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I see a fair number of children between the ages of 4-7 who complain about headaches and tummy aches. This is a common age for children to begin talking about "aches and pains". I know this from my own parenting experience, as I had a child who for several years had frequent tummy aches. They usually appeared after breakfast while en route to school, or when he had to get to his piano lesson, or maybe a sporting event he just wasn't in the mood for that day. They seemed to be random complaints but they were frequent.
The advantage that I had is that I knew a bit about kids and stomach aches. He was growing well, he slept well at night and those tummy aches did not wake him up from his sleep (once he finally went to bed). He did not have a fever with these mystery tummy aches. He did not vomit (okay once in a while he got that vomit bug, but not all of the time). His stools were "normal", in other words he was not always having diarrhea, nor was he constantly constipated and there was not blood in his stool. But, he sure did talk about his tummy a lot!
So, I asked his teacher (who was also a mother) about his tummy aches, and she said that he did sometimes complain, but it usually did not last long. She was very good at reassuring. He occasionally went to the nurse (another mother) where he was allowed to get a peppermint or lie down for a bit before being sent back to class with a hug and an encouraging word. Fortunately, they were not calling his parents to pick him up every time his tummy hurt.
Next, I asked his friend's parents. When he was in carpool with them was he complaining, did he complain when he was at their house playing etc, etc? I also asked them and myself, "was he missing birthday parties or play dates because of these tummy aches." I mean over and over again?
So, luckily I did not "GOOGLE" abdominal pain and decide that he had stomach cancer, an ulcer, gallbladder disease, celiac disease, a parasite, an allergy to food etc. He just had little boy tummy aches. Does that come up on GOOGLE? Is there ever an answer that it might be something that is not terrible?
But when a parent comes in with their child for evaluation of tummy aches I often find that the parent has been quite anxious about what is causing their child's stomachaches, and they are now obsessing about it. They ask their child all of the time "does your tummy hurt?" They have found articles about "child with tummy ache has a worm that eats stomachs". "Dr. Sue we have to do blood tests and tummy tests!"
Anxiety from a parent can often be sensed by a child. So can a parent's reaction to a child's complaints are very important. That is not to say that you should ignore your child. But rather maybe acknowledge the "ache or pain" and then start thinking about your child's overall health picture, rather than just the tummy (or head etc)
You may be relieved like I was that the tummy aches, while persistent were not alarming, but they were there, for a long time. They eventually went away to be replaced by something else.
I know for a fact in both parenting and practicing that BAD THINGS get worse. There are new symptoms or worsening of symptoms that will declare themselves before "the stomach is eaten by the mysterious worm".
Lastly, as we get to the end of school I often remind parents to see how that tummy ache is in June, July and August. I bet I don't see many tummy aches until after Labor Day and that is reassuring for all of us.
That's your daily dose for today. We'll chat again tomorrow.
- Food Allergic Kids Should Carry More Than One Epi Pen
- Food Allergy Awareness Week
- Early Talkers
- Advice from My Mom
- Cognitive Behavioral Therapy


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A method and apparatus for treating heart failure is configured to be placed about at least a portion of a patient's heart to apply a mild compressive force on the heart over a range of elastic deformation of the apparatus. The apparatus can be shifted to second range of deformation. In some embodiments, the apparatus is shifted to the second range of deformation by application of a stimulus or alteration of environmental conditions beyond a threshold level.
1-32. (Canceled)
33. A cardiac harness for treating a heart, comprising:
a cardiac harness having a premounted size; and
the cardiac harness premounted size being about 25% to about 70% of the size of the heart prior to the harness being mounted on the heart.
34. The cardiac harness of
35. The cardiac harness of
36. The cardiac harness of
37. The cardiac harness of
38. The cardiac harness of
39. The cardiac harness of
40. The cardiac harness of
41. A cardiac harness for treating a diseased heart, comprising:
a cardiac harness having a premounted size;
the cardiac harness premounted size being about 25% to about 70% of the size of the heart prior to the harness being mounted on the heart; and
the cardiac harness being configured so that the harness is elastically deformed as the harness is mounted on the heart thereby automatically applying a compressive force on the heart.
42. The cardiac harness of
43. The cardiac harness of
44. The cardiac harness of
45. The cardiac harness of
46. The cardiac harness of
This application claims priority to U.S. Provisional Application No. 60/335,437, which was filed on Oct. 31, 2001, the entirety of which is hereby incorporated by reference.
1. Field of the Invention
The present invention relates to a device for treating heart failure. More specifically, the invention relates to a cardiac harness configured to be fit around at least a portion of a patient's heart.
2. Description of the Related Art
Congestive heart failure ("CHF") is characterized by the failure of the heart to pump blood at sufficient flow rates to meet the metabolic demand of tissues, especially the demand for oxygen. One characteristic of CHF is remodeling of at least portions of a patient's heart. Remodeling involves physical changes to the size, shape and thickness of the heart wall. For example, a damaged left ventricle may have some localized thinning and stretching of a portion of the myocardium. The thinned portion of the myocardium often is functionally impaired, and other portions of the myocardium attempt to compensate. As a result, the other portions of the myocardium may expand so that the stroke volume of the ventricle is maintained notwithstanding the impaired zone of the myocardium. Such expansion may cause the left ventricle to assume a somewhat spherical shape.
Cardiac remodeling often subjects the heart wall to increased wall tension or stress, which further impairs the heart's functional performance. Often, the heart wall will dilate further in order to compensate for the impairment caused by such increased stress. Thus, a vicious cycle can result, in which dilation leads to further dilation and greater functional impairment.
Historically, congestive heart failure has been managed with a variety of drugs. Devices have also been used to improve cardiac output. For example, left ventricular assist pumps help the heart to pump blood. Multi-chamber pacing has also been employed to optimally synchronize the beating of the heart chambers to improve cardiac output. Various skeletal muscles, such as the latissimus dorsi, have been used to assist ventricular pumping. Researchers and cardiac surgeons have also experimented with prosthetic "girdles" disposed around the heart. One such design is a prosthetic "sock" or "jacket" that is wrapped around the heart.
Although some of the above-discussed devices hold promise, there remains a need in the art for a device for treating CHF to prevent a remodeled heart from further remodeling and/or help reverse remodeling of a diseased heart.
In accordance with one aspect of the present invention, an organ reshaping device is provided. A reshaping member of the device is comprised of elastic material, and is configured to be placed about at least a portion of the organ such that the elastic material is subject to substantially the same environmental conditions as the surface of the organ. The elastic material has an elastic characteristic which: a) changes upon alteration of the environmental conditions beyond a threshold level; and b) remains at least partially changed upon return of the environmental conditions from beyond the threshold level to an unaltered level.
In accordance with another embodiment, an organ reshaping device for exerting a force on an organ comprises a bending member configured to be placed in contact with the organ so that the organ urges the bending member into a deformed shape relative to an at rest shape of the member, and the bending member exerts a bending force on the organ. The bending member has a first elastic deflection range and a second elastic deflection range, and may operate over only one deflection range at a time. Further, the bending member is responsive to inputs to shift between the first and second elastic deflection ranges.
In accordance with still another aspect of the invention, a method is provided comprising providing a harness comprised of a shape memory material and placing the harness around an organ while the shape memory material is in a generally martensitic state. The method further includes raising the temperature of the shape memory material to transform the shape memory material to a generally austenitic state so that the harness generally hugs the surface of the organ.
In accordance with a further aspect, a method of reshaping an organ from an initial shape to a desired shape is provided. A reshaping harness is placed about at least a portion of the organ, said placing comprising elastically deforming the harness such that reshaping forces in response to the deformation are applied by the harness to the organ within an elastic deflection range of the harness. The reshaping forces urge the organ from the initial shape towards an intermediate shape between the initial shape and the desired shape. After the organ has assumed the intermediate shape, the elastic deflection range of the harness is altered so that the reshaping forces act within the altered deflection range to urge the organ from the intermediate shape towards the desired shape.
In accordance with yet another aspect, the present invention provides an organ shaping device for exerting a force on an organ. A bending member is configured to be placed around at least a portion of the organ so that the organ urges the bending member into an expanded deformed shape relative to an at rest shape of the member, and the bending member exerts a bending force on the organ that tends to squeeze the organ. The bending member comprises a material configured to increase in stiffness as the temperature of the material is increased within an operational range of temperatures.
In accordance with a further aspect, the material comprises a shape memory material.
In accordance with another aspect of the present invention, a method comprises providing a harness comprised of a shape memory material having an at rest shape and placing the harness around an organ. The placing comprises expandingly deforming the harness from the at rest shape so that the harness fits around at least a portion of the organ and the harness applies a pressure onto the organ in resistance to the deformation. The shape memory material is in a generally austenitic state when at a temperature of the organ.
Further features and advantages of the present invention will become apparent to one of skill in the art in view of the Detailed Description of Preferred Embodiments which follows, when considered together with the attached drawings and claims.
As discussed in Applicants' co-pending application entitled "Expandable Cardiac Harness For Treating Congestive Heart Failure," Ser. No. 09/634,043, which was filed on Aug. 8, 2000, the entirety of which is hereby expressly incorporated by reference, it is anticipated that remodeling of a diseased heart can be resisted or even reversed by alleviating the wall stresses in such a heart. The present application discusses certain embodiments, methods of manufacture, methods of use, and advantages of devices for reducing such cardiac wall stresses. Additional embodiments and aspects are also discussed in Applicants' co-pending application entitled "Device for Treating Heart Failure," Ser. No. 10/242,016, which was filed on Sept. 10, 2002, the entirety of which is hereby expressly incorporated by reference.
The term "cardiac harness" as used herein is a broad term that refers to a device fit onto a patient's heart to apply a compressive force on the heart during at least a portion of the cardiac cycle. Other devices that are intended to be fit onto a heart and are referred to in the art as "girdles," "socks," "jackets," or the like are included within the meaning of "cardiac harness."
The cardiac harness 32 illustrated in
In the embodiment illustrated in
With reference to
In the embodiment shown in
As discussed above, the undulating spring elements 34 exert a force in resistance to expansion of the heart 30. Collectively, the force exerted by the spring elements tends toward compressing the heart, thus alleviating wall stresses in the heart as the heart expands. Accordingly, the harness helps to decrease the workload of the heart, enabling the heart to more effectively pump blood through the patient's body and enabling the heart an opportunity to heal itself. It should be understood that several arrangements and configurations of spring members can be used to create a mildly compressive force on the heart so as to reduce wall stresses. For example, spring members can be disposed over only a portion of the circumference of the heart or harness.
As can be appreciated, a variety of hinge/spring designs and arrangements can be used in embodiments of cardiac harnesses.
The embodiment shown in
With next reference to
With reference next to
In accordance with further embodiments, one, several or all strands of a cardiac harness can have an aspect ratio configured such that out-of-plane deformation occurs during extension of the strand. In such embodiments, the inwardly-jutting portions are directed against the heart wall, increasing the friction between the harness and the heart. As such, the out-of-plane deformation helps anchor the harness to the heart. In a preferred embodiment, at least one strand of spring elements at or adjacent the base of the harness is configured so that the spring elements display out-of-plane deformation when the strand is longitudinally deformed. As such, anchoring forces are focused at or near the base of the harness. In further embodiments, one or several spring elements of a strand are configured to display such out-of-plane deformation.
In the embodiment illustrated in
During the cardiac cycle, cardiac wall stress is greatest at or near the end of diastole DF, when the left ventricle has been filled with blood to be pumped into the vasculature of the patient. Conversely, wall stress is lowest at the beginning of diastole DS, before the ventricle has been filled. In accordance with embodiments described in more detail below, a cardiac harness can be configured to take advantage of the properties of various materials in order to minimize the applied force at the beginning of diastole DS and maximize the applied force of the harness at or near the end of diastole DF.
With reference next to
The stress/strain characteristics of the material as illustrated in
As depicted in
Although the embodiment depicted in
With next reference to
The curve 94 of
In the same manner as used in
Studies have indicated that relieving cardiac wall stress can significantly benefit a diseased heart, especially an enlarged heart. As wall stress is relieved, the heart muscle is better able to rest. Also, the pumping load on the heart is decreased significantly. Reducing wall stress in an enlarged heart will help stop and may even reverse enlarging, or remodeling of the heart. In this manner, the cardiac harness can function as a reshaping member, or reshaping harness, to help reshape or reverse remodel, a diseased heart.
As a heart reverse remodels, the size of the heart will tend to decrease; thus, the size of the heart at the beginning and end of diastole will change. For instance, in
As illustrated in
With continued application of a compressive force to relieve cardiac wall stresses, it is anticipated that the heart will continue to reverse remodel and become even smaller still. As such, the size of an even further reverse remodeled heart at the beginning and end of diastole, represented in
With specific reference next to
In the embodiments discussed above, the cardiac harness has been shown to facilitate reverse remodeling of a heart. However, as the heart reverse remodels, the magnitude of the compressive force exerted by the harness becomes less and less, as shown in
In accordance with another embodiment, the cardiac harness can be constructed of a shape memory/superelastic material, such as one of the family of nickel titanium alloys known as Nitinol. Such a harness can be configured so that it is easily adjustable and can be repeatedly tightened about a patient's heart as the heart becomes smaller as a result of reverse remodeling. In this manner, the benefits of the mild compressive force exerted by the harness can be achieved over a wider range of heart sizes, and the degree of reverse remodeling of a heart will not be limited by the elastic range of the harness.
Nitinol is a material having structural and mechanical characteristics that are particularly suitable for cardiac harness applications. In order to appreciate these characteristics and to better describe embodiments comprising Nitinol, a basic understanding of the behavior of Nitinol alloys is helpful.
Nitinol exhibits transformational superelasticity, which refers to the ability of a material to reversibly transform a crystal structure upon the application of stress so that the material can undergo large elastic deformations without substantial plastic deformation. This type of superelasticity is exhibited when one crystal structure of the material transforms into another crystal structure. In Nitinol, a first crystal structure or phase is known as the austenitic phase, and a second crystal structure is known as the martensitic phase. In one state of the material, a Nitinol material is generally in a martensitic phase. In another state, a Nitinol material can be generally austenitic. In further states, a Nitinol material can be partially austenitic and partialy martensitic.
As discussed above, the family of Nitinol materials comprises various nickel titanium alloys. The alloys generally exhibit similar behaviors, although properties may vary somewhat between particular alloys. One property that is common among Nitinol alloys is that at relatively higher temperatures, Nitinol is at rest in the austenitic phase, and at relatively lower temperatures, Nitinol is at rest in the martensitic phase. More specifically, at temperatures above an austenite finish temperature AF, unstrained Nitinol can be expected to be in the austenitic phase. The martensitic phase is not stable at such temperatures, and will automatically transform to the austenitic phase when the material exceeds an austenite finish temperature AF. In practice, martensite transitions to austenite as the martensite is heated. The transition from martensite to austenite begins at an austenite start temperature AS. At the austenite finish temperature AF, the phase transformation is substantially complete, and relaxed Nitinol is substantially completely in the austentic phase.
However, austenitic Nitinol can be transformed into martensitic Nitinol, even at temperatures above the finish temperature AF, by inducing stress to the material.
As discussed above, martensite is unstable at temperatures above the austenite finish temperature AF. When stress-induced martensite is unloaded, the material will automatically return to its austenitic phase along the unloading curve 122. With continued reference to
With continued reference to
Once the martensite has been unloaded, it can be repeatedly elastically loaded and unloaded, but will remain within the new elastic deformation range 160, as shown in
As discussed above, martensite is unstable at temperatures above the austenite finish temperature AF, and will automatically begin to transform into austenite if subjected to temperatures above the austenite start temperature AS. If thermally-induced martensite is heated to a temperature above the austenite finish temperature AF, the martensite will spontaneously transform into austenite. However, if the material is under stress, or has been strained, it will behave like stress-induced martensite and will follow the generally flat unloading plateau 122 depicted in
One way of controlling the shrinking of the Nitinol while at a temperature above the austenite transition temperature AF is to introduce an obstacle that prevents the Nitinol from shrinking beyond a certain size. For example, an obstacle may prevent the Nitinol device from shrinking beyond size Y in
The transition temperatures AS, AF, MS, MF discussed above are partly a function of the particular Nitinol alloy employed and partly a function of the heat treatment to which the alloy is exposed. As such, through the use of known heat treatment methods, a Nitinol alloy can be customized to have austenite start and finish temperatures AS, AF and martensite start and finish tempratures MS, MF as desired for a particular Nitinol cardiac harness embodiment.
Further, throughout this specification, applicants employ a "functional" use of the transition temperatures AS, AF, MS, MF. Such a functional use is based upon the observed behavior of the Nitinol material in an embodiment of a cardiac harness rather than upon a molecular analysis of the material. For example, in this specification the functional austenite finish temperature AF is the temperature about at which the material begins to exhibit properties and behavior of substantially fully austenitic Nitinol. The functional austenite finish temperature AF does not necessarily require that 100% of the Nitinol, at a molecular level, is in the austenitic phase.
In a preferred embodiment, a cardiac harness is constructed of a Nitinol material having an austenite finish temperature AF above a normal human body temperature. Such a Nitinol material may be provided by using a particular alloy of Nitinol and/or by appropriately heat treating Nitinol in a known manner. The Nitinol harness of this embodiment preferably will be in a thermally-induced martensitic condition while inside the human body.
The thermally-induced martensitic Nitinol harness is sized so that when it is at rest it is substantially smaller than the diseased heart upon which it is to be placed. Additionally, the at rest size preferably is smaller than or about the same as a target heart size of the patient.
With next reference to
As can be seen in
As also discussed above, application of the mild compressive force will tend to help the diseased heart reverse remodel so that the size of the heart will decrease, and correspondingly the size of the heart at the beginning and end of diastole decreases. In a similar manner as discussed in connection with
In the illustrated embodiment, the Nitinol harness can be adjusted so as to move from the elastic deformation range A′ to a new elastic deformation range B′. To adjust the harness, the temperature of the harness is increased above the austensite finish temperature AF of the Nitinol material. There are many ways to apply thermal energy to raise the temperature of a Nitinol reshaping harness. For example, application of electricity, warm liquids, etc., can raise the temperature as desired.
With continued reference to
The warm liquid will soon disperse or cool to body temperature, which preferably is below the martensite transition temperature MF. Thus, the Nitinol harness will resume its thermally-induced martensitic structure and will again exhibit behavior along the curve 150 of
As time passes and the heart further reverse remodels, the heart will become yet smaller still. Eventually, as happened previously when the harness was operating in elastic range A′, the size of the further reverse remodeled heart at the beginning and end of diastole (now labeled D″S, D″F) will be such that the harness, when operating in elastic range B′, no longer helps the heart further reverse remodel. At or near such time, the procedure described above, wherein the harness is warmed to a temperature above the austenite finish temperature AF so that the harness shrinks to the current size of the heart, and then cools back below the martensite finish temperature MF, is repeated. The harness is again fit snugly about the heart and the elastic range shifts from range B′ to a new range C′.
As can be appreciated, the adjustment process can be repeated as often as desired or until the heart has reverse remodeled to a point at which the patient and clinician are satisfied with the results. This process can also be controlled so that the heart reverse remodels to a target heart size. The harness can be configured and manipulated to exert substantially no compressive force at the beginning of diastole when the heart has reached its target size.
As shown in
This principle is especially beneficial in improving the safety of the harness, because the maximum reshaping force of the ranges remains substantially the same over the working range of the harness, even though the size of the harness can change. As such, the harness preferably is sized and configured so that the maximum reshaping force does not exceed a predetermined value during use of the device. For example, in one embodiment, a cardiac harness is sized and configured relative to the diseased heart to be treated so that the compressive force exerted by the harness on the heart will never exceed about 20 mmHg. In another embodiment, the compressive force limit can be about 15-17 mmHg.
The above-described harness embodiments are relatively easy to install and adjust. Minimally invasive methods can be used to install the Nitinol harness around the heart. Additionally, the clinician need not worry excessively about deforming the harness unevenly or sizing the harness imprecisely when installing the apparatus around the heart. This is because even if the apparatus is somewhat larger than the heart, the apparatus will operate in a range of elasticity which will include the size and shape of the heart. Besides, the harness can be easily adjusted at any time as discussed above so as to fit snugly around the heart.
In an additional embodiment, during installation, the clinician stretches the harness during installation so that the harness it is larger than the heart. This allows the clinician to install the harness minimally invasively and with relatively little need to avoid deforming the harness to be larger than the heart. After the harness is wrapped, perhaps loosely, around the heart, the clinician bathes the heart and harness in a warm liquid having a temperature above the austenite finish temperature AF of the harness. In a manner as described above, the harness will shrink to substantially conform to the size and shape of the heart. As the liquid cools to body temperature, the harness again cools to a thermally-induced martensite structure and operates in an anticipated elastic range. As such, the clinician needs only very little precision in installing the harness over the heart, yet the harness will be shaped to match and hug the heart once installed.
In a further additional embodiment of a method for installing and using embodiments of the harness, after installation of the harness on the patient's heart, the patient's pericardium is substantially closed by the clinician. With the pericardium substantially closed, the heart can be bathed in a warm saline or water solution by simply injecting the warm liquid into the space between the pericardium and the heart. The warm liquid will be held in that space, and thus will be able to substantially evenly heat the harness to a temperature above the austenite finish temperature AF. The clinician may allow the warm liquid to cool and then naturally disperse from the pericardium, or the clinician can suck the warm liquid out of the pericardium by using the same medium used to deliver the liquid. Even if the pericardium is not substantially closed by the clinician, the heart and harness still can be bathed in warm water in order to heat the harness as desired.
As discussed above, the process of warming the harness so that it adjusts itself snugly about the patient's heart can be repeatedly performed in order to accommodate and encourage reverse remodeling. Preferably, the repeated adjustments are performed by injecting warm liquid between the closed pericardium and the heart, as just discussed. This operation can be conveniently and safely performed by a surgical procedure such as a procedure similar to the well known pericardiocentesis procedure.
With next reference to
With next reference to
In the illustrated embodiment, two wire leads 202 are disposed on the harness 32, one near the base 52 of the harness and the other near the apex 56. In an additional embodiment, several wire leads are provided, and the internal controller selectively actuates the leads in accordance with a control system so that only certain pairs of leads are actuated at any one time. As such, the internal controller controls how the harness is adjusted on the heart. For instance, in one embodiment, leads near the base of the heart are actuated before leads near the apex. As such, the size of the harness 32 is adjusted from the base 52 towards the apex 56. This helps maintain the position of the harness upon the heart, because if the harness were made tighter about the apex than it is about the base, there may be an increased tendency for the harness to be pulled toward the base, and the fit of the harness 32 on the heart 30 may be compromised.
In embodiments discussed above, the behavior of the Nitinol cardiac harness has been depicted as movable between the curves of
In a still further additional embodiment, a Nitinol cardiac harness is provided having an austenite start temperature that is less than a patient's normal body temperature, about 37� C. As such, the harness is partially austenitic during normal operation within a patient's body, and will exhibit characteristics of both austenite and thermally-induced martensite.
With next reference to
An applied pressure within a therapeutic range is defined herein as a pressure of sufficient magnitude that, when applied to an organ such as the heart, results in a benefit to the organ. In one embodiment, the therapeutic range for a cardiac harness is between about 5-20 mmHg. More preferably, the therapeutic pressure is about 7-15 mmHg.
In another embodiment of a Nitinol cardiac harness, the harness is treated to have an austenite start temperature AS below room temperature, about 30-33� C. As such, the stiffening properties of austenite help the harness to hug the heart even if the harness and heart are exposed to relatively-low room temperatures during harness installation. Of course, when installation is complete and the harness warms to the patient's body temperature, the proportion of austenite rises, and the pressure exerted by the harness will correspondingly rise. In a still further embodiment, a harness having an AS below room temperature has an austenite finish temperature AF below body temperature so that the harness is substantially fully austenitic during operation. Alternatively, the AF remains above body temperature so that the harness remains at least partially martensitic.
With continued reference to
With next reference to
In accordance with embodiments-discussed above, the cardiac harness is deformed from an at-rest, unstretched size and shape to a stretched configuration in order to be installed on a patient's heart and apply a therapeutic pressure thereon. In such embodiments, the harness can be extensively deformed from its at-rest size and shape. In accordance with one embodiment, the unstretched size of the harness is about 25-70% of the size of the enlarged heart to be treated. More preferably, the at rest size of the harness is about 30-50% of the size of the enlarged heart to be treated.
The principles discussed above can be applied to any number of other embodiments. Such embodiments can comprise modifications of the embodiments discussed above or can comprise totally different products. More specifically, aspects of the cardiac harness embodiments discussed above can be applied to other types of apparatus for reshaping organs. As such, various reshaping harnesses or reshaping devices can apply aspects of the above-discussed cardiac harness embodiments for other uses and organs.
As a patient's heart enlarges during congestive heart failure, the annulus of certain valves, such as the mitral valve, tends to grow with the heart. Eventually, the valve annulus may increase in size to a point at which the leaflets are not large enough to completely close the valve. Another factor contributing to valve dysfunction is that as the heart enlarges, the geometry of the heart changes somewhat. Portions of the heart such as the papillary muscles are moved outwardly from the leaflets to which the papillary muscles are attached via the chordae tendinaea. These papillary muscles may be stretched to their limit so that they prevent the valve leaflets from adequately approximating each other. As such, the leaflets will not be able to fully close, and the valve will leak; such valve leakage simply makes the patient's heart problems worse.
In accordance with another embodiment, a harness or collar comprising one or more rows of undulating springs/hinges can be configured to exert a compressive force on specific portions of a heart so as to help prevent or diminish valve dysfunction. For example, a collar-type device comprising one or more undulating hinges can be specially configured to fit around a region of the heart known as the AV groove. The AV groove is generally adjacent the mitral and tricuspid valves of the heart. An AV groove collar can be arranged and configured according to the principles discussed in this application so as to exert a compressive force that will tend to decrease the size of the valvular annuli and/or prevent enlargement of the valvular annuli beyond a desired size.
In another embodiment, a papillary muscle band can be provided, comprising a plurality of undulating springs/hinges specifically sized and configured to be placed around the heart in the area of the papillary muscles. As known in the art, the papillary muscles are generally midway between the AV groove and the apex of the heart. Thus, a papillary muscle band can. exert a compressive force to reduce the diameter of the heart at the level of the papillary muscles. This will help the papillary muscles become less stretched so that they do not prevent closure of the valve leaflets.
As discussed above, a cardiac harness applies a mild compressive force on a patient's heart. It is anticipated that embodiments of an AV groove collar and papillary muscle band will exert a more aggressive compressive force than a typical cardiac harness. It is also anticipated that the AV groove collar and papillary muscle band can be used independent of one another or in conjunction with one another and either independent of or in conjunction with a cardiac harness. For example, a papillary muscle band can be placed on the heart before or after installation of a cardiac harness.
In still further embodiments, portions of a cardiac harness can be provided with varying stiffness, and an AV groove collar and papillary band can be incorporated into a cardiac harness so as to apply specially-directed forces to the specific portions of the heart.
Embodiments of an AV groove collar and papillary muscle band can be manufactured of Nitinol or other shape memory material. As such, these devices can be placed upon a heart without worrying about fitting the devices too closely. Applying heat will then shrink the devices so that they fit snugly about the respective portions of the heart. Additionally, these devices can be adjusted after the initial installation so as to prolong the beneficial effect anticipated by such devices.
In accordance with still further embodiments, reshaping harnesses made of material such as Nitinol can be used to change the shape or affect the function of various organs within the body, and can be adjusted in place so as to apply a reshaping force on those organs.
It is not uncommon for certain relatively obese patients to undergo a procedure known as stomach stapling. In this procedure, the size of the stomach is reduced so as to correspondingly reduce the appetite and food intake of the patient. In another embodiment having aspects of the present invention, a stomach harness or gastric band can be provided that is configured to fit substantially around at least a portion of a patient's stomach. The harness applies a compressive force on the stomach so as to substantially restrict the size of the stomach. The device can be installed relatively loosely around the stomach and then be heated briefly so as to shrink the device tightly about the stomach. The device will then exert a force on the stomach that will tend to reduce the stomach size and reduce the patient's appetite. Of course, this device can later be tightened again and again by repeatedly supplying heat to the device.
Yet another advantageous embodiment of the device is used to treat aneurysms in various regions of the body such as, for example, in the brain, a ventricle, or the aorta. Such aneurysms often contain clotting blood or the like and it is not necessarily advantageous to completely and suddenly reshape the aneurysm or return it to its original shape. In contrast, it may be preferable to slowly urge the aneurysm back to its original and intended shape. A harness-type band can be installed about the aneurysm and configured and adjusted to fit snugly over the aneurysm, while exerting a mild compressive force thereon. As time passes, the aneurysm will be slowly reshaped. If necessary, the compressive band can also be adjusted in a manner as described above. As such, a flexible Nitinol band can controllably and safely treat an aneurysm.
In still another embodiment, a Nitinol harness can be useful in retinal surgery. It is common in retinal surgery to apply a scleral band or scleral buckle about a patient's eyeball at the completion of the surgery. In one embodiment, a ring-shaped scleral band is preferably constructed of Nitinol having an austenite finish temperature AF below normal body temperature. Thus, the band can be expanded to be easily placed around the patient's eyeball, and will automatically constrict to hold itself snugly on the eyeball. In another embodiment, the scleral band is constructed of Nitinol having an austenite finish temperature AF above human body temperature. Thus, a clinician can deform the band to fit it over the patient's eye and then can apply heat so that the band shrinks down to the size of the eye. After the band cools to the thermally-induced martensite condition, it will exert a mild compressive force on the eye, but will be still be relatively flexible.
In still further embodiments, a Nitinol reshaping harness can be used in other applications such as, for example, compression bandages, which help reduce swelling immediately after surgery.
Although the embodiments discussed above have been discussed specifically in light of Nitinol, it is to be understood that various other materials can be used for a cardiac harness and can employ some or all of the aspects discussed herein. For example, non-Nitinol superelastic and/or shape memory materials can exhibit properties and behavior that is similar to, if not the same as, at least some of the aspects of Nitinol as discussed above. For example, other materials exhibit transformational superlasticity. Some suitable cardiac harness materials can include metals and polymers such as oligo (e-caprolactone), dimethacrylate, Elgiloy™, titanium and tantalum.
The devices in the above embodiments have been described as comprising a plurality of hinges or spring elements. It should be understood, however, that a variety of configurations and arrangements that allow the harness to expand and contract would be acceptable. For example, in other embodiments, a harness-type device can be constructed of expandable, braided filaments. Such embodiments can be constructed of a variety of materials, but, if shape memory/superelastic materials such as Nitinol are used, these devices can take advantage of the principles and characteristics described above.
Although this invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof. In addition, while a number of variations of the invention have been shown and described in detail, other modifications, which are within the scope of this invention, will be readily apparent to those of skill in the art based upon this disclosure. It is also contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments may be made and still fall within the scope of the invention. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for one another in order to form varying modes of the disclosed invention. Thus, it is intended that the scope of the present invention herein disclosed should not be limited by the particular disclosed embodiments described above, but should be determined only by a fair reading of the claims that follow.
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subset: commoncrawl


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Splash into the deep for an exciting underwater treasure hunt! Four coins and two giant gems are the "booty" in this swashbuckling pool adventure. Be the first to slot them into the floating treasure chest to win . . . or use the included game ideas to inspire hours of variety and fun.
Extension Activities: More Ways to Play and Learn:
- UNDERSEA TREASURE HUNT (2 players)
Toss these coins and gems into the briny deep of the
swimming pool, then see how many you can gather in the treasure chest before the other pirates do!
- Toss the "booty" (coins and jewels) into the pool. On the count of three, start your treasure hunt! Each player must collect two coins and insert them into the treasure chest first. After "paying the octopus," a player may hunt for one of the red and green jewels. The first to come out of the water holding a jewel is the winner!
- Bring one of the jewels to the surface using only the coins to lift it. You may use one or two coins, and you may use coins of any color, but no hands allowed, matey! The first to bring a jewel to dry land earns the title of "captain." (For a single-player game: Bring a jewel to land, deposit the coins into the treasure chest, and return to the water for the other coins and jewel.)
- More play ideas available!
Dimensions: 9.5" x 9" x 5.75" Packaged
Recommended Ages: 6+ years
Adult supervision required.
Item #6672


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Some might call it an odd pairing—and Army ROTC program housed at a Jesuit university in the heart of one of the country's most liberal cities—but the ROTC program at USF has found a peaceful coexistence, turning out leaders that are making the university and the U.S. Army proud.
Kelli Ishihara felt confident in her leadership abilities. As a captain on her high school track team, both her coaches and fellow athletes looked to her to help keep the team organized at track meets and make sure athletes were at their events on time.
Now, as a senior at the University of San Francisco, Ishihara says that level of leadership was nothing compared with what she handles as a cadet in the Army Reserve Officers' Training Corps.
A recent week found her helping to plan the battalion's combat water survival exercise in the pool at the Koret Health and Recreation Center. The training includes a 10-minute swim in uniform and a 25-meter swim holding a dummy rifle above the water. The logistics of the training—from coordinating with Koret staff to making sure cadets show up at the right time for the right tests—are up to Ishihara and other senior cadets. Yet, they know that handling the logistics is but on aspect of being a leader.
"In ROTC, you have to take on more of a teaching role, more so than in high school, providing direction to others," said Ishihara, a biology major who is applying to medical school with the hope the Army will pay for it in exchange for extended service. "Teaching is a big thing and during your senior year, it's your job to pass on your experience and knowledge to those less experienced in the program. That's a big thing—teaching and guiding of other people. Throughout, you have to keep in mind that you always have to represent yourself as a professional and conduct yourself in front of others in a professional manner."
Those can be challenging expectations for anyone, let alone a college student, but cadets in the program are preparing for leadership positions from the very moment they step into the Army jobs waiting for them.
—Lt. Col. Derek Reeve, USF military science professor
Ishihara, like all cadets, will graduate and earn her commission as an Army second lieutenant the same day. While the financial benefit of ROTC is most often what draws students to the program—four years of college completely paid for by the Army in exchange for eight years of service—cadets often cite leadership skills as the biggest non-monetary benefit, one that can serve them in the Army and beyond.
Yet despite being in good company—USF's ROTC program has grown by 38 percent in the past five years—Ishihara has chosen an educational path that is unfamiliar to many. Sure, it's difficult to miss the group of cam-
ouflage-clad cadets exercising on the slope of Lone Mountain, but few outside the program understand much about it, how the cadets benefit, or how their Army training fits in with a Jesuit education.
"Our main job is to make leaders," said Lt. Col. Derek Reeve, a military science professor at USF. "We're making the Army's leaders and the values piece of it is absolutely critical. From the first day on the job, officers are making decisions, from managing tax-payer-purchased equipment to looking out for other people."
Formally established in 1916, ROTC is a college-based officer-commissioning program and is the largest officer-producing organization within the American military. The USF battalion is one of the largest, as a percentage of the student body, in California, and the number continues to increase, currently enroll-
ing about 90 cadets. Although the battalion also includes students from several other local universities, including San Francisco State University, the vast majority of cadets are USF students.
The program draws cadets from all majors —currently 26 represented—as well as a number of female students. About 33 percent of cadets are women, well above the national ROTC average of 20 to 25 percent. Two of the three previous battalion commanders have been women.
Behind the numbers is a significant in-school commitment all cadets must make. In addition to the regular coursework required for their majors, cadets take a military science course each semester to learn the ins and outs of the Army. They also must participate in a weekly three-hour leadership lab that focuses on hands-on Army skills such as land navigation training, combat water survival training, and squad tactics.
That's all in addition to crack-of-dawn physical training in Hagan Gymnasium three times a week and a once-per-semester field training exercise that lasts from Thursday afternoon through Sunday afternoon. Often held on military bases, the field training hones cadets' land navigation skills—they use nothing but a compass—while also teaching them how to effectively issue orders to carry out whatever Army-related mission they're on. Both physically and mentally demanding, the training exercise often leaves cadets exhausted, just in time to begin a new week of classes and homework.
Cadets are expected to step into various leadership roles throughout their tenure in the program, helping to plan and implement trainings. As cadets progress through the program, they are given an increasing level of leadership responsibility. Freshmen and sophomore cadets, for example, primarily follow orders. Juniors and seniors give orders as they rotate through a variety of specific leadership positions in the battalion.
Just as a definite chain of command exists in the Army, so, too, does it exist in ROTC. The battalion's officers determine the focus of the weekly labs and the main objectives they want cadets to learn. The seniors then take that direction and plan out all the details for the weekly labs, from the specific drills to be done to the time and location. Junior cadets make sure sophomores and freshmen know where to be and when and what's expected of them during the trainings; juniors also typically run the trainings while the senior cadets evaluate how well they lead. A significant part of that leadership is learning to serve as a role model and to be comfortable speaking in front of groups. "I wasn't afraid of public speaking before ROTC, but I can definitely tell I'm better at it now," said Ishihara.
Additionally, cadets learn to trust their own judgment and to not be afraid to make decisions, but to do so in a way that takes into consideration their fellow cadets. "We're forced to work together and find a way to make things work and get things done without upsetting your peers, without stepping on their toes," Ishihara said.
Not only does the leadership experience prepare cadets for their Army careers, but it also helps ready them for the Leadership Development and Assessment Course (LDAC), a four-week program cadets attend at Ft. Lewis, Wash. between their junior and senior years. Throughout the program, cadets are given tactical tasks and situations to contend with and are evaluated on their leadership skills. That evaluation, along with other criteria, goes into the rank ordering of all senior ROTC cadets nationally. It's that ordering that determines whether cadets receive one of their top choices of branch assignments after graduation.
In addition to the four weeks at LDAC, many cadets participate even more fully in ROTC through activities such as Color Guard and Ranger Challenge. Sophomore history major Mike O'Connor, for example, was part of the battalion's nine-person Ranger Challenge team last year that placed first at a regional competition and is again training for the competition this year.
For ROTC cadets, the financial reward is great—four years at USF paid for, including housing—but it's no free ride.
Here's what is expected of cadets while they're in school:
The challenge, which provides cadets with physical and mental challenges while competing against other ROTC battalions, requires months of intense preparation.
For his part, O'Connor wakes at 5 a.m. every weekday to make it to a 5:45 a.m. physical training with his teammates. The specific exercises vary—some days it could be a full body circuit workout, other days may bring an 8-1/2-mile run up Twin Peaks—but each lasts until 7:30 a.m. That gives O'Connor barely enough time to rush back to his dorm room on Lone Mountain, shower, change, and make it to his 8 a.m. class. After a full day of classes, he and other Challenge members work on non-physical skills such as first aid.
It all adds up to a demanding schedule that requires O'Connor to stay not just on top of schoolwork, but ahead of it. "If it's an essay due in two weeks, then I start on it now," he said. "The time management aspect of ROTC has definitely been a challenge. I wasn't used to so much on my plate at one time."
It's a sentiment consistently echoed by cadets, all of whom are juggling the typical demands of college life with their ROTC obligations. As demanding as the physical component of ROTC can be, they say, the balancing of everything can be even more of a challenge. Like O'Connor, cadets must learn to plan ahead when it comes to assignments and even day-to-day preparation. There is no rolling out of bed, grabbing a backpack, and heading out to class just in time; like many cadets, O'Connor always preps his bags the night before.
Yet cadets say they don't feel as though they're missing out on typical college life. They have friends—both in the program and outside it—and enjoy downtime, especially on weekends.
"I do have less available time to watch TV, but that's not a big deal," said Ishihara.
More fundamental is less time available to sleep. Cadet Morgan Harper, a junior nursing major, aims to finish homework by midnight, but said she can only handle that and an early wake-up for physical training because she sneaks in naps whenever she can.
As Ishihara puts it: "I think everybody's sleep suffers a little bit in ROTC."
Still, the sacrifice, cadets say, is worth it. The program pays cadets' full tuition for four years and also provides $1,200 each year for books and between $300 and $500 a month for living expenses. As testament to USF's commitment to the ROTC program, the university pays for cadets' on-campus room and board for four years, a level of financial support few other universities offer.
If cadets fail any of these requirements, they lose their tuition scholarship for that semester.
For Harper, ROTC made attending USF a possibility. She'd longed to study nursing at USF, but had no idea how to pay for it. Financial aid wasn't available to her family, so she worried about her parents footing the entire bill.
"Going through college and not worrying about the finances is very comforting," said Harper. "The economy is rough right now and who knows how the economic state of the country is going to be when I graduate? I made the decision to join ROTC because of the financial and job security post-graduation. Instead of trying to dig myself out of a debt hole, I can focus on financially stabilizing myself with the income I'll have when I graduate and commission."
After graduating, all cadets have jobs waiting for them in one of the Army's branches, from infantry to military police to the Army Nurse Corps. And with USF's strong nursing school, the ROTC battalion has historically been one of the top producers of Army nurses.
—Cadet Morgan Harper, junior, nursing major
On college campuses across the nation, ROTC programs have been the target of criticism throughout the decades, with recent complaints often stemming from disagreement over the wars in Iraq and Afghanistan as well as the military's don't ask, don't tell policy regarding gay and lesbian soldiers. Some schools outright ban ROTC programs.
Yet at USF—in the heart of this most liberal city—ROTC cadets say they feel right at home. So much so, in fact, that many are surprised by the lack of reaction.
"I thought there was going to be some uneasiness with students, but people have been very accepting," Harper said. "I have yet to encounter a student or teacher or staff person who has said anything negative."
That's not to say there aren't misperceptions the program and its cadets try to remedy. Harper, for example, occasionally finds fellow students are surprised to learn she's in ROTC. Like other cadets, she doesn't often wear her uniform to class and instead favors perfectly on-trend clothes. Many students, she said, don't expect that from someone training for an Army career. Instead, Harper said, they think that anyone in the Army must be very rigid, structured, and politically conservative.
While that may describe some ROTC cadets, it is in no way true of everyone. "We're not all cookie-cutters," Harper said. "We have our own personalities."
What they do share is a desire to be leaders. While ROTC provides that very training, there remains a perception that the program is creating mindless followers, Lt. Col. Reeve said. No one is brainwashed and no one is being trained to kill, he said. Instead, cadets are learning to be leaders in their careers, which may include time on the battlefield. (The program has had a number of its graduates serve in the Middle East.) There is no boot camp or basic training involved since cadets will be commissioned officers and not enlisted soldiers.
Despite this, Lt. Col. Reeve sometimes runs into the belief that any college-aged person could qualify for ROTC. The reality is that there are far fewer scholarships available than the number of applicants, allowing each ROTC program—including USF's—to be even more selective about its cadets.
And at USF, ROTC officers know cadets will have a Jesuit education to draw on as they train to be Army leaders and once they actually step into those roles. While Lt. Col. Reeve sometimes finds himself discussing with cadets Jesuit philosophies they've learned in class, he says the connection between a Jesuit education and an Army career is more intrinsic. The Army's core values, which include such things as integrity and selfless service, are expected of those receiving a Jesuit education. "We probably hold our cadets to an even higher standard because they do go to a Jesuit school," Lt. Col. Reeve said.
As USF President Stephen A. Privett, S.J., explains, the university's mission is to offer a rigorous, humanizing education that enables students to fashion a more humane and just world for all—whatever their profession may be.
"Unless one is a total pacifist, defense forces are essential institutions and a respected profession," Fr. Privett said. "Armed forces are to nations what self defense is to individuals. The military profession, like all other professions, will be better served if and when it is led by persons in full possession of their humanity and committed to a better world. I like to think that the My Lai Massacre would never have happened were Lt. William Calley Jesuit-educated or that Jesuit-educated officers would have moved quickly to prevent the genocide in Rwanda and the vicious abuse of women, children, and innocent civilians in the Congo."
In fact, a Jesuit education will likely make cadets even better officers. Lt. Col. Reeve said cadets may not realize that now, but they will once they're dealing with any of the various ethical dilemmas they may face as leaders in the Army. It is then that they will understand the importance of having their ROTC training grounded in a Jesuit education.
"If USF can produce officers of high moral quality, who are concerned with doing the right thing, concerned with ethics," said Lt. Col. Reeve, "that's exactly what the Army wants."


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How do I get my password?
Your password is used for MyMtech, Moodle, E-Mail and Campus Computers.
To retrieve your password go straight to MyMtech.mtech.edu or click on MyMtech at the top of Techs Home Page.
Inside there you will see Sign In With CAS, right below that is New User? Start Here.
Click that Link and you will be prompted for your last name and student I.D. If you do not have your student I.D. you can find it on your Digger Card, admission acceptance letter or by calling the Registrar's Office at 406.496.4256. If you continue having difficulty retrieving your username and password, please contact the Computer Technology Services Help Desk at (406).496.4244 or by email at email@example.com.
The username is case sensitive, so it is important to enter it correctly. Students have the first 3 letters of their username capitalized, the rest are lower case. Example is listed when you retrieve your password.
Once you have your username and password, you are ready to login. The next screen you will see our Central Authentication Service (CAS) screen. CAS in our single sign on solution that allows you to seamlessly access MyMtech and Moodle without re-entering your username and password.


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Doltinn Brown, Payton Gentry, and Erika Taylor from Antlers High School FCCLA Chapter joined over 350 Family, Career and Community Leaders of America students and advisers at the Oklahoma State Capitol for FACS Day at the Capitol. The day's activities were planned by the Oklahoma Association Teachers of Family and Consumer Sciences and coordinated by Legislative Chairmen Ann Heard and Cindy Franks.
The February 21st event was designed to stress the importance of being a young leader in their families, careers, and communities. More than 350 students, representing over 55 chapters registered to attend the event, as well as the 11 state FCCLA officers and representatives from Oklahoma State University and East Central University.
The purpose of the visit was to meet with Oklahoma representatives and senators to update them on activities of FCCLA chapters in their legislative districts and to thank them for supporting the FACS program. Students had the opportunity to tour the capitol and be introduced in the House of Representatives and Senate.
"It was an exciting day," said Carolyn Cotton, OATFACS adviser. "A record number of students and advisers participated in this year's activities."
Shelley Moyer, Antlers FCCLA Advisor, stated the students were able to meet with our local Representative RC Pruett and Senator Jerry Ellis in their offices. They were informed the group of students about some important legislation that they (Pruett and Ellis) would be voting on in the near future. It was a very educational and informative day.
FCCLA is a dynamic national student organization that helps young men and women become leaders and address important personal, family, work, and societal issues through CareerTech's Family and Consumer Sciences Education. The organization is unique among youth organizations because it is the only CareerTech in-school student organization with the family as its central focus.
FCCLA is one of seven CareerTech student organizations affiliated with CareerTech career areas. The other six include FFA and Agricultural Education, BPA and Business and Information Technology Education, HOSA and Health Careers Education, DECA and Marketing Education, TSA and Technology Engineering, and SkillsUSA and Trade and Industrial Education.
[1] http://www.theantlersamerican.com/sites/default/files/FCCLA Day at Capitol.jpg


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The Chicago YIVO Society brings Yiddish and Jewish programming to the Chicago area, including free lectures and performances. It publishes a newsletter and provides stipends to young scholars to attend the Uriel Weinreich Program in Yiddish Language, Literature, and Culture, the intensive summer language course co-sponsored by YIVO and Columbia University.
In partnership with the Workmen's Circle and Opus Instruments of Miami, Florida, The Chicago YIVO Society has recently embarked upon a new venture, The Melamdovich Yiddish Language Project, the creation of an interactive CD-Rom for the teaching of introductory Yiddish. The project is funded by a special grant from YIVO National Board member Leo Melamed in memory of his parents, longtime Chicago YIVO activists Isaac and Feygl Melamdovich. Professor Jan Schwarz of the University of Illinois is developing the CD-Rom's content.
To find out more about The Chicago YIVO Society's activities or to volunteer, please contact:
The Chicago YIVO Society
141 West Jackson Boulevard
Suite 1910A
Chicago, IL 60604
Phone: (312) 435-2800
Fax: (312) 922-2465
Or visit their web site at http://www.chicagoyivo.org.


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During her 25-year talk show run, Oprah Winfrey had 283 "favorite things": products she handed out in her annual audience scream-a-thon each holiday season. Her carefully chosen gifts ranged from favorite books and CDs to BlackBerrys (de rigeur at the time) to, famously, shiny new cars for all 275 hyperventilating audience members.
Some of the nascent products she promoted became instant bestsellers, like shapewear brand Spanx, in its first year of production when Winfrey held a pair of footless pantyhose aloft in front of millions of viewers. Spanx founder (and now, like Winfrey, a billionaire) Sara Blakely's website crashed with the immediate influx of buyers.
Winfrey also chose favorite foods and beauty products, like Fat Witch Brownies and Carol's Daughter makeup. Both companies reported huge surges in interest. Patricia Helding of Fat Witch told ABC News that her phone didn't stop ringing for six months. Lisa Price, founder of Carol's Daughter, said her site "went from four visitors to 17,000 within 10 seconds."
So, Winfrey can sell other people's products. But what about her own?
On Monday, the New York Post unearthed a handful of applications to the US Patent and Trademark Organization for Oprah-branded organic food and health products. A search of the office's records shows seven in total under the names "Oprah's Organics", "Oprah's Harvest" and "Oprah's Farm". Among the products Winfrey looks set to make, taken straight from the filings:
Organic salad dressing; organic sauces; organic beverages; Frozen organic vegetables; organic soups; organic snack dips. Food, beverages, agricultural and catering services.
Beauty products:
Bar soaps; bath and shower gels; bath oils; bath salts; bubble bath; massage oils; non-medicated skin care preparations for the face and body, namely, cleansers, toners, moisturizers, creams, lotions, oils, scrubs and masks; lip balms; sunscreens; eye creams; hand lotions; hand creams; hair care preparations, namely shampoos, conditioners, hair sprays, hair gels, hair mousse and hair oils.
The official line from Winfrey's spokesperson is that these trademarks "were filed for Oprah's farm on Maui to enable the farm to grow and distribute produce on Maui and throughout the Hawaiian Island." The talk show queen, worth $2.7 billion, indeed started buying up land in Hawaii a decade ago and co-owns parcels of land in Hana with one-time personal trainer Bob Greene. It seems unlikely, though, that someone with Winfrey's reach and influence would go to the effort of filing extensive trademarks only to confine her new organic food business to Hawaii.
A source with knowledge of the filings said there's no guarantee Winfrey will start production on every product mentioned, from frozen veggies to lip balm. "The trademark is broader than the intention," the source said. "But you need to cover the name." The concern, it seems, is that if Winfrey doesn't protect her brand as it expands, someone else will jump in and squat on a trademark like they would a sought-after website URL.
Still, if Winfrey does end up taking her food and beauty line national, she's chosen the right time. "Organic is the hottest growth segment in the supermarket industry," said Robert Vosburgh, responsible for all things health-related at Supermarket News, including natural, gluten-free and non-GMO food. "The market is still growing at around 10% a year so there's room for new products in all categories."
She'll have to tread carefully, though. A "favorite things" endorsement would often propel products off the shelves, but there was no risk for Winfrey herself if one of her giveaways wasn't a huge hit. "Becoming an expert in selecting products is very different from making the product yourself," said Craig Garthwaite, a professor at Northwestern University's Kellogg School of Management who has written on the power of The Oprah Effect on everything from book sales to Obama's first election win.
"It's not clear to me that Oprah's an expert in salad dressing," he said. "Newman's Own has been a consistent hit not because of Paul Newman's face on the bottle but because people like the taste. Oprah's got to solve that problem." Garthwaite added that Winfrey's name on a food package might sell an item once, but after that, it's down to the quality alone.
Vosburgh agrees. "With organic or otherwise, food is only as good as it tastes," he said. "It doesn't matter the price or the method of promotion. Flavor keeps people coming back. It could be produced by the Holy Maker himself, but if it isn't good, people aren't buying."
Read More:
The Education Of Oprah Winfrey: How She Saved Her South African School


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Full of treasure and high seas adventure, this set is sure to spark the imagination.
- Quilt: 36 x 45 inches
- Two fitted sheet: fit standard size crib mattress
- Dust ruffle: 14-inch drop
- Window valance: 60 inches wide, 14-inch drop
- Diaper stacker: 25.5 x 12 x 8 inches
- Three fabric wall hangings: 9 x 9 inches
Made with cotton, polyester, and nylon materials. Bumper sold separately. Machine wash cold with like colors, gentle cycle.
Shipping Note: This item ships via FedEx Ground within contiguous United States only. Cannot be shipped to AK/HI, PO boxes, US territories, or APO/FPO addresses.


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I saw TF Prime Ultra Magnus Platinum edition today at TRU. It looks great! Problem is paying 60 dollars for a 25 dollar figure is ridiculous.
I saw TF Prime Ultra Magnus Platinum edition today at TRU. It looks great! Problem is paying 60 dollars for a 25 dollar figure is ridiculous.
Nowhere in your incoherent ramblings did you come anywhere close to the answer. Thanks to you, everyone in this room is now stupider having heard you. I award you no points and may God have mercy on your soul. -Billy Madison-
Target (in Cathedral City) had the Decepticon WFC cassettes on clearance, along with Springer.
Curiously, my phone's autocorrect knows Galvatron, but not Decepticon.
Tommy, close your eyes.
Just, for the record, the current Masterpiece line is bringing more joy to my heart than anything else in my collection. MP Prowl is awesome. I hope the rumors about Bumblebee, Wheeljack, and Ultra Magnus are true. That is all.
Hasbro ended up replacing my defective Trailcutter with Hoist. While not a terrible swap, I simply didn't want Hoist, so I returned him to Target using the Trailcutter receipt and it worked because Target only tracks SKUs, not UPCs. I then took that money and bought Thundercracker, who is very nice and possibly better than Starscream, the use of materials and paint is a little nicer with TC. Oddly, the pin holding the right cannon together - the barrel is pinned into the geared cylinder - is not tapped deep enough and so that tri-barrel is wobbly, but it's not enough to make it a dealkiller for me. Still, yet another QC fail, it's getting pretty crazy.
I bought some comics and haven't read them yet, it's been so long that I think another round is coming out tomorrow.
I so very much want an MP Wheeljack from a Lancia Stratos HF!
Darth Vader is becoming the Mickey Mouse of Star Wars.
"In Brooklyn, a castle, is where dwell I"
The use of a lightsaber does not make one a Jedi, it is the ability to not use it.
Darth Vader is becoming the Mickey Mouse of Star Wars.
"In Brooklyn, a castle, is where dwell I"
The use of a lightsaber does not make one a Jedi, it is the ability to not use it.
JT, I'd recommend Hoist over Trailbreaker for many of the same reasons as Thundercracker over Starscream. Colors pop out more and so forth.
Curiously, four other Targets had the cassettes and Voyagers (?) at full price. Not sure what was up with Cathedral City. I should've bought an extra Rumble/Ravage (which I'd previously found on clearance at WM) and exchanged it at another Target for Rewind/Sunder, but I thought the entire chain was finally dropping them.
Tommy, close your eyes.
How much are those car-bot masterpieces?
Are they the same size / quality as the Human Alliance or how about the Alternators?
I'd be interested if they made the Stunticon cars and possibly Swindle that way.
I am an Autobot fan, but my collection has so many more Autobots than Decepticons...
They could also make MP Contructicons which might of might not combine. Still Scrapper would be great!
BAD Pts Need: R5-C7 lf leg (x2), , R4-P44 right leg BAD Pts Offered For Trade: PM me - I have lots of parts now including BG-J38!. New Kyle Katarn is also available.


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you will need
White or yellow crepe paper
green crepe paper
bendy straws
yellow and orange water colour paints
paint brush
pot of water
first you need to paint the tissue paper, i started with the middle part of the flower and cut a long strip of crepe paper with a jagged edge, and then painted it orange on one end and then faded it to yellow and left it to dry. then i glued it in to a cylinder shape.
for the petals i cut some light yellow crepe paper and then painted it a brighter yellow on the ends and then used a wet brush to drag the colour out.
then glue the petals on around it in a star shape. then add some more green crepe paper over where you glued the petals.


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A group of surfers watch a wall of water roll toward them as they stand at the end of Bob Hall Pier on Padre Island.
A home on David street had this to say about FEMA on Friday.
City employee Henry Cantu rearranges partitions in Memorial Coliseum after the facility was cleaned earlier in the day in anticipation of the evacuees from Hurricane Rita. The city was under mandatory evacuation from Hurricane Rita
The H-E-B at Moore Plaza was packed with last minute shoppers in a city that was under mandatory evacuation from Hurricane Rita
People line up on the bus stop at Corpus Christi City Hall on Thursday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita.
Buddy Lindsey fills up his truck at a Diamond Shamrock in Rockport, TX on Wednesday. It was the fifth gas station Lindsey had been to before he found any gasoline. The gas station ran out of gas shortly after that, but they expect a shipment of gas at 6 a.m. Thursday.
Steve McMurrey loads up his truck at the Knight's Inn in Corpus Christi on Saturday. McMurrey, his wife and three other neighbors fled Seabrook, TX as Hurricane Rita threatened their homes. They were headed back to their homes Saturday to check out the potential damage.
The restaurants Doc's (foreground) and Snoopy's in the background were surrounded by water. The high water from hurricane Rita covered the streets leading up to the restaurants under the JFKennedy causeway in Padre Island.
CCC Group Inc. employees Armando Jaramillo (left) and Salvador Martinez load rebar being used at the seawall construction site to be moved and stored in preparation for Hurricane Rita. All construction materials will be removed from the site to help minimize potential damage, said Dan Garza, engineer with Shiner Moseley and Associates Inc.
Coastal Bend Blood Center employee A. J. Angeles donated blood at the center on Friday, which was his day off. As a result of the mandatory evacuation in Corpus Christi four days of blood drives were canceled and there was a loss of 350 to 400 units of blood normally collected during this time. The center needs between 100 to 120 blood donors daily and 10 to 12 platelet donors daily, said Leticia Mondragon, media relations spokesperson for the Coastal Bend Blood Center. The center has continued regular operations and plans to resume mobile operations on Sunday.
Ruben Ortega loads gorceries at the H-E-B on Port Avenue as he prepares to take his wife Irene Ortega back to Ft. Worth where he is currently employed.
William Lumry (left) helps load Willie Jerome's luggage onto a bus on Wednesday. Jerome and other Hurricane Katrina evacuees being housed at the Memorial Coliseum were transported to shelters outside of the area in preparation for Hurricane Rita.
Sutherland Wiser waits to evacuate Corpus Christi with her dog Princess at Corpus Christi City Hall on Wednesday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita.
xEmmett Bowers moves everything out of his yard at the Paradise RV Park in Rockport, TX in preparation for Hurricane Rita. He has lived in Rockport for seven years and said he and his wife will head to Iowa to stay with their family. "My wife wants to stay," Bowers said. "She doesn't know what a hurricane is, I do. We're leaving."
Ron and Sally Romanski have been visiting Corpus Christi from Northern Illinois for several years and finally decided the time was right to move here. They have been living on Padre Island for two months. Today they finished putting up newly cut plywood boards on their windows and doors and will be evacuating later
Jose Chapa was recently stationed in North Carolina with the Marines and deployed with the Navy when hurricanes threatened the east coast. He purchased four sheets of plywood at Sutherlands at 4041 South Staples to have on hand just in case Rita visits the Coastal Bend.
After a week of cloudless skies and near record heat, the fringes of Hurricane Rita showed in the skies over the Corpus Christi Marina
Jon Kinstely and Joseph Adamek and Barbara Trlicek (left to right) load up client files for Jonís mother, who owns Darlene Kinstely Certified Public Accountant, on Padre Island as the prepare to evacuate Wednesday due to Hurricane Rita.
Karina Villarreal remembers her bouquet two minutes before she was set to walk down the aisle. "Where's Felix? Where's my bouquet," she said. Holding her throwaway bouquet in one hand, she calls her florist who had evacuated to Dallas and arrived at 2:30 a.m. that morning for her ceremony that was cancelled then reinstated as Hurricane Rita headed north.
Yvette Garcia , municipal court clerk for the City of Rockport, TX, covers her desk at city hall with plastic in preparation for Hurricane Rita. On Wednesday, the city removed computer equipment, forms and anything else that they may need to start up business again if the hurricane were to hit Rockport. In addition, documents such as the original city minutes from 1871 were removed from the building, said Irma Parker, city secretary for the City of Rockport.
A worker with CCC Group Inc. works to fill in the gap behind the seawall with dirt in preparation for Hurricane Rita. After the hole is filled in, a three-inch slab of concrete will be placed on top to help prevent possible damage if a hurricane were to hit, said Dan Garza, engineer with Shiner Moseley and Associates Inc.
Karina Villarreal and Ben Garza (right) cancelled then reinstated their Saturday wedding at Most Precious Blood Catholic Church as Hurricane Rita headed north. They decided in San Antonio Friday to have their wedding as originally planned, minus a rehearsal and a bridesmaid. Father Bob Dunn gives directions to the puzzled groom just before the ceremony. (09/24/05 rdc)
Nurses from the NeoNatal Intensive care unit at Christus Spohn Hospital South carry babies into the hospital after arriving from San Antonio by helicopter that landed on the hospital parking lot on Friday.
Andrew Balderas (from left), Daniel Balderas and Jennifer Balderas wait to be evacuated from Corpus Christi at the Corpus Christi City Hall on Thursday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita. The Balderas family said the buses were the only way for them to leave town.
Cathleen Claarand her daughter, Esther Claar (1 1/2) wait for a bus at Corpus Christi City Hall on Thursday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita. "I don't want to risk my child," Claar said. "Storms in general are always unpredictable. This is the only way we have to get out of here."
Three surfers leap from Bob Hall Pier on Padre Island into the storm churned waters of the Gulf of Mexico. Top left is Robert Howard. Front left is Nick Mackrizz and lower right is his father Luis Mackrizz
After a week of cloudless skies and near record heat, the fringes of Hurricane Rita showed in the skies over Corpus Christi Friday
Richard Hooks (from left), Emergency Management Coordinator, Billy Delgado, superintendent of the City of Corpus Christi Parks and Recreation Special Projects and Stuart Sher, manager of transportation at the Regional Transit Authority, discuss city plans relating to Hurricane Rita at the Corpus Christi Office of Emergency Management on Friday.
Bill Krenek secures his Beneteau Ocean's 351 boat that is docked in the City Harbor in Rockport, TX in preparation for Hurricane Rita on Wednesday. He has not yet decided if he will evacuate from Rockport and said he can only hope that his boat will be there when he returns to the harbor.
Babies in incubators arrived by helicopter from San Antonio on Friday. They were taken into the neo natal dept. of Christus Spohn Hospital South on Saratoga blvd.
A sign gives people coming into Corpus Christi, TX on North Padre Island Drive a number for hotel information.
Ross Lopez and his daughter Rosslynn Lopez (10 months) board a bus at Corpus Christi City Hall on Thursday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita.
Merlin Soler, 83, evacuee from New Orleans, relaxes at Memorial Coliseum Monday as he keeps a eye on a near by televisions set broadcasting the latest new of Tropical Storm Rita. Soler said heís not to worry about the storm, but if a evacuation order was issued he would leave the city.
Daniel Garcia (left) and Kendall Garcia wait to evacuate at Corpus Christi City Hall on Thursday. The city provided buses for families to evacuate from Corpus Christi in preparation for Hurricane Rita.


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Thunder in the Vicinity
Wind: 3 mph
No reasonable-minded skier should dare complain about the lavish amount of snow that has fallen on The Valley since before Christmas. To have every skiable trail, downhill and cross-country, open for the holiday week is a true blessing for skiers and for the local economy.
Business at Ole's was unusually brisk and reports of record days came drifting in (yes, there's a bad pun there) from across The Valley at Sugarbush and Mad River Glen.
Soft snow, however, can present challenges for cross-country skiers, especially skaters. Every time you try to kick off a ski, the pressure from your effort pushes the ski into the soft snow, and at times it can feel as if you have engaged the emergency brake. Pole plants that you expect to find purchase at the surface of the snow end up probing the deep, as much as two feet below the surface, and your timing and rhythm goes all to hell.
So there you have it from the unreasonable spoilsports of cross-country – the joy of abundant, soft snow can still give you the great pleasure of complaining about something.
What remedy is there for this situation? You could always hope, of course, that the snow would just ease up and that groomers, by making multiple passes around the trails, could pack down a firm, fast surface. But to wish that would make you a truly irascible and unpardonable spoilsport. So the solution lies in you and your skiing technique.
Simply put, soft-snow skiing requires a soft touch. Think of that soft surface as something you want to caress, rather than bludgeon into submission. Be especially gentle in the kick phase and especially if you are skating. That starts with proper mental imaging of what is needed. Don't think of kicking off of a ski to generate power; think instead of making a smooth, balanced weight transfer from one ski to the other. The less edge you put into the snow the better.
If your balance is good, you'll find your glide ski easing onto the snow rather than crashing down and becoming instantly submerged. Balance, balance, balance – the three magic words of good cross-country technique.
A gentle touch is also important when it comes to your pole plants. A little extra forward angle with your poles when you plant them can help, pushing back in the snow rather than straight down into the snow. And by being less forceful with your poling, you will probably find the need to be more active with your lower body, where your bigger leg and butt muscles do most of the work. An active lower body will make you a better cross-country skier in the long run, regardless of the snow conditions.
Now, a quick switch of gears. Most of you have presumably not been following World Cup cross-country racing this winter, if for no reason other than that much of the U.S. media has decided to stick its head in the sands of oblivion when it comes to cross-country racing. But U.S. skiers, especially U.S. women, who in the past have largely been distant also-rans at the elite level, are truly killing it this winter.
The big star of the U.S. show has been Kikkan Randall, now the world's top-ranked sprinter. Along with teammate Holly Brooks, Randall won a pre-Christmas team sprint when the World Cup visited Quebec City. This week, Randall won two of the first three stages of the Tour de Ski, a seven-event stage race modeled after cycling's Tour de France. Meanwhile, other U.S. women – Brooks, Vermonter Liz Stephen, Jessie Diggins, and Ida Sargent – have been logging solid results to back up Randall.
The U.S. men haven't had quite the success to match what the women have accomplished. But guys like Vermonter Andy Newell, Kris Freeman and Noah Hoffman have consistently registered top-30 results to earn World Cup points. Nothing spectacular but better than the U.S. has typically done in years past.
Universal Sports (Channels 37 and 237 on Waitsfield Cable) is covering the Tour de Ski, which continues through this weekend. Watch for Stephen, a tiny woman who goes uphill with the ease of a butterfly, to do well in the Tour-ending hill climb. Meanwhile, Randall will be in the hunt for the overall Tour de Ski title. You go, girls!


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With only two starters returning from last season, Jones County's offense was pretty ragged, with a number of fumbles and an interception. It managed only one touchdown and a field goal, while the defense recovered a fumble in the end zone for one touchdown and forced a couple more turnovers that would have set up easy scores in normal situations.
"In some ways it was what we thought going in," Jones County coach Dwight Jones said of the scrimmage and two weeks of spring practice.
"We're more experienced on defense. We've still got to get a lot better on that side of the ball, too, but I thought the guys did a good job of recognizing what the offense was doing and getting to the ball," he said.
"On offense, we've got a long way to go. We've got to protect the ball, we've got to make the handoffs. But we did do some good things. Considering we had two or three guys we expect to be starters on the line out with injuries, we did a pretty good job moving the front. We ran the ball pretty good at times. Chandler Ramage, Reggie Lewis and Aaron Shaheen all had some good runs. And Walker Juhan showed he can be tough in the middle for us. But we have a lot of work still to do."
For the full story, pick up a copy of this week's newspaper or subscribe to our e-Edition at http://ee.jcnews.com.


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BOONE - Starmount alum Dillon Dobson kicked off his collegiate career at Appalachian State in a big way.
After getting the start in the Mountaineers' season-opening 6-3 victory over No. 8 North Carolina State on Friday, the 2011 grad followed that up with his first career home run in the teams' home-opener Monday afternoon against Canisius.
Dobson capped a four-run second inning for ASU with a two-run longball to left on the first pitch he saw for his first-career hit. He became the second Mountaineer freshmen this season to go deep for his first hit.
The Boonville native smacked a fourth-inning double down the left-field line to finish 2-for-4 with two RBIs and two runs scored in his first home game.
Former Starmount teammate Alex Barr saw his first career action down the road at Southern Conference rival Western Carolina.
Barr came on in relief against Washington State Saturday in the sixth inning. The Hamptonville native allowed two hits and two runs in his first appearance for the Catamounts.
Reach Matthew Gorry at 835-1513 or email@example.com.


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HOME NASCAR Matt Kenseth Gear Matt Kenseth Mens Matt Kenseth Mens Hats Sale Items (17 items) Product ID: 1116403
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Ways to get involved in promoting the Victorious Gospel
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Good concise explanation Jab..... Blessings....
Quote from: Cardinal on May 26, 2009, 04:46:55 AM Good concise explanation Jab..... Blessings....Thanks Card. Once in awhile, even a blind squirrel finds a nut.
Thanks Card. Once in awhile, even a blind squirrel finds a nut.
LOL And WW, we'll do just fine without a picture of a pig for me...thanks anyway
P.S. Ever see the movie 'Babe'? "That'll do, pig".
Blessings everyone!! I am so happy that I discovered the tentmaker website...I remember discussing (arguing) with my Dad about my beliefs which were what the bible taught (so i thought) especially about hell...he said he could not accept that a loving God who calls Himself our Father could possible condemn or watch His children be tortured eternally in hell....He asked me if i could watch that happen to my children ...i could only say to him no i could not but that is what the bible says....I have learned so much this past week in seeking out the truth...this feels "right" .... the eternal hell thing never really sat well with me and i couldn't help but think if all these Christians really truly believe in eternal hell then we are being pretty relaxed about the whole thing..there should be a sincere, desperate sense of urgency in each of us to reach out and save the unsaved but we all go about our everyday life without that sense of urgency....one question i have though about all mankind being reconciled to God, if that is true that those who die without knowing God will pay for their sins in judgement and then be reconciled to God...why then did Jesus need to die for our sins?? Bless you all...