text:
|Publication number
|Publication type
|Application number
|Publication date
|Mar 6, 2007
|Filing date
|Jun 11, 2003
|Priority date
|Apr 28, 2003
|Fee status
|Also published as
|Publication number
|Keith G. Lurie
|Original Assignee
|Advanced Circulatory Systems Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (121), Non-Patent Citations (27), Referenced by (26), Classifications (21), Legal Events (3)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation-in-part of U.S. patent application Ser. No. 10/426,161, filed Apr. 28, 2003, the complete disclosure of which is herein incorporated by reference.
This invention relates generally to the field of intracranial and intraocular pressures. More specifically, the invention relates to devices and methods for decreasing intracranial and intraocular pressures, such as those resulting from a traumatic head injury.
Head trauma is generally regarded as the leading cause of morbidity and mortality in the United States for children and young adults. Head trauma often results in swelling of the brain. Because the skull cannot expand, the increased pressures within the brain can lead to death or serious brain injury. While a number of therapies have been evaluated in order to reduce brain selling, including use of hyperventilation and steroids, an effective way to treat intracranial pressures remains an important medical challenge.
In one embodiment, the invention provides a device for decreasing intracranial or intraocular pressures. The device comprises a housing having an inlet opening and an outlet opening that is adapted to be interfaced with a person's airway. The device further includes a valve system that is operable to regulate respiratory gas flows through the housing and into the person's lungs during spontaneous or artificial inspiration. The valve system assists in lowering intrathoracic pressures during inspiration to continuously or intermittently lower pressures in the venous blood vessels that transport blood out of the head to thereby reduce intracranial or intraocular pressures.
Such a device may also be used to facilitate movement of cerebral spinal fluid. In so doing, intracranial pressures may be further reduced. Such a device may therefore be used to treat those suffering from head trauma associated with elevated intracranial pressures as well as those suffering from heart conditions that increase intracranial pressures.
In one aspect, the valve system is configured to open to permit respiratory gasses to freely flow to the person's lungs when the negative intrathoracic pressure reaches a pressure in the range from about −2 cmH2O to about −20 cmH2O in order to reduce intracranial or intraocular pressures. In this way, the negative intrathoracic pressure is lowered until a threshold pressure is reached, at which time the valve opens. The cycle may be repeated continuously or periodically to repetitively lower intrathoracic pressures.
The device may also include means for causing the person to artificially inspire through the valve system. For example, the device may utilize an electrode, an iron lung cuirass device, a chest lifting device, a ventilator or the like.
In another embodiment, the device may comprise a means to reduce intrathoracic pressure by applying a vacuum within the airway. The vacuum may be adjusted in terms of frequency, amplitude, and duration. This results in a decrease in intracranial pressure in proportion to the degree of vacuum applied. Hence, intracranial pressures may be reduced simply by manipulating airway pressures to reduce intrathoracic pressures.
The device may further include a mechanism for varying the level of impedance of the valve system. This may be used in combination with at least one physiological sensor that is configured to monitor at least one physiological parameter of the person. In this way, the mechanism for varying the level of impedance may be configured to receive signals from the sensor and to vary the level of impedance of the valve system based on the signals. Examples of sensors that may be used include those that measure respiratory rate, intrathoracic pressure, intratracheal pressure, blood pressure, heart rate, end tidal CO2, oxygen level, intracranial perfusion, and intracranial pressure.
In one aspect, a coupling mechanism may be used to couple the valve system to the person's airway. Examples of coupling mechanisms include a mouthpiece, an endotracheal tube, and a face mask.
A wide variety of valve systems may be used to repetitively decrease the person's intrathoracic pressure. For example, valve systems that may be used include those having spring-biased devices, those having automated, electronic or mechanical systems to occlude and open a valve lumen, duck bill valves, ball valves, other pressure sensitive valve systems capable of opening a closing when subjected to low pressure differentials triggered either by spontaneous breathing and/or external systems to manipulate intrathoracic pressures (such as ventilators, phrenic nerve stimulators, iron lungs, and the like).
In another embodiment, the invention provides a method for decreasing intracranial or intraocular pressures. According to the method, a valve system is coupled to a person's airway and is configured to at least periodically reduce or prevent respiratory gases from flowing to the person's lungs. With the valve system coupled to the airway, the person's negative intrathoracic pressure is repetitively decreased to in turn repetitively lower pressures in the venous blood vessels that transport blood out of the head. In so doing, intracranial and intraocular pressures are reduced. Such a method also facilitates movement of cerebral spinal fluid. In so doing, intracranial pressures are further reduced. As such, this method may also be used to treat a person suffering from head trauma that is associated with elevated intracranial pressures as well as those suffering from heart conditions that increase intracranial pressures, such as atrial fibrillation and heart failure.
The person's negative intrathoracic pressure may be repetitively decreased as the person repeatedly inspires through the valve system. This may be done by the person's own efforts (referred to as spontaneous breathing), or by artificially causing the person to repeatedly inspire through the valve system. For example, the person may be caused to artificially inspire by repeatedly stimulating the phrenic nerve, by manipulating the chest with an iron lung cuirass device, by generating negative pressures within the thorax using a ventilator, by applying a high frequency ventilator that supplies oscillations at a rate of about 200 to about 2000 per minute, or the like.
In another aspect, the level of impedance of the valve system may be fixed or variable. If variable, at least one physiological parameters of the person may be measured, and the impedance level may be varied based on the measured parameters.
To couple the valve system to the airway, a variety of techniques may be used, such as by using a mouthpiece, an endotracheal tube, a face mask or the like. Further, the respiratory gases may be prevented from entering the lungs through the valve system until a negative intrathoracic pressure in the range from about 0 cmH2O to about −25 cmH2O is achieved, at which time the valve system permits respiratory gases to flow to the lungs.
In a broad sense, the invention provides devices and techniques for lowering intracranial and intraocular pressures. Such devices and techniques may be particularly helpful with patients who have suffered a traumatic brain injury. One way to lower such pressures is by using a valve system that is coupled to a person's airway and that is used to lower intrathoracic pressures. In so doing, the valve systems may be used to accelerate the removal of venous blood from the brain, thereby decreasing intracranial and intraocular pressures. Other techniques may be used as well, such as by creating a vacuum intermittently within the thorax. By reducing intracranial pressures, movement of cerebral spinal fluid is also enhanced. In so doing, intracranial pressures are further reduced thereby providing further treatment for those suffering from head trauma. In some cases, the valve systems may also be used to treat the brain function in a person suffering from a heart condition (atrial fibrillation, heart failure, cardiac tamponade, and the like) that results in elevated intracranial pressures. Such heart conditions may include, for example, atrial fibrillation or heart failure. By reducing intracranial pressures, cerebral spinal fluid movement and translocation is increased to help improve brain function.
Intracranial pressures are regulated by the amount the cerebral perfusion pressure, which is determined by the arterial blood pressure to the head, the pressures within the skull, and the pressures within the venous system that drains blood flow from the brain. The devices and methods of the invention may be used to enhance the egress of venous blood out of the brain, thereby lowering intracranial pressures. To do so, the devices and methods may be used to augment the intrathoracic vacuum effect each time a patient inhales (or in the case of a non-breathing patient, each time the pressure within the chest is manipulated to fall below atmospheric pressure), thereby lowering the pressures in the thorax and in the venous blood vessels that transport blood out of the brain. The vacuum effect is transduced back into the brain, and as a result, intracranial pressures are lowered with each inspiratory effort. This in turn causes more venous blood to flow out of the head than would otherwise be possible, resulting in lower intracranial pressures and lower intraocular pressures.
To prevent or impede respiratory gases from flowing to the lungs, a variety of impeding or preventing mechanisms may be used, including those described in U.S. Pat. Nos. 5,551,420; 5,692,498; 6,062,219; 5,730,122; 6,155,257; and 6,224,562, and in U.S. patent application Ser. No. 10/224,263, filed on Aug. 19, 2002 ("Systems and Methods for Enhancing Blood Circulation", U.S. patent application Ser. No. 10/401,493, filed Mar. 28, 2003 ("Diabetes Treatment Systems and Methods"), U.S. patent application Ser. No. 09/966,945, ("Face Mask Ventillation/Perfusion Systems & Method"), filed Sep. 28, 2001 and U.S. patent application Ser. No. 09/967,029, ("Systems and Methods to Facilitate the Delivery of Drugs"), filed Sep. 28, 2001, the complete disclosures of which are herein incorporated by reference. The valve systems may be configured to completely prevent or provide resistance to the inflow of respiratory gases into the patient while the patient inspires. For valve systems that completely prevent the flow of respiratory gases, such valves may be configured as pressure responsive valves that open after a threshold negative intrathoracic pressure has been reached.
For example, the resistance to the inflow of respiratory gases may be set between about 0 cm H2O and about −25 cm H2O and may be variable or fixed. More preferably, the valve system may be configured to open when the negative intrathoracic pressure is in the range from about −2 cmH2O to about −20 cmH2O.
Although not intended to be limiting, specific kinds of impedance valves that may be used to reduce intracranial and intraocular pressures include those having spring-biased devices, automated/electronic and mechanical means to occlude and open a valve lumen, duck bill valves, ball valves, and other pressure sensitive valve systems capable of opening and closing when subjected to low pressure differentials triggered either by spontaneous breathing and/or external means to manipulate intrathoracic pressure (such as ventilators, phrenic nerve stimulators, an iron lung, and the like).
In the past, such threshold valve systems have been used to increase the venous preload on the heart and to increase cardiac output, stroke volume and blood pressure because of the augmented effects of the intrathoracic vacuum on the subsequent cardiac contraction. In contrast, the techniques of the invention function by facilitating the removal of blood from the venous side of the brain. Although there may be an increase in blood flow out of the heart to the vital organs (including to the brain) when using such valve systems, the effect of the valve systems on lowering of intracranial pressures was quite unexpected because of the known increase in blood flow to the brain. Remarkably, however, the reduction of venous blood pressures from the brain remains substantial when using the valve systems. Thus, despite the increase in blood flow to the brain, the net effect of the valve system is a decrease in intracranial pressures.
With the valve system coupled to the person's airway, the negative intrathoracic pressure may be enhanced by inspiring through the valve system. If the person is spontaneously breathing, the person may simply breath through the valve system. If the person is not breathing, artificial inspiration may be induced using a variety of techniques, including electrical stimulation of the diaphragm, a negative pressure ventilator such as a body cuirass or iron lung, or a positive pressure ventilator capable of also generating a vacuum between positive pressure ventilations. As one example, at least some of the respiratory muscles, and particularly the inspiratory muscles, may be stimulated to contract in a repeating manner in order to cause the person to inspire through the valve system, thereby increasing the magnitude and prolonging the duration of negative intrathoracic pressure, i.e., respiratory muscle stimulation increases the duration and degree that the intrathoracic pressure is below or negative with respect to the pressure in the peripheral venous vasculature. Upon contraction of the respiratory muscles, the patient will typically "gasp". These techniques may be performed alone, or in combination with a valve system.
Among the respiratory muscles that may be stimulated to contract are the diaphragm, the chest wall muscles, including the intercostal muscles and the abdominal muscles. Specific chest wall muscles that may be stimulated to contract include those that elevate the upper ribs, including the scaleni and stemocleidomastoid muscles, those that act to fix the shoulder girdle, including the trapezii, rhomboidei, and levatores angulorum scapulorum muscles, and those that act to elevate the ribs, including the serrati antici majores, and the pectorales majores and minores as described generally in Leslie A. Geddes, "Electroventilation—A Missed Opportunity?", Biomedical Instrumentation & Technology, July/August 1998, pp. 401–414, the complete disclosure of which is herein incorporated by reference. Of the respiratory muscles, the two hemidiaphragms and intercostal muscles appear to be the greatest contributors to inspiration and expiration. The respiratory muscles may be stimulated to contract in a variety of ways. For example, the diaphragm may be stimulated to contract by supplying electrical current or a magnetic field to various nerves or muscle bundles which when stimulated cause the diaphragm to contract. Similar techniques may be used to stimulate the chest wall muscles to contract. A variety of pulse trains, pulse widths, pulse frequencies and pulse waveforms may be used for stimulation. Further, the electrode location and timing of pulse delivery may be varied. In one particular aspect, an electrical current gradient or a magnetic field is provided to directly or indirectly stimulate the phrenic nerve.
To electrically stimulate the inspiratory motor nerves, electrodes are preferably placed on the lateral surface of the neck over the point where the phrenic nerve, on the chest surface just lateral to the lower sternum to deliver current to the phrenic nerves just as they enter the diaphragm, on the upper chest just anterior to the axillae to stimulate the thoracic nerves, in the oral pharyngeal region of the throat, or on the larynx itself. However, it will be appreciated that other electrode sites may be employed. For example, in one embodiment the respiratory muscles are stimulated by a transcutaneous electrical impulse delivered along the lower antero-lat margin of the rib cage. In one embodiment, inspiration is induced by stimulating inspiratory muscles using one or more electrodes attached to an endotracheal tube or pharyngeal tube. To stimulate the diaphragm, the phrenic nerve may be stimulated in the neck region near C3–C7, such as between C3, C4 or C5, or where the phrenic nerves enter the diaphragm. Alternative techniques for stimulating diaphragmatic contraction include magnetic field stimulation of the diaphragm or the phrenic nerve. Magnetic field stimulation may also be employed to stimulate the chest wall muscles. Electrical field stimulation of the diaphragm or the chest wall muscles may be accomplished by placing one or more electrodes on the skin, preferably in the vicinity of the neck or the lower rib cage (although other locations may be employed) and then providing an electrical voltage gradient between electrodes that induces transcutaneous current flow to stimulate the respiratory muscles to contract. Still further, subcutaneous electrodes may also be used to stimulate respiratory muscle contraction. Other techniques are described in U.S. Pat. No. 6,463,327, the complete disclosure of which is herein incorporated by reference.
The valve systems may have a fixed actuating pressure or may be variable so that once a desired negative intrathoracic pressure is reached, the resistance to flow may be lessened. Further, the valves of the invention may be configured to be variable, either manually or automatically. The extent to which the resistance to flow is varied may be based on physiological parameters measured by one or more sensors that are associated with the person being treated. As such, the resistance to flow may be varied so that the person's physiological parameters are brought within an acceptable range. If an automated system is used, such sensors may be coupled to a controller which is employed to control one or more mechanisms that vary the resistance or actuating pressure of the inflow valve as generally described in the references that have been incorporated by reference.
Hence, the valve systems of the invention may also incorporate or be associated with sensors that are used to detect changes in intrathoracic pressures or other physiological parameters. In one aspect, the sensors may be configured to wirelessly transmit their measured signals to a remote receiver that is in communication with a controller. In turn the controller may use the measured signals to vary operation of the valve systems described or incorporated by reference herein. For example, sensors may be used to sense blood pressure, pressures within the heart, intrathoracic pressures, positive end expiratory pressure, respiratory rate, intracranial pressures, intraocular pressures, respiratory flow, oxygen delivery, temperature, blood pH, end tidal CO2, tissue CO2, blood oxygen, cardiac output or the like. Signals from these sensors may be wirelessly transmitted to a receiver. This information may then be used by a controller to control the actuating pressure or the resistance of an inflow valve as described in the references incorporated herein by reference.
The techniques for reducing intracranial pressures may be used in a variety of settings. For example, the techniques may be used in person's who are spontaneously breathing, those who are not breathing but whose hearts are beating, and those in cardiac arrest. In the latter case, the techniques may use some means to create a vacuum intermittently within the thorax during the performance of CPR. This could be by using a valve system or some other type of pressure manipulation system. Further, such systems may be used in other settings as well, including when the person is breathing.
As shown in step 30, various physiological parameters of the person may optionally be measured. Examples of such parameters include respiratory rate, intrathoracic pressure, intertracheal pressure, intracranial pressure, intracranial blood flow, intraocular pressure, blood pressure, heart rate, end tidal CO2, oxygen saturation, and the like. Further, as shown in step 40, the valve system's actuating threshold level may optionally be varied based on the measured physiological parameters. This may be done to maximize the amount of blood drawn out of the brain or simply to monitor the patient's condition to insure that the patient remains stable.
Referring also to
When the patient is actively ventilated, respiratory gases are forced through ventilation tube 208. The gases flow through filter 210, through duck bill valve 212, and forces up diaphragm 216 to permit the gases to exit through port 218. Hence, at any time the patient may be ventilated simply by forcing the respiratory gases through tube 208.
During the exhalation phase of a breathing cycle, expired gases flow through port 218 and lift up diaphragm 216. The gases then flow through a passage 227 in ventilation tube 208 where they exit the system through openings 229 (see
During the inhalation phase of a breathing cycle, valve system 200 prevents respiratory gases from flowing into the lungs until a threshold negative intrathoracic pressure level is exceeded. When this pressure level is exceeded, check valve 224 is pulled downward as springs 224 a are compressed to permit respiratory gases to flow through openings 226 and to the patient's lungs by initially passing through tube 208 and duck bill valve 212. Valve 224 may be set to open when the negative intrathoracic pressure is in the range from about 0 cm H2O to about −25 cm H2O, and more preferably from about −2 cm H2O to about −20 cm H2O. Hence, the magnitude and duration of negative intrathoracic pressure may be enhanced during patient inhalation by use of valve system 200. Once the intrathoracic pressure falls below the threshold, recoil spring 224 a again close check valve 224. In this way, pressure within the venous blood vessels that transport blood out of the brain are also lowered. In so doing, more blood is drawn out of the brain to reduce intracranial and intraocular pressures.
Any of the valve systems described herein may be incorporated into a treatment system 300 as illustrated in
For example, valve system 200 may include a pressure transducer for taking pressure measurements (such as intrathoracic pressures, intracranial pressures, intraocular pressures), a flow rate measuring device for measuring the flow rate of air into or out of the lungs, or a CO2 sensor for measuring expired CO2.
Examples of other sensors or measuring devices include a heart rate sensor 330, a blood pressure sensor 340, and a temperature sensor 350. These sensors may also be coupled to controller 310 so that measurements may be recorded. Further, it will be appreciated that other types of measuring devices may be used to measure various physiological parameters, such as oxygen saturation and/or blood levels of O2, blood lactate, blood pH, tissue lactate, tissue pH, blood pressure, pressures within the heart, intrathoracic pressures, positive end expiratory pressure, respiratory rate, intracranial pressures, intraocular pressures, respiratory flow, oxygen delivery, temperature, end tidal CO2, tissue CO2, cardiac output or the like.
In some cases, controller 310 may be used to control valve system 200, to control any sensors or measuring devices, to record measurements, and to perform any comparisons. Alternatively, a set of computers and/or controllers may be used in combination to perform such tasks. This equipment may have appropriate processors, display screens, input and output devices, entry devices, memory or databases, software, and the like needed to operate system 300.
A variety of devices may also be coupled to controller 310 to cause the person to artificially inspire. For example, such devices may comprise a ventilator 360, an iron lung cuirass device 370 or a phrenic nerve stimulator 380. Ventilator 360 may be configured to create a negative intrathoracic pressure within the person, or may be a high frequency ventilator capable of generating oscillations at about 200 to about 2000 per minute.
The following is a non-limiting example illustrating how intracranial pressures may be lowered according to the invention. In this example, 30 kg pigs were anesthetized with propofol. Using a micromannometer-tipped electronic Millar catheter inserted below the dura, intracranial pressures were measured continuously in the spontaneously breathing pigs. Intrathoracic pressures (ITP) were recorded using a Millar catheter placed in the trachea at the level of the carina. After stabilizing the pigs blood pressure, heart rate, and ventilation rate, intracranial pressures (ICP) and intrathoracic pressures were recorded, with 0 cmH2O inspiratory impedance and then with inspiratory impedances of 5, 10, 15, and 20 cm H2O. Inspiratory impedance was achieved using an impedance threshold valve (ITV) as described in
At base, the intracranial pressure was approximately 8/4 mmHg. With increasing amounts of inspiratory impedance, the intracranial pressure was lowered proportionally as shown in
In this example, intracranial pressures were increased in the setting of recovery from cardiac arrest. The example used a pig model with ventricular fibrillation for 6 minutes followed by cardiopulmonary resuscitation for 6 minutes, followed by defibrillation. Spontaneous breathing resulted in an up to 50% decrease in intracranial pressures when the animals breathed through an inspiratory impedance of 10 cm H2O using a valve system similar to Example 1.
In all examples above, the intrathoracic pressure decreased relative to the rest of the body, creating a suction effect that reduced the pressure in the venous blood vessels draining the brain, thereby reducing intracranial pressures.
The invention further provides techniques and devices for reducing intracranial pressure (ICP) by facilitating movement of cerebral spinal fluid (CFS). There are a number of causes of increased ICP including: head injury, ischemia, osmolar imbalance, cerebral edema, tumors, complications of dialysis, infections, stroke, hypertensive crises. Each can result in a slow, and in some cases, an acute rise in the ICP. The solid matter of the brain contents makes up about 80–85% of the material enclosed by the skull. Cerebral blood volume accounts for 3–6% and CSF for 5–15%. See, Anesthesia, Third Edition Editor, Ron Miller. Chapter authors: Shapiro and Drummond. Chapter 54 (1990), the complete disclosure of which is herein incorporated by reference. CSF moves within the brain from its site of production to its site of reabsorption in the brain in an unimpeded manner under normal physiological states. Since the contents in the brain are practically incompressible, a change in volume of any one of the three major components (brain matter, blood volume, CSF volume) results in a reciprocal change in one or both of the other brain components. When the volume of the brain expands, secondary to an increase in the non-CSF component(s), some of the CSF is forced to other locations, including through the foramen magnum (hole in skull connecting skull to space where the spinal cord is located) and into the CSF fluid space surrounding the spinal cord. When the non-CSF components expand in volume or size, the intracranial pressure rises. Normal ICP levels are 10–15 mmHg when supine. At levels greater than 15–20 mmHg, damage to the brain can occur secondary to compression and resultant tissue ischemia (lack of adequate blood flow). A reduction in ICP levels can be achieved by a number of clinical interventions including water restriction, diuretics, steroids, hyperventilation, a reduction of cerebral venous pressure, hypothermia, CSF drainage, and surgical decompression.
Increased ICP results in reduced CSF fluid movement and translocation. CSF fluid production generally remains constant (about 150 ml/day) despite elevated ICP. CSF fluid reabsorption is can be slowed by elevated ICP. By using the valve systems described herein, central venous pressures may be reduced. In turn, this results in a decrease in ICP and results in an increase in CSF fluid movement or translocation and reabsorption. This results in a further reduction in ICP.
The valve systems of the invention may be used in spontaneously breathing individuals, in patients ventilated with negative pressure ventilation or in patients ventilated with a ventilator that causes a decrease in central venous pressures for at least a portion of the respiratory cycle. Each time the intrathoracic pressure is reduced with the valve systems of the invention, there is a concomitant reduction in ICP and an increase in the movement of CSF. In other words, there is an increase in the difference between the peak and trough of the ICP wave form when using the valve systems. The sinusoidal movement occurs in spontaneously breathing people because of the change in pressure in the thorax that is transmitted to the brain via the venous blood vessels. The normally fluctuating CSF pressures (the pressure increases and decreases with each inspiration) are altered by the valve systems. More specifically, the valve systems create a lower trough value thereby creating an overall created change in the ICP with each inspiration. In the non-breathing patient, a similar effect can be produced with the valve systems when used with a variety of ventilator devices, including an iron lung, a phrenic nerve stimulator (such as those described in U.S. Pat. Nos. 6,234,985; 6,224,562; and 6,312,399, incorporated herein by reference), a suction cup on the chest that is used to periodically expand the chest and the like.
Increased CSF fluid movement results in an overall improved metabolic state for the brain. This is shown schematically in
By treating the elevated ICP associated with all of the conditions noted above using the valve systems described herein, brain swelling can be reduced. In so doing, CFS movement and fluid translocation is increased under those same conditions. This results in a further decrease in intracranial pressure as the CSF is able to relocate.
Referring now to
Hence, the amount of inspiratory resistance, or the amount of negative intrathoracic pressure generation (which may be generated using a variety of techniques) can be controlled or regulated by feedback from measurement of ICP, blood pressure, respiratory rate, or other physiological parameters. Such a system could include a closed loop feedback system.
The invention has now been described in detail for purposes of clarity and understanding. However, it will be appreciated that certain changes and modifications may be practiced within the scope of the appended claims.
|Cited Patent
|Filing date
|Publication date
|Jul 13, 1953
|Dec 18, 1956
|Dorothy L Bischof
|Jun 13, 1957
|Feb 19, 1963
|Batrow Lab Inc
|Electro-physiotherapy apparatus
|Sep 19, 1960
|Jun 29, 1965
|Bird Forrest M
|May 1, 1963
|Mar 7, 1967
|Carl E Hewson
|Heart and lung resuscitator
|Jun 1, 1967
|Aug 5, 1969
|Sierra Eng Co
|Pressure compensated exhalation valve
|Feb 26, 1968
|Jun 2, 1970
|East & Co Ltd H G
|Respiratory apparatus
|May 20, 1970
|May 16, 1972
|Michigan Instr Inc
|Automatic respirator-inhalation therapy device
|Oct 20, 1969
|Jun 13, 1972
|Veriflo Corp
|Nov 8, 1972
|Feb 26, 1974
|Lanz Medical Prod Co
|Endotracheal tube with inflatable cuff and check valve
|Sep 21, 1972
|Jun 11, 1974
|Mazal C
|Endotracheal catheter
|Dec 11, 1972
|Sep 10, 1974
|Puritan Bennett Corp
|Respiration apparatus with flow responsive control valve
|Apr 9, 1974
|Jan 20, 1976
|Airco, Inc.
|Anesthesia breathing circuit with positive end expiratory pressure valve
|Aug 8, 1974
|Aug 10, 1976
|Dupaco Incorporated
|Anaesthetist's respiration apparatus
|Aug 25, 1975
|Aug 16, 1977
|Miller Bruce B
|Control apparatus for variable regulation of lung inflation hold time
|Oct 19, 1976
|Mar 7, 1978
|H. B. W. Medical Instruments Manufacturing Company, Inc.
|Breathing equipment such as resuscitators
|May 22, 1978
|Sep 4, 1979
|Harrigan Roy Major
|External cardiac resuscitation aid
|Oct 10, 1978
|Oct 7, 1980
|Longevity Products, Inc.
|Jul 30, 1979
|Apr 7, 1981
|Chesebrough-Pond's Inc.
|Dual valve for respiratory device
|Sep 9, 1980
|Nov 3, 1981
|Mcginnis Gerald E
|Spring loaded exhalation valve
|May 8, 1979
|Feb 23, 1982
|National Research Development Corporation
|Patient ventilators
|Dec 21, 1979
|Mar 23, 1982
|Watson Robert L
|Controllable partial rebreathing anesthesia circuit and respiratory assist device
|Nov 14, 1980
|Sep 14, 1982
|Physio-Control Corporation
|Manually-actuable CPR apparatus
|Mar 23, 1981
|Aug 9, 1983
|The John Hopkins University
|Integrated system for cardiopulmonary resuscitation and circulation support
|Jul 7, 1981
|May 8, 1984
|Watson Robert L
|Emergency ventilation tube
|Nov 27, 1981
|May 22, 1984
|Elam James O
|Mask breathing system
|Oct 16, 1981
|Nov 13, 1984
|Lindley John E
|Resuscitator, respirator and/or incubator
|Mar 13, 1984
|Aug 6, 1985
|Healthscan Inc.
|Pulmonary training method
|Mar 22, 1984
|Jul 22, 1986
|Roy Jean Yves
|Device for stimulating the human respiratory system
|Mar 28, 1988
|Mar 7, 1989
|Carla Hanson
|Aid for cardio-pulmonary resuscitation
|Apr 24, 1986
|May 9, 1989
|Purdue Research Foundation
|Demand electroventilator
|Nov 14, 1988
|Nov 21, 1989
|Lerman Samuel I
|Cardiac assist cuirass
|Apr 14, 1988
|Feb 6, 1990
|Physician Engineered Products, Inc.
|Resuscitation bag control apparatus
|Nov 21, 1988
|May 29, 1990
|The Johns Hopkins University
|Cardiopulmonary resuscitation and assisted circulation system
|Oct 23, 1989
|Nov 20, 1990
|Lerman Samuel I
|Cardiac assist curiass
|Oct 2, 1989
|May 14, 1991
|Leonard Bloom
|Method of and system for monitoring and treating a malfunctioning heart
|Nov 27, 1989
|May 21, 1991
|Auergesellschaft Gmbh
|Lung-governed valve
|Jun 1, 1990
|Sep 24, 1991
|Massachusetts Institute Of Technology
|Respirator triggering mechanism
|Jan 30, 1990
|Oct 15, 1991
|Regents Of The University Of Minnesota
|Chest compression apparatus
|Feb 14, 1991
|May 5, 1992
|Specialty Packaging Licensing Company
|Resuscitator having directional control valve with internal "PEEP" adjustment valve
|Jan 27, 1992
|Nov 17, 1992
|Ambu International A/S
|Disposable resuscitator
|Dec 26, 1991
|Feb 9, 1993
|Marquette Electronics, Inc.
|Method of using a multiple electrode pad assembly
|Jan 31, 1991
|Mar 16, 1993
|Board Of Trustees Of The Leland Stanford Junior University
|System for conveying gases from and to a subject's trachea and for measuring physiological parameters in vivo
|Sep 24, 1991
|Jun 8, 1993
|Mcculloch Norma D
|In or relating to a resuscitator
|Jun 23, 1992
|Aug 17, 1993
|Augustine Medical, Inc.
|Tracheal intubation with a stylet guide
|Feb 1, 1993
|Nov 23, 1993
|Henson-Thiery Corporation
|Enclosure system for burn victims
|Nov 1, 1991
|Mar 22, 1994
|Geeham Calvin T
|Cardiopulmonary resuscitation assist device
|Aug 3, 1992
|Apr 12, 1994
|Vital Signs, Inc.
|Pressure limiting valve for ventilation breathing bag apparatus
|Feb 1, 1993
|Apr 26, 1994
|Brain Archibald Ian Jeremy
|Artificial airway device
|Jan 22, 1993
|May 31, 1994
|Regents Of The University Of Minnesota
|Enzymatic fluorometric assay for adenylate cyclase
|May 7, 1993
|Oct 18, 1994
|Brain Archibald Ian Jeremy
|Laryngeal-mask construction
|Oct 23, 1992
|Nov 1, 1994
|Lloyd Lee J
|Manual resuscitator
|Sep 16, 1991
|Jan 3, 1995
|Cardiopulmonary Corporation
|Cardiac synchronous ventilation
|Nov 5, 1993
|Feb 28, 1995
|Nissho Corporation
|Emergency resuscitation apparatus
|Jul 8, 1993
|Mar 21, 1995
|Price; William E.
|Resuscitation and inhalation device
|Aug 13, 1993
|Jun 13, 1995
|Daig Corporation
|Coronary sinus catheter
|Apr 12, 1994
|Oct 3, 1995
|The Regents Of The University Of California
|Devices and methods for external chest compression
|Apr 11, 1994
|Dec 12, 1995
|The Ohio State University
|Intrathoracic mechanical, electrical and temperature adjunct to cardiopulmonary cerebral resuscitation, shock, head injury, hypothermia and hyperthermia
|Dec 8, 1993
|Feb 20, 1996
|Abramov; Vladimir V.
|Resuscitation breathing apparatus
|Jun 3, 1994
|Feb 20, 1996
|Respironics Inc.
|Respiratory mask with floating seal responsive to pressurized gas
|Apr 22, 1994
|Mar 5, 1996
|Kelly Medical Products, Inc.
|Apparatus for assisting in the application of cardiopulmonary resuscitation
|Sep 28, 1993
|May 21, 1996
|Respironics, Inc.
|Two-point/four-point adjustable headgear for gas delivery mask
|Jan 12, 1995
|Aug 27, 1996
|Daig Corporation
|Coronary sinus catheter
|Nov 9, 1993
|Sep 3, 1996
|Cprx, Inc.
|CPR device and method with structure for increasing the duration and magnitude of negative intrathoracic pressures
|Nov 17, 1992
|Dec 31, 1996
|Regents Of The University Of Minnesota
|Methods and pharmaceutical compositions for enhanced cardiopulmonary resuscitation
|Jan 21, 1994
|Apr 8, 1997
|Regents Of The University Of Minnesota
|Enzymatic fluorometric assay for adenylate cyclase
|Sep 27, 1995
|May 13, 1997
|Richard J. Melker
|Universal ventilation device
|Mar 17, 1995
|May 27, 1997
|Artinian; Hagop
|Resuscitation and inhalation device
|Jun 1, 1995
|Jul 1, 1997
|Daig Corporation
|Coronary sinus catheter
|May 4, 1993
|Jul 8, 1997
|The Regents Of The University Of California
|Devices and methods for controlled external chest compression
|Apr 21, 1995
|Oct 21, 1997
|Dimarco; Anthony Fortunato
|Method and apparatus for electrical stimulation of the respiratory muscles to achieve artificial ventilation in a patient
|Mar 10, 1995
|Dec 2, 1997
|Cprx, Inc.
|CPR device having valve for increasing the duration and magnitude of negative intrathoracic pressures
|Jul 10, 1995
|Jan 6, 1998
|Inoue; Masaaki
|High frequency oscillatory ventilator
|Apr 1, 1996
|Mar 3, 1998
|Daig Corporation
|Coronary sinus catheter
|Nov 12, 1996
|Mar 24, 1998
|Cprx, Inc.
|Heart failure mask and methods for increasing negative intrathoracic pressures
|Oct 25, 1995
|Apr 7, 1998
|Galvani Ltd.
|Electrical cardiac output forcing method and apparatus for an atrial defibrillator
|Dec 15, 1995
|Apr 14, 1998
|Deca-Medics, Inc.
|Chest compression apparatus for cardiac arrest
|Oct 25, 1995
|Jul 21, 1998
|Galvani Ltd.
|Suboptimal output device to manage cardiac tachyarrhythmias
|Oct 14, 1997
|Sep 29, 1998
|Pacesetter Ab
|Perex respiratory system stimulation upon tachycardia detection
|Apr 4, 1997
|Oct 20, 1998
|Chang; Tien-Tsai
|Manual pressing and automatic air breathing cardiopulmonary resuscitation first-aid device
|Mar 29, 1996
|Oct 27, 1998
|Lurie; Keith G.
|Mechanical and pharmacological therapies to treat cardiac arrest
|Dec 20, 1996
|Apr 27, 1999
|Resmed Limited
|Valve for use in a gas delivery system
|Apr 10, 1997
|Jul 6, 1999
|Pharmatarget, Inc.
|Device and method for detection and treatment of syncope
|Sep 3, 1998
|Nov 16, 1999
|Daig Corporation
|Coronary sinus catheter
|May 31, 1995
|Nov 23, 1999
|Dranez Anstalt
|Ventilator apparatus
|Dec 23, 1997
|Dec 14, 1999
|Daig Corporation
|Coronary sinus catheter
|Feb 6, 1998
|Feb 29, 2000
|Cprx Llc
|Heart failure mask and methods for increasing negative intrathoracic pressures
|Oct 15, 1997
|May 16, 2000
|Cprx Llc
|Apparatus and methods for assisting cardiopulmonary resuscitation
|Feb 25, 1999
|Jun 20, 2000
|Pharmatarget, Inc.
|Device and method for detection and treatment of syncope
|Oct 7, 1998
|Dec 5, 2000
|Cprx Llc
|Cardiopulmonary resuscitation ventilator and methods
|Nov 20, 1998
|May 1, 2001
|Cprx Llc
|Methods and devices for performing cardiopulmonary resuscitation
|Jun 11, 1998
|May 22, 2001
|Cprx Llc
|Device and method for performing cardiopulmonary resuscitation
|May 9, 1997
|Aug 21, 2001
|Daig Corporation
|Guiding introducer for introducing medical devices into the coronary sinus and process for using same
|May 20, 1999
|Nov 6, 2001
|Cprx, Llc
|Stimulatory device and methods to enhance venous blood return during cardiopulmonary resuscitation
|Aug 31, 1999
|Jul 30, 2002
|Cprx Llc
|Automatic variable positive expiratory pressure valve and methods
|May 4, 2000
|Oct 1, 2002
|Cprx Llc
|Remote control arrhythmia analyzer and defibrillator
|Mar 22, 2000
|Oct 8, 2002
|Cprx Llc
|Stimulatory device and methods to electrically stimulate the phrenic nerve
|Mar 29, 2000
|Nov 26, 2002
|Cprx Inc.
|Mechanical and pharmacologic therapies to treat cardiac arrest
|Apr 10, 2000
|Mar 4, 2003
|Cprx Llc
|Apparatus and methods for assisting cardiopulmonary resuscitation
|Mar 26, 1999
|Jun 17, 2003
|Ambu International A/S
|Device for administering artificial respiration to a patient
|May 29, 2002
|Jul 1, 2003
|Cprx Llc
|Stimulatory device and methods to electrically stimulate the phrenic nerve
|May 11, 2001
|Aug 12, 2003
|Cprx Llc
|Apparatus and methods for enhancing cardiopulmonary blood flow and ventilation
|Dec 18, 1998
|Sep 2, 2003
|Cisco Technology, Inc.
|Secure multi-user cable modem configuration editor and viewer
|Aug 15, 2001
|Dec 2, 2003
|St. Jude Medical
|Guiding introducer for introducing medical devices into the coronary sinus and process for using same
|Sep 28, 2001
|Aug 17, 2004
|Advanced Circulatory Systems, Inc.
|Systems and methods to facilitate the delivery of drugs
|Aug 25, 2000
|Sep 21, 2004
|O-Two Systems International Inc.
|Flow control valve for manual resuscitator devices
|Sep 20, 2002
|Mar 8, 2005
|Advanced Circulatory Systems, Inc.
|Stress test devices and methods
|Aug 17, 2004
|Aug 30, 2005
|Advanced Circulatory Systems, Inc.
|Systems and methods to facilitate the delivery of drugs
|Sep 11, 2003
|Sep 6, 2005
|Advanced Circulatory Systems, Inc.
|Bag-valve resuscitation for treatment of hypotention, head trauma, and cardiac arrest
|Aug 19, 2002
|Jan 17, 2006
|Advanced Circulatory Systems, Inc.
|Systems and methods for enhancing blood circulation
|May 1, 2001
|Oct 11, 2001
|Ku David N.
|Poly (vinyl alcohol) hydrogel
|May 11, 2001
|Jun 13, 2002
|Cprx Llc
|Apparatus and methods for enhancing cardiopulmonary blood flow and ventilation
|Apr 8, 2002
|Nov 21, 2002
|Cprx Llc
|Shock treatment systems and methods
|Mar 28, 2002
|Jan 2, 2003
|Fred Gobel
|Method for controlling a ventilator, and system therefor
|Aug 19, 2002
|Feb 27, 2003
|Cprx Llc
|Systems and methods for enhancing blood circulation
|Sep 28, 2001
|Apr 3, 2003
|Lurie Keith G.
|Face mask ventilation/perfusion systems and method
|Sep 28, 2001
|Apr 3, 2003
|Cprx Llc
|Systems and methods to facilitate the delivery of drugs
|Mar 24, 2003
|Oct 16, 2003
|Cprx Llc
|CPR mask with compression timing metronome and methods
|Apr 8, 2003
|Oct 14, 2004
|Cprx Llc
|CPR demonstration device and methods
|Jan 26, 2004
|Oct 14, 2004
|Advanced Circulatory Systems, Inc.
|Systems and methods for modulating autonomic function
|Apr 28, 2003
|Oct 28, 2004
|Cprx Llc
|Systems and methods for reducing intracranial pressure
|Jun 11, 2003
|Oct 28, 2004
|Advanced Circulatory Systems, Inc.
|Systems and methods for increasing cerebral spinal fluid flow
|Christenson, J.M., "Abdominal Compressions During CPR: Hemodynamic Effects of Altering Timing and Force", The Journal of Emergency Medicine, vol. 10, pp. 257-266, 1992.
|Cohen, Todd J. et al., "Active Compression-Decompression Resuscitation: a Novel Method of Cardiopulmonary Resuscitation", Department of Medicine and the Cardiovascular Research Institute, UC San Francisco, American Heart Journal 126(5):1145-1150, 1992.
|Dupuis, Yvon G., Ventilators-Theory and Clinical Application, pp. 447-448, 481, 496; Jan. 1986, Mosby Company.
|Geddes, L.A. "Electroventilation-A Missed Oppurtunity?", Biomedical Instrumentation & Technology, Jul./Aug. 1998, pp. 401-414.
|Geddes, L.A. et al., "Inspiration Produced by Bilateral Electromagnetic, Cervical Phrenic Nerve Stimulation In Man," IEEE Transactions on Biomedical Engineering 38(9): 1047-1048 (Oct. 1991).
|Geddes, L.A. et al., "Optimum Stimulus Frequency for Contracting the Inspiratory Muscles with chest Surface Electrodes to Produce Artificial respiration," Annals of Biomedical Engineering 18:103-108 (1990).
|Geddes, L.A., "Electrically Produced Artificial Ventilation," Medical Instrumentation 22(5): 263-271 (1988).
|Glenn, William W.L. et al., "Diaphragm Pacing by Electrical Stimulation of the Phrenic Nerve," Neurosurgery 17(6): 974-984 (1985).
|Glenn, William W.L., et al., "Twenty Years of Experience in Phrenic Nerve Stimulation to Pace the Diaphragm," Pace 9: 780-784 (Nov./Dec. 1986, Part I).
|Kotze, P.L. et al., "Diaphragm Pacing in the Treatment of Ventilatory Failure," San. Deel 68:223-224 (Aug. 17, 1995).
|Laghi, Franco et al., "Comparison of Magnetic and Electrical Phrenic Nerve Stimulation in assessment of Diaphragmantic Contractility," American Physiological society, pp. 1731-1742 (1996).
|Lindner, Karl H. et al., "Effects of Active Compression-Decompression Resuscitation on Myocardial and Cerebral Blood Flow in Pigs" Department of Anesthesiology and Critical Care Medicine, University of Ulm, Germany, Circulation 88(3):1254-1263, (Oct. 7, 1993).
|Lurie, Keith G. et al., "Regulated to Death: The Matter of Informed Consent for Human Experimentation in Emergency Resuscitation Research," Cardiac Arrhythmia Center at the University of Minnesota, PACE 18:1443-1447(Jul. 1995).
|Mushin W. W. et al., "Automatic Ventilation of the Lungs-The Lewis-Leigh Inflating Valve," Blackwell Scientific, Oxford, GB, p. 838.
|U.S. Appl. No. 10/119,203, filed Apr. 8, 2002, Lurie et al.
|U.S. Appl. No. 10/396,007, filed Mar. 24, 2003, Lurie et al.
|U.S. Appl. No. 10/401,493, filed Mar. 28, 2003, Lurie.
|U.S. Appl. No. 10/410,229, filed Apr. 8, 2003, Lurie et al.
|U.S. Appl. No. 10/426,161, filed Apr. 28, 2003, Lurie.
|U.S. Appl. No. 10/460,558, filed Jun. 11, 2003, Lurie.
|U.S. Appl. No. 10/660,462, filed Sep. 11, 2003, Lurie.
|U.S. Appl. No. 10/765,318, filed Jan. 26, 2004, Lurie.
|U.S. Appl. No. 10/796,875, filed Mar. 8, 2004, Lurie et al.
|U.S. Appl. No. 11/034,996, filed Jan. 12, 2005, Lurie.
|U.S. Appl. No. 11/051,345, filed Feb. 4, 2005, Lurie.
|U.S. Appl. No. 11/127,993, filed May 11, 2005, Lurie et al.
|US 5,584,866, 12/1996, Kroll et al. (withdrawn)
|Citing Patent
|Filing date
|Publication date
|Aug 3, 2010
|Advanced Circulatory Systems, Inc.
|Positive pressure systems and methods for increasing blood pressure and circulation
|Mar 8, 2004
|Nov 23, 2010
|Advanced Circulatory Systems, Inc.
|Ventilator and methods for treating head trauma and low blood circulation
|Feb 27, 2007
|Sep 6, 2011
|Advanced Circulatory Systems, Inc.
|CPR devices and methods utilizing a continuous supply of respiratory gases
|Oct 12, 2007
|Apr 10, 2012
|Advanced Circulatory Systems, Inc.
|Volume exchanger valve system and method to increase circulation during CPR
|Jul 3, 2012
|Advanced Circulatory Systems, Inc.
|Method and system to decrease intracranial pressure, enhance circulation, and encourage spontaneous respiration
|Jul 26, 2010
|Apr 2, 2013
|Advanced Circulatory Systems, Inc.
|Positive pressure systems and methods for increasing blood pressure and circulation
|Apr 23, 2013
|Covidien Lp
|Nitric oxide measurements in patients using flowfeedback
|Sep 30, 2008
|Feb 18, 2014
|Covidien Lp
|Sampling circuit for measuring analytes
|Feb 14, 2011
|Apr 22, 2014
|Advanced Circulatory Systems, Inc.
|Guided active compression decompression cardiopulmonary resuscitation systems and methods
|Jun 21, 2010
|Mar 3, 2015
|Advanced Circulatory Systems, Inc.
|Vacuum and positive pressure ventilation systems and methods for intrathoracic pressure regulation
|Mar 2, 2012
|Mar 24, 2015
|Advanced Circulatory Systems, Inc.
|CPR volume exchanger valve system with safety feature and methods
|Dec 19, 2012
|Jan 19, 2016
|ResQSystems, Inc.
|Systems and methods for therapeutic intrathoracic pressure regulation
|Oct 23, 2014
|May 31, 2016
|Advanced Circulatory Systems, Inc.
|Systems and methods to increase survival with favorable neurological function after cardiac arrest
|Mar 8, 2004
|Nov 25, 2004
|Advanced Circulatory Systems, Inc.
|Ventilator and methods for treating head trauma and low blood circulation
|Feb 27, 2007
|Sep 27, 2007
|Advanced Circulatory Systems, Inc.
|Cpr devices and methods utilizing a continuous supply of respiratory gases
|Mar 22, 2007
|Dec 6, 2007
|Advanced Circulatory Systems, Inc.
|Systems and methods for modulating autonomic function
|Sep 26, 2007
|Feb 28, 2008
|Advanced Circulatory Systems, Inc.
|Bag-valve resuscitation for treating of hypotension, head trauma, and cardiac arrest
|Apr 16, 2007
|Oct 16, 2008
|Advanced Circulatory Systems, Inc.
|Intrathoracic pressure limiter and cpr device for reducing intracranial pressure and methods of use
|Oct 12, 2007
|Oct 23, 2008
|Advanced Circulatory Systems, Inc.
|Volume exchanger valve system and method to increase circulation during cpr
|Jun 18, 2008
|Jan 22, 2009
|Advanced Circulatory Systems, Inc.
|Method and system to decrease intracranial pressure, enhance circulation, and encourage spontaneous respiration
|Jun 30, 2008
|Mar 5, 2009
|Advanced Circulatory Systems, Inc.
|Lower extremity compression devices, systems and methods to enhance circulation
|Mar 16, 2009
|Oct 1, 2009
|Nellcor Puritan Bennett Llc
|Nitric oxide measurements in patients using flowfeedback
|May 12, 2008
|Nov 12, 2009
|Advanced Circulatory Systems, Inc.
|System, method, and device to increase circulation during cpr without requiring positive pressure ventilation
|Sep 30, 2008
|Apr 1, 2010
|Nellcor Puritan Bennett Llc
|Sampling Circuit for Measuring Analytes
|Apr 28, 2011
|Advanced Circulatory Systems, Inc.
|Positive pressure systems and methods for increasing blood pressure and circulation
|Aug 18, 2011
|Advanced Circulatory Systems, Inc.
|Guided active compression decompression cardiopulmonary resuscitation systems and methods
|U.S. Classification
|128/203.11, 128/206.15, 128/207.12, 128/202.28, 128/205.24
|International Classification
|Cooperative Classification
|European Classification
|Aug 8, 2003
Owner name: ADVANCED CIRCULATORY SYSTEMS, INC., MINNESOTA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:LURIE, KEITH G.;REEL/FRAME:014372/0795
Effective date: 20030730
|Aug 24, 2010
|Fee payment
Year of fee payment: 4
|Aug 6, 2014
|Fee payment
Year of fee payment: 8


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Firmin (Paperback)
Usually Ships in 1-5 Days
In the basement of a Boston bookstore, Firmin is born in a shredded copy Finnegans Wake, nurtured on a diet of Zane Grey, Lady Chatterley's Lover, and Jane Eyre (which tastes a lot like lettuce). While his twelve siblings gnaw these books obliviously, for Firmin the words, thoughts, deeds, and hopes—all the literature he consumes—soon consume him. Emboldened by reading, intoxicated by curiosity, foraging for food, Firmin ventures out of his bookstore sanctuary, carrying with him all the yearnings and failings of humanity itself. It's a lot to ask of a rat—especially when his home is on the verge of annihilation.
A novel that is by turns hilarious, tragic, and hopeful, Firmin is a masterpiece of literary imagination. For here, a tender soul, a vagabond and philosopher, struggles with mortality and meaning—in a tale for anyone who has ever feasted on a book…and then had to turn the final page.
About the Author
Sam Savage is the author of the bestseller Firmin: Adventures of a Metropolitan Lowlife, an American Library Association Notable Book and Barnes & Noble Discover Great New Writers Award finalist. A native of South Carolina, Savage holds a PhD in philosophy from Yale University, was once an editor of a literary quarterly, and now lives in Madison, Wisconsin.
Praise For…
"Firmin is one of the most enjoyably surprising books I've read for a long time. It's a work of great originality: whenever I thought it was going to be one sort of book, it gently swerved aside and became another. This suggests an uncertainty of purpose, but that's not the impression at all. It's held together by the character of the narrator himself, a rat of deep humanity and intelligence, and the final impression is one of delicate tragedy. This really is a book like nothing else."—Philip Pullman
"Delicious. Firmin is a book that is written for Readers, that is, for people who have the book passion and for whom books are as real as anything else in life. Realer, perhaps." —Donna Leon
"Surprising and moving meditation on the advantages (and disadvantages) of an entirely fictional life. Eloquent and witty, Firmin speaks for the book-loving rodent in all of us." —Karen Joy Fowler, bestselling author of The Jane Austen Book Club
"[A] moving and wildly inventive novel…Firmin is a hero in the Dickensian mode…with the sardonic shadings of Vonnegut, and the same explicit tenderness." —Los Angeles Times
"An alternately whimsical and earnest paean to the joys of literature." —Publishers Weekly
"Mouth-wateringly creative, clever, unconventional and entertaining....Firmin is the kind of debut novel that exemplifies an author's raw creativity and passion for the art of writing, as much as the story. All readers will want to take a bite, both figuratively and literally, out of this page-turner."—BookBrowse.com

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FDA Approves Ruconest to Treat Rare Genetic Disease »
"The U.S. Food and Drug Administration yesterday approved Ruconest, the first recombinant C1-Esterase Inhibitor product for the treatment of acute attacks in adult and adolescent patients with hereditary angioedema (HAE).
Hereditary angioede"...
Read the FDA Approves Ruconest to Treat Rare Genetic Disease article »
No overdoses have been reported with CAYSTON in clinical trials to date. In clinical trials, 225 mg doses of CAYSTON via inhalation were associated with higher rates of drug-related respiratory adverse reactions, particularly cough. Since the peak plasma concentration of aztreonam following administration of CAYSTON (75 mg) is approximately 0.6 mcg/mL, compared to a serum concentration of 54 mcg/mL following administration of aztreonam for injection (500 mg), no systemic safety issues associated with CAYSTON overdose are anticipated.
CAYSTON is contraindicated in patients with a known allergy to aztreonam.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 10/10/2012
Cayston FDA Prescribing Information
Additional Cayston Information
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Women's Health
Find out what women really need.


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Latest from Jeff
Review: Catacombs
A dual-stick shooter that tries to emulate the gameplay of the classic Gauntlet game. Does it do well, or is it just an endless, bland survival game?
Jeff Yue
| April 2
Review: Zenonia 2
The original Zenonia was a very lengthy RPG that many enjoyed. Now it's successor is here, bringing many new additions to the table.
Jeff Yue
| April 1
Review: Caligo Chaser
Com2uS has just released their own sidescrolling hack 'n slash RPG. Hybrid: Eternal Whisper may have a serious competitor now.
Jeff Yue
| March 20
Review: Brothers In Arms 2: Global Front
The sequel to Gameloft's Brothers In Arms® Hour of Heroes is here with a first person view and improved graphics.
Jeff Yue
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Review: Street Fighter IV
The classic fighting and action game, Street Fighter, is out for the iPhone and iPod Touch. Is it worth $9.99, or is the price based on the Street Fighter name? Overall how does it stack up?
Jeff Yue
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Review: Raging Thunder 2
If you are interested in high-speed and action-driven racing, Raging Thunder 2 is a game you should consider.
Jeff Yue
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Review: DOOM Classic
DOOM has a cult following, and the classic game is now here. Is it fun, or does it doom itself?
Jeff Yue
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The Diffutils tool collection
The Diffutils tool set helps you compare text files, discover and display the differences between files, and even automatically synchronize files.
The Diffutils are a collection of useful tools. Diff compares two text files, outputting the differences in the command line, and storing suggested changes in a patch file, which you can use to automatically modify a file, if needed. If you need to compare three text files, Diff3 is the right tool for you. Read on for more tips and tricks.
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Mirantis to Refactor OpenStack Fuel for Kubernetes
The company is collaborating with Google and Intel to use Kubernetes as an engine for Fuel
Canonical Joins Document Foundation Advisory Board
The upcoming release of LibreOffice will be available as a snap package
SUSE Joins the Microsoft Test Drive Program
Customers can take a free test drive of SLES for HPC on the Azure Cloud
SiFive Launches a Line of Open Source Chips
San Francisco-based chip company announces their first fully open source chip platform.
Fedora 24 Released
The whole distro gets rebuilt on glibc 2.3
Canonical Announces Cross-Distro Support for Snaps
Ubuntu Vendor tries to solve app packaging and distribution problem across distributions.
ownCloud Forked
Founder of ownCloud launches the Nextcloud project.
HP Enterprise Unveils a Futuristic Computer
Will The Machine change the way future programmers think about memory?
CoreOS Announces Distributed Storage System
The new Torus distributed storage system is available under an open source license on GitHub
Google Beats Oracle in the Android Lawsuit
Juries decides Google's use of Java APIs Was Fair Use


text:
How r u?
I installed WordPress in my server, but I can't write posts, change themes... Nothing.
Appears the message:
You don't have permission to access /blog/wp-admin/index-extra.php on this server.
Additionally, a 404 Not Found error was encountered while trying to use an ErrorDocument to handle the request.
How can I solve this problem? Please, help me.
Thanks a lot.


text:
There's a new big man on the block - the Barronett Blinds Big Mike Hunting Blind with BLOODTRAIL Blades Camo. Most bow-hunters practice shooting while standing, yet they hunt out of small, cramped hunting blinds. The Big Mike Hub Blind from Barronett Blinds is 80 inches tall, allowing most archers enough room to shoot while standing!
Mack's Prairie Wings is not responsible for typographical errors in pricing or product specification inaccuracies in our web site. Prices are subject to change without notice.
Copyright © 2016 - Mack's Sport Shop LLLP - All rights reserved. Site Developed and Maintained by Ability Commerce
Copyright © 2004-2013 - Mack's Prairie Wings, Inc. - All rights reserved. Site Developed and Maintained by Ability Commerce


text:
Navicula sp.
Navicula sp. is a tube-dwelling diatom that is particularly abundant in spring from the high to the lower intertidal zone. The outer covering of each diatom, which is a single cell, is made of two silica valves ("shells"); diatoms live in "glass houses." This diatom often fools experts, because it can look like a filamentous brown alga.
Photos by Sarah Hall.


text:
Business insurance is a subject of great concern to small business owners. Legal requirements and cost are usually the major issues. Owners often say, "I can't afford it." They should be asking themselves "Can I afford not to have it?"
The first consideration should be an analysis of the risk involved. In other words, what is at risk in the event something bad occurs? For example, if the owner or key employee dies or is disabled, what is the outcome? What happens if a fire or natural disaster destroys business assets? How about personal injury lawsuits, work related injuries and loss of income due to business interruption. Unless a business has the financial strength to survive these disasters, insurance is needed to "hedge" such losses.
Lenders can dictate certain insurance requirements. For example, when assets are pledged as collateral for loans, the lender will require that they be insured. Also, when small businesses have key personnel on whom the business is dependent, lenders may require that life and/or disability insurance is maintained for the duration of the loan.
Due to the cost, workers' compensation insurance is an area of common concern. Any business not carrying workers' compensation insurance (called "going bare") faces unlimited liability if an injured employee can prove the employer negligent to any degree. Also, many organizations and individuals require that their suppliers carry workers' compensation - especially if contractor personnel work on their premises. The real risk is the exposure you have for work related injuries to employees. After a four-year legal battle, a federal bankruptcy judge ordered a funeral home in the DFW area to immediately sell their business to satisfy the claim of a former employee who received an electrical shock from an embalming machine. Are you willing to risk your business to save the premiums?
Bonds are a common point of confusion for many small business owners. Actually, there are several different types of business bonds - i.e. performance bonds and bid bonds. Bonds are a specific form of insurance normally related to contract fulfillment. Their purpose is to protect the buyer in the event of contractor default and they are quite common in the construction and high-tech industries.
Business interruption insurance provides a business with income in the event of a disaster. Let's assume that a retail business was gutted by fire and took three months to reopen. This type of insurance would pay benefits during the period of interruption.
General liability insurance protects the business from personal injury and property damage claims. Vehicles are required under Texas law to have minimum liability coverage. However, a business should also carry a general liability policy to cover other forms of claims.
A business is not legally required to provide employee benefits. However, without some benefits (especially health insurance), a business risks losing good employees. Lack of the ability to attract and keep good people often leads to loss of customers that can lead to business failure.
Insurance companies "hedge risk" by offering policies to thousands of businesses based on statistical probability. Insurance underwriters assess the risk involved in the requested coverage and determine premiums. This spreads the risk and premium income across a much wider population and gives an individual business the ability to cover their risk exposures. Insurance premiums vary from one business to another. For example, workers' compensation insurance for a company in the manufacturing or construction industry would cost considerably more than similar coverage for a small retailer.
If you have questions or need guidance in locating sources for various types of insurance, call our office (806) 372-5151 for an appointment. We don't sell insurance and our counseling services are free.
Bill Harrington is the Director of the West Texas A&M University Small Business Development Center. You can reach him at (806) 372-5151.
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text:
|Publication number
|Publication type
|Publication date
|Aug 30, 1966
|Filing date
|Sep 14, 1964
|Priority date
|Sep 14, 1964
|Publication number
|John C Kinney
|Original Assignee
|John C Kinney
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (11), Referenced by (14), Classifications (20)
|External Links: USPTO, USPTO Assignment, Espacenet
39, 1966 J. c. KINNEY 3,269,768
INVALID'S CHAIR Filed Sept. 14, 1964 2 Sheets-Sheet 1 JOHN C. KINNEY M INVENTOR.
' ATT'Y Aug. 30, 1966 -J. c KINNEY INVALID'S CHAIR Filed Sept. 14, 1964 2 Sheets-Sheet 2 JOHN C. KiNNEY INVENTOR.
United States Patent "ice 3,269,768 INVALIDS CHAIR John C. Kinney, 1411 SE. 30th Ave., Portland, Oreg. Filed Sept. 14, 1964, Ser. No. 396,299 1 Claim. (Cl. 29768) This invention relates to improvements in invalids chairs especially, though not restrictively, designed for use by patients suffering the after effects of cerebral palsy or other afllictive consequences.
It is one of the principal objects of my invention to provide a chair of the character described with readily adjustable cushioned means for effectively and comfortably supporting those parts of the occupants anatomy which are deprived of muscular control and in such a manner that a more or less natural posture can be attained for feeding and other administrations.
A further object of the invention is the inclusion of new and novel means in the form of a tray for supporting the arms and hands of the user and of such length and width as to induce reaching forward or from side to side for attractive articles placed along or toward the outer edge or edges of the tray. A footrest of similar construction is also provided which will comfortably support the feet of the user but will not interfere with their movement and hence the movement of the legs toward the outer edge or edges of the footrest. A backrest is hingedly linked to the footrest whereby adjustment of the backrest throughout its operative range will impart movement to the footrest and thus impel foot movement.
Since users of the chair are patients afilicted as aforesaid and incapable of manipulating the adjustable instrumentalities of the chair, a still further object of the invention is to provide means within convenient reach of a nurse or other attendant for actuating or flexing the legs of the patient alternately, upwardly and downwardly.
A still further object is the provision of a chair of the character described which is of simple, efficient, durable, light weight construction and so designed that it can be manufactured and sold within a considerably lower price range than any other such equipment I am aware of.
The foregoing and other objects and advantages which will become subsequently apparent reside in the details of construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part hereof and in which:
FIGURE 1 is a side elevational view of an invalids chair made in accordance with my invention and with fragments broken away for convenience of illustration.
FIGURE 2 is a front elevational view of FIGURE 1.
FIGURE 3 is a perspective rear elevational view of a backrest.
FIGURE 4 is a sectional detail View taken approxi mately along the line 44 of FIGURE 3.
FIGURE 5 is an enlarged detail view of pad-adjusting means.
FIGURE 6 is a sectional view taken approximately along the line 66 of FIGURE 5.
FIGURE 7 is a view similar to FIGURE 1 and on an enlarged scale of a modified form of the invention with fragments broken away and illustrating motor-driven means for imparting alternate swinging movement to the leg and footrests, for flexing the legs of a user, as above pointed out.
FIGURE 8 is a wiring diagram.
FIGURE 9 is a sectional elevational view taken approximately along the line 99 of FIGURE 7, and
FIGURE 10 is a longitudinal sectional side elevational view on a reduced scale of a permabulator illustrating the operative incorporation therein of the modification of FIGURE 7.
3,269,768 Patented August 30, 1966 With continuing reference to the drawings, wherein like reference characters designate like parts, and particularly FIGURES 1-3 thereof, reference numeral 1 indicates generally one form of embodiment of the invention comprising side members 2 and 3 secured near their bottom end in parallel relation to each other by a cross member 4 and by a seat 5 secured to both side members by brackets 6.
The side members 2 and 3 are preferably, though not restrictively, made of solid plywood panels in the interest of economy and lightweight construction with their front, rear, top and bottom edges trimmed with finishing strips 7, 8, 9, and 10 respectively. The strips 7-9 add to the pleasing appearance of the chair and strips 10 contribute to its stability.
A backrest, indicated generally at 12, is hingedly attached near its bottom end to the rearward edge of the seat 5 by a piano hinge 13. The bottom end of the backrest is connected by a link to a panel 16 swingably suspended from the bottom of the front of the seat 5 by similar hinges 17. Adjustably mounted to the panel 16 and extending forwardly therefrom is a footrest of box-like formation comprising a front wall 20', side walls 2122, and a bottom wall 23. The footrest is vertically adjustable by means of slots 24 and bolted brackets 25.
The backrest is adjustable throughout an operating range as indicated by full and broken lines in FIGURE 1, and is lockable in any selected position therewithin by outwardly spring-urged detents 28 slidable within, and normally extending outwardly from, a tubular housing 29 secured to the back wall 30 of the backrest 12, in any suitable manner. The detents are normally held in the extended position shown in FIGURE 3 by a compression spring 31, interposed between the inner ends of the detents which are provided with outwardly extending pins or finger grips 32, for convenience in retracting the detents when desired from engagement with openings in both side members 2 and 3. A cross member 36, secured to the side members 2 and 3, serves as a limit stop for the maximum backward tilt of the backrest 12 and also contributes to the rigidity of the chair.
A tray, indicated generally at 38, is provided with an up-standing rim 39 across its front edge and along both of its sides. The tray is adjustably supported upon the top flanges 9 of the side members 2 and 3 by depending flanges 41, each of which carries a pin 42 for selective engagement with apertures 44 in the top flanges 9 for adjustably locking the tray in extended, or retracted, positions relative to the backrest 12.
The top of the backrest is provided with a pair of cooperating laterally spaced apart padded head supports, indicated generally at 45-46, which, as best illustrated in FIGURE 3, are mounted to the backrest for simultaneous vertical adjustment and individual lateral adjustment relative to each other for supporting the head of the user. The head support 45 is secured, as at 50, to a forwardly extending end 51 of a metal band 52 bent, as at 53, around its respective side of the backrest then inwardly, as at 54, and terminates in a reduced inner end or tong portion 55 adjustably engaged within the bifurcated end 57 of a similar band 58 bent, as at 59, around the opposite side of the backrest and terminates on the front surface thereof in a forwardly projecting portion 60 to which is secured, as at 61, the companion headrest 46. The rearward inwardly bent portions of the bands 52 and 58 are provided with elongated slots 64 and 65, respectively, to accommodate locking bolts 66 and 67 which extend through vertical slots 68 and 69, respectively, and provided with heads 71 and wing nuts as shown.
Arranged above the seat at both sides thereof are laterally adjustable padded supports (see also FIG. 5) carried by angle plates 76 extending outwardly through slots 77 in the side members 2 and 3, and each thereat additionally supported by a flanged nut 78 secured to the side members 2 and 3. For convenience in adjusting the pads 75 inwardly or outwardly relative to the torso of the user to hold it in an upright position or for adjustment more to one side than the other into firm, but comfortable, supporting contact with both sides of the occupant, I provide each pad plate 76 with a shaft 79 threaded through the nut 78, swivel connected as at 80 to the angle plate 76 and provided at its outer end with a hand wheel 81.
From the foregoing it will be readily apparent that I have provided an invalids chair of greatly simplified and relatively inexpensive construction, and wherein the back rest and footrest are adjustable simultaneously into various positions for comfortable repose of the occupant with very little effort on the part of an attendant.
In the modified form of the invention illustrated in FIGURES 7 and 9, the side members 2A-3A backrest 12A and its related parts, and the seat 5A are the same as their counterparts in the first form of the invention.
The dominant features of this modification are the two individual footrests 82 and 83 secured to and extending outwardly from the bottom end of supporting panels 84 and 85 respectively, both hingedly attached, as at 86, to the underside of the forward edge of the seat 5A.
As shown in full lines in FIGURES 7 and 9, both footrests are on a common horizontal plane.
To provide the means as aforesaid for actuating or fiexing the legs of a user alternately outwardly, inwardly, and upwardly and downwardly, I provide a crank shaft 87 journaled at both of its ends, as at 88 and 89 in the side members 2A and 3A, respectively, and linked to the panels 84-85 by connecting rods 90 and 91.
One end of the crank shaft is provided with a worm wheel 93 at all times enmeshed with a worm gear 94 secured to the outer end of the shaft 95 of an electric motor 96 mounted in any suitable manner as by bracket 97 to the side frame member 3A.
The further modification shown in FIGURE 10 is illustrative of the fact that the seat (5B), leg rests 84A-85A and their related parts, may be readily applied to a wheel supported perambulator, or the like, wherein motive power for swinging the leg rests to flex the legs, as aforesaid, is derived from the rear wheels 100 of the vehicle as it is pushed along by an attendant.
The crack shaft 87A is journaled in bearings, not shown, depending from the sides of the vehicle frame 101 and is connected by links 90A and 91A to the leg rests 84A-85A.
Secured to one end of the crank shaft 87A is a sprocket wheel 103 driven by a chain 104 entrained over a driving sprocket wheel 105 secured to the rear axle 106 of the perambulator.
From the foregoing it will be readily apparent that the rate of swinging movement of both leg rests in FIG- URE 7 will be determined by the speed of the motor 96 regulated by manipulation of the rheostat R (FIG. 8) in electrical circuit with the motor and a source of current (not shown) through conductors 110-111. In FIGURE 10 the rate of leg rest movement is regulated by the speed of travel of the perambulator through the medium of its driven parts above pointed out.
While I have shown particular forms of embodiment of my invention, 1 am aware that many minor changes therein will readily suggest themselves to others skilled in the art without departing from the spirit and scope of the invention. Having thus described my invention, what I claim as new and desire to protect by Letters Patent is:
An invalids chair comprising in combination,
a vertically disposed frame made of two spaced apart plywood panels,
a seat fixedly secured within the frame and maintaining said panels in said spaced apart relation,
a brackrest and a foot rest,
means hingedly attaching said backrest to the seat whereby the backrest extends above and below said seat,
cooperating adjustable detent means carried by the backrest and said frame panels for regulating the angulation of said backrest relative to said seat, means hingedly depending said footrest from said seat, means interconnecting said backrest and footrest for imparting alternate upward and downward swinging movement to the footrest,
a tray, and
means adjustably mounting said tray forwardly and rearwardly on the top of said frame.
References Cited by the Examiner UNITED STATES PATENTS 101,764 4/1870 Poppendieche 297-91 1,344,255 6/ 1920 Beckrnan 272-5 8 2,383,340 8/1945 Tezzano 297-71 X 2,638,152 5/1953 Pulsifer 297-410 X 2,642,927 6/1953 Rising 297-410 X 2,798,565 7/1957 Rosenthal et a1. -65 3,058,742 10/1962 Jaffe 272-58 3,111,181 11/1963 Yatich 180-65 3,112,001 11/1963 Wise 180-65 3,112,108 11/1963 Hanke 272-58 FOREIGN PATENTS 360,849 11/1938 Italy.
FRANK B. SHERRY, Primary Examiner.
J. T. McCALL, Assistant Examiner.
|Cited Patent
|Filing date
|Publication date
|Apr 12, 1870
|Improved east-chair
|Sep 19, 1919
|Jun 22, 1920
|Bernard T Beckman
|Jun 6, 1944
|Aug 21, 1945
|Pezzano Joseph
|Combination wheel chair, table, and bed
|Jan 16, 1948
|May 12, 1953
|Pulsifer Newell B
|May 6, 1952
|Jun 23, 1953
|Rising Rachel L
|Headrest for automobiles
|Dec 23, 1954
|Jul 9, 1957
|Motorized wheel chair steered by driving
|Dec 12, 1960
|Oct 16, 1962
|Sarah Jaffe
|Adjustable muscle building apparatus and manipulator
|Jul 5, 1961
|Nov 19, 1963
|George D Yatich
|Powered wheelchair
|Sep 4, 1962
|Nov 26, 1963
|Charles W Wise
|Drive means for an invalid's bed
|Jul 3, 1961
|Nov 26, 1963
|Hanke Clarence F
|Exercising apparatus with crankshaft operable selectively by foot pedals or hand levers
|Title not available
|Citing Patent
|Filing date
|Publication date
|Jul 30, 1979
|May 12, 1981
|Calderone Michael P
|Exercise device
|Sep 10, 1979
|Aug 17, 1982
|Henry Fleischer
|Folding baby carriers
|Jan 8, 1981
|May 17, 1983
|Roston Stewart A
|Orthopedic support apparatus for infants
|Jul 17, 1981
|May 29, 1984
|Pietro Giordani
|Seat for a baby's push chair
|Sep 26, 1984
|Jan 5, 1988
|G O Giken Co., Ltd.
|Rotary health promoting exercise apparatus
|Mar 30, 1987
|Mar 8, 1988
|Bergeron Timothy J
|Wheeled seat carrying apparatus and stroller for the handicapped
|Jun 13, 1986
|Jun 14, 1988
|Bergeron Timothy J
|Seat support and restraint system for the handicapped
|Sep 9, 1992
|Aug 16, 1994
|Ken Endelman
|Exercise apparatus
|Dec 21, 1992
|Nov 22, 1994
|Hopital Marie-Enfant
|Modular pediatric seating system
|Jul 8, 1996
|Mar 4, 1997
|Endelman; Ken
|Exercise apparatus
|Jan 14, 2014
|Mar 10, 2015
|Scott Novins
|Rehabilitation device
|Feb 5, 2015
|May 3, 2016
|Scott Novins
|Rehabilitation device
|Dec 13, 2002
|Dec 23, 2004
|Stuart Moore
|Torso support structures
|Apr 26, 2002
|Oct 30, 2002
|Plasticline Srl
|Chair with adjustable back
|U.S. Classification
|297/68, 482/142, 297/464
|International Classification
|Cooperative Classification
|European Classification


text:
Whoa! Not So Fast, Say Astronomers
For a long time, galaxies such as the elliptical galaxy M105, which lies about 40 million light-years away, were thought by astronomers to be "dead" — that is, lacking in the activities that lead to star formation. A new look at this old galaxy, done by University of Michigan astronomers, shows that it's still creating stars. The discovery required that they look at the galaxy through ultraviolet-sensitive instruments to see the sites of starbirth (which glow brighter in UV).The galaxy isn't flashy and bright like other, younger galaxies, but astronomers say that it's still kicking out some newborn stars, albeit at a low level.
Galaxies generally come in two types: spiral galaxies, like our own Milky Way, and elliptical galaxies. The stars in spiral galaxies lie in a disk that also contains cold, dense gas, from which new stars are regularly formed at a rate of about one Sun per year.
Stars in elliptical galaxies, on the other hand, are nearly all billions of years old. These galaxies contain stars that orbit every which way, like bees around a beehive. Ellipticals have little, if any, cold gas, and no star formation was known.
According to University of Michigan research fellow Alyson Ford and astronomy professor Joel Bregman, astronomers really hadn't seen much activity in older galaxies and assumed they stopped making stellar newborns long ago. "Astronomers previously studied star formation by looking at all of the light from an elliptical galaxy at once, because we usually can't see individual stars," Ford said. "Our trick is to make sensitive ultraviolet images with the Hubble Space Telescope, which allows us to see individual stars."
The technique enabled the astronomers to observe star formation, even if it is as little as one Sun every 100,000 years.
Ford and Bregman are working to understand the stellar birth rate and likelihood of stars forming in groups within ellipticals. In the Milky Way, stars usually form in associations containing from tens to 100,000 stars. In elliptical galaxies, conditions are different because there is no disk of cold material to form stars.
"We were confused by some of the colors of objects in our images until we realized that they must be star clusters, so most of the star formation happens in associations," Ford said.
The team's breakthrough came when they observed Messier 105, a normal elliptical galaxy that is 34 million light-years away, in the constellation Leo. Though there had been no previous indication of star formation in Messier 105, Ford and Bregman saw a few bright, very blue stars, resembling a single star 10 to 20 times the mass of the Sun.
They also saw objects that aren't blue enough to be single stars, but instead are clusters of many stars. When accounting for these clusters, stars are forming in Messier 105 at an average rate of one Sun every 10,000 years, Ford and Bregman concluded. "This is not just a burst of star formation but a continuous process," Ford said.
These findings bring about new mysteries to explore, such as the origin of the gas that forms the stars. "We're at the beginning of a new line of research, which is very exciting, but at times confusing," Bregman said. "We hope to follow up this discovery with new observations that will really give us insight into the process of star formation in these 'dead' galaxies."</p>
The two collaborators present their findings today at a meeting of the Canadian Astronomical Society in London, Ontario.


text:
Definition of biodefense in English:
Defensive measures taken to protect against an attack using biological weapons: senators say that the government should spend $1.6 billion next year to bolster public health and biodefense
More example sentences
- The country is the world's biggest investor in "biodefence".
- So it's given biodefence a greater priority, spending billions more dollars a year.
- "Investment in biodefence may look like a screen for the development of weapons that are intended for offensive use," it said.
For editors and proofreaders
Syllabification: bi·o·de·fense
Definition of biodefense in:
What do you find interesting about this word or phrase?
Comments that don't adhere to our Community Guidelines may be moderated or removed.
= trending


text:
He is Risen!
Dear Friends:
As we joyfully celebrate the glorious resurrection of Our Redeemer and King, Jesus Christ, from the dead, please allow me to extend to you and yours my very warmest wishes and most ardent prayers for a grace-filled Eastertide.
Please look for a new article, entitled "The Week That Changed the World, The Day That Defeated Death: An Easter Interview with Gerry Matatics," to be posted here later this week.
Yours in our risen Savior and Mary our rejoicing Mother,
Gerry Matatics
...Read more


text:
Apr 12
We are opening for SEVENDUST, COAL CHAMBER, and LACUNA COIL ..... PARTY BUS IN THE MAKING get some!!
Apr 5
Mar 24
Benefit for the family of the late Jason Swanson
Mar 9
Feb 15
Skin Deep Tattoo Expo and MMA fighting
Sounds Like: All That Remains, Bullet for My Valentine, Sevendust, Killswitch Engage, Avenged Sevenfold
Manager: Josh Dennis
Stone the Manic is a five piece original hard rock / metal band hailing from Grand Rapids, MI.
This quintet has established itself in the local and regional scene as a crowd-drawing,
ticket-selling force to be reckoned with. Even at this early stage in their existence, Stone
the Manic has perf...See Full Bio


text:
Absolute Pixel Robbers
By Jonas Johnsson
Game CenterView More by This Developer
Open iTunes to buy and download apps.
No matter how high you jump, you will always get caught!
At least in real world! But here the Pixel Robbers are ruling the world, and it's up to you to help them survive as long as possible!
View In iTunes
This app is designed for both iPhone and iPad
- Free
- Category: Games
- Released: May 03, 2014
- Version: 1.0
- Size: 8.1 MB
- Language: English
- Seller: Jonas Johnsson
- © Captain Chaos Games
Compatibility: Requires iOS 5.0 or later. Compatible with iPhone, iPad, and iPod touch.


text:
Accutane is perhaps the most potent acne medication that we have seen. However, as you might suspect, it is believable that Accutane might produce some undesirable consequences. It is exceedingly vital that in preparation to you utilizing Accutane as an acne medicine, that you are familiar with of the likely outcomes that can surface with its usage.
If you are pregnant, it is especially critical that you are completely conscious of the potential ramifications of Accutane. One of the most notorious outcomes of utilizing Accutane as an acne remedy is the threat that it poses on a baby in the wombs of pregnant women. Women who are pregnant, should not ever, make use of employing Accutane as an acne medicine in view of the fact that of the severity of the side effects and the incidents of miscarriages and birth defects.
One of the ways that Accutane is successful in impeding acne flare-ups is because of its ability to shrink the glands that produce abundant sebum. However, another one of the potential side effects of Accutane is extremely dry skin, which may be especially blistery and peel excessively. Your lips may also be rough as well as your eyes being dehydrated and your nose parched out which may give rise to nosebleeds.


text:
Worth the Wait
Starting with your first /etc/rant column, I have loved them. You are
saying aloud what
many in the community think, with a very loud voice. I wanted to ask you,
why is this available only to subscribers? I'd love to make some comments on
my blog and then link to your columns, or translate them to Spanish and let
my friends read them in my blog. Tell me if this is feasible, please. I
already commented on the /etc/rant of February 2006 issue and plan to do it
on the April one I've just received, because I have lots of friends using
GNOME just because they think it embodies the spirit of Free Software.
Keep up the rant...er, the work.
Enrique Verdes
We do not publish in print and on the Web simultaneously, but we do publish our print content on the Web after a period of time expires. You can find archives of the magazine at the URL www.linuxjournal.com/xstatic/magazine/archives. —Ed.
Rant about Rant
Teams work very hard to release and offer their programming works of art.
I doubt any of them wishes to bash each other's software. How about
some constructive rants? The developers just might be inclined to offer
a feature/fix that your "opinion" had a problem with. Or,
heck, maybe
you might even spawn a reader to contribute constructively instead
of complain.
Thanks for listening to my rant.
Ryan Ferguson
Content Must Be Free of Unwanted Influence
The position of editor in chief traditionally allows ultimate control
of all aspects of a publication—from which letters will be included,
to whether GNOME or KDE screenshots are used, to what articles are
published and who is allowed to contribute. Perhaps
LJ has a system of
checks and balances in place that the casual reader doesn't know about,
but from the cheap seats, I'm concerned. Not to sound alarmist, but
a strong bias from the editor in chief is a contamination that can't
possibly be quarantined only to the last page of a publication!
Matt McElheny
It is the job of an editor in chief to serve the magazine's readers, period. That means keeping the content separate from the influence of advertising and unaffected by the editor's own personal opinions. If at any point you believe the content reflects otherwise, I will take your complaints very seriously. —Ed.
On the Spirit of Open Source
Great rant [April 2006]. But, as I see it, the real problem is not about advocacy,
it's about (never-ending) fragmentation. Big players (such as Oracle and Dell) are
complaining about it, and no one seems to listen.
The real problem is that a genius like Miguel is wasting his time with
GTK or Mono (the C# equivalent of the GNU Java compiler), when he could
do really useful stuff. It's a pity.
GCJ Deserves an Apology
I just got the latest LJ in the mail today. I wonder about the genesis of the "practically useless GCJ" remark in the etc/rant column [April 2006].
The version of Eclipse on my Debian Sid installation was built with GCJ, and it seems to run fine with no Sun JRE in sight. I thought Eclipse was a fairly large and complex project (although I have never tried to build it from scratch myself), so what does GCJ need to be able to do to get out of the "practically useless" category?
I also thought the limits of GCJ were due to limits of the GNU classpath,
and that work on that was progressing nicely. Maybe I'm not following
developments closely enough, though.
I'm the one not following the developments closely enough. Granted, it's not supported for Swing, but if you can compile the SWT-based Eclipse with GCJ, I owe it an apology. —Ed.
Even Einstein Agrees
So far, I just want say that I like the rants closing the new Linux Journal issues, although a blog of some kind might be a more appropriate place.
Still, you are echoing sentiments that I have expressed many times in the past. From the moment Miguel said, "UNIX sucks", and started making Linux look like Windows, I've felt like I've been lost in some kind of terrible nightmare, unable to awaken. I love UNIX, and although it certainly needs help on the desktop from a development API standpoint, I'm not about to throw away everything about UNIX that makes it great. Please reference the late Mr Einstein's genius (I use the following quotation in my e-mail signature) for why UNIX is great, IMHO:
"Any intelligent fool can make things bigger and more complex....It takes
a touch of genius—and a lot of courage—to move in the opposite
direction."—Albert Einstein
Michael P. Soulier
LJ Is Way Too Practical
Please cancel my subscription, because the Linux Journal disappoints me
thoroughly. It's too practical for this budding theoretical computer
William J. McEnaney Jr.
Size Does Matter
You now have a very inconvenient size and it ruins the display I have
of Linux Journal.
It doesn't fit on my lap in the men's reading room; it doesn't fit
in most places while reading, except in your hands, and it is
awkward there as well.
I love Linux Journal; I hate the new size of the pages.
Pete Gandy
SSH Quibbles
In "Demons Seeking Dæmons—A Practical Approach to Hardening Your OpenSSH Configuration" [March 2006], Phil Moses mentions the UsersAllow directive, but it is really the AllowUsers directive (as Listing 2 shows). And UsersDeny is really DenyUsers.
The meaning of an entry such as email@example.com is misleading.
He seems to indicate that it allows access to user from hostname.domain,
but it really means that people from hostname.domain can access user's
account (according to O'Reilly's SSH book).
Byron Rendar
Ow, No OWFS?
In your recent article on temperature monitoring [see "Remote Temperature Monitoring with Linux" by Steven M. Lapinskas, LJ, April 2006], you didn't mention Paul Alfille's OWFS Project (owfs.sourceforge.net).
OWFS already has been ported to the Linksys WRT54G wireless
router, providing a cheap and readily available hardware
platform for monitoring projects like the one described in the
article (owfs.sourceforge.net/WRT54G.html).
Xoops! A Security Hole
Juan Marcelo Rodriguez's XOOPS article [April 2006] tells us to set three directories so that any local user, including the Web server, can create and execute programs in them:
chmod 777 uploads cache templates_c
That's poor security practice. If XOOPS needs it, XOOPS needs a redesign. These wide open directories are just the place to install a 'bot for spamming or DoS attacks. It's begging for an Internet worm, if one doesn't exist already.
Mambo has similar issues. It seems the easier they make these complex Web
apps to install, the less care they pay to securing those installations.
Cameron Spitzer
Trending Topics
Practical Task Scheduling Deployment
On Demand
One of the best things about the UNIX environment (aside from being stable and efficient) is the vast array of software tools available to help you do your job. Traditionally, a UNIX tool does only one thing, but does that one thing very well. For example, grep is very easy to use and can search vast amounts of data quickly. The find tool can find a particular file or files based on all kinds of criteria. It's pretty easy to string these tools together to build even more powerful tools, such as a tool that finds all of the .log files in the /home directory and searches each one for a particular entry. This erector-set mentality allows UNIX system administrators to seem to always have the right tool for the job.
Cron traditionally has been considered another such a tool for job scheduling, but is it enough? This webinar considers that very question. The first part builds on a previous Geek Guide, Beyond Cron, and briefly describes how to know when it might be time to consider upgrading your job scheduling infrastructure. The second part presents an actual planning and implementation framework.
Join Linux Journal's Mike Diehl and Pat Cameron of Help Systems.
Free to Linux Journal readers.View Now!
|The Firebird Project's Firebird Relational Database
|Jul 29, 2016
|Stunnel Security for Oracle
|Jul 28, 2016
|SUSE LLC's SUSE Manager
|Jul 21, 2016
|My +1 Sword of Productivity
|Jul 20, 2016
|Non-Linux FOSS: Caffeine!
|Jul 19, 2016
|Murat Yener and Onur Dundar's Expert Android Studio (Wrox)
|Jul 18, 2016
- The Firebird Project's Firebird Relational Database
- Stunnel Security for Oracle
- My +1 Sword of Productivity
- SUSE LLC's SUSE Manager
- Non-Linux FOSS: Caffeine!
- Managing Linux Using Puppet
- Murat Yener and Onur Dundar's Expert Android Studio (Wrox)
- Parsing an RSS News Feed with a Bash Script
- Google's SwiftShader Released
- Doing for User Space What We Did for Kernel Space
Geek Guides
With all the industry talk about the benefits of Linux on Power and all the performance advantages offered by its open architecture, you may be considering a move in that direction. If you are thinking about analytics, big data and cloud computing, you would be right to evaluate Power. The idea of using commodity x86 hardware and replacing it every three years is an outdated cost model. It doesn't consider the total cost of ownership, and it doesn't consider the advantage of real processing power, high-availability and multithreading like a demon.
This ebook takes a look at some of the practical applications of the Linux on Power platform and ways you might bring all the performance power of this open architecture to bear for your organization. There are no smoke and mirrors here—just hard, cold, empirical evidence provided by independent sources. I also consider some innovative ways Linux on Power will be used in the future.Get the Guide


text:
Talk about workaholic bees.
On Memorial Day, when most traders had the day off and businesses were closed, thousands of tireless worker bees were buzzing on Wall Street.
The insects swarmed around the doorway of a high-end restaurant, Cipriani Wall Street, on Monday. Others filled the air.
Before they could enjoy a power lunch, the bees were sucked up in a low-pressure vacuum by the police department's beekeeper.
It's not clear where the bees came from.
Officer Anthony Planakis says the bees likely were looking for a new home. He says they probably were suffering overcrowding in the hive, or maybe the queen was failing.
It wasn't immediately clear if anyone was stung, but the swarm attracted the attention of dozens of onlookers.
The bees will be relocated to a hive in Connecticut.
It's A Bee Market! Worker Bees Swarm Wall Street
© 2010 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.


text:
Student registration
Professional registration
Gateway Technical College is hosting a "Meet the Professionals" event on September 30 to provide career awareness and information to assist Gateway students with their career choices. This conference-style event will include keynote presentation, a career breakout session and a networking reception.
Area professionals and technical college alumni will be sharing their career experiences and insights with Gateway students. Following the professional panel sessions students can continue to engage with professionals in their field of study during the networking reception.
Wednesday, September 30
Gateway Technical College – Kenosha Campus
Academic Building – Atrium
5:00 - 5:30 p.m. Light Dinner Available
5:30 - 6:00 p.m. Keynote speaker, Greg Mueller, Vice President of Marketing at Kenall
6:00 - 6:15 p.m. Arrive at Designated Room Locations
6:15 - 7:00 p.m. Meet the Professionals Breakout Session (by program of study)
7:00 - 7:30 p.m. Networking Reception
Questions? If you have questions or need additional information please contact:
Jacqueline E. Watson
Career Services Specialist
Celeste Henken
Foundation and Alumni Relations Coordinator


text:
huntress x black canary by amorimcomicartWatch
©2009-2016 amorimcomicart
new arts in ebay(U.K.)
great looking layout!!
What's Ms. Marvel's doing there?
Awsome work here
Nice work, man!
You DO do a gorgeous female form Di. Truly, you are a master. At the risk of sounding like a broken record, you hinted that there was more Arwyn coming. Anytime soon? I know, I'm annoying. But you're just so damn good at this stuff!
Oh my!
You're REALLT good!
You're REALLT good!
Nicely done!
Very good job! Nice work


text:
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August 1988
A family portrait: from left to right on the back row, Santo Versace, Gianni Versace and Donatella's then husband Paul Beck. On the front, Donatella with Allegra and Santo's wife Christina with their children, Francesca and Antonio.
Credit: Rex Features