text:
It may have slipped by unnoticed, but last week we started selling the very final batch of tickets.
At the end of the last WordCamp Europe in Vienna, when we announced Paris as the next host city, we released the first batch of 2000 tickets. That first batch sold out at the end of January 2017 and we decided to release the second batch immediately after, along with 300 microsponsor tickets.
With over 2200 tickets already sold or reserved (for our sponsors, speakers, and volunteers), WordCamp Europe 2017 will be the biggest WordCamp to date.
Keep in mind that there won't be any more tickets after this release, except reserved tickets that won't get collected.
What do you need to know?
Well, first, if you haven't purchased your ticket just yet, don't wait – get it today, as numbers can be misleading (in January alone we sold around 500 tickets). Getting your ticket today is a way of showing your support for people working hard to make WordCamp Europe 2017 the best experience ever.
Hotels list
With your ticket in your pocket (or inbox), you can check the list of hotels we recommend. Our local team (Merci, amis) prepared a list of hotels and grouped them by vicinity to the WordCamp's venue, or by theme. If you're in a mood for "Grand Paris", "Amelie" or "Moulin Rouge" – you'll find something for yourself. Each hotel is listed with an address, phone number, price for single and double rooms and with directions on how to get to the venue (Merci Jenny).
VISA invitation letters and invoices
You bought a ticket, and you need a VISA invitation letter or an invoice? Head to our WCEU VISA Application or Request an Invoice form. Once you fill the information required and you hit submit, give us at least five working days to respond (as we're quite busy with organising everything).
Frequent Questions
Last week we published the FAQ page. We have answered some of the most common questions there, and we will be updating that page with more answers as they come along.
If you applied to speak or volunteer
If you applied to volunteer, you should get back from our volunteers team by the end of February. We received 292 volunteer applications (from 53 countries) this year, and we will need some time to go through them. So, be patient, sit back and relax while our team sends you an email.
As with volunteers, we received an enormous amount of speaker submissions, 310 of them to be exact. It will take the entire month of February to go through them, and we will start contacting selected speakers in March. For all of you who asked when will we publish the schedule – not before the end of March/beginning of April.
Sponsor or become a media partner
If you want to sponsor WordCamp Europe (or know someone that might be interested) go to our Call for Sponsors (or send them a link). We will appreciate it :). Keep in mind that there are just a few spots left (and we already sold out editor/author slots), so don't wait the last minute to get in touch ;).
If you want to be a media partner of WordCamp Europe, you can apply before the end of February. This year we introduced some perks for those selected media partners, so they will have more visibility and a dedicated person who to get in touch if they need anything.
To stay in touch with what is going on with WordCamp Europe, you should subscribe to our news, or follow us on Facebook and Twitter.
As a bonus we recommend reading two of our first editorial articles – "Counting Down To WCEU: Looking At Paris From Above" and "WordPress People: Bernhard Kau". Enjoy!


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Mara the little-known Wellington Warrior
His panelbeating work has stalled, but Alehana Mara's league career may be set to take off.
The 21-year-old hooker from Porirua is something of an unknown Warrior, impressing in his first three NRL games late last season before injury scrubbed him out of the finals.
This year, Mara had to bide his time until round six, when coach Ivan Cleary finally let him off the leash in a loss to Manly.
He did enough to hold his spot for Monday's upset win in Melbourne, a victory which Mara hopes will ignite both his personal season and that of the team.
"This has been my best start to the season because every other year I've been at the club I've been injured," Mara said.
"I've just been lucky to not pull up with any injuries and everything is coming together."
Mara underwent off-season arthroscopic surgery on a troublesome medial ligament and to his delight he hasn't had to reach for the strapping tape so far this year.
It also means his backup career has been put on hold.
"When I was in the under-20s I was doing a bit of panelbeating and I try and get back to my old work every now and then, just to brush up on some skills. But I always end up just having a long-as lunch with the boss and next thing you know it's five o'clock and they've closed up. I try to get back in there but I'm really just focusing on league at the moment."
Mara, who played for St George and the Wellington Orcas while attending St Pat's Town, joined the Warriors as a 17-year-old and found the initial transition tough. "There were five of us that moved into a house and we were all from out of Auckland. It was a real reality check eh, being out of home and I had to do washing, shopping, stuff I had to worry about like the bills. But it was a good thing, it helped me grow up. I'm better for it."
Mara is currently operating as the club's No 2 rake behind Aaron Heremaia and both come off contract at the end of the season.
The recent signing of highly-rated Gold Coast hooker Nathan Friend for next season took Mara by surprise.
But the word out of Mt Smart is Heremaia is likely to be released with the younger Mara a good chance to be offered another contract.
"I was nervous at first but I'm trying to turn it into a positive," Mara said of Friend's signing.
"When it came, it was a reality check, that no-one is safe these days, it's about how you perform. I can't do anything about it and it is a good signing for the club and they're doing what they need to do to ensure the club's future.
"I know that's how league goes these days. But just because they've signed someone doesn't mean I can't still push hard for a spot."
Despite his inexperience, Mara looks at home in the hurly burly world of the NRL and he attributes that to on-field guidance from Aussie halves Brett Seymour and James Maloney and off-field mentoring from the injured Jerome Ropati.
"I'm loving it here. My goals are not to take a backward step and don't give the coaches a reason to drop me. Jerome Ropati has been huge in my life.
"He lives just around the corner from me and in the off-season we go training every day and just being around him, hanging out with him, we grew closer.
"He's just a guy that I'd love to be like, just a good role model off the field and when he's on the field he just goes hard. He's a great guy."
Mara boldly declared the gutsy defeat of the Storm as evidence the Warriors were title contenders.
If they play to the same level at home against Penrith on Sunday a win should follow, although Mara believed the midweek axing of coach Matt Elliott would fire the Panthers.
"We are confident but the Storm game is done and dusted and this is a new week. They'll be hurting from their coach leaving at the end of the year."
A battle within the battle will be Mara's contest with former Warriors under-20 hooker Nafe Seluini.
Both little men will be asked to spark their teams from the bench.
"Ivan just gives me a licence to roam. He likes me to come on and pick up the tempo of the game.
"He tells me when I get my opportunities to run, to take them and don't hesitate."
Alehana Mara
Position: Hooker
Age: 21
Physical: 1.78m, 83kg
NRL games: 5 (debut v Manly at Brookvale Oval, 2010)
Previous clubs: Wellington Orcas, St George (Wellington)
Rep honours: NZ under-18s (2007), Junior Kiwis (2006)
Educated: St Pat's Town
The Dominion Post

subset: commoncrawl


text:
Graduate Sales Executive
- Recruiter
- Advanced
- Location
- Birmingham, West Midlands
- Posted
- 19 Apr 2017
- Closes
- 22 Apr 2017
- Sector
- Engineering
Are you looking for your next big career move? Are you a talented and competitive individual looking for an exciting challenge? Do you enjoy working towards targets? If this sounds like you then this could be your next career move! The UK's 3rd largest software company is looking for people like you to join their Inside Sales team in our new offices in the Mailbox, Birmingham. If this sounds like what you are looking for, click apply to get your career started! The Team and Role You will play a pivotal role in our complex sales process, helping to identify prospects and drive awareness of our solutions. Working as part of a close team, you will: Within an assigned product or market area, generate interest in our products through active outbound callingRespond to initial enquiries from potential new customersResearch and engage with prospects, discovering key information about their needsExplain and position our products & solutionsConduct market research and identify new business opportunities for field sales to follow upRecruit attendees for the customer and prospect events programme and provide pre and post event follow up support.Book sales appointments and demonstrations for the field sales team with qualified prospectsContinually update and cleanse the customer database with key marketing and competitor information. Requirements In order to qualify: You'll be passionate about developing a career in sales. You might have some previous experience in customer-facing environments.You'll have an interest in the software/technology domainYou will most likely (although it's not a prerequisite) be a graduate (in any discipline)You will be fearless, have a natural desire to do the right thing, and enjoy delivering to deadlines and targets at pace We're Advanced Join a business that embraces innovation, gives you the scope to seize every opportunity and will help get you where you want to go. Life at Advanced begins in an unprecedented environment with a role that matters, taking you on a fast paced journey of discovery, however big that might be. We're one of the UK's largest and fastest growing software companies. True partnership is the defining thing that makes us different from the competition. We pride ourselves on delivering focused software solutions for public sector, enterprise commercial and health & care organisations that simplify complex business challenges and deliver immediate value. This role is the first step in your software sales career in Advanced. As well as continuous personal development, when you join the team, you will also benefit from: Excellent benefits from day one: contributory pension, life insurance, income protection insurance, childcare voucher salary sacrifice, cycle to work scheme, and employee assistance programme25 days holidaysSpecial focus on training and development with the opportunity to excel your career from our internal Talent Development TeamBe part of an organisation that has recently been ranked by Deloitte in the Top 50 fastest-growing tech companiesPrestigious location in Birmingham City centre. Advanced is an equal opportunity employer, committed to removing bias from the hiring process. We accept applications from all academic and professional backgrounds.


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"hi I have a question, does this ring have the certificate?"
I bought this as my wedding band, it was to large for my small fingers. It was absolutely beautiful and I hated having to return it for another band. The customer service agents I spoke with were all very great with helping me find another - and the return was easy....
Montebello 14k White Gold Women's 1/2ct TDW Diamond Wedding Band (G-H, SI2)by Montebello Jewelry
ITEM#: 14341608The reason the princess-cut diamond is a favorite among diamond lovers is that gives the wearer the best of everything a diamond can offer. Not only does the princess cut look unique and stand out in a crowd, it also offers stunning brilliance and fire. White gold is often used to enhance diamonds and other gemstones.
Wedding band
- White diamonds: Eleven
- White diamond cut: Princess
- White diamond weight: 1/2 carat
- Color: G-H
- White diamond clarity: SI2
- White diamond setting: Micro-pave Hybrid
Metal information and dimensions
- Metal: 14-karat white gold
- Style: Pave
- Band: 2.95 mm wide
Diamond total weight: 1/2 carat(s) TW
All weights and measurements are approximate and may vary slightly from the listed information. T.W. (total weight) is approximate. 1/2 carat T.W. may be 0.45 to 0.55 carat. Treatment code N . See Gemstone Treatments for further information.
Click here for ring sizing guide
The Montebello Jewelry collection is a third generation family legacy where manufacturing diamonds from the rough and creating amazing designs is more than a mission -- it's a way of life. As a De Beers Sightholder and a member of the responsible jewelry council the Montebello collection is held to higher standards of ethical sourcing and the assurance of the natural integrity of the diamonds.
|Total Diamond Weight
|.5 to 1 Carats
|Ring Style
|Gold Karat
|Stone Shape
|Band Width
|3-4 mm
|Birthstone Month
|Gold, White, White G-H
|Cut Grade
|Very Good
|Jewelry Setting
|Metal Color
|4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8
|Stone Color
|See details
|Model Number
|Country of Origin
|United States
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Product Reviews
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wedding band
I bought this as my wedding band, it was to large for my small fingers. It was absolutely beautiful and I hated having to return it for another band. The customer service agents I spoke with were all very great with helping me find another - and the return was easy.Read More
This ring is stunning and soo sparkly in person!! I was very nervous to order a wedding band online without seeing it in person but it exceeded my expectations by far! This ring looks great with princess cut engagement rings. I was looking for a wedding band that was not channel set or prong set and I found it! Love love love this ring!Read More
Questions & Answers
Hello kamil84, I'm sorry this does not come with a certificate. Have a great day!
Shopping Tips & Inspiration
How to Clean a Diamond Ring
Wearing a keepsake diamond ring every day means keeping your precious piece of jewelry sparkling clean so that it always looks its best. Luckily, jewelry cleaning is easy to do at home with the right materials and approach. It's simple to make your own jewelry cleaning solution out of household cleaning materials that are likely in your pantry right now.
Diamond Band Buying Guide
Traditional as wedding rings and popular as fine fashion jewelry, the diamond band is a ring you need in your jewelry wardrobe.
Shopping for the Modern Bride - Wedding Bands
Shopping for the Modern Bride: Wedding Bands from Overstock.com. Our guides provide customers with information about shopping for modern wedding bands.
Best Black Diamond Jewelry for Casual Outfits
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Diamond Clarity Enhancement Quick Facts
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How to Buy a Certified Diamond
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Diamond Cuts Fact Sheet
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How to Buy Colored Diamonds
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Black Diamond Buying Guide
Black Diamond Buying Guide from Overstock.com. Black diamonds have become an increasingly popular design element in diamond jewelry. Learn more about black diamonds.
FAQs about Black Diamond Jewelry
FAQs about Black Diamond Jewelry from Overstock.com. Here are the answers to the most frequently asked questions about black diamond jewelry. Learn about black diamonds before you shop!
Wedding Party Gift Packs
Make time to remember the people who will help you celebrate your big day with personalized gifts for the bridesmaids and groomsmen.
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Contact Information
Shipping Information:
Our standard shipping method is ground shipping. We also offer expedited shipping for most items. Your final
shipping cost and estimated delivery timeframe will be available at checkout.
Standard shipping details
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Standard Return Policy for Jewelry:
Items must be returned in new or unused condition and contain all original materials included with the shipment.
More Details
For your protection, all orders are screened for security purposes. If your order is selected for review, our Loss Prevention Team may contact you by phone or email. There may be a two business day delay to process your order.
** Most Oversize orders are delivered within 1-4 weeks. Some orders may take 6 weeks to be delivered.


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Pic by Cheryl Oliver of fire at Mount Zion AME Church in Greeleyville, 60 miles north of Charleston. #ChurchFires pic.twitter.com/5CNFwePXhA — Andrew Knapp (@offlede)
July 1, 2015
After a spate of arsons at six black churches in several southern states prompted a federal investigation, a fire broke out in yet another predominantly black congregation in South Carolina on Tuesday.
A fire has heavily damaged the Mt. Zion AME Church in Greeleyville – a church already rebuilt once after its previous structure was burned down in 1995 by the white supremacist group the Ku Klux Klan.
No injuries were reported and the blaze was brought under control, according to fire department officials.
CCFD on scene mutual aide to Williamsburg County for working fire at Mt. Zion AME Church. Fire now under control. pic.twitter.com/Wt13RLGQDo — Clarendon County FD (@clarendonfire)
July 1, 2015
Heavy fire at Mt Zion AME church near Greeleyville in Williamsburg County. Mutual aid dept's on scene. pic.twitter.com/GoQESXdJPS — Carter Jones (@SCFireCarter)
July 1, 2015
You Should Read: Saying The Charleston Shooting Isn't About Race Is Racist
Officials don't yet know what caused the fire.
Mt. Zion AME is now the seventh church to go up in flames in almost a week following the tragedy in Charleston in which 21-year-old Dylann Roof allegedly shot and killed nine people in Emanuel AME Church.
Though the FBI has denied any evidence connecting the blazes, outraged people have taken to Twitter raising concern over the similar incidents of arson using the hashtag #WhoIsBurningBlackChurches.
7 Black churches set on fire in a WEEK. At least 3 confirmed arsons? What are we doing about it?! #WhoIsBurningBlackChurches — Linda Sarsour (@lsarsour)
July 1, 2015
While we have not yet apprehended #WhoIsBurningBlackChurches, we know that they will never destroy our spirit. We will endure. We will win. — deray mckesson (@deray)
June 30, 2015
This is domestic terrorism aimed at our fellow citizens. Everyone should be asking #WhoIsBurningBlackChurches — Sarah Kendzior (@sarahkendzior)
June 30, 2015
Offended by property damage during protests? Are you equally offended by destruction of black churches. #WhoIsBurningBlackChurches — Yolanda Pierce (@YNPierce)
June 30, 2015
Define terrorism: Me telling my mother not to attend church this Sunday #WhoIsBurningBlackChurches — BlackGirlNerds (@BlackGirlNerds)
July 1, 2015
No evidence of hate crimes? Six black churches burned in a few weeks? #WhoIsBurningBlackChurches? We need massive resources focused on this. — Lisa Bloom (@LisaBloom)
July 1, 2015
Other churches that caught fire in the past week include College Hill Seventh Day Adventist Church in Knoxville, Tennessee; God's Power Church of Christ in Macon, Georgia; Briar Creek Road Baptist Church in Charlotte, North Carolina; Glover Grove Baptist Church in Warrenville, South Carolina; the Greater Miracle Apostolic Holiness Church in Tallahassee, Florida; and Fruitland Presbyterian Church in Gibson County, Tennessee.
Read More: Dylann Roof Is A White Supremacist American Terrorist


text:
Financial Advisor Services
55 simbi value
I will help you understand what your financial needs are and get you in the right direction. I can help you get out of debt, save up for retirement or college, or invest your money.
Training & Qualifications
Trading Preference: Trade only – I just want direct exchanges
I am state certified.
About Amanda Erwin
Hi there! I am trying to make a difference in people's lives and make sure they're not being ripped off! I am not a salesperson. I don't sell anything! I am a free service that helps get people on the... right path to a financially stable future.show moreOpen to other proposals
Amanda Erwin is looking for:
- Photography
- Massage
- Travel
- Fun & Quirky


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You have no items in your shopping cart.
Ingredients: Sea Salt, Dehydrated Garlic, Black Pepper, Dehydrated Onion, Coriander, Dill Seed, Caraway, Soybean Oil, Chili Pepper.
Nutritional Info: Serving size: 1/4 tsp (1g), Servings: 88, Amount per serving: Calories 0, Total Fat 0g (0%dv), Sodium 135mg (6%dv), Total Carbohydrates 0g (0%dv), Protein 0g. Not a significant source of Fat Calories, Sat cal, Trans Fat, Cholesterol, Fiber, Sugar, Vitamin A, Vitamin C, Iron and Calcium. Percent Daily Values (dv) are based on a 2,000 calorie diet.
|Urban Accents
|Accessory Type
|Sauces, Rubs & Seasonings
|Best for
|Beef, Steak, Veggies
|Item Type
|Dry Rub


text:
Genap - Anti-Algae Tensioned Cover for Water Reservoirs
From Horticulture Water Storage
In addition to floating covers we also supply tensioned covers. This type of cover also prevents the water from becoming contaminated due to algae growth or from dirt blowing in such as leaves, sand or twigs. The tensioned cover is made from black HDPE woven fabric, which is called Genatex® 1000 and which is fitted with an open edge around the sides for fitting a greenhouse tube *) or heating pipe*) into the edge. The cover is tensioned using a tape with ratchet strap, secured to an anchoring post*) in the toe of the dike. Generally used for reservoirs with a width of up to 20 metres.
- Suitable for both straight and sloping reservoirs up to 20 metres wide
- Compact transport volume
- Single-piece sizes possible up to 2000 m2
- Supplied including installation materials and technical manual
- Very easy to install without the need for special tools
- Suitable for covering every type of horticultural water storage system
- Water permeable
- Maximum reduction in algae growth by almost 100% light exclusion from the reservoir
- Low maintenance
- High UV-resistance.
Customer reviews
No reviews were found for Genap - Anti-Algae Tensioned Cover for Water Reservoirs. Be the first to review!


text:
Rawtenstall Tel: 01706 253530
NelsonTel: 01282 731415
PadihamTel: 01282 644600
Seasonal Flu Clinics are now bookable for the following dates:
Rawtenstall 24 Sept 08:30 - 13:00
Padiham 01 October 09:00 - 12:00
Nelson 08 October 08:30 - 13:00
Heatwaves can be dangerous, especially for the very young, the elderly or those with a chronic disease. Prolonged exposure to very high temperatures can mean the body is unable to reduce its own temperature, causing dehydration and heatstroke, which can be fatal. In particular, hot temperatures overnight make it difficult for the body to cool.
The Heat Health Watch Service operates in England from 1 June to 15 September each year, in association with Public Health England.
The Met Office forecasts day-time and night-time maximum temperatures, which are monitored regionally. When certain heat thresholds are passed, a warning is issued and sent to relevant NHS, social care, local and national government professionals, well as being displayed on our website. This enables organisations, frontline staff and individuals to take action to minimise the impact of the heat on peoples' health.
The practice is currently offering a new audiology service from the Padiham and Nelson sites - ask at reception for further information. Over 55 year old can ask to be referred into the service for Free NHS hearing aids.
we have added a link under clinics and services for patient who require patient transport services to get them to the hospital for an appointment - Patient Transport Services
Follow link on right side of home page and down load your personalised child immunisations due date planner to help and assist in planning when they are due and to make an appointment for your child continuing immunisation schedule.
Over the last 18 months East Lancashire CCG has been working alongside patients, carers and wider stakeholders like doctors and pharmacists to develop a vision for how they would like GP services to develop in future. Our vision is for GPs and partner organisations to work together more closely; to provide quality joined up care; with equal access to services wherever you live in East Lancashire. Together we came up with a simplified system to provide appointments in the practice, on the phone, online and in patients' homes as required. Further information in document below.
Patients on long-term medication can order repeat prescriptions in a number of ways:
Please note we do not accept medication requests over the telephone due to increased risk of error.
Requests for medication that is not due will only be given in exceptional circumstances.
Your prescription will be ready for collection 2 working days after we have received it.
Patients on repeat medication will be asked to see a doctor, nurse practitioner or practice nurse at least once a year to review these regular medications and notification should appear on your repeat slip. Please ensure that you book an appropriate appointment to avoid unnecessary delays to further prescriptions.
Repeat prescriptions will be issued at the doctor's discretion and are normally for patients on long-term treatment.
When you receive a prescription for your medication it will have two parts:
1. The left hand part is given to the pharmacist to keep when your medication is dispensed.
2. The right hand part is your tear-off slip. You need to keep this to order your repeat medication. Handy Tip – Put this tear off slip into your handbag or pocket ready for when you need to reorder.
All the items of medication that are on your tear-off slip are repeat items and you must TICK clearly in the box opposite the items you wish to order.
If an item of medication does not appear on your tear-off slip then it is an ACUTE item and not a REPEAT. A receptionist must ask the GP to authorise these.
If you find that your medication runs out at different times and you are ordering more than once a month then please get your medication synchronised by informing the receptionists.
Before you order your next repeat prescription:
Kindly Stop and Consider –
Extensive exemption and remission arrangements protect those likely to have difficulty in paying charges (NHS prescription and dental charges, optical and hospital travel costs). The NHS prescription charge is a flat-rate amount which successive Governments have thought it reasonable to charge for those who can afford to pay for their medicines. Prescription prepayment certificates (PPCs) offer real savings for people who need extensive medication.
These charges apply in England only. In Northern Ireland, Scotland and Wales prescriptions are free of charge. (As of April 2015)
If you will have to pay for four or more prescription items in three months, or more than 15 items in 12 months, you may find it cheaper to buy a PPC.
There is further information about prescription exemptions and fees on the NHS website
Please allow 48 hours, excluding weekends and Bank Holidays, for your request to be processed. Any problems please telephone the surgery.
The electronic prescription service (EPS) is an NHS service. It gives you the chance to change how your GP sends your prescription to the place you choose to get your medicines or appliances from.
Pick up a leaflet in practice or from your local pharmacy to mke your nomination.
Yes, if you have a stable condition and you:
It may not be if you:
Copyright 2006 - 2017 My Surgery Website | Privacy & Usage | Edit | Staff Home | Site Map | Accessibility | Site T&C's | Service T&C's


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2014 has been the year of big purchases and investments. We have seen some big purchases being made by big name companies buying a number of startups. And that trend continues with Yahoo now acquring Banglore-based tech startup Bookpad.
The US Internet giant, also set to make about $9.5 billion (Rs 57,000 crore) from Alibaba's initial public offering, has now bought the Bangalore-based firm in a deal that's worth around Rs 50 crore ($ 8.3 million).
The information comes directly from two people with direct knowledge of the development. "The deal is done. The team will be moving to Silicon Valley soon," said a person familiar with the ongoing deal. "Large firms like Autodesk and Dropbox were also eyeing Bookpad."
To date, Yahoo has bought over 100 companies. In fact, the deal comes a few months after Facebook acquired Bangalore's Little Eye Labs. Bookpad has actually become the first Indian tech startup to be bought by Yahoo, and it has been just a year since the startup first came to life.
Recommended: NoiseTube App Launched: Measures Intensity of Noise in Locality
Founded by IIT-Guwahati alumni Niketh Sabbineni, Aditya Bandi and Ashwik Reddy, who are all friends and in their early twenties, Bookpad is currently taking the game to larger companies like Google and Crocodoc in terms of document viewing.
"Bookpad pivoted its business model by focusing on enterprises rather than consumers. It bagged customers ranging from e-Learning firms to cloud storage companies. Last October when Bookpad made a pitch at the Nasscom product conclave, the Microsoft Ventures director Ravi Narayan got impressed and selected them for the company's accelerator programme," ET writes.
Recommended: Arya Z2 Launched in India at Rs 6,999
Back in January, Bangalore-based Little Eye Labs became the first Indian firm to be bought by Facebook.


text:
|Publication number
|Publication type
|Application number
|Publication date
|Dec 29, 1998
|Filing date
|May 8, 1995
|Priority date
|Jul 26, 1993
|Fee status
|Also published as
|Publication number
|Scott Bair
|Original Assignee
|Surgijet, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (59), Non-Patent Citations (4), Referenced by (71), Classifications (16), Legal Events (6)
|External Links: USPTO, USPTO Assignment, Espacenet
This application is a continuation-in-part of application Ser. No. 08/438,905, filed May 10, 1995, U.S. Pat. No. 5,562,692, which is a continuation of Ser. No. 08/096,297 filed Jul. 26, 1993, abandoned, the contents of which are incorporated herein by reference.
1. Field of the Invention
The present disclosure generally relates to surgical cutting tools, and, more particularly, to cutting tools employing a fluid jet as the active cutting agent. The disclosure further relates to surgical cutting tools utilizing suction for aspiration purposes, and, in particular, relates to a tool for amplifying the suction force at the surgical site.
2. Discussion of the Prior Art
There is currently a great amount of interest in new technologies to replace or supplant traditional surgical cutting tools such as the scalpel. Laser-based tools, electrosurgical cutters, plasma jets, and fluid jets have all been introduced to improve various surgical and medical procedures. Each technology has advantages for particular procedures, as well as intrinsic drawbacks. Fluid jet cutters have several characteristics that make it an attractive new technology. For example, pulsed fluid jet cutters involve no electrical current or voltage, which can present a safety risk factor in delicate surgeries. Likewise, there is no heat generated by fluid jets. Indeed, fluid jets are inherently self-cooling. Also, the effects of pulsed fluid jets can be extremely localized and directional, unlike electrosurgical tools and some laser instruments.
Moreover, fluid jet cutters excel at removing soft tissue, due to the fact that high pressure pulsed jets tend to emulsify soft tissue, and the emulsified tissue is easily transported by aspiration away from the surgical site. In contrast, competing technologies such as laser cutters and electrosurgical cutters remove tissue by ablation or electrothermal dissolution.
Indeed, the fact that fluid jet cutting devices include aspiration and evacuation as an integral portion of the device is an added benefit for many surgical procedures. Surgical cutting and excision often involves exsanguination that occludes the surgical field, and the surgeon must employ an assistant to aspirate the field to permit adequate visualization. Fluid jet devices that aspirate the fluid and emulsified tissue also remove the blood and other fluids that might otherwise affect visualization by the surgeon, and they do so without involving additional personnel.
However, fluid jet devices known in the prior art exhibit some negative characteristics that limit their usefulness. Within restricted body cavities and organs, the volume of the fluid introduced by the cutting instrument may exceed the aspiration ability of the instrument, resulting in distention and expansion that can have deleterious side effects. The emulsification effect is primarily a consequence of pulsing the high pressure fluid jet, and the pulse parameters are critical in efficiently emulsifying tissue. Generally speaking, prior art fluid jet tools have not been capable of achieving sufficiently short, well-defined pulses of high pressure fluid to emulsify tissue effectively and completely. Any portion of a fluid pulse that is not delivered at high pressure is ineffective, and merely adds fluid to the surgical field. As a result, a greater volume of fluid is consumed for a given cutting or excision procedure, requiring more time for the surgeon and the provision of more robust aspiration capabilities in the tool.
As a safety measure, it is critical that any fluid jet cutting tool be prevented from emitting a steady stream of high pressure fluid, which can quickly penetrate deeply into soft tissue and can cause catastrophic damage. Some prior art pulsed fluid jet instruments are not designed to inherently prevent a high pressure stream, and must be carefully controlled by external devices to avoid serious accidents.
In addition, many devices in the prior art provide for connection to a source of suction to permit the surgeon to aspirate the excess fluid from the surgical site utilizing the single instrument. These devices provide a constant suction force, which is disadvantageous in that many times a greater or lesser suction force may be desirable. It may be necessary to interrupt the surgical procedure to adjust the suction force at the source which, usually, is remote from the instrument. Typically, these instruments only provide for activating and deactivating the suction force not for adjusting or modifying the level of force.
Furthermore, in the event that the aspiration or suction cannula of a conventional device becomes clogged with emulsified tissue or the like, manual cleaning of the cannula tip is required, thus, necessitating an interruption of the surgical procedure to permit surgical personnel to clear the blockage. This can be disadvantageous to the patient, particularly for those undergoing procedures such as cataract surgery or the like. Removing the instrument for cleaning during cataract surgery at the very least requires second entry puncture to the eye capsule. Even further, the emulsified tissue which clogs the cannula tip and fails to enter the aspiration cannula will cause an increase in suction within the instrument. The increase in suction will result at the very least in a reduced internal volume of the flexible hose connecting the suction source with the aspiration cannula and possible breakdown of the system.
Thus, a need exists for a fluid jet cutting instrument having aspiration capabilities, which provides for a variation in the force of the suction and which permits for automatic clearing of the instrument in the event of a blockage.
The present disclosure generally relates to a pulsed fluid jet instrument for surgical cutting and excision. The instrument features superior pulse characteristics which optimize cutting and emulsification while minimizing the amount of fluid used in the process and preventing the emission of a steady stream of high pressure fluid into tissue.
In a preferred embodiment, the instrument includes a handpiece, a cannula extending from a handpiece and having an inner needle designed to emit a pulsed fluid jet for cutting and emulsification purposes and an outer concentric needle or tube connected to a negative pressure source for aspiration and evacuation of the fluid and tissue. The handpiece features a pressure intensifier piston arrangement that receives fluid at relatively low pressure. The piston arrangement operates reciprocally and reiteratively to pump the fluid through the jet needle in a series of high pressure pulses, each having a nearly rectangular pressure waveform.
The pressure intensifier piston is preferably T-shaped having a broad end which divides a drive bore into an actuating chamber and a retracting chamber. A bistable valve is connected to admit high pressure gas into the actuating chamber, thereby driving the piston to translate. The narrow end of the piston is disposed in a fluid pumping chamber which is connected to a supply of fluid. The translating piston drives the fluid from the pumping chamber through a first check valve into the fluid jet needle which directs the high pressure fluid pulse to a tissue target. Pressurized gas is admitted to the retracting chamber via the bistable valve, thereby driving the piston retrograde and allowing the pumping chamber to refill with fluid through a second check valve.
There is no high pressure fluid supplied to the handpiece. The pressure intensifying pumping action of the piston creates a high pressure fluid pulse. Moreover, the gas supply to drive the piston is at a relatively low pressure such that gas pressure cannot form a safety risk to the patient. Thus, failure of the piston mechanism will not result in the emission of a stream of high pressure fluid. Consequently, the instrument is inherently safer than prior art instruments which are connected to a high pressure fluid source.
Another feature of the present disclosure lies in the provision of an aspiration mechanism including a vacuum generating mechanism for increasing the suction force at the tip of the cannula portion of the instrument. The vacuum generating mechanism is disposed in the handle of the instrument and may be utilized to create a suction at the cannula tip, or, to supplement a constant suction source connected to the instrument. The vacuum generating mechanism includes a spring biased piston member which is disposed in the housing and separates the interior into at least a driving chamber and a suction chamber. Preferably, the end of the piston disposed in the suction chamber includes a sealing member, such as an O-ring or the like, which assists in creating the suction force. The suction chamber is positioned in-line between the cannula and the discharge port.
The driving chamber of the aspiration mechanism is connected to a low pressure gas source and has a venting port for venting the gas supplied from the gas source. As gas is charged to the driving chamber, pressure builds until the gas pressure overcomes the spring force, thereby driving the piston member into the suction chamber. The gas present in the driving chamber is then vented from the chamber through the vent port to permit the piston member to return to the driving chamber under the influence of the spring force. This returning movement of the piston in conjunction with the sealing ring creates a suction force in the cannula for aspiration purposes. The charging and venting of the gas from the driving chamber is repeated as desired either in a continuous mode or in an intermittent mode. The vacuum generating mechanism may be provided by itself, or, may be utilized to supplement and enhance a continuous, remote suction source coupled to the instrument. The vacuum generating mechanism may also be provided in an instrument for aspiration only, or may be provided in an instrument having irrigation or fluid jet cutting capabilities.
So that one skilled in the art to which the subject disclosure appertains will better understand how to make and use the disclosure, preferred embodiments of the surgical apparatus will be described hereinbelow with reference to the drawings wherein:
FIG. 1 is a functional block diagram of the fluid jet surgical instrument of the present disclosure;
FIG. 2 is a perspective view showing the fluid jet surgical instrument in use;
FIG. 3 is a cross-sectional view of the pressure intensifier portion of the fluid jet surgical instrument of the present disclosure;
FIG. 4 is a cross-sectional view of another embodiment of the pressure intensifier portion of the fluid jet surgical instrument;
FIG. 5 is a cross-sectional view of the cannula portion of the fluid jet surgical instrument;
FIG. 6 is an end view of the cannula portion of the fluid jet surgical instrument;
FIG. 7 is a cross-sectional view of the instrument of FIG. 4 in an at rest position;
FIG. 8 is a cross-sectional view of the instrument of FIG. 7 as the pressure intensifier is activated;
FIG. 9 is a cross-sectional view of the instrument of FIG. 7 as the fluid is ejected from the instrument;
FIG. 10 is a cross-sectional view of the instrument of FIG. 7 as the pressure intensifier completes a stroke and is re-charged with fluid;
FIG. 11 is a cross-sectional view of a suction device of the present disclosure in an at rest condition;
FIG. 12 is a cross-sectional view of the device of FIG. 11 in an operational mode;
FIG. 13 is a cross-section view of the device of FIG. 11 illustrating the piston moved to its retracted position to create a suction force;
FIG. 14 is a cross-sectional view of a preferred embodiment of the present disclosure employing the pressure intensifier for fluid jet cutting and the suction device for aspiration; and
FIG. 15 is a perspective view of the instrument of FIG. 14.
The present disclosure generally includes a pulsed fluid jet surgical instrument for cutting, excision, emulsification and removal of tissue. With reference to FIG. 1, the instrument includes a handpiece 21 adapted to be wielded manually with a cannula 22 extending therefrom. Cannula 22 emits a pulsed jet of high pressure fluid for surgical cutting and tissue emulsification. Cannula 22 is connected to an aspiration system 23 which provides vacuum aspiration to remove the fluid introduced by the instrument, as well as body fluids and emulsified tissue. The handpiece 21 is also connected to a low pressure fluid supply 24 that provides the fluid which forms the high pressure pulsed cutting jet. A low pressure gas supply 26 is also connected to the handpiece 21 to power the handpiece to produce high pressure fluid pulses.
The instrument is wielded by a surgeon as shown in FIG. 2 to produce surgical cutting and excision tasks for therapeutic purposes. It should be noted initially that the handpiece 21 is devoid of any connection to a high pressure source of any kind. As a result, failure of the instrument will not introduce a high pressure fluid stream into the patient. Thus, the disclosure is inherently safer than conventional instruments utilizing fluid cutting capabilities.
With regard to FIG. 3, the handpiece 21 includes an interior gas reservoir 31 that is connected through port 32 to the low pressure gas supply 26. The handpiece also provides a piston 36 having a broad head 37 that is disposed concentrically in a bore 33 in a pressure sealing, translating fashion. The head 37 divides the bore 33 into a driving chamber 34 and a retracting chamber 38. The retracting chamber 38 communicates through port 39 to an actuating valve (not shown) that selectively vents the retracting chamber 38 and permits pulsed operation of the unit. The actuating valve may include a pneumatic switch on the handpiece, or a footswitch coupled by tubing to the port 39.
The handpiece further includes a bistable valve assembly 40 consisting of valve pintle 41 slidably disposed in a bore 42. Bore 42 is connected through passageway 43 to retracting chamber 38. A valve port 44 extends from the driving chamber 34 to the gas reservoir 31. The tip of valve pintle 41 seats in port 44 to selectively block gas flow from gas reservoir 31 to driving chamber 34. A compression spring (shown schematically as element 35) is disposed in the bore 42 to bias pintle 41 to close the port 44.
Piston 36 includes a narrow pumping end 52 disposed in a pump chamber 51. Pump chamber 51 communicates through an outlet passage 50 to a relief valve 53, which in turn leads to a tube 54 connected to the jet outlet port. The relief valve 53 is set to open at a relatively high pressure, so that no fluid flow is admitted to the jet outlet port until pressure in the pump chamber 51 attains a predetermined high value. With this arrangement, the jet pulses are comprised solely of high pressure fluid, and the pressure versus time profile of each pulse approaches a rectangular waveform. Fluid such as sterile saline solution, Ringer's solution, or the like is supplied to the pump chamber 51 from supply 24 through inlet port 59 and ball check valve 57.
To operate the apparatus depicted in FIG. 3, the actuating valve connected to port 39 is opened, venting the retracting chamber 38 to ambient pressure. The pressure in bore 42 likewise drops, due to the flow communication of passageway 43. Low pressure gas is supplied into gas reservoir 31 through port 32. When the gas pressure in reservoir 31 overcomes the spring force of spring 35 acting on the pintle 41, the pintle 41 is driven rearwardly into the bore 42, opening port 44 and admitting pressurized gas from the reservoir 31 into the driving chamber 34. As a result, piston 36 translates toward the jet tube 54, compressing the fluid in the pump chamber 51. When the pressure in the pump chamber 51 exceeds the threshold of the relief valve 53, fluid is expelled through the jet tube 54 as a high pressure fluid pulse.
It is significant to note that the driving surface of the piston head 37 is far greater in area than the pump end 52, and that the same force develops an intensified pressure thereby creating a very high pressure pulse on the order of ten times or more from a low pressure fluid supply and a low pressure gas supply. For example, fluid to pump chamber 51 may be provided at approximately 100 psig, and the relief valve may be set to open at 300 psig or more. The maximum pressure developed during the pressure pulse may exceed 1000 psig, even though the gas pressure supplied to the instrument may only be 100-120 psig.
When the actuating valve which is in communication with vent 39 is closed, gas pressure leaking past the pintle 41 and through the passageway 43 begins to build pressure in the retracting chamber 38. Pressure also builds in the bore 42, urging the pintle 41 to translate forwardly and seal the inlet port 44. Gas pressure bleeds from the driving chamber 34 through a bleed passage 56, and the piston 36 retracts. The relief valve 53 closes when the piston begins to retract, and inlet valve 57 opens to permit pump chamber 51 to refill. Thus, the high pressure fluid jet pulse is completed, and the apparatus is set to deliver another pulse. However, it should be noted that the actuating valve must be reopened to initiate another pulse, and that the mechanism is not free-running. Thus, there is no possibility of the instrument delivering additional pulses after shutdown is desired. Consequently, the apparatus is inherently safe in another important characteristic.
With regard to FIG. 4 and FIGS. 7-10, a further embodiment 121 of the handpiece is illustrated, which possesses enhanced manufacturing, cleaning, and servicing capabilities. The handpiece 121 includes an interior gas reservoir 131 that is connected through side port 132 to the low pressure gas supply 26. The handpiece includes a piston 136 having a broad head 137 that is disposed concentrically in a bore 133 in a pressure sealing, translating fashion. The head 137 divides the bore 133 into a driving chamber 134 and a retracting chamber 138. The retracting chamber 138 communicates through port 139 to an actuating valve 190 FIG. 7! that selectively vents the retracting chamber 138 to permit pulsed operation of the unit. The actuating valve 190 may comprise a pneumatic switch on the handpiece, or a footswitch coupled by tubing to the port 139. If the actuating valve 190 is remote to the handpiece, an accumulator (not shown) and a restrictor (not shown) may be required to achieve correct timing. Preferably, the accumulator is added adjacent valve bore 142 and the restrictor is placed between valve bore 142 and actuating valve 190. A bleed port 156 extends from the driving chamber 134 to ambient air.
The handpiece further includes a bistable valve assembly 140, consisting of a valve pintle 141 slidably disposed in a bore 142. A valve port 144 extends from the driving chamber 134 through port 161 to the gas reservoir 131, and the tip of the valve pintle 141 seats in the port 144 to selectively block gas flow from the reservoir to the driving chamber 134. A compression spring 145 is disposed in the bore 142 to bias the pintle 141 to close the port 144. A connector 160 is coupled to the outer end of the bore 142, and is connected to join the bore 142 in flow communication with the port 139 of the retracting chamber 138.
The piston 136 includes a narrow pumping end 152 disposed in a pump chamber 151. The pump chamber 151 communicates through an outlet passage 150 to a relief valve 153, which in turn leads to a tube 154 connected to the jet outlet port. The relief valve 153 is set to open at a relatively high pressure, so that no fluid flow is admitted to the jet outlet port until pressure in the pump chamber attains a predetermined high value. With this arrangement, the jet pulses consist mostly of high pressure fluid, and the pressure versus time profile of each pulse approaches a rectangular waveform. Fluid such as sterile saline solution, Ringer's solution, or the like is supplied to the pump chamber from supply 24 through inlet port 159 and check valve 157.
To operate the apparatus 121, as best seen in the sequence of FIGS. 7-10, the actuating valve 190 connected to port 139 and 160 is opened, venting the retracting chamber 138 to ambient pressure. The pressure in bore 142 likewise drops, due to the flow connection between port 139 and connector 160. Gas introduced into gas reservoir 131 communicates through port 161. When the gas pressure overcomes the spring force of compression spring 145 acting on the pintle 141, the pintle 141 is driven into the bore 142 as shown by the directional arrow of FIG. 8, opening the port 144 and admitting pressurized gas from the reservoir 131 into the driving chamber 134. The piston 136 translates toward the jet tube 154 to compress the fluid in the pump chamber 151. When the pressure in the pump chamber 151 exceeds the threshold of the relief valve 153, fluid is expelled through the jet tube 154 as a high pressure fluid pulse, as shown in FIG. 9.
When the actuating valve 190 is closed, gas pressure leaking past the pintle 141 and through the connection to port .139 begins to build pressure in the retracting chamber 138. Pressure also builds in the bore 142, allowing the spring 145 to urge the pintle 141 to translate and seal the inlet port 144 as shown in FIG. 10. Gas pressure bleeds from the driving chamber 134 through the bleed passage 156, and the relatively higher pressure in the retracting chamber 138 causes the piston 136 to retract. The relief valve 153 closes when the piston begins to retract, and inlet valve 157 opens to permit the pump chamber to refill returning the apparatus to the position shown in FIG. 7. Thus one high pressure fluid jet pulse is completed, and the apparatus is set to deliver another pulse. As in the previous embodiment, the actuating valve 190 must be reopened to initiate another pulse, and the mechanism is not free-running. Thus there is no possibility of the apparatus delivering additional pulses after shutoff is desired.
Referring now to FIGS. 5 and 6, the cannula assembly 22 of the fluid jet cutting instrument includes an aspiration tube 201 extending coaxially and distally from a housing 202. A jet tube 203 is disposed concentrically and coaxially within the aspiration tube 201, and is supported by a mandrel 204 secured within the housing 202. The distal end of the jet tube 203 is recessed slightly within the distal end of the aspiration tube, and the proximal end of the jet tube 203 is connected to the high pressure pulse output 54 (embodiment of FIG. 1) or 154 (FIG. 4) described previously. The interior of the housing 202 communicates with the interior space of the aspiration tube 201, and port 206 connects the aspiration tube to the aspiration system 23 described previously. The housing 202 is joined to either of the handpieces 21 or 121 described above.
The distal end of the jet tube 203 emits a train of pulses of high pressure fluid from the handpiece apparatus, causing the target tissue to be cut and emulsified. The suction provided by the aspiration tube removes the fluid emitted by the jet tube, as well as the emulsified tissue and body fluids, so that surgical cutting and tissue excision and removal may be carried out quickly and efficiently.
Referring now to FIGS. 11 and 12, there is illustrated a suction device utilized for suction of fluids and emulsified tissue at the surgical site. Suction device 220 can be utilized as a stand alone device or may be incorporated into a handpiece such as in the handpiece 121 illustrated in FIGS. 4 and 7-10 as will be described in detail below. Suction device 220 includes a housing 221 which incorporates a piston member 222 for creating an increased suction force at the distal end of the unit illustrated as tube 230. Piston member 222 is similar to piston 136 as described above and includes a sealing member such as O-ring 224 to prevent the passage of gaseous fluid. Piston 222 is positioned in a central bore of housing 221 and separates the central bore into a suction chamber 228 and a drive chamber 238. Piston member 222 is spring biased to the position shown in FIG. 11 by spring member 226. The distal end of piston member 222 is further provided with a sealing device such as O-ring 234. Suction device 220 may be used to create a suction force at the distal end of tube 230, or may be used to supplement a conventional, constant suction source external to the instrument which may be connected to the instrument at suction port 232. Drive chamber 238 is supplied with gas through gas port 236 and includes a vent port 240 whose function will also be described below.
Suction device 220 will first be described for intensifying the conventional, constant suction source connected to the device at suction port 232. As is known, the external or remote suction source provides a constant suction force at the distal end of tube 230. In order to intensify the suction force, gas is supplied through gas port 236 to drive chamber 238, until the pressure within drive chamber 238 builds to a point where it overcomes the biasing force of spring 226. Once the biasing force of the spring 226 is overcome, piston 222 translates into suction chamber 228. As can be appreciated, the initial force of the piston 222 being driven into suction chamber 228 has the potential of creating a negative force of air through tube 230 and suction port 232. However, check valves 227, 229 prevent this from occurring. After piston 222 translates to the position shown in FIG. 12, vent port 240 is opened to release the gas pressure in drive chamber 238. As the pressure drops in drive chamber 238, the biasing force of spring 226 drives the piston back to the position shown in FIG. 13. As the piston moves in the direction of drive chamber 238, it creates a vacuum or suction force in suction chamber 228 via the O-ring 234 so as to enhance the suction force provided by the remote suction source in tube 230. Once the retraction stroke is completed and the device is in the position shown in FIG. 13, vent 240 is closed to allow the gas supply to charge the drive chamber 238 to translate the piston 222 to the position shown in FIG. 12 to repeat the suction stroke. This procedure is continued for as long as the increased suction is desired.
Suction device 220 may also be utilized as a stand alone instrument, in which suction is created by the reciprocating movement of piston 222, without connection to a conventional remote suction source. In this case, suction port 232 is connected to tubing which provides for drainage, so that as a suction force is created by the reciprocal movement of the piston, the emulsified tissue and excess fluid is drained through the tube connected to port 232.
FIGS. 14 and 15 illustrate an alternate embodiment of a handpiece to be incorporated into the fluid jet surgical instrument of the present disclosure. In accordance with this embodiment, the handpiece incorporates the suction device 220 of FIG. 11. The remaining components, e.g., the pressure intensifier mechanism, are substantially similar to the jet cutting instrument disclosed in FIGS. 7-10. With reference to FIGS. 14 and 15, in conjunction with FIGS. 7 and 11, handpiece 250 has a suction tube 252 connected to suction port 232 which supplies a continuous suction force provided by a remote suction source (not shown). Handpiece 250 further includes fluid tube 254 which is connected to check valve 157 (FIG. 7) and gas supply tube 256 which communicates with both gas port 236 (see also FIG. 11) via tube 260 and gas port 132 (FIG. 7). One skilled in the art can readily determine the mechanism required, such as a T-fitting or the like, for connecting the gas supply tube 256 with both gas port 236 and gas port 132. A trigger mechanism 258 is also provided to selectively actuate actuating valve 190 (FIG. 7) to vent retracting chamber 138 and bore 142 of the fluid intensifying mechanism and to actuate vent port 240. As seen in FIG. 14, suction tube 230 is connected to suction port 192 as seen in FIG. 7. The operation of handpiece 250 is similar to that described above with respect to FIGS. 7-12, and allows the operator to cut tissue with a fluid jet while at the same time providing for suction to aspirate excess fluid and emulsified tissue, while also providing for enhanced suction in the event a greater pressure is necessary or a blockage in cannula 170 occurs.
Although the subject disclosure has been described with respect to preferred embodiments, it will be readily apparent to those having ordinary skill in the art to which it appertains that changes and modifications may be made thereto without departing from the spirit or scope of the subject disclosure as defined by the appended claims.
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|Feb 12, 2010
|Jul 12, 2011
|The Spectranetics, Corp.
|Thrombectomy and soft debris removal device
|Feb 14, 2005
|Nov 22, 2011
|Hydrocision, Inc.
|Fluid jet surgical instruments
|Nov 20, 2009
|Apr 3, 2012
|Boston Scientific Scimed, Inc.
|Fluid delivery system and related methods of use
|Oct 27, 2003
|Apr 24, 2012
|Hydrocision, Inc.
|Surgical devices incorporating liquid jet assisted tissue manipulation and methods for their use
|Sep 25, 2008
|Oct 23, 2012
|Novartis Ag
|Spring-less check valve for a handpiece
|Aug 29, 2002
|Nov 13, 2012
|Applied Medical Resources Corporation
|High flow-low pressure irrigation system
|Jul 10, 2008
|Nov 20, 2012
|Cook Medical Technologies Llc
|Hydraulic guidewire advancement system
|Dec 22, 2009
|Dec 25, 2012
|Smith & Nephew, Inc.
|Disposable pumping system and coupler
|Aug 15, 2003
|Apr 9, 2013
|Novartis Ag
|Tip assembly
|Sep 9, 2008
|Sep 10, 2013
|Smith & Nephew, Inc.
|Liquid jet surgical instruments incorporating channel openings aligned along the jet beam
|Feb 23, 2012
|Jan 14, 2014
|Boston Scientific Scimed, Inc.
|Fluid delivery system and related methods of use
|Apr 19, 2007
|Jun 17, 2014
|Sonendo, Inc.
|Apparatus and methods for treating root canals of teeth
|Oct 12, 2007
|Dec 30, 2014
|The Spectranetics Corporation
|Thrombectomy and soft debris removal device
|Dec 18, 2012
|Jan 13, 2015
|Smith & Nephew, Inc.
|Disposable pumping system and coupler
|Oct 30, 2009
|Dec 15, 2015
|Ferton Holding S.A.
|Instrument for treating biological tissue, method for generating shock wave-like pressure waves in such an instrument
|Dec 14, 2007
|Feb 9, 2016
|Covidien Lp
|Methods and apparatus for thrombectomy system
|Jan 12, 2015
|May 17, 2016
|Smith & Nephew, Inc.
|Disposable pumping system and coupler
|Oct 23, 2015
|Nov 8, 2016
|Integrated Surgical, Llc
|Suction device for surgical instruments
|Nov 12, 2010
|Nov 15, 2016
|Sonendo, Inc.
|Liquid jet apparatus and methods for dental treatments
|Feb 4, 2014
|Nov 29, 2016
|Sonendo, Inc.
|Dental treatment system
|Oct 13, 2008
|Dec 6, 2016
|Boston Scientific Scimed, Inc.
|Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation
|Feb 2, 2004
|Mar 21, 2017
|Hydrocision, Inc.
|Nozzle assemblies for liquid jet surgical instruments and surgical instruments employing the nozzle assemblies
|Oct 21, 2011
|Jun 13, 2017
|Sonendo, Inc.
|Apparatus, methods, and compositions for endodontic treatments
|Aug 15, 2003
|Feb 17, 2005
|Ghannoum Ziad R.
|Tip Assembly
|Jan 15, 2004
|Jul 21, 2005
|Medical Instrument Development Laboratories, Inc.
|Vented seal having redundant sealing components
|Apr 27, 2004
|Oct 27, 2005
|Nash John E
|Thrombectomy and soft debris removal device
|Mar 25, 2005
|Sep 28, 2006
|Alcon, Inc.
|Tip assembly
|Mar 16, 2005
|Oct 5, 2006
|Alcon, Inc.
|Pumping chamber for a liquefaction handpiece
|Mar 31, 2006
|Oct 11, 2007
|Stokes Michael J
|Endoscopic instrument with secondary vacuum source
|May 21, 2007
|Dec 6, 2007
|Nash John E
|Thrombectomy and soft debris removal device
|Dec 10, 2007
|Jun 26, 2008
|Stacy Faught
|Fluidic Coupling For Surgical Hand Piece
|Nov 21, 2007
|Jul 3, 2008
|Vascure Ltd.
|Atherectomy methods and apparatus
|Jun 19, 2001
|Jul 17, 2008
|Roger Ammann
|Device for producing a fluid jet used especially to remove biological tissue, and use thereof
|Apr 15, 2005
|Oct 2, 2008
|Erbe Elektromedizin Gmbh
|Applicator For Water-Jet Surgery
|Oct 16, 2008
|Apr 23, 2009
|Renzo Melotti
|Doctor blade assembly
|Jul 10, 2008
|Jan 14, 2010
|Cook Incorporated
|Hydraulic guidewire advancement system
|Sep 25, 2008
|Mar 25, 2010
|Bourne John M
|Spring-Less Check Valve For A Handpiece
|Sep 25, 2009
|Apr 15, 2010
|Nash John E
|Systems and methods for delivering agents into targeted tissue of a living being
|Oct 13, 2008
|Apr 15, 2010
|Boston Scientific Scimed, Inc.
|Assisted aspiration catheter system
|Jan 25, 2008
|Jun 10, 2010
|Dentatek Corporation
|Apparatus and methods for monitoring a tooth
|Feb 12, 2010
|Jun 10, 2010
|The Spectranetics Corporation
|Thrombectomy and soft debris removal device
|Feb 11, 2010
|Aug 12, 2010
|Mark Mallaby
|Neurovascular microcatheter device, system and methods for use thereof
|Nov 5, 2010
|May 12, 2011
|Dentatek Corporation
|Apparatus and methods for root canal treatments
|Dec 22, 2009
|Jun 23, 2011
|Smith & Nephew, Inc.
|Disposable Pumping System and Coupler
|Jul 6, 2009
|Jul 21, 2011
|Ellis Shawn D
|High pressure intensifier system
|Feb 27, 2012
|Aug 30, 2012
|Seiko Epson Corporation
|Surgical instrument
|Apr 15, 2013
|Dec 22, 2015
|Sonendo, Inc.
|Dental handpiece
|Apr 15, 2005
|Jul 8, 2009
|Applicator for water jet surgery
|Oct 31, 2008
|May 5, 2010
|Ferton Holding SA
|Instrument for treating biological fabric, and method of producing shock wave-like pressure waves in such an instrument
|Oct 31, 2008
|Dec 5, 2012
|Ferton Holding SA
|Instrument for treating biological fabric, and method of producing shock wave-like pressure waves in such an instrument
|Aug 29, 2002
|Apr 24, 2003
|Applied Medical Resources Corporation
|High-flow low-pressure irrigation system
|Apr 15, 2005
|Nov 10, 2005
|Erbe Elektromedizin Gmbh
|Applicator for water jet surgery
|Jul 6, 2009
|Jan 14, 2010
|Parker-Hannifin Corporation
|High pressure intensifier system
|Oct 30, 2009
|May 6, 2010
|Ferton Holding S.A.
|Instrument for treating biological tissue, method for generating shock wave-like pressure waves in such an instrument
|May 5, 2016
|Nov 10, 2016
|Novartis Ag
|Ophthalmic surgical device handle and associated devices, systems, and methods
|U.S. Classification
|604/22, 604/141, 604/143
|International Classification
|Cooperative Classification
|European Classification
|Jul 12, 1995
Owner name: SENTINEL MEDICAL, INC., GEORGIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BAIR, SCOTT;REEL/FRAME:007554/0433
Effective date: 19950702
|Oct 19, 1997
Owner name: SURGIJET, INC., CALIFORNIA
Free format text: CHANGE OF NAME;ASSIGNOR:SENTINEL MEDICAL, INC.;REEL/FRAME:008761/0677
Effective date: 19950918
|Jun 19, 2002
|Fee payment
Year of fee payment: 4
|Jul 19, 2006
|Maintenance fee reminder mailed
|Dec 29, 2006
|Lapse for failure to pay maintenance fees
|Feb 27, 2007
|Expired due to failure to pay maintenance fee
Effective date: 20061229


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The defunct Bitcoin exchange Mt. Gox, once the world's leading cryptocurrency trading platform, has received approval from an American court to initiate the Chapter 15 bankruptcy proceedings in the United States.
The company has been trying to settle with its American customers, while looking for a buyer brave enough to try and save the exchange. The platform was closed earlier this year after announcing it had lost around 850,000 BTC due to a hack.
Judge Stacey Jernigan of the US Bankruptcy Court, in Dallas, recognized and approved the Chapter 15 filing, which means the exchange's representatives can now pursue funds to repay its creditors within a wider time frame.
The request was presented to the court back in March, when Mt. Gox was fighting to prevent the American customers who had filed a class action lawsuit from seizing its United States-based assets – computer servers, for instance – and demanding evidence or having access to Mt. Gox executives, Reuters reports.
The deal establishes that both American and Canadian customers will split the 200,000 BTC currently held by Mt. Gox (the exchange announced it found these Bitcoins after the first wave of controversy) and also share in a 16.5 percent stake after the trading platform is sold.
Maria Santos
Latest posts by Maria Santos (see all)
- The 6 best Bitcoin mining software - April 24, 2016
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Search results
Your search (subject="Form (Aesthetics) Addresses, essays, lectures") found 1 title(s).
Aesthetics and the arts [by] Lee A. Jacobus.
author: Jacobus, Lee A., comp.
title: Aesthetics and the arts
pagination: xii, 315 p. 23 cm.
publisher: New York, McGraw-Hill [1968]
notes: Bibliography: p. 311-315.
subjects: Form (Aesthetics) Addresses, essays, lectures. Art Philosophy Addresses, essays, lectures.
MARC view


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Slide 14 of 28
This slide shows a representative sample of programs that fit within this framework. It's meant to be hard to read, because the list is a long one.
It's an alphabet soup of acronyms.
Some are familiar, like SBIR. Some may seem new to this kind of list -- like our networking infrastructure activities, our long-term ecological research sites, and our program in Innovation and Organizational Change.
All have state-fed connections and are, more or less, drivers of innovation.
Successful partnerships rest on trust among the partners. Partnerships also rely on the diversity of contributions that the participants bring to the table. A partnership of government and industry will move differently than a partnership of government and academe. When you include all three, you have different goals and outcomes.
We know this won't be easy – but we know it is a must, if NSF is to continue to thrive in it's next 50 years.


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Give this traditional Mexican dessert a try! It's like a Mexican creme brulee made with essentially the same ingredients and a similarly custard taste. Both have a delicious caramelized sugar topping and mixed egg yolk, so take a trip south of the border with this tasty dessert!
Use your mouse to follow along with Sara's recipe.


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Let us know when your receive great advice so we can thank our lawyers and point others with similar questions in the right direction.Got it!
I am a mother that has standard visitation rights to my seven-year-old daughter. Is it possible for my parents who are divorced, to take my child's father to court separately for grandparent visitation rights? Also, if this can be done, what is a typical visitation schedule if the rulings were in the favor of my parents?
In Arkansas, there is a presumption that if a parent does not wish for grandparents to visit the child, then the denial of visitation is in the child's best interests.
That presumption can be overcome, but there are a few hurdles that the grandparent must overcome before they can establish that they can seek grandparent visitation. Because your parents are divorced, they can certainly file separately because it may be that the court finds that one may establish visitation rights, but not the other (or both of them, or neither of them).
They each need to speak to an attorney to see if they can establish visitation rights. There is U.S. Supreme Court law, as well as several Arkansas appellate decisions and statutory requirements, and they are likely to become overwhelmed very quickly if they try to proceed on their own.
This response is for information purposes only, it does not create any attorney-client relationship. Responses to questions posted on this Forum are of a general nature only. Because it is not possible to have all of the facts of your issue addressed in this forum, you should consult with an attorney to review the unique circumstances specific to your situation. www.TheSchollLawFirm.comAsk a similar question
The first answer is a good one. You should know, however, that decisions in this type of case depends on the facts of the case - and that your parents should discuss their situation in detail with a local attorney.
Under the rules governing the conduct of attorneys in New York it may be necessary to remind you that this answer could be considered attorney advertising.Ask a similar question
I agree with the other answers. If your parents try to proceed on their own in this type of case, they may get their day in court, and let their voices be heard on this issue. However, they likely need an attorney to adequately advice them on what is necessary to establish their claims, and how they each should proceed.
If you find this answer helpful, please mark the answer as "helpful." This is legal information and not legal advice. Contact an attorney in your area for legal advice. This answer is intended to be used for informational purposes only, and does not establish an attorney-client relationship.Ask a similar question
Why don't your parents see the child during your visitation periods? The court will want to know why these grandparents are having to sue dad for visitation when they could see the child with you.
This attorney is licensed in the State of Texas only and this information does not constitute legal advice. If you are seeking legal advice, please consult with an attorney at your earliest convenience.Ask a similar question
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I've been somewhat of a latecomer to Firefox. Earlier versions of the browser seemed to load content more slowly than IE. But Firefox 2.0, esp. with the Fasterfox extension, loads content much faster than IE7. Plus, one of the best benefits of the Firefox browser is the Deepest Sender extension. This extension makes posting to your blog much, much easier. All you do is click a button on your browser, and a dialog box pops up that interfaces remotely with your blog. There are many more extensions too -- I just really like Firefox now.
If you haven't used Firefox, you're missing out. See http://www.mozilla.com/en-US/firefox/ to download it.
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I'm a technical writer based in the California San Francisco Bay area. Topics I write about on this blog include technical writing, authoring and publishing tools, API documentation, tech comm trends, visual communication, technical writing career advice, information architecture and findability, developer documentation, and more. If you're a professional or aspiring technical writer, be sure to subscribe to email updates using the form above. You can learn more about me here.


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The nonprofit Detroit Zoological Society (DZS), which operates the Detroit Zoo and Belle Isle Nature Zoo, says it will power the Detroit Zoo with 100% renewable electricity from wind farms.
The organization says its commitment to sustainable electricity with the purchase of renewable energy certificates (RECs) is being made possible through the support of ITC Holdings Corp. through 2018.
The Detroit Zoo's RECs are certified by Green-e Energy, which provides independent, third-party certification to ensure that renewable energy products meet strict environmental and consumer-protection standards.
This initiative is one of many goals of the DZS Greenprint, a strategic plan to refine and improve green practices and facilities at the Detroit Zoo and Belle Isle Nature Zoo, incorporate sustainability in all policies and programs, and improve green literacy and action in the community.
In recognition of these continuous efforts – including discontinuing the sale of bottled water at the Detroit Zoo and building the first zoo-based dry biodigester in the country – the DZS says it received the 2015 Green Award from the Association of Zoos and Aquariums.
"We continue to look for ways to reduce our ecological footprint and thank ITC for helping us to accomplish that goal," says Ron Kagan, CEO and executive director of DZS. "Our hope is to inspire others to look to clean, renewable energy sources."


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If you are an Android user, you might want to extend the functionality of the OS to your home phone-if you still use one. Binatone's iDECT iHome phone uses an unnamed build of Android (1.6?) to power a wireless, cordless phone.
You will get most of all of the great things that the green robot offers like YouTube, Internet Browser,e-mail, mp3 player and more. The only major feature missing is the Android Market. The phone offers 8 hours of talk time and 80 hours of standby and is equipped with a 14 minute digital answering machine. The display is a 2.8 inch resistive touchscreen with resolution of 320 x 240 and a look at the picture below surely brings back memories of Android builds from the past (who could forget the analog clock?)
Unfortunately, distribution of the iHome phone is limited to Europe where it retails for 99 EUR (approximately $139 USD). Hopefully this product will make it across the pond so that those Android users in the States can continue to use Google's open source OS at home. You can check out the areas where the product is available by clicking on this link.
source: AndroidandMe
Make Android your home phone with Binatone's iDECT iHome phone
1 Comments
posted on 29 Aug 2011, 04:56 0
1. Bob (unregistered)
There is NO flash on it which means NO Youtube and there NEVER was. This phone is a useless POS.
You people should get your facts straight before you start telling people to buy it.
Make Android your home phone with Binatone's iDECT iHome phone


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Really great friendly team. Left the place neat and tidy - nothing was too much trouble. We had to wait a while for them to fit us in but then again I would be worried if the turned up the next day! Value for money yes - not the cheapest but by no means most expensive. Would be happy to have them back again.
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With a vision of creating an IT company where quality, innovation and personalized services outdo low cost, make-shift solutions, Niraj set up Cygnet Infotech which has today grown from a team of 7 people to over 550 employees working for clients in 29 countries. His passion for building software products led to the development and marketing of several products such as FACE Accounting Software, Optifocus software for optical retailers, xChange POS point of sale solution, TestingWhiz test automation solution and m1-order mobile app for ordering. Along with delivering quality IT solutions, Niraj has strongly promoted relationship driven client and people engagements in Cygnet. Niraj belongs to the famous Hutheesing family whose forefathers built the famous Hutheesing Jain Temple in Ahmedabad. Coming from an Entrepreneurial background Niraj's 31 years of experience is spread over diverse industries like Manufacturing, Textiles, Chemicals and IT.
Apurva Ashar, with over 25 years of experience in book production, publishing and software engineering, is Executive Director at Cygnet. Over the years, he has functioned as Design and Production Consultant, Pre-press In-charge, Typographer & Book Designer, and Head of Data Center for top Gujarati publishing houses like Image Publications, Rajkalp Mudranalaya, Navjivan Trust and others. He is the originator of the ambitious e-Shabda Project at Cygnet, and his unique blend of technological skills, creativity and 'it-can-be-done' attitude inspire the company's culture.
Mr. Tejinder Pal Singh Oberoi is the Executive Director at Cygnet and oversees the horizontal & vertical business development, overall business strategy and marketing initiatives. He is also responsible for PR activities of the organization including company image building & relationship activities with different trade bodies. He brings over 20 years of experience in establishing new business operations, launching new products & services in direct sales & distribution networks. Prior to Cygnet Infotech, he has worked with Tata Donnelley Ltd, DSS Mobile Comm. Ltd., Microwave Comm. Ltd. and Johnson & Johnson Ltd. in the sales function.
Sachin Bedi, an enthusiastic business leader spearheads Global Sales and Marketing initiatives. Nurturing client relationships, creating value for shareholders and looking after the business development functions, with over 17 years of experience Sachin has worked with premium organizations in the past. An alumni from Southern New Hampshire University and ITM, Mumbai, Sachin is also associated with TiE, New York who mentors young professionals in the field of Technology and Creating Business Value.
Dr. Nilesh Modi, envisions to revolutionize the Computer Industry with his pro-active knowledge in Technology and Innovation. He holds a Doctorate degree in Electrical and Computer Engineering from the University of California (USA). A well-travelled techie, he has co-authored books and holds a technology patent on his research work. An alumni from prominent universities around the globe, he has an excellent mix of academic background and experience bridging hardware and software design implementation.
An email with the relevant details is on its way to your inbox.
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Our motto 'IT is About You' is more than just a tag line – it is the very heart of Cygnet. We always ensure the continued success of our clients and employees by placing problem solving ahead of anything else and walking the extra mile when needed.


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Additional snapshots from Gloucester's snowy day winter wonderland event.Beacon Marine Basin Dusk
Rocky Neck Smith's Cove Twilight
Additional snapshots from Gloucester's snowy day winter wonderland event.Beacon Marine Basin Dusk
Rocky Neck Smith's Cove Twilight
(To use a favorite expression of Joey's). As the fog was dissipating in the setting sun, whichever direction the camera was pointed, we were treated to a breathtaking view.
Last night's sunset over Essex Bay
The storm swirled in late yesterday afternoon. I was on the way home from filming at Good Harbor Beach and stopped at Pirate's Lane to watch it sweep across the Harbor. Kayaks were hurling through the air, boats racing pell mell to shore, great gusts whistling, bells clanging, and it was over before it began! The after storm glow and cloud formations were exquisite.
Happy Summer Storm Drama! (As long as everyone is safely on shore)
Snowy Egret coming in for a landing
Dominic Nesta and his unmistakeable fishing boat 'Tide Skipper' coming home Friday night, with the Fort in the background. I think the pilot house on the small book gives it a very interesting, unique look, making it always easy to identify whenever seen in the Harbor.
After nearly two solid weeks of planting client gardens in dismal drismal, what a welcome treat to see Mr. Sunny make an appearance. Snapshots from yesterday's beautiful late day light.
Tulips in our garden
Schooner Adventure masts and Gloucester's UU Church steeple
Click the panorama to see the full size.
Gloucester City Skyline with Rocky Neck
Don't you love when sunsets go from orange to violet?
Easter Sunset Gloucester Harbor.
Last night's saturated sunset from East Gloucester was arresting, becoming even more so after the sun set. The colors on the water momentarily reflected the voluptuous hues of the twilight sky, when very quickly the horizon turned glowing coral-pink-peach before extinguishing itself in purple.
The violet-orange on the water's glass-like surface in the foreground looked as though it had been applied by paint.
Gloucester's Unitarian Universalist Church beautiful steeple
Last night's red sky was not today's sailor's delight. Is that old adage true more often than not I wonder?
Red sky at night, sailors' delight.
Red sky at morning, sailors take warning.
Twilight Smith's Cove looking towards Gloucester Marine Railways
Long Beach Sunset
Tonight's sunset panorama from Rocky Neck's Wonson's Cove, with a pretty rainbow-like arch over the Harbor.
How fortunate we are to be experiencing a delightfully warm El Nino December although many regions in the rest of the country are not faring as well as we in the Northeast. Thinking about where we were almost to the date a year ago at this time…see the end of this post.
Photographing from the same location last year at this time, Smith's Cove, December 18, 2014 ~
Pirate's Lane Smith's Cove East Gloucester
Duckworth's Bistrot December 2014
Love my neighborhood!
Today, late day, as happens so many afternoons, I looked up from my work and saw the sky beginning to catch fire–an irresistible reason to take a break and run down to the bottom of our hill to take a few snapshots. I am thankful!
Last evening's late summer sunset began quietly, in soft shades of coral rose and lavender blue. The sky's light swiftly transformed to a riotous rainbow of super saturated hues.
Click image below to view larger panorama.


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BGP Class of Service Interconnection
- Authors
- Publisher
- Universitätsbibliothek Chemnitz
- Publication Date
- Source
- Legacy
- Keywords
This document focuses on Class of Service Interconnection at inter- domain peering points. It specifies two new non-transitive attributes, which enable adjacent peers to signal Class of Service Capabilities and certain Class of Service admission control Parameters. The new "CoS Capability Attribute" is deliberately kept simple and denotes the general EF, AF Group and BE forwarding support across the advertising AS. The second "CoS Parameter Attribute" is of variable length and contains a more detailed description of available forwarding behaviours using the PHB id Code encoding. Each PHB id Code is associated with rate and size based traffic parameters, which will be applied in the ingress AS Border Router for admission control purposes to a given forwarding behaviour. The denoted Class of Service forwarding support is meant as the AS externally available (transit) Class of Service support.


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Author | Pallavi Goorha Kashyup | Friday, Dec 18,2009 8:08 AM
Shavon Barua is joining Euro RSCG as Director of the agency's Mumbai office. Barua takes charge from January 2010. She had earlier worked with Euro RSCG in Delhi, where she was Head of the Reckitt Benckiser business.
In between these two innings, Barua was with JWT as Executive Business Director. She has also worked with Bates, SSC&B Lintas, Rediffusion, Ambience and Dentsu. She has worked on clients like Reckitt, Colgate Palmolive, Pepsi Foods, Nestle, ITC and Lakme.
Suman Srivastava, Chief Executive Officer, Euro RSCG India, said, "Rajan Patel, the current Director of the Mumbai office, has expressed the desire to take some time off and pursue other interests. He was part of the team that started Euro RSCG in India and has been with us for nearly 14 years. I shall miss him, but wish him all the best."
On Barua's appointment, Srivastava said, "I am delighted to have her back and am sure that she will make a huge positive impact on the quality of the work and also help grow the business."
Barua said, "It's my second innings at Euro RSCG and I am looking forward to all the challenges and excitement. The people who are critical in our business are some of the very best at Euro, a good bouquet of clients and the opportunity to work with Suman again. I am glad to be back."
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