condition is apparent to anyone in the vicinity of the doctor, including patients, supervisors, regulators, and peers. The social pressure associated with being identified easily as not having disinfected hands is an effective way to improve the frequency and thoroughness of cleaning. The system does not force the doctor to comply. Compliance with cleaning rules and policies may remain less than perfect using the badges. Yet it is likely that the compliance will improve significantly. Any degree of improvement translates into reduced costs and injuries now associated with hands that have not been disinfected.
A wide variety of other implementations are within the scope of the following claims.
Although we sometimes have referred to use of the system by a doctor, it is also useful for a wide variety of other people, including other health care workers, clean room workers, and guests, consumers, vendors, employees, and other parties involved in any kind activity in which cleanliness of the hands or other parts of the body is important.
For example, although a simple matching of a measured ethanol concentration against a threshold can be used to determine simply whether the state should be disinfected or not disinfected, it is also possible to provide a more complicated analysis of measured concentration over time and a comparison of the measured concentration against dynamically selected thresholds.
More than two states would be possible, for example, to denote different levels of disinfection or to denote that longer periods of time may elapse before another measurement is required.
The length of time before a first measurement is considered stale and another measurement is required need not be based on an estimate of how long the ethanol on the skin will be effective, but can be based on an arbitrary period such as every hour.
The degree of accuracy and repeatability of the measurement of ethanol concentration may be traded with the cost and complexity of the circuitry needed to do the measurements. In some examples, the goal need not be to assure that the user's hands are thoroughly disinfected at all times. Rather, if the system encourages more frequent and more thorough cleaning to any noticeable degree, great benefits will result. Thus a very simple system may be quite useful and effective even though it may allow some users to cheat and may fail to determine the state accurately at all times.
Additional lights and displayed words may be used for a variety of purposes. The approach of the end of the disinfected period could be indicated by a yellow light to alert the user that a cleaning would soon be needed.
The lights and LCD display could be supplemented with or replaced by audible alerts for all functions or some of them.
In some examples, not all of the circuitry need be mounted in a single badge. Some of the circuitry could be located in a different piece of equipment. For example, a sensor used in common by many people may be mounted on a wall and convey (say by wireless communication) the measured concentration of ethanol to the badge, which would then determine the state and indicate that state through lights and on the LCD. By separating the two, the badge could be lower cost, the sensor could be more complex and accurate, and the sensor could be located at places where the disinfectant solution is dispensed. Fewer sensors would be needed.
Each badge could itself be split into two components that communicate with each other wirelessly or by wire. For example, a sensor module could be located in the user's pocket, while the badge contains only the logic circuitry.
The cleaning agent that is being measured need not be limited to ethanol but could include combinations of ethanol with other materials or other materials in the absence of ethanol; an appropriate sensor for the other materials would be used.
The badge could include clips, hook and loop fasteners, chains, pins, ribbons, and belt loops, and other devices to hold the badge on the user.
The device need not take the form of a badge but could be an ID device that attaches to a belt, a lapel, any other article of clothing, and other parts of the body including an arm, a leg, or a neck.
Instead of integrating the badge, sensor, and indicators in one unit, the badge could be an already existing badge of the kind used in hospitals, for example, to identify employees. Such badges often include names, photographs, and magnetic stripes or bar codes that can be swiped on readers. A shown in
In some examples, the badge, the holder, and the RFID transceiver 87 could be arranged differently. For example, the RFID transceiver could be located on a different device worn by the user while the badge could remain mounted on the holder.
The badge could be powered by photovoltaic cells using ambient light instead of a battery.
Although two different lights could be used to indicate the disinfected and not disinfected conditions, a single light that can change color could also be used, saving cost and space.
Because the ethanol sensor has a lifetime that is limited by the number of test cycles, the badge can include a circuit that counts the number of tests performed and illuminates a warning light or provides some other indicator when the sensor is reaching the end of its useful life.
Other types of ethanol sensors can be used. One such sensor comprises a ceramic chip but is considerably more expensive than the sensors described earlier.
Although ethanol and an ethanol sensor form the basis of some of the examples described here, other disinfectants (for example, trichlosan) may also be used provided that effective sensors are available for them.
In general, in addition to triggering a change in state of the badge after a period elapses, it is also useful to maintain a count of the number of times a person has run a test (sometimes called the number of taps) using the sensor in a given period of time. The badge can contain a counter that keeps track of the number of taps and determines the count per 24 hours. This number can then be reported to the person's employer or to regulatory agencies as evidence of good cleanliness practices in an institution. For reporting purposes, the number of counts can be communicated to a reader by RFID technology, or any other communication technique.
The sensor and indicators need not be associated with identification information but could be provided in a device the sole purpose of which is to measure the concentration and provide an indication of it.
The device can be used in non-health care environments in which hand cleanliness is important or expected.
In a health-care environment, the device could be used by anyone who is providing services as well as by patients and their families or friends.
Information about the frequency, timing, and results of measurements performed historically by the user can be stored on the badge.
Many additional functions could be added to the badge by increasing the capacity of its processor, memory, displaying, communications ability, and user inputs features.
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When the person wearing the badge enters the bathroom, or any other monitored space such as a patient room, or a surgical theater, the triggering device sends a signal to the badge that causes the badge to enter the not disinfected state and light the lamp that indicates that state. This triggering will encourage the user to disinfect his hands before leaving the bathroom or before proceeding further into the monitored space in order to avoid the social disapproval associated with leaving the bathroom with the red light on. In these examples, the badge's state could be forced to change to the not disinfected state regardless of how much time has passed since the most recent successful test using the badge sensor. The user can be reset to the disinfected state by the user cleaning his hands and testing them.
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The person entering the room could cause the light to turn from red back to green by touching the sensor (assuming his hands bear enough ethanol to imply a disinfected condition) or by first cleaning his hands and then touching the sensor.
In some examples, the monitor could be placed on in interior wall of a patient's room. Whenever anyone enters the room, including health care workers, the patient, or guests, the monitor would indicate a possibly not disinfected condition until someone touches the sensor and causes the red light to turn green. Social pressure of people in the room, who would observe the red light would help to enforce good cleanliness habits on every person entering the room.
The parts of the monitor need not be included in a single integrated wall unit. For example, a portion of the monitor that detects that a person has entered or left a space could be a separate system, including an existing system, that would exchange the information with the monitor as needed. The indicators could also be located separately from the monitor to make the lights visible to many people even though the monitor is located near an entrance to or exit from a monitored space. The sensor, too, could be located separately from the monitor. For example, the badge sensors could provide the re-test information to the monitor.
In some examples, an entire building could be monitored by providing monitors on the walls at all entrances to the building. In addition to the social pressure associated with public display of the not disinfected condition, an employee or automated gate at each entrance could require that the person entering either prove that his hands are disinfected by using the sensor either upon entry or after using a disinfectant available at the entrance.
A variety of spaces could be monitored, including bathrooms (or other locations where disinfecting is especially important) and changing areas in hospitals or food processing facilities, for example.
In some examples, the monitor could include circuitry that would detect, in other ways than described above) a presence of one or more people within a space (whether or not the people have entered or left the space), would determine a cleanliness state of hands of the people detected as present, would include circuitry to report the cleanliness state.
A publicly viewable monitor used to indicate the disinfected condition for people within a space can facilitate social pressure being applied by people in a room to people who enter the room even without the monitor having any information about the identity of a person entering the room. In addition, the monitor may include or be part of a system that includes devices to determine who has entered a space and to correlate that information with a person who then uses the sensor to indicate that his hands have been disinfected.
For example, the person entering the room may carry a badge (of the kind issued by a health care facility) that uniquely identifies him and includes a bar code, a magnetic stripe, an RFID element, or another device that can be read by a reader 114 (for example, the RF transceiver 75 in
An enterprise could issue temporary identification cards to every person who enters a building or other space and does not already have an identification badge for use with the system.
A variety of other techniques could be used to identify the person entering a space, including detection of biometric information (such as a voice print or a finger print or a facial print) or requiring a person to enter an identification code on a keypad 116 on the monitor. The person could enter the identification both upon entering the room (in some cases as a trigger for a locked door or other entry gate) and upon passing a disinfection test using the monitor. In some implementations, it may be possible to identify a person using a fingerprint detection technique at the same location on the monitor and at the same time as the disinfection test is performed. Other techniques could also be used to assure that a successful test is accurately correlated to an identifiable person.
The monitor can also include circuitry that keeps track of how many people are in the space (for example, by also detecting when someone has left the space). When the oldest successful disinfection test (among tests that number as many as there are people still in the room) occurred more than a predetermined period (say 2 hours) earlier, the monitor can time out and change the green light to red until someone in the room successfully tests his hands again.
In these examples, and others, it is possible for people to deceive the monitor, for example, by having one person in the room repeatedly test his hands positively on behalf of other people in the room. However, as indicated earlier, at least in some examples, the social pressure associated with the public display of the disinfection state of the space and the shifting of green to red in certain situations, may be sufficient to significantly improve the frequency and quality of hand cleaning among people in the space.
Other arrangements could be used to reduce the degree and nature of the deception that may be possible and to increase the ability of a monitoring system to track and report the performance of identified people or groups of people in maintaining hand cleanliness. Some such arrangements would use the unique identifiers associated with different people to track their performance.
For example, the wall monitor could include a processor and software to track individuals who enter and leave a room based on their unique identifiers and correlate the identities with tests that are performed successfully. The monitor could then control the red light and green light based on the successful testing of hand cleanliness by each individual in the space at least as often as some pre-specified time period (say every two hours). By including a small display 120 on the face of the monitor, the person whose hand cleanliness requires re-testing can be identified by name or identifier or some other indicator. In this way, each of the people in the space can be alerted from time to time of the need to re-clean, and re-test and everyone in the space can know who needs to do so.
Such a monitor could be used in conjunction and cooperation with worn badges, for example, of the kind discussed earlier. For example, using RFID or wireless or other kinds of communication capability in the monitor and at least some badges, the monitor and the badge could communicate, exchange information, control actions, and make reports, all in a wide variety of ways.
In a simple example, the monitor could cause the light on a badge to switch from red to green at the same time (or different times) as the lights are switched on the monitor, to indicate to others in the space which person in the space needs to re-clean and re-test. A successful test performed on the badge can be reported to the monitor for use, for example, in the same way that a test on the monitor would be used. Conversely, the monitor can report to a badge a successful (or unsuccessful test) performed on the monitor by the owner of the badge. More generally, the badges and monitors in one or more spaces can continually be synchronized to store common information about tests by the owner of the badge and to cause common indications of the cleanliness state of the badge owner to be given by both the monitor and the badge.
As a person moves around in a building that has more than one monitored space, the monitors and the badges will together in that way maintain current information and provide current indications of the cleanliness state of the badge owner.
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The monitors, the badges, and/or the central server or servers may include memory or mass storage 144 that contains a database 146 or other organized information about the permanently or temporarily registered people who have access to a building or space. The database can store information that is associated with individuals and information that is statistically relate to groups and subgroups of the individuals.
In some implementations, an individual badge can maintain a small database of information about a complete history of an individual's cleanliness testing beginning at the time when the badge was first issued, or at some later time. Or a rolling set of data ending at the current time may be kept. The data may catalog every instance when the user tested the cleanliness of his hands, the result, the time of the test, and the parameter values that were produced by the sensor in the testing. When the badge is able to communicate with monitors in different spaces or subspaces, the badge database may also track the places in which each of the tests was performed, which other people were present in the space when the tests were performed, and other information. Information in the badge database can be uploaded to one or more monitors using the communication links to the monitors, or may be uploaded from the badges directly to a central server using special badge readers located in one or more places in the facility.
Each monitor can maintain a database of information using information from badges of people with whom the monitor has interacted and information from other monitors in other spaces (for example, contiguous spaces). The database of a monitor could track every time a person has entered a monitored space and every time she has left the space. The data could include the time of entry, the time of exit, the space in which the user was most recently monitored, the time between entry into the space and when a re-test was performed, the results of the re-test, the number of re-tests performed in the room, the identities of other people in the room at the time of re-test, and a wide variety of other information.
If a person leaves a monitored space 131 and enters a monitored space 132, the monitors in the two spaces could be arranged to communicate so that the monitor in space 132 need not require a re-test if a re-test had been done in space 131 within a pre-specified earlier period.
When the monitors and/or badges are networked with a central server, the central server can use information provided from the monitors and/or badges to track the overall cleanliness testing activity of all of the monitored people in all spaces that are networked.
The central server could maintain a database 134 that could include detailed historical information and statistical summaries of information. The information could track every time any of the monitored people enters or leaves a monitored space, the number of times and the times at which re-testing has been done, the results of each re-test, the routes of the people moving through the building or campus, whether the people are wearing their badges, whether they used their badges or the wall monitors to re-test cleanliness, and a wide variety of other information.
The central server can use software 140 running on the server or servers to analyze information stored in the central database or the databases of one or more of the badges or the monitors. The analyses can address the performance of different groups on cleanliness, the correlation of cleanliness to location, the correlation of demographics (age, gender, geographic location) with cleanliness, the impact of training, monitoring, and other actions on the cleanliness performance, and time dependent changes by individuals, groups, and subgroups of cleanliness performance.
In addition to monitoring and analyzing information about cleanliness performance the central service can provide reports that are useful to or required by the party that operates the building or campus, other institutions, liability carriers, and governmental bodies that regulate certain aspects of the performance of the party and the individuals employed by the party. For example, governmental agencies may require hospitals to assure that hospital employees are disinfecting their hands more often than a certain number of times a day and to report failures to meet that requirement. Reports may also be given to individuals being monitored to groups of individuals, to their supervisors, and to others. Reporting to individuals can be done by email. For example, a doctor who is not disinfecting his hands often enough would periodically be sent an automatic email urging him to improve his cleanliness practices.
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Photographer Ben Long describes and demonstrates high dynamic range (HDR) photography, a technique that broadens the luminance or range between the lightest and darkest areas of an image.
"I took several Photoshop classes at local community colleges and couldn't seem to master it—until lynda.com. It was exponentially easier with video learning, and now I create beautiful digital art that gets rave reviews." —Cathy N.
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Fall Sport Athletes to Return For Training Camp
Mens and women's soccer, women's volleyball start August 19
- Release Date:
- July 26, 2010
- Contact:
- The Office of Sports Information
- (716) 649-7900 ext. 333
HAMBURG, NY - The Athletics Department at Hilbert College is looking forward to welcoming back the fall sport student-athletes on Thursday, August 19 for their NCAA designated first date of organized practice. Any interested student-athlete should speak with the correct coach prior to arriving on campus for the training camp move-in. (staff directory)
All athletes must complete NCAA and Hilbert College compliance paperwork prior to their participation in the first practice. Each first-year athlete must have a physical on file which clears them for Division III athletics competition. Returning student-athletes are required to have their vitals updated by the sports medicine staff or present a physical from a physician prior to their first practice.
All Hilbert College forms can be found by following this link. The NCAA forms and Hilbert's Drug and Alcohol Policy page will be reviewed at each team's compliance meeting with an athletic director on August 19th.
The men's and women's soccer teams kick off their season September 1 when they travel to Wells College for a simultaneous match beginning at 4 pm on two different fields. On September 3rd, the women's volleyball team travels to D'Youville College to participate in the Spartan Invitational with their first match set for 4 pm against the host institution.
All student-athletes not involved in men's/women's soccer or women's volleyball must attend a Student-Athlete Orientation Meeting which will take place during the first week of classes.
Hilbert College, located in suburban Hamburg, N.Y., south of Buffalo, is a private four-year college founded in 1957 in the Catholic Franciscan tradition. With nearly 1,100 students, Hilbert is a dynamic Western New York college that offers career-focused majors, including one of the top criminal justice programs in the region, and more than 50 minors and concentrations. The college's engaging, student-centered campus community offers numerous leadership, internship, and service learning opportunities from which students launch successful careers while making positive changes in their communities. The Hilbert Blueprint promotes a well-rounded student experience over four years – starting with the Foundations Seminar in the freshman year, followed by Sophomore Service, Junior Symposium, and culminating with the Senior Capstone. Hilbert has expanded its academic offerings with the college's first graduate programs and new Accelerated Degree Programs geared to adult learners.
Upcoming Events
- First Year Student Orientation
- Aug 14, 2015
- Summer Session A2 Ends
- Aug 21, 2015
- First Year Student Orientation
- Aug 28, 2015


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Wind: 9 mph
We are writing in response to Diane Weir's letter attacking our store for not being open on Sundays. We normally have a strict personal and professional policy against indirect communication; however, since we cannot find any listing for Ms. Weir, we are forced to answer here.
If Ms. Weir from Warren and Connecticut had chosen to come by or call to talk to us directly, we would have explained to her that we were open Sundays for the first four years we owned Sweet Pea. In those four years, we never made money on Sundays; in other words it cost us more to be open than to be closed! We always did it as a service to our customers.
However, with the recession, which I am fairly sure hit Warren and Connecticut too, we could no longer afford to stay open on Sundays. This did not mean that we took all those Sundays off. All of the renovations and improvements we have made to Sweet Pea we have done ourselves, mostly on Sundays. We work 60 to 80 hours a week and having some Sundays off is very important to our family. We are sorry that you were "appalled" at our hours, but believe us, they are necessary. As for your crack about us being a "so-called health food store," you will need to come and have that discussion face to face. Instead of making digs and cracks in the newspaper, why not come to us directly with any suggestions or complaints? After all, we are the only ones who can correct any problems.
The second issue we have is with The Valley Reporter. Has your paper sunk so low as printing personal attacks against local businesses? First the hardware store, then us. Do you really feel that it is appropriate for the only newspaper in The Valley? Do you really want to sell more papers through divisiveness and gossip?
After reading this letter, our approach to this issue was a bit different than Ms. Weir from Connecticut and Warren. We called the paper to speak directly to the editor and explained our displeasure. We were told by the editor that, yes, they should have called us about the letter, and yes, they should have checked the facts in the letter but they didn't have enough time. It used to be that if you could not check the facts, you did not print. We were also told that by printing these letters, it gets the conversation going. Just because all of the major media outlets have gone from reporting news and facts to entertainment and gossip, does The Valley Reporter have to follow? Do you really just want to sell more papers through gossip and dividing the community? We have the utmost respect for Al Benjamin, both personally and professionally, but you really need to get off this slippery slope or before you know it, you will be tapping our phones.
For what it's worth, we have some advice for customers of local businesses. If you have a problem with a local business, talk directly with the owner; we are all here most of the time. This is the only way you can make change. We are approaching seven billion people on our planet; if we cannot speak directly to each other, we are in trouble. To all of our customers who shop with us every day and have stopped by to voice their support, thank you, it means a lot.
Carin Fredette and Tom Clements are the owners of Sweet Pea Natural Market.


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It's speed that has gotten both Churubusco (12-1) and No. 1 Lafayette Central Catholic (13-0) to be one of the last four teams remaining in class A high school football in Indiana.
Friday night, the speed of two teams ranking in the top 10 all season will come together for a chance at a state finals appearance.
The class's No. 1 Knights defense — allowing a state best four points per game — comes in riding a 27-game winning streak that spans over two years and includes a state championship over Fountain Central 52-0 in 2009.
"Speed-wise, they are as fast as anybody we've seen," Churubusco head coach Lee Etzler said. "They have speed at every position so it's a lot to contend with and a lot to defend."
The Knights graduated 17 starters from a 14-0 state title team in '09. Meanwhile, the Eagles have the same familiar firepower as it had a year ago.
Senior fullback Kyle Mathewson's 2,410 single-season record in rushing yards has been joined by a complement of 660 yards from junior Josh LeFever. Most of that has come in the postseason with teams focused on Mathewson.
Down as much as 14 points in the sectional championship, it was LeFever who turned the tide for 'Busco leading them to their second sectional title and semistate appearance in four seasons.
Back for the first time since a 48-13 loss to Sheridan in 2007, the Eagles have a different mindset with seniors on the roster a part of the first deep postseason run for Etzler's squad.
"How exactly we'll respond when it's crunch time, I don't know," Etzler admitted. "But I don't think this team gets to worked up over numbers. There is a degree of excitement playing against a team that's No. 1 in the state."
The excitement has 'Busco facing arguably its toughest match-up since Sheridan.
The Knights rank in the top five on both sides of the ball including a state best eight shutouts this season.
LCC has averaged a margin of victory over its opponents that is only second to one team in the state at 45.4 points.
The high powered offense of the Knights has been mostly to blame for that averaging 49.4 points per game compared to Churubusco's 42.2.
An Eagles defense giving up just over two touchdowns per game will have to contend with a list of threats LCC has to offer.
At the top of them all is Danny Anthrop who splits his time as a leader on the Knights secondary and the lead scorer on offense.
"Their best athlete is Danny Anthrop," Etzler noted. "But any of their skilled players are capable of cutting your heart out as much as Anthrop. If it was just one kid it'd be easy but its not."
Anthrop has split his time on offense with 10 rushing TDs and 12 through the air. The bulk his yards come in the passing game. His 47 receptions and 815 yards receiving are set up by Knights QB Austin Munn's 68 completion percentage.
Nearly 2,000 yards in the air, Munn has rarely turned the ball over throwing 23 touchdowns compared to just four interceptions.
The closest game all season for LCC came in the regional round in a 35-14 win over South Central.
Despite missed opportunities, SC used time of possession to prove that Lafayette Central Catholic can be competed with.
"They were a different team than us," Etzler said. "But it exposed some things and shows they can be beat and I think our kids understand that.
"We've been preparing all week to give it our best shot to win the game. It's not our attitude to keep it close. We want to win the game and we're not going to be intimidated."


text:
Bering Sea Gold DVD
Product Rating
(4 reviews)
(4 reviews)
- Additional Details
- Format: DVD
- Rating: Not Rated
- Number of Discs: 2
- Run Time: 352 Minutes
- Region: 1
- Studio: Discovery Channel
- DVD Release Date: August 13, 2013
- Cast: Thom Beers, Zeke Tenhoff, Steve Pomrenke
- Genre: TV Series
- Release Date: 2011
This two-disc set of Bering Sea Gold will present gold mining as you've never seen it before, with the treasure hidden deep in the bottom of the sea. You'll meet the vastly different crew members - from gold-mining veterans to childhood friends to the rookie captain and the social worker who left a desk job in search of gold. The miners will all face the same hardships as mining on land - close quarters, mishandled machinery, bad luck, and short tempers - with the additional dangers of working underwater at the mercy of the fickle sea. These eight episodes will venture out in search of the sparkle at the bottom of the sea, while exposing the reality of the true price of gold.


text:
Infiniti Repair in Toomsuba
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Mike's Auto Center
606 S Cedar Ave, Demopolis
(334) 377-4867
"They are friendly, they try to work with you, they charge you a reasonable price. Good people who try to help others is how I see them."See more
Parts & Labor Warranty:
12 months / 12,000 miles
Mon - Fri: 7:30am to 5:00pm
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Real Customer Reviews
Real Customer Review(s)
"They are friendly, they try to work with you, they charge you a reasonable price. Good people who try to help others is how I see them." Velma - Verified Customer
"They do a good job for me and I have been going to them for years and years." Alice - Verified Customer
"I've had nothing but excellent service there. I know some of the workers and they're timely about getting your work done. I get what I asked for done and they occasionally find one or two things I didn't go in for and they request permission to fix it. I feel like they have my best interest in mind." Keith - Verified Customer
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Mike's Auto Center was established in 2003 and has been providing Demopolis and the surrounding area with quality automotive repairs ever since. This RepairPal Certified shop features a team of very experienced, highly trained technicians who are equipped with the tools and diagnostic equipment necessary to perform a wide range of repairs. These repairs can range from minor and major mechanical repairs, to tires and wheel alignment, to check engine light diagnosis and repairs, as well as your scheduled maintenance needs. This work is backed by a 12-month / 12,000-mile warranty for your peace of mind. Our survey of their recent customers revealed a group who describe the team here as: "excellent", "helpful", "friendly", and "honest". A local shuttle service is available for your convenience.
There are 21 Infiniti service shops and mechanics in Toomsuba. Edit searchSee other Infiniti repair shops and dealerships
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Infiniti repair shops and dealerships near Toomsuba.
1811 11th St, Meridian
Service & Repair, Tire Sales/Repair
11706 Nancy Drive, Collinsville
302 South Broad, York
8879 Hwy 19 North, Colinsville
1303 15th Street, Meridian
Service & Repair, Tire Sales/Repair
1824 B Street, Meridian
Muffler & Exhaust, Service & Repair, Tire Sales/Repair
1324 B Street, Meridian
5479 Hwy 19 Frontage Rd, Meridian
615 22nd Avenue South, Meridian
Service & Repair, Tire Sales/Repair
4679 Us Highway 80 E, Savannah
Oil Change & Lube, Service & Repair
1578 Highway 80 East, Vicksburg
615 Highway 19 N, Meridian
2401 US Highway 80 E , Mesquite
1001 15th St, Meridian
3420 8th St, Meridian
Muffler & Exhaust, Tire Sales/Repair
"Very pleased! I was out of town and went to another car repair shop. The mechanic told me that I needed new bearing i..."
5024 Poplar Springs Dr, Meridian
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5992 Oak St, Meridian
2727 Highway 39 N, Meridian
5525 1st Street, Meridian
9060 Hwy 19 N in, Collinsville
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text: Prev | Next Staff Sgt. Debra Richardson/West Virginia Army National Guard A member of the West Virginia Army National Guard approaches an apartment complex in Summersville, W.Va., to assess the structural damage incurred after Hurricane Sandy brought over two feet of snow to the mountainous region. Soldiers assigned to West Virginia's Chemical, Biological, Radiological, Nuclear (CBRNE) and High-Yield Explosive Enhanced Response Force Package team, or CERFP, ensure that governors and adjutants general have the capabilities to mitigate risks associated with collapsed structures rescue, medical triage and stabilization, mass decontamination, and the recovery of fatalities. While chemical, radiological and biological hazards are not expected during the relief efforts, the soldiers are assessing structural damage to houses and businesses across the state and will remain on stand-by to assist with any necessary extraction rescues. Gallery: West Virginia National Guard storm response Nov. 02, 2012 @ 09:21 AM 2012/The Herald-Dispatch Here are photos from the West Virginia National Guard's response to Hurricane Sandy. (u'nobuy',)


text: Regardless of which side of the religious and socio-political spectrum a child's parent or guardian is on, that child is innocent. Children are not billboards for hatred, malice and lies. But they can be purveyors of truth, and speak for the greater good. After all, it's their faces and that most affect us.


text: Dramatic Encounter is a dark, burgundy red with faint burgundy shimmer. It's mostly opaque in color, and it has an amplified finish. MAC describes it as deep purple, but it's more wine–a lot of red in this shade. This shade lasted for six hours on me, and it was neither drying nor hydrating; I did see some very faint feathering along the upper left edge of my lip after three and a half hours. The texture was very slick–almost wet in a way–creamy but thin. Chanel L'Impatiente is redder, lighter. MAC Hang Up is a bit redder, more berry–makes this shade look brown-ish. MAC Endless Drama is a smidgen redder.


text:
Bringing some sass to the yoga mat, the reversible Love Lace-up Halter Top has contrast lacing in the back for adjust-ability and a pop of color. This flattering halter top reverses from deep purple to butter with cherry lacing. Wearing shades of purple (crown) - Spirituality and awareness. Enhances focus, intuition, imagination, passion, and determination. Represents royalty, dignity, strength, beauty, harmony, wealth, and opportunity.
|92% organic cotton / 8% spandex


text:
- auto-structure (1)
- integrate and fire (1)
- non-Poissonian (1)
- spike train (1)
- temporal correlations (1)
- EEG processing with TESPAR for depth of anesthesia detection (2009)
- Poster presentation: Introduction Adequate anesthesia is crucial to the success of surgical interventions and subsequent recovery. Neuroscientists, surgeons, and engineers have sought to understand the impact of anesthetics on the information processing in the brain and to properly assess the level of anesthesia in an non-invasive manner. Studies have indicated a more reliable depth of anesthesia (DOA) detection if multiple parameters are employed. Indeed, commercial DOA monitors (BIS, Narcotrend, M-Entropy and A-line ARX) use more than one feature extraction method. Here, we propose TESPAR (Time Encoded Signal Processing And Recognition) a time domain signal processing technique novel to EEG DOA assessment that could enhance existing monitoring devices. ...
- Cuff overinflation and endotracheal tube obstruction : case report and experimental study (2010)
- Background: Initiated by a clinical case of critical endotracheal tube (ETT) obstruction, we aimed to determine factors that potentially contribute to the development of endotracheal tube obstruction by its inflated cuff. Prehospital climate and storage conditions were simulated. Methods: Five different disposable ETTs (6.0, 7.0, and 8.0 mm inner diameter) were exposed to ambient outside temperature for 13 months. In addition, every second of these tubes was mechanically stressed by clamping its cuffed end between the covers of a metal emergency case for 10 min. Then, all tubes were heated up to normal body temperature, placed within the cock of a syringe, followed by stepwise inflation of their cuffs to pressures of 3 kPa and >=12 kPa, respectively. The inner lumen of the ETT was checked with the naked eye for any obstruction caused by the external cuff pressure. Results: Neither in tubes that were exposed to ambient temperature (range: -12°C to +44°C) nor in those that were also clamped, visible obstruction by inflated cuffs was detected at any of the two cuff pressure levels. Conclusions: We could not demonstrate a critical obstruction of an ETT by its inflated cuff, neither when the cuff was over-inflated to a pressure of 12 kPa or higher, nor in ETTs that had been exposed to unfavorable storage conditions and significant mechanical stress.
- Soluble triggering receptor on myeloid cells-1 is expressed in the course of non-infectious inflammation after traumatic lung contusion : a prospective cohort study (2011)
- Introduction: The triggering receptor expressed on myeloid cells-1 (TREM-1) is known to be expressed during bacterial infections. We investigated whether TREM-1 is also expressed in non-infectious inflammation following traumatic lung contusion. Methods: In a study population of 45 adult patients with multiple trauma and lung contusion, we obtained bronchoalveolar lavage (BAL) (blind suctioning of 20 ml NaCl (0.9%) via jet catheter) and collected blood samples at two time points (16 hours and 40 hours) after trauma. Post hoc patients were assigned to one of four groups radiologically classified according to the severity of lung contusion based on the initial chest tomography. Concentration of soluble TREM-1 (sTREM-1) and bacterial growth were determined in the BAL. sTREM-1, IL-6, IL-10, lipopolysaccharide binding protein, procalcitonin, C-reactive protein and leukocyte count were assessed in blood samples. Pulmonary function was evaluated by the paO2/FiO2 ratio. Results: Three patients were excluded due to positive bacterial growth in the initial BAL. In 42 patients the severity of lung contusion correlated with the levels of sTREM-1 16 hours and 40 hours after trauma. sTREM-1 levels were significantly (P < 0.01) elevated in patients with severe contusion (2,184 pg/ml (620 to 4,000 pg/ml)) in comparison with patients with mild (339 pg/ml (135 to 731 pg/ml)) or no (217 pg/ml (97 to 701 pg/ml)) contusion 40 hours following trauma. At both time points the paO2/FiO2 ratio correlated negatively with sTREM-1 levels (Spearman correlation coefficient = -0.446, P < 0.01). Conclusions: sTREM-1 levels are elevated in the BAL of patients following pulmonary contusion. Furthermore, the levels of sTREM-1 in the BAL correlate well with both the severity of radiological pulmonary tissue damage and functional impairment of gas exchange (paO2/FiO2 ratio).
- Spike train auto-structure impacts post-synaptic firing and timing-based plasticity (2011)
- Cortical neurons are typically driven by several thousand synapses. The precise spatiotemporal pattern formed by these inputs can modulate the response of a post-synaptic cell. In this work, we explore how the temporal structure of pre-synaptic inhibitory and excitatory inputs impact the post-synaptic firing of a conductance-based integrate and fire neuron. Both the excitatory and inhibitory input was modeled by renewal gamma processes with varying shape factors for modeling regular and temporally random Poisson activity. We demonstrate that the temporal structure of mutually independent inputs affects the post-synaptic firing, while the strength of the effect depends on the firing rates of both the excitatory and inhibitory inputs. In a second step, we explore the effect of temporal structure of mutually independent inputs on a simple version of Hebbian learning, i.e., hard bound spike-timing-dependent plasticity. We explore both the equilibrium weight distribution and the speed of the transient weight dynamics for different mutually independent gamma processes. We find that both the equilibrium distribution of the synaptic weights and the speed of synaptic changes are modulated by the temporal structure of the input. Finally, we highlight that the sensitivity of both the post-synaptic firing as well as the spike-timing-dependent plasticity on the auto-structure of the input of a neuron could be used to modulate the learning rate of synaptic modification.
- Superimposed high-frequency jet ventilation combined with continuous positive airway pressure/assisted spontaneous breathing improves oxygenation in patients with H1N1-associated ARDS (2012)
- Background: Numerous cases of swine-origin 2009 H1N1 influenza A virus (H1N1)-associated acute respiratory distress syndrome (ARDS) bridged by extracorporeal membrane oxygenation (ECMO) therapy have been reported; however, complication rates are high. We present our experience with H1N1-associated ARDS and successful bridging of lung function using superimposed high-frequency jet ventilation (SHFJV) in combination with continuous positive airway pressure/assisted spontaneous breathing (CPAP/ASB). Methods: We admitted five patients with H1N1 infection and ARDS to our intensive care unit. Although all patients required pure oxygen and controlled ventilation, oxygenation was insufficient. We applied SHFJV/CPAP/ASB to improve oxygenation. Results: Initial PaO2/FiO2 ratio prior SHFJV was 58-79 mmHg. In all patients, successful oxygenation was achieved by SHFJV (PaO2/FiO2 ratio 105-306 mmHg within 24 h). Spontaneous breathing was set during first hours after admission. SHFJV could be stopped after 39, 40, 72, 100, or 240 h. Concomitant pulmonary herpes simplex virus (HSV) infection was observed in all patients. Two patients were successfully discharged. The other three patients relapsed and died within 7 weeks mainly due to combined HSV infection and in two cases reoccurring H1N1 infection. Conclusions: SHFJV represents an alternative to bridge lung function successfully and improve oxygenation in the critically ill.
- Deguelin attenuates reperfusion injury and improves outcome after orthotopic lung transplantation in the rat (2012)
- The main goal of adequate organ preservation is to avoid further cellular metabolism during the phase of ischemia. However, modern preservation solutions do rarely achieve this target. In donor organs hypoxia and ischemia induce a broad spectrum of pathologic molecular mechanisms favoring primary graft dysfunction (PGD) after transplantation. Increased hypoxia-induced transcriptional activity leads to increased vascular permeability which in turn is the soil of a reperfusion edema and the enhancement of a pro-inflammatory response in the graft after reperfusion. We hypothesize that inhibition of the respiration chain in mitochondria and thus inhibition of the hypoxia induced mechanisms might reduce reperfusion edema and consecutively improve survival in vivo. In this study we demonstrate that the rotenoid Deguelin reduces the expression of hypoxia induced target genes, and especially VEGF-A, dose-dependently in hypoxic human lung derived cells. Furthermore, Deguelin significantly suppresses the mRNA expression of the HIF target genes VEGF-A, the pro-inflammatory CXCR4 and ICAM-1 in ischemic lungs vs. control lungs. After lung transplantation, the VEGF-A induced reperfusion-edema is significantly lower in Deguelin-treated animals than in controls. Deguelin-treated rats exhibit a significantly increased survival-rate after transplantation. Additionally, a downregulation of the pro-inflammatory molecules ICAM-1 and CXCR4 and an increase in the recruitment of immunomodulatory monocytes (CD163+ and CD68+) to the transplanted organ involving the IL4 pathway was observed. Therefore, we conclude that ischemic periods preceding reperfusion are mainly responsible for the increased vascular permeability via upregulation of VEGF. Together with this, the resulting endothelial dysfunction also enhances inflammation and consequently lung dysfunction. Deguelin significantly decreases a VEGF-A induced reperfusion edema, induces the recruitment of immunomodulatory monocytes and thus improves organ function and survival after lung transplantation by interfering with hypoxia induced signaling.
- Prednisolone as preservation additive prevents from ischemia reperfusion injury in a rat model of orthotopic lung transplantation (2013)
- The lung is, more than other solid organs, susceptible for ischemia reperfusion injury after orthotopic transplantation. Corticosteroids are known to potently suppress pro-inflammatory processes when given in the post-operative setting or during rejection episodes. Whereas their use has been approved for these clinical indications, there is no study investigating its potential as a preservation additive in preventing vascular damage already in the phase of ischemia. To investigate these effects we performed orthotopic lung transplantations (LTX) in the rat. Prednisolone was either added to the perfusion solution for lung preservation or omitted and rats were followed for 48 hours after LTX. Prednisolone preconditioning significantly increased survival and diminished reperfusion edema. Hypoxia induced vasoactive cytokines such as VEGF were reduced. Markers of leukocyte invasiveness like matrix metalloprotease (MMP)-2, or common pro-inflammatory molecules like the CXCR4 receptor or the chemokine (C-C motif) ligand (CCL)-2 were downregulated by prednisolone. Neutrophil recruitment to the grafts was only increased in Perfadex treated lungs. Together with this, prednisolone treated animals displayed significantly reduced lung protein levels of neutrophil chemoattractants like CINC-1, CINC-2α/β and LIX and upregulated tissue inhibitor of matrix metalloproteinase (TIMP)-1. Interestingly, lung macrophage invasion was increased in both, Perfadex and prednisolone treated grafts, as measured by MMP-12 or RM4. Markers of anti-inflammatory macrophage transdifferentiation like MRC-1, IL-13, IL-4 and CD163, significantly correlated with prednisolone treatment. These observations lead to the conclusion that prednisolone as an additive to the perfusion solution protects from hypoxia triggered danger signals already in the phase of ischemia and thus reduces graft edema in the phase of reperfusion. Additionally, prednisolone preconditioning might also lead to macrophage polarization as a beneficial long-term effect.
- The small fibrinopeptide bβ15-42 as renoprotective agent preserving the endothelial and vascular integrity in early ischemia reperfusion injury in the mouse kidney and vascular integrity in early ischemia reperfusion injury in the mouse kidney (2014)
- Disruption of the renal endothelial integrity is pivotal for the development of a vascular leak, tissue edema and consequently acute kidney injury. Kidney ischemia amplifies endothelial activation and up-regulation of pro-inflammatory mechanisms. After restoring a sufficient blood flow, the kidney is damaged through complex pathomechanisms that are classically referred to as ischemia and reperfusion injury, where the disruption of the inter-endothelial connections seems to be a crucial step in this pathomechanism. Focusing on the molecular cell-cell interaction, the fibrinopeptide Bβ15–42 prevents vascular leakage by stabilizing these inter-endothelial junctions. The peptide associates with vascular endothelial-cadherin, thus preventing early kidney dysfunction by preserving blood perfusion efficacy, edema formation and thus organ dysfunction. We intended to demonstrate the early therapeutic benefit of intravenously administered Bβ15–42 in a mouse model of renal ischemia and reperfusion. After 30 minutes of ischemia, the fibrinopeptide Bβ15–42 was administered intravenously before reperfusion was commenced for 1 and 3 hours. We show that Bβ15–42 alleviates early functional and morphological kidney damage as soon as 1 h and 3 h after ischemia and reperfusion. Mice treated with Bβ15–42 displayed a significantly reduced loss of VE-cadherin, indicating a conserved endothelial barrier leading to less neutrophil infiltration which in turn resulted in significantly reduced structural renal damage. The significant reduction in tissue and serum neutrophil gelatinase-associated lipocalin levels reinforced our findings. Moreover, renal perfusion analysis by color duplex sonography revealed that Bβ15–42 treatment preserved resistive indices and even improved blood velocity. Our data demonstrate the efficacy of early therapeutic intervention using the fibrinopeptide Bβ15–42 in the treatment of acute kidney injury resulting from ischemia and reperfusion. In this context Bβ15–42 may act as a potent renoprotective agent by preserving the endothelial and vascular integrity.
- The Early Activation of Toll-Like Receptor (TLR)-3 Initiates Kidney Injury after Ischemia and Reperfusion (2014)
- Acute kidney injury (AKI) is one of the most important complications in hospitalized patients and its pathomechanisms are not completely elucidated. We hypothesize that signaling via toll-like receptor (TLR)-3, a receptor that is activated upon binding of double-stranded nucleotides, might play a crucial role in the pathogenesis of AKI following ischemia and reperfusion (IR). Male adult C57Bl6 wild-type (wt) mice and TLR-3 knock-out (-/-) mice were subjected to 30 minutes bilateral selective clamping of the renal artery followed by reperfusion for 30 min 2.5h and 23.5 hours or subjected to sham procedures. TLR-3 down-stream signaling was activated already within 3 h of ischemia and reperfusion in post-ischemic kidneys of wt mice lead to impaired blood perfusion followed by a strong pro-inflammatory response with significant neutrophil invasion. In contrast, this effect was absent in TLR-3-/- mice. Moreover, the quick TLR-3 activation resulted in kidney damage that was histomorphologically associated with significantly increased apoptosis and necrosis rates in renal tubules of wt mice. This finding was confirmed by increased kidney injury marker NGAL in wt mice and a better preserved renal perfusion after IR in TLR-3-/- mice than wt mice. Overall, the absence of TLR-3 is associated with lower cumulative kidney damage and maintained renal blood perfusion within the first 24 hours of reperfusion. Thus, we conclude that TLR-3 seems to participate in the pathogenesis of early acute kidney injury.


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|167 posts found
Spotlight Poster
Joined: 3/28/11
They probably wouldn't let me play then, so the choice wouldn't be mine. I know I'm not that smart because I can't even figure out how to play EVE or Age of Wushu.
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Hard Core Member
Joined: 1/30/09
Personally, if the game is good, I'd play it... if it's not, I wouldn't, having an IQ test to participate wouldn't even factor in that.
Not that I think the IQ test would be any good, anyway. IQ tests measure a partiular kind of mental ability, to be honest that is completely irrelevant to personality and how you play and behave around others, which is what would be important to the quality of a game community... plus, I'd bet that within a couple of weeks (to give it too much time), there would be lots of websites with all the possible questions and all the "right" answers to them.
What can men do against such reckless hate?
Apprentice Member
Joined: 1/21/13
cheese cheese wheres da bloody cheese
we are talking about eve here right? dont take this the wrong way but i hate that game, i know its a great game and i have NO complaint aginst it because it really is well made, but i hate it thats just my personel opion nothing more
i like a game that makes me think and a game that rewards people who do but at the same time i want to have fun, there is a limit to how complicated a game should be even for non casual gamers.
by makeing it extreamly hard and need a higher level of thinking you label the players right off the bat as elitest which is always bad
so in the end to answer would i play a game that required a IG test, sure if i passed it and liked the game, the IQ test itself would not be a selling point though it would be a detriment overall.
Advanced Member
Joined: 6/27/11
I would love to give it my best shot.
I would probably fall flat on my subhuman face, but I would show perserverance and tenacity while getting my tiny brain turned to goo.
and It would probably be very enjoyable while I lasted as well :)
(hint: MMOs are supposed to be challenges that not all Players succeed at... some are supposed to fail by design if it is a good MMO. Hard but true, and when a MMO is designed hardcore, it's more fun than can be described with words. "Addicting" comes to mind though...)
Novice Member
Joined: 5/15/06
The doctors say his chances are 50/50...but there's only a 10% chance of that.
Here's some food for thought:
Minecraft can be a very simple, basic, fun game.
The more imagination, time, and thought applied, the more amazing outcomes.
People are rewarded when they see what they have built with a sense of accomplishment, regardless of IQ or what others think.
Some of the most amazing things get thousands if not millions of views on youtube.
It's a game that doesn't alienate people based on IQ, has rewarding gameplay to millions, is not pay to win, and players achieve something of status when their constructions are shown to the world. Not to mention it being adopted by a few countries into their education programs.
So perhaps the best games aren't the ones that cast out the less intelligent, but the ones that reward people for what they do on any level, and allow players recognition from their peers for their imagination, creativity, planning and thought.
El Psy Congroo
Advanced Member
Joined: 6/27/11
Originally posted by kadepsyson
I give you credit for your idea for a game, it would be a refreshing change in gameplay as compared to the usual competitive nature of MMOs. You have a good point there, assuming Minecraft is a MMO, which is what this thread was asking...." would we play a MMO.."
I personally don't consider Minecraft a MMO, at least not a conventional one. Maybe it is (I don't have a good opinion of Minecraft btw).
Also... why would you want the whole world seeing what you do in a MMO? I play MMOs but I don't want the whole world to see what I do, other MMO Players sure, but not the whole world, they wouldn't understand...it's none of their business to be honest. I would never put gameplay footage on Youtube.
I don't understand you young people.... a strange Generation you are.
Elite Member
Joined: 10/07/03
Originally posted by PWN_FACE
That in no way means you aren't "smart". You may not comprehend those particular games well, but I am sure there is something else you excel at.
Long, long ago they stopped giving IQ tests for a very good reason. Look into it.
Novice Member
Joined: 5/15/06
The doctors say his chances are 50/50...but there's only a 10% chance of that.
Originally posted by Gardavsshade
I wasn't suggesting Minecraft was an MMO, but rather it had some very interesting gameplay that scaled with the user you could say. Rather than scaling with level or zone.
The part about seeing what you do in an MMO is of course an ability of any mmo when combined with screen capture software. Minecraft allows people to use such software to share their creativity. Not saying it'd be a great thing to implement so people can see you kill the same Boss millions of times over again in your GW2 youtube channel hehe
El Psy Congroo
Novice Member
Joined: 7/06/12
I like your idea, but I take it in a different meaning. By the way, the 50 cent coin John f Kennedy is on it I believe. Now back to the idea.
Your idea of a IQ test is wrong because while I have not taken this test some people say "are you a genius" to be honest I don't need to be a genius nor do I care if I was instead of making a game for people of superior intelligence-genius (120-145) the industry should make the games more challenging and put a learning curve in there. While people of higher IQ's would be able to figure it out faster they will still have a fun time with it like a puzzle.
The gaming industry has dumbed everything down which gives us nothing to learn or figure out. Take the game EQ as an example starting out you needed to figure how to travel to the different parts and learn their skill system. This was their learning curve which has kept a lot of people interested in the game.
I will take myself as an example I hate easy tasks for instance school work that is easy = busy work to me which makes it a chore. I do it, but I procrastinate which generally leaves less time to sleep. So if games put a learning curve in and did not make it a WOW copy they would keep more people.
But this is the age of idiots were if a game requires any sort of learning people will leave.
Originally posted by Rider071
Are you sure about that.
I took several IQ tests under 18 because I was in AT classes. They were for accelerated learning. I was reading college level under 15 years old so of course they were always tracking your progress and expecting you to keep a lead. I don't know if they have AT anymore but they did when I was in school. Last I heard they don't even teach cursive now.
Then I skipped all of high school and passed a GED in lockup (for skipping school). The choices were go to high school in lockup or get the GED and work in the library instead. See, being smart was ruining my teenage reputation so I cut every class in every school they sent me to until they finally locked me up for it. Yeah, yeah, hindsight, I'm grown now and know my kiddie faults. In lockup they gave me several tests, one for IQ and two for personality. You know, to see if I was a nasty type that would stay nasty. I remember one test kept talking about horses. How do you feel about horses. Would you ride a horse. Do horses frighten you. I kept thinking, where was this test made frickin' Oklahoma, there are no horses near me. Of course they could have been a thin veil of horses = people but so it was, the horse test was completed.
Once I started college, again they offered an IQ test along with several times doing the MBTI tests. In one class we even had to do them as part of the curriculum. That was as late as '05.
Those things have been a part of my life throughout all my years. I've worked at 2 temp companies and both of them asked me to take many tests to prove that I could do what I said on my resume. Those test results then went along with my resume to companies that I was offered to be placed with.
Tests are common everywhere I've been from lockup to the outside world. I can't imagine a world without them. Is this uncommon to other people?
I don't want to jump the fence and say they are perfection but they are about the only thing we have on paper to say - better than, worse than in these subjects.
Novice Member
Joined: 7/06/12
Originally posted by greenreen
Wait what I was reading about 5 years ahead of my age in grade school and I was never in any accelerated courses or was given a IQ test. Most of the people in the "CATS" which was what we used in grade school wondered why I was not in it. This is what I get for an Arizona education... Which is now why in high school I have basically resorted to taking all AP math classes and science classes and next year is my junior. I go after school and have the physics teacher and AP Chem teacher teach me something and I take online classes.
The reason that they have become less popular is because there were some studies that showed motivation played a large amount of the test scores so if there was an incentive to do well then they would score higher. They also stopped doing it because it could discourage some students because you will get people who think that they are all high and mighty because of their IQ. If someone tries to do that I say that I reply " Good for you now what have you done with it" That pretty much shuts them up. The point is people are only looking for something to brag about which is why atleast Arizona and Jan Brewers all mighty wisdom >.> Don't give them out anymore.
Novice Member
Joined: 5/15/06
The doctors say his chances are 50/50...but there's only a 10% chance of that.
Originally posted by greenreen
Under 18 on several IQ tests? I'm so, so very sorry. (teasing)
El Psy Congroo
Originally posted by kadepsyson
It's not that big of a deal either as they made it. My mother liked reading and taught us to read before we entered school. She let us go to the library whenever we asked - free ride and all the kids had library cards. That she did right, forcing piano lessons on me for 6 years wasn't such a good thing. I can't even read music anymore - forgot it all. If you wanted to go to a friends' house, you walked, that trip to the library or school was free for the asking.
That was her pre-training that got me there, reward her not me. You know what I think of that prodigy tag. It works something like this, a 10 year old doing something adult is enamored, an adult doing that thing is no longer special. Prodigy wears off simply by aging is my thought on the whole - my kid is special outlook. I never took it to heart like some might. As evidenced by me rebelling against what it did to my social life at one point. Now, I can embrace it but only as a thought of I have the capability to learn anything, not I know everything.
Now I'm going to listen to an old skid row song and celebrate my 18 IQ hehe. http://www.youtube.com/watch?v=0Xd8ykpZkwA
Originally posted by Destac
Yeah, sounds like they bilked you. We had kids that were just a few levels above their grade in those classes. Maybe your school ran out of space? The only good part about them was that the teachers would answer any obscure question you would think up versus regular classes where they teach directly from the book and that's it.
Elite Member
Joined: 9/05/10
Logic, reason and fact do not supersede human nature. Ignorance reigns without justice.
I'd play a game that had some sort of maturity barrier to apply for it; the prospect of the test being an IQ one is easily exploited and not really indicative of someone being mature or logical.
There are a lot of people with high IQs that have no where near the wisdom or logic prowess as some who are average or even below it. It usually has to do with egos and the like, as well as one thinking their thoughts should be law.
When faced with strife or discontent, the true nature of a man is brought forth. It is then when we see the character of the individual. It is then we are able to tell if he is mature enough to grin and bare it, or subject his fellow man to his complaints and woes.
Apprentice Member
Joined: 1/22/09
Being a lot brighter than most of you noobs, let me offer this through a tacit example:
1. Human adopts cat. Human feels smart.
2. Human meets Flying Spaghetti Monster. Human feels stupid.
Life's flavo(u)r often arrives from the interactions with those lesser than you. Do not shun them. I work (now) as an asset compiler for a worldwide top 10 (100 billion +) bank.
If you ever want to feel meh, hang out with some of the macro analysts that do derivative forecasting at one of these places. You'll be glad you can melt face via stunted noobs whenever you hop online.
Hard Core Member
Joined: 1/02/08
Let em put a slave ring thru u're nose u're prob not going to like where they're taking you. Think.
I'm surprised at all the people who said, "yes." I thought for sure they would vote "no" as I did. It sounds like another way to troll people. I don't think much of people who go to scientists to get preg, either. The lab is allowed to keep the fertilized "specimens" that are not inserted in a women's uterus for experimentation. All those scientists who hack away on unborn children would pass an IQ test with flying colors! So intelligence, tho helpful in survival situations, is NOT the most important aspect of human behavior. Try compassion.
Best console game: DD Dark Arisen. Best mmo: GW2. Best game series ever: The Sims.
Novice Member
Joined: 6/10/06
This is kind of an interesting question because as others have pointed out it would do nothing to improve the quality of the mmo community on a social level, in fact it could hurt it. However it would improve the skill of the people you play with, which is probably a good thing - but modern day mmos don't really require competence to play, so does that really matter? Id check it out, but if its not a good game i wouldn't stick around just to be part of some special club.
The messiest part of all this is that we already all play together, the higher and the lower. Anything claimed about the higher already exists in these games, same with the lower even though they aren't on the hot seat for the topic.
Thanks everyone for participating no matter your opinion. This one got lively. I don't want to artificially bump it by responding but it was so tempting to not jump in sometimes I posted more than normal because of that pondering I already had some of my thoughts about how I would argue the in favor of while maintaining that the results weren't concrete knowing that it could be viewed as separatism but that one was an easy debate, we see that all the time. It worked out well because not many were in favor in type, guess the majority of them kept their reasons to themselves.
Have fun with it if there is any juice left in the conversation, I'm done making long posts.


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To The Editor:
We are writing to encourage Waitsfield voters to vote yes next Tuesday, October 22, in support of a new town office. The $850,000 in grants and gifts that have been secured by the town provide a once-in-a-lifetime opportunity. We are now positioned to build a new, energy-efficient office that can be designed specifically to meet the town's needs in a great location at minimal cost to local taxpayers. In addition to the new offices, the Farm Stand location offers many other advantages to Waitsfield residents, including greatly enhancing the future use of the town-owned polo field for a wide range of recreational and cultural activities.
We support a creative, fiscally sound approach to the preservation and adaptive reuse of the Methodist Church. However, we think the evidence is clear that trying to make that site work for a new town office is not the right answer for the town and all of us taxpayers.
Let's seize the moment and the good fortune that has come the town's way by moving forward with the Farm Stand site.
Audrey and Phil Huffman


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